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Rehbinder EM, Wärnberg Gerdin S, Hoyer A, Bradley M, Lødrup Carlsen KC, Granum B, Hedlin G, Jonassen CM, Leblanc M, Nordlund B, Rudi K, Skjerven HO, Staff AC, Vettukattil R, Söderhäll C. Frequent oil baths and skin barrier during infancy in the PreventADALL study. Br J Dermatol 2024; 191:49-57. [PMID: 38446755 DOI: 10.1093/bjd/ljae091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 02/22/2024] [Accepted: 02/23/2024] [Indexed: 03/08/2024]
Abstract
BACKGROUND In the general population randomized controlled trial PreventADALL, frequent emollient bath additives from 2 weeks of age did not prevent atopic dermatitis, while the effect on skin barrier function throughout infancy is not established. OBJECTIVES The primary aim of this exploratory substudy was to assess the effect of mineral-based oil baths on transepidermal water loss (TEWL) and dry skin through infancy, and secondarily to explore if filaggrin (FLG) mutations modified the effect. METHODS Overall, 2153 infants were included and randomized to either the 'Skin intervention' (SI) group (n = 995) (oil bath 4 times weekly from 2 weeks through 8 months) or 'No skin intervention' (NSI) group (n = 1158), with TEWL measurements at 3, 6 and/or 12 months of age. Information on FLG mutation status was available for 1683 of these infants. Effects of the skin intervention on TEWL and dry skin through infancy were assessed by mixed-effects regression modelling. Background characteristics and protocol adherence were collected from electronic questionnaires, birth records and weekly diaries. RESULTS The TEWL (95% confidence interval) was on average 0.42 g m-2 h-1 (0.13-0.70, P = 0.004) higher in the SI group compared with the NSI group through the first year of life, with significantly higher levels at 3 months [8.6 (8.3-9.0) vs. 7.6 (7.3-7.9)], but similar at 6 and 12 months. Dry skin was observed significantly more often in the NSI group compared with the SI group at 3 months (59% vs. 51%) and at 6 months of age (63% vs. 53%), while at 12 months of age, the difference was no longer significant. At 3 months, the TEWL of FLG mutation carriers was similar to the TEWL in the SI group. No interaction between SI and FLG mutation was found in the first year of life. CONCLUSIONS Infants given frequent oil baths from 2 weeks of age had reduced skin barrier function through infancy compared with controls, largely attributed to higher TEWL at 3 months of age, while the skin at 3 and 6 months appeared less dry in infants subjected to the skin intervention.
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Affiliation(s)
- Eva Maria Rehbinder
- Department of Dermatology, Oslo University Hospital, Oslo, Norway
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo,Norway
| | - Sabina Wärnberg Gerdin
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Angela Hoyer
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Maria Bradley
- Dermatology Unit, Department of Medicine Solna, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Karin C Lødrup Carlsen
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo,Norway
- Divisions of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Berit Granum
- Department of Chemical Toxicology, Norwegian Institute of Public Health, Oslo, Norway
| | - Gunilla Hedlin
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Christine Monceyron Jonassen
- Center for Laboratory Medicine, Østfold Hospital Trust, Kalnes, Norway
- Department of Virology, Norwegian Institute of Public Health, Oslo, Norway
| | - Marissa Leblanc
- Oslo Centre for Biostatistics and Epidemiology; University of Oslo, Oslo, Norway
- Norwegian Institute of Public Health, Oslo, Norway
| | - Björn Nordlund
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Knut Rudi
- Department of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences, Ås, Norway
| | - Håvard O Skjerven
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo,Norway
- Divisions of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Anne Cathrine Staff
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo,Norway
- Divisions of Obstetrics and Gynaecology; Oslo University Hospital, Oslo, Norway
| | - Riyas Vettukattil
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo,Norway
- Divisions of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Cilla Söderhäll
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
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McCarthy RL, Tawfik SS, Theocharopoulos I, Atkar R, McDonald B, Dhoat S, Hughes A, Thomas BR, O’Toole EA. Vitamin D deficiency and atopic dermatitis severity in a Bangladeshi population living in East London: A cross-sectional study. SKIN HEALTH AND DISEASE 2024; 4:e358. [PMID: 38846698 PMCID: PMC11150754 DOI: 10.1002/ski2.358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 01/30/2024] [Accepted: 03/01/2024] [Indexed: 06/09/2024]
Abstract
Background Atopic eczema is a common, chronic, inflammatory skin condition with considerable heterogeneity. South Asian people living in the UK frequently have low serum vitamin D3 (25(OH)D3), and those with atopic disease can present with severe eczema. The association between vitamin D deficiency and eczema severity, and the role of vitamin D supplementation in atopic eczema is inconsistent, and under-researched in people with Asian ancestry. Objectives This cross-sectional study investigates the association between serum 25(OH)D3 and eczema severity in a cohort of South Asian children and young adults living in London. Methods Eligible participants were Bangladeshi children and young adults aged 0-30 years with eczema, living in London and participating in the Tower Hamlets Eczema Assessment study. Data was collected via parent/patient self-reporting, clinical history and examination, and hospital databases. 25(OH)D3 levels were documented retrospectively, if available, from hospital databases. Eczema severity was classified by Eczema Area and Severity Index (EASI) score less than or greater than 10 (clear-mild vs. moderate-severe). Multivariate logistic regression was used to adjust for confounding factors. Results 681 participants were included in analyses. 25(OH)D3 results were available for 49.6% (338/681), 84.3% of which had deficient or insufficient lowest 25(OH)D3. Lowest 25(OH)D3 was inversely correlated with EASI score (Spearman's rank R 2 = -0.24, p < 0.001). 26.1% (178/681) had EASI >10 and a lower median lowest and nearest 25(OH)D3. After adjustment for confounding EASI > 10 was significantly associated with a lowest 25(OH)D3 < 25 (OR 3.21, 95%CI 1.35, 8.60), use of mild-moderate potency topical steroid on the face and neck (OR 3.11, 95%CI 1.86, 5.31), calcineurin inhibitor on the face and neck (OR 2.79, 95% CI 1.26, 6.10) and potent - very potent topical steroid on the face and neck (OR2.23, 95%CI 1.02, 4.77) and body (OR 2.11, 95%CI 1.18, 3.87). Discussion Vitamin D plays a role in modulation of proteins required for skin barrier function and regulation of the innate immune system, suggesting 25(OH)D3 deficiency contributes to skin inflammation. This study demonstrates a relationship between 25(OH)D3 deficiency and worse eczema severity in a cohort of South Asian children and young adults.
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Affiliation(s)
- Rebecca L. McCarthy
- Dermatology DepartmentThe Royal London HospitalBarts Health NHS TrustLondonUK
- Blizard InstituteThe Faculty of Medicine and DentistryQueen Mary University of LondonLondonUK
| | - Soha S. Tawfik
- Dermatology DepartmentThe Royal London HospitalBarts Health NHS TrustLondonUK
- Blizard InstituteThe Faculty of Medicine and DentistryQueen Mary University of LondonLondonUK
- Department of DermatologyVenereology and AndrologyFaculty of MedicineAlexandria UniversityAlexandriaEgypt
| | - Ioannis Theocharopoulos
- Blizard InstituteThe Faculty of Medicine and DentistryQueen Mary University of LondonLondonUK
| | - Ravinder Atkar
- Dermatology DepartmentThe Royal London HospitalBarts Health NHS TrustLondonUK
| | - Bryan McDonald
- Dermatology DepartmentThe Royal London HospitalBarts Health NHS TrustLondonUK
| | - Sasha Dhoat
- Dermatology DepartmentThe Royal London HospitalBarts Health NHS TrustLondonUK
| | - Aaron Hughes
- Dermatology DepartmentThe Royal London HospitalBarts Health NHS TrustLondonUK
- Blizard InstituteThe Faculty of Medicine and DentistryQueen Mary University of LondonLondonUK
| | - Bjorn R. Thomas
- Blizard InstituteThe Faculty of Medicine and DentistryQueen Mary University of LondonLondonUK
| | - Edel A. O’Toole
- Dermatology DepartmentThe Royal London HospitalBarts Health NHS TrustLondonUK
- Blizard InstituteThe Faculty of Medicine and DentistryQueen Mary University of LondonLondonUK
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3
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Faye O, Flohr C, Kabashima K, Ma L, Paller AS, Rapelanoro FR, Steinhoff M, Su JC, Takaoka R, Wollenberg A, Yew YW, Postigo JAR, Schmid-Grendelmeier P, Taïeb A. Atopic dermatitis: A global health perspective. J Eur Acad Dermatol Venereol 2024; 38:801-811. [PMID: 38151270 DOI: 10.1111/jdv.19723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 11/17/2023] [Indexed: 12/29/2023]
Abstract
The International Society of AD (ISAD) organized a roundtable on global aspects of AD at the WCD 2023 in Singapore. According to the Global Burden of Disease (GBD) consortium, at least 171 million individuals were affected with AD in 2019, corresponding to 2.23% of the world population, with age-standardized prevalence and incidence rates that were relatively stable from 1990 to 2019. Based on the panel experience, most AD cases are mild-to-moderate. Without parallel data on disease prevalence and severity, the GBD data are difficult to interpret in many regions. This gap is particularly important in countries with limited medical infrastructure, but indirect evidence suggests a significant burden of AD in low-and-medium resource settings, especially urban areas. The Singapore roundtable was an opportunity to compare experiences in World Bank category 1 (Madagascar and Mali), 3 (Brazil, China) and 4 (Australia, Germany, Qatar, USA, Singapore, Japan) countries. The panel concluded that current AD guidelines are not adapted for low resource settings and a more pragmatic approach, as developed by WHO for skin NTDs, would be advisable for minimal access to moisturizers and topical corticosteroids. The panel also recommended prioritizing prevention studies, regardless of the level of existing resources. For disease long-term control in World Bank category 3 and most category 4 countries, the main problem is not access to drugs for most mild-to-moderate cases, but rather poor compliance due to insufficient time at visits. Collaboration with WHO, patient advocacy groups and industry may promote global change, improve capacity training and fight current inequalities. Finally, optimizing management of AD and its comorbidities needs more action at the primary care level, because reaching specialist care is merely aspirational in most settings. Primary care empowerment with store and forward telemedicine and algorithms based on augmented intelligence is a future goal.
