综述
ENGLISH ABSTRACT
度普利尤单抗治疗特应性皮炎患者过程中眼表不良事件研究现状
陈玮
马黎
林伟青 [综述]
作者及单位信息
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DOI: 10.3760/cma.j.cn115989-20200126-00041
Dupilumab-associated ocular adverse event in patients with atopic dermatitis
Chen Wei
Ma Li
Lam Waichlam
Authors Info & Affiliations
Chen Wei
Department of Ophthalmology, The University of Hong Kong-Shenzhen Hospital, Shenzhen 518000, China
Ma Li
Department of Dermatology, The University of Hong Kong-Shenzhen Hospital, Shenzhen 518000, China
Lam Waichlam
Department of Ophthalmology, The University of Hong Kong-Shenzhen Hospital, Shenzhen 518000, China
·
DOI: 10.3760/cma.j.cn115989-20200126-00041
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摘要

特应性皮炎是一种慢性复发性炎症性皮肤病,度普利尤单抗是一种单克隆抗体,其与细胞表面白细胞介素(IL)-4α受体结合阻断IL-4及IL-13的信号通路,治疗中到重度特应性皮炎。结膜炎及睑缘炎的发病率升高是其治疗过程中较常见的不良事件,其发生的机制尚不明确,推测可能与眼表黏膜免疫调节异常、屏障功能受损以及蠕形螨定植有关。本文就度普利尤单抗治疗特应性皮炎过程中眼表症状流行病学、临床特征以及治疗方案进行综述,分析目前该药物引起眼表不良事件研究中存在的不足,深入探索发病机制的方向以及诊治的相关注意事项。

特应性皮炎;度普利尤单抗;结膜炎;睑缘炎
ABSTRACT

Atopic dermatitis (AD) is a chronic, relapsing, pruritic inflammatory skin disease.Dupilumab is a monoclonal antibody that inhibits interleukin (IL)-4 and IL-13 signaling pathways through its binding to IL-4α receptor, which has been demonstrated effective in treatment of moderate-to-severe AD.There is an increased incidence of the associated ocular adverse event in the treatment of AD, the probable mechanisms of which are likely related to abnormal mucosal immune regulation, dysfunction of the ocular barrier, and Demodex colonization.In this article, the epidemiology, clinical features, and management of dupilumab for AD were reviewed, and the shortcomings of the current researches about dupilumab-associated adverse events were analyzed, as well as further study directions in exploring etiology, mechanism, and matters needing attention in diagnosis and treatment were discussed.

Dermatitis, atopic;Dupilumab;Conjunctivitis;Blepharitis
Ma Li, Email: grodef.habzs-ukh6lam
引用本文

陈玮,马黎,林伟青. 度普利尤单抗治疗特应性皮炎患者过程中眼表不良事件研究现状[J]. 中华实验眼科杂志,2022,40(03):276-279.

DOI:10.3760/cma.j.cn115989-20200126-00041

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特应性皮炎(atopic dermatitis,AD)是一种慢性复发性炎症性皮肤病,常伴有剧烈瘙痒,在成人中的发病率为2%~3% [ 1 ]。流行病学数据显示,AD患者本身有较高风险罹患结膜炎、角膜炎、圆锥角膜等眼表疾病 [ 2 ];AD患者眼部相关疾病的发生率为20%~43% [ 3 ]。度普利尤单抗是抗白细胞介素4受体α亚基(interleukin-4 receptor α,IL-4Rα)的单克隆抗体,能抑制IL-4Rα与IL-4和IL-13结合并阻断其介导的下游信号,阻断AD的信号通路,对中到重度AD患者有显著疗效 [ 4 ]。该药物于2017年3月获得美国食品药物管理局批准用于治疗成人中到重度AD;2017年9月获欧洲药品管理局授权于欧洲上市 [ 5 ]。2020年,该药物已于中国上市获批治疗中到重度AD,但尚缺乏国内AD患者经度普利尤单抗治疗后相关眼表不良事件的临床数据 [ 6 ]。为提高国内眼科医生及皮肤科医生对该药物引起的相关眼表不良事件的认识,本文根据国内外已发表研究,将度普利尤单抗治疗特应性皮炎后常见眼部不良事件中结膜炎及睑缘炎的发病率、临床表现、治疗方式以及可能的发病机制进行综述。
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