1
|
Elgenidy A, Gad EF, Shabaan I, Abdelrhem H, Wassef PG, Elmozugi T, Abdelfattah M, Mousa H, Nasr M, Salah-Eldin M, Altaweel A, Hussein A, Bazzazeh M, Elganainy MA, Ali AM, Ezzat M, Elhoufey A, Alatram AA, Hammour A, Saad K. Examining the association between autism spectrum disorder and atopic eczema: meta-analysis of current evidence. Pediatr Res 2024:10.1038/s41390-024-03456-1. [PMID: 39128926 DOI: 10.1038/s41390-024-03456-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 07/03/2024] [Accepted: 07/18/2024] [Indexed: 08/13/2024]
Abstract
OBJECTIVES This study aims to investigate the association between autism spectrum disorder (ASD) and atopic eczema (AE), shedding light on potential associations and underlying mechanisms. METHODS A comprehensive review of literature was conducted to identify relevant studies published up to August 2023. Various electronic databases, including PubMed, Embase, Scopus, Web of Science, and Cochrane, were searched using specific keywords related to ASD and AE. RESULTS The meta-analysis covered a total of 30 studies. The first analysis included 23 studies with a combined total of 147430 eczema patients in the ASD group and 8895446 eczema patients in non-ASD group. We calculated the risk ratio of eczema in ASD and non-ASD groups, which revealed a significantly higher risk of eczema in patients with ASD (RR 1.34; 95% CI 1.03, 1.76). The second analysis included seven studies with a combined total of 3570449 ASD patients in the AE group and 3253973 in the non-Eczema group. The risk ratio of ASD in the Eczema and Non-Eczema groups showed a significantly increased risk of ASD in patients with eczema (RR 1.67; 95% CI 0.91, 3.06). CONCLUSION This study underscores the possible link between ASD and atopic eczema, shedding light on their potential association. IMPACT Our study conducted a meta-analysis on the association between autism spectrum disorder (ASD) and atopic eczema (AE), shedding light on potential associations and underlying mechanisms. The review we conducted covered a total of 30 studies. This study underscores the possible link between ASD and atopic eczema, shedding light on their potential association.
Collapse
Affiliation(s)
| | - Eman F Gad
- Pediatric Department, Faculty of Medicine, Assiut University, Assiut, 71516, Egypt
| | - Islam Shabaan
- Department of Psychiatry, Faculty of Medicine, Al Azhar University, Assiut, Egypt
| | | | | | - Taher Elmozugi
- Faculty of Medicine, Benghazi University, Benghazi, Libya
| | | | - Hisham Mousa
- Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mohamed Nasr
- Faculty of Medicine, Al-Azhar University, New Damietta, Egypt
| | | | - Ahmed Altaweel
- Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | | | | | | | - Ahmed M Ali
- Pediatric Department, Faculty of Medicine, Assiut University, Assiut, 71516, Egypt
| | - Mohamed Ezzat
- Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Amira Elhoufey
- Department of Community Health Nursing, Alddrab University College, Jazan University, Jazan, 45142, Saudi Arabia
- Department of Community Health Nursing, Faculty of Nursing, Assiut University, Assiut, Egypt
| | - Abdulrahman A Alatram
- Department of Psychiatry, College of Medicine, Majmaah University, Al Majmaah, Saudi Arabia
| | - Ahmed Hammour
- Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Khaled Saad
- Pediatric Department, Faculty of Medicine, Assiut University, Assiut, 71516, Egypt.
| |
Collapse
|
2
|
Nagata A, Onishi K, Masumoto T, Nakagawa T, Ishitsuka K, Kurozawa Y. Early childhood neurodevelopmental milestones in children with allergic diseases: the Japan Environment and Children's Study (JECS). Sci Rep 2024; 14:6460. [PMID: 38499597 PMCID: PMC10948893 DOI: 10.1038/s41598-024-57210-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Accepted: 03/15/2024] [Indexed: 03/20/2024] Open
Abstract
This study investigated the potential link between early childhood allergic diseases and neurodevelopmental milestone attainment during the first 3 years of life. Utilizing data from a large-scale prospective birth cohort study in Japan, encompassing 87,986 children, we examined physician-diagnosed and caregiver-reported allergic conditions, including atopic dermatitis (AD), asthma, and food allergy (FA). Neurodevelopmental milestones were assessed using the Ages and Stages Questionnaires at 1, 1.5, 2, 2.5, and 3 years of age. Stabilized inverse probability-weighted generalized estimating equation models were employed to estimate odds ratios (ORs). Our analysis revealed no significant association of AD and asthma with delay in communication, gross motor, fine motor, problem-solving, and personal-social skills during the initial 3 years of life. However, children with FA showed an increased likelihood of experiencing gross motor delay compared with that shown by those without FA (weighted adjusted OR: 1.14). Despite this, no significant association of FA with other developmental domains was observed. Early childhood allergies may not influence neurodevelopmental delays. However, there is a potential association between FA and delays, specifically in gross motor skills, that warrants routine developmental monitoring and additional investigations.
Collapse
Affiliation(s)
- Abir Nagata
- Department of Regenerative Dermatology, Graduate School of Medicine, Osaka University, 2-2, Yamadaoka, Suita-shi, Osaka, 565-0871, Japan.
- Graduate School of Public Health, St. Luke's International University, Tokyo, Japan.
| | - Kazunari Onishi
- Division of Environmental Health, Graduate School of Public Health, St. Luke's International University, 3-6-2 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.
| | - Toshio Masumoto
- Division of Health Administration and Promotion, Faculty of Medicine, Tottori University, Tottori, Japan
| | - Takatoshi Nakagawa
- Department of Regenerative Dermatology, Graduate School of Medicine, Osaka University, 2-2, Yamadaoka, Suita-shi, Osaka, 565-0871, Japan
| | - Kazue Ishitsuka
- Department of Social Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Youichi Kurozawa
- Division of Health Administration and Promotion, Faculty of Medicine, Tottori University, Tottori, Japan
| |
Collapse
|
3
|
Day DB, LeWinn KZ, Karr CJ, Loftus CT, Carroll KN, Bush NR, Zhao Q, Barrett ES, Swan SH, Nguyen RHN, Trasande L, Moore PE, Adams Ako A, Ji N, Liu C, Szpiro AA, Sathyanarayana S. Subpopulations of children with multiple chronic health outcomes in relation to chemical exposures in the ECHO-PATHWAYS consortium. ENVIRONMENT INTERNATIONAL 2024; 185:108486. [PMID: 38367551 PMCID: PMC10961192 DOI: 10.1016/j.envint.2024.108486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 02/01/2024] [Accepted: 02/05/2024] [Indexed: 02/19/2024]
Abstract
A multimorbidity-focused approach may reflect common etiologic mechanisms and lead to better targeting of etiologic agents for broadly impactful public health interventions. Our aim was to identify clusters of chronic obesity-related, neurodevelopmental, and respiratory outcomes in children, and to examine associations between cluster membership and widely prevalent chemical exposures to demonstrate our epidemiologic approach. Early to middle childhood outcome data collected 2011-2022 for 1092 children were harmonized across the ECHO-PATHWAYS consortium of 3 prospective pregnancy cohorts in six U.S. cities. 15 outcomes included age 4-9 BMI, cognitive and behavioral assessment scores, speech problems, and learning disabilities, asthma, wheeze, and rhinitis. To form generalizable clusters across study sites, we performed k-means clustering on scaled residuals of each variable regressed on study site. Outcomes and demographic variables were summarized between resulting clusters. Logistic weighted quantile sum regressions with permutation test p-values associated odds of cluster membership with a mixture of 15 prenatal urinary phthalate metabolites in full-sample and sex-stratified models. Three clusters emerged, including a healthier Cluster 1 (n = 734) with low morbidity across outcomes; Cluster 2 (n = 192) with low IQ and higher levels of all outcomes, especially 0.4-1.8-standard deviation higher mean neurobehavioral outcomes; and Cluster 3 (n = 179) with the highest asthma (92 %), wheeze (53 %), and rhinitis (57 %) frequencies. We observed a significant positive, male-specific stratified association (odds ratio = 1.6; p = 0.01) between a phthalate mixture with high weights for MEP and MHPP and odds of membership in Cluster 3 versus Cluster 1. These results identified subpopulations of children with co-occurring elevated levels of BMI, neurodevelopmental, and respiratory outcomes that may reflect shared etiologic pathways. The observed association between phthalates and respiratory outcome cluster membership could inform policy efforts towards children with respiratory disease. Similar cluster-based epidemiology may identify environmental factors that impact multi-outcome prevalence and efficiently direct public policy efforts.
Collapse
Affiliation(s)
- Drew B Day
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, 1920 Terry Avenue, Seattle, Washington 98101, USA.
| | - Kaja Z LeWinn
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, 675 18th Street, San Francisco, CA 94143, USA
| | - Catherine J Karr
- Department of Environmental and Occupational Health, University of Washington, 4245 Roosevelt Way NE, Seattle, WA 98105, USA; Department of Epidemiology, University of Washington, 4245 Roosevelt Way NE, Seattle, WA 98105, USA; Department of Pediatrics, University of Washington, 4245 Roosevelt Way NE, Seattle, WA 98105, USA
| | - Christine T Loftus
- Department of Environmental and Occupational Health, University of Washington, 4245 Roosevelt Way NE, Seattle, WA 98105, USA
| | - Kecia N Carroll
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York, NY 10029, USA; Department of Pediatrics, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York, NY 10029, USA
| | - Nicole R Bush
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, 675 18th Street, San Francisco, CA 94143, USA; Department of Pediatrics, University of California San Francisco, San Francisco, CA, USA
| | - Qi Zhao
- Department of Preventive Medicine, Division of Preventive Medicine, University of Tennessee Health Science Center, 66 North Pauline Street, Memphis, TN 38163, USA
| | - Emily S Barrett
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, 683 Hoes Lane West, Piscataway, NJ 08854, USA; Environmental and Occupational Health Sciences Institute, Rutgers University, 170 Frelinghuysen Road, Piscataway, NJ 08854, USA
| | - Shanna H Swan
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York, NY 10029, USA
| | - Ruby H N Nguyen
- Department of Epidemiology and Community Health, University of Minnesota, 420 Delaware Street Southeast, Minneapolis, Minnesota 55455, USA
| | - Leonardo Trasande
- Department of Pediatrics, New York University Grossman School of Medicine, 550 First Avenue, New York, NY 10016, USA
| | - Paul E Moore
- Division of Allergy, Immunology, and Pulmonary Medicine, Department of Pediatrics, Vanderbilt University Medical Center, 2200 Children's Way, Nashville, TN 37232, USA
| | - Ako Adams Ako
- Department of Pediatrics, Children's Hospital at Montefiore, 3415 Bainbridge Avenue, Bronx, NY 10467, USA
| | - Nan Ji
- Division of Environmental Health, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, 1845 N Soto St, MC 9239, Los Angeles, CA, 90039, USA
| | - Chang Liu
- Department of Psychology, Washington State University, Johnson Tower, Pullman, WA 99164, USA
| | - Adam A Szpiro
- Department of Biostatistics, University of Washington, 3980 15th Avenue NE, Seattle, WA 98195, USA
| | - Sheela Sathyanarayana
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, 1920 Terry Avenue, Seattle, Washington 98101, USA; Department of Environmental and Occupational Health, University of Washington, 4245 Roosevelt Way NE, Seattle, WA 98105, USA; Department of Epidemiology, University of Washington, 4245 Roosevelt Way NE, Seattle, WA 98105, USA; Department of Pediatrics, University of Washington, 4245 Roosevelt Way NE, Seattle, WA 98105, USA
| |
Collapse
|
4
|
Lv H, Liu K, Xie Y, Wang Y, Chen S, Liu P, Guan M, Cong J, Xu Y. No causal association between allergic rhinitis and migraine: a Mendelian randomization study. Eur J Med Res 2024; 29:78. [PMID: 38281051 PMCID: PMC10821569 DOI: 10.1186/s40001-024-01682-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 01/17/2024] [Indexed: 01/29/2024] Open
Abstract
PURPOSE Allergic rhinitis (AR) and migraine are among the most common public health problems worldwide. Observational studies on the correlation between AR and migraine have reported inconsistent results. This study aimed to investigate the causal relationship of AR with migraine and its subtypes, including migraine with aura (MA) and migraine without aura (MO). METHODS Bidirectional two-sample Mendelian randomization (MR) analysis was performed with publicly available summary-level statistics of large genome-wide association studies to estimate the possible causal effects. The inverse variance-weighted method was selected for primary analysis and was supplemented with the weighted median, weighted mode, and MR-Egger methods. The causal analysis using summary effect estimates (CAUSE) were further performed to verify the causality. Several sensitivity tests, including the leave-one-out, Cochran's Q, MR-Egger intercept, and MR-PRESSO tests, were performed to assess the robustness of the results. RESULTS AR did not exhibit a significant causal correlation with the elevated risk of any migraine (odd ratio (OR), 0.816; 95% confidence interval (CI), 0.511-1.302; P = 0.394), MA (OR, 0.690; 95% CI 0.298-1.593; P = 0.384), or MO (OR, 1.022; 95% CI 0.490-2.131; P = 0.954). Consistently, reverse MR analysis did not reveal causal effects of any migraine or its subtypes on AR. Almost all sensitivity analyses supported the robustness of the results. CONCLUSIONS This MR study did not reveal a clear causal association between AR and migraine risk. More research is warranted to reveal the complex association between AR and migraine.
Collapse
Affiliation(s)
- Hao Lv
- Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, 430060, Hubei, China
- Department of Rhinology and Allergy, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, 430060, Hubei, China
| | - Kunyu Liu
- Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, 430060, Hubei, China
- Department of Rhinology and Allergy, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, 430060, Hubei, China
| | - Yulie Xie
- Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, 430060, Hubei, China
- Department of Rhinology and Allergy, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, 430060, Hubei, China
| | - Yunfei Wang
- Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, 430060, Hubei, China
- Department of Rhinology and Allergy, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, 430060, Hubei, China
| | - Siyuan Chen
- Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, 430060, Hubei, China
- Department of Rhinology and Allergy, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, 430060, Hubei, China
| | - Peiqiang Liu
- Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, 430060, Hubei, China
- Department of Rhinology and Allergy, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, 430060, Hubei, China
- Research Institute of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, 430060, Hubei, China
| | - Mengting Guan
- Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, 430060, Hubei, China
- Department of Rhinology and Allergy, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, 430060, Hubei, China
| | - Jianchao Cong
- Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, 430060, Hubei, China
- Department of Rhinology and Allergy, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, 430060, Hubei, China
| | - Yu Xu
- Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, 430060, Hubei, China.
