Section : Conference Notes

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

INTRODUCTION

  • 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)

METHODS

  • 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

RESULTS

  • 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

CONCLUSIONS

  • 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.

Contributors:

Dr Christophe HSU – dermatologist. Geneva, Switzerland