Topical Tiacrilast, a Potent Mast Cell Degranulation Inhibitor, Does Not Improve Adult Atopic Eczema

Czarnetzki, B. M.; Brechtel, B.; Braun‐Falco, Otto; Christophers, Enno; Schöpf, Erwin; Reckers-Czaschka, R.; Baudin, Marianne; Dupuy, P

doi:10.1159/000247218

Cited by 6 publications

(4 citation statements)

References 9 publications

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“…Accordingly, the application of mast cell degranulation inhibitors or stabilizers seems reasonable. However, in a multicenter, double‐blind, placebo‐controlled trial applying 3% hydrogel formulation of tiacrilast (mast cell inhibitor) against vehicle in atopic dermatitis, there was no significant improvement of pruritus 125 . In another study, pruritus in children with AE responded to topical sodium cromoglycate, 126 which was proven by a recent placebo‐controlled study 127 …”

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confidence: 99%

Guidelines for treatment of atopic eczema (atopic dermatitis) Part I

Ring

Alomar

Bieber

et al. 2012

Acad Dermatol Venereol

544

471

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The existing evidence for treatment of atopic eczema (atopic dermatitis, AE) is evaluated using the national standard Appraisal of Guidelines Research and Evaluation. The consensus process consisted of a nominal group process and a DELPHI procedure. Management of AE must consider the individual symptomatic variability of the disease. Basic therapy is focused on hydrating topical treatment, and avoidance of specific and unspecific provocation factors. Anti‐inflammatory treatment based on topical glucocorticosteroids and topical calcineurin inhibitors (TCI) is used for exacerbation management and more recently for proactive therapy in selected cases. Topical corticosteroids remain the mainstay of therapy, but the TCI tacrolimus and pimecrolimus are preferred in certain locations. Systemic immune‐suppressive treatment is an option for severe refractory cases. Microbial colonization and superinfection may induce disease exacerbation and can justify additional antimicrobial treatment. Adjuvant therapy includes UV irradiation preferably with UVA1 wavelength or UVB 311 nm. Dietary recommendations should be specific and given only in diagnosed individual food allergy. Allergen‐specific immunotherapy to aeroallergens may be useful in selected cases. Stress‐induced exacerbations may make psychosomatic counselling recommendable. ‘Eczema school’ educational programs have been proven to be helpful. Pruritus is targeted with the majority of the recommended therapies, but some patients need additional antipruritic therapies.

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confidence: 99%

Guidelines for treatment of atopic eczema (atopic dermatitis) Part I

Ring

Alomar

Bieber

et al. 2012

Acad Dermatol Venereol

544

471

View full text Add to dashboard Cite

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“…3,4 Clinical studies of mast cell degranulation inhibition in AD patients have produced divergent results with both improvement of the eczema seen in some, 5,6 but not all studies. Several authors describe an increased density of mast cells in AD 1,2 and speculate on the pathophysiological relevance of mast cells in AD.…”

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confidence: 99%

“…Several authors describe an increased density of mast cells in AD 1,2 and speculate on the pathophysiological relevance of mast cells in AD 3,4 . Clinical studies of mast cell degranulation inhibition in AD patients have produced divergent results with both improvement of the eczema seen in some, 5,6 but not all studies 7,8 . However, mast cell density has not been shown to correlate with severity of AD, 9 and plasma levels of mast cell mediators in AD have been found to be normal.…”

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confidence: 99%

Mast cell mediators other than histamine induce pruritus in atopic dermatitis patients: a dermal microdialysis study

Rukwied

Lischetzki

McGlone

et al. 2000

British Journal of Dermatology

174

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While histamine is the crucial mediator of pruritus in type 1 allergic reactions, its role in atopic dermatitis (AD) is unclear. In this study, the role of mast cell mediators in protein extravasation and pruritus was evaluated using intradermal microdialysis. The microdialysis capillaries were used to apply the mast cell degranulating substance compound 48/80 (C48/80; 0.05%) or histamine (0.01%) and also to deliver H1-blockers (cetirizine, 200 microg mL-1) in nine AD patients and nine controls. Large pore size membranes (3000 kDa) enabled simultaneous analysis of protein extravasation. Itch sensation was measured psychophysically and weal and flare reaction were evaluated planimetrically. Protein extravasation induced by histamine and C48/80 was significantly reduced in AD patients. Blockade of H1-receptors by cetirizine significantly reduced C48/80-induced protein extravasation in AD patients and controls to an identical level. C48/80-induced pruritus was abolished by cetirizine in controls, whereas pruritus in AD patients was unchanged after H1 blockade. We conclude that mast cell mediators others than histamine are involved in C48/80-induced pruritus in AD patients. Whether the reduced capacity of AD patients to induce protein extravasation is of pathophysiological relevance for pruritus remains to be established.

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“…Tryptase and histamine, released by mast cells, lead to the induction of pruritus in AD. Some studies have reported the usefulness of mast cell stabilizers in AD (2b, B) 121 . However, further controlled trials are needed.…”

Section: Resultsmentioning

confidence: 99%

Consensus Guidelines for the Treatment of Atopic Dermatitis in Korea (Part I): General Management and Topical Treatment

Kim

Lew

et al. 2015

Ann Dermatol

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BackgroundSince the treatment guidelines for atopic dermatitis (AD) were released by the Korean Atopic Dermatitis Association (KADA) work group in 2006, there have been several advances in AD management.ObjectiveWe aimed to establish updated evidence- and experience-based treatment guidelines for Korean AD.MethodsWe collected a database of references from relevant systematic AD reviews and guidelines regarding general AD management such as bathing and skin care, avoidance of exacerbating factors, education and psychosocial support, and the use of moisturizers and topical anti-inflammatory and antipruritic drugs. Evidence for each statement was graded and the strength of the recommendation for each statement classified. Thirty-nine KADA council members participated in three rounds of voting to establish an expert consensus of recommendations.ResultsBasic AD treatment includes proper bathing and skin care, avoidance of exacerbating factors, proper education and psychosocial support, and use of moisturizers. The regular use of moisturizer has a steroid-sparing effect and reduces relapse episodes. The short- and long-term use of topical corticosteroids and calcineurin inhibitors improves AD symptoms and should be encouraged to use in an active and proactive treatment. Wet-wrap therapy can be used for rapid recovery of acute exacerbation. Topical antipruritic drugs cannot be recommended for the treatment of AD.ConclusionThis report provides up-to-date evidence- and experience-based treatment guidelines for AD regarding general management and topical treatment. In addition, the average agreement scores obtained by a panel of experts based on the Korean healthcare system and patient adherence are presented.

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Topical Tiacrilast, a Potent Mast Cell Degranulation Inhibitor, Does Not Improve Adult Atopic Eczema

Cited by 6 publications

References 9 publications

Guidelines for treatment of atopic eczema (atopic dermatitis) Part I

Guidelines for treatment of atopic eczema (atopic dermatitis) Part I

Mast cell mediators other than histamine induce pruritus in atopic dermatitis patients: a dermal microdialysis study

Consensus Guidelines for the Treatment of Atopic Dermatitis in Korea (Part I): General Management and Topical Treatment

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