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Rezaei A, Ganashalingam Y, Schindler S, Spengler B, Keck CM, Schulz S. Metabolipidomic changes induced by dermal nickel penetration determined in an ex vivo porcine ear skin model. RAPID COMMUNICATIONS IN MASS SPECTROMETRY : RCM 2024; 38:e9891. [PMID: 39180446 DOI: 10.1002/rcm.9891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2024] [Revised: 07/30/2024] [Accepted: 07/31/2024] [Indexed: 08/26/2024]
Abstract
RATIONAL Nickel is one of humans' most prevalent triggers of allergic contact dermatitis. However, the underlying mechanisms of this allergy still need to be fully understood. One aspect that has yet to be explored is the direct impact of common metal allergens on the skin's metabolites and lipids composition. METHOD Our study employed matrix-assisted laser desorption/ionization mass spectrometry imaging (MALDI MSI) to analyze spatially resolved metabolic alterations induced by nickel exposure. Cross-sections of ex vivo porcine ear skin exposed to increasing nickel (II) ion concentrations (17-167 μg/cm2) were measured with an AP-SMALDI5 AF ion source coupled to Q Exactive HF Orbitrap mass spectrometer. Additionally, the penetration of nickel ions into the skin was observed through its pink complexation with dimethylglyoxime under light microscopy. RESULTS For nickel ion concentrations up to 84 μg/cm2, most nickel ions were stopped within the stratum corneum, while only a very small proportion of nickel ions penetrated the viable epidermis and dermis. Stratum corneum locations with high nickel ion concentrations showed a decrease in arginine and ceramides. Furthermore, several phosphatidylcholine and sphingomyelin species were found to be downregulated in the viable epidermis and dermis due to the nickel exposure. CONCLUSION Nickel penetrates at a trace level into the viable skin and induces severe metabolomic and lipidomic changes in the stratum corneum, epidermis, and dermis, indicating a change in the skin (barrier) function. These findings contribute to a deeper understanding of nickel-induced skin allergies and provide a solid foundation for further research.
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Affiliation(s)
- Azar Rezaei
- Institute of Inorganic and Analytical Chemistry, Justus Liebig University, Giessen, Germany
| | - Yameera Ganashalingam
- Department of Pharmaceutics and Biopharmaceutics, Philipps University Marburg, Marburg, Germany
| | - Siegfried Schindler
- Institute of Inorganic and Analytical Chemistry, Justus Liebig University, Giessen, Germany
| | - Bernhard Spengler
- Institute of Inorganic and Analytical Chemistry, Justus Liebig University, Giessen, Germany
| | - Cornelia M Keck
- Department of Pharmaceutics and Biopharmaceutics, Philipps University Marburg, Marburg, Germany
| | - Sabine Schulz
- Institute of Inorganic and Analytical Chemistry, Justus Liebig University, Giessen, Germany
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Rezaei SJ, Linggonegoro D, Admani S. Neonatal skin health and associated dermatological conditions. Curr Opin Pediatr 2024; 36:418-424. [PMID: 38832936 DOI: 10.1097/mop.0000000000001372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/06/2024]
Abstract
PURPOSE OF REVIEW This review describes recent developments in neonatal skincare management and situates these findings within the preexisting literature on neonatal dermatology. RECENT FINDINGS The studies included in this review expand research methods evaluating skincare management to different contexts across the world. Several studies explore the roles of emollient therapy, disinfection, and skin-to-skin contact on improving neonates' long-term health outcomes. Recent findings also assess the impact of neonatal interventions on atopic dermatitis risk later in life as well as epidemiological and microbiome variables that may predict this risk. Additionally, updates on various dermatological conditions unique to neonates are discussed in further detail. SUMMARY Neonatal skincare management differs in notable ways from that of other age groups. The presentation of dermatologic diseases as well as the rare conditions that affect neonates make their clinical management unique. The recent literature on neonatal dermatology can help inform clinicians regarding important considerations in treating their neonatal population.
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Affiliation(s)
- Shawheen J Rezaei
- Department of Dermatology, Stanford University School of Medicine, Stanford, California, USA
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Chu DK, Koplin JJ, Ahmed T, Islam N, Chang CL, Lowe AJ. How to Prevent Atopic Dermatitis (Eczema) in 2024: Theory and Evidence. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2024; 12:1695-1704. [PMID: 38703820 DOI: 10.1016/j.jaip.2024.04.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 04/21/2024] [Accepted: 04/24/2024] [Indexed: 05/06/2024]
Abstract
Atopic dermatitis (AD) or eczema is a chronic inflammatory skin disease characterized by dry, itchy, and inflamed skin. We review emerging concepts and clinical evidence addressing the pathogenesis and prevention of AD. We examine several interventions ranging from skin barrier enhancement strategies to probiotics, prebiotics, and synbiotics; and conversely, from antimicrobial exposure to vitamin D and omega fatty acid supplementation; breastfeeding and hydrolyzed formula; and house dust mite avoidance and immunotherapy. We appraise the available evidence base within the context of the Grades of Recommendation, Assessment, Development, and Evaluation approach. We also contextualize our findings in relation to concepts relating AD and individual-patient allergic life trajectories versus a linear concept of the atopic march and provide insights into future knowledge gaps and clinical trial design considerations that must be addressed in forthcoming research. Finally, we provide implementation considerations to detect population-level differences in AD risk. Major international efforts are required to provide definitive evidence regarding what works and what does not for preventing AD.
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Affiliation(s)
- Derek K Chu
- Evidence in Allergy Group, Department Medicine and Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.
| | - Jennifer J Koplin
- Child Health Research Centre, University of Queensland, Brisbane, Queensland, Australia; Centre for Food Allergy Research, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Tasnuva Ahmed
- Evidence in Allergy Group, Department Medicine and Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Nazmul Islam
- Evidence in Allergy Group, Department Medicine and Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Chia-Lun Chang
- Centre for Food Allergy Research, Murdoch Children's Research Institute, Melbourne, Victoria, Australia; Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Adrian J Lowe
- Centre for Food Allergy Research, Murdoch Children's Research Institute, Melbourne, Victoria, Australia; Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
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Bradshaw LE, Wyatt LA, Brown SJ, Haines RH, Montgomery AA, Perkin MR, Sach TH, Lawton S, Flohr C, Ridd MJ, Chalmers JR, Brooks J, Swinden R, Mitchell EJ, Tarr S, Jay N, Thomas KS, Allen H, Cork MJ, Kelleher MM, Simpson EL, Lartey ST, Davies-Jones S, Boyle RJ, Williams HC. Emollient application from birth to prevent eczema in high-risk children: the BEEP RCT. Health Technol Assess 2024; 28:1-116. [PMID: 39021147 PMCID: PMC11261424 DOI: 10.3310/rhdn9613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2024] Open
Abstract
Background Atopic eczema is a common childhood skin problem linked with asthma, food allergy and allergic rhinitis that impairs quality of life. Objectives To determine whether advising parents to apply daily emollients in the first year can prevent eczema and/or other atopic diseases in high-risk children. Design A United Kingdom, multicentre, pragmatic, two-arm, parallel-group randomised controlled prevention trial with follow-up to 5 years. Setting Twelve secondary and four primary care centres. Participants Healthy infants (at least 37 weeks' gestation) at high risk of developing eczema, screened and consented during the third trimester or post delivery. Interventions Infants were randomised (1 : 1) within 21 days of birth to apply emollient (Doublebase Gel®; Dermal Laboratories Ltd, Hitchin, UK or Diprobase Cream®) daily to the whole body (excluding scalp) for the first year, plus standard skin-care advice (emollient group) or standard skin-care advice only (control group). Families were not blinded to allocation. Main outcome measures Primary outcome was eczema diagnosis in the last year at age 2 years, as defined by the UK Working Party refinement of the Hanifin and Rajka diagnostic criteria, assessed by research nurses blinded to allocation. Secondary outcomes up to age 2 years included other eczema definitions, time to onset and severity of eczema, allergic rhinitis, wheezing, allergic sensitisation, food allergy, safety (skin infections and slippages) and cost-effectiveness. Results One thousand three hundred and ninety-four newborns were randomised between November 2014 and November 2016; 693 emollient and 701 control. Adherence in the emollient group was 88% (466/532), 82% (427/519) and 74% (375/506) at 3, 6 and 12 months. At 2 years, eczema was present in 139/598 (23%) in the emollient group and 150/612 (25%) in controls (adjusted relative risk 0.95, 95% confidence interval 0.78 to 1.16; p = 0.61 and adjusted risk difference -1.2%, 95% confidence interval -5.9% to 3.6%). Other eczema definitions supported the primary analysis. Food allergy (milk, egg, peanut) was present in 41/547 (7.5%) in the emollient group versus 29/568 (5.1%) in controls (adjusted relative risk 1.47, 95% confidence interval 0.93 to 2.33). Mean number of skin infections per child in the first year was 0.23 (standard deviation 0.68) in the emollient group versus 0.15 (standard deviation 0.46) in controls; adjusted incidence rate ratio 1.55, 95% confidence interval 1.15 to 2.09. The adjusted incremental cost per percentage decrease in risk of eczema at 2 years was £5337 (£7281 unadjusted). No difference between the groups in eczema or other atopic diseases was observed during follow-up to age 5 years via parental questionnaires. Limitations Two emollient types were used which could have had different effects. The median time for starting emollients was 11 days after birth. Some contamination occurred in the control group (< 20%). Participating families were unblinded and reported on some outcomes. Conclusions We found no evidence that daily emollient during the first year of life prevents eczema in high-risk children. Emollient use was associated with a higher risk of skin infections and a possible increase in food allergy. Emollient use is unlikely to be considered cost-effective in this context. Future research To pool similar studies in an individual patient data meta-analysis. Trial registration This trial is registered as ISRCTN21528841. Funding This award was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme (NIHR award ref: 12/67/12) and is published in full in Health Technology Assessment; Vol. 28, No. 29. See the NIHR Funding and Awards website for further award information.
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Affiliation(s)
- Lucy E Bradshaw
- Nottingham Clinical Trials Unit, School of Medicine, University of Nottingham, Nottingham, UK
| | - Laura A Wyatt
- Nottingham Clinical Trials Unit, School of Medicine, University of Nottingham, Nottingham, UK
| | - Sara J Brown
- Centre for Genomic and Experimental Medicine, Institute of Genetics and Cancer, University of Edinburgh, Edinburgh, UK
- Department of Dermatology, NHS Lothian, Edinburgh, UK
| | - Rachel H Haines
- Nottingham Clinical Trials Unit, School of Medicine, University of Nottingham, Nottingham, UK
| | - Alan A Montgomery
- Nottingham Clinical Trials Unit, School of Medicine, University of Nottingham, Nottingham, UK
| | - Michael R Perkin
- Population Health Research Institute, St George's, University of London, London, UK
| | - Tracey H Sach
- Health Economics Group, Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, UK
| | | | - Carsten Flohr
- Unit for Population-Based Dermatology Research, St John's Institute of Dermatology, Guy's & St Thomas' NHS Foundation Trust and King's College London, London, UK
| | - Matthew J Ridd
- Population Health Sciences, University of Bristol, Bristol, UK
| | - Joanne R Chalmers
- Centre of Evidence Based Dermatology, School of Medicine, University of Nottingham, Nottingham, UK
| | - Joanne Brooks
- Nottingham Clinical Trials Unit, School of Medicine, University of Nottingham, Nottingham, UK
| | - Richard Swinden
- Nottingham Clinical Trials Unit, School of Medicine, University of Nottingham, Nottingham, UK
| | - Eleanor J Mitchell
- Nottingham Clinical Trials Unit, School of Medicine, University of Nottingham, Nottingham, UK
| | - Stella Tarr
- Nottingham Clinical Trials Unit, School of Medicine, University of Nottingham, Nottingham, UK
| | - Nicola Jay
- Sheffield Children's Hospital, Sheffield, UK
| | - Kim S Thomas
- Unit for Population-Based Dermatology Research, St John's Institute of Dermatology, Guy's & St Thomas' NHS Foundation Trust and King's College London, London, UK
| | - Hilary Allen
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Michael J Cork
- Sheffield Dermatology Research, Department of Infection and Immunity, University of Sheffield, Sheffield, UK
| | - Maeve M Kelleher
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Eric L Simpson
- Department of Dermatology, Oregon Health & Science University, Portland, Oregon, USA
| | - Stella T Lartey
- Health Economics Group, Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, UK
| | - Susan Davies-Jones
- Centre of Evidence Based Dermatology, School of Medicine, University of Nottingham, Nottingham, UK
| | - Robert J Boyle
- Centre of Evidence Based Dermatology, School of Medicine, University of Nottingham, Nottingham, UK
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Hywel C Williams
- Centre of Evidence Based Dermatology, School of Medicine, University of Nottingham, Nottingham, UK
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Hülpüsch C, Rohayem R, Reiger M, Traidl-Hoffmann C. Exploring the skin microbiome in atopic dermatitis pathogenesis and disease modification. J Allergy Clin Immunol 2024; 154:31-41. [PMID: 38761999 DOI: 10.1016/j.jaci.2024.04.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 03/04/2024] [Accepted: 04/24/2024] [Indexed: 05/20/2024]
Abstract
Inflammatory skin diseases such as atopic eczema (atopic dermatitis [AD]) affect children and adults globally. In AD, the skin barrier is impaired on multiple levels. Underlying factors include genetic, chemical, immunologic, and microbial components. Increased skin pH in AD is part of the altered microbial microenvironment that promotes overgrowth of the skin microbiome with Staphylococcus aureus. The secretion of virulence factors, such as toxins and proteases, by S aureus further aggravates the skin barrier deficiency and additionally disrupts the balance of an already skewed immune response. Skin commensal bacteria, however, can inhibit the growth and pathogenicity of S aureus through quorum sensing. Therefore, restoring a healthy skin microbiome could contribute to remission induction in AD. This review discusses direct and indirect approaches to targeting the skin microbiome through modulation of the skin pH; UV treatment; and use of prebiotics, probiotics, and postbiotics. Furthermore, exploratory techniques such as skin microbiome transplantation, ozone therapy, and phage therapy are discussed. Finally, we summarize the latest findings on disease and microbiome modification through targeted immunomodulatory systemic treatments and biologics. We believe that targeting the skin microbiome should be considered a crucial component of successful AD treatment in the future.
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Affiliation(s)
- Claudia Hülpüsch
- Environmental Medicine, Faculty of Medicine, University of Augsburg, Augsburg, Germany; Institute of Environmental Medicine, Helmholtz Center Munich-German Research Center for Environmental Health, Augsburg, Germany; Christine-Kühne Center for Allergy Research and Education, Davos, Switzerland
| | - Robin Rohayem
- Environmental Medicine, Faculty of Medicine, University of Augsburg, Augsburg, Germany; Christine-Kühne Center for Allergy Research and Education, Davos, Switzerland; Dermatology, Faculty of Medicine, University of Augsburg, Augsburg, Germany
| | - Matthias Reiger
- Environmental Medicine, Faculty of Medicine, University of Augsburg, Augsburg, Germany; Institute of Environmental Medicine, Helmholtz Center Munich-German Research Center for Environmental Health, Augsburg, Germany
| | - Claudia Traidl-Hoffmann
- Environmental Medicine, Faculty of Medicine, University of Augsburg, Augsburg, Germany; Chair of Environmental Medicine, Technical University of Munich, Munich, Germany; Institute of Environmental Medicine, Helmholtz Center Munich-German Research Center for Environmental Health, Augsburg, Germany; Christine-Kühne Center for Allergy Research and Education, Davos, Switzerland; ZIEL-Institute for Food & Health, Technical University of Munich, Freising, Germany.
