자료유형  

 학위논문

Control Number  

0016931393

International Standard Book Number  

9798379965068

Dewey Decimal Classification Number  

610

Main Entry-Personal Name  

Singh, Katelyn.

Publication, Distribution, etc. (Imprint  

[S.l.] : Yale University., 2023

Publication, Distribution, etc. (Imprint  

Ann Arbor : ProQuest Dissertations & Theses, 2023

Physical Description  

1 online resource(47 p.)

General Note  

Source: Dissertations Abstracts International, Volume: 85-02, Section: B.

General Note  

Advisor: Damsky, William.

Dissertation Note  

Thesis (M.D.)--Yale University, 2023.

Restrictions on Access Note  

This item must not be sold to any third party vendors.

Summary, Etc.  

요약Dupilumab, a monoclonal antibody that inhibits IL4 and IL13, has revolutionized the treatment of atopic dermatitis (AD). However, not all patients respond optimally, and this may relate to underlying molecular heterogeneity. Yet, clinically useful and accessible methods to assess such heterogeneity have not been developed. Additionally, As the number of targeted medications continues to expand, the choice of which specific therapy to initiate in any individual patient will become increasingly difficult. Currently, there are no biomarkers that can be used to guide treatment selection in common inflammatory diseases such as atopic dermatitis (AD) and psoriasis. This study aims to determine whether cytokine staining and/or histologic features correlate with clinical response to dupilumab in patients with eczematous dermatitis. We retrospectively analyzed biopsies from 61 patients with eczematous dermatitis treated with dupilumab. RNA in situ hybridization (RISH) was used to measure markers of Type 2 (IL4, IL13), Type 1 (IFNG) and Type 3 (IL17A, IL17F, IL22) inflammation. Histologic features were also assessed. Patterns were compared among complete (n=16), partial (n=37), and non-responders (n=8) to dupilumab. We found that increased IL13 expression was associated with optimal response to dupilumab. In contrast, non-responders tended to express less IL13 and relatively greater levels of Type 1 and 3 cytokines. Histologically, non-responders tended to have increased levels of spongiosis, acanthosis, and epidermal inflammation. Overall, these findings suggest that cytokine profiles determined by RISH may aid in treatment selection for eczematous disorders and imply that tissue-based biomarkers may be useful in the personalization of the treatment of inflammatory skin disease.

Subject Added Entry-Topical Term  

Medicine.

Subject Added Entry-Topical Term  

Immunology.

Index Term-Uncontrolled  

Atopic dermatitis

Index Term-Uncontrolled  

Cytokines

Index Term-Uncontrolled  

Dupilumab

Index Term-Uncontrolled  

Eczema

Index Term-Uncontrolled  

RNA

Added Entry-Corporate Name  

Yale University Yale School of Medicine

Host Item Entry  

Dissertations Abstracts International. 85-02B.

Host Item Entry  

Dissertation Abstract International

Electronic Location and Access  

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Control Number  

joongbu:642169