- Department of Rhinology and Allergy, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, 430060, Hubei, China.
- Research Institute of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, 430060, Hubei, China.
- Hubei Province Key Laboratory of Allergy and Immunology, Wuhan, 430071, Hubei, China.
| |
Collapse
|
5
|
Man MQ, Yang S, Mauro TM, Zhang G, Zhu T. Link between the skin and autism spectrum disorder. Front Psychiatry 2023; 14:1265472. [PMID: 37920540 PMCID: PMC10619695 DOI: 10.3389/fpsyt.2023.1265472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Accepted: 09/28/2023] [Indexed: 11/04/2023] Open
Abstract
Autism spectrum disorder (ASD) is a common neurological disorder. Although the etiologies of ASD have been widely speculated, evidence also supports the pathogenic role of cutaneous inflammation in autism. The prevalence of ASD is higher in individuals with inflammatory dermatoses than in those without inflammatory diseases. Anti-inflammation therapy alleviates symptoms of ASD. Recent studies suggest a link between epidermal dysfunction and ASD. In the murine model, mice with ASD display epidermal dysfunction, accompanied by increased expression levels of proinflammatory cytokines in both the skin and the brain. Children with ASD, which develops in their early lifetime, also exhibit altered epidermal function. Interestingly, improvement in epidermal function alleviates some symptoms of ASD. This line of evidence suggests a pathogenic role of cutaneous dysfunction in ASD. Either an improvement in epidermal function or effective treatment of inflammatory dermatoses can be an alternative approach to the management of ASD. We summarize here the current evidence of the association between the skin and ASD.
Collapse
Affiliation(s)
- Mao-Qiang Man
- Dermatology Hospital, Southern Medical University, Guangzhou, China
- Department of Dermatology, University of California, San Francisco, CA, United States
- Dermatology Service, San Francisco VA Medical Center,San Francisco, CA, United States
| | - Shuyun Yang
- Department of Dermatology, The People’s Hospital of Baoshan, Baoshan, China
| | - Theodora M. Mauro
- Department of Dermatology, University of California, San Francisco, CA, United States
- Dermatology Service, San Francisco VA Medical Center,San Francisco, CA, United States
| | - Guoqiang Zhang
- Department of Dermatology, The First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Tingting Zhu
- Department of Dermatology, The First Affiliated Hospital of Soochow University, Suzhou, China
| |
Collapse
|
6
|
Jackson-Cowan L, Silverberg JI. Longitudinal course of cognitive impairment in patients with atopic dermatitis. Arch Dermatol Res 2023; 315:1553-1560. [PMID: 36708375 DOI: 10.1007/s00403-023-02536-2] [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: 09/06/2022] [Revised: 01/10/2023] [Accepted: 01/13/2023] [Indexed: 01/29/2023]
Abstract
Atopic dermatitis (AD) is a common inflammatory skin disease. Cognitive dysfunction was recently demonstrated to be increased in adults and children with AD. However, little is known about the longitudinal course of cognitive impairment in AD and its relationship with pruritus. To investigate the longitudinal course and predictors of cognitive impairment in AD a prospective dermatology practice-based study was performed using questionnaires and evaluation by a dermatologist (n = 210). Patients with ≥ 2 visits were included (mean follow-up time: 318 days). Cognitive function was assessed using the Patient-Reported Outcomes Measurement Information System (PROMIS) Cognitive Function 8-item Short-Form. At baseline, 20.85% of patients had PROMIS T scores ≤ 45, indicating cognitive impairment (CI). Among patients with CI at baseline, 34.09% had persistent CI, 47.72% had a fluctuating course, and 18.18% had sustained improvement of cognitive function. In repeated-measures regression models, cognitive function scores declined overtime in patients with worse AD severity [SCORing Atopic Dermatitis (SCORAD): p = 0.01, Atopic Dermatitis Severity Index: p = 0.001], increased itch (p = 0.01), skin pain (p = 0.001), and sleep disturbance (p = 0.001). In multivariable logistic regression models, persistent CI was associated with female gender and depressive symptoms [moderate-to-severe Patient Health Questionnaire-9 score (PHQ9)]. Latent class analysis identified two classes of cognitive dysfunction: normal cognition (77.23%), moderate dysfunction (16.21%) and severe impairment (6.55%). Black/African-American race (p = 0.02), moderate-to-severe SCORAD (p = 0.03), dermatology life quality index (p < 0.0001), PHQ9 (p < 0.0001), itch (p = 0.02) and skin pain (p < 0.0001) were more likely to experience moderate dysfunction or severe cognitive impairment. AD is associated with a heterogeneous longitudinal course of cognitive function in adults, with some patients experiencing persistent CI over time.
Collapse
Affiliation(s)
- Ladonya Jackson-Cowan
- AU/UGA Medical Partnership, The Medical College of Georgia at Augusta University, Athens, GA, USA
| | - Jonathan I Silverberg
- Department of Dermatology, The George Washington University School of Medicine and Health Sciences, Suite 2B-425, 2150 Pennsylvania Avenue, Washington, DC, 20037, USA.
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, USA.
| |
Collapse
|
7
|
The Role of Noncoding RNA in Airway Allergic Diseases through Regulation of T Cell Subsets. Mediators Inflamm 2022; 2022:6125698. [PMID: 36248190 PMCID: PMC9553461 DOI: 10.1155/2022/6125698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 08/31/2022] [Accepted: 09/23/2022] [Indexed: 11/18/2022] Open
Abstract
Allergic rhinitis and asthma are common airway allergic diseases, the incidence of which has increased annually in recent years. The human body is frequently exposed to allergens and environmental irritants that trigger immune and inflammatory responses, resulting in altered gene expression. Mounting evidence suggested that epigenetic alterations were strongly associated with the progression and severity of allergic diseases. Noncoding RNAs (ncRNAs) are a class of transcribed RNA molecules that cannot be translated into polypeptides and consist of three major categories, microRNAs (miRNAs), long noncoding RNAs (lncRNAs), and circular RNAs (circRNAs). Previous studies showed that ncRNAs were involved in the physiopathological mechanisms of airway allergic diseases and contributed to their occurrence and development. This article reviews the current state of understanding of the role of noncoding RNAs in airway allergic diseases, highlights the limitations of recent studies, and outlines the prospects for further research to facilitate the clinical translation of noncoding RNAs as therapeutic targets and biomarkers.
Collapse
|
8
|
Peng C, Yu N, Ding Y, Shi Y. Epidemiological variations in global burden of atopic dermatitis: An analysis of trends from 1990 to 2019. Allergy 2022; 77:2843-2845. [PMID: 35587441 DOI: 10.1111/all.15380] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 04/28/2022] [Accepted: 05/16/2022] [Indexed: 01/27/2023]
Affiliation(s)
- Chen Peng
- Department of Dermatology, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China.,Institute of Psoriasis, Tongji University School of Medicine, Shanghai, China
| | - Ning Yu
- Department of Dermatology, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China.,Institute of Psoriasis, Tongji University School of Medicine, Shanghai, China
| | - Yangfeng Ding
- Department of Dermatology, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China.,Institute of Psoriasis, Tongji University School of Medicine, Shanghai, China
| | - Yuling Shi
- Department of Dermatology, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China.,Institute of Psoriasis, Tongji University School of Medicine, Shanghai, China
| |
Collapse
|
9
|
Chang SJ, Kuo HC, Chou WJ, Tsai CS, Lee SY, Wang LJ. Cytokine Levels and Neuropsychological Function among Patients with Attention-Deficit/Hyperactivity Disorder and Atopic Diseases. J Pers Med 2022; 12:jpm12071155. [PMID: 35887652 PMCID: PMC9316989 DOI: 10.3390/jpm12071155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 07/15/2022] [Accepted: 07/16/2022] [Indexed: 11/16/2022] Open
Abstract
Since atopic disease and inflammatory cytokines are both involved in attention deficit hyperactivity disorder (ADHD), in this study, we examined the relationship among cytokine levels, neuropsychological function, and behavioral manifestations in patients with ADHD and atopic diseases. Participants were categorized into individuals with ADHD and atopic disease (n = 41), those with ADHD without allergy (n = 74), individuals without ADHD but with allergy (n = 23), and those without ADHD or allergy (n = 49). We used the Swanson, Nolan, and Pelham IV Scale (SNAP-IV), Conners’ Continuous Performance Test (Conners CPT), and Conners’ Continuous Auditory Test of Attention (CATA) to assess patients’ behavioral symptoms, visual attention, and auditory attention, respectively. Participants’ IFN-γ, IL-1B, IL-6, IL-10, IL-13, IL-17, MCP-1, and TNF-α plasma levels were assessed using multiplex assays. We found that the prevalence rates of atopic diseases (asthma, allergic rhinitis, or atopic dermatitis) were similar between individuals with ADHD and those without ADHD. ADHD behavioral symptoms (SNAP-IV), CPT omission scores, and CATA detectability scores demonstrated significant differences between individuals with ADHD and those without ADHD, regardless of atopic diseases. However, plasma levels of cytokines (TNF-α, IFN-γ, and IL-17) were negatively correlated with inattention symptoms. This study demonstrates a potential relationship between cytokine levels and neuropsychological function among patients with ADHD and atopic diseases.
Collapse
Affiliation(s)
- Shung-Jie Chang
- Department of Child and Adolescent Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan; (S.-J.C.); (W.-J.C.); (C.-S.T.)
| | - Ho-Chang Kuo
- Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan;
- Kawasaki Disease Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan
| | - Wen-Jiun Chou
- Department of Child and Adolescent Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan; (S.-J.C.); (W.-J.C.); (C.-S.T.)
| | - Ching-Shu Tsai
- Department of Child and Adolescent Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan; (S.-J.C.); (W.-J.C.); (C.-S.T.)
| | - Sheng-Yu Lee
- Department of Psychiatry, Kaohsiung Veterans General Hospital, Kaohsiung 83301, Taiwan;
- Department of Psychiatry, College of Medicine, Kaohsiung Medical University, Kaohsiung 83301, Taiwan
| | - Liang-Jen Wang
- Department of Child and Adolescent Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan; (S.-J.C.); (W.-J.C.); (C.-S.T.)
- Correspondence: ; Tel.: +886-7-7317123 (ext. 8753); Fax: +886-7-7326817
| |
Collapse
|
10
|
Germundson DL, Nookala S, Smith NA, Warda Y, Nagamoto-Combs K. HLA-II Alleles Influence Physical and Behavioral Responses to a Whey Allergen in a Transgenic Mouse Model of Cow's Milk Allergy. FRONTIERS IN ALLERGY 2022; 3:870513. [PMID: 35769584 PMCID: PMC9234862 DOI: 10.3389/falgy.2022.870513] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Accepted: 03/24/2022] [Indexed: 11/24/2022] Open
Abstract
The symptoms of food allergies vary significantly between individuals, likely due to genetic determinants. In humans, allergy development is initiated by antigen-presenting cells via class II human leukocyte antigen (HLA-II). The HLA-II gene is highly polymorphic, and its allelic variance is thought to influence the susceptibility of individuals to a particular allergen. However, whether antigen presentation by different HLA-II variants contributes to symptom variation is not clear. We hypothesized that HLA-II allelic variance affects symptom phenotypes, including immediate physical reactions and delayed behavioral changes, in individuals with food hypersensitivity. To test our hypothesis, male and female mice of three transgenic strains expressing an HLA-II variant, DR3, DR15, or DQ8, were used to establish a cow's milk allergy model. Mice were sensitized to a bovine whey allergen, β-lactoglobulin (BLG; Bos d 5), weekly for 5 weeks, followed by an acute oral allergen challenge. At 30 min post-challenge, BLG-sensitized DR3 mice showed moderate to severe anaphylaxis resulting in perioral redness, swelling, and death. In contrast, DQ8 and DR15 mice were generally asymptomatic. The production of allergen-specific immunoglobulins was also HLA- and sex-dependent. Both male and female DR3 and female DR15 mice significantly increased BLG-specific IgE production, while robust elevation in BLG-specific IgG1 was observed in sensitized DQ8 mice of both sexes and, to a lesser extent, in DR15 males. Furthermore, BLG-sensitized DR15 mice showed sex-specific behavior changes, with males exhibiting mobility changes and anxiety-like behavior and females showing spatial memory impairment. When splenocytes from transgenic mice were stimulated in vitro with BLG, phenotypes of immune cells were HLA- and sex-specific, further underscoring the influence of HLA-II on immune responses. Our results support that HLA-II alleles influence behavioral responses in addition to immune and physical reactions of food allergy, suggesting that certain HLA-II variants may predispose individuals to food-allergy-associated behavioral changes.