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Mendonca CE, Andreae DA. Food Allergy. Med Clin North Am 2024; 108:655-670. [PMID: 38816109 DOI: 10.1016/j.mcna.2023.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2024]
Abstract
Food allergy is a growing health problem affecting both pediatric and adult patients. Food allergies are often immunoglobulin E (IgE) mediated but other food-induced non-IgE-mediated diseases exist. Diagnosis of food allergy relies on the combination of clinical and reaction history, skin and IgE testing as well as oral food challenges. Although oral immunotherapy has been able to achieve sustained unresponsiveness in some patients, no cure for food allergies has been found to date. Avoidance of the inciting food as well as availability of epinephrine autoinjectors remains the mainstay of treatment.
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Affiliation(s)
- Chelsea Elizabeth Mendonca
- Department of Family and Community Medicine, Baylor College of Medicine, 1100 West 34th Street, Houston, TX 77018, USA.
| | - Doerthe A Andreae
- Division of Allergy and Immunology, Department of Dermatology, University of Utah, 30 North 1900 East, 4A330, Salt Lake City, UT 84132, USA
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7
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Staubach-Renz P, Schulz S, Weyer-Elberich V, Peveling-Oberhag A, Zimmer S, Wegner J, Sohn A, Mann C, Lang BM. [Midwives as influencers in skin care for newborns at risk of atopic diseases : Survey of midwives' current recommendations]. DERMATOLOGIE (HEIDELBERG, GERMANY) 2024; 75:548-553. [PMID: 38639765 PMCID: PMC11224080 DOI: 10.1007/s00105-024-05334-7] [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] [Accepted: 03/18/2024] [Indexed: 04/20/2024]
Abstract
INTRODUCTION The prevalence of atopic diseases remains high. Initial studies suggest that primary prevention with regular basic care may influence the incidence of atopic dermatitis in infants; however, data are unclear. Midwives play an important role in the care of women in the peripartum period and therefore also in providing advice on topics such as skin care, breastfeeding and nutrition of the newborn and young infant. The aim of this study was to determine the care recommendations for newborns by midwives. METHODS We conducted a cross-sectional survey among German midwives using questionnaires on the topic of newborn skin care. RESULTS A total of 128 questionnaires were analyzed. The most common recommendations were oil-based herbal topicals (34.9%) and plain water (34.0%). Approximately 70% of midwives reported recommending various options when there was a known family history of atopic diathesis. It was remarkable that most of the midwives' recommendations were identical regardless of the presence of an atopic diathesis. Essential care products are only used "when necessary". CONCLUSION Training programs for midwives on the topic of "care and strengthening of the skin barrier", taking into account the current guidelines for allergy prevention, should be implemented.
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Affiliation(s)
- Petra Staubach-Renz
- Hautklinik Universitätsmedizin Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland.
| | - Sara Schulz
- Hautklinik Universitätsmedizin Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland
| | - Veronika Weyer-Elberich
- Institut für Biostatistik und klinische Forschung, Universität Münster, Münster, Deutschland
| | | | - Sebastian Zimmer
- Hautklinik Universitätsmedizin Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland
| | - Joanna Wegner
- Hautklinik Universitätsmedizin Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland
| | - Anna Sohn
- Hautklinik Universitätsmedizin Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland
| | - Caroline Mann
- Hautklinik Universitätsmedizin Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland
| | - Berenice M Lang
- Hautklinik Universitätsmedizin Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland
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Lee SH, Jeon JJ, Lee WS, Lee S. Autoimmune Connective Tissue and Dermatologic Diseases in Children with Autism Spectrum Disorder. J Invest Dermatol 2024:S0022-202X(24)01503-3. [PMID: 38871023 DOI: 10.1016/j.jid.2024.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 05/14/2024] [Accepted: 05/18/2024] [Indexed: 06/15/2024]
Affiliation(s)
- Sang-Hoon Lee
- Department of Dermatology, Yonsei University College of Medicine, Wonju, Republic of Korea
| | - Jae Joon Jeon
- Department of Dermatology, Yonsei University College of Medicine, Wonju, Republic of Korea
| | - Won-Soo Lee
- Department of Dermatology, Yonsei University College of Medicine, Wonju, Republic of Korea
| | - Solam Lee
- Department of Dermatology, Yonsei University College of Medicine, Wonju, Republic of Korea.
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9
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Stamatas GN, Sato T, Chaoimh CN, Oddos T, Insel R, Hourihane JO, Irvine AD. Early skin inflammatory biomarker is predictive of development and persistence of atopic dermatitis in infants. J Allergy Clin Immunol 2024; 153:1597-1603.e4. [PMID: 38460678 DOI: 10.1016/j.jaci.2024.02.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 02/07/2024] [Accepted: 02/16/2024] [Indexed: 03/11/2024]
Abstract
BACKGROUND The Short-Term Topical Application for Prevention of Atopic Dermatitis (STOP AD) study, a randomized, open-label trial evaluating the effect of short-term (from the first 4 postnatal days to age 8 weeks) skin barrier protection using Aveeno Dermexa Fast & Long-Lasting Balm (Johnson & Johnson, New Brunswick, NJ) in infants with a parent with allergic disease, demonstrated decreased cumulative incidence and decreased prevalence of atopic dermatitis (AD) at age 12 months. OBJECTIVE In the STOP AD study, we aimed to identify skin biomarkers that are associated with risk of development of AD. METHODS Skin swabs were collected from the cheek and antecubital fossa (AF) at baseline, age 8 weeks, and age 12 months from subsets of study participants from the intervention arm (n = 43 of 119) and control arm (n = 43 of 138) and were analyzed for specific cytokines (CCL27, CXCL2, human β-defensin-1 [hBD-1], IL-18, IL-8, IL-1α, IL-1 receptor antagonist [IL-1RA], IL-1β, S100A8/9, and IL-36γ) by ELISA. RESULTS Higher titers of S100A8/9 at the AF at age 8 weeks in infants with the filaggrin wild-type genotype (FLGwt), but not in those with filaggrin loss-of-function mutation (FLGmut), predicted (1) development of AD in the first year of life (P = .033), (2) presence of AD at ages 6 or 12 months (P = .009 and .035, respectively), (3) persistence of AD between ages 6 and 12 months (P < .001), and (4) development of AD with the emollient intervention. CONCLUSION Increased titers of S100A8/9 from skin swabs of the AF in high-risk infants at age 8 weeks with FLGwt were predictive of AD development in the first year of life and other AD features. These findings suggest that there are different molecular pathways leading to AD in individuals with FLGmut and in individuals with FLGwt. Early identification of infants who are likely to develop AD will allow more targeted interventions.
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Affiliation(s)
- Georgios N Stamatas
- Translational Science Essential Health, Johnson & Johnson Santé Beauté, Santé Beauté, France.
| | - Takahiro Sato
- World Without Disease Accelerator, Janssen R&D, Titusville, NJ
| | - Carol Ní Chaoimh
- Paediatrics and Child Health, University College Cork, Cork, Ireland; INFANT Research Centre, University College Cork, Cork, Ireland
| | - Thierry Oddos
- Translational Science Essential Health, Johnson & Johnson Santé Beauté, Santé Beauté, France
| | - Richard Insel
- World Without Disease Accelerator, Janssen R&D, Titusville, NJ
| | - Jonathan O'B Hourihane
- INFANT Research Centre, University College Cork, Cork, Ireland; Paediatrics and Child Health, Royal College of Surgeons, Dublin, Ireland
| | - Alan D Irvine
- Clinical Medicine, Trinity College Dublin, Dublin, Ireland
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10
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Boriboonhirunsarn D, Puttapratimonk S. Evaluation of Childhood Allergy Risk Among Pregnant Women in a Tertiary Care Hospital in Thailand. Cureus 2024; 16:e63322. [PMID: 39070479 PMCID: PMC11283371 DOI: 10.7759/cureus.63322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/26/2024] [Indexed: 07/30/2024] Open
Abstract
OBJECTIVES This study aims to evaluate the prevalence of pregnant women whose children are at higher risk for childhood allergies and to assess knowledge of risk assessment and prevention strategies. METHODS A cross-sectional study was conducted on 310 pregnant women in an antenatal care clinic at a tertiary care hospital in Thailand. In addition to baseline demographic and obstetric characteristics, all participating pregnant women were asked to complete a questionnaire regarding risk evaluation and knowledge of childhood allergies on various topics. A childhood allergy risk assessment was evaluated based on the history of allergy disease in immediate family members. The questionnaire on knowledge was derived from a guideline issued by the Allergy, Asthma, and Immunology Association of Thailand, with possible scores of 0-30. RESULTS The mean maternal age was 30.6 years, and 139 (44.8%) were nulliparous. Overall, 86 couples (27.7%) were at high risk for childhood allergies. The mean total knowledge score was 15.2 out of 30, and only 24 women (7.7%) had an overall score of >20, and 40 women (12.9%) had an overall score of ≤10. The mean knowledge score for almost every subtopic was less than half of the possible points, except for the risk reduction strategies during pregnancy. Comparisons between those with higher and lower scores (≥16 vs. ≤15 points) showed that women with higher knowledge scores were significantly more likely to have had a previous child with an allergy (p=0.010). CONCLUSION The prevalence of pregnant women whose children were at higher risk for childhood allergies was 27.7% (86 of 310 couples). The women had limited knowledge of childhood allergies with regard to risk assessment, risk reduction strategies, and various interventions. The only factor associated with a higher knowledge score was having a previous child with an allergy.
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Affiliation(s)
| | - Siraluck Puttapratimonk
- Obstetrics and Gynaecology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, THA
- Obstetrics and Gynaecology, Wat Raja O Ros School, Bangkok, THA
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11
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Gomes M, Zuchi IDP, Pavi CP, Fongaro G, da Silva IT, Pezzini BR. Skin- and Eco-Friendly Hand Sanitizer: A Novel Composition of Natural Extracts to Prevent the Spread of Respiratory Viruses. AAPS PharmSciTech 2024; 25:98. [PMID: 38714600 DOI: 10.1208/s12249-024-02808-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 04/17/2024] [Indexed: 05/10/2024] Open
Abstract
Respiratory diseases caused by viruses are a serious global health threat. Although the use of hand sanitizers containing alcohol and synthetic antiseptic agents is recognized as an effective, simple, and low-cost measure to combat viral transmission, they can harm human health and the environment. Thus, this work aimed to study the efficacy of combining Camellia sinensis and Chamomilla recutita extracts in a skin- and eco-friendly leave-on hand sanitizer to prevent the spread of respiratory viruses. An oil-in-water emulsion containing C. recutita oily extract (5.0%), C. recutita glycolic extract (0.2%) and C. sinensis glycolic extract (5.0%) showed virucidal activity against HAdV-2 (respiratory virus) and two surrogate viruses of SARS-CoV-2 (HSV-1 and MVH-3), showing great potential to prevent the spread of respiratory viruses. These natural extracts combined are also promising to combat a broad spectrum of other viruses, in the form of antiseptic mouthwashes or throat sprays, surface disinfectants, and veterinary products, among others. Complementally, the developed hand sanitizer demonstrated efficacy against bacteria and fungus.
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Affiliation(s)
- Marina Gomes
- Department of Pharmaceutical Sciences, Federal University of Santa Catarina, Florianópolis, SC, 88040-900, Brazil
| | - Isabella Dai Prá Zuchi
- Department of Pharmaceutical Sciences, Federal University of Santa Catarina, Florianópolis, SC, 88040-900, Brazil
| | - Catielen Paula Pavi
- Department of Microbiology, Immunology and Parasitology, Federal University of Santa Catarina, Florianópolis, SC, 88040-900, Brazil
| | - Gislaine Fongaro
- Department of Microbiology, Immunology and Parasitology, Federal University of Santa Catarina, Florianópolis, SC, 88040-900, Brazil
| | - Izabella Thaís da Silva
- Department of Pharmaceutical Sciences, Federal University of Santa Catarina, Florianópolis, SC, 88040-900, Brazil
- Department of Microbiology, Immunology and Parasitology, Federal University of Santa Catarina, Florianópolis, SC, 88040-900, Brazil
| | - Bianca Ramos Pezzini
- Department of Pharmaceutical Sciences, Federal University of Santa Catarina, Florianópolis, SC, 88040-900, Brazil.
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12
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Paller AS, Scharschmidt TC, Kezic S, Irvine AD. Preclinical Atopic Dermatitis Skin in Infants: An Emerging Research Area. J Invest Dermatol 2024; 144:1001-1009. [PMID: 38573278 DOI: 10.1016/j.jid.2024.02.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 02/16/2024] [Accepted: 02/20/2024] [Indexed: 04/05/2024]
Abstract
Whereas clinically apparent atopic dermatitis (AD) can be confirmed by validated diagnostic criteria, the preclinical phenotype of infants who eventually develop AD is less well-characterized. Analogous to unaffected or nonlesional skin in established AD, clinically normal-appearing skin in infants who will develop clinical AD has distinct changes. Prospective studies have revealed insights into this preclinical AD phenotype. In this study, we review the structural, immunologic, and microbiome nature of the preclinical AD phenotype. Determination of markers that predict the development of AD will facilitate targeting of interventions to prevent the development or reduce the severity of AD in infants.
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Affiliation(s)
- Amy S Paller
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA; Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
| | - Tiffany C Scharschmidt
- Department of Dermatology, University of California San Francisco, San Francisco, California, USA
| | - Sanja Kezic
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Alan D Irvine
- Clinical Medicine, Trinity College Dublin, Dublin, Ireland
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13
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Schmuth M, Eckmann S, Moosbrugger-Martinz V, Ortner-Tobider D, Blunder S, Trafoier T, Gruber R, Elias PM. Skin Barrier in Atopic Dermatitis. J Invest Dermatol 2024; 144:989-1000.e1. [PMID: 38643989 DOI: 10.1016/j.jid.2024.03.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 02/27/2024] [Accepted: 03/07/2024] [Indexed: 04/23/2024]
Abstract
A compromised permeability barrier is a hallmark of atopic dermatitis (AD). Localized to the outermost skin layer, the stratum corneum (SC) is critically dependent on terminal differentiation of epidermal keratinocytes, which transform into protein-rich corneocytes surrounded by extracellular lamellae of unique epidermal lipids, conferring permeability barrier function. These structures are disrupted in AD. A leaky barrier is prone to environmental insult, which in AD elicits type 2-dominant inflammation, in turn resulting in a vicious cycle further impairing the SC structure. Therapies directed at enforcing SC structure and anti-inflammatory strategies administered by topical and systemic route as well as UV therapy have differential effects on the permeability barrier. The expanding armamentarium of therapeutic modalities for AD treatment warrants optimization of their effects on permeability barrier function.
