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J Christian Cather

Publications and source records attributed to J Christian Cather.

5 recordsLinked to original sources
PubMed2003

Modulating T cell responses for the treatment of psoriasis: a focus on efalizumab.

An improved understanding regarding the pathophysiology of psoriasis, coupled with advances in molecular research, has prompted the development of targeted biologic treatments for patients with plaque psoriasis. T lymphocytes play an important role in initiating the immune system and the inflammatory responses that result in the development and maintenance of psoriatic plaques. Efalizumab (anti-CD11a, Raptiva; Genentech, Inc.) is a mAb that targets the T cell adhesion molecule, leukocyte function-associated antigen-1 (LFA-1). By binding to CD11a - the alpha-subunit of LFA-1 - LFA-1 is prevented from binding with its ligand, intercellular adhesion molecule-1 (ICAM-1). This inhibits various T cell processes believed to be important in the pathogenesis of psoriasis, including T cell activation, T cell adhesion to endothelial cells and T cell migration. Clinical trials demonstrate that efalizumab, given subcutaneously once-weekly, provides clinical benefit, including improved quality of life, in patients with moderate-to-severe plaque psoriasis. Efalizumab is associated with an early onset of action, with improvement noted as early as 14 days. Studies with extended treatment suggest that continuing efalizumab therapy is more beneficial in maintaining and improving responses. Relapse of psoriasis is usually seen within 60 - 70 days after discontinuation of therapy, and rebound in approximately 5% of patients (i.e., flare to > 125% of baseline) is noted. Efalizumab is associated with acute adverse events during the first and second injections, which decrease in incidence with each subsequent injection. Data indicate that efalizumab can be safely administered for extended periods of time. Given the efficacy, early onset of clinical benefit, the safety profile and the convenience of once-weekly subcutaneous home dosing, efalizumab offers an interesting new therapeutic option for the treatment of psoriasis and the potential for improved and potentially safer long-term, continuous 'maintenance' therapy.

Animals↗
PubMed2002

Update on botulinum toxin for facial aesthetics.

The use of botulinum toxin has revolutionized the treatment of facial lines with an incomparable safety record over the past 14 years. The most common used injection sites are shown in Fig. 9. With the recent FDA approval for Botox in the treatment of glabellar lines, its use will likely increase dramatically. It is essential that practitioners have a detailed and specific knowledge of the facial and neck musculature to be injected to minimize untoward side effects, especially in the early days of new users' learning curve. The specifics of the dilutions and units per amount used for the various different commercial forms of botulinum toxin types A and B need to be understood fully and standardized together with the potential for antigenicity with the higher protein load of type B. In addition, specific indications for the use of botulinum toxin as adjunctive therapy for specific facial surgical procedures (i.e., blepharoplasty, surgical brow lift, and laser resurfacing) will become better understood. [figure: see text] Finally, even though the anatomy of the facial musculature is well described, individual differences in men and women, in different population groups, and in tissue qualities, such as turgor and elasticity [87], are important factors to be considered before undertaking botulinum toxin injections. It is likely that the use of specific measuring devices, such as digital imaging, will further help define the use of botulinum toxin for different muscle groups and facial aesthetic indications.

Botulinum Toxins, Type A↗