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Biazus Soares G, Hashimoto T, Yosipovitch G. Atopic Dermatitis Itch: Scratching for an Explanation. J Invest Dermatol 2024; 144:978-988. [PMID: 38363270 DOI: 10.1016/j.jid.2023.10.048] [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: 08/26/2023] [Revised: 10/20/2023] [Accepted: 10/31/2023] [Indexed: 02/17/2024]
Abstract
Chronic pruritus is a cardinal symptom of atopic dermatitis (AD). The mechanisms underlying atopic itch involve intricate crosstalk among skin, immune components, and neural components. In this review, we explore these mechanisms, focusing on key players and interactions that induce and exacerbate itch. We discuss the similarities and differences between pruritus and pain in patients with AD as well as the relationship between pruritus and factors such as sweat and the skin microbiome. Furthermore, we explore novel targets that could provide significant itch relief in these patients as well as exciting future research directions to better understand atopic pruritus in darker skin types.
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Affiliation(s)
- Georgia Biazus Soares
- Miami Itch Center, Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Takashi Hashimoto
- Department of Dermatology, National Defense Medical College, Tokorozawa, Japan
| | - Gil Yosipovitch
- Miami Itch Center, Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA.
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2
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Lorestani F, Zhang X, Abdullah AM, Xin X, Liu Y, Rahman M, Biswas MAS, Li B, Dutta A, Niu Z, Das S, Barai S, Wang K, Cheng H. A highly sensitive and long-term stable wearable patch for continuous analysis of biomarkers in sweat. ADVANCED FUNCTIONAL MATERIALS 2023; 33:2306117. [PMID: 38525448 PMCID: PMC10959519 DOI: 10.1002/adfm.202306117] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Indexed: 03/26/2024]
Abstract
Although increasing efforts have been devoted to the development of non-invasive wearable or stretchable electrochemical sweat sensors for monitoring physiological and metabolic information, most of them still suffer from poor stability and specificity over time and fluctuating temperatures. This study reports the design and fabrication of a long-term stable and highly sensitive flexible electrochemical sensor based on nanocomposite-modified porous graphene by simple and facile laser treatment for detecting biomarkers such as glucose in sweat. The laser-reduced and patterned stable conductive nanocomposite on the porous graphene electrode provides the resulting glucose sensor with an excellent sensitivity of 1317.69 μAmM-1cm-2 with an ultra-low limit of detection (LOD) of 0.079 μM. The sensor can also detect pH and exhibit extraordinary stability to maintain more than 91% sensitivity over 21 days in ambient conditions. Taken together with a temperature sensor based on the same material system, the dual glucose and pH sensor integrated with a flexible microfluidic sweat sampling network further results in accurate continuous on-body glucose detection calibrated by the simultaneously measured pH and temperature. The low-cost, highly sensitive, and long-term stable platform could facilitate and pave the way for the early identification and continuous monitoring of different biomarkers for non-invasive disease diagnosis and treatment evaluation.
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Affiliation(s)
- Farnaz Lorestani
- Department of Engineering Science and Mechanics, Pennsylvania State University, University Park, PA,16802, USA
| | - Xianzhe Zhang
- Department of Engineering Science and Mechanics, Pennsylvania State University, University Park, PA,16802, USA
| | - Abu Musa Abdullah
- Department of Engineering Science and Mechanics, Pennsylvania State University, University Park, PA,16802, USA
| | - Xin Xin
- Department of Engineering Science and Mechanics, Pennsylvania State University, University Park, PA,16802, USA
| | - Yushen Liu
- Department of Engineering Science and Mechanics, Pennsylvania State University, University Park, PA,16802, USA
| | - Mashfiqur Rahman
- Department of Engineering Science and Mechanics, Pennsylvania State University, University Park, PA,16802, USA
| | - Md Abu Sayeed Biswas
- Department of Engineering Science and Mechanics, Pennsylvania State University, University Park, PA,16802, USA
| | - Bowen Li
- Department of Engineering Science and Mechanics, Pennsylvania State University, University Park, PA,16802, USA
| | - Ankan Dutta
- Department of Engineering Science and Mechanics, Pennsylvania State University, University Park, PA,16802, USA
- Center for Neural Engineering, The Pennsylvania State University, University Park, PA, 16802, USA
| | - Zhenyuan Niu
- Department of Engineering Science and Mechanics, Pennsylvania State University, University Park, PA,16802, USA
| | - Shuvendu Das
- Department of Engineering Science and Mechanics, Pennsylvania State University, University Park, PA,16802, USA
| | - Shishir Barai
- Department of Engineering Science and Mechanics, Pennsylvania State University, University Park, PA,16802, USA
| | - Ke Wang
- Materials Research Institute, The Pennsylvania State University, University Park, PA 16802
| | - Huanyu Cheng
- Department of Engineering Science and Mechanics, Pennsylvania State University, University Park, PA,16802, USA
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3
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Belzer A, Parker ER. Climate Change, Skin Health, and Dermatologic Disease: A Guide for the Dermatologist. Am J Clin Dermatol 2023:10.1007/s40257-023-00770-y. [PMID: 37336870 DOI: 10.1007/s40257-023-00770-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/12/2023] [Indexed: 06/21/2023]
Abstract
Climate change has a pervasive impact on health and is of clinical relevance to every organ system. Climate change-related factors impact the skin's capacity to maintain homeostasis, leading to a variety of cutaneous diseases. Stratospheric ozone depletion has led to increased risk of melanoma and keratinocyte carcinomas due to ultraviolet radiation exposure. Atopic dermatitis, psoriasis, pemphigus, acne vulgaris, melasma, and photoaging are all associated with rising levels of air pollution. Elevated temperatures due to global warming induce disruption of the skin microbiome, thereby impacting atopic dermatitis, acne vulgaris, and psoriasis, and high temperatures are associated with exacerbation of skin disease and increased risk of heat stroke. Extreme weather events due to climate change, including floods and wildfires, are of relevance to the dermatologist as these events are implicated in cutaneous injuries, skin infections, and acute worsening of inflammatory skin disorders. The health consequences as well as the economic and social burden of climate change fall most heavily on vulnerable and marginalized populations due to structural disparities. As dermatologists, understanding the interaction of climate change and skin health is essential to appropriately manage dermatologic disease and advocate for our patients.
