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Aryl Hydrocarbon Receptor Treatments for PP


Lauren Miller, MPAS, and Tj Chao, MPAS, discuss new treatments for plaque psoriasis (PP) and their mechanisms of action.


Lauren Miller, MPAS, PA-C: Speaking specifically about topical therapy, we have some newer therapeutic options and mechanisms of action. Two came out last year relatively close together. I’d be very surprised—because you see so many patients with psoriasis—if you don’t have experience with these. Let’s talk specifically about aryl hydrocarbon receptors. What are they, and how can they play into therapeutic options for patients with plaque psoriasis?

TJ Chao, MPAS, PA-C: Speaking specifically about tapinarof, I’ve had over 100 patients who I’ve prescribed that product to. I’ve seen it help drive improvements in the disease. If you look at the mechanism of action of tapinarof, essentially it binds to the aryl hydrocarbon receptor and drives through gene transcription normalcy of the cell. You’re trying to get it to homeostasis and not allow those pathogenic cytokines to occur, like T helper 17 releasing pathogenic IL-17 cytokines.

Lauren Miller, MPAS, PA-C: Specifically, it’s interesting that aryl hydrocarbon receptor is something we’ve never heard of before. That’s novel. In this instance, tapinarof specifically, is an agonist. That’s something that we haven’t heard of either. Everything else we have is inhibitory or a blocker. That’s a novelty, and that’s very important. It probably plays into its efficacy and its safety. But 1 of the interesting things about aryl hydrocarbon receptors is that they’re found throughout the body in different areas, not just the skin. It’s very ligand specific. Depending on what it binds to and where it is in the body is going to determine what the effect is. Specifically, we’re talking about the skin, but it’s interesting to note that it’s also in other areas of the body too.

Transcript edited for clarity.

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