The Use of Dupilumab in Atopic Dermatitis During Coronavirus Disease-19 Era – A Review

Authors

  • Laura Pauline Kosasih Department of Dermatology, Cardiff University, Cardiff, Wales, United Kingdom

DOI:

https://doi.org/10.3889/oamjms.2020.5359

Keywords:

Atopic dermatitis, Dupilumab, Biologic treatment, Coronavirus disease-19

Abstract

The global pandemic of coronavirus (CoV) d0isease 2019 (COVID-19), caused by severe acute respiratory syndrome CoV (SARS-CoV 2), has been a challenging event for every individual. It is known that COVID-19 may exhibit a vast range of symptoms ranging from mild to severe. Acute respiratory distress syndrome (ARDS) and multiple organ failure are the most common causes of death in COVID-19 cases [3]. Accumulating evidence shows that T-helper type (Th-1) inflammation cascade plays a major role in COVID-19 pathogenesis. It is proposed that aberrant immune reaction, or known as cytokine storm, is one of the main causals of ARDS in COVID-19 case, while dupilumab, the first Food and Drug Administration-approved immunomodulatory treatment for atopic dermatitis, is known for its effectiveness in suppressing the Th-2 inflammation pathway. It is postulated that both types of inflammation can cross-regulate each other. Therefore, some may believe that the regression of Th-2 cascade may upregulate the Th-1 cascade, leading to an exaggerated cytokine storm. This hypothesis leads to the uncertainty of the safety of continuing this modality during the pandemic.

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References

Rothan HA, Byrareddy SN. The epidemiology and pathogenesis of coronavirus disease (COVID-19) outbreak. J Autoimmun. 2020;109:102433. https://doi.org/10.1016/j.jaut.2020.102433 PMid:32113704

Kakodkar P, Kaka N, Baig M. A comprehensive literature review on the clinical presentation, and management of the pandemic coronavirus disease 2019 (COVID-19). Cureus. 2020;12(4):e7560. https://doi.org/10.7759/cureus.7560 PMid:32269893

Ye Q, Wang B, Mao J. The pathogenesis and treatment of the “Cytokine Storm’’ in COVID-19. J Infect. 2020;80(6):607-13. PMid:32283152

Wang FP, Tang XJ, Wei CQ, Xu LR, Mao H, Luo FM. Dupilumab treatment in moderate-to-severe atopic dermatitis: A systematic review and meta-analysis. J Dermatol Sci. 2018;90(2):190-8. https://doi.org/10.1016/j.jdermsci.2018.01.016 PMid:29472119

Beck LA, Thaçi D, Hamilton JD, Graham NM, Bieber T, Rocklin R, et al. Dupilumab treatment in adults with moderateto-severe atopic dermatitis. N Engl J Med. 2014;371(2):130-9. https://doi.org/10.1056/nejmoa1314768

Kidd P. Th1/Th2 balance: The hypothesis, its limitations, and implications for health and disease. Altern Med Rev. 2003;8(3):223-46. PMid:12946237

Balkwill FR. The Cytokine Network. Oxford: Oxford University Press; 2000. Available from: https://www.books.google.com.vc/books?id=8tdCmwEACAAJ. [Last accessed on 2020 Aug 07].

Wollenberg A, Barbarot S, Bieber T, Christen-Zaech S, Deleuran M, Fink-Wagner A, et al. Consensus-based European guidelines for treatment of atopic eczema (atopic dermatitis) in adults and children: Part I. J Eur Acad Dermatol Venereol. 2018;32(5):657-82. https://doi.org/10.1111/jdv.14891 PMid:29676534

Asher MI, Montefort S, Björkstén B, Lai CK, Strachan DP, Weiland SK, et al. Worldwide time trends in the prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and eczema in childhood: ISAAC Phases One and Three repeat multicountry cross-sectional surveys. Lancet (London, England). 2006;368(9537):733-43. https://doi.org/10.1016/s0140-6736(06)69283-0 PMid:16935684

Kapur S, Watson W, Carr S. Atopic dermatitis. Allergy Asthma Clin Immunol. 2018;14(2):52. https://doi.org/10.1186/s13223-018-0281-6 PMid:30275844

Koszorú K, Borza J, Gulácsi L, Sárdy M. Quality of life in patients with atopic dermatitis. Cutis. 2019;104(3):174-7. PMid:31675393

Price KN, Frew JW, Hsiao JL, Shi VY. COVID-19 and immunomodulator/immunosuppressant use in dermatology. J Am Acad Dermatol. 2020;82(5):e173-5. PMid:32224277

Krakowski AC, Eichenfield LF, Dohil MA. Management of atopic dermatitis in the pediatric population. Pediatrics. 2008;122(4):812-24. https://doi.org/10.1542/peds.2007-2232 PMid:18829806

Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, Wolff K. Fitzpatrick’s Dermatology in General Medicine. 8th ed. New York: McGraw-Hill; 2012. p. 165-7. https://doi.org/10.1111/j.1524-4725.2008.34211.x

Boguniewicz M, Fonacier L, Leung DY. Atopic and Contact Dermatitis: Clinical Immunology. 5th ed. Netherland: Elsevier Ltd.; 2006. p. 611-24.