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Affiliation(s)
- Annika Belzer
- Yale University School of Medicine, New Haven, CT, USA
| | - Eva Rawlings Parker
- Department of Dermatology, Center for Biomedical Ethics and Society, Vanderbilt University Medical Center, 719 Thompson Lane, Suite 26-300, Nashville, TN, 37204, USA.
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4
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Gao F, Liu C, Zhang L, Liu T, Wang Z, Song Z, Cai H, Fang Z, Chen J, Wang J, Han M, Wang J, Lin K, Wang R, Li M, Mei Q, Ma X, Liang S, Gou G, Xue N. Wearable and flexible electrochemical sensors for sweat analysis: a review. MICROSYSTEMS & NANOENGINEERING 2023; 9:1. [PMID: 36597511 PMCID: PMC9805458 DOI: 10.1038/s41378-022-00443-6] [Citation(s) in RCA: 64] [Impact Index Per Article: 64.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Revised: 07/26/2022] [Accepted: 08/10/2022] [Indexed: 06/10/2023]
Abstract
Flexible wearable sweat sensors allow continuous, real-time, noninvasive detection of sweat analytes, provide insight into human physiology at the molecular level, and have received significant attention for their promising applications in personalized health monitoring. Electrochemical sensors are the best choice for wearable sweat sensors due to their high performance, low cost, miniaturization, and wide applicability. Recent developments in soft microfluidics, multiplexed biosensing, energy harvesting devices, and materials have advanced the compatibility of wearable electrochemical sweat-sensing platforms. In this review, we summarize the potential of sweat for medical detection and methods for sweat stimulation and collection. This paper provides an overview of the components of wearable sweat sensors and recent developments in materials and power supply technologies and highlights some typical sensing platforms for different types of analytes. Finally, the paper ends with a discussion of the challenges and a view of the prospective development of this exciting field.
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Affiliation(s)
- Fupeng Gao
- School of Electronic, Electrical, and Communication Engineering, University of Chinese Academy of Sciences (UCAS), 100190 Beijing, China
- State Key Laboratory of Transducer Technology, Aerospace Information Research Institute (AIR), Chinese Academy of Sciences, 100190 Beijing, China
| | - Chunxiu Liu
- School of Electronic, Electrical, and Communication Engineering, University of Chinese Academy of Sciences (UCAS), 100190 Beijing, China
- State Key Laboratory of Transducer Technology, Aerospace Information Research Institute (AIR), Chinese Academy of Sciences, 100190 Beijing, China
| | - Lichao Zhang
- School of Electronic, Electrical, and Communication Engineering, University of Chinese Academy of Sciences (UCAS), 100190 Beijing, China
- State Key Laboratory of Transducer Technology, Aerospace Information Research Institute (AIR), Chinese Academy of Sciences, 100190 Beijing, China
| | - Tiezhu Liu
- School of Electronic, Electrical, and Communication Engineering, University of Chinese Academy of Sciences (UCAS), 100190 Beijing, China
- State Key Laboratory of Transducer Technology, Aerospace Information Research Institute (AIR), Chinese Academy of Sciences, 100190 Beijing, China
| | - Zheng Wang
- School of Electronic, Electrical, and Communication Engineering, University of Chinese Academy of Sciences (UCAS), 100190 Beijing, China
- State Key Laboratory of Transducer Technology, Aerospace Information Research Institute (AIR), Chinese Academy of Sciences, 100190 Beijing, China
| | - Zixuan Song
- School of Electronic, Electrical, and Communication Engineering, University of Chinese Academy of Sciences (UCAS), 100190 Beijing, China
- State Key Laboratory of Transducer Technology, Aerospace Information Research Institute (AIR), Chinese Academy of Sciences, 100190 Beijing, China
| | - Haoyuan Cai
- School of Electronic, Electrical, and Communication Engineering, University of Chinese Academy of Sciences (UCAS), 100190 Beijing, China
- State Key Laboratory of Transducer Technology, Aerospace Information Research Institute (AIR), Chinese Academy of Sciences, 100190 Beijing, China
| | - Zhen Fang
- School of Electronic, Electrical, and Communication Engineering, University of Chinese Academy of Sciences (UCAS), 100190 Beijing, China
- State Key Laboratory of Transducer Technology, Aerospace Information Research Institute (AIR), Chinese Academy of Sciences, 100190 Beijing, China
| | - Jiamin Chen
- School of Electronic, Electrical, and Communication Engineering, University of Chinese Academy of Sciences (UCAS), 100190 Beijing, China
- State Key Laboratory of Transducer Technology, Aerospace Information Research Institute (AIR), Chinese Academy of Sciences, 100190 Beijing, China
| | - Junbo Wang
- School of Electronic, Electrical, and Communication Engineering, University of Chinese Academy of Sciences (UCAS), 100190 Beijing, China
- State Key Laboratory of Transducer Technology, Aerospace Information Research Institute (AIR), Chinese Academy of Sciences, 100190 Beijing, China
| | - Mengdi Han
- Department of Biomedical Engineering, College of Future Technology, Peking University, 100871 Beijing, China
| | - Jun Wang
- Beijing Shuimujiheng Biotechnology Company, 101102 Beijing, China
| | - Kai Lin
- PLA Air Force Characteristic Medical Center, 100142 Beijing, China
| | - Ruoyong Wang
- PLA Air Force Characteristic Medical Center, 100142 Beijing, China
| | - Mingxiao Li
- Institute of Microelectronics of the Chinese Academy of Sciences, 100029 Beijing, China
| | - Qian Mei
- CAS Key Laboratory of Biomedical Diagnostics, Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences (CAS), 215163 Suzhou, China
| | - Xibo Ma
- CBSR&NLPR, Institute of Automation, Chinese Academy of Sciences, Beijing, China
| | - Shuli Liang
- Functional Neurosurgery Department, Beijing Children’s Hospital, Capital Medical University, 100045 Beijing, China
| | - Guangyang Gou
- School of Electronic, Electrical, and Communication Engineering, University of Chinese Academy of Sciences (UCAS), 100190 Beijing, China
- State Key Laboratory of Transducer Technology, Aerospace Information Research Institute (AIR), Chinese Academy of Sciences, 100190 Beijing, China
| | - Ning Xue
- School of Electronic, Electrical, and Communication Engineering, University of Chinese Academy of Sciences (UCAS), 100190 Beijing, China
