Academic Journal
Reduced conjunctival goblet cells and altered tear film stability predispose atopic dermatitis patients to develop dupilumab-associated ocular surface disease and show a Th1/innate immune response in tear fluid.
| Τίτλος: | Reduced conjunctival goblet cells and altered tear film stability predispose atopic dermatitis patients to develop dupilumab-associated ocular surface disease and show a Th1/innate immune response in tear fluid. |
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| Συγγραφείς: | Cho YT; Department of Dermatology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan., Chan TC; Department of Dermatology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan., Chen WL; Department of Ophthalmology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan., Chu HS; Department of Ophthalmology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan. Electronic address: hschu818@ntu.edu.tw., Chu CY; Department of Dermatology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan. Electronic address: chiayu@ntu.edu.tw. |
| Πηγή: | Allergology international : official journal of the Japanese Society of Allergology [Allergol Int] 2026 Oct; Vol. 75 (4), pp. 602-611. Date of Electronic Publication: 2026 Jun 11. |
| Τύπος έκδοσης: | Journal Article; Observational Study |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Elsevier Country of Publication: England NLM ID: 9616296 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1440-1592 (Electronic) Linking ISSN: 13238930 NLM ISO Abbreviation: Allergol Int Subsets: MEDLINE |
| Imprint Name(s): | Publication: 2015- : London : Elsevier Original Publication: Carlton, Vic., Australia : Blackwell Science, c1996- |
| Ιατρικοί όροι (MeSH): | Dermatitis, Atopic*/drug therapy , Dermatitis, Atopic*/immunology , Dermatitis, Atopic*/complications , Dermatitis, Atopic*/pathology , Tears*/immunology , Tears*/metabolism , Antibodies, Monoclonal, Humanized*/adverse effects , Antibodies, Monoclonal, Humanized*/therapeutic use , Goblet Cells*/pathology , Goblet Cells*/immunology , Th1 Cells*/immunology , Conjunctiva*/pathology , Conjunctiva*/immunology , Immunity, Innate*, Humans ; Female ; Male ; Adult ; Middle Aged |
| Περίληψη: | Background: Atopic dermatitis (AD) is often associated with ocular surface disease (OSD). Dupilumab, an IL-4Rα inhibitor, is an effective treatment for AD but it sometimes induces dupilumab-associated OSD (DAOSD). DAOSD may associate with a paucity of conjunctival goblet cells or altered immune response; however, the mechanism remains undetermined. Therefore, we aimed to identify ophthalmological alterations and to explore the potential mechanisms of DAOSD in AD patients receiving dupilumab. Methods: We conducted a prospective, single-arm, observational study with 50 moderate-to-severe AD patients receiving dupilumab for 24 weeks. We performed ophthalmological evaluations, conjunctival impression cytology analysis, and tear fluid profiling at baseline, weeks 4, 12, and 24. Results: Clinical severity scores of AD indicated significant improvement with dupilumab. At baseline, 18% of patients already exhibited OSD. During the study period, DAOSD ever occurred in 46% of patients, and it was mild and controllable by topical anti-inflammatory drops. AD patients with reduced conjunctival goblet cells at baseline had significantly a lower level of BDNF and higher levels of VEGF-A, PDGF-BB, and MCP-1 in tears. Patients with DAOSD had higher residual AD severity at weeks 12 and 24. Elevated levels of IL-9, IL-16, and GM-CSF in tears were specific for new onset DAOSD, indicating a shift toward Th1/9 and innate immune activation. Conclusions: DAOSD is common but transient in AD patients receiving dupilumab. Its underlying mechanisms may involve pre-existing goblet cell deficiency, changes in tear composition, and an altered inflammatory profile. Timely ophthalmic intervention may mitigate the damage and symptoms associated with related complications. (Copyright © 2026 Japanese Society of Allergology. Published by Elsevier B.V. All rights reserved.) |
| Competing Interests: | Conflict of interest YTC and TCC have served as sub investigators for AbbVie, Amgen, Dermira, Janssen, Eli Lilly, Novartis, Oneness Biotech, Pfizer, Regeneron, and Sanofi. YTC has received speaker fees from Sanofi, Eli Lilly, AbbVie, Pfizer, Viatris, Roche, and Novartis. CYC has served as an investigator for AbbVie, Amgen, Dermira, Janssen, Eli Lilly, Novartis, Oneness Biotech, Pfizer, Regeneron, Roche, and Sanofi; a consultant/advisory board member for AbbVie, Amgen, Eli Lilly, Novartis, Pfizer, Roche, Sanofi, and Viatris; and has received speaker fees from AbbVie, Eli Lilly, Janssen, Novartis, Pfizer, Roche, Sanofi, and Viatris. The rest of the authors have no conflict of interest. |
| Contributed Indexing: | Keywords: Atopic dermatitis; Conjunctiva; Dupilumab; Ocular surface disease; Tears |
| Substance Nomenclature: | 420K487FSG (dupilumab) 0 (Antibodies, Monoclonal, Humanized) |
| Entry Date(s): | Date Created: 20260611 Date Completed: 20260930 Latest Revision: 20260930 |
| Update Code: | 20261001 |
| DOI: | 10.1016/j.alit.2026.04.009 |
| PMID: | 42276866 |
| Βάση Δεδομένων: | MEDLINE |
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