度普利尤单抗治疗特应性皮炎相关皮肤T细胞淋巴瘤风险

Dupilumab Therapy and Its Association with the Risk of Cutaneous T-cell Lymphoma in Atopic Dermatitis Patients

  • 摘要: 度普利尤单抗可阻断白细胞介素(interleukin,IL)-4和IL-13的信号传导,用于特应性皮炎(atopic dermatitis,AD)、结节性痒疹、慢性荨麻疹、大疱性类天疱疮等患者的治疗。然而,该药在治疗AD时,有诱发皮肤T细胞淋巴瘤(cutaneous T-cell lymphoma,CTCL)或加速疾病进展的风险,具体机制尚不明确,可能与Th1/Th2细胞因子的失衡、IL-13受体α2亚基(IL-13Rα2)过度激活、淋巴细胞异常增殖和疾病误诊等相关。为预防度普利尤单抗相关的CTCL发生,在诊断AD患者时应注意与CTCL或副银屑病鉴别,治疗过程中也需要对患者疗效进行持续监测。

     

    Abstract: Dupilumab can block the signal transduction of interleukin (IL)-4 and IL-13, and is used for the treatment of patients with atopic dermatitis (AD), prurigo nodularis, chronic urticaria, bullous pemphigoid, and other conditions. However, when used in the treatment of AD, this drug carries the risk of inducing cutaneous T-cell lymphoma (CTCL) or accelerating disease progression. The specific mechanism remains unclear, and it may be related to the imbalance of Th1/Th2 cytokines, overactivation of the IL-13 receptor α2 subunit (IL-13Rα2), abnormal lymphocyte proliferation, and disease misdiagnosis, etc. To prevent dupilumab-associated CTCL, careful differentiation between AD and CTCL or parapsoriasis should be made during the diagnosis of AD patients, and continuous monitoring of the therapeutic efficacy in patients is also required during the treatment process.

     

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