- State Key Laboratory of Transducer Technology, Aerospace Information Research Institute (AIR), Chinese Academy of Sciences, 100190 Beijing, China
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5
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Sweat therapy, a novel treatment of psoriasis: prospective pre-post intervention design. ADVANCES IN TRADITIONAL MEDICINE 2022. [DOI: 10.1007/s13596-022-00645-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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6
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Salimian J, Salehi Z, Ahmadi A, Emamvirdizadeh A, Davoudi SM, Karimi M, Korani M, Azimzadeh Jamalkandi S. Atopic dermatitis: molecular, cellular, and clinical aspects. Mol Biol Rep 2022; 49:3333-3348. [PMID: 34989960 DOI: 10.1007/s11033-021-07081-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 12/09/2021] [Indexed: 10/19/2022]
Abstract
Atopic dermatitis (AD) is a complicated, inflammatory skin disease, which numerous genetic and environmental factors play roles in its development. AD is categorized into different phenotypes and stages, although they are mostly similar in their pathophysiological aspects. Immune response alterations and structural distortions of the skin-barrier layer are evident in AD patients. Genetic makeup, lifestyle, and environment are also significantly involved in contextual factors. Genes involved in AD-susceptibility, including filaggrin and natural moisturizing, cause considerable structural modifications in the skin's lipid bilayer and cornified envelope. Additionally, the skin's decreased integrity and altered structure are accompanied by biochemical changes in the normal skin microflora's dysbiosis. The dynamic immunological responses, genetic susceptibilities, and structural modifications associated with AD's pathophysiology will be extensively discussed in this review, each according to the latest achievements and findings.
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Affiliation(s)
- Jafar Salimian
- Chemical Injuries Research Center, Systems Biology and Poisonings Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Zahra Salehi
- Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Ahmadi
- Molecular Biology Research Center, Systems Biology and Poisonings Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Alireza Emamvirdizadeh
- Department of Genetics, Faculty of Bio Sciences, Tehran North Branch, Islamic Azad University, Tehran, Iran
| | - Seyyed Masoud Davoudi
- Department of Dermatology, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Mehrdad Karimi
- Department of Traditional Medicine, School of Persian Medicine, Tehran University of Medical Sciences, Tehran, Iran.,Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohsen Korani
- Department of Biochemistry, Faculty of Medicine, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Sadegh Azimzadeh Jamalkandi
- Chemical Injuries Research Center, Systems Biology and Poisonings Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran.
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7
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Chao L, Sun Y, An Z, Li J, Wu W, Liu Y, Song J. Effects of ambient temperature on outpatient visits for dermatitis in Xinxiang, China: a time-series analysis. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:15999-16005. [PMID: 34642884 DOI: 10.1007/s11356-021-16710-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 09/21/2021] [Indexed: 06/13/2023]
Abstract
Previous studies have reported regional variations in the relationship between ambient temperature and dermatitis, which therefore remain inconclusive. This study aimed to understand the short-term effects of ambient temperature in outpatients with dermatitis in Xinxiang. Routine data of dermatitis outpatient visits between January 1, 2015, and December 31, 2018 were acquired from the First Affiliated Hospital of Xinxiang Medical University. A distributed lag nonlinear model (DLNM) in combination with a generalized additive model (GAM) was applied to investigate the acute impact of ambient temperature on dermatitis outpatients. Two stratified analyses based on age and sex were conducted to explore their potential modification effects. A total of 18,064 dermatitis outpatient records were retrieved during the study period. The relationship between ambient temperature and dermatitis outpatients was found to be nonlinear; exposure-response curves were approximately "J" shaped. The risk of dermatitis outpatient increased with a corresponding elevation in temperature from 11.5 to 27.5°C. However, the significance was lost when the temperature exceeded the given range. Stratified analysis demonstrated higher sensitivity to temperature in females than in males, and the young groups (<15 years) might be sensitive to heat temperature. This study provides first-hand epidemiological evidence demonstrating a higher risk of dermatitis outpatient visits associated with moderately higher temperatures. The outcomes of this study create awareness among citizens to take the necessary precautions to prevent the adverse effects of moderate heat temperature during early summer and autumn seasons.
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Affiliation(s)
- Ling Chao
- Henan International Collaborative Laboratory for Air Pollution Health Effects and Intervention, School of Public Health, Xinxiang Medical University, Xinxiang, 453003, China
| | - Yajun Sun
- Zhuhai Center for Chronic Disease Control, The Third People's Hospital of Zhuhai, Zhuhai, 519000, China
| | - Zhen An
- Henan International Collaborative Laboratory for Air Pollution Health Effects and Intervention, School of Public Health, Xinxiang Medical University, Xinxiang, 453003, China
| | - Juan Li
- Henan International Collaborative Laboratory for Air Pollution Health Effects and Intervention, School of Public Health, Xinxiang Medical University, Xinxiang, 453003, China
| | - Weidong Wu
- Henan International Collaborative Laboratory for Air Pollution Health Effects and Intervention, School of Public Health, Xinxiang Medical University, Xinxiang, 453003, China
| | - Yue Liu
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100021, China.
| | - Jie Song
- Henan International Collaborative Laboratory for Air Pollution Health Effects and Intervention, School of Public Health, Xinxiang Medical University, Xinxiang, 453003, China.