Collapse
Affiliation(s)
- Danielle L. Germundson
- Department of Pathology, Clinical and Translational Sciences Graduate Program, University of North Dakota School of Medicine & Health Sciences, Grand Forks, ND, United States
| | - Suba Nookala
- Department of Biomedical Sciences, University of North Dakota School of Medicine & Health Sciences, Grand Forks, ND, United States
| | - Nicholas A. Smith
- Department of Pathology, Clinical and Translational Sciences Graduate Program, University of North Dakota School of Medicine & Health Sciences, Grand Forks, ND, United States
| | - Yassmine Warda
- Department of Biomedical Sciences, University of North Dakota School of Medicine & Health Sciences, Grand Forks, ND, United States
| | - Kumi Nagamoto-Combs
- Department of Biomedical Sciences, University of North Dakota School of Medicine & Health Sciences, Grand Forks, ND, United States
- *Correspondence: Kumi Nagamoto-Combs
| |
Collapse
|
11
|
Ha EK, Kim JH, Kwak JH, Lee S, Cha HR, Chung EH, Han MY. Association of clinical and social factors with risk of fracture in children with atopic dermatitis. Pediatr Allergy Immunol 2022; 33:e13712. [PMID: 34862671 DOI: 10.1111/pai.13712] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 11/17/2021] [Accepted: 11/24/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Children with atopic dermatitis (AD) have multiple risk factors for accidental fractures, injuries that can lead to significant morbidity and mortality. However, little is known about the factors that mediate the relationship between AD and fracture in children. OBJECTIVE Our purpose was to examine the association of AD with fracture and to identify potential mediating factors. METHODS This retrospective cohort study examined children with and without AD from a longitudinal matched cohort database of 353,040 children registered in the national health insurance service and participated in the national health-screening program of Korea. We defined AD using medical claims and medication prescription records. We investigated accidental fracture events between the index date and the end of follow-up in a propensity score-matched cohort. Pre-specified subgroup analyses considered fractures in four different regions of the body. The mediating effects of 10 possible clinical factors (including the use of antihistamines and systemic corticosteroids) and social factors (including nutritional status and parental safety awareness) were determined. RESULTS There were 145,704 participating children, 20% with AD and 49% girls. Fractures occurred in 6,652 of the children with AD (23%, mean age: 64.6 ± 29.2 months) and in 24,698 of the control group (21%, mean age 65.0 ± 28.9 months). Children with AD had an 8% greater risk of fracture events overall (adjusted relative risk [aRR]: 1.08, 95% CI: 1.05-1.10). In subgroup analysis, AD was related to increased rates of skull and facial bone fracture (aRR: 1.09, 95% CI: 1.04-1.14), for trunk including vertebrae (aRR: 1.58, 95% CI: 1.22- 2.05), and for distal limbs (aRR: 1.11, 95% CI: 1.07-1.15). However, the relationship with proximal limb fracture was insignificant. Duration of systemic corticosteroid prescription was the largest mediating factor, followed by duration of antihistamine prescription, and infant feeding practices. In particular, the duration of systemic corticosteroid prescription was significantly associated with fracture events (incidence: 20.1% at the 25th percentile and 23.6% at the 75th percentile; difference: 3.4% [95% CI: 2.8-4.0%]). CONCLUSIONS Children with AD were related to increased fracture events. The key factors with mediating effects were systemic use of corticosteroid and antihistamine. Infant feeding practices had weaker mediating effects.
Collapse
Affiliation(s)
- Eun Kyo Ha
- Department of Pediatrics, Hallym University Kangnam Sacred Heart Hospital, Seoul, Korea
| | - Ju Hee Kim
- Department of Pediatrics, Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea
| | - Ji Hee Kwak
- Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Soonchul Lee
- Department of Orthopaedic Surgery, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
| | - Hye Ryeong Cha
- Department of Data Science, Sejong University College of Software Convergence, Seoul, Korea
| | - Eun Hee Chung
- Department of Pediatrics, Chungnam National University College of Medicine, Daejeon, Korea
| | - Man Yong Han
- Department of Pediatrics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
| |
Collapse
|
12
|
Yaneva M, Darlenski R. The link between atopic dermatitis and asthma- immunological imbalance and beyond. Asthma Res Pract 2021; 7:16. [PMID: 34911576 PMCID: PMC8672460 DOI: 10.1186/s40733-021-00082-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 12/09/2021] [Indexed: 12/20/2022] Open
Abstract
Atopic diseases are multifactorial chronic disturbances which may evolve one into another and have overlapping pathogenetic mechanisms. Atopic dermatitis is in most cases the first step towards the development of the atopic march and represents a major socio-economic burden in the industrialized countries. The treatment of atopic diseases is often long-lasting and in some cases with lower effectiveness than expected. In order to prevent the development of the atopic march, the links between the atopic diseases have to be understood. The aim of this review is to present some major points outlining the link between atopic dermatitis and asthma, through a research in the medical literature from recent years. Stratifying patient populations according to the clinical phenotype of their disease and according to specific measurable values (biomarkers) can help to establish the main etiopathogenetic mechanisms of the disease in these populations. This will add predictive value for the evolution of the disease, and will allow the use and research of more targeted therapy in order to stop this evolution and comorbidities.
Collapse
Affiliation(s)
- Martina Yaneva
- Department of Dermatology and Venereology, Acibadem City Clinic, Sofia, Bulgaria.
| | - Razvigor Darlenski
- Department of Dermatology and Venereology, Acibadem City Clinic, Sofia, Bulgaria.,Section of Dermatovenereology, Trakia University, Stara Zagora, Bulgaria
| |
Collapse
|
13
|
DESCRIBE-AD: A novel classification framework for atopic dermatitis. J Am Acad Dermatol 2021; 87:541-550. [PMID: 34774658 PMCID: PMC10119387 DOI: 10.1016/j.jaad.2021.10.058] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Revised: 09/27/2021] [Accepted: 10/29/2021] [Indexed: 12/22/2022]
Abstract
BACKGROUND Atopic dermatitis (AD) is a chronic, inflammatory skin disease associated with heterogeneous morphology, distribution, symptoms, severity, extent, longitudinal courses, quality of life burden, comorbidities, and treatment responses. This heterogeneity contributes to challenges in diagnosis, the characterization of disease activity, and therapeutic stratification. OBJECTIVE To develop a framework to standardize AD assessment. METHODS We propose a novel framework to assess AD based on a literature review and clinical experience. RESULTS DESCRIBE-AD is a framework that can effectively capture the clinical domains contributing to AD heterogeneity and includes both patient- and clinician-reported perspectives. DESCRIBE-AD includes assessments of Dermatitis morphology and phenotype, Evolution of disease, Symptom severity, Comorbid health disorders, Response to therapy, Intensity of lesions, Burden of disease, and Extent of lesions. Rather than placing the focus on any single, specific aspect of AD, DESCRIBE-AD allows for a comprehensive approach to the assessment and clinical management of AD. CONCLUSIONS DESCRIBE-AD is a novel framework that can be used to better describe the heterogeneity of AD and guide treatment decisions.
Collapse
|
14
|
Ayasse MT, Ahmed A, Espinosa ML, Walker CJ, Yousaf M, Thyssen JP, Silverberg JI. What are the highest yielding search strategy terms for systematic reviews in atopic dermatitis? A systematic review. Arch Dermatol Res 2021; 313:737-750. [PMID: 33221950 DOI: 10.1007/s00403-020-02165-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 10/16/2020] [Accepted: 10/30/2020] [Indexed: 12/30/2022]
Abstract
The impact of search strategies on systematic reviews (SR) of atopic dermatitis (AD) is unknown. The purpose of this review was to evaluate search strategies used in SR of AD and their impact on the frequency of manuscripts identified. MEDLINE and EMBASE were searched for SR related to AD. Simulations were performed by running combinations of search terms in MEDLINE and EMBASE. Overall, 250 SR met inclusion criteria, of which 225 specified search strategies. SR using 5-6 terms (20.0% to 12.1%) or ≥ 7 (40.0% to 18.8%) terms decreased, whereas SR using 3-4 terms numerically increased (18.8% to 30.2%) and 1-2 terms remained similar (37.5% to 38.9%) from 1999-2009 to 2015-2019. The most commonly searched terms were "atopic dermatitis" (n = 166), followed by "eczema" (n = 156), "dermatitis atopic'" (n = 81), "atopic eczema" (n = 74), "neurodermatitis" (n = 59), "Besniers prurigo" (n = 29), "infantile eczema" (n = 27), and "childhood eczema" (n = 19). Simulations revealed that "eczema" and "atopic dermatitis" yielded the most hits. The number of search terms that maximized hits in MEDLINE and EMBASE was 5 and 4, respectively. Search strategies for AD were heterogeneous, with high proportions of search strategies providing few search hits. Future studies should use standardized and optimized search terms.
Collapse
Affiliation(s)
- Marissa T Ayasse
- Department of Dermatology, The George Washington University School of Medicine and Health Sciences, 2150 Pennsylvania Avenue NW, Suite 2B-425, Washington, DC, 20037, USA
| | - Adnan Ahmed
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Maria L Espinosa
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Christina J Walker
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Muhammad Yousaf
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Jacob P Thyssen
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
| | - Jonathan I Silverberg
- Department of Dermatology, The George Washington University School of Medicine and Health Sciences, 2150 Pennsylvania Avenue NW, Suite 2B-425, Washington, DC, 20037, USA.
| |
Collapse
|
15
|
Batmaz SB, Birinci G, Akpınar Aslan E. Quality of Life of Children with Allergic Disease: The effect of Depression and Anxiety of Children and Their Mothers. J Asthma 2021; 59:1776-1786. [PMID: 34503366 DOI: 10.1080/02770903.2021.1978480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Introduction: In comparison with the general population, several studies have reported higher anxiety and depression rates not only in children with allergic diseases but also in their parents. We aimed to evaluate the mental health of children and their mothers affecting quality of life (QoL) in children with allergic diseases, and to compare anxiety and depression in these patients and their parents with the general population.Methods: One hundred and sixty-eight patients aged 8-18 years diagnosed with an allergic disease who visited our outpatient clinic and a control group of 61 children who did not have any chronic or allergic diseases were included in the study. Patients completed the Pediatric QoL Inventory, Trait Anxiety Inventory for Children, and Children's Depression Inventory, while mothers completed the General Anxiety Disorder-7 (GAD-7) scale and the Patient Health Questionnaire-9 (PHQ-9). Independent samples' t-test was used to compare children's QoL, trait anxiety, and depression scores and mothers' GAD-7 and PHQ-9 scores between the controlled/mild and uncontrolled/moderate-severe groups. The effects of age, gender, disease severity, maternal depression/anxiety, and children's depression/anxiety on QoL were analyzed with multivariate regression analyses.Results: QoL was lower in children with allergic diseases than healthy children, and although the mean QoL score was lower in the group with high disease severity, QoL in children with allergic diseases was not associated with disease severity but inversely related to anxiety/depression and maternal depression.Conclusions: As per the results, QoL is impaired in children with allergic diseases. Both anxiety/depression in the child and maternal depression may adversely affect QoL in these patients.
Collapse
Affiliation(s)
- Sehra Birgül Batmaz
- Department of Pediatric Allergy and Clinical Immunology, Tokat State Hospital, Tokat, Turkey
| | | | - Esma Akpınar Aslan
- Department of Psychiatry, School of Medicine, Tokat Gaziosmanpasa University, Tokat, Turkey
| |
Collapse
|
16
|
Rodrigues J, Franco-Pego F, Sousa-Pinto B, Bousquet J, Raemdonck K, Vaz R. Anxiety and depression risk in patients with allergic rhinitis: a systematic review and meta-analysis. Rhinology 2021; 59:360-373. [PMID: 34254060 DOI: 10.4193/rhin21.087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Allergic diseases appear to be associated with mood disorders. However, particularly regarding allergic rhinitis (AR), such association has not been adequately systematically reviewed. Therefore, we conducted a systematic review and meta-analysis to quantify the association between AR and depression and anxiety. METHODOLOGY We performed an electronic search of PubMed, Web of Science and Scopus for observational studies assessing the association between AR and depression and anxiety. Such association was quantified by means of random-effects meta-analysis, with estimation of pooled odds ratio (OR). Sources of heterogeneity were explored by subgroup analysis. RESULTS We included a total of 24 primary studies, of which 23 assessed depression and 11 assessed anxiety. Of these, 12 studies presented OR from multivariable regression models and were included in our meta-analysis. AR was associated with higher odds of depression and anxiety. CONCLUSIONS AR appears to be associated with high risk of depression and anxiety. While our results point to the importance of mental comorbidities among patients with AR, longitudinal studies are needed adopting uniform definitions and presenting results stratified by AR severity.
Collapse
Affiliation(s)
- J Rodrigues
- Otorhinolaryngology Department, Centro Hospitalar Universitario de S. Joao, EPE, Porto, Portugal; Unit of Anatomy, Department of Biomedicine, Faculty of Medicine, University of Porto, Porto, Portugal; CINTESIS â€" Center for Health Technology and Services Research, University of Porto, Porto, Portugal
| | - F Franco-Pego
- CINTESIS "Center for Health Technology and Services Research, University of Porto, Porto, Portugal; MEDCIDS" Department of Community Medicine, Information and Health Decision Sciences; Faculty of Medicine, University of Porto, Porto, Portugal
| | - B Sousa-Pinto
- CINTESIS "Center for Health Technology and Services Research, University of Porto, Porto, Portugal; MEDCIDS" Department of Community Medicine, Information and Health Decision Sciences; Faculty of Medicine, University of Porto, Porto, Portugal
| | - J Bousquet
- Charite, Universitatsmedizin Berlin, Humboldt-Universitat zu Berlin, Berlin, Germany; Comprehensive Allergy Center, Department of Dermatology and Allergy, Berlin Institute of Health, Berlin, Germany; MACVIA-France, Montpellier, France
| | - K Raemdonck
- Unit of Anatomy, Department of Biomedicine, Faculty of Medicine, University of Porto, Porto, Portugal; CINTESIS" Center for Health Technology and Services Research, University of Porto, Porto, Portugal; CESPU â€" Institute of Research and Advanced Training in Health Sciences and Technologies (IINFACTS), Gandra, Portugal
| | - R Vaz
- Otorhinolaryngology Department, Centro Hospitalar Universitario de S. Joao, EPE, Porto, Portugal; Unit of Anatomy, Department of Biomedicine, Faculty of Medicine, University of Porto, Porto, Portugal; CINTESIS â€" Center for Health Technology and Services Research, University of Porto, Porto, Portugal
| |
Collapse
|
17
|
Xu YC, Wang JP, Zhu WJ, Li P. Childhood atopic dermatitis as a precursor for developing attention deficit/hyperactivity disorder. Int J Immunopathol Pharmacol 2021; 34:2058738420962902. [PMID: 33045857 PMCID: PMC7557683 DOI: 10.1177/2058738420962902] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Atopic dermatitis (AD) is a skin disease characterized by chronic inflammatory condition that shows hallmark presentations in terms of sleep disturbances, pruritus, and psychological stress, and an association with increased attention deficit/hyperactivity disorder (ADHD) risk. A number of studies have suggested for the co-occurrence of the two diseased conditions. In terms of global prevalence, AD and ADHD almost exhibit a parallel increment according to epidemiological data. In addition, recent reports indicate AD to show a temporal association with later onset of ADHD. Although several studies suggest for the potential link between AD and ADHD, currently there is no definitive answer to this regard. Furthermore, epidemiological evidence of co-occurrence does not ascertain a pathophysiological link between the two conditions. The pathophysiological basis behind the association of AD and ADHD also remain poorly elucidated. The objective of this review is to present an extensive account of AD and associated comorbidities with a special attention toward ADHD as well as to elaborate on the mechanisms underlying their association. The review can provide healthcare providers with the recent updates on AD-ADHD association and help them while dealing with such patients. In general, AD and ADHD show a positive association in majority of the cross-sectional studies. However, large longitudinal studies are required to draw any conclusion on the temporal nature of such association.