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Affiliation(s)
- Matthias Schmuth
- Dermatology, Venerology and Allergy, Medical University Innsbruck, Innsbruck, Austria; Institute for Pediatric Dermatology and Rare Diseases, Karl Landsteiner Society, Innsbruck, Austria.
| | - Sonja Eckmann
- Dermatology, Venerology and Allergy, Medical University Innsbruck, Innsbruck, Austria
| | | | | | - Stefan Blunder
- Dermatology, Venerology and Allergy, Medical University Innsbruck, Innsbruck, Austria
| | - Thomas Trafoier
- Dermatology, Venerology and Allergy, Medical University Innsbruck, Innsbruck, Austria
| | - Robert Gruber
- Dermatology, Venerology and Allergy, Medical University Innsbruck, Innsbruck, Austria; Institute for Pediatric Dermatology and Rare Diseases, Karl Landsteiner Society, Innsbruck, Austria
| | - Peter M Elias
- Dermatology, Veteran Affairs Health Care System, San Francisco, California, USA; University of California San Francisco, San Francisco, California, USA
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14
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Mohammad S, Karim MR, Iqbal S, Lee JH, Mathiyalagan R, Kim YJ, Yang DU, Yang DC. Atopic dermatitis: Pathophysiology, microbiota, and metabolome - A comprehensive review. Microbiol Res 2024; 281:127595. [PMID: 38218095 DOI: 10.1016/j.micres.2023.127595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 10/11/2023] [Accepted: 12/24/2023] [Indexed: 01/15/2024]
Abstract
Atopic dermatitis (AD) is a prevalent inflammatory skin condition that commonly occurs in children. Genetics, environment, and defects in the skin barrier are only a few of the factors that influence how the disease develops. As human microbiota research has advanced, more scientific evidence has shown the critical involvement of the gut and skin bacteria in the pathogenesis of atopic dermatitis. Microbiome dysbiosis, defined by changed diversity and composition, as well as the development of pathobionts, has been identified as a potential cause for recurring episodes of atopic dermatitis. Gut dysbiosis causes "leaky gut syndrome" by disrupting the epithelial lining of the gut, which allows bacteria and other endotoxins to enter the bloodstream and cause inflammation. The same is true for the disruption of cutaneous homeostasis caused by skin dysbiosis, which enables bacteria and other pathogens to reach deeper skin layers or even systemic circulation, resulting in inflammation. Furthermore, it is now recognized that the gut and skin microbiota releases both beneficial and toxic metabolites. Here, this review covers a range of topics related to AD, including its pathophysiology, the microbiota-AD connection, commonly used treatments, and the significance of metabolomics in AD prevention, treatment, and management, recognizing its potential in providing valuable insights into the disease.
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Affiliation(s)
- Shahnawaz Mohammad
- Graduate School of Biotechnology, College of Life Sciences, Kyung Hee University, Yongin-si, Gyeonggi-do 17104, Republic of Korea
| | - Md Rezaul Karim
- Department of Biopharmaceutical Biotechnology, College of Life Sciences, Kyung Hee University, Yongin-si, Gyeonggi-do 17104, Republic of Korea; Department of Biotechnology and Genetic Engineering, Faculty of Biological Sciences, Islamic University, Kushtia 7003, Bangladesh
| | - Safia Iqbal
- Department of Biopharmaceutical Biotechnology, College of Life Sciences, Kyung Hee University, Yongin-si, Gyeonggi-do 17104, Republic of Korea; Department of Microbiology, Varendra Institute of Biosciences, Affiliated by Rajshahi University, Natore, Rajshahi 6400, Bangladesh
| | - Jung Hyeok Lee
- Graduate School of Biotechnology, College of Life Sciences, Kyung Hee University, Yongin-si, Gyeonggi-do 17104, Republic of Korea
| | - Ramya Mathiyalagan
- Graduate School of Biotechnology, College of Life Sciences, Kyung Hee University, Yongin-si, Gyeonggi-do 17104, Republic of Korea; Department of Oriental Medicinal Biotechnology, College of Life Sciences, Kyung Hee University, Yongin-si, Gyeonggi-do 17104, Republic of Korea
| | - Yeon Ju Kim
- Graduate School of Biotechnology, College of Life Sciences, Kyung Hee University, Yongin-si, Gyeonggi-do 17104, Republic of Korea; Department of Oriental Medicinal Biotechnology, College of Life Sciences, Kyung Hee University, Yongin-si, Gyeonggi-do 17104, Republic of Korea
| | - Dong Uk Yang
- Graduate School of Biotechnology, College of Life Sciences, Kyung Hee University, Yongin-si, Gyeonggi-do 17104, Republic of Korea; Department of Oriental Medicinal Biotechnology, College of Life Sciences, Kyung Hee University, Yongin-si, Gyeonggi-do 17104, Republic of Korea.
| | - Deok Chun Yang
- Graduate School of Biotechnology, College of Life Sciences, Kyung Hee University, Yongin-si, Gyeonggi-do 17104, Republic of Korea; Department of Oriental Medicinal Biotechnology, College of Life Sciences, Kyung Hee University, Yongin-si, Gyeonggi-do 17104, Republic of Korea.
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15
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Zysk W, Trzeciak M. Tape Stripping - Searching for Minimally Invasive Biomarkers in Atopic Dermatitis. Dermatol Pract Concept 2024; 14:dpc.1402a123. [PMID: 38810072 PMCID: PMC11135974 DOI: 10.5826/dpc.1402a123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/04/2024] [Indexed: 05/31/2024] Open
Abstract
Atopic dermatitis (AD) is nowadays entering a new era of more targeted treatments. However, to make personalized medicine, which we are currently striving for, a reality, a reliable set of validated biomarkers is needed. The most practical seem to be biomarkers that can be obtained easily and minimally invasively. Tape stripping (TS) is a method that provides such an opportunity. This review summarizes the potential biomarkers of AD identified by the minimally invasive TS method. Thymic stromal lymphopoietin (TSLP), interleukin (IL)-13, CC chemokine ligand 17 (CCL17)/thymus and activation-regulated chemokine (TARC) and stratum corneum (SC) lipids can be used as predictive biomarkers for AD occurrence. CCL17/TARC also holds great promise for being reliable biomarkers for AD severity as well as treatment response. Nitric oxide synthase 2 (NOS2)/inducible nitric oxide synthase (iNOS) which high expression is specific for psoriasis may be a good biomarker for differential diagnosis between psoriasis and AD in challenging clinical situations. AD children with food allergy (FA) have a unique endotype characterized by selectively altered expression of various molecules in the skin that can indicate FA coexistence. Unfortunately, although numerous potential biomarkers have been found, none of these candidates have been validated and implemented into routine clinical practice, which still separates us from the possibility of a precise approach to AD patients.
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Affiliation(s)
- Weronika Zysk
- Department of Dermatology, Venereology and Allergology, Faculty of Medicine, Medical University of Gdansk, Poland
| | - Magdalena Trzeciak
- Department of Dermatology, Venereology and Allergology, Faculty of Medicine, Medical University of Gdansk, Poland
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16
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Cavallo A, Camera E, Bottillo G, Maiellaro M, Truglio M, Marini F, Chavagnac-Bonneville M, Fauger A, Perrier E, Pigliacelli F, Picardo M, Cristaudo A, Mariano M. Biosignatures of defective sebaceous gland activity in sebum-rich and sebum-poor skin areas in adult atopic dermatitis. Exp Dermatol 2024; 33:e15066. [PMID: 38532571 DOI: 10.1111/exd.15066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 03/07/2024] [Accepted: 03/14/2024] [Indexed: 03/28/2024]
Abstract
Atopic dermatitis (AD) is a composite disease presenting disruption of the skin permeability barrier (SPB) in the stratum corneum (SC). Recent evidence supports derangement of the sebaceous gland (SG) activity in the AD pathomechanisms. The objective of this study was to delineate profiles of both sebaceous and epidermal lipids and of aminoacids from SG-rich (SGR) and SG-poor (SGP) areas in AD. Both sebum and SC were sampled from SGR areas, while SC was sampled also from SGP areas in 54 adult patients with AD, consisting of 34 and 20 subjects, respectively with and without clinical involvement of face, and in 44 age and sex-matched controls. Skin biophysics were assessed in all sampling sites. Disruption of the SBP was found to be associated with dysregulated lipidome. Abundance of sapienate and lignocerate, representing, respectively, sebum and the SC type lipids, were decreased in sebum and SC from both SGR and SGP areas. Analogously, squalene was significantly diminished in AD, regardless the site. Extent of lipid derangement in SGR areas was correlated with the AD severity. The abundance of aminoacids in the SC from SGR areas was altered more than that determined in SGP areas. Several gender-related differences were found in both controls and AD subgroups. In conclusion, the SG activity was differently compromised in adult females and males with AD, in both SGR and SGP areas. In AD, alterations in the aminoacidome profiles were apparent in the SGR areas. Lipid signatures in association with aminoacidome and skin physical properties may serve the definition of phenotype clusters that associate with AD severity and gender.
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Affiliation(s)
- Alessia Cavallo
- Laboratory of Cutaneous Physiopathology, San Gallicano Dermatological Institute-IRCCS, Rome, Italy
| | - Emanuela Camera
- Laboratory of Cutaneous Physiopathology, San Gallicano Dermatological Institute-IRCCS, Rome, Italy
| | - Grazia Bottillo
- Laboratory of Cutaneous Physiopathology, San Gallicano Dermatological Institute-IRCCS, Rome, Italy
| | - Miriam Maiellaro
- Laboratory of Cutaneous Physiopathology, San Gallicano Dermatological Institute-IRCCS, Rome, Italy
| | - Mauro Truglio
- Laboratory of Cutaneous Physiopathology, San Gallicano Dermatological Institute-IRCCS, Rome, Italy
| | - Federico Marini
- Department of Chemistry, 'La Sapienza' University, Rome, Italy
| | - Marlène Chavagnac-Bonneville
- Research and Development Department, NAOS Ecobiology Company (Bioderma- Institute Esthederm - Etat Pur), Aix-en-Provence, France
| | - Aurélie Fauger
- Research and Development Department, NAOS Ecobiology Company (Bioderma- Institute Esthederm - Etat Pur), Aix-en-Provence, France
| | - Eric Perrier
- NAOS, Institute of Life Science, Aix-en-Provence, France
- Department of Dermatological Clinic and Research, San Gallicano Dermatological Institute-IRCCS, Rome, Italy
| | - Flavia Pigliacelli
- Department of Dermatological Clinic and Research, San Gallicano Dermatological Institute-IRCCS, Rome, Italy
| | - Mauro Picardo
- Laboratory of Cutaneous Physiopathology, San Gallicano Dermatological Institute-IRCCS, Rome, Italy
| | - Antonio Cristaudo
- Department of Dermatological Clinic and Research, San Gallicano Dermatological Institute-IRCCS, Rome, Italy
| | - Maria Mariano
- Department of Dermatological Clinic and Research, San Gallicano Dermatological Institute-IRCCS, Rome, Italy
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17
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Lu HF, Zhou YC, Yang LT, Zhou Q, Wang XJ, Qiu SQ, Cheng BH, Zeng XH. Involvement and repair of epithelial barrier dysfunction in allergic diseases. Front Immunol 2024; 15:1348272. [PMID: 38361946 PMCID: PMC10867171 DOI: 10.3389/fimmu.2024.1348272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Accepted: 01/15/2024] [Indexed: 02/17/2024] Open
Abstract
The epithelial barrier serves as a critical defense mechanism separating the human body from the external environment, fulfilling both physical and immune functions. This barrier plays a pivotal role in shielding the body from environmental risk factors such as allergens, pathogens, and pollutants. However, since the 19th century, the escalating threats posed by environmental pollution, global warming, heightened usage of industrial chemical products, and alterations in biodiversity have contributed to a noteworthy surge in allergic disease incidences. Notably, allergic diseases frequently exhibit dysfunction in the epithelial barrier. The proposed epithelial barrier hypothesis introduces a novel avenue for the prevention and treatment of allergic diseases. Despite increased attention to the role of barrier dysfunction in allergic disease development, numerous questions persist regarding the mechanisms underlying the disruption of normal barrier function. Consequently, this review aims to provide a comprehensive overview of the epithelial barrier's role in allergic diseases, encompassing influencing factors, assessment techniques, and repair methodologies. By doing so, it seeks to present innovative strategies for the prevention and treatment of allergic diseases.
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Affiliation(s)
- Hui-Fei Lu
- Department of Graduate and Scientific Research, Zhuhai Campus of Zunyi Medical University, Zhuhai, China
- Department of Otolaryngology, Longgang Otolaryngology Hospital & Shenzhen Key Laboratory of Otolaryngology, Institute of Otolaryngology Shenzhen, Shenzhen, China
| | - Yi-Chi Zhou
- Department of Gastroenterology, Beijing University of Chinese Medicine Shenzhen Hospital (Longgang), Shenzhen, China
| | - Li-Tao Yang
- Clinical Laboratory Department of The Second Affiliated Hospital, School of Medicine, The Chinese University of Hong Kong, Shenzhen & Longgang District People’s Hospital of Shenzhen, Shenzhen, China
| | - Qian Zhou
- Department of Graduate and Scientific Research, Zhuhai Campus of Zunyi Medical University, Zhuhai, China
| | - Xi-Jia Wang
- Department of Graduate and Scientific Research, Zhuhai Campus of Zunyi Medical University, Zhuhai, China
- Department of Otolaryngology, Longgang Otolaryngology Hospital & Shenzhen Key Laboratory of Otolaryngology, Institute of Otolaryngology Shenzhen, Shenzhen, China
| | - Shu-Qi Qiu
- Department of Otolaryngology, Longgang Otolaryngology Hospital & Shenzhen Key Laboratory of Otolaryngology, Institute of Otolaryngology Shenzhen, Shenzhen, China
| | - Bao-Hui Cheng
- Department of Otolaryngology, Longgang Otolaryngology Hospital & Shenzhen Key Laboratory of Otolaryngology, Institute of Otolaryngology Shenzhen, Shenzhen, China
| | - Xian-Hai Zeng
- Department of Graduate and Scientific Research, Zhuhai Campus of Zunyi Medical University, Zhuhai, China
- Department of Otolaryngology, Longgang Otolaryngology Hospital & Shenzhen Key Laboratory of Otolaryngology, Institute of Otolaryngology Shenzhen, Shenzhen, China
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18
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Lapeere H, Speeckaert R, Baeck M, Dezfoulian B, Lambert J, Roquet-Gravy PP, Stockman A, White J, Castelijns F, Gutermuth J. Belgian atopic dermatitis guidelines. Acta Clin Belg 2024; 79:62-74. [PMID: 37997950 DOI: 10.1080/17843286.2023.2285576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 10/13/2023] [Indexed: 11/25/2023]
Abstract
Atopic dermatitis (AD) is one of the most common, bothersome and difficult to treat skin disorders. Recent introduction of new systemic treatments has revolutionized the management of AD. The goal of this guideline is to provide evidence-based recommendations for the management of patients suffering from atopic dermatitis that easily can be implemented in clinical practice. These recommendations were developed by 11 Belgian AD experts. Comments of all experts on the proposed statements were gathered, followed by an online voting session. The most relevant strategies for the management and treatment of AD in the context of the Belgian health care landscape are discussed. General measures, patient education and adequate topical treatment remain the cornerstones of AD management. For moderate to severe AD, the introduction of biologics and JAK inhibitors show unprecedented efficacy, although currently access is limited to a subgroup of patients meeting the reimbursement criteria.
