Phosphodiesterase-4 Inhibition in Psoriasis.
Phosphodiesterase-4 Inhibition in Psoriasis.
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DOI：
10.2147/ptt.s303634
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发表时间：
2021
期刊：
影响因子：
--
通讯作者：
Gooderham MJ
中科院分区：
文献类型：
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作者：
Milakovic M;Gooderham MJ
牛皮癣是一种慢性免疫介导的炎症性疾病。磷酸二酯酶-4 （PDE-4）是一种介导炎症反应的酶，在银屑病的发病过程中起作用。PDE-4将其底物环磷酸腺苷（cAMP）降解为一磷酸腺苷（AMP），随后导致促炎介质的产生。PDE-4抑制剂通过阻断cAMP的降解而起作用，从而减少炎症。Apremilast是唯一被批准用于治疗银屑病的口服PDE-4抑制剂。虽然它对一些病人有效，但对另一些病人的副作用可能会限制它。一种局部PDE-4抑制剂罗氟米司特正在银屑病中进行研究，并显示出有希望的结果。Crisaborole是一种外用PDE-4抑制剂，已被批准用于特应性皮炎，也已被研究用于牛皮癣。这是一篇最新的综合综述，总结了PDE-4抑制剂阿普米司特、罗氟米司特和crisaborole治疗银屑病的现有证据，重点是随机临床试验的数据。
Psoriasis is a chronic immune-mediated inflammatory disorder. Phosphodiesterase-4 (PDE-4) is an enzyme that mediates inflammatory responses and plays a role in psoriasis pathogenesis. PDE-4 degrades its substrate cyclic adenosine monophosphate (cAMP) to adenosine monophosphate (AMP), which subsequently leads to the production of pro-inflammatory mediators. Inhibitors of PDE-4 work by blocking the degradation of cAMP, which leads to a reduction in inflammation. Apremilast is the only approved oral PDE-4 inhibitor for the treatment of psoriasis. While it is effective for some patients, it may be limited by adverse effects in others. A topical PDE-4 inhibitor, roflumilast, is being investigated in psoriasis and showing promising results. Crisaborole, a topical PDE-4 inhibitor approved for use in atopic dermatitis, has also been investigated in psoriasis. This is an updated comprehensive review to summarize the currently available evidence for the PDE-4 inhibitors apremilast, roflumilast and crisaborole in the treatment of psoriasis, with a focus on data from randomized clinical trials.