Which medications in the drug class Oral immunosuppressive agents are used in the treatment of Atopic Dermatitis in Emergency Medicine?

Updated: Apr 26, 2021
  • Author: Cassandra Bradby, MD; Chief Editor: Barry E Brenner, MD, PhD, FACEP  more...
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Answer

Oral immunosuppressive agents

Oral immunosuppressive agents are for use in severe refractory atopic dermatitis.

Cyclosporine (Neoral, Sandimmune)

Cyclosporine is an 11-amino acid cyclic peptide and a natural product of fungi. It acts on T-cell replication and activity. Cyclosporine is a specific modulator of T-cell function and an agent that depresses cell-mediated immune responses by inhibiting helper T-cell function. Preferential and reversible inhibition of T lymphocytes in the G0 or G1 phase of cell cycle is suggested. It binds to cyclophilin, an intracellular protein, which, in turn, prevents the formation of interleukin 2 and the subsequent recruitment of activated T cells.

Cyclosporine has about 30% bioavailability, but there is marked interindividual variability. It specifically inhibits T-lymphocyte function with minimal activity against B cells. Maximum suppression of T-lymphocyte proliferation requires that the drug be present during first 24 hours of antigenic exposure.

Cyclosporine suppresses some humoral immunity and, to a greater extent, cell-mediated immune reactions (eg, delayed hypersensitivity, allograft rejection, experimental allergic encephalomyelitis, and graft vs host disease) for a variety of organs.


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