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Affiliation(s)
- Hilde Lapeere
- Department of Dermatology, Ghent University Hospital, Ghent, Belgium
| | | | - Marie Baeck
- Department of Dermatology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Bita Dezfoulian
- Department of Dermatology, Liège University Hospital, Liège, Belgium
| | - Julien Lambert
- Department of Dermatology, University Hospital Antwerp (UZA), Edegem, Belgium
| | | | - Annelies Stockman
- Department of Dermatology, AZ Delta campus Rembert Torhout, Torhout, Belgium
| | - Jonathan White
- Department of Dermatology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | | | - Jan Gutermuth
- Vrije Universiteit Brussel (VUB), Department of Dermatology, Universitair Ziekenhuis Brussel, Brussels, Belgium
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19
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Scadding GK, McDonald M, Backer V, Scadding G, Bernal-Sprekelsen M, Conti DM, De Corso E, Diamant Z, Gray C, Hopkins C, Jesenak M, Johansen P, Kappen J, Mullol J, Price D, Quirce S, Reitsma S, Salmi S, Senior B, Thyssen JP, Wahn U, Hellings PW. Pre-asthma: a useful concept for prevention and disease-modification? A EUFOREA paper. Part 1-allergic asthma. FRONTIERS IN ALLERGY 2024; 4:1291185. [PMID: 38352244 PMCID: PMC10863454 DOI: 10.3389/falgy.2023.1291185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 12/26/2023] [Indexed: 02/16/2024] Open
Abstract
Asthma, which affects some 300 million people worldwide and caused 455,000 deaths in 2019, is a significant burden to suffers and to society. It is the most common chronic disease in children and represents one of the major causes for years lived with disability. Significant efforts are made by organizations such as WHO in improving the diagnosis, treatment and monitoring of asthma. However asthma prevention has been less studied. Currently there is a concept of pre- diabetes which allows a reduction in full blown diabetes if diet and exercise are undertaken. Similar predictive states are found in Alzheimer's and Parkinson's diseases. In this paper we explore the possibilities for asthma prevention, both at population level and also investigate the possibility of defining a state of pre-asthma, in which intensive treatment could reduce progression to asthma. Since asthma is a heterogeneous condition, this paper is concerned with allergic asthma. A subsequent one will deal with late onset eosinophilic asthma.
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Affiliation(s)
- G. K. Scadding
- Department of Allergy & Rhinology, Royal National ENT Hospital, London, United Kingdom
- Division of Immunity and Infection, University College, London, United Kingdom
| | - M. McDonald
- The Allergy Clinic, Blairgowrie, Randburg, South Africa
| | - V. Backer
- Department of Otorhinolaryngology, Head & Neck Surgery, and Audiology, Rigshospitalet, Copenhagen University, Copenhagen, Denmark
| | - G. Scadding
- Allergy, Royal Brompton Hospital, London, United Kingdom
| | - M. Bernal-Sprekelsen
- Head of ORL-Deptartment, Clinic Barcelona, Barcelona, Spain
- Chair of ORL, University of Barcelona, Barcelona, Spain
| | - D. M. Conti
- The European Forum for Research and Education in Allergy and Airway Diseases Scientific Expert Team Members, Brussels, Belgium
| | - E. De Corso
- Otolaryngology Head and Neck Surgery, A. Gemelli University Hospital Foundation IRCCS, Rome, Italy
| | - Z. Diamant
- Department of Respiratory Medicine & Allergology, Institute for Clinical Science, Skane University Hospital, Lund University, Lund, Sweden
- Department of Respiratory Medicine, First Faculty of Medicine, Charles University and Thomayer Hospital, Prague, Czech Republic
- Department Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
- Deptarment of Microbiology Immunology & Transplantation, KU Leuven, Catholic University of Leuven, Leuven, Belgium
| | - C. Gray
- Paediatric Allergist, Red Cross Children’s Hospital and University of Cape Town, Cape Town, South Africa
- Kidsallergy Centre, Cape Town, South Africa
| | - C. Hopkins
- Department of Rhinology and Skull Base Surgery, Guy’s and St Thomas’ Hospital NHS Foundation Trust, London, United Kingdom
| | - M. Jesenak
- Department of Clinical Immunology and Allergology, University Teaching Hospital in Martin, Martin, Slovakia
- Department of Paediatrics, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Teaching Hospital in Martin, Martin, Slovakia
- Department of Pulmonology and Phthisiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Teaching Hospital in Martin, Martin, Slovakia
| | - P. Johansen
- Department of Dermatology, University of Zurich, Zurich, Switzerland
- Department of Dermatology, University Hospital of Zurich, Zurich, Switzerland
| | - J. Kappen
- Department of Pulmonology, STZ Centre of Excellence for Asthma, COPD and Respiratory Allergy, Franciscus Gasthuis & Vlietland, Rotterdam, Netherlands
| | - J. Mullol
- Rhinology Unit and Smell Clinic, ENT Department, Hospital Clínic, FRCB-IDIBAPS, Universitat de Barcelona, CIBERES, Barcelona, Spain
| | - D. Price
- Observational and Pragmatic Research Institute, Singapore, Singapore
- Division of Applied Health Sciences, Centre of Academic Primary Care, University of Aberdeen, Aberdeen, United Kingdom
| | - S. Quirce
- Department of Allergy, La Paz University Hospital, IdiPAZ, Madrid, Spain
| | - S. Reitsma
- Department of Otorhinolarynogology and Head/Neck Surgery, Amsterdam University Medical Centres, Location AMC, University of Amsterdam, Amsterdam, Netherlands
| | - S. Salmi
- Department of Otorhinolaryngology, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland
- Department of Allergy, Inflammation Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - B. Senior
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - J. P. Thyssen
- Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - U. Wahn
- Former Head of the Department for Pediatric Pneumology and Immunology, Charite University Medicine, Berlin, Germany
| | - P. W. Hellings
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospitals, Leuven, Belgium
- Laboratory of Allergy and Clinical Immunology, University Hospitals Leuven, Leuven, Belgium
- Upper Airways Research Laboratory, Department of Head and Skin, Ghent University, Ghent, Belgium
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20
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Lei D, Liu D, Zhang J, Zhang L, Man MQ. Benefits of topical natural ingredients in epidermal permeability barrier. Front Physiol 2024; 14:1275506. [PMID: 38239888 PMCID: PMC10794395 DOI: 10.3389/fphys.2023.1275506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 12/07/2023] [Indexed: 01/22/2024] Open
Abstract
Because of the crucial role of epidermal permeability barrier in regulation of cutaneous and extracutaneous functions, great efforts have been made to identify and develop the regimens that can improve epidermal permeability barrier function. Studies have demonstrated that oral administration of natural ingredients can improve epidermal permeability barrier in various skin conditions, including inflammatory dermatoses and UV-irradiation. Moreover, topical applications of some natural ingredients can also accelerate the repair of epidermal permeability barrier after acute barrier disruption and lower transepidermal water loss in the intact skin. Natural ingredient-induced improvements in epidermal permeability barrier function can be attributable to upregulation of keratinocyte differentiation, lipid production, antioxidant, hyaluronic acid production, expression of aquaporin 3 and sodium-hydrogen exchanger 1. In this review, we summarize the benefits of topical natural ingredients in epidermal permeability barrier in normal skin with or without acute barrier disruption and the underlying mechanisms.
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Affiliation(s)
- Dongyun Lei
- Department of Dermatology, Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital, Tianjin, China
| | - Dan Liu
- Dermatology Hospital, Southern Medical University, Guangzhou, China
| | - Junling Zhang
- Department of Dermatology, Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital, Tianjin, China
| | - Litao Zhang
- Department of Dermatology, Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital, Tianjin, China
| | - Mao-Qiang Man
- Dermatology Hospital, Southern Medical University, Guangzhou, China
- Dermatology Service, Veterans Affairs Medical Center San Francisco, Department of Dermatology, University of California San Francisco, San Francisco, CA, United States
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21
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Edwards T, Felix K, Francois S, Cardwell L, Rice Z. Nonprescription Treatment Options. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2024; 1447:151-167. [PMID: 38724792 DOI: 10.1007/978-3-031-54513-9_14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2024]
Abstract
The pathogenesis of atopic dermatitis (AD) is complex and multifactorial. However, recent advancements in the genetics and pathophysiology of AD suggest that epidermal barrier dysfunction is paramount in the development and progression of the condition (Boguniewicz M, Leung DYM, Immunol Rev 242(1):233-246, 2011). In addition to standard therapy for AD, there are a plethora of nonprescription treatment modalities which may be employed. Over-the-counter treatments for atopic dermatitis can come in the form of topical corticosteroids, moisturizers/emollients, and oral antihistamines. Though these treatments are beneficial, prescription treatments may be quicker acting and more efficacious in patients with moderate to severe disease or during flares. OTC agents are best used for maintenance between flares and to prevent progression of mild disease. Alternative and complementary treatments lack strong efficacy evidence. However, wet wraps, bleach baths, and other treatments appear to be promising when used in conjunction with conventional treatments. With the financial burden of atopic dermatitis ranging from 364 million to 3.8 billion dollars each year in the United States, we suspect this topic will gain further research attention.
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Affiliation(s)
- Taylor Edwards
- Ohio University Heritage College of Osteopathic Medicine, Athens, OH, USA
| | - Kayla Felix
- Department of Dermatology, Wake Forest University School of Medicine, Winston Salem, NC, USA
| | - Sandy Francois
- Department of Dermatology, Emory School of Medicine, Atlanta, GA, USA
| | - Leah Cardwell
- Department of Dermatology, Wake Forest University School of Medicine, Winston Salem, NC, USA
| | - Zakiyyah Rice
- Department of Dermatology, Emory School of Medicine, Atlanta, GA, USA.
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Kido M, Yonezawa K, Haruna M, Tahara-Sasagawa E, Usui Y. A global survey on national standard care for newborn bathing. Jpn J Nurs Sci 2024; 21:e12558. [PMID: 37635681 DOI: 10.1111/jjns.12558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Revised: 07/04/2023] [Accepted: 07/20/2023] [Indexed: 08/29/2023]
Abstract
AIM To describe national standard care for newborn bathing and its influential factors. METHODS A global survey was conducted using a web-based questionnaire. The targeted countries were 166 member countries of either the International Confederation of Midwives (ICM) or the International Council of Nurses (ICN). An eligible person included someone well informed of midwifery education/training or neonatal care, including newborn bathing, in their country. To examine the factors associated with the standard care for newborn bathing, information on mean annual temperature, precipitation, gross domestic product per capita, and basic water coverage was collected as external factors. Student's t tests and Chi-square tests were used for analysis. RESULTS Care standards were identified in 46 countries: seven from Africa, eight from the Americas, 15 from Asia, 14 from Europe, and two from Oceania. In most countries, newborns were bathed with warm water in a tub within 10 min. Bathing frequency, moisturization, and use of soap or cleanser varied by country. There were significant associations between bathing frequency and temperature and between moisturization and precipitation. CONCLUSION The national standard care for newborn bathing in each country was unique. Standard bathing care was associated with the climate. More consideration should be given to the differences in standard care for newborn bathing between countries when interpreting existing studies and conducting future studies on neonatal skin care.
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Affiliation(s)
- Minako Kido
- Department of Midwifery and Women's Health, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kaori Yonezawa
- Department of Midwifery and Women's Health, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Division of Care Innovation, Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Megumi Haruna
- Department of Midwifery and Women's Health, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Division of Care Innovation, Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Emi Tahara-Sasagawa
- Department of Midwifery and Women's Health, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Division of Care Innovation, Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yuriko Usui
- Department of Midwifery and Women's Health, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Division of Care Innovation, Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Adamson AS. The Economic Impact of Atopic Dermatitis. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2024; 1447:91-104. [PMID: 38724787 DOI: 10.1007/978-3-031-54513-9_9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2024]
Abstract
Atopic dermatitis (AD) is a chronic inflammatory disorder that affects over 30 million people in the United States. Given the large and growing prevalence of AD, the associated economic burden is significant. It has been estimated that AD costs over $5 billion dollars annually. These costs include both direct and indirect costs. Direct costs include prescription medicines, visits to health-care providers, hospitalizations, and transportation. Indirect costs include missed days or lost productivity at work or school, career modification, and reduced quality of life. Understanding and measuring these costs can be accomplished through rigorous economic evaluation, which is the organized process of considering inputs and outcomes of various activities. Economic evaluation has been used to contextualize the burden of AD in society. It has also been used to inform patients, providers, and other stakeholders on how to deliver the most evidence-based, efficient way possible. Understanding the economic impact of atopic dermatitis is an important aspect of delivering high-quality care.
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Affiliation(s)
- Adewole S Adamson
- University of North Carolina Hospitals, Department of Dermatology, Chapel Hill, NC, USA
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Mrkić Kobal I, Plavec D, Vlašić Lončarić Ž, Jerković I, Turkalj M. Atopic March or Atopic Multimorbidity-Overview of Current Research. MEDICINA (KAUNAS, LITHUANIA) 2023; 60:21. [PMID: 38256282 PMCID: PMC10819021 DOI: 10.3390/medicina60010021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 12/11/2023] [Accepted: 12/18/2023] [Indexed: 01/24/2024]
Abstract
The atopic march encompasses a sequence of allergic conditions, including atopic dermatitis, food allergy, allergic rhinitis, and asthma, that frequently develop in a sequential pattern within the same individual. It was introduced as a conceptual framework aimed at elucidating the developmental trajectory of allergic conditions during childhood. Following the introduction of this concept, it was initially believed that the atopic march represented the sole and definitive trajectory of the development of allergic diseases. However, this perspective evolved with the emergence of new longitudinal studies, which revealed that the evolution of allergic diseases is far more intricate. It involves numerous immunological pathological mechanisms and may not align entirely with the traditional concept of the atopic march. The objective of our review is to portray the atopic march alongside other patterns in the development of childhood allergic diseases, with a specific emphasis on the potential for a personalized approach to the prevention, diagnosis, and treatment of atopic conditions.
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Affiliation(s)
- Iva Mrkić Kobal
- Clinic for Pediatric Medicine Helena, Ulica kneza Branimira 71, 10000 Zagreb, Croatia
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Josipa Huttlera 4, 31000 Osijek, Croatia
| | - Davor Plavec
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Josipa Huttlera 4, 31000 Osijek, Croatia
- Prima Nova, Zagrebačka cesta 132a, 10000 Zagreb, Croatia
| | - Željka Vlašić Lončarić
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Josipa Huttlera 4, 31000 Osijek, Croatia
- Children’s Hospital Srebrnjak, Srebrnjak 100, 10000 Zagreb, Croatia
| | - Ivana Jerković
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Josipa Huttlera 4, 31000 Osijek, Croatia
- Children’s Hospital Srebrnjak, Srebrnjak 100, 10000 Zagreb, Croatia
| | - Mirjana Turkalj
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Josipa Huttlera 4, 31000 Osijek, Croatia
- Children’s Hospital Srebrnjak, Srebrnjak 100, 10000 Zagreb, Croatia
- Faculty of Medicine, Catholic University of Croatia, Ilica 242, 10000 Zagreb, Croatia
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Proksch E. Prevention of AD in early childhood: Finding the right emollient and the right usage. J Eur Acad Dermatol Venereol 2023; 37:2403-2404. [PMID: 38011658 DOI: 10.1111/jdv.19533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 09/25/2023] [Indexed: 11/29/2023]
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Fernandes B, Alves S, Schmidt V, Bizarro AF, Pinto M, Pereira H, Marto J, Lourenço AM. Primary Prevention of Canine Atopic Dermatitis: Breaking the Cycle-A Narrative Review. Vet Sci 2023; 10:659. [PMID: 37999481 PMCID: PMC10674681 DOI: 10.3390/vetsci10110659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 10/24/2023] [Accepted: 11/14/2023] [Indexed: 11/25/2023] Open
Abstract
Canine atopic dermatitis (cAD) is a common and distressing skin condition in dogs, affecting up to 30% of the canine population. It not only impacts their quality of life but also that of their owners. Like human atopic dermatitis (hAD), cAD has a complex pathogenesis, including genetic and environmental factors. Current treatments focus on managing clinical signs, but they can be costly and have limitations. This article emphasizes the importance of preventing cAD from developing in the first place. Understanding the role of the skin's protective barrier is crucial, as its dysfunction plays a vital role in both hAD and cAD. hAD prevention studies have shown promising results in enhancing the skin barrier, but more research is needed to support more robust conclusions. While hAD primary prevention is currently a focal point of intensive investigation in human medicine, research on cAD primary prevention remains under-researched and almost non-existent. Pioneering effective prevention strategies for cAD holds immense potential to enhance the quality of life for both dogs and their owners. Additionally, it bears the promise of a translational impact on human research. Hence, further exploration of this crucial topic is not only relevant but also timely and imperative, warranting support and encouragement.
