SELECTED ARTICLES FROM THE RECENT LITERATURE 2006

12/29/06

Emerging therapies for atopic dermatitis

Summary
Background - There have been a number of new therapeutic approaches to chronic atopic dermatitis (AD) in recent years.

Findings - Conner and Beck of the Johns Hopkins Allergy and Asthma Center in Baltimore, MD reviewed some emerging treatment approaches being investigated in AD. These include: 1) recombinant interferon-gamma, with the objective of converting the predominant Th2-type immune response during acute flares of AD to a Th1-predominant response. The use of interferon-gamma may be limited by adverse effects seen in about 50% of cases; 2) Omalizumab (anti-IgE) – limited to cases of AD in which the serum IgE is not so high so that the IgE can be bound by this monoclonal anti-IgE antibody; 3) Efalizumab (monoclonal anti-CD11a antibody) –with the objective of reducing emigration of pathogenic T cells into the involved skin areas. This approach is currently in initial trials of therapy in AD – rare serious adverse effect; 4) TNF-alpha inhibitors – no impressive results in AD to date; 5) probiotic diets.

Reference
Current Allergy and Asthma Reports 2006;6:275-81

Editor's Comments
The topical application of tacrolimus and pimecrolimus has considerably changed the therapy of AD, reducing the need for topical cortico-steroid therapy. There are concerns expressed by the FDA about the potential for malignancy with such therapy (without convincing evidence in the opinion of many AD experts).

The exciting and potentially valuable approaches described in this review may provide supplemental benefit in severe AD and also teach us about pathogenesis.

<-- BACK