Isosorbide-based fatty acid diesters, particularly isosorbide dicaprylate (IDC) and isosorbide di-linoleate/oleate (IDL), represent a novel dual-action therapeutic strategy for inflammatory skin diseases, most notably atopic dermatitis (AD). Preclinical studies using cytokine-induced keratinocyte models of AD demonstrate that IDC and IDL act synergistically to:
In addition, reduced secretion of lactate dehydrogenase (LDH) suggests decreased cellular stress and tissue damage, underscoring their cytoprotective potential. The LDH-lowering effect is particularly noteworthy in patients with elevated serum LDH, a group that often shows diminished long-term response to biologics such as Dupilumab (Dupixent).
Importantly, IDC and IDL leverage distinct signaling pathways to simultaneously enhance barrier resilience and mitigate both inflammatory and pruritic responses. This is highly relevant given the multifactorial nature of AD pathogenesis, which encompasses:
By restoring stratum corneum cohesion, normalizing transepidermal water loss (TEWL), and stabilizing skin surface pH, IDC and IDL address both the “outside-in” and “inside-out” mechanisms of AD. Their ability to deliver sustained barrier support alongside anti-inflammatory activity positions them as strong candidates for long-term, non-steroidal maintenance therapy.
Clinical data reinforces the therapeutic potential of IDC and IDL. In two randomized, double-blind, vehicle-controlled trials involving both pediatric and adult patients with mild-to-moderate AD, IDC+IDL formulations demonstrated:
| Parameters | Adults | Pediatrics (2 – 17 years old) |
|---|---|---|
| Skin Clearance | ||
| Itch Reduction | ||
| Reduce Topical Steroid Use | ||
| Reduce S. Aureus on the skin |
Future research directions include:
to other inflammatory dermatoses linked to barrier dysfunction, such as psoriasis and seborrheic dermatitis
of interactions with transcriptional regulators (NRF2, NF-κB, IRF1) and skin-resident immune cells
evaluating real-world effectiveness in diverse patient populations
CuralysMD, through its IDC and IDL components, introduces a new class of barrier-supportive, anti-inflammatory therapeutics for inflammatory skin disorders. With demonstrated efficacy in clinical trials, proven steroid-sparing benefits, and potential for microbiome normalization, IDC and IDL hold promise as cornerstone agents in the evolution of non-steroidal, long-term maintenance regimens for atopic dermatitis and beyond.
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CuralysMD Dermaceuticals
Middlesex, Monmouth, Ocean counties, NJ 07735
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