Th1 and Th2 cytokine expression in hyperkeratotic chronic hand eczema and the role of Tofacitinib a oral JAK inhibitor.
Humans
Pyrimidines
/ administration & dosage
Male
Piperidines
/ administration & dosage
Female
Th2 Cells
/ immunology
Th1 Cells
/ immunology
Middle Aged
Adult
Cytokines
/ metabolism
Janus Kinase Inhibitors
/ administration & dosage
Eczema
/ drug therapy
Chronic Disease
Pyrroles
/ administration & dosage
Administration, Oral
Treatment Outcome
Aged
Hand Dermatoses
/ drug therapy
Cost
Cytokines
Dupilumab
Hand eczema
Hyperkeratotic
IFN-γ
IL-4
JAK inhibitor
Relapse
Side effects
TNF-α
Th1
Th2
Therapy
Tissue
Tofacitinib
Journal
Archives of dermatological research
ISSN: 1432-069X
Titre abrégé: Arch Dermatol Res
Pays: Germany
ID NLM: 8000462
Informations de publication
Date de publication:
14 Oct 2024
14 Oct 2024
Historique:
received:
28
08
2024
accepted:
30
09
2024
revised:
28
08
2024
medline:
14
10
2024
pubmed:
14
10
2024
entrez:
14
10
2024
Statut:
epublish
Résumé
Tissue cytokines in chronic hand eczema (CHE) can predict targeted therapy with novel drugs including JAK inhibitors. Our primary objective was to assess the tissue expression of cytokines of Th1 and Th2 cell lines in CHE patients and to study the efficacy of oral tofacitinib. We recruited patients presenting with recalcitrant CHE. Lesional and non-lesional tissue samples were assessed for Th1(IFN-γ, TNF-α) and Th2 related cytokines (IL-4, IL-13, IL-2,) using real time PCR. Tofacitinib 5 mg twice daily was initiated with 4 weekly assessment and we also noted relapses post therapy.Of 21 refractory hyperkeratotic CHE patients, cytokine analysis was performed in 11 patients which showed upregulation of IL-4 [n = 5/11, 1.87-fold increase], TNF-α (n = 5/11, 5.13-fold) and IFN-γ (n = 6/11, 1.98-fold) as compared to uninvolved skin. All patients (100%) had used topical corticosteroids (TCS) and 4/21 (19%) had failed methotrexate and 2/21 (9.5%) had failed acitretin. Tofacitinib 5 mg twice daily was given in 15/21 patients. The mean time to achieve hand eczema severity index 90 (HECSI 90) was 4 weeks (mean duration of treatment:5.8 months, n = 12). Side effects were observed in 4/12 (33.3%) patients and relapse was noted in 3/12 (25%) patients after a mean duration of 7 months after discontinuation of tofacitinib. Tofacitinib (pan-JAK inhibitor) showed an excellent response in refractory CHE patients with predominant tissue Th1/Th2 cells related cytokine expression.
Identifiants
pubmed: 39400740
doi: 10.1007/s00403-024-03438-7
pii: 10.1007/s00403-024-03438-7
doi:
Substances chimiques
Pyrimidines
0
tofacitinib
87LA6FU830
Piperidines
0
Cytokines
0
Janus Kinase Inhibitors
0
Pyrroles
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
682Informations de copyright
© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
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