Dupilumab (anti-IL-4Rα) for moderate-to-severe atopic dermatitis achieves remission by blocking which specific cytokines?

• A IL-5 and IL-13 only
• B IL-31 and IL-33 from keratinocytes and ILC2
• C TSLP and IL-25 produced by damaged epithelium
• D IL-4 and IL-13 simultaneously (shared IL-4Rα subunit) ✓

Explanation

Dupilumab is a human IgG4 monoclonal antibody that binds the IL-4 receptor alpha (IL-4Rα) subunit, which is shared between the Type I receptor (IL-4Rα + γc chain, signals in hematopoietic cells) and Type II receptor (IL-4Rα + IL-13Rα1, signals in non-hematopoietic cells). Blocking IL-4Rα simultaneously prevents both IL-4 and IL-13 signaling — the central Th2 cytokines driving atopic dermatitis. This single antibody thus inhibits two cytokines with one target. IL-5 is targeted by mepolizumab (eosinophilic conditions). IL-31 (pruritus cytokine) is targeted by nemolizumab. TSLP is targeted by tezepelumab. Dupilumab is also approved for prurigo nodularis, eosinophilic esophagitis, and asthma.

Reference: Neena Khanna Illustrated Synopsis of Dermatology & STD, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.