Collapse
Affiliation(s)
- Yang-Chun Xu
- Department of Dermatology, the Second Hospital of Jilin University, Changchun, Jilin, China
| | - Jin-Peng Wang
- Department of Cardiology, the Second Hospital of Jilin University, Changchun, Jilin, China
| | - Wen-Jing Zhu
- Department of Dermatology, the Second Hospital of Jilin University, Changchun, Jilin, China
| | - Ping Li
- Department of Developmental Pediatrics, the Second Hospital of Jilin University, Changchun, Jilin, China
| |
Collapse
|
18
|
Smith NA, Germundson DL, Gao P, Hur J, Floden AM, Nagamoto-Combs K. Anxiety-like behavior and intestinal microbiota changes as strain-and sex-dependent sequelae of mild food allergy in mouse models of cow's milk allergy. Brain Behav Immun 2021; 95:122-141. [PMID: 33705867 PMCID: PMC8525516 DOI: 10.1016/j.bbi.2021.03.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 02/20/2021] [Accepted: 03/02/2021] [Indexed: 12/12/2022] Open
Abstract
A number of studies have reported comorbidity of food allergies with various neuropsychiatric disorders, such as anxiety, depression, attention-deficit hyperactivity disorder, and autism. However, inconsistent results across clinical studies have left the association between food allergy and behavioral disorders inconclusive. We postulated that the heterogeneities in genetic background among allergic cohorts affect symptom presentation and severity of food allergy, introducing bias in patient selection criteria toward individuals with overt physical reactions. To understand the influence of genetic background on food allergy symptoms and behavioral changes beyond anaphylaxis, we generated mouse models with mild cow's milk allergy by sensitizing male and female C57BL/6J and BALB/cJ mice to a bovine whey protein, β-lactoglobulin (BLG; Bos d 5). We compared strain- and sex-dependent differences in their immediate physical reactions to BLG challenge as well as anxiety-like behavior one day after the challenge. While reactions to the allergen challenge were either absent or mild for all groups, a greater number of BLG-sensitized BALB/cJ mice presented visible symptoms and hypothermia compared to C57BL/6J mice. Interestingly, male mice of both strains displayed anxiety-like behavior on an elevated zero maze without exhibiting cognitive impairment with the cross maze test. Further characterization of plasma cytokines/chemokines and fecal microbiota also differentiated strain- and sex-dependent effects of BLG sensitization on immune-mediator levels and bacterial populations, respectively. These results demonstrated that the genetic variables in mouse models of milk allergy influenced immediate physical reactions to the allergen, manifestation of anxiety-like behavior, levels of immune responses, and population shift in gut microbiota. Thus, stratification of allergic cohorts by their symptom presentations and severity may strengthen the link between food allergy and behavioral disorders and identify a population(s) with specific genetic background that have increased susceptibility to allergy-associated behavioral disorders.
Collapse
Affiliation(s)
- Nicholas A Smith
- Department of Pathology, University of North Dakota School of Medicine & Health Sciences, Grand Forks, ND, USA.
| | - Danielle L Germundson
- Department of Pathology, University of North Dakota School of Medicine & Health Sciences, Grand Forks, ND, USA.
| | - Pan Gao
- Department of Biomedical Sciences, University of North Dakota School of Medicine & Health Sciences, Grand Forks, ND, USA.
| | - Junguk Hur
- Department of Biomedical Sciences, University of North Dakota School of Medicine & Health Sciences, Grand Forks, ND, USA.
| | - Angela M Floden
- Department of Biomedical Sciences, University of North Dakota School of Medicine & Health Sciences, Grand Forks, ND, USA.
| | - Kumi Nagamoto-Combs
- Department of Biomedical Sciences, University of North Dakota School of Medicine & Health Sciences, Grand Forks, ND, USA.
| |
Collapse
|
19
|
Manjunath J, Silverberg JI. Association between atopic dermatitis and headaches throughout childhood and adolescence-A longitudinal birth cohort study. Pediatr Dermatol 2021; 38:780-786. [PMID: 33931896 DOI: 10.1111/pde.14607] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND/OBJECTIVES Atopic dermatitis (AD) is associated with sleep disturbance, psychosocial distress, anxiety, depression, and atopic comorbidities, which may be associated with increased headaches. Our objective was to understand the association of AD and comorbid asthma, sleep and mental health disturbances with headaches throughout childhood and adolescence. METHODS Data were analyzed from The Fragile Families and Child Wellbeing Study, a longitudinal birth cohort study of 4898 urban children born in 1998-2000. RESULTS AD was associated with headaches at age 5 (adjusted odds ratio [95% confidence interval]: 2.14 [1.27-3.59]), 9 (1.69 [1.27-2.27]) and 15 years (1.71 [1.37-2.14]). AD at age 9 was associated with higher odds of subsequent headaches at age 15 (1.36 [1.05-1.76]). Children with AD at two (1.60 [1.12-2.29]) or all three (1.79 [1.16-2.75]) study-waves had higher odds of headaches at age 15 years. In multivariable repeated measures logistic regression models, significant two-way interactions were found for AD with sleep disturbance (4.59 [3.15-6.69]), attention deficit (hyperactivity) disorder (2.85 [1.87-4.35]), asthma (2.87 [2.18-3.76]), anxiety (2.47 [1.76-3.48]) or depression (2.86 [1.89-4.34]) as predictors of headaches. CONCLUSION Children and adolescents with AD, particularly those with sleep disturbances, atopic and mental health comorbidities, had increased headaches. Persistent childhood AD was associated with headaches in adolescence.
Collapse
Affiliation(s)
- Jaya Manjunath
- Department of Dermatology, George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Jonathan I Silverberg
- Department of Dermatology, George Washington University School of Medicine and Health Sciences, Washington, DC, USA.,Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| |
Collapse
|
20
|
Hou A, Silverberg JI. Predictors and age-dependent pattern of psychologic problems in childhood atopic dermatitis. Pediatr Dermatol 2021; 38:606-612. [PMID: 33890299 DOI: 10.1111/pde.14588] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 02/07/2021] [Accepted: 03/07/2021] [Indexed: 01/02/2023]
Abstract
BACKGROUND/OBJECTIVES Little is known about the predictors and trends of psychological comorbidities in childhood atopic dermatitis (AD), or whether they occur in an age-dependent pattern. We hypothesized racial/ethnic and socioeconomic disparities lead to increased psychological problems among children with AD and psychological comorbidities occur in an age-dependent manner. METHODS We analyzed cross-sectional data on 228 898 children aged 2-17 years from the 1997-2018 National Health Interview Survey. RESULTS Children with AD had higher proportions of depression/sadness (17.2% vs 12.6%; odds ratio [95% confidence interval]: 1.44 [1.37-1.51]), attention deficit (hyperactivity) disorder (ADD/ADHD) (10.0% vs 7.1%; 1.46 [1.38-1.55]), emotional/behavioral difficulties (29.9% vs 23.5%; 1.77 [1.69-1.84]), feelings of frequent worry (38.8% vs 23.5%; 1.66 [1.58-1.74]), and autism (1.9% vs 0.9%; 2.00 [1.75-2.29]). Among children with AD, psychologic comorbidity was associated with atopic comorbidities and multimorbidity and white race, households with lower income and education, and no insurance coverage. In children with or without AD, the prevalence of autism peaked during pre-adolescence; ADD/ADHD and emotional/behavioral difficulties peaked in adolescence; and depression/sadness and feelings of frequent worry increased steadily throughout childhood without plateau. CONCLUSION Atopic dermatitis was associated with multiple psychologic disorders, particularly among those with atopic comorbidities, white race, and low household income. Psychologic comorbidities increased in an age-dependent pattern, though similar to children without AD.
Collapse
Affiliation(s)
- Alexander Hou
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Jonathan I Silverberg
- Department of Dermatology, George Washington University School of Medicine, Washington, DC, USA
| |
Collapse
|
21
|
Mu Z, Zhang Y, Li L, Han X. Mapping knowledge structures and theme trends of atopic dermatitis: a co-word biclustering and quantitative analysis of the publication between 2015 and 2019. J DERMATOL TREAT 2021; 33:2024-2033. [PMID: 33761805 DOI: 10.1080/09546634.2021.1905769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Atopic dermatitis (AD) has been a hot research direction of dermatologists for a long time. However, the knowledge structures and theme trends for AD have not yet been studied bibliometrically. OBJECTIVE To investigate the distribution pattern and knowledge structure of AD related literatures in PubMed. METHODS Bibliographic information was generated by the Bibliographic Item Co-Occurrence Matrix Builder (BICOMB). A visual matrix was created by the gCLUTO software. GraphPad Prism 5 software was used to construct a Strategic diagram analysis. Ucinet 6.0 software and NetDraw 2.084 software were used to generate a social network analysis (SNA). RESULTS Among all the extracted MeSH terms and subheadings, 77 MeSH terms/MeSH subheadings with a high-frequency were identified, and hot topics were gathered together into 6 groups. In the strategic diagram, immunology, microbiology, and drug therapy of AD were fully developed. In contrast, prevention, pathology, genetics, metabolism, administration, cost of illness, quality of life therapeutic paradigm, and immunosuppressive agents of AD were considerably immature offering prospective scope for further research. CONCLUSIONS The results may potentially aid in describing an all-round grasp of the current research areas and furnish guidelines for the researchers for beginning new projects.
Collapse
Affiliation(s)
- Zhenzhen Mu
- Department of Dermatology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yue Zhang
- Department of Dermatology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Lin Li
- Department of Dermatology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Xiuping Han
- Department of Dermatology, Shengjing Hospital of China Medical University, Shenyang, China
| |
Collapse
|
22
|
Association of food hypersensitivity in children with the risk of autism spectrum disorder: a meta-analysis. Eur J Pediatr 2021; 180:999-1008. [PMID: 33145704 DOI: 10.1007/s00431-020-03826-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Revised: 09/28/2020] [Accepted: 10/01/2020] [Indexed: 12/22/2022]
Abstract
This meta-analysis was performed to clarify the association between food hypersensitivity in children and autism spectrum disorder (ASD) in detail. Relevant studies published in 8 databases before March 2020 were retrieved and screened according to established inclusion criteria. The odds ratio (OR) with the 95% confidence interval (CI) was pooled to estimate the effect. Subgroup analyses were performed in terms of publication year, study design, location, sample size, definition of food hypersensitivity, definition of ASD, and study quality score. Furthermore, we stratified studies by participant sex and age to perform a more detailed analysis. This meta-analysis included 12 published articles with 434,809 subjects. A significant association was observed between food hypersensitivity and the risk of ASD (OR = 2.792, 95% CI: 2.081-3.746). The risk of ASD among girls and subjects younger than 12 with food hypersensitivity may be greater than that among boys and those older than 12. The results of sensitivity analysis and publication bias analysis show that the association is relatively stable.Conclusion: Our results showed a positive association between food hypersensitivity and autism spectrum disorder, and girls and subjects younger than 12 may be more sensitive to this association. The role of food hypersensitivity in the onset of ASD deserves more attention. What is Known: • Food hypersensitivity is a term used to describe food allergies and food intolerance. • ASD is a group of neurodevelopmental disorders that are characterized by deficits in social interaction, repetitive or stereotypic behavior, and verbal communication disorder. • The prevalence rates of ASD and food hypersensitivity in the developed world are increasing. What is New: • In this work, we reviewed and analyzed the available data and studies and found a positive association between food hypersensitivity and ASD. • Girls and children younger than 12 may be more sensitive to have ASD than boys and children older than 12.
Collapse
|
23
|
Atopic Dermatitis Is Associated With Lower Patient Satisfaction in US Adults. Dermatitis 2021; 33:323-331. [PMID: 33675329 DOI: 10.1097/der.0000000000000733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Atopic dermatitis (AD) is complex with unmet needs and management challenges in clinical practice. Little is known about patient satisfaction among adults with AD. OBJECTIVE The aim of the study was to determine patterns and predictors of patient satisfaction among adults with AD. METHODS Data were analyzed from the 2000-2015 Medical Expenditure Panel Survey. Patient satisfaction was assessed by the Consumer Assessment of Healthcare Providers and Systems survey. RESULTS Atopic dermatitis (linear regression; adjusted β [95% confidence interval {95% CI}] = -0.75 [-1.25 to -0.25]) was associated with lower patient satisfaction compared with no AD. Adults with 1 or more office-based visits had increased odds of high satisfaction (>75th percentile; logistic regression; adjusted odds ratio [95% CI] = 1.81 [1.30-2.52]). Adults who saw an outpatient dermatologist or allergist had lower satisfaction (adjusted β [95% CI] = -0.65 [-1.27 to -0.03]). Patient satisfaction among adults with AD was associated with older age (adjusted β [95% CI] = 40-59 years, 1.85 [0.90-2.80]; ≥60 years, 6.13 [5.18-7.09]) and inversely associated with lower income (-1.82 [-2.68 to -0.96]) or middle income (-0.85 [-1.59 to -0.12]), race/ethnicity (Hispanic, -1.40 [-2.42 to -0.38]; other/multiracial, -2.34 [-3.53 to -1.15]), public (-4.50 [-6.43 to -2.58]) or no insurance (-4.53 [-6.47 to -2.59]), and multimorbidity (-0.48 [-0.61 to -0.35]). CONCLUSIONS Adults with AD in the United States had decreased patient satisfaction, particularly those with lower income, fewer outpatient visits, and multimorbidity. There are substantial unmet needs in patient satisfaction for AD.