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Affiliation(s)
- Ousmane Faye
- Department of Dermatology, Faculty of Medicine and Odontostomatology, Université des Sciences, des Techniques et des Technologies de Bamako (USTTB), Bamako, Mali
| | - Carsten Flohr
- Paediatric & Population-Based Dermatology Research, St John's Institute of Dermatology, London, UK
- Guy & St Thomas' NHS Foundation Trust and King's College London, London, UK
| | - Kenji Kabashima
- Department of Dermatology, Kyoto University Graduate School of Medicine, Singapore Research Institute of Singapore (SRIS), Kyoto, Japan
- A*STAR Skin Research Labs (A*SRL), Agency for Science, Technology, and Research (A*STAR)Biopolis, Singapore City, Singapore
| | - Lin Ma
- Department of Dermatology, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Amy S Paller
- Departments of Dermatology and Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | | | - Martin Steinhoff
- Department of Dermatology and Venereology, Hamad Medical Corporation, Doha, Qatar
- Translational Research Institute, Academic Health System, Hamad Medical Corporation, Doha, Qatar
- Dermatology Institute, Academic Health System, Hamad Medical Corporation, Doha, Qatar
- Weill Cornell Medicine-Qatar, Ar-Rayyan, Qatar
- College of Medicine, Qatar University, Doha, Qatar
- School of Health and Life Sciences, Hamad Bin Khalifa University, Doha, Qatar
- Department of Dermatology, Weill Cornell Medicine, New York City, New York, USA
| | - John C Su
- Eastern Health, Monash University, Melbourne, Victoria, Australia
- Murdoch Children's Research Institute, University of Melbourne, Melbourne, Victoria, Australia
| | - Roberto Takaoka
- International Society of Atopic Dermatitis, Davos, Switzerland
- Division of Dermatology, University of São Paulo Medical School Hospital, São Paulo, Brazil
| | - Andreas Wollenberg
- International Society of Atopic Dermatitis, Davos, Switzerland
- Division of Dermatology, University of São Paulo Medical School Hospital, São Paulo, Brazil
- University Hospital Augsburg, Augsburg, Germany
- Ludwig-Maximilian University, Munich, Germany
| | | | | | - Peter Schmid-Grendelmeier
- International Society of Atopic Dermatitis, Davos, Switzerland
- World Allergy Organization, Milwaukee, Wisconsin, USA
- Allergy Unit, Department of Dermatology, University Hospital of Zurich, Zurich, Switzerland
- Christine Kühne Center for Allergy Research and Education CK-CARE, Davos, Switzerland
| | - Alain Taïeb
- International Society of Atopic Dermatitis, Davos, Switzerland
- INSERM U 1312, University of Bordeaux, Bordeaux, France
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4
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Färdig M, Hoyer A, Almqvist C, Bains KES, Carlsen KCL, Gudmundsdóttir HK, Granum B, Haugen GN, Hedlin G, Jonassen CM, Konradsen JR, Lie A, Rehbinder EM, Skjerven HO, Staff AC, Vettukattil R, Söderhäll C, Nordlund B. Infant lung function and early skin barrier impairment in the development of asthma at age 3 years. Allergy 2024; 79:667-678. [PMID: 38239099 DOI: 10.1111/all.16024] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 12/08/2023] [Accepted: 12/17/2023] [Indexed: 03/01/2024]
Abstract
BACKGROUND Largely unexplored, we investigated if lower lung function, impaired skin barrier function by transepidermal water loss (TEWL), eczema, and filaggrin (FLG) mutations in infancy were associated with asthma in early childhood. METHODS From the factorially designed randomized controlled intervention study PreventADALL, we evaluated 1337/2394 children from all randomization groups with information on asthma at age 3 years, and at age 3 months either lung function, TEWL, eczema, and/or FLG mutations. Lower lung function was defined as the time to peak tidal expiratory flow to expiratory time (tPTEF /tE ) <0.25, and skin barrier impairment as a high TEWL >9.50 g/m2 /h. Eczema was clinically observed, and DNA genotyped for FLG mutations. Asthma was defined as asthma-like symptoms (≥3 episodes of bronchial obstruction) between age 2-3 years as well as a history of doctor-diagnosed asthma and/or asthma medication use. Associations were analyzed in logistic regression models, presented with adjusted ORs (aOR) and 95% confidence intervals (CI). RESULTS Lower lung function and skin barrier impairment were associated with asthma in general; aOR (95% CI) 5.4 (2.1, 13.7) and 1.6 (1.1, 2.5), while eczema and FLG mutations were associated with asthma in children with atopic dermatitis or allergic sensitization only. Stratifying for sex, the risk of asthma was only increased in boys with lower lung function; aOR (95% CI) 7.7 (2.5, 23.6), and in girls with FLG mutations; aOR (95% CI) 3.5 (1.5, 8.2). CONCLUSION Lower lung function and impaired skin barrier function in infancy may increase the risk of asthma at age 3 years.
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Affiliation(s)
- Martin Färdig
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Angela Hoyer
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Catarina Almqvist
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Karen Eline S Bains
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Karin C Lødrup Carlsen
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Hrefna Katrín Gudmundsdóttir
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Berit Granum
- Department of Chemical Toxicology, Norwegian Institute of Public Health, Oslo, Norway
| | - Guttorm Nils Haugen
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
| | - Gunilla Hedlin
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Christine Monceyron Jonassen
- Department of Virology, Norwegian Institute of Public Health, Oslo, Norway
- Genetic Unit, Centre for Laboratory Medicine, Østfold Hospital Trust, Kalnes, Norway
| | - Jon R Konradsen
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Anine Lie
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Eva Maria Rehbinder
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Dermatology and Vaenerology, Oslo University Hospital, Oslo, Norway
| | - Håvard O Skjerven
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Anne Cathrine Staff
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
| | - Riyas Vettukattil
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Cilla Söderhäll
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Björn Nordlund
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
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5
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Wan J, Shin DB, Syed MN, Abuabara K, Lemeshow AR, Fuxench ZCC, Gelfand JM. Malignancy risk in patients with atopic dermatitis: a population-based cohort study. Br J Dermatol 2023; 189:53-61. [PMID: 37418646 DOI: 10.1093/bjd/ljad072] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 03/02/2023] [Indexed: 07/09/2023]
Abstract
BACKGROUND Atopic dermatitis (AD) is associated with immunological dysfunction, which may influence cancer development. Previous studies of AD and cancer demonstrate inconsistent results and few of these studies examined children or AD severity and treatment. OBJECTIVES To determine malignancy risk among children and adults with AD. METHODS We conducted a cohort study using electronic health records data from UK general practices in The Health Improvement Network between 1994 and 2015. Children (< 18 years old) and adults (≥ 18 years old) with AD were matched on age, practice and index date to patients without AD. AD was categorized as mild, moderate or severe using treatments and dermatology referrals as proxies. The primary outcome was any incident malignancy, including in situ malignancy, identified using diagnosis codes and categorized into haematological, skin and solid organ malignancies. Secondary outcomes included specific malignancies: leukaemia, lymphoma, melanoma, nonmelanoma skin cancer (NMSC) and common solid-organ cancers. RESULTS Among 409 431 children with AD (93.2% mild, 5.5% moderate, 1.3% severe) and 1 809 029 children without AD who had median follow-up of 5-7 years, the incidence rates of malignancy were 1.9-3.4 and 2.0 per 10 000 person-years (PY), respectively. The adjusted risk of malignancy overall did not differ with respect to AD [hazard ratio (HR) 1.02 (95% confidence interval 0.92-1.12)]. Severe AD was associated with increased lymphoma risk [HR 3.18 (1.41-7.16), excluding cutaneous T-cell lymphoma (CTCL)], and mild AD was associated with increased NMSC risk [1.55 (1.06-2.27)]. Among 625 083 adults with AD (65.7% mild, 31.4% moderate, 2.9% severe) and 2 678 888 adults without AD who had median follow-up of 5 years, incidence rates of malignancy were 97.4-125.3 per 10 000 PY and 103.7 per 10 000 PY, respectively. The adjusted risk of any malignancy did not differ with respect to AD [HR 1.00 (0.99-1.02)]. However, adults with severe AD had a twofold higher risk of non-CTCL lymphoma. AD was also associated with slightly higher skin cancer risk [HR 1.06 (1.04-1.08)] and slightly lower solid cancer risk [0.97 (0.96-0.98)] but results varied by specific cancers and AD severity. CONCLUSIONS Epidemiological evidence does not support a strong overall malignancy risk in AD but lymphoma risk may be increased with severe AD.
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Affiliation(s)
- Joy Wan
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | | | - Katrina Abuabara
- Department of Dermatology, University of California San Francisco, San Francisco, CA, USA
| | | | | | - Joel M Gelfand
- Departments of Dermatology
- Biostatistics, Epidemiology and Informatics; University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
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6
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Julander A, Rietz Liljedahl E, Korres de Paula H, Assarsson E, Engfeldt M, Littorin M, Shobana Anto C, Lidén C, Broberg K. Nickel penetration into stratum corneum in FLG null carriers - a human experimental study. Contact Dermatitis 2022; 87:154-161. [PMID: 35474514 PMCID: PMC9544599 DOI: 10.1111/cod.14137] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 04/06/2022] [Accepted: 04/07/2022] [Indexed: 11/21/2022]
Abstract
Background The filaggrin gene (FLG) plays a role in skin diseases, with the skin barrier function being impaired in FLG null carriers. The role of FLG status in relation to nickel penetration into the skin remains unclear. Objectives To elucidate the association between FLG status and nickel penetration into stratum corneum (SC) in individuals without self‐reported history of nickel allergy. Methods Forty participants (23 FLG wt and 17 FLG null) were exposed to a nickel solution (80 μg/cm2) which was applied onto 2 × 2 cm on their left forearm. After 4 h, the area was tape‐stripped with 10 consecutive tapes. Nickel in each tape was quantified using inductively coupled plasma mass spectrometry. Results The average recovered nickel dose was 35%–48%. A tendency towards lower recovery was seen in FLG null carriers compared to FLG wt carriers, and lower recovery in those with history of skin and/or respiratory symptoms compared to those without such history. This was however not statistically significant. Conclusion FLG null carriers had less nickel recovered by tape strips compared with FLG wt carriers and, compared with individuals without a history of skin and/or respiratory symptoms, indicating higher nickel penetration into SC for FLG null carriers, but further studies are needed.
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Affiliation(s)
- Anneli Julander
- Unit of Integrative Toxicology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Emelie Rietz Liljedahl
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - Helena Korres de Paula
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - Eva Assarsson
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - Malin Engfeldt
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - Margareta Littorin
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - Christine Shobana Anto
- Unit of Metals and Health, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Carola Lidén
- Unit of Integrative Toxicology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Karin Broberg
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden.,Unit of Metals and Health, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
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7
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Hoyer A, Rehbinder EM, Färdig M, Asad S, Lødrup Carlsen KC, Endre KMA, Granum B, Haugen G, Hedlin G, Monceyron Jonassen C, Katayama S, Konradsen JR, Landrø L, LeBlanc M, Mägi Olsson CA, Rudi K, Skjerven HO, Staff AC, Vettukattil R, Bradley M, Nordlund B, Söderhäll C. Filaggrin mutations in relation to skin barrier and atopic dermatitis in early infancy. Br J Dermatol 2021; 186:544-552. [PMID: 34698386 DOI: 10.1111/bjd.20831] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Loss-of-function mutations in the skin barrier gene filaggrin (FLG) increase the risk of atopic dermatitis (AD), but their role in skin barrier function, dry skin and eczema in infancy is unclear. OBJECTIVES To determine the role of FLG mutations for impaired skin barrier function, dry skin, eczema and AD at three months of age and through infancy. METHODS FLG mutations were analyzed in 1836 infants in the Scandinavian population-based PreventADALL study. Transepidermal water loss (TEWL), dry skin, eczema and AD were assessed at three, six and 12 months of age. RESULTS Filaggrin mutations were observed in 166 (9%) infants. At three months, carrying FLG mutations was not associated with impaired skin barrier function (TEWL > 11.3 g/m2 /h) or dry skin, but with eczema (OR(95%CI): 2.76 (1.81, 4.23), p < 0.001). At six months, mutation carriers had significantly higher TEWL than non-mutation carriers (mean (95%CI) 9.68 (8.69, 10.68) vs. 8.24 (7.97, 8.15), p < 0.01) and at three and six months an increased risk of dry skin on truncus (OR: 1.87 (1.25, 2.80), p = 0.002; 2.44 (1.51, 3.95), p < 0.001) or extensor limb surfaces (1.52 (1.04, 2.22), p = 0.028; 1.74 (1.17, 2.57), p = 0.005). FLG mutations were associated with eczema and AD in infancy. CONCLUSION Filaggrin mutations were not associated with impaired skin barrier function or dry skin in general at three months of age, but increased the risk for eczema, as well as for dry skin on truncus and extensors at three and six months.
