Calcipotriol and betamethasone dipropionate synergistically enhances the balance between regulatory and proinflammatory T cells in a murine psoriasis model

Satake, Kenzo; Amano, Toru; Okamoto, Takeaki

doi:10.1038/s41598-019-52892-1

Cited by 20 publications

(22 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Topical treatment with Cal/BD foam in the InflammaSkin model almost completely inhibited Th17 cytokine secretion and upregulated LOR and IVL expression at the mRNA and protein level. CP cream significantly reduced Th17 cytokine levels, but to a lesser extent than Cal/BD foam, and did not improve LOR and IVL expression, highlighting the additive and/or complementary effects by calcipotriol on Th17 cytokine secretion and on epidermal differentiation, respectively, as previously reported [ 8 , 9 , 13 , 17 ].…”

Section: Discussionsupporting

confidence: 73%

See 1 more Smart Citation

Calcipotriol/Betamethasone Dipropionate Foam Inhibits Th17 Cytokine Secretion and Improves Epidermal Barrier Markers in a Human Th17 Skin Inflammation Model

Lovato

Hebsgaard

et al. 2021

Dermatol Ther (Heidelb)

View full text Add to dashboard Cite

Introduction T-helper 17 (Th17) cytokines play a key role in the pathophysiology of psoriasis by driving inflammatory responses that lead to epidermal alterations. Markers of epidermal differentiation, including the proteins loricrin (LOR), filaggrin (FLG) and involucrin (IVL), are dysregulated in psoriatic skin. The fixed-dose combination of calcipotriol/betamethasone dipropionate (Cal/BD) foam and clobetasol propionate (CP) are widely used, effective topical treatments for psoriasis. In this study, we investigated the effects of Cal/BD foam and CP cream on Th17 cytokine secretion and epidermal differentiation using a human Th17 skin inflammation model (InflammaSkin®). Methods The fixed-dose combination Cal/BD foam and the CP cream were applied once and twice daily, respectively, onto the air-exposed epidermal surface of InflammaSkin cultures for 7 days. Th17 cytokine levels were measured in culture supernatants, and gene expression analysis and immunohistochemical staining for LOR, FLG and IVL were performed on the skin samples. Results Topical treatment with Cal/BD foam almost completely inhibited Th17 cytokine secretion and upregulated LOR and IVL expression, but not FLG expression, at the mRNA and protein levels. Topical treatment with CP cream significantly reduced Th17 cytokine levels, but to a lesser extent than Cal/BD foam, and did not improve expression of any of the epidermal differentiation markers. Conclusion Compared with CP treatment, the fixed-dose combination Cal/BD foam showed a greater suppression of Th17 cytokine secretion and improved epidermal differentiation, resulting in an overall higher degree of improvement of the skin. These results support our understanding of the mechanisms behind the clinical efficacy observed for Cal/BD foam and of its use for long-term proactive treatment of psoriasis vulgaris.

show abstract

Section: Discussionsupporting

confidence: 73%

“…Taken together, these findings support the complementary modes of action of Cal and BD. Due to the promoting effect on epidermal differentiation and lipid synthesis [ 13 ], as well as the immunomodulatory action of calcipotriol [ 8 , 9 , 17 ], Cal/BD foam may prevent the onset of new psoriatic lesions.…”

Section: Discussionmentioning

confidence: 99%

Calcipotriol/Betamethasone Dipropionate Foam Inhibits Th17 Cytokine Secretion and Improves Epidermal Barrier Markers in a Human Th17 Skin Inflammation Model

Lovato

Hebsgaard

et al. 2021

Dermatol Ther (Heidelb)

View full text Add to dashboard Cite

show abstract

“…3b). An explanation for this finding could be that Cal/BD induces an increase in CD8 + lymphocytes, which restores the CD4 + and CD8 + lymphocyte epidermal counts thus normalizing the skin microenvironment 20 . However, to confirm this hypothesis, biopsies may have been needed to perform immunohistochemical studies.…”

Section: Discussionmentioning

confidence: 99%

Non‐invasive clinical and microscopic evaluation of the response to treatment with clobetasol cream vs. calcipotriol/betamethasone dipropionate foam in mild to moderate plaque psoriasis: an investigator‐initiated, phase IV, unicentric, open, randomized clinical trial

