Conjunctival transcriptomic profile predicts dupilumab ocular adverse events ➜ DOI: 10.1016/j.jid.2024.08.024 DNA microarray analysis was used to compare the transcriptome of AD patients’ conjunctival cells collected before and 4 months after initiating dupilumab treatment. Interestingly, patients developing ocular adverse effects had both before and after treatment a similar transcriptome signature, characterized by the over-expression of several genes involved in epidermal keratinocyte differentiation.
Successful Use of Dupilumab in Atopic Dermatitis-Like Graft-Versus-Host Disease ➜ DOI: 10.1111/srt.70075 This case report confirms earlier observations concerning a recently described subset of GVDH, which is characterized by a highly pruritic rash, eosinophilia, and hyper IgE not responsive to the combination of systemic steroids and mycophenolate mofetil.
Neuroimmune communication: γδ T cells tune allergic itch ➜ DOI: 10.1038/s41586-024-07869-0 Given that a subset of atopic dermatitis patients fails dupilumab therapy but respond to JAK inhibitors, this paper published in a prestigious journal but based mostly on mouse work suggests that alternative pathways to IL-4Rα and JAK1, such as IL-3Rα and JAK2, could be new targets in atopic dermatitis and other itch disorders. Mechanistically, IL-3 acts on Il3ra-expressing sensory neurons in a JAK2-dependent manner to lower their threshold for allergen activation without independently eliciting itch. This γδ T cell–IL-3 signaling axis further acts by means of STAT5 to promote neuropeptide production and the initiation of allergic immunity.
Ceramide synthase 1 (CERS1) as a new biomarker of Staphylococcus aureus abundance and AD Severity ➜ DOI: 10.1016/j.jaci.2024.09.017 The link: increased S aureus carriage-defective skin barrier is not well explained in AD. This study highlights CERS1 as a unique molecular biomarker of cutaneous S. aureus abundance associated with AD severity, altered sphingolipid composition, and skin barrier dysfunction. It suggests that shorter chain sphingolipid composition may be related to CERS1 in an elongase-dependent manner.
Cutaneous T-Cell lymphoma and dupilumab use: new recommendations ➜ DOI: 10.1016/j.jid.2024.08.015 CTCL occurrence in dupilumab-treated patients is a rare but embarrassing event for clinicians. Most investigators think that dupilumab-associated CTCL may have been initially misdiagnosed as AD and that CTCL was unmasked rather than induced by dupilumab. Before starting dupilumab, the authors suggest ruling out systematically CTCL in patients with adult-onset AD (aged >40 years) with no previous history of atopy as well as in patients with atypical clinical features. A skin biopsy and a TCR clonality assay needs to be obtained. In cases of erythroderma or extensive lesions, peripheral blood flow cytometry and TCR clonality needs to be performed in combination with skin biopsies.
