How Do Topical Immunosuppressive Agents Work?

Reviewed on 5/19/2021

WHAT ARE TOPICAL IMMUNOSUPPRESSIVE AGENTS AND HOW DO THEY WORK?

Topical immunosuppressive agents are drugs that control or suppress the immune system and are used to treat inflammatory skin diseases.

Topical immunosuppressive agents work on both the immune system (by inhibiting pro-inflammatory cytokines) and the skin cells called “keratinocytes”.

  • On the immune system:
    • They bind to a receptor within the cell called FK binding proteins.
    • This results in a drug-protein complex that further inhibits calcineurin (a calcium-dependent phosphatase-transmitting chemical)
    • Inhibition of calcineurin, in turn, reduces the activity of T-lymphocytes in the immune system.
    • T-lymphocytes are responsible for killing infected host cells, activating other immune cells, producing cytokines, and regulating the immune response.
    • As a result, T-cells fail to release cytokines (chemicals that cause inflammation, redness, and itching).
  • On the skin cells:
    • They reduce the number of interleukin-8 (IL-8) cytokine receptors on the skin cells, thus reducing inflammation.
    • IL-8 is produced by various tissues and responsible for attracting and activation of neutrophils (white blood cells) at the site of inflammation.

Topical immunosuppressive agents work equally well for both adults and children with more than two-thirds of both groups having an improvement of greater than 50 percent.

Topical immunosuppressive agents should be applied on lesions (a thin layer rubbed in gently) two to three times a day until they subside.

HOW ARE TOPICAL IMMUNOSUPPRESSIVE AGENTS USED?

Skin conditions treated with topical immunosuppressive drugs include the following:

SLIDESHOW

Rosacea, Acne, Shingles, Covid-19 Rashes: Common Adult Skin Diseases See Slideshow

WHAT ARE SIDE EFFECTS OF TOPICAL IMMUNOSUPPRESSIVE AGENTS?

Avoid using in sensitive areas such as eyes and inside mouth/nose, and if you apply the medication in those areas, flush with plenty of water.

Common side effects include:

  • Burning/and or stinging
  • Dryness
  • Pruritis (itchy skin)
  • Soreness

Other rare side effects include:

Information contained herein is not intended to cover all possible side effects, precautions, warnings, drug interactions, allergic reactions, or adverse effects. Check with your doctor or pharmacist to make sure these drugs do not cause any harm when you take them along with other medicines. Never stop taking your medication and never change your dose or frequency without consulting your doctor.

WHAT ARE DRUG NAMES OF TOPICAL IMMUNOSUPPRESSIVE AGENTS?

Drug names include:                               

References
https://reference.medscape.com/drugs/immunosuppressive-agents-topical

https://dermnetnz.org/topics/tacrolimus/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3834721/

https://www.aafp.org/afp/2002/1115/p1899.html

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4837243/#:~:text=Introduction,immune%20response%20are%20in%20balance.

https://www.webmd.com/drugs/2/drug-20330/tacrolimus-topical/details#:~:text=This%20drug%20works%20by%20weakening,topical%20calcineurin%20inhibitors%20(TCIs).

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