fevereiro 13, 2019

Estes resultados indicam abordagens de tratamento específicas por idade provavelmente beneficiar pacientes com dermatite atópica.

Age-specific treatment modalities may be more beneficial for patients with dermatite atópica (DE ANÚNCIOS) across the life span, according to research that explored changes in the molecular profiles of people with moderate to severe AD. The findings were published in the Journal of Allergy and Clinical Immunology.

Researchers examined age-specific changes in blood and lesional/non-lesional tissues from patients with moderate to severe AD (n=246) and age-matched, healthy controls (n=72) via Singulex, quantitative reverse transcription-polymerase chain reaction, and immunohistochemistry. Participants were categorized into 18-40, 41-60, e 61+ age groups for analysis.

Although disease severity, as measured by SCORing Atopic Dermatitis (SCORAD), was similar across the age groups with AD (mean: ∼60; P =.873), dendritic cell infiltrates (CD1b+, FcεRI+; P <.05) decreased with age. Measures of T_H2 (IL-5, IL-13, CCL13, CCL18, CCL26) decreased significantly with age in participants with AD, but increased with age in controls. T_H22-secreted IL-22 also decreased with age in participants with AD only (P <.05), while T_H1- (IFN-γ, IL-12/23p40, STAT1, CXCL9; P <.05 for CXCL9) and T_H17-related markers (IL-17A, IL-20; P <.05 for IL-20) increased with age in both controls and patients with AD.

Significant increases in terminal differentiation measures were observed in older participants with AD (LOR, FLG; P <.05), while decreases were observed in hyperplasia markers (epidermal thickness, K16, Ki67; P <.05 for K16) and S100As (S100A8; P <.01). Serum trends among participants with AD mimicked skin findings, with age-related T_H2 downregulation (CCL26; r =-0.32, P <.1) and T_H1 upregulation (IFN-γ; r=0.48, P <.01).

Study investigators concluded that these findings indicate age-specific treatment approaches would likely benefit patients with AD. “Therapeutic targeting with T_H2-, T_H22-, and T_H17/T_H1-specific antagonists are needed in order to understand the varying pathogenic roles of these axes in [dermatite atópica]. Elucidating the differential patterns of immune skewing and barrier abnormalities among different [dermatite atópica] phenotypes may be useful for developing personalized treatment approaches, especially in patients with recalcitrant [dermatite atópica]."

divulgações: Study authors disclose consulting fees and research funds received from Abbvie, Amgen, Anacor, AnaptysBio, Asana, Aventis, Baxter, BiogenIdec, Boehringer, Celgene, Dermira, Eli Lilly, Glenmark, Galderma, Innovaderm, Janssen, Kadmon, Kyowa, Leo Pharma, Mitsubishi Tanabe, Medimmune/Astra Zeneca, Novartis, Paraxel, Pfizer, Promius, Regeneron, Sanofi, Serono, Stiefel/GlaxoSmithKline, UCB, Vitae, and Xenoport.

siga @DermAdvisor

Referência

Zhou L, Leonard A, Pavel AB, et al. Age-specific changes in the molecular phenotype of patients with moderate-to-severe atopic dermatitis [publicado em janeiro on-line 24, 2019]. J Allergy Clin Immunol. doi: 10.1016/j.jaci.2019.01.015