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    Research advances yield new treatments for skin disease


    In psoriasis, elucidation of the IL-12 and -23 pathways has driven the development of several new biologic drugs.

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    "Understanding the inflammatory and immunological pathways has led pharmaceutical companies to develop highly specific drugs that are beneficial and, so far, relatively safe." However, Dr. Katz says, one company had to halt development of an antibody that targeted the IL-17A pathway when the company identified an association with depression and suicide. This association is still being scrutinized, he says.

    "Five years ago," he adds, "metastatic melanoma was a death sentence. Nowadays, if we know the mutation in the metastatic melanoma, there are currently three drugs on the market that will interfere with certain transcriptional pathways such as the BRAF pathway and the MEK pathway. In addition, we have checkpoint inhibitors, which are humanized monoclonal antibodies used to enhance the immune response to melanoma."

    Examples include anti-cytotoxic T-lymphocyte associated protein 4 (CTLA4), which enhances the presentation of tumor-associated antigens to T cells by dendritic cells. Similarly, anti-programmed cell death protein 1 (PD1) blocks the inhibition of T cells' killing of tumors, thereby enhancing the immune response, he says.

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    Thanks to combinations of drugs and monoclonal antibodies, he says, "We in medicine have been able to make outcomes for patients with melanoma a little brighter. People are living significantly longer than the six to 10 months that was previously typical after a diagnosis of metastatic melanoma."

    John Jesitus
    John Jesitus is a medical writer based in Westminster, CO.


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