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8
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Brihan I, Fekete G, Turda C, Tica O, Venter A, Ianosi S, Neagoe CD, Branisteanu D. Clinicopathological correlation of transient acantholytic dermatosis: A case report. Exp Ther Med 2021; 23:173. [PMID: 35069854 PMCID: PMC8764573 DOI: 10.3892/etm.2021.11096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 10/13/2021] [Indexed: 11/05/2022] Open
Affiliation(s)
- Ilarie Brihan
- Dermatology Department, Dermatology Clinic, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania
| | - Gyula Fekete
- Dermatology Department, Dermatology Clinic, ‘George Emil Palade’ University of Medicine, Pharmacy, Science and Technology, 540530 Targu Mureș, Romania
| | - Constanta Turda
- Department of Psycho‑Neuroscience and Recovery, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania
| | - Ovidiu Tica
- Department of Morphological Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania
| | - Alina Venter
- Department of Morphological Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania
| | - Simona Ianosi
- Department of Dermatology, University of Medicine and Pharmacy, 200349 Craiova, Romania
| | - Carmen-Daniela Neagoe
- Department of Internal Medicine, University of Medicine and Pharmacy, 200349 Craiova, Romania
| | - Daciana Branisteanu
- Department of Dermatology, University of Medicine and Pharmacy ‘Grigore T. Popa’, 700115 Iasi, Romania
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Abstract
Atopic dermatitis (AD), a chronic inflammatory skin condition, negatively affects sexual health in various ways including causing physical discomfort and changes in physical appearance that can lead to low self-confidence. The chronic and debilitating nature of this disease can interfere with the sexual well-being of patients and their partners. This review describes the ways that AD affects sexual health. In addition, we review the impact that partnered relationships and physical intimacy can have on AD and provide practical recommendations for optimizing sexual health in AD patients.
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Wilson TE, Narra S, Metzler-Wilson K, Schneider A, Bullens KA, Holt IS. Role of Bradykinin Type 2 Receptors in Human Sweat Secretion: Translational Evidence Does Not Support a Functional Relationship. Skin Pharmacol Physiol 2021; 34:162-166. [PMID: 33794540 DOI: 10.1159/000514497] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 01/14/2021] [Indexed: 11/19/2022]
Abstract
Bradykinin increases skin blood flow via a cGMP mechanism but its role in sweating in vivo is unclear. There is a current need to translate cell culture and nonhuman paw pad studies into in vivo human preparations to test for therapeutic viability for disorders affecting sweat glands. Protocol 1: physiological sweating was induced in 10 healthy subjects via perfusing warm (46-48°C) water through a tube-lined suit while bradykinin type 2 receptor (B2R) antagonist (HOE-140; 40 μM) and only the vehicle (lactated Ringer's) were perfused intradermally via microdialysis. Heat stress increased sweat rate (HOE-140 = +0.79 ± 0.12 and vehicle = +0.64 ± 0.10 mg/cm2/min), but no differences were noted with B2R antagonism. Protocol 2: pharmacological sweating was induced in 6 healthy subjects via intradermally perfusing pilocarpine (1.67 mg/mL) followed by the same B2R antagonist approach. Pilocarpine increased sweating (HOE-140 = +0.38 ± 0.16 and vehicle = +0.32 ± 0.12 mg/cm2/min); again no differences were observed with B2R antagonism. Last, 5 additional subjects were recruited for various control experiments which identified that a functional dose of HOE-140 was utilized and it was not sudorific during normothermic conditions. These data indicate B2R antagonists do not modulate physiologically or pharmacologically induced eccrine secretion volumes. Thus, B2R agonist/antagonist development as a potential therapeutic target for hypo- and hyperhidrosis appears unwarranted.
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Affiliation(s)
- Thad E Wilson
- Division of Biomedical Sciences, Marian University College of Osteopathic Medicine, Indianapolis, Indiana, USA.,Department of Physiology, University of Kentucky College of Medicine, Lexington, Kentucky, USA
| | - Seetharam Narra
- Division of Biomedical Sciences, Marian University College of Osteopathic Medicine, Indianapolis, Indiana, USA
| | - Kristen Metzler-Wilson
- Department of Physical Therapy, Indiana University, Indianapolis, Indiana, USA.,Department of Anatomy, Cell Biology, & Physiology, Indiana University, Indianapolis, Indiana, USA.,Department of Dermatology, Indiana University, Indianapolis, Indiana, USA
| | - Artur Schneider
- Division of Biomedical Sciences, Marian University College of Osteopathic Medicine, Indianapolis, Indiana, USA
| | - Kelsey A Bullens
- Division of Biomedical Sciences, Marian University College of Osteopathic Medicine, Indianapolis, Indiana, USA
| | - Ian S Holt
- Division of Biomedical Sciences, Marian University College of Osteopathic Medicine, Indianapolis, Indiana, USA
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11
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Fenton C, Al-Salama ZT. Fabrics can greatly improve or exacerbate atopic dermatitis. DRUGS & THERAPY PERSPECTIVES 2021. [DOI: 10.1007/s40267-021-00822-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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12
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Ezure T, Amano S, Matsuzaki K. Aging-related shift of eccrine sweat glands toward the skin surface due to tangling and rotation of the secretory ducts revealed by digital 3D skin reconstruction. Skin Res Technol 2021; 27:569-575. [PMID: 33576542 PMCID: PMC8359204 DOI: 10.1111/srt.12985] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 10/02/2020] [Indexed: 12/27/2022]
Abstract
Background Sweat gland function deteriorates with aging, leading to loss of heat tolerance. However, it is unclear whether and how the structure of sweat glands changes during aging, because the 3D structure is complex and inaccessible. Methods To clarify age‐dependent changes in sweat glands, we developed a method for 3D structure analysis of sweat glands by means of X‐ray micro‐CT observation of human skin specimens followed by 3D digital reconstruction on computer (digital 3D skin). Results Comparison of eccrine sweat glands of abdominal skin from young and old subjects showed that the density and volume of sweat glands do not change with aging. In contrast, the depth of the secretory coil from the skin surface is decreased in the aged group. Surprisingly, the secretory ducts appear tortuous or meandering though their length is unchanged. The secretory coils are located at the dermal‐adipose layer boundary in both groups, but the thickness of the dermal layer decreases with aging, and the depth of the coils is correlated with the dermal thickness. Conclusion Our results suggest that sweat glands twist and rotate with aging to maintain the position of the coil at the dermal‐adipose boundary, causing an overall shift toward the skin surface.
