A Potential Role for miRNAs in Topical Drug Development
February 2013 | Volume 12 | Issue 2 | Editorials | 152 | Copyright © 2013
Joshua W. Hagen MD PhDa and William R. Levis MDb
aDepartment of Medicine, New York Downtown Hospital, New York, NY bDepartment of Dermatology, New York University, New York, NY
No abstract available
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MicroRNAs (miRNAs) are small, noncoding regulatory RNAs demonstrated to play a role in regulating diverse physiologic and pathologic processes in humans. The understanding of their role in dermatologic disorders has been rapidly expanding, and technological advances in the field of small RNA therapeutics have provided a window into the possibilities for using our understanding of miRNA activities as a stepping-stone to treating a variety of skin diseases. The topical immunomodulator diphenylcyclopropenone (DPCP) has been used for the treatment of skin cancers and alopecia areata and represents one of many drug targets with potential for manipulation of miRNA pathways to enhance clinical efficacy. By exploring the miRNA pathways involved in specific skin diseases and the miRNAs impacted by drug treatments, investigators will discover new ways to treat skin disease and improve preexisting therapies.
MicroRNAs (miRNAs) have recently emerged as a family of important regulatory molecules with far-reaching implications for the practice of medicine, especially with regard to our understanding of disease pathogenesis, improved diagnostics, and potential for new therapeutics. Numerous publications have revealed roles for miRNAs in many aspects of dermatology,1 raising the issue of the potential for modulating miRNA activity in dermatologic diseases as an effective means of treatment, especially using topically delivered preparations. The field of topical delivery of small RNA therapeutics remains in its infancy, but significant advances have been made that promise future benefits for the field of dermatology. The most advanced of these are efforts to bring topical small interfering RNA–based treatments into clinical use for the autosomal dominant, keratinopathic pachyonychia congenita (PC)2-4 as well as for reducing pigmentation in melasma.5 Employing technology ranging from creams to cell-penetrating peptides to microneedle arrays, there is great potential for targeted delivery of small RNA therapeutics, including miRNAs.
Diphenylcyclopropenone (DPCP) is a compound that has been used to treat skin cancers such as metastatic melanoma (MM)6,7 as well as the autoimmune disease alopecia areata (AA).8-10 In both cases, the treatment works in approximately half of patients and fails to work in the second half. Immunologically, it is likely that different mechanisms or pathways are involved in how DPCP works against cancer, where upregulation of CD8 killing is desirable, whereas for AA downregulation of CD8 activity is likely required. A DPCP gel formulation is currently in clinical trials as a measure of immunocompetence in human immunodeficiency virus–positive subjects11 as well as for a treatment for warts, melanoma, and pending for AA (ongoing trials, W.L.R., 2012). Study of the molecular mechanisms, including changes in miRNA regulation, by which DPCP achieves therapeutic effect is important,12,13 as it is theoretically possible to improve the efficacy for cancer and autoimmune disease by manipulating topically the specific pathways that work in parallel to, and/or synergize with, the mechanisms of DPCP. Taking advantage of the growing collective data set on the roles of miRNAs in skin diseases and the rapidly advancing drug delivery technology available today, treatments such as DPCP and many others like it represent candidates for studies investigating how concurrent modulation of miRNA activity influences therapeutic efficacy.
DisclosuresDr. Levis is an advisor for Hapten Pharmaceuticals in the development of a DPCP gel formulation. Dr. Hagen has no relevant conflicts of interest to disclose.
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- Ohlmeier MC, Traupe H, Luger TA, Böhm M. Topical immunotherapy with diphenylcyclopropenone of patients with alopecia areata-a large retrospective study on 142 patients with a self-controlled design. J Eur Acad Dermatol Venereol. 2012;26(4):503-507.
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William R. Levis MD