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Affiliation(s)
- A Hoyer
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - E M Rehbinder
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Dermatology and Venerology, Oslo University Hospital, Oslo, Norway
| | - M Färdig
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.,Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - S Asad
- Dermatology Unit, Department of Medicine Solna, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - K C Lødrup Carlsen
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - K M A Endre
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Dermatology and Venerology, Oslo University Hospital, Oslo, Norway
| | - B Granum
- Department of Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - G Haugen
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
| | - G Hedlin
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.,Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - C Monceyron Jonassen
- Faculty of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences, Ås, Norway.,Genetic Unit, Centre for Laboratory Medicine, Østfold Hospital Trust, Kalnes, Norway
| | - S Katayama
- Folkhälsan Research Center, Helsinki, Finland.,Department of Biosciences and Nutrition, Karolinska Institute, Huddinge, Sweden.,Stem Cells and Metabolism Research Program, University of Helsinki, Helsinki, Finland
| | - J R Konradsen
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.,Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - L Landrø
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Dermatology and Venerology, Oslo University Hospital, Oslo, Norway
| | - M LeBlanc
- Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
| | - C A Mägi Olsson
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.,Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - K Rudi
- Faculty of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences, Ås, Norway
| | - H O Skjerven
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - A C Staff
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
| | - R Vettukattil
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - M Bradley
- Dermatology Unit, Department of Medicine Solna, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - B Nordlund
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.,Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - C Söderhäll
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.,Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
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8
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Lai QWS, Guo MSS, Wu KQ, Liao Z, Guan D, Dong TT, Tong P, Tsim KWK. Edible Bird's Nest, an Asian Health Food Supplement, Possesses Moisturizing Effect by Regulating Expression of Filaggrin in Skin Keratinocyte. Front Pharmacol 2021; 12:685982. [PMID: 34354585 PMCID: PMC8329658 DOI: 10.3389/fphar.2021.685982] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 06/03/2021] [Indexed: 11/13/2022] Open
Abstract
Edible bird's nest (EBN) has been consumed as a Chinese delicacy for hundreds of years; the functions of which have been proposed to prevent lung disease, strengthen immune response, and restore skin youthfulness. To support the skin function of EBN, the water extract and the enzymatic digest of EBN with enriched digested peptides were tested in cultured keratinocyte, HaCaT cell line. The effects of EBN extract and digest in inducing proteins crucial for skin moisturizing were determined in both in vitro and ex vivo models. In cultured keratinocytes, the expressions of S100-fused type proteins contributing to skin barrier function in the stratum corneum, e.g. filaggrin and filaggrin-2, were determined in both mRNA and protein levels, which were markedly induced in the treatment of EBN extract or digest. The EBN-induced gene transcriptions of filaggrin and filaggrin-2 were mediated by activation of p38 MAPK pathway and various transcription factors, e.g. GATA3, PPARα, PPARβ, and PPARγ: these transcriptional factors were markedly activated by the digested products of EBN, as compared to the extract, in cultured keratinocytes. By using atomic force microscopy (AFM), the EBN-treated keratinocyte was shown to have more liquid-like morphology, as compared to a control cell. The EBN digest showed better induction on these moisturizing effects as compared to the extract. These lines of evidence therefore suggested the water moisturizing effect of EBN in skin function.
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Affiliation(s)
- Queenie Wing Sze Lai
- Shenzhen Research Institute, The Hong Kong University of Science and Technology, Shenzhen, China.,Division of Life Science and Center for Chinese Medicine R and D, The Hong Kong University of Science and Technology, Hong Kong, China
| | - Maggie Sui Sui Guo
- Shenzhen Research Institute, The Hong Kong University of Science and Technology, Shenzhen, China.,Division of Life Science and Center for Chinese Medicine R and D, The Hong Kong University of Science and Technology, Hong Kong, China
| | - Kevin Qiyun Wu
- Shenzhen Research Institute, The Hong Kong University of Science and Technology, Shenzhen, China.,Division of Life Science and Center for Chinese Medicine R and D, The Hong Kong University of Science and Technology, Hong Kong, China
| | - Zhitao Liao
- Department of Physics, The Hong Kong University of Science and Technology, Hong Kong, China
| | - Dongshi Guan
- State Key Laboratory of Nonlinear Mechanics, Institute of Mechanics, Chinese Academy of Sciences, Beijing, China
| | - Tina Tingxia Dong
- Shenzhen Research Institute, The Hong Kong University of Science and Technology, Shenzhen, China.,Division of Life Science and Center for Chinese Medicine R and D, The Hong Kong University of Science and Technology, Hong Kong, China
| | - Penger Tong
- Department of Physics, The Hong Kong University of Science and Technology, Hong Kong, China
| | - Karl Wah Keung Tsim
- Shenzhen Research Institute, The Hong Kong University of Science and Technology, Shenzhen, China.,Division of Life Science and Center for Chinese Medicine R and D, The Hong Kong University of Science and Technology, Hong Kong, China
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9
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Andersson AM, Halling AS, Loft N, Skov L, Koch A, Guttman-Yassky E, Thyssen JP. Atopic dermatitis among children and adolescents in the Arctic region - a systematic review and meta-analysis. J Eur Acad Dermatol Venereol 2021; 35:1642-1654. [PMID: 33829579 DOI: 10.1111/jdv.17276] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 03/10/2021] [Indexed: 11/30/2022]
Abstract
The prevalence of atopic dermatitis (AD) varies across the globe, and the clinical phenotype with racial background and ethnicity. AD in the Arctic region has only been scarcely studied. We performed a systematic review and meta-analysis to examine the prevalence, clinical manifestations and risk factors for AD among children and adolescents in the Arctic. Three medical databases PubMed, Embase and Web of Science were screened. All studies published between 1990 to 2020 with epidemiologic data on AD in children and adolescents in the Arctic region, were included. Data were extracted and a meta-analysis was performed to obtain pooled proportions and incidences with 95% confidence intervals (CI). We identified 21 studies from 8 different Arctic regions with 31 403 participants. The cumulative incidence of AD was 23% (95% CI 20-26) and 1-year prevalence was 19% (95% CI 15-25). The incidence of AD was higher in the Arctic parts of Scandinavia and lower in Greenland and Russia. Children of indigenous descent had a slightly lower incidence of AD (19%, 95% CI 13-26) compared to the overall population. The dominant phenotype of AD was mild to moderate flexural dermatitis with facial involvement. Asthma and allergic rhinitis were common and observed in 20-30% of children with AD. In conclusion, AD is highly prevalent in the Arctic, but varies between regions and races. Indigenous children living in less urbanized countries appear to have a slightly lower risk of AD. Future studies should confirm this and examine whether this correlation relates to behavioural differences or genetic signature.
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Affiliation(s)
- A M Andersson
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark.,Greenlandic University, Nuuk, Greenland.,Copenhagen Research Group for Inflammatory Skin (CORGIS), Hellerup, Denmark
| | - A S Halling
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark.,Copenhagen Research Group for Inflammatory Skin (CORGIS), Hellerup, Denmark
| | - N Loft
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark.,Copenhagen Research Group for Inflammatory Skin (CORGIS), Hellerup, Denmark
| | - L Skov
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark.,Copenhagen Research Group for Inflammatory Skin (CORGIS), Hellerup, Denmark
| | - A Koch
- Greenlandic University, Nuuk, Greenland.,Department of Epidemiology Research, Statens Serum Institute, Copenhagen, Denmark
| | - E Guttman-Yassky
- Department of Dermatology, Ichan School of Medicine at Mount Sinai, Manhattan, NY, USA
| | - J P Thyssen
- Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
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10
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Hart PH, Norval M. The Multiple Roles of Urocanic Acid in Health and Disease. J Invest Dermatol 2021; 141:496-502. [DOI: 10.1016/j.jid.2020.07.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 07/15/2020] [Accepted: 07/30/2020] [Indexed: 12/31/2022]
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11
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Rietz Liljedahl E, Johanson G, Korres de Paula H, Faniband M, Assarsson E, Littorin M, Engfeldt M, Lidén C, Julander A, Wahlberg K, Lindh C, Broberg K. Filaggrin Polymorphisms and the Uptake of Chemicals through the Skin-A Human Experimental Study. ENVIRONMENTAL HEALTH PERSPECTIVES 2021; 129:17002. [PMID: 33439052 PMCID: PMC7805408 DOI: 10.1289/ehp7310] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 11/20/2020] [Accepted: 11/20/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND The filaggrin protein is important for skin barrier structure and function. Loss-of-function (null) mutations in the filaggrin gene FLG may increase dermal absorption of chemicals. OBJECTIVE The objective of the study was to clarify if dermal absorption of chemicals differs depending on FLG genotype. METHOD We performed a quantitative real-time polymerase chain reaction (qPCR)-based genetic screen for loss-of-function mutations (FLG null) in 432 volunteers from the general population in southern Sweden and identified 28 FLG null carriers. In a dermal exposure experiment, we exposed 23 FLG null and 31 wild-type (wt) carriers to three organic compounds common in the environment: the polycyclic aromatic hydrocarbon pyrene, the pesticide pyrimethanil, and the ultraviolet-light absorber oxybenzone. We then used liquid-chromatography mass-spectrometry to measure the concentrations of these chemicals or their metabolites in the subjects' urine over 48 h following exposure. Furthermore, we used long-range PCR to measure FLG repeat copy number variants (CNV), and we performed population toxicokinetic analysis. RESULTS Lag times for the uptake and dermal absorption rate of the chemicals differed significantly between FLG null and wt carriers with low (20-22 repeats) and high FLG CNV (23-24 repeats). We found a dose-dependent effect on chemical absorption with increasing lag times by increasing CNV for both pyrimethanil and pyrene, and decreasing area under the urinary excretion rate curve (AUC(0-40h)) with increasing CNV for pyrimethanil. FLG null carriers excreted 18% and 110% more metabolite (estimated by AUC(0-40h)) for pyrimethanil than wt carriers with low and high CNV, respectively. CONCLUSION We conclude that FLG genotype influences the dermal absorption of some common chemicals. Overall, FLG null carriers were the most susceptible, with the shortest lag time and highest rate constants for skin absorption, and higher fractions of the applied dose excreted. Furthermore, our results indicate that low FLG CNV resulted in increased dermal absorption of chemicals. https://doi.org/10.1289/EHP7310.