Collapse
|
24
|
Cheng BT, Silverberg JI. Association of pediatric atopic dermatitis and psoriasis with school absenteeism and parental work absenteeism: A cross-sectional United States population-based study. J Am Acad Dermatol 2021; 85:885-892. [PMID: 33667540 DOI: 10.1016/j.jaad.2021.02.069] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 02/07/2021] [Accepted: 02/25/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND The impact of childhood atopic dermatitis (AD) and psoriasis on school absenteeism is not fully elucidated. OBJECTIVE To determine the burden and predictors of chronic school absenteeism in children with AD and psoriasis. METHODS Data were analyzed from the 1999-2015 Medical Expenditure Panel Surveys, cross-sectional, population-based studies of health status and function in the United States. RESULTS Among 3132 and 200 children with AD and psoriasis, respectively, 1544 (67.7%) and 97 (62.5%) missed ≥1 day, and 120 (3.9%) and 5 (3.6%) missed ≥15 days (chronically absent) per year due to illness. AD was associated with chronic absenteeism overall (logistic regression; adjusted odds ratio 1.42, 95% CI [1.13-1.78]) and with more severe disease (mild-moderate: 1.33 [1.04-1.70], severe: 2.00 [1.21-3.32]). No statistical difference in chronic absenteeism was found for children with versus those without psoriasis (1.26 [0.51-3.12]). Parents of children with AD were more likely to miss work for caregiving versus those of children without AD, whereas parents of children with psoriasis had similar rates of work absenteeism versus those of children without psoriasis. LIMITATIONS The severity of AD and psoriasis was assessed by treatment pattern. CONCLUSION Children in the United States with AD had increased chronic school absenteeism. Further interventions are warranted to prevent school absenteeism in childhood AD.
Collapse
Affiliation(s)
- Brian T Cheng
- Department of Allergy & Immunology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Jonathan I Silverberg
- Department of Dermatology, The George Washington University School of Medicine and Health Sciences, Washington, DC.
| |
Collapse
|
25
|
Association of Atopic Dermatitis With Bacterial, Fungal, Viral, and Sexually Transmitted Skin Infections. Dermatitis 2021; 31:157-164. [PMID: 32049716 DOI: 10.1097/der.0000000000000526] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Atopic dermatitis (AD) is associated with altered skin barrier, microbiome, and immune dysregulation that may increase risk of skin infections. OBJECTIVE The aim of the study was to determine whether AD is associated with skin infections and related outcomes. METHODS Data from the 2006 to 2012 National Emergency Department Sample were analyzed, including an approximately 20% sample of all US emergency department (ED) visits (N = 198,102,435 adults or children). RESULTS Skin infections were increased in ED visits of adults (7.14% vs 3.76%) and children (5.15% vs 2.48%) with AD. In multivariable logistic regression models, AD was associated with significantly higher odds of skin infection in adults (adjusted odds ratio [95% confidence interval] = 1.93 [1.89-1.97]) and children (2.23 [2.16-2.31]). Pediatric and adult AD were associated with significantly higher odds of carbuncle/furuncles, impetigo, cellulitis, erysipelas, methicillin-resistant and methicillin-sensitive Staphylococcus aureus infections, molluscum contagiosum, cutaneous warts, herpes simplex and zoster viruses, eczema herpeticum, dermatophytosis, and candidiasis of skin/nails and vulva/urogenitals. Adults with AD had significantly higher odds of genital warts (1.51 [1.36-1.52]) and herpes (1.23 [1.11-1.35]). Skin infections were associated with US $19 million excess annual costs of ED care in persons with AD. CONCLUSIONS Atopic dermatitis patients had higher odds of multiple bacterial, viral, fungal, and sexually transmitted skin infections.
Collapse
|
26
|
Alomayri W, Alanazi N, Faraj F. Correlation Between Atopic Dermatitis and Sleep Quality Among Adults in Saudi Arabia. Cureus 2020; 12:e12051. [PMID: 33447480 PMCID: PMC7802111 DOI: 10.7759/cureus.12051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background Atopic dermatitis is a chronic inflammatory skin disease characterized by pruritic, dry, and eczematous lesions. The effect of atopic dermatitis on the quality of patients' lives has been investigated. However, its impact on the quality of sleep is still controversial. Objective This study aims to identify the correlation between sleep quality and atopic dermatitis disease among adults living in Saudi Arabia. Design and setting This is a cross-sectional, quantitative survey study, carried out during July and August 2020, which included atopic dermatitis patients. The study used Arabic versions of a self-administered, Internet-based questionnaire of the Pittsburgh Sleep Quality Index (PSQI) and Dermatology Life Quality Index (DLQI). Face-to-face patient interviews were not applicable due to the COVID-19 pandemic. Results A total of 400 patients participated in this survey study. Eighty-six percent (86%) were females while 39.6% were in the age group of 18 to 25 years old. A third of the responders could not sleep within half an hour, and a third of them woke up at night or early in the morning more than three times a week. Twenty-three point eight percent (23.8%) of the responders rated their sleep quality as a very good quality of sleep while 17.8% rated it as very bad. Inability to get to sleep within half an hour (p-value=0.002), waking up at night (p-value=0.005), and not being able to sleep because of pain (p-value<0.001) were all significantly correlated to the occurrence of many or a lot of skin symptoms of atopic dermatitis. There was a significantly higher total score among patients with atopic dermatitis (p value<0.001), which shows a poorer quality of sleep. Conclusion Symptoms of atopic dermatitis negatively influence the quality of sleep of adults in Saudi Arabia. The frequency of symptoms are significantly correlated to the poor quality of sleep. Therefore, we suggest that the evaluation of sleep quality is necessary for the management of atopic dermatitis patients.
Collapse
Affiliation(s)
- Waad Alomayri
- Department of Family Medicine, Family Medicine Residency Training Program, King Salman Armed Forces Hospital, Tabuk, SAU
| | - Nawal Alanazi
- Department of Family Medicine, Family Medicine Residency Training Program, King Salman Armed Forces Hospital, Tabuk, SAU
| | - Fatma Faraj
- Department of Family Medicine, King Salman Armed Forces Hospital, Tabuk, SAU
| |
Collapse
|
27
|
Wang L, Shen W, Yao H, Zheng R, Chen W, Zhang W. Association between Autism Spectrum Disorder and Food Allergy: A Systematic Review and Meta‐analysis. Autism Res 2020. [DOI: 10.1002/aur.2454] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Lei Wang
- Department of Pediatric Allergy and Immunology The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University Wenzhou China
| | | | - Hao Yao
- Department of Pediatric Allergy and Immunology The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University Wenzhou China
| | - Rongying Zheng
- Department of Pediatric Allergy and Immunology The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University Wenzhou China
| | - Wenshu Chen
- Department of Gynecology and Obstetrics Dingli Clinical Institute of Wenzhou Medical University, Wenzhou Central Hospital Wenzhou China
| | - Weixi Zhang
- Department of Pediatric Allergy and Immunology The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University Wenzhou China
| |
Collapse
|
28
|
Association of atopic dermatitis severity with cognitive function in adults. J Am Acad Dermatol 2020; 83:1349-1359. [DOI: 10.1016/j.jaad.2020.05.041] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 05/07/2020] [Accepted: 05/08/2020] [Indexed: 12/16/2022]
|
29
|
Germundson DL, Vendsel LP, Nagamoto-Combs K. Region-specific regulation of central histaminergic H3 receptor expression in a mouse model of cow's milk allergy. Brain Res 2020; 1749:147148. [PMID: 33035498 DOI: 10.1016/j.brainres.2020.147148] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Revised: 09/29/2020] [Accepted: 10/01/2020] [Indexed: 01/04/2023]
Abstract
Central histaminergic H3 receptor (H3R) has been extensively investigated as a potential therapeutic target for various neurological and neurodegenerative disorders. Despite promising results in preclinical rodent models, clinical trials have not provided conclusive evidence for the benefit of H3R antagonists to alleviate cognitive and behavioral symptoms of these disorders. Inconsistent pharmacological efficacies may arise from aberrant changes in H3R over time during disease development. Because H3R is involved in feedback inhibition of histamine synthesis and secretion, the expression of the autoreceptor may also be reciprocally regulated by altered histamine levels in a pathological condition. Thus, we investigated H3R expression in a mouse model of cow's milk allergy, a condition associated with increased histamine levels. Mice were sensitized to bovine whey proteins (WP) over 5 weeks and H3R protein and transcript levels were examined in the brain. Substantially increased H3R immunoreactivity was observed in various brain regions of WP-sensitized mice compared to sham mice. Elevated H3R expression was also found in the thalamic/hypothalamic region. The expression of histaminergic H1, but not H2, receptor subtype was also increased in this and the midbrain regions. Unlike the brain, all three histaminergic receptors were increased in the small intestine. These results indicated that the central histaminergic receptors were altered in WP-sensitized mice in a subtype- and region-specific manner, which likely contributed to behavioral changes we observed in these mice. Our study also suggests that altered levels of H3R could be considered during a pharmacological intervention of a neurological disease.
Collapse
Affiliation(s)
- Danielle L Germundson
- Department of Pathology, University of North Dakota School of Medicine and Health Sciences, 1301 N. Columbia Rd, Grand Forks, ND, United States
| | - Lane P Vendsel
- Department of Pathology, University of North Dakota School of Medicine and Health Sciences, 1301 N. Columbia Rd, Grand Forks, ND, United States
| | - Kumi Nagamoto-Combs
- Department of Biomedical Sciences, University of North Dakota School of Medicine and Health Sciences, 1301 N. Columbia Rd, Grand Forks, ND, United States.
| |
Collapse
|
30
|
Agnafors S, Torgerson J, Rusner M, Kjellström AN. Injuries in children and adolescents with psychiatric disorders. BMC Public Health 2020; 20:1273. [PMID: 32838787 PMCID: PMC7445910 DOI: 10.1186/s12889-020-09283-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Accepted: 07/20/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Unintentional injuries are a leading cause of morbidity and mortality in children of all ages. Prevention strategies require knowledge of risk factors, and behavior and psychiatric disorders have been suggested to influence the risk of injury during childhood. While externalizing disorders have been found to increase the risk for injuries, results are mixed regarding internalizing disorders, such as affective and anxiety conditions, and Autism Spectrum Disorders (ASD). There is a need for large scale studies relying on robust data sources. The aim of the present study was to examine the association between psychiatric disorders and injuries requiring medical attention, in a large population-based cohort of 350,000 children and adolescents in Sweden. METHODS Data were obtained from the regional health care database Vega. Psychiatric diagnoses and injury diagnoses obtained during 2014-2018 for individuals aged 0-17 years in 2016 were extracted. Descriptive statistics were used to examine differences in 5-year injury prevalence between children with and without different psychiatric diagnoses. Logistic regression was used in age-stratified models to test the association between psychiatric diagnoses and injuries requiring medical attention. RESULTS The results show an increased risk for concurrent injuries in general, but the patterns vary by age and psychiatric disorder. Externalizing disorders and anxiety conditions were associated with concurrent injuries, while individuals with ASD had a lower risk for most injuries included. Affective disorders were associated with an increased risk for wounds, concussion, complications and poisoning, while the risk for fractures was decreased. Self-inflicted injury was more common in all psychiatric conditions investigated during adolescence, except for ASD. Children and adolescents with many types of psychiatric disorders were also at increased risk for a concurrent maltreatment diagnosis. CONCLUSIONS A general pattern of increased risk for concurrent injuries in children and adolescents with most psychiatric diagnoses was found, but the associations vary by age and type of psychiatric disorder. The results add to the literature on risk factors for injuries in children and adolescents, supporting diagnosis specific patterns. Several psychiatric diagnoses were associated with a marked increase in injury risk, indicating a high burden of disease for affected individuals.
Collapse
Affiliation(s)
- Sara Agnafors
- Division of Children's and Women's health, BKV, Department of Biomedical and Clinical Sciences, Linköping University, S-581 85, Linköping, Sweden. .,Department of Research, Södra Älvsborgs Hospital, Borås, Sweden.
| | - Jarl Torgerson
- Department of Psychosis, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Marie Rusner
- Department of Research, Södra Älvsborgs Hospital, Borås, Sweden.,Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Anna Norman Kjellström
- Department of Data Management and Analysis, Head Office, Region Västra Götaland, Skövde, Sweden
| |
Collapse
|
31
|
Silverberg JI, Lei D, Yousaf M, Janmohamed SR, Vakharia PP, Chopra R, Chavda R, Gabriel S, Patel KR, Singam V, Kantor R, Hsu DY. Measurement properties of the Rajka-Langeland severity score in children and adults with atopic dermatitis. Br J Dermatol 2020; 184:87-95. [PMID: 32348552 DOI: 10.1111/bjd.19159] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Multiple atopic dermatitis (AD) severity scales exist, with no gold standard for use in clinical practice. OBJECTIVES To determine the measurement properties of the Rajka-Langeland score and compare it with other clinician-reported outcomes in adults and children with AD. METHODS We performed a prospective dermatology practice-based study using questionnaires and evaluation by a dermatologist (n = 427). RESULTS Rajka-Langeland had good concurrent validity with the Eczema Area and Severity Index (Spearman rho = 0·63), SCORing AD (SCORAD) (rho = 0·61), objective-SCORAD (rho = 0·52) and body surface area (rho = 0·51); good convergent validity with the numeric rating scale average-itch (rho = 0·60) and worst-itch (rho = 0·59), Patient-Oriented Eczema Measure (rho = 0·57), Dermatology Life Quality Index (rho = 0·53), Patient-Reported Outcomes Measurement Information System Itch Questionnaire (rho = 0·35-0·55) in adults and/or children; fair discriminant validity for patient- and physician-reported global AD severity; good responsiveness to change of severity of AD and itch; good reliability; internal consistency; with no floor or ceiling effects. Interpretability bands (3, clear/almost clear; 4-5, mild; 6-7, moderate; 8-9, severe) and minimal clinically important difference (1 point) were established. CONCLUSIONS The Rajka-Langeland score showed good construct validity, reliability, internal consistency and responsiveness in adults and children with AD.
