Clinical Application of Nonantibiotic Macrolides for Inflammation-Driven Immune Dysfunction in Inflammatory Skin Diseases

The document discussed the development and clinical application of nonantibiotic macrolides, such as pimecrolimus and tacrolimus, for treating inflammatory skin diseases. These macrolides exhibited anti-inflammatory properties by inhibiting calcineurin and reducing cytokine production, which opened new treatment avenues with minimal side effects. Pimecrolimus showed efficacy in conditions like atopic dermatitis, psoriasis, and oral lichen planus, while tacrolimus was beneficial for vitiligo and Behçet's disease. However, pimecrolimus was less effective for chronic autoimmune urticaria and alopecia areata. New macrolides like CSY0073, EM900, and EM911 demonstrated potential in preclinical studies, indicating promising future applications.