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Affiliation(s)
- Emelie Rietz Liljedahl
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - Gunnar Johanson
- Unit of Integrative Toxicology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Helena Korres de Paula
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - Moosa Faniband
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - Eva Assarsson
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - Margareta Littorin
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - Malin Engfeldt
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - Carola Lidén
- Unit of Integrative Toxicology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Anneli Julander
- Unit of Integrative Toxicology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Karin Wahlberg
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - Christian Lindh
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - Karin Broberg
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
- Unit of Metals and Health, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
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12
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Wang L, Bierbrier R, Drucker AM, Chan AW. Noncutaneous and Cutaneous Cancer Risk in Patients With Atopic Dermatitis: A Systematic Review and Meta-analysis. JAMA Dermatol 2020; 156:158-171. [PMID: 31825457 DOI: 10.1001/jamadermatol.2019.3786] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Importance Impaired skin barrier and aberrant immune function in atopic dermatitis (AD) may alter immune response to malignant cancer. Conflicting data exist on the risk of cancer in patients with AD. Objective To assess the risk of noncutaneous and cutaneous cancers in patients with AD compared with the general population without AD. Data Sources Studies identified from searches of MEDLINE and Embase that were published from 1946 and 1980, respectively, to January 3, 2019. The following search terms were used: [(exp NEOPLASMS/ OR neoplas*.tw. OR tumo*.tw. OR cancer*.tw. OR malignanc*.tw.) AND (exp Dermatitis, Atopic/ OR (atopic adj1 (dermatit* or neurodermatit*)).tw. OR eczema.tw. OR disseminated OR neurodermatit*.tw.)]. Study Selection Included were observational studies (cohort and case-control designs) reporting a risk estimate for cancer in patients with AD compared with a control group (general population or patients without AD). Data Extraction and Synthesis Two independent reviewers extracted data and assessed the risk of bias using the Risk of Bias in Nonrandomized Studies of Interventions (ROBINS-I) assessment tool, modified for observational exposure studies. Data were pooled using a random-effects model and expressed as standardized incidence ratios (SIRs) or odds ratios (ORs) with 95% CIs. Heterogeneity was assessed using the Cochrane Q statistic and the I2 statistic. Main Outcomes and Measures The main outcome of the study was risk of cancer measured by SIRs or ORs. Results This systematic review and meta-analysis included 8 population-based cohort studies (n = 5 726 692 participants) and 48 case-control studies (n = 114 136 participants). Among cohort studies, a statistically significant association was found between AD and keratinocyte carcinoma (5 studies; pooled SIR, 1.46; 95% CI, 1.20-1.77) as well as cancers of the kidney (2 studies; pooled SIR, 1.86; 95% CI, 1.14-3.04), central nervous system (2 studies; pooled SIR, 1.81; 95% CI, 1.22-2.70), and pancreas (1 study; SIR, 1.90; 95% CI, 1.03-3.50). Among 48 case-control studies, pooled effects showed patients with AD had statistically significantly lower odds of central nervous system cancers (15 studies; pooled OR, 0.76; 95% CI, 0.70-0.82) and pancreatic cancer (5 studies; pooled OR, 0.81; 95% CI, 0.66-0.98), contrary to the higher incidence found in cohort studies. Case-control studies also demonstrated lower odds of lung and respiratory system cancers (4 studies; pooled OR, 0.61; 95% CI, 0.45-0.82). No evidence of association was found between AD and other cancer types, including melanoma. There was substantial heterogeneity between studies for many other cancers, which precluded pooling of data, and there was moderate to serious risk of bias among included studies. Conclusions and Relevance Observational evidence suggests potential associations between AD and increased risk of keratinocyte carcinoma and kidney cancer as well as lower odds of lung and respiratory system cancers. Further research is needed to address the heterogeneity and limitations of current evidence and to better understand the mechanisms underlying a possible association between AD and cancer risk.
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Affiliation(s)
- Lily Wang
- MD Program, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Rachel Bierbrier
- Division of Dermatology, McGill University Health Centre, Montreal, Quebec, Canada
| | - Aaron M Drucker
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada.,Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada
| | - An-Wen Chan
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada.,Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada
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13
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Hanel A, Carlberg C. Skin colour and vitamin D: An update. Exp Dermatol 2020; 29:864-875. [PMID: 32621306 DOI: 10.1111/exd.14142] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 06/14/2020] [Accepted: 06/25/2020] [Indexed: 02/06/2023]
Abstract
Homo sapiens evolved in East Africa and had dark skin, hair, and eyes, in order to protect against deleterious consequences of intensive UV radiation at equatorial latitudes. Intensive skin pigmentation was thought to bear the risk of inefficient vitamin D3 synthesis in the skin. This initiated the hypothesis that within the past 75 000 years, in which humans migrated to higher latitudes in Asia and Europe, the need for vitamin D3 synthesis served as an evolutionary driver for skin lightening. In this review, we summarize the recent archeogenomic reconstruction of population admixture in Europe and demonstrate that skin lightening happened as late as 5000 years ago through immigration of lighter pigmented populations from western Anatolia and the Russian steppe but not primarily via evolutionary pressure for vitamin D3 synthesis. We show that variations in genes encoding for proteins being responsible for the transport, metabolism and signalling of vitamin D provide alternative mechanisms of adaptation to a life in northern latitudes without suffering from consequences of vitamin D deficiency. This includes hypotheses explaining differences in the vitamin D status and response index of European populations.
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Affiliation(s)
- Andrea Hanel
- School of Medicine, Institute of Biomedicine, University of Eastern Finland, Kuopio, Finland
| | - Carsten Carlberg
- School of Medicine, Institute of Biomedicine, University of Eastern Finland, Kuopio, Finland
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14
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Abstract
Purpose of review Mutations in the Filaggrin gene can cause absent or reduced filaggrin protein, leading to impaired keratinization and skin barrier defect, which produce characteristic phenotypes. In this short review, we report current evidence on the topic with special reference to atopic dermatitis, suggest future directions, and discuss therapeutic implications. Recent findings Numerous candidate gene association studies, genome-wide association studies, studies on copy number variations and most recently, sequencing studies, have confirmed the robust association of mutations in the Filaggrin gene with atopic dermatitis, and have also linked these mutations with several other disorders. Summary Filaggrin gene defects remain the strongest identified genetic risk factors for atopic dermatitis. Taken in conjunction with other genes found to be associated with this condition, genetic screening and identification of individuals at risk for atopic dermatitis could lead to personalized therapy. Manipulation of genetic regulatory elements to increase the amount of filaggrin protein in deficient individuals is an attractive treatment option for the future.
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15
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Revez JA, Lin T, Qiao Z, Xue A, Holtz Y, Zhu Z, Zeng J, Wang H, Sidorenko J, Kemper KE, Vinkhuyzen AAE, Frater J, Eyles D, Burne THJ, Mitchell B, Martin NG, Zhu G, Visscher PM, Yang J, Wray NR, McGrath JJ. Genome-wide association study identifies 143 loci associated with 25 hydroxyvitamin D concentration. Nat Commun 2020; 11:1647. [PMID: 32242144 PMCID: PMC7118120 DOI: 10.1038/s41467-020-15421-7] [Citation(s) in RCA: 185] [Impact Index Per Article: 46.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 03/03/2020] [Indexed: 02/07/2023] Open
Abstract
Vitamin D deficiency is a candidate risk factor for a range of adverse health outcomes. In a genome-wide association study of 25 hydroxyvitamin D (25OHD) concentration in 417,580 Europeans we identify 143 independent loci in 112 1-Mb regions, providing insights into the physiology of vitamin D and implicating genes involved in lipid and lipoprotein metabolism, dermal tissue properties, and the sulphonation and glucuronidation of 25OHD. Mendelian randomization models find no robust evidence that 25OHD concentration has causal effects on candidate phenotypes (e.g. BMI, psychiatric disorders), but many phenotypes have (direct or indirect) causal effects on 25OHD concentration, clarifying the epidemiological relationship between 25OHD status and the health outcomes examined in this study.
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Affiliation(s)
- Joana A Revez
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, QLD, Australia
| | - Tian Lin
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, QLD, Australia
| | - Zhen Qiao
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, QLD, Australia
| | - Angli Xue
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, QLD, Australia
| | - Yan Holtz
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia
| | - Zhihong Zhu
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, QLD, Australia
| | - Jian Zeng
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, QLD, Australia
| | - Huanwei Wang
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, QLD, Australia
| | - Julia Sidorenko
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, QLD, Australia
| | - Kathryn E Kemper
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, QLD, Australia
| | - Anna A E Vinkhuyzen
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, QLD, Australia
| | - Julanne Frater
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia
| | - Darryl Eyles
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, QLD, Australia
| | - Thomas H J Burne
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, QLD, Australia
| | - Brittany Mitchell
- QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
- School of Biomedical Sciences, Faculty of Health, and Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
| | | | - Gu Zhu
- QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Peter M Visscher
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, QLD, Australia
| | - Jian Yang
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, QLD, Australia
- Institute for Advanced Research, Wenzhou Medical University, Wenzhou, Zhejiang, 325027, China
| | - Naomi R Wray
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, QLD, Australia.
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia.
| | - John J McGrath
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia.
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, QLD, Australia.
- National Centre for Register-based Research, Aarhus University, Aarhus, Denmark.
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16
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Jurakic Toncic R, Kezic S, Jakasa I, Ljubojevic Hadzavdic S, Balic A, Petkovic M, Pavicic B, Zuzul K, Marinovic B. Filaggrin loss-of-function mutations and levels of filaggrin degradation products in adult patients with atopic dermatitis in Croatia. J Eur Acad Dermatol Venereol 2020; 34:1789-1794. [PMID: 31989686 DOI: 10.1111/jdv.16232] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Accepted: 01/07/2020] [Indexed: 01/25/2023]
Abstract
BACKGROUND FLG loss-of-function mutations (FLG LOF) represent the strongest genetic risk factor for atopic dermatitis (AD) and are associated with early-onset and more severe disease. The prevalence of FLG mutations varies greatly across Europe. At present, there are no data on FLG mutation prevalence in Croatian AD patients. OBJECTIVES To investigate the prevalence of FLG LOF mutations in adult patients with AD and healthy controls. Next to measure the stratum corneum (SC) levels of filaggrin degradation products (NMF), transepidermal water loss (TEWL) and pH in lesional and non-lesional skin. METHODS We recruited 100 AD patients with moderate to severe disease and 50 healthy controls. They were screened for three FLG mutations (R501X, 2282del4 and R2447X). Samples of the SC for NMF analysis were collected by adhesive tapes. TEWL and skin surface pH levels were determined on the lesional and non-lesional skin. RESULTS The combined mutation frequency was 4% in the AD group, and all patients with FLG mutations were homozygous carriers. In the control group, no mutations were found. The most common FLG mutation in AD patients was 2282del4 (3%), followed by R501X (1%). As compared to healthy controls, NMF values were strongly reduced in lesional skin; however, no significant difference was found for non-lesional skin. AD patients had elevated TEWL in both lesional and non-lesional skin. The same pattern was observed for pH. CONCLUSIONS Our study expands understanding of the landscape of FLG mutations in the European population. The low frequency of FLG mutations and similar levels of filaggrin degradation products in healthy controls and in non-lesional skin of AD patients suggest that filaggrin deficiency does not confer a major risk for AD in the Croatian population.
