Dermatitis, Atopic Clinical Trial
Official title:
A Phase 2, Exploratory Study to Investigate Safety and Efficacy of Doxycycline Monohydrate Hydrogel (NANODOX® HYDROGEL 1%) In Atopic Dermatitis
This study will investigate the safety and clinical efficacy of a novel doxycycline topical formulation in subjects with Atopic Dermatitis (AD). The investigators hypothesize that daily application of the study drug in AD subjects will reduce severity of the disease, by reducing skin driven inflammation and restoring skin barrier function. The investigators will also monitor the anti-microbial activity of this product on AD skin, as colonization with Staph aureus is typically associated with disease severity.
Atopic Dermatitis (AD) is the most common inflammatory skin disease, affecting about 17% of
children and 6% adults in the USA , . AD is characterized by skin barrier disruption, an
aberrant adaptive immune response (i.e., Th2 polarized) to environmental allergens,
susceptibility to cutaneous bacterial infections and intractable itch , . The intense
pruritus and cutaneous infections contribute to the morbidity of AD and are major drivers of
the reduced quality-of-life associated with this disease , . In the World Health Organization
2010 Global Burden of Disease survey, AD has ranked first among common skin diseases . So
far, AD treatments have targeted inflammation with the widespread use of topical and more
intermittent use of systemic corticosteroids. In summary, despite its high prevalence,
effects on quality-of-life and economic burden - there are few effective treatments for AD.
Doxycycline are tetracycline antibiotics broadly used systemically to treat
inflammatory-dermatologic conditions. Several studies in human and animal models have shown
doxycycline have anti-inflammatory and pro-healing properties, mainly by blocking tissue
proteolytic activity. Doxycycline have been reported to nonselectively inhibit members of the
metalloproteinases (MMP) superfamily [reviewed in , ]. In addition to this direct inhibitory
activity, doxycycline indirectly prevents tryptic kallikreins activation by MMPs . Growing
body of evidence suggests that the tetracycline might also directly downregulate Protease
Activator receptor (PAR)-2 expression and function, which was also found to play a role in
induction of local inflammatory mediators . Importantly, the doxycycline antimicrobial
activity could lead to reduced Staphylococcus infection/colonization in AD skin, a known
trigger of AD flares
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