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Affiliation(s)
- Tomonobu Ezure
- Department of Plastic and Reconstructive Surgery, Shiseido Global Innovation Center, Kanagawa, Japan
| | - Satoshi Amano
- Department of Plastic and Reconstructive Surgery, Shiseido Global Innovation Center, Kanagawa, Japan
| | - Kyoichi Matsuzaki
- Department of Plastic and Reconstructive Surgery, School of Medicine, International University of Health and Welfare, Narita, Japan
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13
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Bosma ALA, Ouwerkerk W, Middelkamp-Hup MA. Children with atopic eczema experiencing increased disease severity in the pollen season more often have hay fever at a young age and a dark skin type. J Dermatol 2021; 48:470-475. [PMID: 33404119 PMCID: PMC8048828 DOI: 10.1111/1346-8138.15750] [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: 11/09/2020] [Revised: 12/10/2020] [Accepted: 12/11/2020] [Indexed: 11/29/2022]
Abstract
Children with atopic eczema are known to experience seasonal variations in disease severity, with winter being the season in which severity generally increases. There is a lack of knowledge about the subgroup of children that experiences increased severity in spring and summer months. We aimed to investigate which phenotype characteristics best describe children flaring in the pollen season. A retrospective database analysis was conducted, including 110 children with difficult‐to‐treat atopic eczema aged 0–17 years. Relevant outcome parameters were extracted from medical records. In our population, 36% (n = 40/110) of children reported flares of atopic eczema in the pollen season. These children were more often sensitized to one or more types of pollen (73% [n = 29/40] vs. 28% [n = 10/36], p < 0.0001) and had more patient‐reported hay fever (70% [n = 28/40] vs. 19% [n = 7/36], p < 0.0001), compared with children who do not flare in the pollen season. Moreover, children flaring in the pollen season more often had a dark skin type (78% [n = 31/40] vs. 44% [n = 16/36], p = 0.003). Based on stepwise multivariable analyses, children flaring in the pollen season were characterized by the combination of younger age, hay fever, and dark skin type (C‐statistic: 0.86). In conclusion, patient‐reported flares in spring and summer are experienced by one‐third of children with difficult‐to‐treat atopic eczema. This phenotype can be characterized as young children having hay fever and a dark skin type and can be identified based on clinical parameters alone without the need to perform immunoglobulin E blood testing or skin prick tests.
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Affiliation(s)
- Angela Leigh-Ann Bosma
- Amsterdam UMC, location Academic Medical Center, Department of Dermatology, Amsterdam Public Health, Infection and Immunity, University of Amsterdam, Amsterdam, The Netherlands
| | - Wouter Ouwerkerk
- Amsterdam UMC, location Academic Medical Center, Department of Dermatology, Amsterdam Public Health, Infection and Immunity, University of Amsterdam, Amsterdam, The Netherlands.,National Heart Center Singapore, Singapore
| | - Maritza Albertina Middelkamp-Hup
- Amsterdam UMC, location Academic Medical Center, Department of Dermatology, Amsterdam Public Health, Infection and Immunity, University of Amsterdam, Amsterdam, The Netherlands
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14
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Goleva E, Calatroni A, LeBeau P, Berdyshev E, Taylor P, Kreimer S, Cole RN, Leung DYM. Skin tape proteomics identifies pathways associated with transepidermal water loss and allergen polysensitization in atopic dermatitis. J Allergy Clin Immunol 2020; 146:1367-1378. [PMID: 32360271 PMCID: PMC7606732 DOI: 10.1016/j.jaci.2020.04.022] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 04/02/2020] [Accepted: 04/10/2020] [Indexed: 01/16/2023]
Abstract
BACKGROUND Atopic dermatitis (AD) and food allergy (FA) are associated with skin barrier dysfunction. OBJECTIVE Skin biomarkers are needed for skin barrier interventions studies. METHODS In this study, skin tape strip (STS) samples were collected from nonlesional skin of 62 children in AD FA+, AD FA-, and nonatopic groups for mass spectrometry proteomic analysis. transepidermal water loss and allergic sensitization were assessed. STS proteomic analysis results were validated in an independent cohort of 41 adults with AD with and without FA versus nonatopic controls. RESULTS A group of 45 proteins was identified as a principal component 1 (PC1) with the highest expression in AD FA+ STSs. This novel set of STS proteins was highly correlative to skin transepidermal water loss and allergic sensitization. PC1 proteins included keratin intermediate filaments; proteins associated with inflammatory responses (S100 proteins, alarmins, protease inhibitors); and glycolysis and antioxidant defense enzymes. Analysis of PC1 proteins expression in an independent adult AD cohort validated differential expression of STS PC1 proteins in the skin of adult patients with AD with the history of clinical reactions to peanut. CONCLUSIONS STS analysis of nonlesional skin of AD children identified a cluster of proteins with the highest expression in AD FA+ children. The differential expression of STS PC1 proteins was confirmed in a replicate cohort of adult AD patients with FA to peanut, suggesting a unique STS proteomic endotype for AD FA+ that persists into adulthood. Collectively, PC1 proteins are associated with abnormalities in skin barrier integrity and may increase the risk of epicutaneous sensitization to food allergens.
