title: Topical immunomodulators for management of oral mucosal conditions, a systematic review; part I: calcineurin inhibitors.
abstract: BACKGROUND
  Topical immunomodulators have been used for the management of oral mucosal diseases. Topical immunomodulating preparations may have utility in local management of oral disease which is resistant to topical steroids and oral findings of an immunologic-mediated systemic disease with primary or persisting, oral mucosal involvement.
  
  
  METHODS
  This paper is the first part of a systematic review of topical immunomodulators for the management of various oral indications focused on calcineurin inhibitors. The literature search revealed that data are available for cyclosporine, tacrolimus and pimecrolimus. In addition to the review of scientific evidence, this paper presents the potential market, the mechanism of action, the competitive environment and future development options.
  
  
  RESULTS
  The reader will find weighted conclusions for the topical use of the calcineurin inhibitors in the management of oral diseases.
  
  
  CONCLUSIONS
  Topical calcineurin inhibitors may be useful as a second-line treatment in several oral diseases, particularly oral lichen planus.
authors.affiliation: Hebrew University-Hadassah School of Dental Medicine, Department of Oral Medicine, POB 12272, Jerusalem 91120, Israel. sharonela@ekmd.huji.ac.il
authors.forename: Sharon
authors.initials: S
authors.lastname: Elad
authors.forename: Joel B
authors.initials: JB
authors.lastname: Epstein
authors.forename: Noam
authors.initials: N
authors.lastname: Yarom
authors.forename: Scott
authors.initials: S
authors.lastname: Drucker
authors.forename: Rinat
authors.initials: R
authors.lastname: Tzach
authors.forename: Inger
authors.initials: I
authors.lastname: von Bültzingslöwen
mesh_terms: D000287:Administration, Topical; D000818:Animals; D065095:Calcineurin Inhibitors; D016572:Cyclosporine / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D015195:Drug Design; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D009059:Mouth Diseases / Q000188:drug therapy* / Q000473:pathology; D009061:Mouth Mucosa / Q000473:pathology; D016559:Tacrolimus / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000494:pharmacology / Q000627:therapeutic use
chemical_list: D065095:Calcineurin Inhibitors; D007166:Immunosuppressive Agents; C117268:pimecrolimus; D016572:Cyclosporine; D016559:Tacrolimus