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Affiliation(s)
- R Jurakic Toncic
- University Department of Dermatology and Venereology, University Hospital Center, Zagreb and University of Zagreb School of Medicine, Zagreb, Croatia
| | - S Kezic
- Coronel Institute of Occupational Health, Amsterdam UMC, Amsterdam, The Netherlands
| | - I Jakasa
- Laboratory for Analytical Chemistry, Department of Chemistry and Biochemistry, Faculty of Food Technology and Biotechnology, University of Zagreb, Zagreb, Croatia
| | - S Ljubojevic Hadzavdic
- University Department of Dermatology and Venereology, University Hospital Center, Zagreb and University of Zagreb School of Medicine, Zagreb, Croatia
| | - A Balic
- University Department of Dermatology and Venereology, University Hospital Center, Zagreb and University of Zagreb School of Medicine, Zagreb, Croatia
| | - M Petkovic
- University Department of Dermatology and Venereology, University Hospital Center, Zagreb and University of Zagreb School of Medicine, Zagreb, Croatia
| | - B Pavicic
- University Department of Dermatology and Venereology, University Hospital Center, Zagreb and University of Zagreb School of Medicine, Zagreb, Croatia
| | - K Zuzul
- University of Zagreb School of Medicine, Zagreb, Croatia
| | - B Marinovic
- University Department of Dermatology and Venereology, University Hospital Center, Zagreb and University of Zagreb School of Medicine, Zagreb, Croatia
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17
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Filaggrin sequencing and bioinformatics tools. Arch Dermatol Res 2019; 312:155-158. [PMID: 31372728 DOI: 10.1007/s00403-019-01956-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Accepted: 07/13/2019] [Indexed: 12/30/2022]
Abstract
Atopic dermatitis (AD) is a common illness that most commonly originates in childhood, but can be seen in all ages. Filaggrin (FLG) loss of function variants have been associated with the onset and severity of atopic dermatitis and are the most common genetic association with AD. Previous studies have shown variability in the frequency of FLG variants. We have recently demonstrated that previous FLG genotyping methods were inadequate for proper genotyping. In this concise report, we show that genotyping using a popular older informatics program is problematic. In fact, publications that used the older program likely do not properly capture all FLG variants.
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18
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Daya M, Barnes KC. African American ancestry contribution to asthma and atopic dermatitis. Ann Allergy Asthma Immunol 2019; 122:456-462. [PMID: 30772392 DOI: 10.1016/j.anai.2019.02.009] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 02/06/2019] [Accepted: 02/08/2019] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Asthma and atopic dermatitis (AD) are complex diseases with striking disparities across racial and ethnic groups, which may be partly attributable to genetic factors. Here we summarize current knowledge from asthma and AD genome-wide association studies (GWAS) and pharmacogenetic studies in African ancestry populations. DATA SOURCES GWAS catalog; PUBMed. STUDY SELECTIONS GWAS catalog studies with trait annotations "asthma" and "atopic eczema" and African ancestry individuals in the discovery dataset; the recent CAAPA asthma GWAS; reports on pharmacogenetic studies in asthma and AD. RESULTS Although GWASs have revolutionized gene discovery for multiple complex traits, African Americans continue to be severely underrepresented in sufficiently powered genetics studies. Indeed, of the 16 asthma and 21 AD loci that reached genomewide significance in Europeans, very few have replicated in African ancestry populations. Challenges in comparing results from European vs African ancestry cohorts include modest sample size, differences in risk allele frequency, effect size, correlation between genetic variants, and environmental exposure in evolutionary history. African Americans also constitute a small percentage of dermatological and respiratory-focused clinical trials. Pharmacogenetic studies have similarly been focused largely on non-Hispanic whites, despite compelling evidence that genetic variation from different ancestral backgrounds may alter therapeutic efficacy of asthma and AD drugs. CONCLUSION Large-scale genetic studies of asthma and AD in African Americans are essential to reduce research and health disparities and empower scientific discoveries.
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Affiliation(s)
- Michelle Daya
- Department of Medicine, University of Colorado Denver, Aurora, Colorado
| | - Kathleen C Barnes
- Department of Medicine, University of Colorado Denver, Aurora, Colorado.
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19
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Elias PM, Williams ML. Comment on: The Vitamin D⁻Folate Hypothesis as an Evolutionary Model for Skin Pigmentation: An Update and Integration of Current Ideas, Nutrients 2018, 10, 554. Nutrients 2018; 10:E1753. [PMID: 30441753 PMCID: PMC6265719 DOI: 10.3390/nu10111753] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Accepted: 11/09/2018] [Indexed: 12/13/2022] Open
Abstract
In response to a recent article by Jones et al. (Nutrients 10: 554⁻568, 2018) [1], we agree that three distinctive features evolved in Homo erectus prior to the emergence of modern humans.[...].
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Affiliation(s)
- Peter M Elias
- Department of Dermatology, University of California San Francisco and Veterans Affairs Medical Center, 4150 Clement Street, San Francisco, CA 94121, USA.
| | - Mary L Williams
- Department of Dermatology, University of California San Francisco and Veterans Affairs Medical Center, 4150 Clement Street, San Francisco, CA 94121, USA.
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20
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Quillen EE, Norton HL, Parra EJ, Lona-Durazo F, Ang KC, Illiescu FM, Pearson LN, Shriver MD, Lasisi T, Gokcumen O, Starr I, Lin YL, Martin AR, Jablonski NG. Shades of complexity: New perspectives on the evolution and genetic architecture of human skin. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2018; 168 Suppl 67:4-26. [PMID: 30408154 DOI: 10.1002/ajpa.23737] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 09/17/2018] [Accepted: 09/20/2018] [Indexed: 02/06/2023]
Abstract
Like many highly variable human traits, more than a dozen genes are known to contribute to the full range of skin color. However, the historical bias in favor of genetic studies in European and European-derived populations has blinded us to the magnitude of pigmentation's complexity. As deliberate efforts are being made to better characterize diverse global populations and new sequencing technologies, better measurement tools, functional assessments, predictive modeling, and ancient DNA analyses become more widely accessible, we are beginning to appreciate how limited our understanding of the genetic bases of human skin color have been. Novel variants in genes not previously linked to pigmentation have been identified and evidence is mounting that there are hundreds more variants yet to be found. Even for genes that have been exhaustively characterized in European populations like MC1R, OCA2, and SLC24A5, research in previously understudied groups is leading to a new appreciation of the degree to which genetic diversity, epistatic interactions, pleiotropy, admixture, global and local adaptation, and cultural practices operate in population-specific ways to shape the genetic architecture of skin color. Furthermore, we are coming to terms with how factors like tanning response and barrier function may also have influenced selection on skin throughout human history. By examining how our knowledge of pigmentation genetics has shifted in the last decade, we can better appreciate how far we have come in understanding human diversity and the still long road ahead for understanding many complex human traits.
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Affiliation(s)
- Ellen E Quillen
- Department of Internal Medicine, Section of Molecular Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina.,Center for Precision Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Heather L Norton
- Department of Anthropology, University of Cincinnati, Cincinnati, Ohio
| | - Esteban J Parra
- Department of Anthropology, University of Toronto - Mississauga, Mississauga, Ontario, Canada
| | - Frida Lona-Durazo
- Department of Anthropology, University of Toronto - Mississauga, Mississauga, Ontario, Canada
| | - Khai C Ang
- Department of Pathology and Jake Gittlen Laboratories for Cancer Research, Penn State College of Medicine, Hershey, Pennsylvania
| | - Florin Mircea Illiescu
- Department of Zoology, University of Cambridge, Cambridge, United Kingdom.,Centro de Estudios Interculturales e Indígenas - CIIR, P. Universidad Católica de Chile, Santiago, Chile
| | - Laurel N Pearson
- Department of Anthropology, Pennsylvania State University, University Park, Pennsylvania
| | - Mark D Shriver
- Department of Anthropology, Pennsylvania State University, University Park, Pennsylvania
| | - Tina Lasisi
- Department of Anthropology, Pennsylvania State University, University Park, Pennsylvania
| | - Omer Gokcumen
- Department of Biological Sciences, State University of New York at Buffalo, Buffalo, New York
| | - Izzy Starr
- Department of Biological Sciences, State University of New York at Buffalo, Buffalo, New York
| | - Yen-Lung Lin
- Department of Biological Sciences, State University of New York at Buffalo, Buffalo, New York
| | - Alicia R Martin
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, Massachusetts.,Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, Massachusetts.,Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, Massachusetts
| | - Nina G Jablonski
- Department of Anthropology, Pennsylvania State University, University Park, Pennsylvania
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21
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Hassani B, Isaian A, Shariat M, Mollanoori H, Sotoudeh S, Babaei V, Ziaali A, Teimourian S. Filaggrin gene polymorphisms in Iranian ichthyosis vulgaris and atopic dermatitis patients. Int J Dermatol 2018; 57:1485-1491. [DOI: 10.1111/ijd.14213] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2017] [Revised: 06/23/2018] [Accepted: 08/07/2018] [Indexed: 12/23/2022]
Affiliation(s)
- Bita Hassani
- Department of Medical Genetics; Iran University of Medical Sciences (IUMS); Tehran Iran
| | - Anna Isaian
- Department of Pathology; Tehran University of Medical Sciences (TUMS); Tehran Iran
| | - Mansoureh Shariat
- Department of Immunology and Allergy; Children's Medical Center; Tehran University of Medical Sciences (TUMS); Tehran Iran
| | - Hasan Mollanoori
- Department of Medical Genetics; Iran University of Medical Sciences (IUMS); Tehran Iran
| | - Soheila Sotoudeh
- Department of Dermathology; Children's Medical Center; Tehran University of Medical Sciences (TUMS); Tehran Iran
| | - Vahid Babaei
- Department of Medical Genetics; Iran University of Medical Sciences (IUMS); Tehran Iran
| | - Arghavan Ziaali
- Children's Medical Center; Tehran University of Medical Sciences (TUMS); Tehran Iran
| | - Shahram Teimourian
- Department of Medical Genetics; Iran University of Medical Sciences (IUMS); Tehran Iran
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22
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Abstract
The skin is the first line of defense against the environment, with the epidermis as the outermost tissue providing much of the barrier function. Given its direct exposure to and encounters with the environment, the epidermis must evolve to provide an optimal barrier for the survival of an organism. Recent advances in genomics have identified a number of genes for the human skin barrier that have undergone evolutionary changes since humans diverged from chimpanzees. Here, we highlight a selection of key and innovative genetic findings for skin barrier evolution in our divergence from our primate ancestors and among modern human populations.
