度普利尤单抗治疗过敏性疾病有效性和安全性研究进展

Research progress on the efficacy and safety of dupilumab in the treatment of allergic diseases

过敏性疾病严重影响着人类生命健康和生活质量,2型辅助性T细胞(Th2)分泌的细胞因子如白细胞介素(IL)‑4和IL‑13在其发病中起关键作用。度普利尤单抗通过识别IL‑4和IL‑13受体并与之结合,阻断IL‑4和IL‑13信号转导通路,抑制Th2型炎症反应,治疗过敏性疾病。目前该药已在全球多个国家和地区上市,但批准的适应证不尽相同,主要包括特应性皮炎、中重度嗜酸粒细胞性哮喘、慢性鼻窦炎伴鼻息肉和嗜酸粒细胞性食管炎等。此外,该药还可能对IgE介导的过敏反应和其他皮肤疾病有较好疗效。度普利尤单抗安全性良好,常见不良反应包括注射部位反应(注射部位疼痛、瘀斑及肿胀)、眼部疾病(结膜炎、角膜炎、眼部瘙痒和干眼)、口腔疱疹、头痛、其他单纯疱疹病毒感染等。在我国,度普利尤单抗被批准用于6岁及以上患者中重度特应性皮炎的治疗,临床应用效果良好,未见明显安全性问题。

Allergic diseases have serious influence on human health and quality of life.Cytokines secreted by T‑helper cell type 2(Th2),such as interleukin(IL)‑4 and IL‑13,play a pivotal role in the patho‑genesis of allergic diseases.By recognizing and binding to IL‑4 and IL‑13 receptors,dupilumab can block the signal transduction pathways of IL‑4 and IL‑13,inhibit Th2 inflammatory reaction,and thus play a thera‑peutic role in allergic diseases.At present,dupilumab has been on the market in many countries and regions around the world,yet with different indications approved,mainly including atopic dermatitis,moderate‑to‑severe eosinophilic asthma,chronic rhinosinusitis with nasal polyps,eosinophilic esophagitis,etc.In addi‑tion,this drug may also have better curative effect on IgE‑mediated allergic reactions and other dermal diseases.Meanwhile,the safety profile of dupilumab is generally good and the common adverse reactions mainly include injection site reactions(pain,ecchymosis and swelling at the injection site),ocular diseases(conjunctivitis,keratitis,itchiness of eyes and dry eyes),oral herpes,headache,and other herpes simplex virus infections.In China,dupilumab has been approved for the treatment of moderate‑to‑severe atopic dermatitis in patients aged≥6 years,showing good efficacy and no obvious safety problems.