Mechanism of action and emerging role of immune response modifier therapy in dermatologic conditions.
Immune response modifiers (IRMs) are agents that target the body's immune system (i.e., cytokines, receptors, and inflammatory cells) to combat disease. Topical IRM therapies, which encompass both proinflammatory and immunosuppressive therapeutics, have been used to successfully treat a number of dermatologic conditions. Proinflammatory treatments include Toll-like receptor agonists (e.g., imiquimod 5% cream) and interferon (e.g., interferon-alpha) therapies, which have been used in the treatment of external genital warts, basal cell carcinoma, and other dermatologic diseases. Immunosuppressive therapies include topical and intralesional corticosteroids, anti-tumor necrosis factor agents (e.g., infliximab and etanercept), and anti-CD4+ T-cell agents, including calcineurin inhibitors and mycophenolate. These agents have been used to treat a number of conditions, including atopic and seborrheic dermatitis and psoriasis. This article reviews the mechanism of action of IRMs and the application of IRMs in several dermatologic diseases.
Sauder
Daniel N
DN
Department of Dermatology, Johns Hopkins University, John Hopkins Outpatient Center, Baltimore, Maryland 21205-0900, USA. dsauder@jhmi.edu
D000276:Adjuvants, Immunologic / Q000494:pharmacology* / Q000627:therapeutic use*; D000077944:Alefacept; D000634:Aminoquinolines / Q000494:pharmacology / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000494:pharmacology / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized; D018845:CD11 Antigens; D065095:Calcineurin Inhibitors; D003876:Dermatitis, Atopic / Q000188:drug therapy; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D000077271:Imiquimod; D007372:Interferons / Q000494:pharmacology* / Q000627:therapeutic use; D008562:Membrane Glycoproteins / Q000037:antagonists & inhibitors; D009173:Mycophenolic Acid / Q000031:analogs & derivatives / Q000494:pharmacology / Q000627:therapeutic use; D011565:Psoriasis / Q000188:drug therapy; D011956:Receptors, Cell Surface / Q000037:antagonists & inhibitors; D011993:Recombinant Fusion Proteins / Q000494:pharmacology / Q000627:therapeutic use; D012871:Skin Diseases / Q000188:drug therapy*; D016559:Tacrolimus / Q000031:analogs & derivatives / Q000494:pharmacology / Q000627:therapeutic use; D051193:Toll-Like Receptors
D000276:Adjuvants, Immunologic; D000634:Aminoquinolines; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D018845:CD11 Antigens; D065095:Calcineurin Inhibitors; D005938:Glucocorticoids; D008562:Membrane Glycoproteins; D011956:Receptors, Cell Surface; D011993:Recombinant Fusion Proteins; D051193:Toll-Like Receptors; C117268:pimecrolimus; D007372:Interferons; D000077944:Alefacept; D009173:Mycophenolic Acid; D000077271:Imiquimod; D016559:Tacrolimus; C472181:efalizumab