Transcript
Announcer:
You’re listening to DermConsult on ReachMD. On this episode, Dr. Brian Kim, Vice President and Chief Biotechnology Officer at Northwell Health and the Feinstein Institutes for Medical Research, will discuss current and emerging approaches to addressing itch in atopic dermatitis. Let’s hear from him now.
Dr. Kim:
Our understanding of itch biology has fundamentally changed our understanding of how therapeutics work, how they should work, and where we should go with alleviating itch. So the best therapies for itch and atopic dermatitis specifically block that connection between the immune and nervous system. That's unequivocal; those are the best therapies. They might hit the immune system itself to a degree, but what they're really good at doing is blocking the exact mediator or communication between the immune and nervous system. That's where molecules like IL-4, IL-13, IL-31, and JAK, Janus kinase, come in. All those therapies are very effective, whether they hit those inflammatory cytokines, the receptor, or downstream of that, enzymes like JAK. We know that. So it's really at that border or interface.
Where we want to go with this is that we could actually now think, are there ways we can hit those interfaces even better or in a multi-pronged fashion? Or can we get within the nervous system in a way that we can now really anesthetize the nerve specifically to those signals? And that's more where we want to go in the future.
Right now, I think where we're at is that in many ways, we can push these convenient buttons and improve a lot of patients with atopic dermatitis. That was not the reality I lived in 10 years ago; the reality back then was much more complicated. But a number of those realities still remain true. And I think what people forget—I used to say this a lot about atopic dermatitis—is that you're educating the patients on how to treat their disease, how to adapt to their disease, how to avoid triggers, and when to treat with what. That's less true today because it's just gotten as easy as just taking a pill or injecting for many. But it's really knowing what parts of their skin react to the environment, what things trigger it, how to alleviate it, These are the things that we used to teach a lot in atopic dermatitis and still remain true. I think we talk about it less because it's gotten easier. But it's really empowering the patient to be able to recognize their symptoms, their flares, their stressors, their triggers and all that. That's the most important thing, and then the treatments are really secondary to that.
One area that we think is going to be really important in the future is not just controlling itch, but controlling how the nervous system, now in turn in the other direction, regulates inflammation in atopic dermatitis. So we know that this inflammation triggers the nerves to become very activated, and we know that through itch. But we also know that a hyperactive nervous system not only causes more itch, but it also causes more inflammation directly, independent of even scratching. So I think that future therapies are going to be aimed at how to control that direction in terms of inflammation.
Announcer:
That was Dr. Brian Kim sharing insights on the future of treating itch in atopic dermatitis. To access this and other episodes in this series, visit DermConsult on ReachMD.com, where you can Be Part of the Knowledge. Thanks for listening!