Yélamos

Alejo

Ertekin

et al. 2020

Acad Dermatol Venereol

View full text Add to dashboard Cite

Background Treatment response for psoriasis is typically evaluated using clinical scores. However, patients can relapse after clinical clearance, suggesting persistent inflammation. Dermoscopy, reflectance confocal microscopy (RCM) and optical coherence tomography (OCT) can non-invasively improve treatment response assessment. Objectives To compare the clinical and non-invasive microscopic features in a psoriatic target lesion treated with clobetasol cream or calcipotriol/betamethasone dipropionate foam (Cal/BD foam). Methods Prospective, unicentric, open, randomized clinical trial comparing clinical data [total clinical score (TCS)] and microscopic data (dermoscopy, RCM and OCT) in psoriasis patients treated with clobetasol or Cal/BD foam. Results We included 36 adult patients (22 men). At week 4, more patients treated with Cal/BD foam achieved TCS ≤1than with clobetasol (63.2% vs. 18.8%, P = 0.016). Treatment satisfaction was higher with Cal/BD foam (P < 0.03).Microscopically, Cal/BD foam induced more reduction in epidermal thickness at week 4 (P < 0.049). Dilated horizontal blood vessels were more common with clobetasol than with Cal/BD foam at week 8 (69.2% vs. 31.2%, P = 0.159). If epidermal hyperplasia was noted at baseline, the response was poorer with clobetasol (P = 0.029).Limitations Small sample size, open study, imaging sampling bias. ConclusionCal/BD foam is more effective than clobetasol, has better patient satisfaction and induces greater reduction in the hyperkeratosis/acanthosis, regardless of baseline epidermal hyperplasia.

show abstract

“…In this study, even in patients with poor adherence, the therapeutic effect of Cal/BDP gel persisted in all indications, including PGA, m‐PASI and BSA, at least until week 12. In addition, from the viewpoint of the mechanism of action of Cal/BDP, the normalization of the imbalance between regulatory and pro‐inflammatory T cells by Cal/BDP is shown to contribute to the successful long‐term control of psoriasis 17 . Therefore, it is conceivable that this sustained therapeutic effect is a major motivator for continuing long‐term treatment.…”

Section: Discussionmentioning

confidence: 99%

Patient satisfaction and efficacy of calcipotriol plus betamethasone dipropionate gel in plaque psoriasis patients with poor adherence

Takahashi

Katayama

Uwajima

et al. 2020

The Journal of Dermatology

View full text Add to dashboard Cite

Poor adherence to treatment makes achievement of expected therapeutic outcomes more difficult, especially in chronic disorders like psoriasis. There are several critical factors that affect adherence, including therapeutic efficacy, patient satisfaction, patient treatment preferences and ease of application, especially in topical therapy. The fixed combination of calcipotriol plus betamethasone dipropionate in a gel formulation (Cal/BDP gel) has been recommended as a first‐line topical treatment for mild to moderate plaque. To examine whether Cal/BDP gel can effectively improve treatment adherence, we investigated the effects of once‐daily Cal/BDP gel on factors affecting adherence at weeks 4, 8 and 12 in patients with plaque psoriasis who had poor adherence. A total of 46 subjects were enrolled and 41 subjects (26 men, 15 women; mean age, 50.5 years) were included in the analysis. The following items were evaluated: Patient Preference Questionnaire, nine‐item Treatment Satisfaction Questionnaire for Medication, Physician’s Global Assessment (PGA), modified Psoriasis Area and Severity Index (m‐PASI), body surface area (BSA), pruritus, medication adherence and application time. In patients with poor adherence, many preferred treatment with Cal/BDP gel and evaluated its convenience as “excellent” at weeks 4 and 12. At week 12, the proportion of “clear”/”very mild” ratings using PGA reached 20.5%, the change from baseline on m‐PASI was −61.3% and the change from baseline on BSA was −39.8%, suggesting that the skin symptoms of psoriasis had improved greatly. In most patients, the longer they used Cal/BDP gel, the greater their preference and satisfaction and the higher the therapeutic effect, which increased markedly over 12 weeks. These results suggest that Cal/BDP gel can effectively improve treatment adherence. Conversely, high adherence to Cal/BDP gel must enhance the therapeutic effect. Therefore, we expect that Cal/BDP gel could become the mainstay of topical psoriasis treatment in patients with poor adherence.

show abstract

Calcipotriol and betamethasone dipropionate synergistically enhances the balance between regulatory and proinflammatory T cells in a murine psoriasis model

Cited by 20 publications

References 38 publications

Calcipotriol/Betamethasone Dipropionate Foam Inhibits Th17 Cytokine Secretion and Improves Epidermal Barrier Markers in a Human Th17 Skin Inflammation Model

Calcipotriol/Betamethasone Dipropionate Foam Inhibits Th17 Cytokine Secretion and Improves Epidermal Barrier Markers in a Human Th17 Skin Inflammation Model

Non‐invasive clinical and microscopic evaluation of the response to treatment with clobetasol cream vs. calcipotriol/betamethasone dipropionate foam in mild to moderate plaque psoriasis: an investigator‐initiated, phase IV, unicentric, open, randomized clinical trial

Patient satisfaction and efficacy of calcipotriol plus betamethasone dipropionate gel in plaque psoriasis patients with poor adherence

Contact Info

Product

Resources

About