Frontiers in Immunology (Aug 2023)

Dupilumab improve acquired reactive perforating collagenosis characterized by type 2 inflammation

  • Ben Liu,
  • Yibei Wu,
  • Xiaoyan Wu,
  • Xinyu Zhong,
  • Ruzeng Xue,
  • Zhenying Zhang

DOI
https://doi.org/10.3389/fimmu.2023.1240262
Journal volume & issue
Vol. 14

Abstract

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BackgroundAcquired reactive perforating collagenosis (ARPC) is a clinically challenging disease with an unclear pathogenesis.ObjectiveTo evaluate the efficacy and safety of dupilumab for the treatment of ARPC, and analyze the expression of type 2 inflammation-related molecules in ARPC lesions.MethodsThis retrospective cohort study included 20 patients with ARPC; 10 received dupilumab and 10 received conventional therapy. The efficacy and safety of dupilumab were evaluated at 12 weeks. Immunohistochemical and immunofluorescence analyses of T- and B-cell markers, and type 2 inflammation-related cytokines, were performed on skin samples from ARPC patients, atopic dermatitis (AD) patients, and healthy controls.ResultsSignificantly more patients showed improvements in the Investigator Global Assessment score (100% vs. 0%; p < 0.0001) and itching (90%/8.33%, P =.001) in the dupilumab group compared to the conventional group at 12 weeks. There were no adverse effects in the dupilumab group. The ARPC lesions showed enhanced dermal infiltration of CD3+ T-cells, with a predominance of Th2 cells, similar to AD lesions. IL-4 and IL-13 were co-localized with GATA3 in ARPC lesions.ConclusionDupilumab improved ARPC charaterized with type 2 inflammation.

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