Inibidores de calcineurina no tratamento das dermatoses alérgicas

Abstract

Objective: To review the role of calcineurin inhibitors in the treatment of allergic dermatitis, focusing on mechanisms of action, efficacy and topical and systemic adverse effects.Sources: Articles written in English and published in MEDLINE using the following keywords: pimecrolimus, tacrolimus, calcineurin inhibitors. Original articles that presented controlled and open studies for assessing efficacy, tolerability and adverse effects were selected. Review articles and case series were also evaluated; the latter was only considered for assessing adverse effects. The official websites of the Food and Drug Administration and of manufacturers of calcineurin inhibitors were also used. Summary of the findings:The data showed that calcineurin inhibitors are efficient in the treatment of mild to severe atopic dermatitis, leading to improvement in symptoms, reduction in number of attacks and need of topical corticotherapy. Calcineurin inhibitors have good tolerability and few topical adverse effects. To date, there has been no evidence to support higher prevalence of neoplasia in patients using these drugs; however, an adequate pharmacovigilance system has been set up to assess this aspect.Conclusions: Calcineurin inhibitors, which are a new drug class in the treatment of allergic dermatitis, are efficient, well tolerated and have few adverse effects. Calcineurin inhibitors should always be used according to recommended guidelines, and patients should always be followed by the physician during and after their administration.J Pediatr (Rio J). 2006;82(5 Suppl):S166-72: Pimecrolimus, tacrolimus, calcineurin inhibitors.

Mecanismos Celulares na Dermatite de Contato Alérgica

“…imune adaptativa, apresentando antígenos aos linfócitos T na pele e contribuindo para a ativação e diferenciação dessas células 4,7,2 .…”

“…Além disso, os queratinócitos interagem com os linfócitos T na pele, tanto os linfócitos T CD4+ (auxiliares) quanto os linfócitos T CD8+ (citotóxicos), desempenhando papéis na ativação e diferenciação dessas células. Os linfócitos T liberam citocinas próinflamatórias em resposta à interação com os queratinócitos, amplificando a resposta inflamatória cutânea 7,5 .…”

Dermatite Atópica Canina: Revisão De Literatura

“…Por não possuir os efeitos indesejáveis dos medicamentos prescritos, ela pode ser utilizada pelo tempo necessário sem causar efeitos deletérios na vida do animal. Os animais tratados apresentam uma alteração no balanço homeostático das respostas Th1 e Th2, com o surgimento de mecanismos imunossupressores realizados principalmente por células T reguladoras CD4+ (AARESTRUP, 2017;ZANON et al, 2008).…”

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

“…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].…”