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Affiliation(s)
- Erin A. Brettmann
- Division of Dermatology, Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
- Center for Pharmacogenomics, Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
- Center for the Study of Itch, Washington University School of Medicine, St. Louis, MO, USA
| | - Cristina de Guzman Strong
- Division of Dermatology, Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
- Center for Pharmacogenomics, Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
- Center for the Study of Itch, Washington University School of Medicine, St. Louis, MO, USA
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23
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Kaufman BP, Guttman-Yassky E, Alexis AF. Atopic dermatitis in diverse racial and ethnic groups-Variations in epidemiology, genetics, clinical presentation and treatment. Exp Dermatol 2018; 27:340-357. [DOI: 10.1111/exd.13514] [Citation(s) in RCA: 115] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/12/2018] [Indexed: 12/13/2022]
Affiliation(s)
- Bridget P. Kaufman
- Department of Dermatology; Mount Sinai St. Luke's and Mount Sinai West; New York NY USA
| | - Emma Guttman-Yassky
- Department of Dermatology and the Laboratory for Inflammatory Skin Diseases; Icahn School of Medicine at Mount Sinai; New York NY USA
| | - Andrew F. Alexis
- Department of Dermatology; Mount Sinai St. Luke's and Mount Sinai West; New York NY USA
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24
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Andersen YMF, Egeberg A, Hamann CR, Skov L, Gislason GH, Skaaby T, Linneberg A, Thyssen JP. Poor agreement in questionnaire-based diagnostic criteria for adult atopic dermatitis is a challenge when examining cardiovascular comorbidity. Allergy 2018; 73:923-931. [PMID: 29150853 DOI: 10.1111/all.13360] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/13/2017] [Indexed: 12/14/2022]
Abstract
BACKGROUND The association between atopic dermatitis (AD) and cardio-metabolic risk factors is not yet established. Furthermore, no validated questionnaire-based method of identifying adults with AD is currently available. OBJECTIVES To assess the cardio-metabolic risk in adults with a history of AD using 3 different questionnaire-based diagnostic criteria. METHODS We utilized data from a general population study including questionnaire data and objective measurements of 9656 Danish adults. To identify adults with a history of AD, we used a question regarding physician-diagnosed AD and 2 versions of the UK Working Party Diagnostic Criteria. Associations between AD status and cardio-metabolic endpoints were estimated using survey weighted logistic and linear regression analysis. RESULTS We identified 462 (4.8%) adults with self-reported physician-diagnosed AD, whereas 903 (9.4%) and 226 (2.3%) had AD according to the UK Working Party Criteria when at least 2 and 3of 4 minor criteria were fulfilled. The populations were not comparable in terms of occurrence of cardio-metabolic risk factors. For example, the prevalence of obesity was lower in participants with physician-diagnosed AD but overall higher in UK 2/4 and UK 3/4. CONCLUSION Due to the heterogeneity in the captured study populations in terms of the studied outcomes and absence of a gold standard, no conclusions regarding the cardio-metabolic risk in adults with AD in a general population could be made. This study serves as an example of the challenges that are often encountered in questionnaire-based epidemiologic studies and highlights the need of better definitions for this patient group.
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Affiliation(s)
- Y. M. F. Andersen
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital; University of Copenhagen; Hellerup Denmark
- Copenhagen Research Group for Inflammatory Skin (CORGIS); Herlev and Gentofte Hospital; Hellerup Denmark
- Department of Cardiology, Herlev and Gentofte Hospital; University of Copenhagen; Hellerup Denmark
| | - A. Egeberg
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital; University of Copenhagen; Hellerup Denmark
- Copenhagen Research Group for Inflammatory Skin (CORGIS); Herlev and Gentofte Hospital; Hellerup Denmark
| | - C. R. Hamann
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital; University of Copenhagen; Hellerup Denmark
- Copenhagen Research Group for Inflammatory Skin (CORGIS); Herlev and Gentofte Hospital; Hellerup Denmark
- Department of Cardiology, Herlev and Gentofte Hospital; University of Copenhagen; Hellerup Denmark
| | - L. Skov
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital; University of Copenhagen; Hellerup Denmark
- Copenhagen Research Group for Inflammatory Skin (CORGIS); Herlev and Gentofte Hospital; Hellerup Denmark
| | - G. H. Gislason
- Department of Cardiology, Herlev and Gentofte Hospital; University of Copenhagen; Hellerup Denmark
- The Danish Heart Foundation; Copenhagen Denmark
- The National Institute of Public Health; University of Southern Denmark; Copenhagen Denmark
| | - T. Skaaby
- Research Centre for Prevention and Health; The Capital Region of Denmark; Copenhagen Denmark
| | - A. Linneberg
- Research Centre for Prevention and Health; The Capital Region of Denmark; Copenhagen Denmark
- Department of Clinical Experimental Research; Rigshospitalet Denmark
- Department of Clinical Medicine; Faculty of Health and Medical Sciences; University of Copenhagen; Copenhagen Denmark
| | - J. P. Thyssen
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital; University of Copenhagen; Hellerup Denmark
- Copenhagen Research Group for Inflammatory Skin (CORGIS); Herlev and Gentofte Hospital; Hellerup Denmark
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25
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Genotypic variability based association identifies novel non-additive loci DHCR7 and IRF4 in sero-negative rheumatoid arthritis. Sci Rep 2017; 7:5261. [PMID: 28706201 PMCID: PMC5509675 DOI: 10.1038/s41598-017-05447-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Accepted: 05/30/2017] [Indexed: 12/21/2022] Open
Abstract
Sero-negative rheumatoid arthritis (RA) is a highly heterogeneous disorder with only a few additive loci identified to date. We report a genotypic variability-based genome-wide association study (vGWAS) of six cohorts of sero-negative RA recruited in Europe and the US that were genotyped with the Immunochip. A two-stage approach was used: (1) a mixed model to partition dichotomous phenotypes into an additive component and non-additive residuals on the liability scale and (2) the Levene’s test to assess equality of the residual variances across genotype groups. The vGWAS identified rs2852853 (P = 1.3e-08, DHCR7) and rs62389423 (P = 1.8e-05, near IRF4) in addition to two previously identified loci (HLA-DQB1 and ANKRD55), which were all statistically validated using cross validation. DHCR7 encodes an enzyme important in cutaneous synthesis of vitamin D and DHCR7 mutations are believed to be important for early humans to adapt to Northern Europe where residents have reduced ultraviolet-B exposure and tend to have light skin color. IRF4 is a key locus responsible for skin color, with a vitamin D receptor-binding interval. These vGWAS results together suggest that vitamin D deficiency is potentially causal of sero-negative RA and provide new insights into the pathogenesis of the disorder.
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26
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Thyssen JP, Elias PM. It Remains Unknown Whether Filaggrin Gene Mutations Evolved to Increase Cutaneous Synthesis of Vitamin D. Genome Biol Evol 2017; 9:900-901. [PMID: 28338939 PMCID: PMC5387992 DOI: 10.1093/gbe/evx049] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/08/2017] [Indexed: 02/07/2023] Open
Abstract
About 8-10% of normal Northern Europeans are heterozygous carriers of common FLG mutations, while only 1-4% of southern Europeans display these mutations, and only very rarely are mutations detected in African populations. Although mutations are found in Asians, they are different from those encountered in Northern Europeans. Importantly, FLG mutation carriers have 10% increased serum vitamin D concentrations compared to controls. Based on these observations, we have proposed that this latitude-dependent gradient of FLG mutations across Europe, Asia and Africa could have provided an evolutionary advantage for heterozygous FLG mutation carriers, residing at northern latitudes, depletion of the FLG downstream product, trans-urocanic acid, would facilitate the intracutaneous synthesis of vitamin D3 by allowing increased transcutaneous absorption of UVB photons. Such loss-of-function FLG mutations would have provided an evolutionary advantage for modern humans, living in the far North of Europe, where little UV-B penetrates the atomosphere. In a recent article, it was concluded not only that the UVB-Vitamin D3 hypothesis is invalid, but also that FLG genetic variations, including loss-of-function variants, provide little or no impact on the fitness of modern humans. While we welcome studies that reassess our hypothesis, their conclusions are not valid for reasons explained in this letter.
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Affiliation(s)
- Jacob P Thyssen
- Department of Dermatology and Allergy, Herlev and Gentofte University Hospital, University of Copenhagen, Hellerup, Denmark
| | - Peter M Elias
- Dermatology Service, Veterans Affairs Medical Center, and Department of Dermatology, UCSF, San Francisco, California
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27
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Mlitz V, Hussain T, Tschachler E, Eckhart L. Filaggrin has evolved from an "S100 fused-type protein" (SFTP) gene present in a common ancestor of amphibians and mammals. Exp Dermatol 2017; 26:955-957. [PMID: 28191671 DOI: 10.1111/exd.13317] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/31/2017] [Indexed: 12/23/2022]
Abstract
The expression of filaggrin in differentiated keratinocytes and the association of filaggrin mutations with ichthyosis vulgaris and atopic dermatitis suggest that this prototypical member of the S100 fused-type protein (SFTP) family plays a key role in the epidermal barrier to the environment. Here, we report that SFTP genes are present not only in amniotes but also in amphibians. Four SFTPs are expressed in the skin of the frog Xenopus laevis. The results of this study indicate that filaggrin has evolved from an ancestral SFTP that may have contributed to skin modifications during the evolutionary transition to terrestrial life.
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Affiliation(s)
- Veronika Mlitz
- Research Division of Biology and Pathobiology of the Skin, Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - Tajamul Hussain
- Research Division of Biology and Pathobiology of the Skin, Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - Erwin Tschachler
- Research Division of Biology and Pathobiology of the Skin, Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - Leopold Eckhart
- Research Division of Biology and Pathobiology of the Skin, Department of Dermatology, Medical University of Vienna, Vienna, Austria
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28
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Andersen YMF, Egeberg A, Balslev E, Jørgensen CLT, Szecsi PB, Stender S, Kaae J, Linneberg A, Gislason G, Skov L, Elias PM, Thyssen JP. Filaggrin loss-of-function mutations, atopic dermatitis and risk of actinic keratosis: results from two cross-sectional studies. J Eur Acad Dermatol Venereol 2017; 31:1038-1043. [PMID: 28213896 DOI: 10.1111/jdv.14172] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Accepted: 01/30/2017] [Indexed: 01/21/2023]
Abstract
BACKGROUND Common loss-of-function mutations in filaggrin gene (FLG) represent a strong genetic risk factor for atopic dermatitis (AD). Homozygous mutation carriers typically display ichthyosis vulgaris (IV) and many have concomitant AD. Previously, homozygous, but not heterozygous, filaggrin gene mutations have been associated with squamous cell carcinomas. OBJECTIVE The first objective was to examine the association between FLG mutations and actinic keratosis (AK). The second objective was to investigate the occurrence of AK in patients with IV and AD, respectively. METHODS FLG mutation status in patients with AK was compared with controls from the general population. Furthermore, based on nationwide data from Danish registers, we compared the risk of AK in patients with IV, AD and psoriasis, respectively. RESULTS The prevalence of homozygous FLG mutations was significantly higher in the AK group (n = 4, 0.8%) in comparison with the control group (n = 18, 0.2%), whereas the prevalence of heterozygous FLG mutations was lower. In hospital registry data, patients with AD exhibited an increased risk of AK than did psoriasis controls (adjusted OR 1.46; [95% CI 1.12-1.90]), whereas no difference in risk was observed between patients with IV and AD. CONCLUSIONS This study indicates an increased susceptibility to AK in individuals with homozygous, but not heterozygous, FLG mutations and in patients with AD compared to psoriasis. Whether a reduction or absence of epidermal filaggrin could contribute to the susceptibility to AK in patients with IV and AD is unknown and additional research is needed to further explore this relationship.
