Gene expression is differently affected by pimecrolimus and betamethasone in lesional skin of atopic dermatitis

Jensen, Jens‐Michael; Scherer, Andreas; Wanke, Christine; Bräutigam, Matthias; Bongiovanni, Sandrine; Letzkus, Martin; Staedtler, Frank; Kehren, Jeanne; Zuehlsdorf, Michael; Schwarz, Thomas; Weichenthal, Michael; Fölster‐Holst, Regina; Proksch, Ehrhardt

doi:10.1111/j.1398-9995.2011.02747.x

Cited by 60 publications

(79 citation statements)

References 36 publications

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“…A recent study of the gene expression profiles of a topical steroid (betamethasone) and pimecrolimus demonstrated differences between the two substances, in particular in relation to epidermal genes [27]. In contrast to the steroid, pimecrolimus led to full restoration of the skin barrier [27], which is certainly beneficial and might be an explanation for the healing of PN lesions.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the Antipruritic Effects of Topical Pimecrolimus in Non-Atopic Prurigo Nodularis: Results of a Randomized, Hydrocortisone-Controlled, Double-Blind Phase II Trial

Siepmann¹,

Lotts²,

Blome

et al. 2013

Dermatology

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Background: In the treatment of atopic dermatitis, pimecrolimus has high antipruritic effects. Objective: To investigate the efficacy of 1% pimecrolimus cream in comparison to 1% hydrocortisone cream in non-atopic prurigo nodularis (PN). Methods: A randomized, controlled, double-blind study with intraindividual randomization was done in 30 patients (17 females, 13 males; mean age 58.5 years) with PN. Results: Pruritus intensity decreased significantly (p < 0.001) on both treated sides as early as after 10 days of treatment; scratch lesions improved (p < 0.001). Quality of life as assessed by the Dermatology Life Quality Index improved significantly. However, a significant advantage of pimecrolimus over hydrocortisone was not found. Conclusion: The results suggest that the non-steroid pimecrolimus is an effective alternative for PN treatment.

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Section: Discussionmentioning

confidence: 99%

Evaluation of the Antipruritic Effects of Topical Pimecrolimus in Non-Atopic Prurigo Nodularis: Results of a Randomized, Hydrocortisone-Controlled, Double-Blind Phase II Trial

Siepmann¹,

Lotts²,

Blome

et al. 2013

Dermatology

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“…Topical steroids result in rapid improvement of skin inflammation and pruritus, but have opposing effects on barrier functions [95,99,100]. Positive effects of topical corticosteroids on the skin barrier include the increase of SC hydration, decrease of TEWL, and normalization of filaggrin and loricrin expression [95,100,101]. However, human studies and animal models demonstrated that long-term application of local glucocorticoids resulted in significant impairment of epidermal barrier function and homeostasis.…”

Section: Topical Glucocorticosteroidsmentioning

confidence: 99%

Pharmacological Targeting of the Epidermal Barrier

Kemény¹,

Nagy²,

Csoma³

et al. 2016

CPD

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The most important function of the skin is to form a barrier between the body and the external environment. The epidermal barrier prevents transepidermal water loss from the skin, but also serves as a barrier to the entry of harmful environmental allergic, toxic or infectious substances. Inherited defects in the genes encoding the components of the epidermal barrier result in the development of rare genetic disorders, whereas polymorphisms in these genes together with environmental factors cause frequent inflammatory skin diseases, such as atopic dermatitis. In this review, components of the skin-barrier function will be reviewed with special emphasis on how the altered epidermal barrier might be repaired. The different strategies to increase the transdermal penetration of drugs is also discussed.3

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“…This multidimensional approach could ultimately lead to the development of disease-specific multiplex diagnostic and/or predictive tools in the future such as RNA-profiling upon distinct therapeutic approaches (114). However, even at this early stage, we can already learn from the acquired knowledge and make a tentative proposal for molecular taxonomy and the clinical value of this information as depicted in Fig.…”

Section: Thymus and Activation-regulated Chemokine (Ccl17/tarc)mentioning

confidence: 99%

Atopic dermatitis 2.0: from the clinical phenotype to the molecular taxonomy and stratified medicine

Bieber

2012

Allergy

169

125

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Atopic dermatitis (AD) is a paradigmatic inflammatory chronic skin disease. As for other chronic skin diseases, (i) the spectrum of the clinical phenotype and severity as well as (ii) the genetic background and (iii) the underlying mechanisms strongly suggest a high degree of pathophysiological heterogeneity yet leading to a similar clinical pattern, that is, the eczematous skin lesion, but showing distinct progression patterns. This review suggests to exploit the recent knowledge about AD for a novel approach proposing a tentative first molecular taxonomy of this disease based on the genotype and endophenotype. The consequences in terms of personalized prevention and management are delineated.As an evolution of the biomedical research and our genetic and pathophysiological understanding of complex diseases, we are currently experiencing a new trend in the classification of diseases moving from the purely phenotypic definition to a molecular taxonomy. It is expected that in future medicine, every disease will be characterized by three main groups of information: (i) the genotype, including epigenotypic information, (ii) the endophenotype (1) that comprises all available biomarkers (BMs), and (iii) the clinical phenotype (Fig. 1). Among all chronic inflammatory diseases, atopic dermatitis (AD) represents a paradigmatic condition because of its genetic and pathophysiological complexity (2) and finally the result thereof: the wide spectrum of clinical phenotype (3). This wide spectrum includes at one end the very minor forms such as atopic stigmata or simply dry skin with minimal itching and the erythrodermic and most severe form of AD at the other end. Due to the recent progress in the research of genetic, immunologic, and environmental factors (the so-called exposome) leading to AD, we are just starting to understand the complexity of the mechanisms underlying the variety in the clinical phenotype and to make first attempts to link the genotype and endophenotype to distinct clinical forms and courses of this disease such as the atopic march. After exposing a brief update of the clinical phenotype and pathophysiological aspects, this review introduces the concept of molecular taxonomy for AD and the consequences for its future management in the context of stratified or personalized medicine.

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Gene expression is differently affected by pimecrolimus and betamethasone in lesional skin of atopic dermatitis

Cited by 60 publications

References 36 publications

Evaluation of the Antipruritic Effects of Topical Pimecrolimus in Non-Atopic Prurigo Nodularis: Results of a Randomized, Hydrocortisone-Controlled, Double-Blind Phase II Trial

Evaluation of the Antipruritic Effects of Topical Pimecrolimus in Non-Atopic Prurigo Nodularis: Results of a Randomized, Hydrocortisone-Controlled, Double-Blind Phase II Trial

Pharmacological Targeting of the Epidermal Barrier

Atopic dermatitis 2.0: from the clinical phenotype to the molecular taxonomy and stratified medicine

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