阿普米司特在皮肤病中的应用进展

The Application of Apremilast in Dermatological Disorders

阿普米司特(apremilast)是一种口服的小分子药物,可特异性抑制磷酸二酯酶4(phosphodiesterase-4,PDE-4)的活性,通过调节免疫系统,增加细胞内环磷酸腺苷的水平,进一步调控肿瘤坏死因子和其他炎性细胞因子的表达,从而有效控制炎症反应。它被美国食品药品监督管理局(FDA)批准用于治疗银屑病、银屑病关节炎(PsA)和贝赫切特综合征(BD)口腔溃疡。最近阿普米司特已被超适应症用于治疗全身性糖皮质激素或免疫抑制剂无效的多种皮肤病,如斑秃(AA)、扁平苔藓(LP)、化脓性汗腺炎(HS)、白癜风、特应性皮炎(AD)、慢性皮肤结节病(CCS)、慢性光化性皮炎(CAD)和慢性口疮口臭。现将该药对上述疾病的临床作用进行综述,以供临床参考。

Apremilast is an oral small-molecule drug that selectively inhibits the activity of phosphodiesterase-4(PDE-4).By modulating the immune system and increasing intracellular levels of cyclic adenosine monophosphate(cAMP),it regulates the expression of tumor necrosis factor(TNF)and other inflammatory cytokines,effectively controlling inflammatory responses.The drug has been approved by the US Food and Drug Administration(FDA)for the treatment of psoriasis,psoriatic arthritis(PsA),and oral ulcers associated with Beh et′s disease(BD).Recently,apremilast has also been used off-label to treat a range of skin diseases that do not respond to systemic corticosteroids or immunosuppressants,including alopecia areata(AA),lichen planus(LP),hidradenitis suppurativa(HS),vitiligo,atopic dermatitis(AD),chronic cutaneous nodular disease(CCS),chronic photodermatitis(CAD),and chronic oral ulcers.This review summarizes the clinical effects of apremilast on these conditions for the benefit of clinical practice.