RESUMO
Lichen planopilaris (LPP) is an inflammatory cicatricial alopecia for which many different therapies are attempted with varying success. The Janus kinase (JAK) inhibitor, tofacitinib, has been shown to be effective in treating the noncicatricial alopecia, alopecia areata. As in alopecia areata, upregulation of interferon and JAK signaling may play a role in LPP. We retrospectively reviewed the cases of 10 patients with recalcitrant LPP who were treated with oral tofacitinib. Patients received oral tofacitinib 5 mg twice or three times daily for 2-19 months as either monotherapy or adjunctive therapy to other ongoing treatments including intralesional triamcinolone, hydroxychloroquine, and tacrolimus ointment. Eight patients had clinical improvement in LPP with tofacitinib as either monotherapy (4/10) or adjunctive therapy (4/10). LPP Activity Index (LPPAI) before and after treatment was measured in seven patients and was significantly different (6.22 before treatment, 3.08 after treatment; p value = .0014). Reduction in LPPAI ranged from 30 to 94%. One patient complained of 10 pound (4.5 kg) weight gain after 12 months on tofacitinib. No other adverse effects were reported. Treatment with oral tofacitinib either as monotherapy or adjunctive therapy can lead to measurable improvement in recalcitrant LPP.
Assuntos
Alopecia/tratamento farmacológico , Fármacos Dermatológicos/administração & dosagem , Inibidores de Janus Quinases/administração & dosagem , Líquen Plano/tratamento farmacológico , Piperidinas/administração & dosagem , Pirimidinas/administração & dosagem , Pirróis/administração & dosagem , Dermatoses do Couro Cabeludo/tratamento farmacológico , Pele/efeitos dos fármacos , Administração Oral , Adulto , Idoso , Alopecia/diagnóstico , Alopecia/enzimologia , Fármacos Dermatológicos/efeitos adversos , Esquema de Medicação , Feminino , Humanos , Inibidores de Janus Quinases/efeitos adversos , Líquen Plano/diagnóstico , Líquen Plano/enzimologia , Masculino , Pessoa de Meia-Idade , Piperidinas/efeitos adversos , Pirimidinas/efeitos adversos , Pirróis/efeitos adversos , Indução de Remissão , Estudos Retrospectivos , Couro Cabeludo , Dermatoses do Couro Cabeludo/diagnóstico , Dermatoses do Couro Cabeludo/enzimologia , Pele/enzimologia , Pele/patologia , Fatores de Tempo , Resultado do TratamentoAssuntos
Neoplasias Meníngeas/complicações , Meningioma/complicações , Doenças do Nervo Trigêmeo/etiologia , Face , Humanos , Imageamento por Ressonância Magnética , Masculino , Neoplasias Meníngeas/diagnóstico , Meningioma/diagnóstico , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Úlcera/etiologiaRESUMO
Here, we report that inactivation of the Caenorhabditis elegans dynamin-related protein DRP-1, a key component responsible for mitochondrial fission and conserved from yeast to humans, dramatically enhanced the effect of reduced insulin signaling (IIS) to extend lifespan. This represents the first report of a beneficial impact of manipulating mitochondrial dynamics on animal lifespan and suggests that mitochondrial morphology and IIS cooperate to modulate aging.