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Affiliation(s)
- Y M F Andersen
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark.,Department of Cardiology, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
| | - A Egeberg
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark.,Department of Cardiology, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
| | - E Balslev
- Department of Pathology, Herlev and Gentofte Hospital, University of Copenhagen, Herlev, Denmark
| | - C L T Jørgensen
- Department of Pathology, Herlev and Gentofte Hospital, University of Copenhagen, Herlev, Denmark
| | - P B Szecsi
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
| | - S Stender
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
| | - J Kaae
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
| | - A Linneberg
- Research Centre for Prevention and Health, the Capital Region of Denmark, Copenhagen, Denmark.,Department of Clinical Experimental Research, Rigshospitalet, Copenhagen, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - G Gislason
- Department of Cardiology, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
| | - L Skov
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
| | - P M Elias
- Dermatology Service, Veterans Affairs Medical Center, and Department of Dermatology, UCSF, San Francisco, CA, USA
| | - J P Thyssen
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
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29
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Eaaswarkhanth M, Xu D, Flanagan C, Rzhetskaya M, Hayes MG, Blekhman R, Jablonski NG, Gokcumen O. Atopic Dermatitis Susceptibility Variants in Filaggrin Hitchhike Hornerin Selective Sweep. Genome Biol Evol 2016; 8:3240-3255. [PMID: 27678121 PMCID: PMC5174745 DOI: 10.1093/gbe/evw242] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Human skin has evolved rapidly, leaving evolutionary signatures in the genome. The filaggrin (FLG) gene is widely studied for its skin-barrier function in humans. The extensive genetic variation in this gene, especially common loss-of-function (LoF) mutations, has been established as primary risk factors for atopic dermatitis. To investigate the evolution of this gene, we analyzed 2,504 human genomes and genotyped the copy number variation of filaggrin repeats within FLG in 126 individuals from diverse ancestral backgrounds. We were unable to replicate a recent study claiming that LoF of FLG is adaptive in northern latitudes with lower ultraviolet light exposure. Instead, we present multiple lines of evidence suggesting that FLG genetic variation, including LoF variants, have little or no effect on fitness in modern humans. Haplotype-level scrutinization of the locus revealed signatures of a recent selective sweep in Asia, which increased the allele frequency of a haplotype group (Huxian haplogroup) in Asian populations. Functionally, we found that the Huxian haplogroup carries dozens of functional variants in FLG and hornerin (HRNR) genes, including those that are associated with atopic dermatitis susceptibility, HRNR expression levels and microbiome diversity on the skin. Our results suggest that the target of the adaptive sweep is HRNR gene function, and the functional FLG variants that involve susceptibility to atopic dermatitis, seem to hitchhike the selective sweep on HRNR. Our study presents a novel case of a locus that harbors clinically relevant common genetic variation with complex evolutionary trajectories.
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Affiliation(s)
- Muthukrishnan Eaaswarkhanth
- Department of Biological Sciences, University at Buffalo, The State University of New York at Buffalo, Buffalo, NY
| | - Duo Xu
- Department of Biological Sciences, University at Buffalo, The State University of New York at Buffalo, Buffalo, NY
| | - Colin Flanagan
- Department of Biological Sciences, University at Buffalo, The State University of New York at Buffalo, Buffalo, NY
| | - Margarita Rzhetskaya
- Division of Endocrinology, Metabolism and Molecular Medicine, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - M Geoffrey Hayes
- Division of Endocrinology, Metabolism and Molecular Medicine, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Ran Blekhman
- Department of Genetics, Cell Biology and Development, University of Minnesota, Minneapolis, MN
| | - Nina G Jablonski
- Department of Anthropology, Pennsylvania State University, University Park, PA
| | - Omer Gokcumen
- Department of Biological Sciences, University at Buffalo, The State University of New York at Buffalo, Buffalo, NY
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30
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Elias PM, Williams ML, Bikle DD. The vitamin D hypothesis: Dead or alive?: Response to Dr. William Grant's "The UVB-vitamin D3-pigment hypothesis is alive and well-AJPA-2016-00237". AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2016; 161:756-757. [PMID: 27634223 DOI: 10.1002/ajpa.23078] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Accepted: 08/11/2016] [Indexed: 12/28/2022]
Affiliation(s)
- Peter M Elias
- Dermatology Service, Department of Veterans Affairs Medical Center, University of California San Francisco, California.,Dermatology Service, Department of Dermatology, University of California San Francisco, California
| | - Mary L Williams
- Department of Dermatology, Pediatrics University of California, San Francisco, California
| | - Daniel D Bikle
- Dermatology Service, Department of Veterans Affairs Medical Center, University of California San Francisco, California.,Dermatology Service, Department of Dermatology, University of California San Francisco, California
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Gupta J, Johansson E, Bernstein JA, Chakraborty R, Khurana Hershey GK, Rothenberg ME, Mersha TB. Resolving the etiology of atopic disorders by using genetic analysis of racial ancestry. J Allergy Clin Immunol 2016; 138:676-699. [PMID: 27297995 PMCID: PMC5014679 DOI: 10.1016/j.jaci.2016.02.045] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Revised: 02/09/2016] [Accepted: 02/25/2016] [Indexed: 12/23/2022]
Abstract
Atopic dermatitis (AD), food allergy, allergic rhinitis, and asthma are common atopic disorders of complex etiology. The frequently observed atopic march from early AD to asthma, allergic rhinitis, or both later in life and the extensive comorbidity of atopic disorders suggest common causal mechanisms in addition to distinct ones. Indeed, both disease-specific and shared genomic regions exist for atopic disorders. Their prevalence also varies among races; for example, AD and asthma have a higher prevalence in African Americans when compared with European Americans. Whether this disparity stems from true genetic or race-specific environmental risk factors or both is unknown. Thus far, the majority of the genetic studies on atopic diseases have used populations of European ancestry, limiting their generalizability. Large-cohort initiatives and new analytic methods, such as admixture mapping, are currently being used to address this knowledge gap. Here we discuss the unique and shared genetic risk factors for atopic disorders in the context of ancestry variations and the promise of high-throughput "-omics"-based systems biology approach in providing greater insight to deconstruct their genetic and nongenetic etiologies. Future research will also focus on deep phenotyping and genotyping of diverse racial ancestry, gene-environment, and gene-gene interactions.
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Affiliation(s)
- Jayanta Gupta
- Division of Asthma Research, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio
| | - Elisabet Johansson
- Division of Asthma Research, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio
| | - Jonathan A Bernstein
- Division of Immunology/Allergy Section, Department of Internal Medicine, University of Cincinnati, Cincinnati, Ohio
| | - Ranajit Chakraborty
- Center for Computational Genomics, Institute of Applied Genetics, Department of Molecular and Medical Genetics, University of North Texas Health Science Center, Fort Worth, Tex
| | - Gurjit K Khurana Hershey
- Division of Asthma Research, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio
| | - Marc E Rothenberg
- Division of Allergy and Immunology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio
| | - Tesfaye B Mersha
- Division of Asthma Research, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio.
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Landeck L, Jakasa I, Dapic I, Lutter R, Thyssen JP, Skov L, Braun A, Schön MP, John SM, Kezic S, Brans R. The effect of epidermal levels of urocanic acid on 25-hydroxyvitamin D synthesis and inflammatory mediators upon narrowband UVB irradiation. PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2016; 32:214-23. [DOI: 10.1111/phpp.12249] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/20/2016] [Indexed: 12/18/2022]
Affiliation(s)
- Lilla Landeck
- Department of Dermatology, Environmental Medicine and Health Theory; University of Osnabrück; Osnabrück Germany
- Department of Dermatology; Ernst von Bergmann General Hospital; Teaching Hospital Charité University Medicine Berlin; Potsdam Germany
| | - Ivone Jakasa
- Laboratory for Analytical Chemistry; Department of Chemistry and Biochemistry; Faculty of Food Technology and Biotechnology; University of Zagreb; Zagreb Croatia
| | - Irena Dapic
- Laboratory for Analytical Chemistry; Department of Chemistry and Biochemistry; Faculty of Food Technology and Biotechnology; University of Zagreb; Zagreb Croatia
| | - René Lutter
- Departments of Respiratory Medicine and Experimental Immunology; Academic Medical Center; University of Amsterdam; Amsterdam The Netherlands
| | - Jacob P. Thyssen
- Department of Dermato-Allergology; Gentofte Hospital; University of Copenhagen; Hellerup Denmark
| | - Lone Skov
- Department of Dermato-Allergology; Gentofte Hospital; University of Copenhagen; Hellerup Denmark
| | - Andrea Braun
- Department of Dermatology, Venereology, and Allergology; University Medical Center Göttingen; Georg August University; Göttingen Germany
- Lower Saxony Institute of Occupational Dermatology; University of Osnabrück and University Medical Center Göttingen; Osnabrück/Göttingen Germany
| | - Michael P. Schön
- Department of Dermatology, Venereology, and Allergology; University Medical Center Göttingen; Georg August University; Göttingen Germany
- Lower Saxony Institute of Occupational Dermatology; University of Osnabrück and University Medical Center Göttingen; Osnabrück/Göttingen Germany
| | - Swen M. John
- Department of Dermatology, Environmental Medicine and Health Theory; University of Osnabrück; Osnabrück Germany
- Lower Saxony Institute of Occupational Dermatology; University of Osnabrück and University Medical Center Göttingen; Osnabrück/Göttingen Germany
| | - Sanja Kezic
- Coronel Institute for Occupational Health; Academic Medical Center; University of Amsterdam; Amsterdam The Netherlands
| | - Richard Brans
- Department of Dermatology, Environmental Medicine and Health Theory; University of Osnabrück; Osnabrück Germany
- Lower Saxony Institute of Occupational Dermatology; University of Osnabrück and University Medical Center Göttingen; Osnabrück/Göttingen Germany
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Gimalova GF, Karunas AS, Fedorova YY, Khusnutdinova EK. The study of filaggrin gene mutations and copy number variation in atopic dermatitis patients from Volga-Ural region of Russia. Gene 2016; 591:85-89. [PMID: 27363669 DOI: 10.1016/j.gene.2016.06.054] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Revised: 06/16/2016] [Accepted: 06/26/2016] [Indexed: 11/15/2022]
Abstract
Atopic dermatitis (AD) is a chronic inflammatory skin disease characterized by age-specific localization, dryness, itch and hypersensitivity to allergens. In our study, we investigated FLG gene mutations and CNVs in AD patients and control subjects of different ethnic origin from Volga-Ural region. AD group included 303 patients (177 Russians, 126 Tatars). Control group consisted of 261 healthy individuals (152 Russians, 109 Tatars). The study revealed 66 FLG mutation carriers and demonstrated an association between c.2282del4 deletion and AD development in Russians and Tatars of Volga-Ural region of Russia. In the analysis of the FLG gene CNVs, the most common was 10-repeat allele in both Russian and Tatar patients and controls. We were unable to find any significant difference in CNV repeats count between AD patients and control individuals.