Collapse
Affiliation(s)
- J I Silverberg
- Department of Dermatology, The George Washington University School of Medicine and Health Sciences, Suite 2B-425, 2150 Pennsylvania Avenue, Washington, DC, 20037, USA.,Department of Dermatology, Feinberg School of Medicine at Northwestern University, Chicago, IL, USA
| | - D Lei
- Department of Dermatology, Feinberg School of Medicine at Northwestern University, Chicago, IL, USA
| | - M Yousaf
- Department of Dermatology, Feinberg School of Medicine at Northwestern University, Chicago, IL, USA
| | - S R Janmohamed
- Department of Dermatology, Feinberg School of Medicine at Northwestern University, Chicago, IL, USA
| | - P P Vakharia
- Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - R Chopra
- State University of New York Downstate Medical Center, Brooklyn, NY, USA
| | - R Chavda
- Galderma SA
- Rx Strategy & Innovation Group, La Tour-de-Peliz, Switzerland
| | - S Gabriel
- Galderma SA
- Rx Strategy & Innovation Group, La Tour-de-Peliz, Switzerland
| | - K R Patel
- Department of Internal Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - V Singam
- Department of Internal Medicine, Weiss Memorial Hospital, Chicago, IL, USA
| | - R Kantor
- State University of New York Downstate Medical Center, Brooklyn, NY, USA
| | - Derek Y Hsu
- Department of Dermatology, Feinberg School of Medicine at Northwestern University, Chicago, IL, USA
| |
Collapse
|
32
|
Gilaberte Y, Pérez-Gilaberte JB, Poblador-Plou B, Bliek-Bueno K, Gimeno-Miguel A, Prados-Torres A. Prevalence and Comorbidity of Atopic Dermatitis in Children: A Large-Scale Population Study Based on Real-World Data. J Clin Med 2020; 9:jcm9061632. [PMID: 32481591 PMCID: PMC7356227 DOI: 10.3390/jcm9061632] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 05/20/2020] [Accepted: 05/25/2020] [Indexed: 12/13/2022] Open
Abstract
This study aimed at exploring atopic dermatitis (AD) prevalence in children and exhaustively analyzing their comorbidity. We conducted a descriptive analysis of their socio-demographic and comorbidity characteristics in the EpiChron Cohort (Aragón, Spain). Adjusted odds ratios (OR) were calculated for each comorbidity using logistic regression models. In total, 33,591 children had a diagnosis of AD, resulting in an overall prevalence of 15.5%. AD prevalence was higher in girls compared to boys, in 3–9-year-olds compared to children of other ages, and in Spanish children compared to those of other nationalities. Multimorbidity was present in 43% of children, with the most frequent chronic comorbidities being asthma (13.1%), psychosocial disorders (7.9%), and visual impairment (7.8%). Many diseases were, regardless of their prevalence, statistically associated with AD. The strongest associations (odds ratio (OR) (95% confidence interval (CI))) were found in asthma (2.10 (2.02–2.17)), allergic rhinitis (2.00 (1.91–2.10)), and irritable bowel syndrome (1.90 (1.56–2.31)). A better understanding of the array of comorbidities associated with AD in children might help improve their clinical management. Future longitudinal studies are encouraged to shed light on the potential underlying pathophysiological mechanisms involved in the identified associations.
Collapse
Affiliation(s)
- Yolanda Gilaberte
- Department of Dermatology, Miguel Servet University Hospital, IIS Aragón, 50009 Zaragoza, Spain;
| | | | - Beatriz Poblador-Plou
- EpiChron Research Group, Aragon Health Sciences Institute (IACS), IIS Aragón, Health Services Research on Chronic Patients Network (REDISSEC), Miguel Servet University Hospital, 50009 Zaragoza, Spain; (B.P.-P.); (A.P.-T.)
| | - Kevin Bliek-Bueno
- Teaching Unit of Preventive Medicine and Public Health, Miguel Servet University Hospital, 50009 Zaragoza, Spain;
| | - Antonio Gimeno-Miguel
- EpiChron Research Group, Aragon Health Sciences Institute (IACS), IIS Aragón, Health Services Research on Chronic Patients Network (REDISSEC), Miguel Servet University Hospital, 50009 Zaragoza, Spain; (B.P.-P.); (A.P.-T.)
- Correspondence: ; Tel.: +349-7676-5500 (ext. 5375)
| | - Alexandra Prados-Torres
- EpiChron Research Group, Aragon Health Sciences Institute (IACS), IIS Aragón, Health Services Research on Chronic Patients Network (REDISSEC), Miguel Servet University Hospital, 50009 Zaragoza, Spain; (B.P.-P.); (A.P.-T.)
| |
Collapse
|
33
|
Shen M, Xiao Y, Su J, Zhao S, Li J, Tao J, Kang X, Wu B, Shan S, Wang X, Chen X. Prevalence and patient-reported outcomes of noncommunicable skin diseases among college students in China. JAAD Int 2020; 1:23-30. [PMID: 34409315 PMCID: PMC8361873 DOI: 10.1016/j.jdin.2020.03.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/07/2020] [Indexed: 01/22/2023] Open
Abstract
Background The prevalence and health-related quality of life of skin disease have been understudied in adolescents. Objective To investigate the prevalence and relevant patient-reported outcomes of noncommunicable skin diseases in college students. Methods First-year college students from 5 universities in China were investigated in the cross-sectional study. Skin diseases were diagnosed by dermatologists in the field survey. Itch and pain, symptoms of depression and anxiety, and sleep quality were measured by validated tools. Results A total of 28,364 students consented to participate and completed the survey. The prevalence of acne, eczema, chronic urticaria, psoriasis, and vitiligo was 10.3%, 5.8%, 2.6%, 0.16%, and 0.23%, respectively. Eczema and chronic urticaria were associated with lower health utility estimates. Most diseases, but not psoriasis and vitiligo, were associated with the symptoms of depression and sleep disturbance. Itch intensity predicted other patient-reported outcome scores better in healthy controls than in individuals with skin diseases. Sex difference in the associations of skin diseases with patient-reported outcomes was not identified. Limitations Cross-sectional study design and limited generalizability to the nonstudent population. Conclusion Skin diseases are associated with moderately impaired emotional well-being, sleep quality, and quality of life, partly attributable to cutaneous symptoms.
Collapse
Affiliation(s)
- Minxue Shen
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
- Hunan Engineering Research Center of Skin Health and Disease, Changsha, China
- Hunan Key Laboratory of Skin Cancer and Psoriasis, Changsha, China
| | - Yi Xiao
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China
- Hunan Engineering Research Center of Skin Health and Disease, Changsha, China
- Hunan Key Laboratory of Skin Cancer and Psoriasis, Changsha, China
- Correspondence to: Yi Xiao, MD, Xiangya Hospital, 87 Xiangya Road, Changsha, Hunan, China 410008.
| | - Juan Su
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China
- Hunan Engineering Research Center of Skin Health and Disease, Changsha, China
- Hunan Key Laboratory of Skin Cancer and Psoriasis, Changsha, China
| | - Shuang Zhao
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China
- Hunan Engineering Research Center of Skin Health and Disease, Changsha, China
- Hunan Key Laboratory of Skin Cancer and Psoriasis, Changsha, China
| | - Ji Li
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China
| | - Juan Tao
- Department of Dermatology, Affiliated Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaojing Kang
- Department of Dermatology, People's Hospital of Xinjiang Uygur Autonomous Region, Urumchi, China
| | - Bin Wu
- Department of Dermatology, The Affiliated People's Hospital of Inner Mongolia Medical University, Hohhot, China
| | - Shijun Shan
- Department of Dermatology, Xiang'an Hospital, Xiamen University, Xiamen, China
| | - Xiaohui Wang
- Department of Dermatology, Zhongshan Hospital, Xiamen University, Xiamen, China
| | - Xiang Chen
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China
- Hunan Engineering Research Center of Skin Health and Disease, Changsha, China
- Hunan Key Laboratory of Skin Cancer and Psoriasis, Changsha, China
- Xiang Chen, MD, Xiangya Hospital, 87 Xiangya Road, Changsha, Hunan, China 410008.
| |
Collapse
|
34
|
Guo MMH, Wang LJ, Hsu TY, Yang KD, Kuo HC. Peanut Sensitivity and Allergic Rhinitis in Young Children are Associated with Attention-Deficit Hyperactivity Disorder Symptoms in Adolescence. Neuropsychiatr Dis Treat 2020; 16:1349-1357. [PMID: 32547038 PMCID: PMC7263365 DOI: 10.2147/ndt.s232299] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 04/17/2020] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE Although childhood allergic diseases have been found to be associated with symptoms of attention-deficit hyperactivity disorder, the temporal relationship between these diseases remains unclear. In this study of 97 children, clinical examination and blood samples for total and specific IgE were collected at 6 and 12 years old. PATIENTS AND METHODS We followed a total of 97 children from 6 to 12 years old. Clinical examination and blood samples for total and specific IgE were collected at 6 and 12 years old. Attention-deficit hyperactivity disorder and oppositional defiant disorder symptoms at 12 years old were evaluated using the Swanson, Nolan, and Pelham, Version IV Scale Parent Form. RESULTS After accounting for the affect of confounding variables, we found that allergic rhinitis at 6 years old was associated with higher inattention score at 12 years old (β-coefficient 0.356, 95% CI 0.104-0.609, p = 0.006). In addition, higher specific IgE levels for peanuts at 6 years of age were correlated with higher hyperactivity/impulsivity scores (β-coefficient 0.088, 95% CI 0.049-0.126, p < 0.001), and higher specific IgE for peanuts at 12 years of age were correlated with higher opposition/defiance scores (β-coefficient 0.054, 95% CI 0.012-0.096, p = 0.012) at 12 years old in our final linear regression models. CONCLUSION Allergic rhinitis and peanut sensitization in childhood may be associated with more symptoms of attention-deficit hyperactivity and oppositional defiant disorder in adolescence.
Collapse
Affiliation(s)
- Mindy Ming-Huey Guo
- Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung City, Taiwan
| | - Liang-Jen Wang
- Department of Child and Adolescent Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung City, Taiwan
| | - Te-Yao Hsu
- Department of Obstetrics, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung City, Taiwan
| | - Kuender D Yang
- Department of Pediatrics and Department of Medical Research, MacKay Memorial Hospital, Taipei, Taiwan.,Institute of Biomedical Sciences, Mackay Medical School, Taipei, Taiwan
| | - Ho-Chang Kuo
- Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung City, Taiwan
| |
Collapse
|
35
|
Noh H, An J, Kim MJ, Sheen YH, Yoon J, Welsh B, Koh HY, Han MY, Yon DK. Sleep problems increase school accidents related to allergic diseases. Pediatr Allergy Immunol 2020; 31:98-103. [PMID: 31578742 DOI: 10.1111/pai.13132] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Hyungrye Noh
- Department of Medicine, CHA University School of Medicine, Seongnam, Republic of Korea
| | - Jaewoo An
- Department of Pediatrics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea
| | - Min Jeong Kim
- Department of Medicine, CHA University School of Medicine, Seongnam, Republic of Korea
| | - Youn Ho Sheen
- Department of Pediatrics, CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, Republic of Korea
| | - Jongwan Yoon
- Department of Pediatrics, Inje University Ilsan Paik Hospital, Inje University College of Medicine, Ilsan, Republic of Korea
| | - Barry Welsh
- Department of English Language, Dongguk University College of Humanities, Seoul, Republic of Korea
| | - Hyun Yong Koh
- F.M. Kirby Neurobiology Center, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Man Yong Han
- Department of Pediatrics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea
| | - Dong Keon Yon
- Department of Pediatrics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea.,Medical Corps, Republic of Korea Army, Seongnam, Republic of Korea
| |
Collapse
|
36
|
Affiliation(s)
- Hiraku Suga
- Department of Dermatology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Shinichi Sato
- Department of Dermatology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| |
Collapse
|
37
|
Yue L, Yin X, Hao F, Dong J, Ren X, Xu O, Shan C. Long Noncoding RNA Linc00632 Inhibits Interleukin-13-Induced Inflammatory Cytokine and Mucus Production in Nasal Epithelial Cells. J Innate Immun 2019; 12:116-128. [PMID: 31315126 DOI: 10.1159/000500420] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Accepted: 03/30/2019] [Indexed: 12/19/2022] Open
Abstract
Allergic rhinitis (AR) is an allergic disease characterized as (immunoglobulin E)-mediated type I hypersensitivity disorder. The interleukin-13 (IL-13) signaling pathway has been implicated in the pathogenesis of AR. In the present study, we investigated the regulatory role and mechanism of long noncoding RNA Linc00632 in IL-13-induced inflammatory cytokine and mucus production in nasal epithelial cells (NECs) from AR patients. We evaluated the expression of Linc00632 in nasal tissues from AR patients and in IL-13-treated NECs. We explored the role of Linc00632 in granulocyte-macrophage colony-stimulating factor (GM-CSF), eotaxin, and MUAC5AC production in IL-13-treated NECs. We searched for the potential target of Linc00632. Downregulation of Linc00632 was identified in nasal tissues of AR patients and in IL-13-treated NECs. Linc00632 inhibited IL-13-induced GM-CSF, eotaxin, and MUAC5AC production. Linc00632 targeted miR-498 and negatively regulated its expression. MiR-498 targeted IL1RN and inhibition of miR-498 suppressed IL-13-induced GM-CSF, eotaxin, and MUC5AC expression. The regulation of IL-13-induced dysfunction of NECs by Linc00632 depended on miR-498. Linc00632 inhibited IL-13-induced GM-CSF, eotaxin, and MUAC5AC production in IL-13-treated NECs by targeting miR-498.
Collapse
Affiliation(s)
- Liyan Yue
- ENT Department 1, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Xiaoyan Yin
- ENT Department 1, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Fang Hao
- ENT Department 1, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Jinhui Dong
- ENT Department 1, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Xiumin Ren
- ENT Department 1, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Ou Xu
- ENT Department 1, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Chunguang Shan
- ENT Department 1, The Second Hospital of Hebei Medical University, Shijiazhuang, China,
| |
Collapse
|
38
|
Smith NA, Germundson DL, Combs CK, Vendsel LP, Nagamoto-Combs K. Astrogliosis Associated With Behavioral Abnormality in a Non-anaphylactic Mouse Model of Cow's Milk Allergy. Front Cell Neurosci 2019; 13:320. [PMID: 31379506 PMCID: PMC6646667 DOI: 10.3389/fncel.2019.00320] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 06/28/2019] [Indexed: 12/22/2022] Open
Abstract
Etiology of neuropsychiatric disorders is complex, involving multiple factors that can affect the type and severity of symptoms. Although precise causes are far from being identified, allergy or other forms of hypersensitivity to dietary ingredients have been implicated in triggering or worsening of behavioral and emotional symptoms, especially in patients suffering from depression, anxiety, attention-deficit hyperactivity, and/or autism. Among such ingredients, cow's milk, along with wheat gluten, is commonly suspected. However, the contributory role of cow's milk in these disorders has not been elucidated due to insufficient pathophysiological evidence. In the present study, we therefore investigated neuroinflammatory changes that are associated with behavioral abnormality using a non-anaphylactic mouse model of cow's milk allergy (CMA). Male and female C57BL/6J mice were subjected to a 5-week oral sensitization procedure without or with a major milk allergen, beta-lactoglobulin (BLG). All mice were then later challenged with BLG, and their anxiety- and depression-associated behaviors were subsequently assessed during the 6th and 7th weeks. We found that BLG-sensitized male mice exhibited significantly increased anxiety- and depression-like behavior, although they did not display anaphylactic reactions when challenged with BLG. Female behavior was not noticeably affected by BLG sensitization. Upon examination of the small intestines, reduced immunoreactivity to occludin was detected in the ileal mucosa of BLG-sensitized mice although the transcriptional expression of this tight-junction protein was not significantly altered when measured by quantitative RT-PCR. On the other hand, the expression of tumor necrosis factor alpha (TNFα) in the ileal mucosa was significantly elevated in BLG-sensitized mice, suggesting the sensitization had resulted in intestinal inflammation. Inflammatory responses were also detected in the brain of BLG-sensitized mice, determined by the hypertrophic morphology of GFAP-immunoreactive astrocytes. These reactive astrocytes were particularly evident near the blood vessels in the midbrain region, resembling the perivascular barrier previously reported by others in experimental autoimmune encephalitis (EAE) mouse models. Interestingly, increased levels of COX-2 and TNFα were also found in this region. Taken together, our results demonstrated that BLG sensitization elicits inflammatory responses in the intestine and brain without overt anaphylactic signs of milk allergy, signifying food allergy as a potential pathogenic factor of neuropsychiatric disorders.