Tada J. Diagnostic standard for atopic dermatitis. JMAJ. 2002;45(4511):460-5l.

Hanifin JM, Rajla G. Diagnostic features of AD. Acta Dermatovener (Stockholm). 1980;92:44-7.

McKenna SP, Doward LC. Quality of life of children with atopic dermatitis and their families. Curr Opin Allergy Clin Immunol. 2008;8(3):228-31. PMid:18560297

Lifschitz C. The impact of atopic dermatitis on quality of life. Ann Nutr Metab. 2015;66(Suppl 1):34-40. PMid:25925339

Correale CE, Walker C, Murphy L, Craig TJ. Atopic dermatitis: A review of diagnosis and treatment. Am Fam Physician. 1999;60(4):1191-8, 1209-10. PMid:10507748

Manousaki D, Paternoster L, Standl M, Moffatt MF, Farrall M, Bouzigon E, et al. Vitamin D levels and susceptibility to asthma, elevated immunoglobulin E levels, and atopic dermatitis: A mendelian randomization study. PLoS Med. 2017;14(5):e1002294. https://doi.org/10.1371/journal.pmed.1002294 PMid:28486474

Martin MJ, Estravís M, García-Sánchez A, Dávila I, Isidoro- García M, Sanz C. Genetics and epigenetics of atopic dermatitis: An updated systematic review. Genes (Basel). 2020;11(4):442. https://doi.org/10.3390/genes11040442 PMid:32325630

Candi E, Schmidt R, Melino G. The cornified envelope: A model of cell death in the skin. Nat Rev Mol Cell Biol. 2005;6(4):328-40. https://doi.org/10.1038/nrm1619 PMid:15803139

Maliyar K, Sibbald C, Pope E, Gary Sibbald R. Diagnosis and management of atopic dermatitis: A review. Adv Skin Wound Care. 2018;31(12):538-50. https://doi.org/10.1097/01.asw.0000547414.38888.8d PMid:30475283

Fujii M. Current understanding of pathophysiological mechanisms of atopic dermatitis: Interactions among skin barrier dysfunction, immune abnormalities and pruritus. Biol Pharm Bull. 2020;43(1):12-9. https://doi.org/10.1248/bpb.b19-00088 PMid:31902917

Seltmann J, Roesner LM, von Hesler FW, Wittmann M, Werfel T. IL-33 impacts on the skin barrier by downregulating the expression of filaggrin. J Allergy Clin Immunol. 2015;135(6):1659-61.e4. https://doi.org/10.1016/j.jaci.2015.01.048 PMid:25863977

Mayba JN, Gooderham MJ. Review of atopic dermatitis and topical therapies. J Cutan Med Surg. 2017;21(3):227-36. https://doi.org/10.1177/1203475416685077 PMid:28300440

Katayama I, Aihara M, Ohya Y, Saeki H, Shimojo N, Shoji S, et al. Japanese guidelines for atopic dermatitis 2017. Allergol Int. 2017;66(2):230-47. https://doi.org/10.1016/j.alit.2016.12.003 PMid:28209325

Mollanazar NK, Smith PK, Yosipovitch G. Mediators of chronic pruritus in atopic dermatitis: Getting the itch out? Clin Rev Allergy Immunol. 2016;51(3):263-92. https://doi.org/10.1007/s12016-015-8488-5

Leung D, Boguniewicz M. Atopic dermatitis and allergic contact dermatitis. In: Middleton’s Allergy Essentials. amsterdam: Elsevier Inc.; 2017. p. 265-300. https://doi.org/10.1016/b978-0-323-37579-5.00011-8

Rich RR, Fleisher TA, Shearer WT, Schroeder HW Jr., Frew AJ. Clinical Immunology: Principles and Practice. 5th ed. Amsterdam, Netherlands: Elsevier; 2019.