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Affiliation(s)
- Galiya F Gimalova
- Institute of Biochemistry and Genetics of Ufa Scientific Centre of Russian Academy of Sciences, Ufa 450054, Pr.Oktyabrya, 71, Russia.
| | - Alexandra S Karunas
- Institute of Biochemistry and Genetics of Ufa Scientific Centre of Russian Academy of Sciences, Ufa 450054, Pr.Oktyabrya, 71, Russia; Bashkir State University, Ufa 450076, ul. Z.Validi, 32, Russia
| | - Yuliya Y Fedorova
- Institute of Biochemistry and Genetics of Ufa Scientific Centre of Russian Academy of Sciences, Ufa 450054, Pr.Oktyabrya, 71, Russia
| | - Elza K Khusnutdinova
- Institute of Biochemistry and Genetics of Ufa Scientific Centre of Russian Academy of Sciences, Ufa 450054, Pr.Oktyabrya, 71, Russia; Bashkir State University, Ufa 450076, ul. Z.Validi, 32, Russia
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Elias PM, Williams ML. Basis for the gain and subsequent dilution of epidermal pigmentation during human evolution: The barrier and metabolic conservation hypotheses revisited. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2016; 161:189-207. [PMID: 27324932 DOI: 10.1002/ajpa.23030] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Revised: 05/27/2016] [Accepted: 05/29/2016] [Indexed: 12/25/2022]
Abstract
The evolution of human skin pigmentation must address both the initial evolution of intense epidermal pigmentation in hominins, and its subsequent dilution in modern humans. While many authorities believe that epidermal pigmentation evolved to protect against either ultraviolet B (UV-B) irradiation-induced mutagenesis or folic acid photolysis, we hypothesize that pigmentation augmented the epidermal barriers by shifting the UV-B dose-response curve from toxic to beneficial. Whereas erythemogenic UV-B doses produce apoptosis and cell death, suberythemogenic doses benefit permeability and antimicrobial function. Heavily melanized melanocytes acidify the outer epidermis and emit paracrine signals that augment barrier competence. Modern humans, residing in the cooler, wetter climes of south-central Europe and Asia, initially retained substantial pigmentation. While their outdoor lifestyles still permitted sufficient cutaneous vitamin D3 (VD3) synthesis, their marginal nutritional status, coupled with cold-induced caloric needs, selected for moderate pigment reductions that diverted limited nutritional resources towards more urgent priorities (=metabolic conservation). The further pigment-dilution that evolved as humans reached north-central Europe (i.e., northern France, Germany), likely facilitated cutaneous VD3 synthesis, while also supporting ongoing, nutritional requirements. But at still higher European latitudes where little UV-B breaches the atmosphere (i.e., present-day UK, Scandinavia, Baltic States), pigment dilution alone could not suffice. There, other nonpigment-related mutations evolved to facilitate VD3 production; for example, in the epidermal protein, filaggrin, resulting in reduced levels of its distal metabolite, trans-urocanic acid, a potent UV-B chromophore. Thus, changes in human pigmentation reflect a complex interplay between latitude, climate, diet, lifestyle, and shifting metabolic priorities.
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Affiliation(s)
- Peter M Elias
- Department of Veterans Affairs Medical Center, Dermatology Service, University of California San Francisco, California. .,Department of Dermatology, Dermatology Service, University of California San Francisco, California.
| | - Mary L Williams
- Department of Dermatology, University of California, San Francisco, California.,Department of Pediatrics, University of California, San Francisco, California
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Marenholz I, Esparza-Gordillo J, Lee YA. The genetics of the skin barrier in eczema and other allergic disorders. Curr Opin Allergy Clin Immunol 2016; 15:426-34. [PMID: 26226353 DOI: 10.1097/aci.0000000000000194] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW We summarize current knowledge on the genetic determinants of skin barrier deficiency in relation to eczema and disease progression to other allergic manifestations. RECENT FINDINGS There is increasing evidence that impairment of epidermal barrier function is not only a risk factor for the development of eczema but also for disease progression to allergic airway disease and food allergy. Support comes from recent association studies linking genetic variants in epidermal genes with eczema and food allergy, from monogenic diseases with severe skin barrier defects which display multiple allergic manifestations, and from mouse models providing a mechanism from skin inflammation to allergic reactions in the lung and intestine. SUMMARY The key role of the skin barrier defect in the development of eczema and eczema-associated allergic diseases may have important implications for prevention and treatment strategies. Initial clinical trials with moisturizing creams revealed promising results for the prevention of eczema in early infancy. Their long-term effects will be critical to demonstrate the potential benefit of barrier repair therapy in allergic disease prevention.
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Affiliation(s)
- Ingo Marenholz
- Pediatric Allergology, Experimental and Clinical Research Center, Charité University Medicine and Max Delbrück Center for Molecular Medicine, Berlin, Germany *These authors contributed equally to this work
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Berents T, Lødrup Carlsen K, Mowinckel P, Sandvik L, Skjerven H, Rolfsjord L, Kvenshagen B, Hunderi J, Bradley M, Lieden A, Carlsen K, Thorsby P, Gjersvik P. Vitamin D levels and atopic eczema in infancy and early childhood in Norway: a cohort study. Br J Dermatol 2016; 175:95-101. [DOI: 10.1111/bjd.14537] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/02/2016] [Indexed: 12/19/2022]
Affiliation(s)
- T.L. Berents
- Institute of Clinical Medicine University of Oslo Oslo Norway
- Department of Dermatology Oslo University Hospital Oslo Norway
| | - K.C. Lødrup Carlsen
- Institute of Clinical Medicine University of Oslo Oslo Norway
- Department of Pediatrics Oslo University Hospital Oslo Norway
| | - P. Mowinckel
- Department of Pediatrics Oslo University Hospital Oslo Norway
| | - L. Sandvik
- Institute of Clinical Medicine University of Oslo Oslo Norway
- Department of Biostatistics and Epidemiology Oslo University Hospital Oslo Norway
- University of Oslo Oslo Norway
| | - H.O. Skjerven
- Institute of Clinical Medicine University of Oslo Oslo Norway
- Department of Pediatrics Oslo University Hospital Oslo Norway
| | - L.B. Rolfsjord
- Institute of Clinical Medicine University of Oslo Oslo Norway
- Department of Pediatrics Elverum Hospital Elverum Norway
| | - B. Kvenshagen
- Department of Pediatrics Østfold Hospital Fredrikstad Norway
| | - J.O.G. Hunderi
- Institute of Clinical Medicine University of Oslo Oslo Norway
- Department of Pediatrics Oslo University Hospital Oslo Norway
- Department of Pediatrics Østfold Hospital Fredrikstad Norway
| | - M. Bradley
- Department of Molecular Medicine Karolinska Institute at Karolinska Hospital Stockholm Sweden
| | - A. Lieden
- Department of Molecular Medicine Karolinska Institute at Karolinska Hospital Stockholm Sweden
| | - K.‐H. Carlsen
- Institute of Clinical Medicine University of Oslo Oslo Norway
- Department of Pediatrics Oslo University Hospital Oslo Norway
| | - P.M. Thorsby
- Institute of Clinical Medicine University of Oslo Oslo Norway
- Hormone Laboratory Department of Medical Biochemistry Oslo University Hospital Oslo Norway
| | - P. Gjersvik
- Institute of Clinical Medicine University of Oslo Oslo Norway
- Department of Dermatology Oslo University Hospital Oslo Norway
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Peterson LA, Canner JK, Cheskin LJ, Prokopowicz GP, Schweitzer MA, Magnuson TH, Steele KE. Proxy measures of vitamin D status - season and latitude - correlate with adverse outcomes after bariatric surgery in the Nationwide Inpatient Sample, 2001-2010: a retrospective cohort study. Obes Sci Pract 2015; 1:88-96. [PMID: 27774252 PMCID: PMC5064633 DOI: 10.1002/osp4.15] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Revised: 09/22/2015] [Accepted: 09/29/2015] [Indexed: 12/16/2022] Open
Abstract
Objective To investigate the association between adverse surgical outcomes following bariatric surgery and proxy measures of vitamin D (VitD) status (season and latitude) in the Nationwide Inpatient Sample (NIS). Background Obesity is an independent risk factor for VitD deficiency (25(OH)D < 20 ng ml−1). VitD deficiency compounds the chronic inflammation of obesity, increasing the risk of adverse outcomes following bariatric surgery. Epidemiology has long used season and latitude as proxies for group VitD, as VitD status is largely determined by sun exposure, which is greatest during summer and at the Equator. Methods We assessed proxy measures of group VitD status. We compared surgeries in VitD Summer (July to September), Winter (January to March), and Fall/Spring (October to December and April to June) and in the North (≥37°N) vs. the South (<37°N). Results We identified 932,091 bariatric surgeries; 81.2% were women and 74.4% were white. Sex was unequally distributed by season (p = 0.005). Median age was 43.0 years (all groups). Most surgeries occurred in the North (64.8%). Adverse outcome rates ranged from 0.01% (wound infections) to 39.4% [prolonged length of stay {LOS}]. Season was inversely associated with wound infection (p = 0.018) and dehiscence (p = 0.001). Extended LOS was inversely correlated with season (p < 0.001). These relationships held after adjustment. Prolonged LOS (p < 0.001) and any complication (p = 0.108) were more common in the North. Conclusions We have demonstrated a graded relationship between seasonality and adverse outcomes following bariatric surgery. The association was strongest for dehiscence and prolonged LOS. These relationships held when using latitude. A prospective study measuring pre‐operative 25(OH)D concentration would strengthen the case for causality in adverse surgical outcomes.
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Affiliation(s)
- L A Peterson
- The Johns Hopkins Center for Bariatric Surgery Baltimore USA; The Johns Hopkins Bloomberg School of Public Health Baltimore USA
| | - J K Canner
- The Johns Hopkins Center for Surgical Trials and Outcomes Research Baltimore USA
| | - L J Cheskin
- The Johns Hopkins Bloomberg School of Public Health Baltimore USA; The Johns Hopkins Weight Management Center Baltimore USA; The Global Obesity Prevention Center at Johns Hopkins Baltimore USA
| | | | - M A Schweitzer
- The Johns Hopkins Center for Bariatric Surgery Baltimore USA
| | - T H Magnuson
- The Johns Hopkins Center for Bariatric Surgery Baltimore USA
| | - K E Steele
- The Johns Hopkins Center for Bariatric Surgery Baltimore USA
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Heede NG, Thyssen JP, Thuesen BH, Linneberg A, Johansen JD. Anatomical patterns of dermatitis in adult filaggrin mutation carriers. J Am Acad Dermatol 2015; 72:440-8. [DOI: 10.1016/j.jaad.2015.01.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Revised: 12/12/2014] [Accepted: 01/05/2015] [Indexed: 01/28/2023]
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