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Affiliation(s)
- Beatriz Fernandes
- CIISA—Centre for Interdisciplinary Research in Animal Health, Faculty of Veterinary Medicine, University of Lisbon, 1649-004 Lisbon, Portugal
- Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), 1300-477 Lisbon, Portugal
- Research Institute for Medicine (iMed.ULisboa), Faculty of Pharmacy, Universidade de Lisboa, 1600-277 Lisbon, Portugal
| | - Susana Alves
- CIISA—Centre for Interdisciplinary Research in Animal Health, Faculty of Veterinary Medicine, University of Lisbon, 1649-004 Lisbon, Portugal
- Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), 1300-477 Lisbon, Portugal
| | - Vanessa Schmidt
- School of Veterinary Science, University of Liverpool, Liverpool L69 3GH, UK
| | - Ana Filipa Bizarro
- CIISA—Centre for Interdisciplinary Research in Animal Health, Faculty of Veterinary Medicine, University of Lisbon, 1649-004 Lisbon, Portugal
- Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), 1300-477 Lisbon, Portugal
- Research Institute for Medicine (iMed.ULisboa), Faculty of Pharmacy, Universidade de Lisboa, 1600-277 Lisbon, Portugal
| | - Marta Pinto
- CIISA—Centre for Interdisciplinary Research in Animal Health, Faculty of Veterinary Medicine, University of Lisbon, 1649-004 Lisbon, Portugal
- Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), 1300-477 Lisbon, Portugal
- Research Institute for Medicine (iMed.ULisboa), Faculty of Pharmacy, Universidade de Lisboa, 1600-277 Lisbon, Portugal
| | - Hugo Pereira
- CIISA—Centre for Interdisciplinary Research in Animal Health, Faculty of Veterinary Medicine, University of Lisbon, 1649-004 Lisbon, Portugal
- Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), 1300-477 Lisbon, Portugal
| | - Joana Marto
- Research Institute for Medicine (iMed.ULisboa), Faculty of Pharmacy, Universidade de Lisboa, 1600-277 Lisbon, Portugal
| | - Ana Mafalda Lourenço
- CIISA—Centre for Interdisciplinary Research in Animal Health, Faculty of Veterinary Medicine, University of Lisbon, 1649-004 Lisbon, Portugal
- Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), 1300-477 Lisbon, Portugal
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Marko M, Pawliczak R. Resveratrol and Its Derivatives in Inflammatory Skin Disorders-Atopic Dermatitis and Psoriasis: A Review. Antioxidants (Basel) 2023; 12:1954. [PMID: 38001807 PMCID: PMC10669798 DOI: 10.3390/antiox12111954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 10/26/2023] [Accepted: 10/31/2023] [Indexed: 11/26/2023] Open
Abstract
Atopic dermatitis (AD) and psoriasis are inflammatory skin diseases whose prevalence has increased worldwide in recent decades. These disorders contribute to patients' decreased quality of life (QoL) and constitute a socioeconomic burden. New therapeutic options for AD and psoriasis based on natural compounds are being investigated. These include resveratrol (3,5,40-trihydroxystilbene) and its derivatives, which are produced by many plant species, including grapevines. Resveratrol has gained interest since the term "French Paradox", which refers to improved cardiovascular outcomes despite a high-fat diet in the French population, was introduced. Resveratrol and its derivatives have demonstrated various health benefits. In addition to anti-cancer, anti-aging, and antibacterial effects, there are also anti-inflammatory and antioxidant effects that can affect the molecular pathways of inflammatory skin disorders. A comprehensive understanding of these mechanisms may help develop new therapies. Numerous in vivo and in vitro studies have been conducted on the therapeutic properties of natural compounds. However, regarding resveratrol and its derivatives in treating AD and psoriasis, there are still many unexplained mechanisms and a need for clinical trials. Considering this, in this review, we discuss and summarize the most critical research on resveratrol and its derivatives in animal and cell models mimicking AD and psoriasis.
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Affiliation(s)
| | - Rafał Pawliczak
- Department of Immunopathology, Faculty of Medicine, Division of Biomedical Science, Medical University of Lodz, 7/9 Zeligowskiego St., 90-752 Lodz, Poland
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Sach TH, Lartey ST, Davies C, Chalmers JR, Haines RH, Bradshaw LE, Montgomery AA, Thomas KS, Brown SJ, Ridd MJ, Lawton S, Cork MJ, Flohr C, Mitchell E, Swinden R, Wyatt L, Tarr S, Davies-Jones S, Jay N, Kelleher MM, Perkin MR, Boyle RJ, Williams HC. Emollients for preventing atopic eczema: Cost-effectiveness analysis of the BEEP trial. Clin Exp Allergy 2023; 53:1011-1019. [PMID: 37574761 DOI: 10.1111/cea.14381] [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: 03/03/2023] [Revised: 06/19/2023] [Accepted: 06/28/2023] [Indexed: 08/15/2023]
Abstract
BACKGROUND Recent discoveries have led to the suggestion that enhancing skin barrier from birth might prevent eczema and food allergy. OBJECTIVE To determine the cost-effectiveness of daily all-over-body application of emollient during the first year of life for preventing atopic eczema in high-risk children at 2 years from a health service perspective. We also considered a 5-year time horizon as a sensitivity analysis. METHODS A within-trial economic evaluation using data on health resource use and quality of life captured as part of the BEEP trial alongside the trial data. Parents/carers of 1394 infants born to families at high risk of atopic disease were randomised 1:1 to the emollient group, which were advised to apply emollient (Doublebase Gel or Diprobase Cream) to their child at least once daily to the whole body during the first year of life or usual care. Both groups received advice on general skin care. The main economic outcomes were incremental cost-effectiveness ratio (ICER), defined as incremental cost per percentage decrease in risk of eczema in the primary cost-effectiveness analysis. Secondary analysis, undertaken as a cost-utility analysis, reports incremental cost per Quality-Adjusted Life Year (QALY) where child utility was elicited using the proxy CHU-9D at 2 years. RESULTS At 2 years, the adjusted incremental cost was £87.45 (95% CI -54.31, 229.27) per participant, whilst the adjusted proportion without eczema was 0.0164 (95% CI -0.0329, 0.0656). The ICER was £5337 per percentage decrease in risk of eczema. Adjusted incremental QALYs were very slightly improved in the emollient group, 0.0010 (95% CI -0.0069, 0.0089). At 5 years, adjusted incremental costs were lower for the emollient group, -£106.89 (95% CI -354.66, 140.88) and the proportion without eczema was -0.0329 (95% CI -0.0659, 0.0002). The 5-year ICER was £3201 per percentage decrease in risk of eczema. However, when inpatient costs due to wheezing were excluded, incremental costs were lower and incremental effects greater in the usual care group. CONCLUSIONS In line with effectiveness endpoints, advice given in the BEEP trial to apply daily emollient during infancy for eczema prevention in high-risk children does not appear cost-effective.
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Affiliation(s)
- Tracey H Sach
- Health Economics Group, Norwich Medical School, University of East Anglia, Norwich, UK
| | - Stella T Lartey
- Health Economics Group, Norwich Medical School, University of East Anglia, Norwich, UK
| | - Charlotte Davies
- Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK
| | - Joanne R Chalmers
- Centre of Evidence Based Dermatology, School of Medicine, University of Nottingham, Nottingham, UK
| | - Rachel H Haines
- Nottingham Clinical Trials Unit, University of Nottingham, Nottingham, UK
| | - Lucy E Bradshaw
- Nottingham Clinical Trials Unit, University of Nottingham, Nottingham, UK
| | - Alan A Montgomery
- Nottingham Clinical Trials Unit, University of Nottingham, Nottingham, UK
| | - Kim S Thomas
- Centre of Evidence Based Dermatology, School of Medicine, University of Nottingham, Nottingham, UK
| | - Sara J Brown
- Centre for Genomic and Experimental Medicine, Institute of Genetics and Cancer, University of Edinburgh, Edinburgh, UK
| | - Matthew J Ridd
- Population Health Sciences, University of Bristol, Bristol, UK
| | | | - Mike J Cork
- Sheffield Dermatology Research, Department of Infection and Immunity, University of Sheffield, Sheffield, UK
| | - Carsten Flohr
- Unit for Population-Based Dermatology Research, St John's Institute of Dermatology, Guy's & St Thomas' NHS Foundation Trust and King's College London, London, UK
| | - Eleanor Mitchell
- Nottingham Clinical Trials Unit, University of Nottingham, Nottingham, UK
| | - Richard Swinden
- Nottingham Clinical Trials Unit, University of Nottingham, Nottingham, UK
| | - Laura Wyatt
- Nottingham Clinical Trials Unit, University of Nottingham, Nottingham, UK
| | - Stella Tarr
- Nottingham Clinical Trials Unit, University of Nottingham, Nottingham, UK
| | - Susan Davies-Jones
- Centre of Evidence Based Dermatology, School of Medicine, University of Nottingham, Nottingham, UK
| | - Nicola Jay
- Sheffield Children's Hospital, Sheffield, UK
| | - Maeve M Kelleher
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Michael R Perkin
- Population Health Research Institute, St. George's University of London, London, UK
| | - Robert J Boyle
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Hywel C Williams
- Centre of Evidence Based Dermatology, School of Medicine, University of Nottingham, Nottingham, UK
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Yonezawa K, Haruna M. Relationship Between Degree of Neonatal Physiologic Desquamation and Skin Barrier Function. J Perinat Neonatal Nurs 2023; 37:348-353. [PMID: 37115943 DOI: 10.1097/jpn.0000000000000694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
BACKGROUND/OBJECTIVES This study examined the relationship between degree of neonatal physiologic desquamation and skin barrier functionality. In addition, we identified factors associated with neonatal desquamation. METHODS This cross-sectional study assessed 4-day-old newborns. The desquamation level was evaluated and placed in one of the following categories based on the severity of the desquamation: no desquamation, a small amount, and severe (including cracked or bleeding). Skin barrier function was assessed by evaluating transepidermal water loss, stratum corneum hydration, skin pH, and sebum secretion. RESULTS Among study participants, 67 (39.9%) showed no desquamation, 82 (48.8%) displayed a small amount, and 19 (11.3%) had severe desquamation. The group with severe desquamation had significantly elevated facial transepidermal water loss levels and reduced levels of stratum corneum hydration throughout the body, indicating skin barrier dysfunction, than other groups. In addition, the group with severe desquamation had a significantly longer gestational age, lower temperature and humidity level, smaller vernix caseosa, and tended to be born during winter. CONCLUSIONS To our knowledge, this is the first report indicating that infants with severe desquamation had worsened skin barrier function versus those with moderate and no desquamation. Future research should consider what kind of care should be provided to newborns with severe desquamation.
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Affiliation(s)
- Kaori Yonezawa
- Department of Midwifery and Women's Health, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan (Drs Yonezawa and Haruna); and Division of Care Innovation, Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan (Drs Yonezawa and Haruna)
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30
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Rajkumar J, Chandan N, Lio P, Shi V. The Skin Barrier and Moisturization: Function, Disruption, and Mechanisms of Repair. Skin Pharmacol Physiol 2023; 36:174-185. [PMID: 37717558 DOI: 10.1159/000534136] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Accepted: 09/12/2023] [Indexed: 09/19/2023]
Abstract
BACKGROUND The anatomic layers of the skin are well-defined, and a functional model of the skin barrier has recently been described. Barrier disruption plays a key role in several skin conditions, and moisturization is recommended as an initial treatment in conditions such as atopic dermatitis. This review aimed to analyze the skin barrier in the context of the function model, with a focus on the mechanisms by which moisturizers support each of the functional layers of the skin barrier to promote homeostasis and repair. SUMMARY The skin barrier is comprised of four interdependent layers - physical, chemical, microbiologic, and immunologic - which maintain barrier structure and function. Moisturizers target disruption affecting each of these four layers through several mechanisms and were shown to improve transepidermal water loss in several studies. Occlusives, humectants, and emollients occlude the surface of the stratum corneum (SC), draw water from the dermis into the epidermis, and assimilate into the SC, respectively, in order to strengthen the physical skin barrier. Acidic moisturizers bolster the chemical skin barrier by supporting optimal enzymatic function, increasing ceramide production, and facilitating ideal conditions for commensal microorganisms. Regular moisturization may strengthen the immunologic skin barrier by reducing permeability and subsequent allergen penetration and sensitization. KEY MESSAGES The physical, chemical, microbiologic, and immunologic layers of the skin barrier are each uniquely impacted in states of skin barrier disruption. Moisturizers target each of the layers of the skin barrier to maintain homeostasis and facilitate repair.
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Affiliation(s)
- Jeffrey Rajkumar
- Department of Dermatology, University of Illinois at Chicago College of Medicine, Chicago, Illinois, USA
| | - Neha Chandan
- Department of Dermatology, University of Illinois at Chicago College of Medicine, Chicago, Illinois, USA
| | - Peter Lio
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Vivian Shi
- Department of Dermatology, University of Arkansas for Medical Sciences, Little Rock, Alaska, USA
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Gupta P, Nagesh K, Garg P, Thomas J, Suryawanshi P, Sethuraman G, Hazarika RD, Verma RJ, Kumar CS, Kumari S, Taneja S, Chavhan V, Thakor P, Pandita A. Evidence-Based Consensus Recommendations for Skin Care in Healthy, Full-Term Neonates in India. Pediatric Health Med Ther 2023; 14:249-265. [PMID: 37654800 PMCID: PMC10465361 DOI: 10.2147/phmt.s414091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 08/03/2023] [Indexed: 09/02/2023] Open
Abstract
Purpose Neonatal skin care practices guided by personal experience and preferences might be substantially different across different hospital settings. The aim of this consensus recommendation is to provide clinical practice guidance to healthcare practitioners on evidence-based neonatal skin care practices from delivery-to-discharge, in hospital settings. Patients and Methods A Scientific Advisory Board meeting on "Evidence-based Neonatal Skin Care Practices and Protocols" was held in December 2020 with an expert panel comprising neonatologists, pediatricians, obstetricians and gynecologists and pediatric dermatologist. Comprehensive literature search was performed up to 23 March 2021 using PubMed and Google Scholar to retrieve relevant evidence. Results Recommendations were developed on critical aspects of skin care in healthy full-term neonates including cleansing at birth, skin-to-skin care, cord care, diaper area care, initial and routine bathing, cleansers and emollients use, and criteria to choose appropriate skin care products. Recommendations include inclusion of skin assessment in routine neonatal care, first bath timing after cardio-respiratory and thermal stabilization, 6-24 hours after birth; bathing with water alone or adding a mild liquid cleanser could be considered appropriate as it does not impact the developing skin barrier; use of emollients is recommended for neonates with higher risk of development of eczema to maintain and enhance skin barrier function and integrity; and inclusion of skin care advice in neonatal discharge checklist. Importance of rigorous quality control, high-quality clinical trials for assessment of baby products, usage of products that are formulated appropriately for newborns, and full label transparency for baby products were highlighted. The panel identified gaps in literature and discussed the scope for future research. Conclusion These recommendations may help to standardize evidence-based skin care for healthy full-term neonates in Indian hospital settings to improve the quality of care that neonates receive in hospital and facilitate improvement in overall neonatal health outcomes.