Collapse
Affiliation(s)
- Nicholas A Smith
- Department of Pathology, University of North Dakota School of Medicine and Health Sciences, Grand Forks, ND, United States
| | - Danielle L Germundson
- Department of Pathology, University of North Dakota School of Medicine and Health Sciences, Grand Forks, ND, United States
| | - Colin K Combs
- Department of Biomedical Sciences, University of North Dakota School of Medicine and Health Sciences, Grand Forks, ND, United States
| | - Lane P Vendsel
- Department of Pathology, University of North Dakota School of Medicine and Health Sciences, Grand Forks, ND, United States
| | - Kumi Nagamoto-Combs
- Department of Pathology, University of North Dakota School of Medicine and Health Sciences, Grand Forks, ND, United States
| |
Collapse
|
39
|
Oh J, An J. Depressive Symptoms, Emotional Aggression, School Adjustment, and Mobile Phone Dependency Among Adolescents with Allergic Diseases in South Korea. J Pediatr Nurs 2019; 47:e24-e29. [PMID: 31029517 DOI: 10.1016/j.pedn.2019.04.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2018] [Revised: 04/10/2019] [Accepted: 04/10/2019] [Indexed: 11/28/2022]
Abstract
PURPOSE This study aimed to examine the effects of depression, aggression, and school adjustment on mobile phone dependency among South Korean adolescents, and to identify the differences in these paths among adolescents with or without allergic diseases. DESIGN AND METHODS The Korean Children and Youth Panel Survey, a nationwide multistage cluster sampling survey, was used for this cross-sectional study. Data were collected from 1937 first-year middle school students in South Korea, using self-reported questionnaires. Multiple-group structural equation modeling was used to test the differences of the critical ratio for the variables depressive symptom, emotional aggression, school adjustment, and mobile phone dependency between adolescents with allergic diseases and those without allergic disease. RESULTS Depressive symptoms and emotional aggression were significantly higher in the allergic disease group. Significantly different effects were found on the path of depressive symptoms to school adjustment and depressive symptoms to mobile phone dependency. CONCLUSIONS Higher depressive symptoms in allergic disease adolescents had a greater negative effect on school adjustment and a more positive effect on mobile phone dependency. Healthcare professionals need to be concerned not only with the physical symptoms of adolescents with allergic diseases but also with psychological issues, such as depression. PRACTICE IMPLICATIONS Early assessments and interventions for depressive symptoms in adolescents with allergic diseases could help prevent over dependency on mobile phones, as well as maladjustment to school.
Collapse
Affiliation(s)
- Juyeon Oh
- Seoul Women's College of Nursing, Seoul, Republic of Korea
| | - Jiwon An
- Department of Nursing Science, Far East University, Chungcheongbuk-do, Republic of Korea.
| |
Collapse
|
40
|
Cheng BT, Silverberg JI. Depression and psychological distress in US adults with atopic dermatitis. Ann Allergy Asthma Immunol 2019; 123:179-185. [PMID: 31201863 DOI: 10.1016/j.anai.2019.06.002] [Citation(s) in RCA: 83] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 05/27/2019] [Accepted: 06/05/2019] [Indexed: 01/16/2023]
Abstract
BACKGROUND Symptoms of anxiety and depression appear to contribute to the overall burden of atopic dermatitis (AD). However, the burden of mental health symptoms and psychological distress in AD have not been fully elucidated. OBJECTIVE To determine the prevalence and predictors of depressive symptoms and psychological distress among US adults with AD and how they compare with psoriasis and other disorders. METHODS We analyzed the 2004-2015 Medical Expenditure Panel Surveys, a representative sample of US adults. Patient Health Questionnaire-2 (PHQ-2) and Kessler-6 index (K-6) scores assessed depressive symptoms and psychological distress, respectively. RESULTS Atopic dermatitis in adults is associated with increased odds of screening positive for depressive symptoms (PHQ-2 ≥2) (44.3% vs 21.9%; adjusted odds ratio [aOR] [95% confidence interval (CI)]: 2.86 [1.14, 7.16]) and severe psychological distress (K-6≥13) (25.9% vs 5.5%; 6.04 [2.28, 15.99]). Adults with vs without AD had increased K6 scores overall (linear regression, P = .04) and severe psychological distress in particular (K-6≥13; logistic regression; adjusted odds ratio [95% CI]: 6.04 [2.28, 15.99]). K-6 scores were associated with lower household income (linear regression; adjusted beta [95% CI]: 6.22 [0.88, 11.56]) and middle income (4.49 [0.39, 8.59]), but inversely associated with black (-7.36 [-11.70, -3.03]) and multiracial/other (-2.85 [-5.67, -0.03]) race/ethnicity. CONCLUSION Atopic dermatitis is associated with more depressive symptoms and psychological distress overall, and even worse than many other chronic diseases. These findings highlight the need for clinicians to consider screening for and monitoring mental health symptoms in AD patients. Future studies are needed to develop interventions to reduce psychological distress in AD.
Collapse
Affiliation(s)
- Brian T Cheng
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Jonathan I Silverberg
- Departments of Dermatology, Preventive Medicine, and Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois; Northwestern Medicine Multidisciplinary Eczema Center, Chicago, Illinois.
| |
Collapse
|
41
|
Alexander H, Patton T, Jabbar-Lopez ZK, Manca A, Flohr C. Novel systemic therapies in atopic dermatitis: what do we need to fulfil the promise of a treatment revolution? F1000Res 2019; 8. [PMID: 30774935 PMCID: PMC6357995 DOI: 10.12688/f1000research.17039.1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/22/2019] [Indexed: 12/26/2022] Open
Abstract
Patients with atopic dermatitis (AD) who do not adequately respond to topical therapy and phototherapy often need systemic immunomodulatory treatment to control their symptoms. Conventional systemic agents, such as ciclosporin, azathioprine, and methotrexate, have been used for decades, but there are concerns about their safety profile. There are now many novel systemic agents emerging through clinical trials, which may have great potential in the treatment of AD. Despite this, there are very few data comparing the performance of these drugs against each other. The purpose of this article is to review the current systemic therapies in AD and present an indirect comparison of systemic AD treatments using effectiveness and safety data from published randomised controlled trials, highlighting important remaining gaps in knowledge. Although the latest developments in systemic AD treatments are exciting and dearly needed, further work is required before the promise of a therapeutic revolution becomes reality.
Collapse
Affiliation(s)
- Helen Alexander
- Unit for Population-Based Dermatology Research, St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust and King's College London, London, UK
| | - Thomas Patton
- Centre for Health Economics, University of York, York, UK
| | - Zarif K Jabbar-Lopez
- Unit for Population-Based Dermatology Research, St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust and King's College London, London, UK
| | - Andrea Manca
- Centre for Health Economics, University of York, York, UK
| | - Carsten Flohr
- Unit for Population-Based Dermatology Research, St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust and King's College London, London, UK
| |
Collapse
|
42
|
Boguniewicz M, Fonacier L, Guttman-Yassky E, Ong PY, Silverberg J, Farrar JR. Atopic dermatitis yardstick: Practical recommendations for an evolving therapeutic landscape. Ann Allergy Asthma Immunol 2019; 120:10-22.e2. [PMID: 29273118 DOI: 10.1016/j.anai.2017.10.039] [Citation(s) in RCA: 190] [Impact Index Per Article: 38.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2017] [Revised: 10/25/2017] [Accepted: 10/31/2017] [Indexed: 12/18/2022]
Abstract
The implementation of treatment guidelines for atopic dermatitis is challenging, in part because of different guidance documents being used by different groups of specialists and in part because the language of guidelines often reflects the evidence base rather than the practical "how to." The Atopic Dermatitis Yardstick is part of a series developed in response to the need to proactively address the loss of disease control for atopic illnesses at all levels of severity. It presents a comprehensive update on how to conduct a sustained step-up in therapy for the patient with inadequately controlled or poorly controlled atopic dermatitis. Patient profiles, based on current guidelines and the authors' combined clinical experience, provide a practical and clinically meaningful guide to aid physicians in helping their patients achieve the goal of clear to almost clear. The intent is not to replace guidelines but to complement their recommendations incorporating the latest research and therapies.
Collapse
Affiliation(s)
- Mark Boguniewicz
- Division of Allergy-Immunology, Department of Pediatrics, National Jewish Health and University of Colorado School of Medicine, Denver, Colorado.
| | - Luz Fonacier
- Section of Allergy and Immunology, NYU Winthrop Hospital, Mineola, New York
| | - Emma Guttman-Yassky
- Department of Dermatology and the Immunology Institute, Icahn School of Medicine at the Mount Sinai Medical Center, New York, New York
| | - Peck Y Ong
- Division of Clinical Immunology and Allergy, Children's Hospital Los Angeles and Department of Pediatrics, University of Southern California, Keck School of Medicine, Los Angeles, California
| | - Jonathan Silverberg
- Departments of Dermatology, Preventive Medicine and Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | | |
Collapse
|
43
|
Huang YF, Chiou HY, Chung CH, Chien WC, Chang HJ. Psychiatric Disorders After Attention-Deficit/Hyperactivity Disorder: A Nationwide Population-Based Study in Taiwan. J Nurs Scholarsh 2019; 51:138-146. [PMID: 30609223 DOI: 10.1111/jnu.12457] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/02/2018] [Indexed: 12/14/2022]
Abstract
PURPOSE To investigate the risk for psychiatric disorders in patients newly diagnosed with attention deficit hyperactive disorder (ADHD) from two longitudinal groups of children with and without ADHD. STUDY DESIGN In total, 1,745 children newly diagnosed with ADHD and 6,980 participants without ADHD were identified from Taiwan's National Health Insurance Research Database in 2005 and followed until 2010. Risks for psychiatric disorders in the ADHD and non-ADHD groups were compared. RESULTS The ADHD group was 3.82 times more likely to develop psychiatric disorders than their counterparts. The ADHD group showed the highest risk for oppositional defiant disorder, followed by adult ADHD and autism spectrum disorder. Moreover, the time effects of psychiatric disorders in the ADHD group were significant. Patients with ADHD subtypes had a significant risk for psychiatric disorders compared to their counterparts. CONCLUSIONS A high risk for psychiatric disorders was revealed in this study among children with ADHD. Childhood ADHD, the duration after the ADHD diagnosis, and the ADHD subtype were associated with psychiatric disorders. CLINICAL RELEVANCE Various psychiatric disorders were observed in children after they had been newly diagnosed with ADHD, indicating a need for integrated care that includes medical practitioners, family members, social workers, and early intervention workers for patients newly diagnosed with ADHD to decrease the risk for comprehensive psychiatric disorders.
Collapse
Affiliation(s)
- Ya-Fang Huang
- PhD Candidate, School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Hung-Yi Chiou
- Distinguished Professor, School of Public Health, Taipei Medical University, Taipei, Taiwan
| | - Chi-Hsiang Chung
- Adjunct Assistant Professor, School of Public Health, National Defense Medical left, and Secretary General, Taiwanese Injury Prevention and Safety Promotion Association (TIPSPA), Taipei, Taiwan
| | - Wu-Chien Chien
- Associate Professor, School of Public Health, National Defense Medical left, and Associate Professor, Department of Medical Research, Tri-Service General Hospital, National Defense Medical left, Taipei, Taiwan
| | - Hsiu-Ju Chang
- Professor, Dean of Student Affairs, School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| |
Collapse
|
44
|
Paller A, Jaworski JC, Simpson EL, Boguniewicz M, Russell JJ, Block JK, Tofte S, Dunn JD, Feldman SR, Clark AR, Schwartz G, Eichenfield LF. Major Comorbidities of Atopic Dermatitis: Beyond Allergic Disorders. Am J Clin Dermatol 2018; 19:821-838. [PMID: 30168085 DOI: 10.1007/s40257-018-0383-4] [Citation(s) in RCA: 149] [Impact Index Per Article: 24.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The consequences of atopic dermatitis reach beyond the skin and past childhood. Patients with atopic dermatitis are at risk of developing allergic comorbidities, but less is known about the associations between atopic dermatitis and non-allergic conditions. Understanding these non-allergic comorbidities has the potential to improve patient outcomes and to help mitigate the cost and burdens associated with these conditions. Atopic dermatitis is associated with cutaneous bacterial infections, more severe forms/courses of cutaneous viral infections, and extra-cutaneous infections. Atopic dermatitis is also associated with several mental health comorbidities particularly attention-deficit hyperactivity disorder, anxiety, and depression. Data are largely inconsistent for specific cancers, but atopic dermatitis appears to protect against malignancy overall; severe long-term atopic dermatitis is associated with adult lymphomas. Atopic dermatitis may also be associated with obesity, cardiovascular disease, and autoimmune disease, particularly alopecia areata and gastrointestinal immune-mediated disorders. Although the causative mechanisms underlying these associations are poorly understood, treating physicians should be aware of associations in seeking to alleviate the burden for patients with atopic dermatitis.
