Biologics, Volume 5, Issue 1 (March 2025) – 3 articles

Background: Dupilumab, a fully human monoclonal antibody targeting the interleukin (IL)-4/IL-13 pathway, is able to dampen T helper (Th)2-mediated inflammation in several conditions characterized by this particular type of phlogosis. The aim of this study was to review the efficacy and safety of dupilumab treatment in conditions underpinned by Th2-type inflammation in a cohort of real-world patients referred to our outpatient clinic. Methods: Data from all patients with atopic dermatitis, chronic rhinosinusitis with nasal polyps, asthma, and other Th2-type-mediated inflammatory conditions treated with dupilumab were retrospectively reviewed. Results: Twenty-two patients were included in the study: 14 with atopic dermatitis, 5 with chronic rhinosinusitis with nasal polyps, 2 with asthma, and 1 with prurigo nodularis; some of the patients had more than one atopic condition. A complete response was observed in 13 out of 22 patients (59.1%); when partial responses were included in the analysis, the overall response rate was 86.4%. No adverse events were recorded, either locally or systemically. Total IgE levels dropped in all patients, in some cases reaching values close to those typically observed in nonatopic subjects. When eosinophilia was present at baseline, this also normalized during dupilumab treatment. Conclusions: Dupilumab was safe and effective across multiple conditions driven by Th2-type chronic inflammation; effective interference with the Th2-type pathway was inferred by the progressive reduction in serum total IgE levels, which reached the normal range in a fraction of patients, and by the reduction in peripheral blood eosinophil counts. Further studies in different Th2-mediated diseases are warranted. Full article

Background/Objectives: Perilla frutescens has historically been used to protect against inflammation and redox stress. This has been partly attributed to its high polyphenolic content; however, polyphenolic components in Perilla extract remain incompletely defined. This study aimed to characterise the polyphenolic composition in Perilla extract and evaluate its effect on the transcription factor nuclear factor erythroid 2-related factor 2 (Nrf2), regulating antioxidant defenses during inflammation and oxidative stress. Methods: Hot water extraction from Perilla leaves was followed by fractionation using four solvents of different polarity, namely methanol, butanol, ethyl acetate and ether. The polyphenolic composition of these fractions was analysed using RP-HPLC, and some of these compounds were quantified. The total phenolic, flavonoid, and ortho-diphenolic contents of each Perilla fraction were determined. The antioxidant activity was assessed using metal cation reduction and radical scavenging assays. A dual-luciferase assay using a human NQO1 ARE-luciferase reporter plasmid was employed to quantify Nrf2 activation by the Perilla fractions. Results: HPLC analysis identified 35 polyphenolic compounds, with the highest phenolic content present in the polar fractions and rosmarinic acid being the major constituent. Radical scavenging tests (DPPH and ABTS) confirmed the highest antioxidant capacity in the polar fractions. On cells in vitro, the methanol Perilla fraction displayed the strongest antioxidant activity, showing up to a 1.5-fold increase in human NQO1 ARE-luciferase reporter induction. Conclusions: This study has shown that Perilla extract contains a diversity of polyphenolic compounds contributing to its potent antioxidant effects, with methanol and butanol being the most efficient extraction solvents. While rosmarinic acid is expected to be the major contributor towards providing protection against inflammation and redox stress, further work is required on the synergystic effects between different polyphenols. Full article

Psoriatic arthritis (PsA) is a systemic inflammatory condition affecting the joints, spine, and entheses, as well as the skin and nails. It affects about 6–42% of patients with psoriasis (PsO), with a prevalence of 1–2 per 1000. PsA can precede skin disease in 7–14% of patients. Different clinical domains may be involved, including psoriatic skin disease, peripheral arthritis, axial involvement, dactylitis, enthesitis, and nail disease. Psoriatic arthritis is a complex, systemic inflammatory condition. While the exact mechanisms underlying PsA are not fully understood, it is believed that the disease arises from a combination of genetic predisposition and environmental triggers that lead to inflammatory processes in both the skin and joints. The treatment approach for PsA focuses on controlling inflammation, improving symptoms, and preventing joint damage. Early initiation of treatment is crucial for achieving better functional outcomes. Various therapeutic agents are available that target different inflammatory pathways. In this review article, various treatment options, focusing on biologic and targeted synthetic disease-modifying antirheumatic drugs, are discussed. Full article