Modifying Immunity-Based Therapies for Chronic Skin Inflammation (Atopic Dermatitis)
Newer Immunomodulatory Treatments Offer Hope for Eczema Sufferers
Eczema, a skin condition characterised by an overactive immune system, affects millions worldwide. Traditional treatments for eczema have often come with a host of side effects, but recent advancements in medical science have led to the development of newer, more precise treatments.
These newer treatments, such as biologics and Janus kinase (JAK) inhibitors, target specific parts of the immune system and are used to counteract the overactive immune response present in people with eczema. Unlike older drugs, they have fewer side effects. However, JAK inhibitors seem to have a much broader and more serious variety of potential side effects than biologics.
Systemic immunomodulatory medications, a class of medications that influence the immune system, can either suppress or enhance it. Common systemic immunomodulatory treatments for eczema primarily include biologic agents targeting key immune pathways, such as monoclonal antibodies against interleukins (e.g., IL-13), and traditional systemic immunosuppressants.
Lebrikizumab, a monoclonal antibody targeting IL-13, significantly improves skin lesions within 16 weeks of treatment. Dupilumab, although not explicitly mentioned in the search results, blocks IL-4 and IL-13 signaling, key drivers of Th2-mediated inflammation. Traditional systemic immunosuppressants such as corticosteroids or cyclosporine are used to broadly suppress immune activity but with more side effects and less targeted action compared to newer biologics.
Traditional Chinese Medicine (TCM) utilises herbal medicines to modulate immune responses and shows steroid-sparing benefits. TCM improves symptoms with a favourable safety profile.
Topical steroids and emollients focus on local inflammation control and skin barrier repair but can be insufficient in moderate-to-severe cases. Systemic immunomodulators like biologics provide targeted inhibition of specific immune pathways central to the disease, leading to better efficacy and fewer systemic side effects compared to broad immunosuppressants.
However, these treatments are not without risks. Pregnant or nursing women cannot take certain systemic immunomodulatory medications due to the risk to the developing baby and the risk of miscarriage and stillbirth. People with liver or kidney disease, those at higher risk for infections or certain cancers, and young children and older adults are generally not considered good candidates for systemic treatment.
Methotrexate, a traditional systemic immunosuppressant, can cause hair loss, diarrhea, vomiting, stomach pain, mouth sores, damage to the liver and kidneys, and miscarriage and stillbirths among pregnant people. Cyclosporine can cause high blood pressure and kidney damage. Those with a history of cancer should exercise caution when considering systemic immunomodulatory medications as they can increase the risk of cancer or lead to a recurrence.
In summary, systemic immunomodulatory therapies for eczema work by modulating key immune cytokines and pathways (mainly Th2-driven inflammation), offering more precise and effective control for moderate-to-severe disease compared to traditional topical or broad immunosuppressive treatments. Emerging treatments like Lebrikizumab exemplify this shift towards targeted immune modulation. As always, it is important to discuss treatment options with a healthcare provider to determine the best course of action.
[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6372529/ [2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6381012/ [3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6831456/ [5] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6354937/
- Seekers of effective treatments for chronic eczema, a skin condition influenced by an immune system overactivity, may find hope in newly established immunomodulatory therapies.
- Switchers from traditional eczema treatments might consider newer, systemic immunomodulatory medications like biologics or Janus kinase (JAK) inhibitors, which target specific immune system components, presenting fewer side effects.
- Treaters of eczema could consult medical-condition literature for information on therapies like monoclonal antibodies, such as Lebrikizumab, addressing IL-13, or Dupilumab, inhibiting IL-4 and IL-13 signaling.
- Skin-care regimens may include topical steroids and emollients to control local inflammation and repair skin barriers; however, they might be insufficient in moderate-to-severe cases, prompting the use of systemic immunomodulators like biologics.
- Science-driven research has led to the development of biosimilars, which offer immunomodulatory options at potentially lower costs compared to originator biologics, benefitting healthcare providers and patients dealing with chronic diseases.
- Individuals with eczema considering systemic immunomodulatory treatments should be aware of potential risks, including those related to pregnancy, liver/kidney disease, cancer history, and increased susceptibility to infections.
- Health-and-wellness practices could include Traditional Chinese Medicine (TCM) herbal medicine to modulate immune responses, showing steroid-sparing benefits with a favourable safety profile.
- In deciding the best treatment for eczema, it is essential to consult with medical professionals, review the latest research papers [1], [2], [3], and [5], and consider the broader implications of various therapies on one's health and wellness.
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