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Affiliation(s)
- Piyush Gupta
- Department of Pediatrics, University College of Medical Sciences, New Delhi, India
| | - Karthik Nagesh
- Department of Neonatology, Manipal Hospitals Group (MHEPL), Bangalore, Karnataka, India
| | - Pankaj Garg
- Department of Neonatology, Sir Ganga Ram Hospital, New Delhi, India
| | - Jayakar Thomas
- Department of Dermatology, The Tamil Nadu Dr. M.G.R. Medical University, Chennai, Tamil Nadu, India
| | | | - Giridhar Sethuraman
- Department of Neonatology, Chettinad Hospital and Research Institute, Chennai, Tamil Nadu, India
| | - Rashna Dass Hazarika
- Department of Pediatrics & Neonatology, Nemcare Superspecialty Hospital, Guwahati, Assam, India
| | - Rahul J Verma
- Department of Neonatology & General Pediatrics, Sir H.N Reliance Hospital, Mumbai, Maharashtra, India
| | - C Suresh Kumar
- Department of Pediatrics, Apollo Cradle, Jubilee Hills, Hyderabad, Telangana, India
| | - Shantha Kumari
- Department of Obstetrics and Gynecology, Yashoda Hospitals, Hyderabad, Telangana, India
| | - Sunil Taneja
- Sushrut Medical Centre Pvt Ltd, Kanpur, Uttar Pradesh, India
| | - Vaishali Chavhan
- Department of Obstetrics and Gynecology, Sahyadri Superspecialty Hospitals, Pune, Maharashtra, India
| | - Priti Thakor
- Department of Medical Affairs, JNTL Consumer Health (India) Pvt. Ltd., Mumbai, Maharashtra, India
| | - Ankita Pandita
- Department of Medical Affairs, JNTL Consumer Health (India) Pvt. Ltd., Mumbai, Maharashtra, India
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Bieber T. Disease modification in inflammatory skin disorders: opportunities and challenges. Nat Rev Drug Discov 2023; 22:662-680. [PMID: 37443275 DOI: 10.1038/s41573-023-00735-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/05/2023] [Indexed: 07/15/2023]
Abstract
Progress in understanding of the mechanisms underlying chronic inflammatory skin disorders, such as atopic dermatitis and psoriasis vulgaris, has led to new treatment options with the primary goal of alleviating symptoms. In addition, this knowledge has the potential to inform on new strategies aimed at inducing deep and therapy-free remission, that is, disease modification, potentially impacting on associated comorbidities. However, to reach this goal, key areas require further exploration, including the definitions of disease modification and disease activity index, further understanding of disease mechanisms and systemic spillover effects, potential windows of opportunity, biomarkers for patient stratification and successful intervention, as well as appropriate study design. This Perspective article assesses the opportunities and challenges in the discovery and development of disease-modifying therapies for chronic inflammatory skin disorders.
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Affiliation(s)
- Thomas Bieber
- Department of Dermatology and Allergy, University Hospital, Bonn, Germany.
- Christine Kühne - Center for Allergy Research and Education, Davos, Switzerland.
- Davos Biosciences, Davos, Switzerland.
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Higuchi S, Yoshida S, Minematsu T, Hatano Y, Notsu A, Ichinose T. Comparison of the Effects of Bathing and the Dry Technique on the Skin Condition of Early Neonates: A Prospective Observational Study. Ann Dermatol 2023; 35:256-265. [PMID: 37550226 PMCID: PMC10407340 DOI: 10.5021/ad.22.098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 03/24/2023] [Accepted: 05/02/2023] [Indexed: 08/09/2023] Open
Abstract
BACKGROUND In Japan, neonates have typically been bathed in a bathtub immediately after birth because bathing is a custom for cleansing impurities. However, dry technique has been introduced into many institutions since 2000. There is little scientific evidence on the benefit or harmfulness of either method to neonatal skin, and consequently, opinion remains split on which method is superior. OBJECTIVE The purpose of the present study was to determine whether bathing or the dry technique of cleaning is better in maintaining skin health in the early neonatal period. METHODS Transepidermal water loss (TEWL) and skin pH, considered an index of skin barrier function, were measured in each group. Tumor necrosis factor (TNF)-alpha and interleukin (IL)-6, which are inflammatory cytokines released by keratinocytes, were measured by skin blotting. RESULTS TEWL and skin pH of neonates were lower with the dry technique than with bathing. The expression level of IL-6 and TNF-α in chest skin of neonates was higher with bathing than with the dry technique. CONCLUSION These results suggest that the dry technique may maintain skin health better than bathing in the early neonatal period.
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Affiliation(s)
- Sachi Higuchi
- Department of Midwifery, Oita University of Nursing and Health Sciences, Oita, Japan.
| | - Seiichi Yoshida
- Department of Health Sciences, Oita University of Nursing and Health Sciences, Oita, Japan
| | - Takeo Minematsu
- Department of Adult Nursing, Ishikawa Prefectural Nursing University, Ishikawa, Japan
| | - Yutaka Hatano
- Department of Dermatology, Faculty of Medicine, Oita University, Oita, Japan
| | - Akifumi Notsu
- Clinical Research Promotion Unit, Shizuoka Cancer Center, Shizuoka, Japan
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O'Connor C, Livingstone V, O’B Hourihane J, Irvine AD, Boylan G, Murray D. Early emollient bathing is associated with subsequent atopic dermatitis in an unselected birth cohort study. Pediatr Allergy Immunol 2023; 34:e13998. [PMID: 37492907 PMCID: PMC10947084 DOI: 10.1111/pai.13998] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 06/20/2023] [Accepted: 06/28/2023] [Indexed: 07/27/2023]
Abstract
BACKGROUND Skin barrier dysfunction is a key component of the pathogenesis of atopic dermatitis (AD). Recent research on barrier optimization to prevent AD has shown mixed results. The aim of this study was to assess the relationship between emollient bathing at 2 months and the trajectory of AD in the first 2 years of life in a large unselected observational birth cohort study. METHODS The Babies After SCOPE: Evaluating the Longitudinal Impact Using Neurological and Nutritional Endpoints Birth Cohort study enrolled 2183 infants. Variables extracted from the database related to early skincare, skin barrier function, parental history of atopy, and AD outcomes. Statistical analysis was performed to adjust for potential confounding variables. RESULTS One thousand five hundred five children had data on AD status available at 6, 12, and 24 months. Prevalence of AD was 18.6% at 6 months, 15.2% at 12 months, and 16.5% at 24 months. Adjusted for potential confounding variables, the odds of AD at any point were higher among infants who had emollient baths at 2 months (OR (95% CI): 2.41 (1.56 to 3.72), p < .001). Following multivariable analysis, the odds of AD were higher among infants who had both emollient baths and frequent emollient application at 2 months, compared with infants who had neither (OR (95% CI) at 6 months 1.74 (1.18-2.58), p = .038), (OR (95% CI) at 12 months 2.59 (1.69-3.94), p < .001), (OR (95% CI) at 24 months 1.87 (1.21-2.90), p = .009). CONCLUSION Early emollient bathing was associated with greater development of AD by 2 years of age in this population-based birth cohort study.
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Affiliation(s)
- Cathal O'Connor
- Paediatrics and Child HealthCork University HospitalCorkIreland
- INFANT Research CentreUniversity College CorkCorkIreland
| | - Vicki Livingstone
- Paediatrics and Child HealthCork University HospitalCorkIreland
- INFANT Research CentreUniversity College CorkCorkIreland
| | - Jonathan O’B Hourihane
- Paediatrics and Child HealthCork University HospitalCorkIreland
- INFANT Research CentreUniversity College CorkCorkIreland
- Paediatrics and Child Health, Royal College of Physicians of IrelandDublinIreland
| | - Alan D. Irvine
- INFANT Research CentreUniversity College CorkCorkIreland
- Department of DermatologyChildren's Health Ireland at CrumlinDublinIreland
| | - Geraldine Boylan
- Paediatrics and Child HealthCork University HospitalCorkIreland
- INFANT Research CentreUniversity College CorkCorkIreland
| | - Deirdre Murray
- Paediatrics and Child HealthCork University HospitalCorkIreland
- INFANT Research CentreUniversity College CorkCorkIreland
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Bratu D, Boda D, Caruntu C. Genomic, Epigenomic, Transcriptomic, Proteomic and Metabolomic Approaches in Atopic Dermatitis. Curr Issues Mol Biol 2023; 45:5215-5231. [PMID: 37367080 DOI: 10.3390/cimb45060331] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 06/03/2023] [Accepted: 06/07/2023] [Indexed: 06/28/2023] Open
Abstract
Atopic dermatitis (AD) is a chronic inflammatory skin disease with a high prevalence in the developed countries. It is associated with atopic and non-atopic diseases, and its close correlation with atopic comorbidities has been genetically demonstrated. One of the main roles of genetic studies is to comprehend the defects of the cutaneous barrier due to filaggrin deficit and epidermal spongiosis. Recently, epigenetic studies started to analyze the influence of the environmental factors on gene expression. The epigenome is considered to be a superior second code that controls the genome, which includes alterations of the chromatin. The epigenetic changes do not alter the genetic code, however, changes in the chromatin structure could activate or inhibit the transcription process of certain genes and consequently, the translation process of the new mRNA into a polypeptide chain. In-depth analysis of the transcriptomic, metabolomic and proteomic studies allow to unravel detailed mechanisms that cause AD. The extracellular space and lipid metabolism are associated with AD that is independent of the filaggrin expression. On the other hand, around 45 proteins are considered as the principal components in the atopic skin. Moreover, genetic studies based on the disrupted cutaneous barrier can lead to the development of new treatments targeting the cutaneous barrier or cutaneous inflammation. Unfortunately, at present, there are no target therapies that focus on the epigenetic process of AD. However, in the future, miR-143 could be an important objective for new therapies, as it targets the miR-335:SOX axis, thereby restoring the miR-335 expression, and repairing the cutaneous barrier defects.
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Affiliation(s)
- Dalia Bratu
- Department of Dermatology, 'Colentina' Clinical Hospital, 020125 Bucharest, Romania
- Department of Dermatology, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Daniel Boda
- Department of Dermatology, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Department of Dermatology, 'Ponderas' Academic Hospital, 014142 Bucharest, Romania
- Department of Dermatology, "Prof. N.C. Paulescu" National Institute of Diabetes, Nutrition and Metabolic Diseases, 011233 Bucharest, Romania
| | - Constantin Caruntu
- Department of Dermatology, "Prof. N.C. Paulescu" National Institute of Diabetes, Nutrition and Metabolic Diseases, 011233 Bucharest, Romania
- Department of Physiology, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
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van den Bogaard EH, Elias PM, Goleva E, Berdyshev E, Smits JPH, Danby SG, Cork MJ, Leung DYM. Targeting Skin Barrier Function in Atopic Dermatitis. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2023; 11:1335-1346. [PMID: 36805053 PMCID: PMC11346348 DOI: 10.1016/j.jaip.2023.02.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 01/31/2023] [Accepted: 02/01/2023] [Indexed: 02/22/2023]
Abstract
Atopic dermatitis (AD) is the most common chronic inflammatory skin disease in the general population. Skin barrier dysfunction is the central abnormality leading to AD. The cause of skin barrier dysfunction is complex and rooted in genetic mutations, interactions between the immune pathway activation and epithelial cells, altered host defense mechanisms, as well as environmental influences that cause epithelial cell activation and release of alarmins (such as thymic stromal lymphopoietin) that can activate the type 2 immune pathway, including generation of interleukins 4 and 13, which induces defects in the skin barrier and increased allergic inflammation. These inflammatory pathways are further influenced by environmental factors including the microbiome (especially Staphylococcus aureus), air pollution, stress, and other factors. As such, AD is a syndrome involving multiple phenotypes, all of which have in common skin barrier dysfunction as a key contributing factor. Understanding mechanisms leading to skin barrier dysfunction in AD is pointing to the development of new topical and systemic treatments in AD that helps keep skin borders secure and effectively treat the disease.
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Affiliation(s)
- Ellen H van den Bogaard
- Department of Dermatology, Radboud Institute for Molecular Life Science, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Peter M Elias
- Department of Dermatology, University of California San Francisco and VA Medical Center, San Francisco, Calif
| | - Elena Goleva
- Department of Pediatrics, Division of Pediatric Allergy and Immunology, National Jewish Health, Denver, Colo
| | - Evgeny Berdyshev
- Department of Pulmonology, Division of Pulmonary, Critical Care and Sleep Medicine, National Jewish Health, Denver, Colo
| | - Jos P H Smits
- Department of Dermatology, Radboud Institute for Molecular Life Science, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Simon G Danby
- Department of Infection, Immunity and Cardiovascular Disease, The Medical School at The University of Sheffield, Beech Hill Road, Sheffield, UK
| | - Michael J Cork
- Department of Infection, Immunity and Cardiovascular Disease, The Medical School at The University of Sheffield, Beech Hill Road, Sheffield, UK
| | - Donald Y M Leung
- Department of Pediatrics, Division of Pediatric Allergy and Immunology, National Jewish Health, Denver, Colo.
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Murashkin NN, Namazova-Baranova LS, Makarova SG, Ivanov RA, Grigorev SG, Fedorov DV, Ambarchian ET, Epishev RV, Materikin AI, Opryatin LA, Savelova AA. Observational study of pimecrolimus 1% cream for prevention of transcutaneous sensitization in children with atopic dermatitis during their first year of life. Front Pediatr 2023; 11:1102354. [PMID: 37181420 PMCID: PMC10167287 DOI: 10.3389/fped.2023.1102354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 03/24/2023] [Indexed: 05/16/2023] Open
Abstract
Introduction Epidermal barrier dysfunction in children with atopic dermatitis can cause transcutaneous sensitization to allergens and allergic diseases. We evaluated the effectiveness of an early-intervention algorithm for atopic dermatitis treatment, utilizing pimecrolimus for long-term maintenance therapy, in reducing transcutaneous sensitization in infants. Method This was a single-center cohort observational study that enrolled children aged 1-4 months with family history of allergic diseases, moderate-to-severe atopic dermatitis, and sensitization to ≥ 1 of the investigated allergens. Patients who sought medical attention at atopic dermatitis onset (within 10 days) were group 1 "baseline therapy with topical glucocorticoids with subsequent transition to pimecrolimus as maintenance therapy"; patients who sought medical attention later were group 2 "baseline and maintenance therapy with topical glucocorticoids, without subsequent use of pimecrolimus". Sensitization class and level of allergen-specific immunoglobulin E were determined at baseline, and 6 and 12 months of age. Atopic dermatitis severity was evaluated using the Eczema Area and Severity Index score at baseline and 6, 9 and 12 months of age. Results Fifty-six and 52 patients were enrolled in groups 1 and 2, respectively. Compared with group 2, group 1 demonstrated a lower level of sensitization to cow's milk protein, egg white and house dust mite allergen at 6 and 12 months of age, and a more pronounced decrease in atopic dermatitis severity at 6, 9 and 12 months of age. No adverse events occurred. Discussion The pimecrolimus-containing algorithm was effective in treating atopic dermatitis and prophylaxis of early forms of allergic diseases in infants. Trial registration https://clinicaltrials.gov/ NCT04900948, retrospectively registered, 25 May 2021.