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Affiliation(s)
- Elena Goleva
- Department of Pediatrics, National Jewish Health, Denver, Colo
| | | | | | | | - Patricia Taylor
- Department of Pediatrics, National Jewish Health, Denver, Colo
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15
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Jaros J, Wilson C, Shi VY. Fabric Selection in Atopic Dermatitis: An Evidence-Based Review. Am J Clin Dermatol 2020; 21:467-482. [PMID: 32440827 DOI: 10.1007/s40257-020-00516-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Clothing fabrics interact closely with the skin to shape our cutaneous microenvironment. Cotton and silk have been traditionally recommended for patients with atopic dermatitis because of reported patient comfort. New synthetic fabrics combine anti-microbial, anti-inflammatory, moisture-wicking, and soothing properties that may augment conventional management strategies in atopic patients. OBJECTIVE We review existing and emerging evidence for fabric selection in patients with atopic dermatitis including cotton, wool, lyocell, silk, anionic, cellulosic/cellulose based, zinc oxide coated, citric acid coated, chitosan coated, silver coated, borage seed oil coated, ethylene vinyl, and polyurethane and offer practical suggestions for clothing and bedding choices. METHODS A systematic search was conducted on PubMed and EMBASE electronic databases for articles from 1 January, 1994 to 1 January, 2020. Studies were included based on the following inclusion criteria: clinical trial, published in English, and fabric as the main agent being evaluated. Case reports, case series, conference abstracts, reviews, animal studies, and duplicates were excluded. Studies were then manually screened by title, abstract, and full-text articles and selected to specifically describe the effects of fabrics in patients with atopic dermatitis. Both adult and pediatric patient studies were included. RESULTS There appears to be an advantage to modern fabric manufacturing and processing techniques that have created smaller diameter, smoother fibers such as super- and ultrafine merino wool and anti-microbial finishes. Traditional cotton and silk fabrics have mixed evidence in improving atopic dermatitis symptoms and severity but have shown to be generally safe. Large-diameter wool has been shown to induce itching and irritation; ultra- or superfine merino wool is non-pruritic and may be recommended as an alternative. Emerging fabrics with potential efficacy in reducing atopic dermatitis severity and Staphylococcus aureus burden include silver-coated, chitosan-coated, and cellulose-based fabrics. Zinc oxide-coated, acid-coated, polyurethane-coated, borage seed oil-coated, anionic, lyocell, and ethylene vinyl fabrics have sparse evidence and require further study before conclusions can be made. CONCLUSIONS Appropriate fabric selection can reduce the symptom severity and exacerbations of atopic dermatitis.
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Affiliation(s)
- Joanna Jaros
- University of Illinois College of Medicine, 808 S. Wood St. - 380 CME, Chicago, IL, 60612-7307, USA
| | - Claire Wilson
- University of Illinois College of Medicine, 808 S. Wood St. - 380 CME, Chicago, IL, 60612-7307, USA
| | - Vivian Y Shi
- Eczema and Skin Barrier Research Program, Dermatology Division, Department of Medicine, University of Arizona, 7165 N Pima Canyon Drive, Tucson, AZ, 85718, USA.
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16
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Sweat gland regeneration: Current strategies and future opportunities. Biomaterials 2020; 255:120201. [PMID: 32592872 DOI: 10.1016/j.biomaterials.2020.120201] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 04/21/2020] [Accepted: 06/09/2020] [Indexed: 12/13/2022]
Abstract
For patients with extensive skin defects, loss of sweat glands (SwGs) greatly decreases their quality of life. Indeed, difficulties in thermoregulation, ion reabsorption, and maintaining fluid balance might render them susceptible to hyperthermia, heatstroke, or even death. Despite extensive studies on the stem cell biology of the skin in recent years, in-situ regeneration of SwGs with both structural and functional fidelity is still challenging because of the limited regenerative capacity and cell fate control of resident progenitors. To overcome these challenges, one must consider both the intrinsic factors relevant to genetic and epigenetic regulation and cues from the cellular microenvironment. Here, we describe recent progress in molecular biology, developmental pathways, and cellular evolution associated with SwGdevelopment and maturation. This is followed by a summary of the current strategies used for cell-fate modulation, transmembrane drug delivery, and scaffold design associated with SwGregeneration. Finally, we offer perspectives for creating more sophisticated systems to accelerate patients' innate healing capacity and developing engineered skin constructs to treat or replace damaged tissues structurally and functionally.
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18
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Kim J, Kim Y, Ahn K. Effect of the indoor environment on atopic dermatitis in children. ALLERGY ASTHMA & RESPIRATORY DISEASE 2020. [DOI: 10.4168/aard.2020.8.4.175] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Jihyun Kim
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- Environmental Health Center for Atopic Diseases, Samsung Medical Center, Seoul, Korea
| | - Youngmin Kim
- Environmental Health Center for Atopic Diseases, Samsung Medical Center, Seoul, Korea
| | - Kangmo Ahn
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- Environmental Health Center for Atopic Diseases, Samsung Medical Center, Seoul, Korea
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19
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Ono R, Yagi M, Shoji A, Fujita K, Yoshida M, Ports WC, Purohit VS. Phase 1 study of crisaborole in Japanese healthy volunteers and patients with atopic dermatitis. J Dermatol 2019; 47:25-32. [PMID: 31657024 DOI: 10.1111/1346-8138.15123] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 09/23/2019] [Indexed: 12/23/2022]
Abstract
Crisaborole ointment, 2%, is a non-steroidal phosphodiesterase 4 inhibitor for the treatment of mild to moderate atopic dermatitis (AD). This parallel-cohort, phase 1 study was conducted to investigate skin irritation potential and safety of crisaborole in healthy Japanese adults (cohort 1) and the safety and pharmacokinetic profile of crisaborole and metabolites AN7602 and AN8323 in Japanese adults with mild to moderate AD (cohort 2). In cohort 1, 20 healthy volunteers received single applications of crisaborole and vehicle simultaneously on separate locations under 48-h occlusion. In cohort 2, 12 patients with mild to moderate AD received crisaborole (n = 10) or vehicle (n = 2) twice daily for 8 days. Skin irritation and safety were assessed in cohort 1. Pharmacokinetics and safety were assessed in cohort 2. Skin irritation index (scale 0-400) was 40.0 for crisaborole and 5.0 for vehicle. No treatment-emergent adverse events (TEAE) were reported in cohort 1. The most common TEAE in the crisaborole group in cohort 2 were application site irritation (n = 7) and application site pain (n = 4). Crisaborole was rapidly absorbed, with limited systemic exposure between days 1 and 8 that was comparable with that seen in US-based participants in previous trials. Crisaborole had higher skin irritation than vehicle under occlusion in healthy Japanese adults and had an acceptable safety profile in Japanese adults with mild to moderate AD.
