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