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Affiliation(s)
- Nikolay N. Murashkin
- National Medical Research Center for Children’s Health, Moscow, Russia
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
- Central State Medical Academy of the Presidential Administration of the Russian Federation, Moscow, Russia
- Research Institute for Pediatrics and Children’s Health Protection, Federal National Public Healthcare Institution “Central Clinical Hospital of the Russian Academy of Sciences”, Ministry of Science and Higher Education, Moscow, Russia
| | - Leyla S. Namazova-Baranova
- Research Institute for Pediatrics and Children’s Health Protection, Federal National Public Healthcare Institution “Central Clinical Hospital of the Russian Academy of Sciences”, Ministry of Science and Higher Education, Moscow, Russia
- Pirogov Russian National Research Medical University, Moscow, Russia
| | | | - Roman A. Ivanov
- National Medical Research Center for Children’s Health, Moscow, Russia
| | - Stepan G. Grigorev
- Kirov Military Medical Academy, St Petersburg, Russia
- Pediatric Infectious Disease Clinical Research Center of the Federal Medical Biological Agency, St Petersburg, Russia
| | - Dmitri V. Fedorov
- National Medical Research Center for Children’s Health, Moscow, Russia
| | - Eduard T. Ambarchian
- National Medical Research Center for Children’s Health, Moscow, Russia
- Research Institute for Pediatrics and Children’s Health Protection, Federal National Public Healthcare Institution “Central Clinical Hospital of the Russian Academy of Sciences”, Ministry of Science and Higher Education, Moscow, Russia
| | - Roman V. Epishev
- National Medical Research Center for Children’s Health, Moscow, Russia
- Research Institute for Pediatrics and Children’s Health Protection, Federal National Public Healthcare Institution “Central Clinical Hospital of the Russian Academy of Sciences”, Ministry of Science and Higher Education, Moscow, Russia
| | | | | | - Alena A. Savelova
- National Medical Research Center for Children’s Health, Moscow, Russia
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Tham EH, Leung ASY, Yamamoto-Hanada K, Dahdah L, Trikamjee T, Warad VV, Norris M, Navarrete E, Levina D, Samuel M, van Niekerk A, Martinez S, Ellis AK, Bielory L, van Bever H, Wallace D, Chu DK, Munblit D, Tang MLK, Sublett J, Wong GWK. A systematic review of quality and consistency of clinical practice guidelines on the primary prevention of food allergy and atopic dermatitis. World Allergy Organ J 2023; 16:100770. [PMID: 37168277 PMCID: PMC10165145 DOI: 10.1016/j.waojou.2023.100770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Revised: 03/27/2023] [Accepted: 03/31/2023] [Indexed: 05/13/2023] Open
Abstract
Background and aims With an increasing number of Clinical Practice Guidelines (CPGs) addressing primary prevention of food allergy and atopic dermatitis, it is timely to undertake a comprehensive assessment of the quality and consistency of recommendations and evaluation of their implementability in different geographical settings. Methods We systematically reviewed CPGs from 8 international databases and extensive website searches. Seven reviewers screened records in any language and then used the AGREE II and AGREE REX instruments to critically appraise CPGs published between January 2011 and April 2022. Results Our search identified 2138 relevant articles, of which 30 CPGs were eventually included. Eight (27%) CPGs were shortlisted based on our predefined quality criteria of achieving scores >70% in the "Scope and Purpose" and "Rigour of Development" domains of the AGREE II instrument. Among the shortlisted CPGs, scores on the "Applicability" domain were generally low, and only 3 CPGs rated highly in the "Implementability" domain of AGREE-REX, suggesting that the majority of CPGs fared poorly on global applicability. Recommendations on maternal diet and complementary feeding in infants were mostly consistent, but recommendations on use of hydrolysed formula and supplements varied considerably. Conclusion The overall quality of a CPG for Food Allergy and Atopic Dermatitis prevention did not correlate well with its global applicability. It is imperative that CPG developers consider stakeholders' preferences, local applicability, and adapt existing recommendations to each individual population and healthcare system to ensure successful implementation. There is a need for development of high-quality CPGs for allergy prevention outside of North America and Europe. PROSPERO registration number CRD42021265689.
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Affiliation(s)
- Elizabeth Huiwen Tham
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, Singapore
| | - Agnes Sze Yin Leung
- Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
- Hong Kong Hub of Paediatric Excellence (HK-HOPE), The Chinese University of Hong Kong, China
| | | | - Lamia Dahdah
- Translational Research in Pediatric Specialities Area, Division of Allergy, Bambino Gesù Children's Hospital, Rome, Italy
| | - Thulja Trikamjee
- Allergy and Immunology Unit, University of Cape Town Lung Institute, Cape Town, South Africa
| | | | - Matthew Norris
- Department of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine, Penn State College of Medicine, Hershey, PA, USA
| | - Elsy Navarrete
- Department of Allergy and Immunology, WAO Center of Excellence, Hospital Infantil de México Federico Gomez, Mexico City, Mexico
| | - Daria Levina
- Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Miny Samuel
- Research Support Unit, Yong Loo Lin School of Medicine, National University of Singapore (NUS), Singapore
| | - Andre van Niekerk
- Department of Paediatrics and Child Health, School of Medicine, University of Pretoria, South Africa
| | | | - Anne K. Ellis
- Department of Medicine, Division of Allergy and Immunology, Queen's University, Kingston, ON, Canada
| | - Leonard Bielory
- Department of Medicine, Allergy, Immunology and Ophthalmology, Hackensack Meridian School of Medicine, Springfield, NJ, USA
- Center for Environmental Prediction, Rutgers University, New Brunswick, NJ, USA
- Kean University, Center for Aerobiology Research, New Jersey Center for Science, Technology and Mathematics, Union, NJ, USA
| | - Hugo van Bever
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, Singapore
| | - Dana Wallace
- Nova Southeastern Allopathic Medical School, Fort Lauderdale, FL, USA
| | - Derek K. Chu
- Departments of Medicine and Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, L8S 4L8, Canada
| | - Daniel Munblit
- Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
- Care for Long Term Conditions Division, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, United Kingdom
| | - Mimi LK. Tang
- Allergy Immunology, Murdoch Children's Research Institute, Melbourne, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
- Department of Allergy and Immunology, Royal Children's Hospital, Melbourne, Australia
| | - James Sublett
- Pediatric Allergy & Immunology, University of Louisville School of Medicine, Louisville, KY, USA
| | - Gary Wing Kin Wong
- Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
- Corresponding author. Department of Paediatrics, Faculty of Medicine, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong
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Ní Chaoimh C, Lad D, Nico C, Puppels GJ, Wong XFCC, Common JE, Murray DM, Irvine AD, Hourihane JO. Early initiation of short-term emollient use for the prevention of atopic dermatitis in high-risk infants-The STOP-AD randomised controlled trial. Allergy 2023; 78:984-994. [PMID: 35997592 PMCID: PMC10952678 DOI: 10.1111/all.15491] [Citation(s) in RCA: 30] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 06/28/2022] [Accepted: 07/21/2022] [Indexed: 01/06/2023]
Abstract
BACKGROUND Protecting the skin barrier in early infancy may prevent atopic dermatitis (AD). We investigated if daily emollient use from birth to 2 months reduced AD incidence in high-risk infants at 12 months. METHODS This was a single-center, two-armed, investigator-blinded, randomized controlled clinical trial (NCT03871998). Term infants identified as high risk for AD (parental history of AD, asthma or allergic rhinitis) were recruited within 4 days of birth and randomised 1:1 to either twice-daily emollient application for the first 8 weeks of life (intervention group), using an emollient specifically formulated for very dry, AD-prone skin, or to standard routine skin care (control group). The primary outcome was cumulative AD incidence at 12 months. AD <6 months was diagnosed based on clinical presence of AD. The UK Working Party Diagnostic Criteria were applied when diagnosing AD between 6 and 12 months. RESULTS Three hundred twenty-one were randomised (161 intervention and 160 control), with 61 withdrawals (41 intervention, 20 control). The cumulative incidence of AD at 12 months was 32.8% in the intervention group vs. 46.4% in the control group, p = 0.036 [Relative risk (95%CI): 0.707 (0.516, 0.965)]. One infant in the intervention group was withdrawn from the study following development of a rash that had a potential relationship with the emollient. There was no significant difference in the incidence of skin infections between the intervention and control groups during the intervention period (5.0% vs. 5.7%, p > 0.05). CONCLUSIONS This study has demonstrated that early initiation of daily specialized emollient use until 2 months reduces the incidence of AD in the first year of life in high-risk infants.
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Affiliation(s)
- Carol Ní Chaoimh
- INFANT Research CentreUniversity College CorkCorkIreland
- Paediatrics and Child HealthUniversity College CorkCorkIreland
| | - Dhanis Lad
- INFANT Research CentreUniversity College CorkCorkIreland
- Paediatrics and Child HealthUniversity College CorkCorkIreland
| | - Claudio Nico
- River D International B.V.RotterdamThe Netherlands
| | - Gerwin J. Puppels
- River D International B.V.RotterdamThe Netherlands
- Department of Dermatology, Erasmus MCUniversity Medical Center RotterdamRotterdamThe Netherlands
| | | | | | - Deirdre M. Murray
- INFANT Research CentreUniversity College CorkCorkIreland
- Paediatrics and Child HealthUniversity College CorkCorkIreland
| | - Alan D. Irvine
- INFANT Research CentreUniversity College CorkCorkIreland
- Clinical Medicine, Trinity CollegeDublinIreland
| | - Jonathan O’Brien Hourihane
- INFANT Research CentreUniversity College CorkCorkIreland
- Paediatrics and Child HealthUniversity College CorkCorkIreland
- Paediatrics and Child HealthRoyal College of Surgeons in IrelandDublinIreland
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Kato T, Adachi Y, Tsuchida A, Matsumura K, Murakami S, Shimizu M, Wada T, Okabe H, Hashimoto K, Hosoya M, Inadera H. Association of soap use when bathing 18-month-old infants with the prevalence of allergic diseases at age 3 years: The Japan Environment and Children's Study. Pediatr Allergy Immunol 2023; 34:e13949. [PMID: 37102383 DOI: 10.1111/pai.13949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 03/02/2023] [Accepted: 03/26/2023] [Indexed: 04/28/2023]
Abstract
BACKGROUND Atopic march is defined as the progression from atopic dermatitis (AD) during early life to other allergic diseases in later childhood. In a nationwide birth cohort study, the Japan Environment and Children's Study, we investigated the association of bathing habits, which are known to affect skin conditions, for infants with their later development of allergic diseases. METHODS Pregnant women who lived in 15 designated regional centers throughout Japan were recruited. We obtained information on bathing habits for their 18-month-old infants and the prevalence of allergic diseases when they were aged 3 years. RESULTS Data for 74,349 children were analyzed. Most 18-month-old infants were bathed or showered almost every day. When they were divided into four groups according to the frequency of soap use during bathing (every time, most of the time, sometimes, and seldom), the risk of AD later at age 3 was shown to increase in association with a decreasing frequency of soap use [most of the time: adjusted odds ratio (aOR) 1.18, 95% confidence interval (CI) 1.05-1.34; sometimes: aOR 1.72, 95% CI 1.46-2.03; seldom: aOR 1.99, 95% CI 1.58-2.50], compared with soap use every time during bathing at 18 months of age. Similar results were obtained for food allergy but not for bronchial asthma. CONCLUSIONS Frequent soap use when bathing 18-month-old infants was associated with a decreased risk of them developing allergic diseases at age 3. Further well-designed clinical studies are warranted to determine an effective bathing regimen for preventing the development of allergic diseases.
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Affiliation(s)
- Taisuke Kato
- Department of Pediatrics, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Yuichi Adachi
- Department of Pediatrics, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Akiko Tsuchida
- Department of Public Health, University of Toyama, Toyama, Japan
| | - Kenta Matsumura
- Department of Public Health, University of Toyama, Toyama, Japan
| | - Shokei Murakami
- Department of Pediatrics, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Muneyuki Shimizu
- Department of Pediatrics, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Takuya Wada
- Department of Pediatrics, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Hisao Okabe
- Department of Pediatrics, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Koichi Hashimoto
- Department of Pediatrics, School of Medicine, Fukushima Medical University, Fukushima, Japan
- Fukushima Regional Center for the Japan Environmental and Children's Study, Fukushima, Japan
| | - Mitsuaki Hosoya
- Department of Pediatrics, School of Medicine, Fukushima Medical University, Fukushima, Japan
- Fukushima Regional Center for the Japan Environmental and Children's Study, Fukushima, Japan
| | - Hidekuni Inadera
- Department of Public Health, University of Toyama, Toyama, Japan
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Abstract
PURPOSE OF REVIEW The increasing global prevalence of food allergy indicates that environmental exposures are likely contributing to food allergy development. This review summarizes recent studies on how specific factors within the external exposome may impact the development of food allergy. RECENT FINDINGS There is strong evidence that nonoral exposure to food allergens within the living environment is a risk factor for food sensitization and food allergy. The role of air pollution in food allergy development remains unclear, as cohort studies have not found consistent relationships between air pollutant exposure and food sensitization. Early-life microbial exposures linked to a rural lifestyle are likely protective against food allergy development, possibly through alteration of the infant microbiome. In contrast, factors associated with urbanization and decreased exposure to microbes may contribute to food allergy development. Recent studies on the role of residential greenness in food allergy development suggest either no relationship or a possible increased risk for food allergy. SUMMARY The external exposome comprises a number of exposures that can modify food allergy risk. Improved understanding of how complex environmental exposures interact with genetic factors will be necessary for developing effective interventions aimed at preventing food allergy development in children.
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Affiliation(s)
- Timothy P. Moran
- Center for Environmental Medicine, Asthma and Lung Biology, University of North Carolina, Chapel Hill, NC, USA
- Department of Pediatrics, University of North Carolina, Chapel Hill, NC, USA
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de Souza Neto AV, Balla DQ, Candido TM, Rosado C, Baby AR, Pessoa FVLS. Effect of an Emollient Emulsion Containing 15.0% of Caprylic/Capric Triglyceride on the Urocanic Acid of the Stratum Corneum. Life (Basel) 2023; 13:life13040876. [PMID: 37109405 PMCID: PMC10143511 DOI: 10.3390/life13040876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 03/15/2023] [Accepted: 03/23/2023] [Indexed: 03/29/2023] Open
Abstract
Natural moisturizing factor (NMF) includes several compounds in the stratum corneum (SC), among them, urocanic acid (UCA). Ultraviolet (UV) exposure turns the trans-UCA of the SC into its cis isomer. We investigated the impact of a topical emollient emulsion treatment on the UCA isomers of the SC exposed to artificial UV stress. Aliquots of emollient emulsion were applied in healthy subjects for 2 h on delimited areas of the volar forearm, then, the SC was removed by tape stripping. Tapes were irradiated in a solar simulator chamber and a high performance liquid chromatograph was used to quantify UCA isomers from stripped SC extract. The amount of both UCA isomers were almost twice higher in the SC treated with the emollient emulsion. We also observed that the UV irradiation elevated the amount of the cis/trans UCA ratio on the SC (non-treated and treated), suggesting that the emollient sample was not able to avoid the UCA isomerization. The in vivo tests corroborated with the UCA data obtained ex vivo, since we found an increase in the superficial skin hydration with respective reduction of the TEWL, probably occurring by the occlusion performed by the emollient emulsion containing 15.0% w/w of caprylic/capric triglyceride.