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Affiliation(s)
- Ryosuke Ono
- Clinical Pharmacology, Pfizer R&D Japan, Tokyo, Japan
| | | | - Akinobu Shoji
- Department of Dermatology, Ikeda Kaisei Hospital, Osaka, Japan
| | - Kayo Fujita
- Clinical Research, Pfizer R&D Japan, Tokyo, Japan
| | | | - William C Ports
- Inflammation & Immunology, Pfizer Inc., Groton, Connecticut, USA
| | - Vivek S Purohit
- Clinical Pharmacology, Pfizer Inc., Groton, Connecticut, USA
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20
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Murota H, Yamaga K, Ono E, Murayama N, Yokozeki H, Katayama I. Why does sweat lead to the development of itch in atopic dermatitis? Exp Dermatol 2019; 28:1416-1421. [PMID: 31152459 DOI: 10.1111/exd.13981] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2018] [Revised: 05/03/2019] [Accepted: 05/21/2019] [Indexed: 01/13/2023]
Abstract
Sweating plays an important role in maintaining temperature homeostasis in humans. However, under certain circumstances, sweat can cause itching. For example, when excessive sweat accumulates on the skin surface for a long period, miliaria can develop and cause itching. Subjects with dermatoses, such as atopic dermatitis (AD), suffer from itch when exposed to heat or psychological stresses, which are also known perspiration stimuli. Recently, some mechanisms of sweat-induced itch have been revealed. For instance, attenuated sweating ability is observed in subjects with AD, causing heat retention, skin dryness, and high susceptibility to itch. Furthermore, the decreased tight junction of the sweat gland in AD leads to sweat leakage in the dermis, which could be designated as a "sweat endocrine response" and may be the cause of tingling itch during sweating. Additionally, metabolomic analysis of sweat from patients with AD revealed that glucose concentration in sweat increases according to disease severity. Sweat with elevated glucose concentration retards the recovery of the damaged skin barrier and may promote itching. This viewpoint essay outlines the relationship between sweat and itch based on recent evidence.
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Affiliation(s)
- Hiroyuki Murota
- Department of Dermatology, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Kosuke Yamaga
- Department of Dermatology, Course of Integrated Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Emi Ono
- Department of Dermatology, Course of Integrated Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Naoya Murayama
- Department of Dermatology, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Hiroo Yokozeki
- Department of Dermatology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Ichiro Katayama
- Department of Dermatology, Course of Integrated Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan
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21
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Elias MS, Wright SC, Remenyi J, Abbott JC, Bray SE, Cole C, Edwards S, Gierlinski M, Glok M, McGrath JA, Nicholson WV, Paternoster L, Prescott AR, Have ST, Whitfield PD, Lamond AI, Brown SJ. EMSY expression affects multiple components of the skin barrier with relevance to atopic dermatitis. J Allergy Clin Immunol 2019; 144:470-481. [PMID: 31158401 PMCID: PMC6683598 DOI: 10.1016/j.jaci.2019.05.024] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 05/07/2019] [Accepted: 05/14/2019] [Indexed: 12/14/2022]
Abstract
Background Atopic dermatitis (AD) is a common, complex, and highly heritable inflammatory skin disease. Genome-wide association studies offer opportunities to identify molecular targets for drug development. A risk locus on chromosome 11q13.5 lies between 2 candidate genes, EMSY and LRRC32 (leucine-rich repeat-containing 32) but the functional mechanisms affecting risk of AD remain unclear. Objectives We sought to apply a combination of genomic and molecular analytic techniques to investigate which genes are responsible for genetic risk at this locus and to define mechanisms contributing to atopic skin disease. Methods We used interrogation of available genomic and chromosome conformation data in keratinocytes, small interfering RNA (siRNA)–mediated knockdown in skin organotypic culture and functional assessment of barrier parameters, mass spectrometric global proteomic analysis and quantitative lipid analysis, electron microscopy of organotypic skin, and immunohistochemistry of human skin samples. Results Genomic data indicate active promoters in the genome-wide association study locus and upstream of EMSY; EMSY, LRRC32, and intergenic variants all appear to be within a single topologically associating domain. siRNA-knockdown of EMSY in organotypic culture leads to enhanced development of barrier function, reflecting increased expression of structural and functional proteins, including filaggrin and filaggrin-2, as well as long-chain ceramides. Conversely, overexpression of EMSY in keratinocytes leads to a reduction in markers of barrier formation. Skin biopsy samples from patients with AD show greater EMSY staining in the nucleus, which is consistent with an increased functional effect of this transcriptional control protein. Conclusion Our findings demonstrate an important role for EMSY in transcriptional regulation and skin barrier formation, supporting EMSY inhibition as a therapeutic approach.