Collapse
|
45
|
Simpson EL, Paller AS, Boguniewicz M, Eichenfield LF, Feldman SR, Silverberg JI, Chamlin SL, Zane LT. Crisaborole Ointment Improves Quality of Life of Patients with Mild to Moderate Atopic Dermatitis and Their Families. Dermatol Ther (Heidelb) 2018; 8:605-619. [PMID: 30345457 PMCID: PMC6261115 DOI: 10.1007/s13555-018-0263-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Indexed: 12/02/2022] Open
Abstract
Introduction The impact of crisaborole ointment, a nonsteroidal phosphodiesterase 4 inhibitor for the treatment of mild to moderate atopic dermatitis (AD), on quality of life (QoL) was assessed in two identically designed phase 3 studies (AD-301: NCT02118766; AD-302: NCT02118792, both at http://www.clinicaltrials.gov). Methods In both studies, patients aged ≥ 2 years with mild to moderate AD per the Investigator’s Static Global Assessment were randomly assigned 2:1 to receive crisaborole or vehicle twice daily for 28 days. QoL was assessed using the Children’s Dermatology Life Quality Index (CDLQI) (2–15 years), the Dermatology Life Quality Index (DLQI) (≥ 16 years), and the Dermatitis Family Impact Questionnaire (DFI) (parents/caregivers/family of patients aged 2–17 years). Established QoL score severity bands provided clinical context. Results Greater mean improvement in QoL was observed in crisaborole-treated patients than in vehicle-treated patients at day 29 [mean change from baseline (∆BL), CDLQI: − 4.6 vs. − 3.0; P < 0.001; DLQI: − 5.2 vs. − 3.5; P = 0.015]. At baseline, more than half the patients had a “moderate effect” or higher of AD on QoL. At day 29, there was a trend toward more crisaborole- than vehicle-treated patients having “small effect” to “no effect”, The QoL of parents/caregivers/family improved more for crisaborole-treated than for vehicle-treated patients (∆BL, DFI: − 3.7 vs. − 2.7; P = 0.003). Conclusion Crisaborole treatment results in clinically meaningful improvement in QoL for patients and their parents/caregivers/families. Trial Registration AD-301: http://www.clinicaltrials.gov, NCT02118766; AD-302: http://www.clinicaltrials.gov, NCT02118792. Funding Anacor Pharmaceuticals, Inc., a wholly owned subsidiary of Pfizer Inc., New York, NY.
Collapse
Affiliation(s)
- Eric L Simpson
- Department of Dermatology, Oregon Health and Science University, Portland, OR, USA.
| | - Amy S Paller
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Mark Boguniewicz
- Division of Allergy-Immunology, Department of Pediatrics, National Jewish Health, Denver, CO, USA.,Department of Pediatrics, University of Colorado School of Medicine, Denver, CO, USA
| | - Lawrence F Eichenfield
- Division of Pediatric and Adolescent Dermatology, Rady Children's Hospital-San Diego, San Diego, CA, USA.,Department of Dermatology, University of California, San Diego, CA, USA.,Department of Pediatrics, University of California, San Diego, CA, USA
| | - Steven R Feldman
- Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Jonathan I Silverberg
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Sarah L Chamlin
- Department of Pediatrics, Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Lee T Zane
- Anacor Pharmaceuticals, Inc., a wholly owned subsidiary of Pfizer Inc., New York, NY, USA
| |
Collapse
|
46
|
Mitchell AE. Bidirectional relationships between psychological health and dermatological conditions in children. Psychol Res Behav Manag 2018; 11:289-298. [PMID: 30104911 PMCID: PMC6074762 DOI: 10.2147/prbm.s117583] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Dermatological conditions are common among children. They are a frequent cause of presentation to health care services and a leading contributor to burden of disease. Evidence supports the notion that bidirectional relationships exist between children’s physical and psychological health, whereby the child’s dermatological condition can impact their psychological health and well-being, while, in the reverse direction, psychological factors (eg, stress) can impact the severity and course of the child’s skin disease. The psychological impact of dermatological conditions in childhood needs to be taken into account during the assessment, planning, and treatment phases of management. Likewise, the potential effect of children’s emotional and behavioral difficulties on management, particularly in terms of the impact on parents’ ability to implement their child’s treatment plan, should be considered. This literature review summarizes the current evidence for the relationships between three common chronic dermatological conditions of childhood – atopic dermatitis, psoriasis, and urticaria – and psychological adjustment and quality of life in childhood. Overall, a general paucity of research in the pediatric context – combined with limitations in terms of study design, variability in operationalization of constructs, and heterogeneity in measurement of outcomes – makes it difficult to draw firm conclusions in this area. Based on the available research, implications for successful long-term management of these conditions are discussed in terms of integrating psychological and parenting support with medical management to improve adherence, reduce disease severity, and improve quality of life for children and their families.
Collapse
Affiliation(s)
- Amy E Mitchell
- Parenting and Family Support Centre, School of Psychology, The University of Queensland, Brisbane, QLD, Australia,
| |
Collapse
|
47
|
Abstract
Atopic dermatitis (AD) is driven by a complex gene-environment interaction. Many of the risk factors and genetic underpinning previously observed for pediatric AD may not apply to adult atopic dermatitis, suggesting that these may largely be different disorders. Whereas AD is classically thought of as a pediatric disease, recent studies have shown high rates of disease in adults as well. Risk factors for persistence of childhood-onset AD, as well as adult-onset AD, are reviewed. Adults with AD are particularly vulnerable to exogenous insults from the outside environment, including climate, ultraviolet exposure, pollution, irritants and pruritogens, and microbes. Finally, adult AD is associated with a substantial health care burden, with increased utilization, direct and indirect costs of care, and lost work productivity.
Collapse
Affiliation(s)
- Ryan Sacotte
- Department of Dermatology, Feinberg School of Medicine at Northwestern University, Chicago, Illinois, USA
| | - Jonathan I Silverberg
- Department of Dermatology, Preventive Medicine and Medical Social Sciences, Feinberg School of Medicine at Northwestern University, Chicago, Illinois, USA; Northwestern Medicine Multidisciplinary AD Center, Chicago, Illinois, USA.
| |
Collapse
|
48
|
Germundson DL, Smith NA, Vendsel LP, Kelsch AV, Combs CK, Nagamoto-Combs K. Oral sensitization to whey proteins induces age- and sex-dependent behavioral abnormality and neuroinflammatory responses in a mouse model of food allergy: a potential role of mast cells. J Neuroinflammation 2018; 15:120. [PMID: 29685134 PMCID: PMC5913881 DOI: 10.1186/s12974-018-1146-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Accepted: 04/03/2018] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Growing evidence has strengthened the association of food allergy with neuropsychiatric symptoms such as depression, anxiety, and autism. However, underlying mechanisms by which peripheral allergic responses lead to behavioral dysfunction are yet to be determined. Allergen-activated mast cells may serve as mediators by releasing histamine and other inflammatory factors that could adversely affect brain function. We hypothesized that eliciting food allergy in experimental animals would result in behavioral changes accompanied by mast cell accumulation in the brain. Our hypothesis was tested in a mouse model of milk allergy using bovine milk whey proteins (WP) as the allergen. METHODS Male and female C57BL/6 mice at 4 weeks (young) and 10 months (old) of age underwent 5-week WP sensitization with weekly intragastric administration of 20 mg WP and 10 μg cholera toxin as an adjuvant. Age-matched sham animals were given the vehicle containing only the adjuvant. All animals were orally challenged with 50 mg WP in week 6 and their intrinsic digging behavior was assessed the next day. Animals were sacrificed 3 days after the challenge, and WP-specific serum IgE, intestinal and brain mast cells, glial activation, and epigenetic DNA modification in the brain were examined. RESULTS WP-sensitized males showed significantly less digging activity than the sham males in both age groups while no apparent difference was observed in females. Mast cells and their activities were evident in the intestines in an age- and sex-dependent manner. Brain mast cells were predominantly located in the region between the lateral midbrain and medial hippocampus, and their number increased in the WP-sensitized young, but not old, male brains. Noticeable differences in for 5-hydroxymethylcytosine immunoreactivity were observed in WP mice of both age groups in the amygdala, suggesting epigenetic regulation. Increased microglial Iba1 immunoreactivity and perivascular astrocytes hypertrophy were also observed in the WP-sensitized old male mice. CONCLUSIONS Our results demonstrated that food allergy induced behavioral abnormality, increases in the number of mast cells, epigenetic DNA modification in the brain, microgliosis, and astrocyte hypertrophy in a sex- and age-dependent manner, providing a potential mechanism by which peripheral allergic responses evoke behavioral dysfunction.
Collapse
Affiliation(s)
- Danielle L Germundson
- Department of Pathology, University of North Dakota School of Medicine and Health Sciences, 1301 North Columbia Road, Stop 9037, Grand Forks, ND, 58202-9037, USA
| | - Nicholas A Smith
- Department of Pathology, University of North Dakota School of Medicine and Health Sciences, 1301 North Columbia Road, Stop 9037, Grand Forks, ND, 58202-9037, USA
| | - Lane P Vendsel
- Department of Pathology, University of North Dakota School of Medicine and Health Sciences, 1301 North Columbia Road, Stop 9037, Grand Forks, ND, 58202-9037, USA
| | - Andrea V Kelsch
- Department of Pathology, University of North Dakota School of Medicine and Health Sciences, 1301 North Columbia Road, Stop 9037, Grand Forks, ND, 58202-9037, USA
| | - Colin K Combs
- Department of Biomedical Sciences, School of Medicine and Health Sciences, University of North Dakota, 1301 North Columbia Road, Stop 9037, Grand Forks, ND, 58202-9037, USA
| | - Kumi Nagamoto-Combs
- Department of Pathology, University of North Dakota School of Medicine and Health Sciences, 1301 North Columbia Road, Stop 9037, Grand Forks, ND, 58202-9037, USA.
| |
Collapse
|
49
|
Relation of Psychiatric Symptoms with Epilepsy, Asthma, and Allergy in Youth with ASD vs. Psychiatry Referrals. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2018; 45:1247-1257. [PMID: 27726054 DOI: 10.1007/s10802-016-0212-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The present study aimed to characterize the association of psychopathology with the clinical correlates of epilepsy, asthma, and allergy within and between neurobehavioral syndromes. Participants were consecutively evaluated youth (6-18 years, 75 % male) with autism spectrum disorder (ASD; n = 589) and non-ASD outpatient psychiatry referrals (n = 653). Informants completed a background questionnaire (parents) and a psychiatric symptom severity rating scale (parents, teachers). Youth with ASD had higher rates of epilepsy and allergy but not asthma than psychiatry referrals, even when analyses were limited to youth with IQ ≥ 70. Somatic conditions evidenced variable associations with medical services utilization, educational interventions, family income, and maternal education. Youth with ASD with versus without epilepsy had more severe ASD social deficits (parents' ratings) and less severe ASD repetitive behaviors (teachers' ratings). Epilepsy was associated with more severe depression, mania, and schizophrenia symptoms in youth with ASD. Youth with allergy (psychiatry referrals only) had more severe anxiety and depression symptoms (parents' ratings) but less severe aggression (teachers' ratings) thus providing evidence of both context- and diagnostic-specificity. Youth with ASD versus non-ASD psychiatry referrals evidence a variable pattern of relations between somatic conditions and a range of clinical correlates, which suggests that the biologic substrates and psychosocial concomitants of neurodevelopmental disorders and their co-occurring somatic conditions may interact to produce unique clinical phenotypes.
Collapse
|
50
|
Lu Z, Chen L, Xu S, Bao Q, Ma Y, Guo L, Zhang S, Huang X, Cao C, Ruan L. Allergic disorders and risk of depression: A systematic review and meta-analysis of 51 large-scale studies. Ann Allergy Asthma Immunol 2018; 120:310-317.e2. [PMID: 29508718 DOI: 10.1016/j.anai.2017.12.011] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Revised: 11/22/2017] [Accepted: 12/19/2017] [Indexed: 11/16/2022]
Abstract
BACKGROUND Previous studies have suggested that allergic disorders are associated with an increased risk of depression. However, the results are conflicting. OBJECTIVE To determine the association between allergic disorders and depression based on large-scale studies. METHODS We reviewed relevant articles obtained from PubMed and Embase. Studies were eligible if they reported an association between allergic disorders and depression and provided available data. Study selection, data extraction, and analyses were undertaken. Pooled relative risks (RRs) with 95% confidence intervals (CIs) were calculated. RESULTS Of 1,827 studies identified, 51 including more than 2.5 million participants met our inclusion criteria. Overall, the results showed that allergic disorders were associated with a significant increased risk of depression (pooled RR 1.59, 95% CI 1.48-1.71). A higher risk of depression also was observed in patients with asthma (RR 1.59, 95% CI 1.46-1.74) and those with allergic rhinitis (RR 1.57, 95% CI 1.27-1.93). Subgroup analyses were conducted based on sex and age. Children (RR 1.66, 95% CI 1.41-1.96) and adults (RR 1.58, 95% CI 1.44-1.74) with allergic disorders had a higher risk of depression than controls. However, no significant association was found between allergic disorders and risk of depression in male subjects (RR 1.37, 95% CI 0.98-1.91), but a positive association was detected in female subjects (RR 1.65, 95% CI 1.44-1.89). CONCLUSION The results from our study showed that allergic disorders significantly increased the risk of depression.
Collapse
Affiliation(s)
- Zhiyu Lu
- Department of Respiratory Medicine, Ningbo First Hospital, Ningbo, China; Ningbo University School of Medicine, Ningbo, China
| | - Lina Chen
- Department of Respiratory Medicine, Ningbo First Hospital, Ningbo, China
| | - Suling Xu
- Department of Dermatology, Affiliated Hospital of Medical College, Ningbo University, Ningbo, China
| | - Qingyi Bao
- Ningbo University School of Medicine, Ningbo, China
| | - Yongyan Ma
- Department of Respiratory Medicine, Ningbo First Hospital, Ningbo, China
| | - Lili Guo
- Department of Respiratory Medicine, Ningbo First Hospital, Ningbo, China
| | - Shuaishuai Zhang
- Department of Respiratory Medicine, Ningbo First Hospital, Ningbo, China
| | - Xiaoping Huang
- Department of Respiratory Medicine, Ningbo First Hospital, Ningbo, China
| | - Chao Cao
- Department of Respiratory Medicine, Ningbo First Hospital, Ningbo, China
| | - Liemin Ruan
- Department of Mental Health, Ningbo First Hospital, Ningbo, China.
| |
Collapse
|