Atopic dermatitis (AD) and eczema are chronic inflammatory skin diseases that affect millions of people worldwide.

They are characterized by symptoms such as itching, redness, and flaking of the skin which can significantly impact the quality of life of those affected. While there is no known cure for AD and eczema, there are various treatment options available, including topical steroids, immunomodulators, and biologics.

Targeted therapy for AD and eczema using monoclonal antibodies has recently emerged as a promising new treatment approach.

What are Monoclonal Antibodies?

Monoclonal antibodies (mAbs) are synthetic proteins designed to target specific molecules in the body’s immune or inflammatory response.

They are produced in a laboratory by cloning a single type of immune cell to create identical copies (or clones) of a single antibody. mAbs have been used to treat a variety of conditions including cancer, autoimmune diseases, and inflammatory disorders.

Why Use Monoclonal Antibodies for AD and Eczema?

The main advantage of using monoclonal antibodies for AD and eczema is their ability to target specific molecules involved in the inflammatory response.

Traditional therapies such as topical steroids and immunomodulators can have non-specific effects on the immune system, potentially causing unwanted side effects. In contrast, monoclonal antibodies can be designed to target specific molecules in the body while leaving healthy cells untouched, reducing the risk of adverse effects.

Examples of Monoclonal Antibodies Used in AD and Eczema

Currently, there are two monoclonal antibodies approved for the treatment of AD:.

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• Dupilumab: This mAb targets the interleukin-4 receptor alpha (IL-4Ra) on immune cells, blocking the signaling pathways that contribute to inflammation. Dupilumab has been shown to improve symptoms in patients with moderate to severe AD.
• Nemolizumab: This mAb targets the interleukin-31 receptor alpha (IL-31Ra), a molecule associated with itching in AD. Nemolizumab has been shown to significantly reduce itching in patients with moderate to severe AD.

Several other mAbs are currently under investigation for the treatment of AD and eczema, including:.

• Tralokinumab: This mAb targets the interleukin-13 (IL-13) pathway, which is also involved in inflammation and itching in AD.
• Lebrikizumab: This mAb targets the interleukin-13 (IL-13) pathway.
• Secukinumab: This mAb targets the interleukin-17 (IL-17) pathway, which is involved in the inflammatory response in many autoimmune and inflammatory disorders.

How are Monoclonal Antibodies Administered?

Monoclonal antibodies are typically administered via subcutaneous injection.

Dupilumab and Nemolizumab are currently approved for self-injection by patients at home, while other mAbs may require administration by a healthcare professional in a clinic or hospital setting.

Are There Any Side Effects to Monoclonal Antibody Therapy?

As with any medication, there is a risk of side effects with monoclonal antibody therapy. The most common side effects reported with dupilumab and nemolizumab include injection site reactions such as redness and itching.

Other potential side effects include eye problems such as conjunctivitis and increased risk of infections.

Conclusion

Targeted therapy for AD and eczema using monoclonal antibodies is an exciting new treatment approach that offers the potential for improved symptom control with fewer side effects.

While currently approved mAbs are limited, ongoing research into new candidates will likely expand the options available for patients with these chronic skin conditions.