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Affiliation(s)
- Martina S Elias
- Skin Research Group, Division of Molecular and Clinical Medicine, School of Medicine, University of Dundee, Dundee, United Kingdom.
| | - Sheila C Wright
- Skin Research Group, Division of Molecular and Clinical Medicine, School of Medicine, University of Dundee, Dundee, United Kingdom
| | - Judit Remenyi
- Skin Research Group, Division of Molecular and Clinical Medicine, School of Medicine, University of Dundee, Dundee, United Kingdom
| | - James C Abbott
- Data Analysis/Bioinformatics Group, School of Life Sciences, University of Dundee, Dundee, United Kingdom
| | - Susan E Bray
- NHS Research Scotland Biorepository Tayside, Ninewells Hospital and Medical School, University of Dundee, Dundee, United Kingdom
| | - Christian Cole
- Data Analysis/Bioinformatics Group, School of Life Sciences, University of Dundee, Dundee, United Kingdom
| | - Sharon Edwards
- Department of Pathology, Ninewells Hospital and Medical School, Dundee, United Kingdom
| | - Marek Gierlinski
- Data Analysis/Bioinformatics Group, School of Life Sciences, University of Dundee, Dundee, United Kingdom
| | - Mateusz Glok
- Skin Research Group, Division of Molecular and Clinical Medicine, School of Medicine, University of Dundee, Dundee, United Kingdom
| | - John A McGrath
- St John's Institute of Dermatology, King's College London (Guy's Campus), London, United Kingdom
| | - William V Nicholson
- Skin Research Group, Division of Molecular and Clinical Medicine, School of Medicine, University of Dundee, Dundee, United Kingdom
| | - Lavinia Paternoster
- MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Alan R Prescott
- Dundee Imaging Facility, School of Life Sciences, University of Dundee, Dundee, United Kingdom
| | - Sara Ten Have
- Centre for Gene Regulation and Expression, School of Life Sciences, University of Dundee, Dundee, United Kingdom
| | - Phillip D Whitfield
- Lipidomics Research Facility, Division of Biomedical Sciences, University of the Highlands and Islands, Inverness, United Kingdom
| | - Angus I Lamond
- Centre for Gene Regulation and Expression, School of Life Sciences, University of Dundee, Dundee, United Kingdom
| | - Sara J Brown
- Skin Research Group, Division of Molecular and Clinical Medicine, School of Medicine, University of Dundee, Dundee, United Kingdom; Department of Dermatology, Ninewells Hospital, Dundee, United Kingdom.
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22
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Maarouf M, Maarouf CL, Yosipovitch G, Shi VY. The impact of stress on epidermal barrier function: an evidence-based review. Br J Dermatol 2019; 181:1129-1137. [PMID: 30614527 DOI: 10.1111/bjd.17605] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/02/2019] [Indexed: 01/02/2023]
Abstract
BACKGROUND The epidermal barrier functions to limit skin infection and inflammation by inhibiting irritant and immunogen invasion. Abundant evidence suggests that psychological stress stemming from crowding, isolation, nicotine smoking, insomnia, mental arithmetic tasks, physical pain, real-life stressors (examinations and marital strain) and lack of positive personality traits may impart both acute and chronic epidermal dysfunction. OBJECTIVES To review the relationship between stress and epidermal barrier dysfunction. METHODS A review of the PubMed and Embase databases was conducted to identify all English-language case-control, cross-sectional and randomized control trials that have reported the effect of stress on epidermal barrier function. The authors' conclusions are based on the available evidence from 21 studies that met the inclusion and exclusion criteria. RESULTS Psychological stressors upregulate the hypothalamic-pituitary-adrenal axis to stimulate local and systemic stress hormone production. This ultimately leads to aberrant barrier dysfunction, characterized by decreased epidermal lipid and structural protein production, decreased stratum corneum hydration and increased transepidermal water loss. CONCLUSIONS This evidence-based review explores the adverse effects of psychological stressors on epidermal barrier function. Future investigations using more real-life stressors are needed to elucidate further their impact on skin physiology and identify practical stress-relieving therapies that minimize and restore epidermal barrier dysfunction, particularly in at-risk populations. What's already known about this topic? The literature reports the negative effect of stress on prolonged wound healing. Less is known about the relationship between stress and epidermal barrier dysfunction, a chronic, superficial wound involving the upper epidermal layers. What does this study add? Psychological stressors impact epidermal barrier function by activating the hypothalamic-pituitary-adrenal axis to stimulate local and systemic stress hormone production. Stress hormones negatively affect the epidermal barrier by decreasing epidermal lipids and structural proteins, decreasing stratum corneum hydration and increasing transepidermal water loss. Identification of such stressors can promote stress-avoidance and stress-reduction behaviours that protect epidermal barrier function and prevent certain dermatological conditions.
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Affiliation(s)
- M Maarouf
- College of Medicine, University of Arizona, Tucson, AZ, U.S.A
| | - C L Maarouf
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, U.S.A
| | - G Yosipovitch
- Department of Dermatology and Cutaneous Surgery, University of Miami, Miami, FL, U.S.A
| | - V Y Shi
- Department of Medicine, Division of Dermatology, University of Arizona, Tucson, AZ, U.S.A
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23
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Yu S, Li Y, Zhou Y, Follansbee T, Hwang ST. Immune mediators and therapies for pruritus in atopic dermatitis and psoriasis. JOURNAL OF CUTANEOUS IMMUNOLOGY AND ALLERGY 2019. [DOI: 10.1002/cia2.12049] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Affiliation(s)
- Sebastian Yu
- Department of Dermatology; University of California Davis School of Medicine; Sacramento California
- Department of Dermatology; Kaohsiung Medical University Hospital; Kaohsiung Medical University; Kaohsiung Taiwan
- Department of Dermatology; College of Medicine; Kaohsiung Medical University; Kaohsiung Taiwan
| | - Yanxi Li
- Department of Dermatology; University of California Davis School of Medicine; Sacramento California
| | - Yan Zhou
- Department of Dermatology; University of California Davis School of Medicine; Sacramento California
| | - Taylor Follansbee
- Department of Neurobiology, Physiology and Behavior; University of California Davis; Davis California
| | - Samuel T. Hwang
- Department of Dermatology; University of California Davis School of Medicine; Sacramento California
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