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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Dupilumab for Atopic Dermatitis, a Possible Risk Factor of Juvenile Ischemic Stroke: A Case Report
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Dupilumab for Atopic Dermatitis, a Possible Risk Factor of Juvenile Ischemic Stroke: A Case Report

机译：Dupilumab用于特应性皮炎，少年缺血性卒中可能的危险因素：案例报告

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摘要

Dupilumab, a dual inhibitor of IL-4 and IL-13 cytokine signaling, is indicated for the treatment of moderate-to-severe atopic dermatitis, which leads to the control of atopic dermatitis. The cytokines IL-4 and IL-13 are related to vascular inflammation, which is mediated by vascular endothelial cells. We report the case of a 20-year-old man with atopic dermatitis treated with dupilumab for half a year, who presented with sudden onset of dizziness, nausea, and slight cerebellar ataxia. Brain magnetic resonance imaging revealed acute infarction in the bicerebellar hemispheres. No risk factors known to be associated with ischemic stroke in young adults were detected. We suspected this ische-mic stroke might be related to dupilumab. The administration of dupilumab was discon-tinued, and he had no recurrence subsequently. IL-4 and IL-13, anti-inflammatory cytokines secreted from T helper 2 cells, suppress proinflammatory cytokines. Therefore, dupilumab, a dual inhibitor of IL-4 and IL-13 cytokine signaling, leads to the promotion of coagulation and thrombosis. We speculate that the activation of proinflammatory cytokines in vascular endothelial cells by the inhibition of IL-4 and IL-13 signaling by dupilumab led to ischemic stroke even at a young age.
机译：Dupilumab是一种IL-4和IL-13细胞因子信号的双重抑制剂，用于治疗中重度特应性皮炎，从而控制特应性皮炎。细胞因子IL-4和IL-13与血管炎症有关，血管炎症由血管内皮细胞介导。我们报告一例20岁男性特应性皮炎患者，接受杜匹单抗治疗半年，突然出现头晕、恶心和轻度小脑共济失调。脑磁共振成像显示双小脑半球有急性梗死。未检测到已知与年轻人缺血性中风相关的危险因素。我们怀疑这种ische-mic中风可能与杜匹单抗有关。dupilumab的给药中断，随后没有复发。辅助性T细胞2分泌的抗炎细胞因子IL-4和IL-13可抑制促炎细胞因子。因此，dupilumab是IL-4和IL-13细胞因子信号传导的双重抑制剂，可促进凝血和血栓形成。我们推测，dupilumab通过抑制IL-4和IL-13信号而激活血管内皮细胞中的促炎细胞因子，即使在年轻时也会导致缺血性中风。

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