An Oral Treatment for Atopic Dermatitis (AD) ?
Apremilast for atopic dermatitis: reversing interleukin-4 dysregulation on primary human keratinocytes (Poster)
Mohan GC et al.
AAD 2015 Annual Meeting, San Francisco CA – United States
- Apremilast (Otezla) is an oral treatment for plaque psoriasis.
- It is a small molecule which acts through inhibition of phosphodiesterase 4 (PDE4) (In atopic dermatitis (AD), there is also an up regulation of PDE4)
- Primary human keratinocytes were cultured in 3 groups and treated for 24 hours:
- one group was contained Il-4 and keratinocytes
- the other contained keratinocytes, Il-4 and apremilast
- vehicle alone
- Gene expression analysis was done through Real-time PCR
- The following study results show that apremilast would have a role in the inhibition of Interleukin 4 (Il-4).
- Il-4 is a TH2 dependent cytokine.
- Apremilast down-regulated these genes:
- IL-31* induces pruritus and overexpressed in AD.
- CCL5: associated with chronic inflammation in AD.
- Il-5: participates in the recruitment of eosinophils following allergen exposure.
- TNF: induces apoptosis and decreases ceramics and fayyt acids in models of AD skin
- Il-25: increased expression in AD contributes to the inhibition of filaffrin expiression in keratinocytes
- This pathway plays an important role in the pathogenesis of Atopic Dermatitis (AD).
- Although further studies are needed (as the study is done in vitro), this article suggests a potential role of apremilast in the treatment of atopic dermatitis (AD).
- It could also have a beneficial effect in associated asthma and allergic rhinitis.
Dr Christophe HSU – dermatologist. Geneva, Switzerland