Thaçi D, Simpson E, Deleuran M, Kataoka Y, Chen Z, Gadkari A, et al. Efficacy and safety of dupilumab monotherapy in adults with moderate-to-severe atopic dermatitis: A pooled analysis of two phase 3 randomized trials (LIBERTY AD SOLO 1 and LIBERTY AD SOLO 2). J Dermatol Sci. 2019;94(2):266-75. https://doi.org/10.1016/j.jdermsci.2019.02.002 PMid:31109652

Wenzel S, Ford L, Pearlman D, Spector S, Sher L, Skobieranda F, et al. Dupilumab in persistent asthma with elevated eosinophil levels. N Engl J Med. 2013;368(26):2455-66. https://doi.org/10.1056/nejmoa1304048 PMid:23688323

Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: A descriptive study. Lancet. 2020;395(10223):507-13. https://doi.org/10.1016/s0140-6736(20)30211-7 PMid:32007143

Li X, Geng M, Peng Y, Meng L, Lu S. Molecular immune pathogenesis and diagnosis of COVID-19. J Pharm Anal. 2020;10(2):102-8. PMid:32282863

World Health Organization. Timeline of WHO’s response to COVID-19. World Health Organ. 2020;1:1-27.

Lauer SA, Grantz KH, Bi Q, Jones FK, Zheng Q, Meredith HR, et al. The incubation period of coronavirus disease 2019 (CoVID-19) from publicly reported confirmed cases: Estimation and application. Ann Intern Med. 2020;172(9):577-82. https://doi.org/10.7326/m20-0504 PMid:32150748

Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus infected pneumonia in Wuhan, China. JAMA. 2020;323(11):1061-9. https://doi.org/10.1001/jama.2020.1585 PMid:32031570

Guo YR, Cao QD, Hong ZS, Tan YY, Chen SD, Jin HJ, et al. The origin, transmission and clinical therapies on coronavirus disease 2019 (COVID-19) outbreak an update on the status. Mil Med Res. 2020;7(1):11. https://doi.org/10.1186/s40779-020-00240-0

Meng X, Deng Y, Dai Z, Meng Z. COVID-19 and anosmia: A review based on up-to-date knowledge. Am J Otolaryngol. 2020;41(5):102581. https://doi.org/10.1016/j.amjoto.2020.102581 PMid:32563019

World Health Organization. Report of the WHO-China Joint Mission on Coronavirus Disease 2019 (COVID-19). WHOChina Jt Mission Coronavirus Disease. Geneva: World Health Organization; 2019. Available from: https://www.who.int/docs/ default-source/coronaviruse/who-china-joint-mission-on-covid- 19-final-report.pdf. [Last accessed on 2020 Aug 03]. https://doi.org/10.3410/f.737509210.793572110

Morawska L, Tang JW, Bahnfleth W, Bluyssen PM, Boerstra A, Buonanno G, et al. How can airborne transmission of COVID-19 indoors be minimised? Environ Int. 2020;142:105832. https://doi.org/10.1016/j.envint.2020.105832 PMid:32521345

Setti L, Passarini F, De Gennaro G, Barbieri P, Perrone MG, Borelli M, et al. Airborne transmission route of covid-19: Why 2 meters/6 feet of inter-personal distance could not be enough. Int J Environ Res Public Health. 2020;17(8):2932. https://doi.org/10.3390/ijerph17082932 PMid:32340347

Zhang H, Kang Z, Gong H, Xu D, Wang J, Li Z, et al. The Digestive System is a Potential Route of 2019-nCov Infection: A Bioinformatics Analysis Based on Single-Cell Transcriptomes. bioRxiv; 2020. Available from: http://www.biorxiv.org/content/early/2020/01/31/2020.01.30.927806.abstract. [Last accessed on 2020 Aug 03]. https://doi.org/10.1101/2020.01.30.927806

Xue X, Mi Z, Wang Z, Pang Z, Liu H, Zhang F. High expression of ACE2 on keratinocytes reveals skin as a potential target for SARS-CoV-2. J Invest Dermatol. 2020;1:1-5. https://doi.org/10.1016/j.jid.2020.05.087

Su S, Wong G, Shi W, Liu J, Lai AC, Zhou J, et al. Epidemiology, genetic recombination, and pathogenesis of coronaviruses. Trends Microbiol. 2016;24(6):490-502. PMid:27012512

Lu R, Zhao X, Li J, Niu P, Yang B, Wu H, et al. Genomic characterisation and epidemiology of 2019 novel coronavirus: Implications for virus origins and receptor binding. Lancet. 2020;395(10224):565-74. PMid:32007145

Tanonaka K, Marunouchi T. Angiotensin-converting enzyme 2. Folia Pharmacol Jpn. 2016;147(2):120-1. https://doi.org/10.1254/fpj.147.120