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Affiliation(s)
- Alicio Vitorino de Souza Neto
- Department of Health Sciences, Faculty of Pharmacy, Federal University of Espírito Santo, São Mateus 29932-540, Brazil
| | - Débora Quintas Balla
- Department of Health Sciences, Faculty of Pharmacy, Federal University of Espírito Santo, São Mateus 29932-540, Brazil
| | - Thalita Marcilio Candido
- Department of Pharmacy, Faculty of Pharmaceutical Sciences, University of São Paulo, São Paulo 05508-900, Brazil
| | - Catarina Rosado
- CBIOS—Research Center for Biosciences and Health Technologies, Lusófona University Lusófona’s, 1749-024 Lisbon, Portugal
| | - André Rolim Baby
- Department of Pharmacy, Faculty of Pharmaceutical Sciences, University of São Paulo, São Paulo 05508-900, Brazil
- Correspondence: (A.R.B.); (F.V.L.S.P.)
| | - Fabiana Vieira Lima Solino Pessoa
- Department of Health Sciences, Faculty of Pharmacy, Federal University of Espírito Santo, São Mateus 29932-540, Brazil
- Correspondence: (A.R.B.); (F.V.L.S.P.)
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Liang J, Hu F, Tang H, Jiang F, Sang Y, Hong Y, Wang Q, Nuer K, Kang X. Systematic review and network meta-analysis of different types of emollient for the prevention of atopic dermatitis in infants. J Eur Acad Dermatol Venereol 2023; 37:501-510. [PMID: 36415973 DOI: 10.1111/jdv.18688] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 10/04/2022] [Indexed: 11/24/2022]
Abstract
Prophylactic application of emollients has been an effective strategy against infant atopic dermatitis (AD); however, the difference of different emollients is unknown. We performed this network meta-analysis to compare different emollients in preventing infant AD. A systematic search was performed in PubMed, EMBASE and Cochrane library to identify relevant studies from their inception through 28 February, 2022. We evaluated the quality of eligible studies using the Cochrane risk of bias assessment tool. Data analysis was performed using STATA 14.0. Eleven studies were included for data analysis. Direct meta-analysis suggested that early application of emollients effectively prevented AD development in high-risk infants (risk ratio [RR], 0.64; 95% confidence interval [CI], 0.47 to 0.88). Network meta-analysis suggested that emollient emulsion might the better option for preventing infant AD development, with a surface under the cumulative ranking curve (SUCRA) of 82.6% for all populations, 78.0% for high-risk populations and 79.2% for populations with food sensitization. Moreover, subjects receiving emollients more frequently experienced adverse events. Overall, early application of emollients is an effective strategy for preventing AD development in high-risk infants and emollient emulsion may be the optimal type. Future study with well-designed and large scale are warranted to validate our findings.
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Affiliation(s)
- Junqin Liang
- Department of Dermatology and Venereology, People's Hospital of Xinjiang Uygur Autonomous Region, Urumchi, China.,Xinjiang Clinical Research Center for Dermatologic Diseases, Urumqi, China.,Xinjiang Key Laboratory of Dermatology Research (XJYS1707), Urumqi, China
| | - Fengxia Hu
- Department of Dermatology and Venereology, People's Hospital of Xinjiang Uygur Autonomous Region, Urumchi, China.,Xinjiang Clinical Research Center for Dermatologic Diseases, Urumqi, China.,Xinjiang Key Laboratory of Dermatology Research (XJYS1707), Urumqi, China
| | - Hongbo Tang
- Department of Dermatology, Meishan City Maternal and Child Health Care Hospital, Sichuang Meishan, China
| | - Fanhe Jiang
- Department of Dermatology and Venereology, People's Hospital of Xinjiang Uygur Autonomous Region, Urumchi, China.,Xinjiang Clinical Research Center for Dermatologic Diseases, Urumqi, China.,Xinjiang Key Laboratory of Dermatology Research (XJYS1707), Urumqi, China
| | - Yingbing Sang
- Department of Dermatology and Venereology, People's Hospital of Xinjiang Uygur Autonomous Region, Urumchi, China.,Xinjiang Clinical Research Center for Dermatologic Diseases, Urumqi, China.,Xinjiang Key Laboratory of Dermatology Research (XJYS1707), Urumqi, China
| | - Yongzhen Hong
- Department of Dermatology and Venereology, People's Hospital of Xinjiang Uygur Autonomous Region, Urumchi, China.,Xinjiang Clinical Research Center for Dermatologic Diseases, Urumqi, China.,Xinjiang Key Laboratory of Dermatology Research (XJYS1707), Urumqi, China
| | - Qian Wang
- Department of Dermatology and Venereology, People's Hospital of Xinjiang Uygur Autonomous Region, Urumchi, China.,Xinjiang Clinical Research Center for Dermatologic Diseases, Urumqi, China.,Xinjiang Key Laboratory of Dermatology Research (XJYS1707), Urumqi, China
| | - Kalibi Nuer
- Department of Dermatology and Venereology, People's Hospital of Xinjiang Uygur Autonomous Region, Urumchi, China.,Xinjiang Clinical Research Center for Dermatologic Diseases, Urumqi, China.,Xinjiang Key Laboratory of Dermatology Research (XJYS1707), Urumqi, China
| | - Xiaojing Kang
- Department of Dermatology and Venereology, People's Hospital of Xinjiang Uygur Autonomous Region, Urumchi, China.,Xinjiang Clinical Research Center for Dermatologic Diseases, Urumqi, China.,Xinjiang Key Laboratory of Dermatology Research (XJYS1707), Urumqi, China
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Proksch E. Enhancing the skin barrier by emollients in neonates to prevent atopic dermatitis. J Eur Acad Dermatol Venereol 2023; 37:463-464. [PMID: 36779829 DOI: 10.1111/jdv.18857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 01/10/2023] [Indexed: 02/14/2023]
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Abstract
Food allergy is a growing health problem affecting both pediatric and adult patients. Food allergies are often immunoglobulin E (IgE) mediated but other food-induced non-IgE-mediated diseases exist. Diagnosis of food allergy relies on the combination of clinical and reaction history, skin and IgE testing as well as oral food challenges. Although oral immunotherapy has been able to achieve sustained unresponsiveness in some patients, no cure for food allergies has been found to date. Avoidance of the inciting food as well as availability of epinephrine autoinjectors remains the mainstay of treatment.
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Epicutaneous Sensitization and Food Allergy: Preventive Strategies Targeting Skin Barrier Repair-Facts and Challenges. Nutrients 2023; 15:nu15051070. [PMID: 36904070 PMCID: PMC10005101 DOI: 10.3390/nu15051070] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 02/16/2023] [Accepted: 02/18/2023] [Indexed: 02/25/2023] Open
Abstract
Food allergy represents a growing public health and socio-economic problem with an increasing prevalence over the last two decades. Despite its substantial impact on the quality of life, current treatment options for food allergy are limited to strict allergen avoidance and emergency management, creating an urgent need for effective preventive strategies. Advances in the understanding of the food allergy pathogenesis allow to develop more precise approaches targeting specific pathophysiological pathways. Recently, the skin has become an important target for food allergy prevention strategies, as it has been hypothesized that allergen exposure through the impaired skin barrier might induce an immune response resulting in subsequent development of food allergy. This review aims to discuss current evidence supporting this complex interplay between the skin barrier dysfunction and food allergy by highlighting the crucial role of epicutaneous sensitization in the causality pathway leading to food allergen sensitization and progression to clinical food allergy. We also summarize recently studied prophylactic and therapeutic interventions targeting the skin barrier repair as an emerging food allergy prevention strategy and discuss current evidence controversies and future challenges. Further studies are needed before these promising strategies can be routinely implemented as prevention advice for the general population.
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Shelley JR, McHugh BJ, Wills J, Dorin JR, Weller R, Clarke DJ, Davidson DJ. A mechanistic evaluation of human beta defensin 2 mediated protection of human skin barrier in vitro. Sci Rep 2023; 13:2271. [PMID: 36755116 PMCID: PMC9908873 DOI: 10.1038/s41598-023-29558-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 02/06/2023] [Indexed: 02/10/2023] Open
Abstract
The human skin barrier, a biological imperative, is impaired in inflammatory skin diseases such as atopic dermatitis (AD). Staphylococcus aureus is associated with AD lesions and contributes to pathological inflammation and further barrier impairment. S. aureus secretes extracellular proteases, such as V8 (or 'SspA'), which cleave extracellular proteins to reduce skin barrier. Previous studies demonstrated that the host defence peptide human beta-defensin 2 (HBD2) prevented V8-mediated damage. Here, the mechanism of HBD2-mediated barrier protection in vitro is examined. Application of exogenous HBD2 provided protection against V8, irrespective of timeline of application or native peptide folding, raising the prospect of simple peptide analogues as therapeutics. HBD2 treatment, in context of V8-mediated damage, modulated the proteomic/secretomic profiles of HaCaT cells, altering levels of specific extracellular matrix proteins, potentially recovering V8 damage. However, HBD2 alone did not substantially modulate cellular proteomic/secretomics profiles in the absence of damage, suggesting possible therapeutic targeting of lesion damage sites only. HBD2 did not show any direct protease inhibition or induce expression of known antiproteases, did not alter keratinocyte migration or proliferation, or form protective nanonet structures. These data validate the barrier-protective properties of HBD2 in vitro and establish key protein datasets for further targeted mechanistic analyses.
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Affiliation(s)
- Jennifer R Shelley
- University of Edinburgh Centre for Inflammation Research, Queen's Medical Research Institute, BioQuarter, University of Edinburgh, 47 Little France Crescent, Edinburgh, EH16 4TJ, Scotland, UK.
- The Commonwealth Building, The Hammersmith Hospital, Du Cane Road, London, W12 0NN, UK.
| | - Brian J McHugh
- University of Edinburgh Centre for Inflammation Research, Queen's Medical Research Institute, BioQuarter, University of Edinburgh, 47 Little France Crescent, Edinburgh, EH16 4TJ, Scotland, UK
| | - Jimi Wills
- Cancer Research UK Edinburgh Centre, Institute of Genetics and Cancer, The University of Edinburgh, Western General Hospital Campus, Crewe Road, Edinburgh, EH4 2XU, Scotland, UK
| | - Julia R Dorin
- University of Edinburgh Centre for Inflammation Research, Queen's Medical Research Institute, BioQuarter, University of Edinburgh, 47 Little France Crescent, Edinburgh, EH16 4TJ, Scotland, UK
| | - Richard Weller
- University of Edinburgh Centre for Inflammation Research, Queen's Medical Research Institute, BioQuarter, University of Edinburgh, 47 Little France Crescent, Edinburgh, EH16 4TJ, Scotland, UK
| | - David J Clarke
- The EastChem School of Chemistry, University of Edinburgh, Joseph Black Building, Brewster Road, Edinburgh, EH9 3FJ, UK
| | - Donald J Davidson
- University of Edinburgh Centre for Inflammation Research, Queen's Medical Research Institute, BioQuarter, University of Edinburgh, 47 Little France Crescent, Edinburgh, EH16 4TJ, Scotland, UK
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Moreno A, Renert-Yuval Y, Guttman-Yassky E. Shedding light on key pharmacological knowledge and strategies for pediatric atopic dermatitis. Expert Rev Clin Pharmacol 2023; 16:119-131. [PMID: 36705936 PMCID: PMC9947941 DOI: 10.1080/17512433.2023.2173172] [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: 08/25/2022] [Accepted: 01/23/2023] [Indexed: 01/28/2023]
Abstract
INTRODUCTION Atopic dermatitis (AD) is an inflammatory disease affecting over 20% of the pediatric population, with 85% of cases presenting before the age of five. Recently, therapeutic options in pediatric patients have evolved rapidly, following extensive development in adult treatments. AREAS COVERED This review will encompass relevant molecular drivers, along with an overlook on treatment modalities in pediatric AD, as well as a summary of pipeline treatments in clinical trials for pediatric patients from PubMed, Google Scholar, and Clinicaltrials.gov up to July 2022. Topical corticosteroids are the mainstay for AD flares in adults and children. Topical approved agents in pediatric AD are calcineurin inhibitors, crisaborolecrisaborole, and ruxolitinib. Dupilumab is the only FDA approved biologic for patients with AD from six months of age. A Janus kinase inhibitor, upadacitinib, is a systemic treatment approved for pediatric AD patients (age >12 years). Systemic immunosuppressants used in pediatric AD include methotrexate, azathioprine, cyclosporinecyclosporine, and mycophenolate mofetil. EXPERT OPINION Data regarding disease prevention are conflicting, however, an abundance of research has transpired regarding amelioration of symptoms and induction of disease clearance by targeting numerous pathological mechanisms. Understanding the pediatric AD phenotype will further advance the field and the development of improved therapeutics.
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Affiliation(s)
- Ariana Moreno
- Laboratory for Investigative Dermatology, The Rockefeller University, New York, NY, USA
| | - Yael Renert-Yuval
- Laboratory for Investigative Dermatology, The Rockefeller University, New York, NY, USA
- Department of Dermatology and the Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Emma Guttman-Yassky
- Department of Dermatology and the Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Pezeshki PS, Nowroozi A, Razi S, Rezaei N. Asthma and Allergy. Clin Immunol 2023. [DOI: 10.1016/b978-0-12-818006-8.00002-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Impact of a Decade of Research Into Atopic Dermatitis. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2023; 11:63-71. [PMID: 36162801 DOI: 10.1016/j.jaip.2022.09.021] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 09/06/2022] [Accepted: 09/13/2022] [Indexed: 01/11/2023]
Abstract
The last decade has seen an unprecedented pace of change, particularly of clinical research in atopic dermatitis (AD). This review summarizes some key discoveries. Over the last 10 years, nearly half of all studies investigated the efficacy and safety of novel therapeutic agents, particularly biologics and small molecules. Clear demonstration of benefit in clinical trials with no significant safety concerns provided strong evidence leading to subsequent Food and Drug Administration approval and routine use of the anti-IL-4 receptor alpha antagonist dupilumab in patients 6 months and older, the selective Janus kinase 1 (JAK1) inhibitors upadacitinib for patients 12 years and older and abrocitinib, the IL-13 antagonist tralokinumab, and the JAK1/2 inhibitor baricitinib for adults 18 years and older. Several other drugs are in the pipeline. Other areas under the spotlight have been trials of skin moisturizers and probiotics in the prevention of AD, investigating the role of filaggrin and skin barrier function and the role of skin and gut microbiome, with Staphylococcus aureus second immunoglobulin-binding protein having been found to uniquely trigger allergic skin responses in AD. Skin microbiome, epidermal metabolites/structural components, and local inflammatory biomarkers are now commonly assessed using genomic and proteomic analysis of tape strips rather than more invasive biopsy to identify factors such as C-C motif chemokine ligand-17 that correlate with disease severity and response to therapy. Overall, the last decade has ushered in a new and exciting era in our understanding, diagnosis, and treatment of this common allergic skin disease.
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