Abstract
Atopic dermatitis (AD) is a highly prevalent, chronic inflammatory skin disease that affects children and adults. The pathophysiology of AD is complex and involves skin barrier and immune dysfunction. Many immune cytokine pathways are amplified in AD, including T helper (Th) 2, Th22, Th17 and Th1. Current treatment guidelines recommend topical medications as initial therapy; however, until recently, only two drug classes were available: topical corticosteroids (TCSs) and topical calcineurin inhibitors (TCIs). Several limitations are associated with these agents. TCSs can cause a wide range of adverse effects, including skin atrophy, telangiectasia, rosacea and acne. TCIs can cause burning and stinging, and the prescribing information lists a boxed warning for a theoretical risk of malignancy. Novel medications with new mechanisms of action are necessary to provide better long-term control of AD. Phosphodiesterase 4 (PDE4) regulates cyclic adenosine monophosphate in cells and has been shown to be involved in the pathophysiology of AD, making it an attractive therapeutic target. Several PDE4 inhibitors are in clinical development for use in the treatment of AD, including crisaborole, which recently became the first topical PDE4 inhibitor approved for treatment of mild to moderate AD. This review will further describe the pathophysiology of AD, explain the possible role of PDE4 in AD and review PDE4 inhibitors currently approved or being investigated for use in AD.
| Original language | English (US) |
|---|---|
| Journal | Experimental Dermatology |
| DOIs | |
| State | Accepted/In press - Jan 1 2018 |
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Keywords
- calcineurin inhibitor
- corticosteroids
- crisaborole
- cytokines
- eczema
ASJC Scopus subject areas
- Biochemistry
- Molecular Biology
- Dermatology
Cite this
The role of phosphodiesterase 4 in the pathophysiology of atopic dermatitis and the perspective for its inhibition. / Guttman-Yassky, Emma; Hanifin, Jon; Boguniewicz, Mark; Wollenberg, Andreas; Bissonnette, Robert; Purohit, Vivek; Kilty, Iain; Tallman, Anna M.; Zielinski, Michael A.
In: Experimental Dermatology, 01.01.2018.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - The role of phosphodiesterase 4 in the pathophysiology of atopic dermatitis and the perspective for its inhibition
AU - Guttman-Yassky, Emma
AU - Hanifin, Jon
AU - Boguniewicz, Mark
AU - Wollenberg, Andreas
AU - Bissonnette, Robert
AU - Purohit, Vivek
AU - Kilty, Iain
AU - Tallman, Anna M.
AU - Zielinski, Michael A.
PY - 2018/1/1
Y1 - 2018/1/1
N2 - Atopic dermatitis (AD) is a highly prevalent, chronic inflammatory skin disease that affects children and adults. The pathophysiology of AD is complex and involves skin barrier and immune dysfunction. Many immune cytokine pathways are amplified in AD, including T helper (Th) 2, Th22, Th17 and Th1. Current treatment guidelines recommend topical medications as initial therapy; however, until recently, only two drug classes were available: topical corticosteroids (TCSs) and topical calcineurin inhibitors (TCIs). Several limitations are associated with these agents. TCSs can cause a wide range of adverse effects, including skin atrophy, telangiectasia, rosacea and acne. TCIs can cause burning and stinging, and the prescribing information lists a boxed warning for a theoretical risk of malignancy. Novel medications with new mechanisms of action are necessary to provide better long-term control of AD. Phosphodiesterase 4 (PDE4) regulates cyclic adenosine monophosphate in cells and has been shown to be involved in the pathophysiology of AD, making it an attractive therapeutic target. Several PDE4 inhibitors are in clinical development for use in the treatment of AD, including crisaborole, which recently became the first topical PDE4 inhibitor approved for treatment of mild to moderate AD. This review will further describe the pathophysiology of AD, explain the possible role of PDE4 in AD and review PDE4 inhibitors currently approved or being investigated for use in AD.
AB - Atopic dermatitis (AD) is a highly prevalent, chronic inflammatory skin disease that affects children and adults. The pathophysiology of AD is complex and involves skin barrier and immune dysfunction. Many immune cytokine pathways are amplified in AD, including T helper (Th) 2, Th22, Th17 and Th1. Current treatment guidelines recommend topical medications as initial therapy; however, until recently, only two drug classes were available: topical corticosteroids (TCSs) and topical calcineurin inhibitors (TCIs). Several limitations are associated with these agents. TCSs can cause a wide range of adverse effects, including skin atrophy, telangiectasia, rosacea and acne. TCIs can cause burning and stinging, and the prescribing information lists a boxed warning for a theoretical risk of malignancy. Novel medications with new mechanisms of action are necessary to provide better long-term control of AD. Phosphodiesterase 4 (PDE4) regulates cyclic adenosine monophosphate in cells and has been shown to be involved in the pathophysiology of AD, making it an attractive therapeutic target. Several PDE4 inhibitors are in clinical development for use in the treatment of AD, including crisaborole, which recently became the first topical PDE4 inhibitor approved for treatment of mild to moderate AD. This review will further describe the pathophysiology of AD, explain the possible role of PDE4 in AD and review PDE4 inhibitors currently approved or being investigated for use in AD.
KW - calcineurin inhibitor
KW - corticosteroids
KW - crisaborole
KW - cytokines
KW - eczema
UR - http://www.scopus.com/inward/record.url?scp=85058312582&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85058312582&partnerID=8YFLogxK
U2 - 10.1111/exd.13808
DO - 10.1111/exd.13808
M3 - Article
C2 - 30332502
AN - SCOPUS:85058312582
JO - Experimental Dermatology
JF - Experimental Dermatology
SN - 0906-6705
ER -