Inibidores de calcineurina no tratamento das dermatoses alérgicas

Castro, Ana Paula Beltran Moschione

doi:10.1590/s0021-75572006000700006

Cited by 7 publications

(2 citation statements)

References 25 publications

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“…Other cases of success are the topical use of immuno-modulators, namely pimecrolimus as a cream with mild-corticosteroid properties, and tacrolimus as a cream with moderate- to strong-corticosteroids properties. Both cases were shown to decrease excoriations, pruritus, and erythema [42].…”

Section: Non-pharmacological and Pharmacological Treatmentsmentioning

confidence: 99%

Trends in Atopic Dermatitis—From Standard Pharmacotherapy to Novel Drug Delivery Systems

Souto

Dias-Ferreira

Oliveira

et al. 2019

IJMS

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Atopic dermatitis (AD) is a predominant and deteriorating chronic inflammation of the skin, categorized by robust burning and eczematous lacerations in diverse portions of the body. AD affects about 20% of both offspring and adults worldwide. The pathophysiology of AD combines environmental, hereditary, and immunological aspects, together with skin barrier dysfunction. The procedures used to prevent the disease are the everyday usage of creams to support the restoration of the epidermal barrier. The classical treatments include the use of topical corticosteroids as a first-line therapy, but also calcineurin inhibitors, antihistamines, antibiotics, phototherapy, and also immunosuppressant drugs in severe cases of AD. Topical drug delivery to deeper skin layers is a difficult task due to the skin anatomic barrier, which limits deeper penetration of drugs. Groundbreaking drug delivery systems, based on nanoparticles (NPs), have received much attention due to their ability to improve solubility, bioavailability, diffusion, targeting to specific types of cells, and limiting the secondary effects of the drugs employed in the treatment of AD. Even so, additional studies are still required to recognize the toxicological characteristics and long-term safety of NPs. This review discusses the current classical pharmacotherapy of AD against new nanoparticle skin delivery systems and their toxicologic risks. a prevalence of atopic conditions, as allergic rhinitis or bronchial asthma, and food allergies [2]. Topical administration of drugs is still the main therapeutic approach for AD. Despite this, several disadvantages may be cited as reduced patient compliance (a consequence of adverse effects as skin irritation or allergy), low efficiency, and specificity of these systems in delivering therapeutic drugs [3]. Innovative drug delivery systems should, therefore, exhibit the capacity to penetrate the stratum corneum (SC), which is naturally impermeable to a range of substances, in order to reduce adverse effects and increase drug targeting [3][4][5]. There is still no medication capable of reversing the pathological effects of AD. However, formulations based on nanoparticles (NPs) have been exploited for topical administration of drugs and are expected to overcome the above-mentioned limitations [6][7][8]. PathophysiologyAD, also called atopic eczema, is the most common skin disease, characterized by a pattern of pruritus, skin deterioration, and chronic inflammation [1,6,7]. This illness affects individuals in early-, mid-or late-stages of their lives and does not have a known cure so far. Over the course of the disease, the levels of IgE increase drastically leading to cutaneous signals that appear in early ages and persist until late stages of life, when they begin to disappear. Because of this, AD is also labelled as "allergic march" [2].AD results from a multiplicity of factors such as environmental injuries, impairments against the natural barrier of the skin and response of the immune system. This latter enhances the ac...

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Section: Non-pharmacological and Pharmacological Treatmentsmentioning

confidence: 99%

Trends in Atopic Dermatitis—From Standard Pharmacotherapy to Novel Drug Delivery Systems

Souto

Dias-Ferreira

Oliveira

et al. 2019

IJMS

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“…The name is the acronym of Tsukuba (the place), macrolide (chemical class), immune suppressant (primary activity). In the search for efficacious drugs that are well tolerated also in the long term [4], topical calcineurin inhibitors (TCIs) have provided a good alternative to TCSs in the treatment of mild to severe forms of AD. TCIs act by blocking calcineurin in the skin, thus inhibiting the transcription and release of inflammatory cytokines and mediators produced by T lymphocytes and mast cells.…”

Section: The Drugsmentioning

confidence: 99%

Role of Topical Calcineurin Inhibitors on Atopic Dermatitis of Children

Ricci¹,

Dondi²,

Patrizi

2007

CMC

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Besides the traditional topical treatment of mild and moderate forms of atopic dermatitis (AD), which includes the daily use of emollients and the intermittent use of topical corticosteroids (TCSs) as anti-inflammatory drugs, a new group of drugs has recently been introduced to control the inflammatory phase of the disease: topical calcineurin inhibitors (TCIs). Although the efficacy of TCSs is evident, prolonged unrestricted use is limited by local and systemic side effects. The major risk in children is the hypothalamic-pituitary-adrenal gland suppression, due to the higher percutaneous absorption of the TCSs. TCIs selectively block the activity of calcineurin, a serin/threonine protein phosphatase regulated by cellular calcium first detected in skeletal muscle and brain. Within the past few years, calcineurin has been implicated in a wide range of biological responses including lymphocyte activation, neuronal and muscle development, and morphogenesis of heart valves. TCIs disrupt the intracellular signalling towards NF-AT by forming a complex with macrophilin-12. This complex inhibits the activity of calcineurin, thereby preventing the dephosphorylation of NF-AT and so interfering with the transcription of several genes. The nuclear component of NF-AT, binding to its nuclear counterpart, is essential for the transcription of various genes, including interleukin (IL)-2 and other proinflammatory cytokines. Recent findings about the therapeutic efficacy of TCIs have provided a possible alternative to TCSs in the treatments of mild to severe forms of AD.

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