Topical calcineurin inhibitors, pimecrolimus and tacrolimus
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Date
2007
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Abstract
Pinecrolimus and tacrolimus represent the first members of a new class of medications, calcineurin inhibitors. These topical macrolide immunomodulators have been successfully introduced in the treatment of atopic dermatitis. They inhibit T cell proliferation, mast cell degranulation, production and release of IL-2, IL-4, IF-γ and TNF-αa. They do not effect endothelial cells and fibroblasts, so they do not induce skin atrophy. In several studies, it has been shown that topical pimecrolimus and tacrolimus are effective, well tolerated and safe in both adults and children with atopic dermatitis. Picmecrolimus permeates less through the skin than tacrolimus and much lessthan corticosteroids. It has a lower potential for transcutaneous absorption resulting in a lower risk of systemic effects. In addition, they have been used in other inflammatory skin diseases including psoriasis, lichen planus, seborrheic dermatitis, allergic contact dermatitis, vitiligo, pyoderma gangrenosum, alopecia areata, graft versus host disease, akne rosacea, etc. In this review article mechanism of action, efficacy, safety of pimecrolimus and tacrolimus, and future directions of these immunomodulators were discussed. © 2007 Bentham Science Publishers Ltd.
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antiinflammatory agent , ascomycin , azathioprine , betamethasone , betamethasone valerate , calcineurin inhibitor , calcipotriol , clobetasol propionate , corticosteroid , cyclosporin , cyclosporin A , drug vehicle , emollient agent , gamma interferon , hydrocortisone acetate , interleukin 2 , interleukin 4 , macrolide , pimecrolimus , placebo , psoralen , steroid , tacrolimus , triamcinolone acetonide , tumor necrosis factor alpha , alopecia areata , atopic dermatitis , bacterial infection , bronchitis , clinical trial , Cushing syndrome , cytokine production , cytokine release , diaper dermatitis , drug efficacy , drug fever , drug mechanism , drug penetration , drug safety , drug synthesis , drug tolerability , drug withdrawal , ear infection , endocrine disease , endothelium cell , fibroblast , graft versus host reaction , herpes simplex , human , injection site burning , injection site erythema , injection site reaction , lichen planus , lymphocyte proliferation , lymphoma , mast cell degranulation , melanoma , molluscum contagiosum , mycosis , nonhuman , photoallergy , phototoxicity , pruritus , psoriasis , pyoderma gangrenosum , review , rhinopharyngitis , rosacea , seborrheic dermatitis , skin allergy , skin atrophy , skin cancer , skin infection , skin inflammation , skin irritation , skin papilloma , T lymphocyte , tinea cruris , upper respiratory tract infection , virus infection , vitiligo