中国实用儿科杂志

中国实用儿科杂志 ›› 2021, Vol. 36 ›› Issue (9): 660-665.DOI: 10.19538/j.ek2021090605

• 党为人民谋健康的 100 年·专题笔谈 • 上一篇    下一篇

度普利尤单抗治疗儿童中重度特应性皮炎研究进展

  

  1. 首都儿科研究所附属儿童医院皮肤科，北京  100020
  • 出版日期:2021-09-06 发布日期:2021-12-02
  • 通讯作者: 高莹，电子信箱：srxying@sina.com

Research advances in the treatment of moderate-to-severe atopic dermatitis in children with dupilumab

  1. Department of Dermatology，Children’s Hospital of Capital Institute of Pediatrics，Beijing  100020，China
  • Online:2021-09-06 Published:2021-12-02

摘要： 特应性皮炎（AD）是一种复杂的慢性瘙痒性炎症性皮肤病，根据其临床表现可分为4期：婴儿期、儿童期、青少年与成人期、老年期。多数AD患者在婴儿期和儿童期发病，病情迁延伴有瘙痒，影响日常生活。轻度AD可外用药物局部治疗，慢性反复伴有严重瘙痒的中重度AD在局部治疗控制不佳时需联合系统药物治疗，dupilumab是一种靶向白细胞介素-4受体亚基α（IL-4Rα）的全人源化的免疫球蛋白G4 （IgG4）亚类单克隆抗体，通过与IL-4Rα亚基结合，抑制IL-4 和IL-13信号传导，从而抑制辅助型T细胞2（Th2）介导的炎症反应，有效地阻断2型炎症引起的皮肤屏障破坏和瘙痒，从而达到治疗作用。dupilumab治疗效果显著且无免疫抑制作用，具有良好的安全性，其作为儿童AD的系统治疗用药具有良好前景。

关键词: 儿童, 特应性皮炎, 度普利尤单抗

Abstract: Atopic dermatitis (AD) is a chronic pruritic inflam-matory dermatosis. Based on the clinical manifestations it is divided into four stages：infancy，childhood，adolescence and adulthood，and old age. Most patients with AD develop symptoms at infancy and childhood stage，which affect their life quality due to long-term course and pruritus. Children with mild AD can benefit from topical local treatment，but children with moderate-to-severe AD need systematic therapy in combination with topical treatment，especially those with chronic recurrence and severe pruritis. Dupilumab is a fully human IgG4 monoclonal antibody against interleukin-4 receptor alpha（IL-4Rα） that inhibits IL-4/IL-13 signalling，and the inhibition effectively blocks the Th2-mediated type 2 inflammatory response that leads to the destruction of skin barrier and pruritus of AD by inhibiting IL-4 and IL-13，thus achieving the effect of treating AD. As a systematic treatment of AD in children，dupilumab has a good prospect for its significant effect of long-term application，being without immunosuppression and with favorable safety.

Key words: child, atopic dermatitis, dupilumab