Dupilumab (REGN-668) is a systemic immunomodulator for AD. Dupilumab is a fully human monoclonal antibody against the alpha subunit of the interleukin-4 receptor, which inhibits downstream signaling of IL-4 and IL-13 and has been shown to improve atopic dermatitis.

Dupilumab inhibited mRNA expression of T cells, dc, eosinophils, inflammatory pathways and Th2-induced chemokine activation related genes in skin lesions, and showed no activity against IL-17A and significantly decreased IL-22 levels, but 300 mg Dupilumab significantly decreased the expression of IL-17-related genes. Such as elafin (PI3), IL23p19/IL23A and S100A8, and have inhibitory potential (CXCL1 and S100A7). Dupilumab (300 mg) inhibited hyperproliferation-related genes, such as K16, and decreased the expression of S100A, as measured by microarray and qRT-PCR.[1]

In human whole blood, dupilumab inhibits IL-4 and il-13 to stimulate thymus secretion and activates chemokine/chemokine C motif ligand 17 (TARC/CCL17). (Clinical biomarker for atopic dermatitis) with yarnamore potency (50% inhibition at 0.24 to 0.52 nM and 0.26 to 0.27 nM).[1]