Advancements in Ichthyosis Treatment in Pediatric Patients: Evaluating the Impact of Immune System Inhibitors Targeting TNF-alpha, IL-17A, IL-4, and IL-12

Abstract

Lamellar, X-linked recessive, and Vulgaris ichthyosis represent rare genetic variants distinguished by abundant dry surface scales. The etiology of childhood ichthyosis involves a combination of acquired and inherited factors. Children with Ichthyosis have a Th17-dominant immune profile, similar to psoriasis, with a correlation between ichthyosis severity, erythema, Trans Epidermal Water Loss (TEWL), and immunological markers. In order to examine the safety and effectiveness of immune system inhibitors that target TNF-alpha, IL-17A, IL-4, and IL-12 in the treatment of pediatric Ichthyosis, a retrospective research study was conducted on 30 pediatric patients aged 6-12 years at tertiary care pediatric dermatology hospitals in UAE, for a time duration of 5 months. IL-17-A is a key cytokine of Ichthyosis, and its specific suppression is considered necessary in contrast to other cytokines. Consequently, the choice of treatment was dictated by elements unique to the condition and the intensity of symptoms, focusing on using Secukinumab as an IL-17-A inhibitor. The findings showed that, following five months of treatment, patients receiving secukinumab showed positive outcomes, with their ichthyosis area severity index score declining by 45 to 50%. Additionally, the proinflammatory rate of cytokines was significantly lower in this group of patients compared to the placebo-treated control group. The safety and Efficacy of Secukinumab compared to Ixekizumab and Brodalumab vs placebo were examined using t-tests, with statistical significance determined at P< 0.05. The present research study concludes that Secukinumab effectively enhances skin texture and reduces scaling severity in Ichthyosis, suggesting clinical relevance. The findings underscore Secukinumab’s potential as a beneficial agent for various ichthyosis types, such as lamellar, X-linked, and vulgaris. The study’s comparison with placebo and other IL-17A inhibitors like Ixekizumab and Brodalumab provides valuable insights into Secukinumab’s Efficacy and potential clinical uses.