Perlman S, Netland J. Coronaviruses post-SARS: Update on replication and pathogenesis. Nat Rev Microbiol. 2009;7(6):439-50. https://doi.org/10.1038/nrmicro2147 PMid:19430490

Channappanavar R, Fehr AR, Vijay R, Mack M, Zhao J, Meyerholz DK, et al. Dysregulated Type I interferon and inflammatory monocyte-macrophage responses cause lethal pneumonia in SARS-CoV-infected mice. Cell Host Microbe. 2016;19(2):181-93. https://doi.org/10.1016/j.chom.2016.01.007 PMid:26867177

Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497-506. https://doi.org/10.1016/s0140-6736(20)30183-5

Li H, Liu SM, Yu XH, Tang SL, Tang CK. Coronavirus disease 2019 (COVID-19): Current status and future perspectives. Int J Antimicrob Agents. 2020;55(5):105951. https://doi.org/10.1016/j.ijantimicag.2020.105951 PMid:32234466

Chen G, Wu D, Guo W, Cao Y, Huang D, Wang H, et al. Clinical and immunological features of severe and moderate coronavirus disease 2019. J Clin Invest. 2020;130(5):2620-9. PMid:32217835

Gao Y, Li T, Han M, Li X, Wu D, Xu Y, et al. Diagnostic utility of clinical laboratory data determinations for patients with the severe COVID-19. J Med Virol. 2020;92(7):791-6. https://doi.org/10.1002/jmv.25770 PMid:32181911

Ruan Q, Yang K, Wang W, Jiang L, Song J. Clinical predictors of mortality due to COVID-19 based on an analysis of data of 150 patients from Wuhan, China. Intensive Care Med. 2020;46:846-8. https://doi.org/10.1007/s00134-020-05991-x PMid:32125452

Patruno C, Nisticò SP, Fabbrocini G, Napolitano M. COVID-19, quarantine, and atopic dermatitis. Med Hypotheses. 2020;143(1):109852. https://doi.org/10.1016/j.mehy.2020.109852 PMid:32447099

Wollenberg A, Flohr C, Simon D, Cork MJ, Thyssen JP, Bieber T, et al. European Task Force on Atopic Dermatitis statement on severe acute respiratory syndrome coronavirus 2 (SARSCov-2) infection and atopic dermatitis. J Eur Acad Dermatology Venereol. 2020;34(6):e241-2. https://doi.org/10.1111/jdv.16411 PMid:32223003

Napolitano M, Patruno C, Ruggiero A, Nocerino M, Fabbrocini G. Safety of dupilumab in atopic patients during COVID-19 outbreak. J Dermatolog Treat. 2020;1:1-2. https://doi.org/10.1080/09546634.2020.1771257

Georgakopoulos JR, Yeung J. Patient-driven discontinuation of dupilumab during the COVID-19 pandemic in two academic hospital clinics at the University of Toronto. J Cutan Med Surg. 2020;1:1-2. https://doi.org/10.1177/1203475420930223

Lafaille JJ. The role of helper T cell subsets in autoimmune diseases. Cytokine Growth Factor Rev. 1998;9(2):139-51. https://doi.org/10.1016/s1359-6101(98)00009-4 PMid:9754708

Hamilton JD, Suárez-Fariñas M, Dhingra N, Cardinale I, Li X, Kostic A, et al. Dupilumab improves the molecular signature in skin of patients with moderate-to-severe atopic dermatitis. J Allergy Clin Immunol. 2014;134(6):1293-300. https://doi.org/10.1016/j.jaci.2014.10.013 PMid:25482871

Patruno C, Stingeni L, Fabbrocini G, Hansel K, Napolitano M. Dupilumab and COVID-19: What should we expect? Dermatol Ther. 2020;33(4):13502. https://doi.org/10.1111/dth.13502

Nicolson KS, Streeter HB, Verhagen J, Sabatos-peyton CA, Morgan DJ, Wraith DC. Negative feedback control of the autoimmune response through antigen-induced differentiation of IL-10-secreting Th1 cells. J Exp Med. 2009;206(8):1755-67. https://doi.org/10.1084/jem.20082118 PMid:19635862

Fowler DH. Th1/Th2 and Tc1/Tc2 cells: Experimental models and clinical translation. J Allergy Clin Immunol. 2001;107(2):337-44.

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Published

2020-10-26

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1.
Kosasih LP. The Use of Dupilumab in Atopic Dermatitis During Coronavirus Disease-19 Era – A Review. Open Access Maced J Med Sci [Internet]. 2020 Oct. 26 [cited 2024 Nov. 21];8(T1):399-407. Available from: https://oamjms.eu/index.php/mjms/article/view/5359