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Soung J, Ständer S, Gutermuth J, Pau-Charles I, Dawson Z, Yang FE, Sun L, Pierce E, Elmaraghy H, Stein-Gold L. Lebrikizumab monotherapy impacts on quality of life scores through improved itch and sleep interference in two Phase 3 trials. J DERMATOL TREAT 2024; 35:2329240. [PMID: 38679419 DOI: 10.1080/09546634.2024.2329240] [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: 12/04/2023] [Accepted: 03/05/2024] [Indexed: 05/01/2024]
Abstract
BACKGROUND Lebrikizumab improved itch, interference of itch on sleep, and quality of life (QoL) in patients with moderate-to-severe atopic dermatitis (AD), in two Phase 3 trials at 16 weeks compared to placebo. OBJECTIVES We assess improvements in itch and sleep interference due to itch and their impact on QoL measurements after treatment. METHODS Data were analyzed from ADvocate1 (NCT04146363) and ADvocate2 (NCT04178967) in patients with moderate-to-severe AD. QoL was evaluated using Dermatology Life Quality Index (DLQI) at Week 16 in patients (>16 years of age) who were itch responders/non-responders (defined as ≥4-point improvement in Pruritus Numeric Rating Scale) or Sleep-Loss Scale responders/non-responders (defined as ≥2-point improvement in itch interference on sleep). RESULTS In ADvocate1 and ADvocate2, significantly greater proportions of itch responders had a clinically meaningful improvement in measures related to QoL (DLQI scores (0/1), ≤5 DLQI total score and ≥4-point DLQI improvement) compared to itch non-responders. In both studies, a significantly greater proportion of Sleep-Loss Scale responders, reported a DLQI score of (0/1), DLQI total score of ≤5 and DLQI improvement of ≥4 points compared to Sleep-Loss Scale non-responders. CONCLUSIONS Improvement in itch and sleep interference due to itch is associated with improvement in the QoL of patients after treatment with lebrikizumab for moderate-to-severe AD. ClinicalTrials.gov registration NCT04146363 (ADvocate1) and NCT04178967 (ADvocate2).
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Affiliation(s)
- Jennifer Soung
- Southern California Dermatology, Inc, Santa Ana, CA, USA
| | - Sonja Ständer
- University Hospital Westphalian Wilhems University, Munster, Germany
| | - Jan Gutermuth
- Department of Dermatology, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Jette, Belgium
| | | | - Zach Dawson
- Eli Lilly and Company, Indianapolis, IN, USA
| | | | - Luna Sun
- Eli Lilly and Company, Indianapolis, IN, USA
| | | | | | - Linda Stein-Gold
- Clinic for Dermatology, Henry Ford Health System, Detroit, MI, USA
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2
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Ferrucci SM, Tavecchio S, Nicolini G, Angileri L, Ceresa A, Del Tordello G, Berti E, Marzano AV, Buoli M. Mental health in patients affected by atopic dermatitis: which effects of treatment with dupilumab? Int Clin Psychopharmacol 2024; 39:201-205. [PMID: 37781860 DOI: 10.1097/yic.0000000000000511] [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: 10/03/2023]
Abstract
Atopic dermatitis (AD) is an inflammatory skin disease. Patients with AD are prone to develop anxiety and mood disorders. Aim of this study is to investigate if treatment with dupilumab may improve mental health status of patients affected by AD. A total of 66 patients with severe AD were included: 24 subjects were candidate or have just started (one month) treatment with dupilumab, and 42 have been in treatment for one year. 25.8%, 30.3%, and 45.5% of the total sample showed, respectively, clinically significant anxiety, depression, and symptoms of Internet addiction. Patients with anxiety symptoms resulted to have more severe AD, more sleep problems ( P = 0.028), less quality of life ( P = 0.001), more severe depressive symptoms ( P < 0.001), to be more frequently women ( P = 0.016), to be less frequently treated with dupilumab for one year ( P = 0.025). Similarly, patients with clinically significant depressive symptoms resulted to have more severe AD, more sleep problems ( P = 0.003), less quality of life ( P < 0.001), more severe anxiety symptoms ( P < 0.001), to be less frequently treated with dupilumab for one year ( P = 0.008). Patients with AD treated for one year with dupilumab showed a better mental health profile in terms of less severe anxiety and depression with respect to their counterparts.
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Affiliation(s)
| | - Simona Tavecchio
- Dermatology Section, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico
- Department of Pathophysiology and Transplantation, University of Milan
| | - Gregorio Nicolini
- Department of Mental Health, Department of Biomedical and Clinical Sciences Luigi Sacco, Luigi Sacco Hospital, University of Milan
| | - Luisa Angileri
- Dermatology Section, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico
| | - Alessandro Ceresa
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giulia Del Tordello
- Dermatology Section, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico
| | - Emilio Berti
- Dermatology Section, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico
- Department of Pathophysiology and Transplantation, University of Milan
| | - Angelo Valerio Marzano
- Dermatology Section, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico
- Department of Pathophysiology and Transplantation, University of Milan
| | - Massimiliano Buoli
- Department of Pathophysiology and Transplantation, University of Milan
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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Chong AC, Schwartz A, Lang J, Ong PY, Myles IA, Silverberg JI, Capozza K. Patients' and Caregivers' Preferences for Mental Health Care and Support in Atopic Dermatitis. Dermatitis 2024; 35:S70-S76. [PMID: 37579072 DOI: 10.1089/derm.2023.0111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/16/2023]
Abstract
Background: Atopic dermatitis (AD) has large mental health impacts for patients and caregivers, yet their preferences regarding how to relieve these impacts are poorly understood. Objective: To understand patients' and caregivers' preferences for AD-related mental health care and support. Methods: We surveyed 279 adult AD patients and 154 caregivers of children with AD across 26 countries regarding their AD-related mental health burden, preferred strategies for improving AD-related mental health, and experiences with mental health care in AD. Results: Caregivers reported significantly worse overall mental health (P = 0.01) and anxiety (P = 0.03) than adult patients when controlling for AD severity. Among adult patients, 58% selected treating the AD, 51% managing itch, 44% wearing clothing to cover up skin, 43% avoiding social situations, and 41% spending time alone, as strategies they felt would improve their own AD-related mental health. Caregivers selected managing itch and treating the AD most frequently for both their own (76% and 75%, respectively) and their children's (75% and 61%) mental health. Adult patients were less satisfied with mental health care from mental health providers versus nonmental health providers (P < 0.001). Conclusions: Effective AD management is the preferred method for improving mental health among patients as well as caregivers, who may experience the greatest mental health impacts. Self-care strategies should be considered in a shared decision-making approach.
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Affiliation(s)
- Albert C Chong
- From the Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Alan Schwartz
- Department of Medical Education and Department of Pediatrics, University of Illinois Chicago, Chicago, Illinois, USA
| | - Jessica Lang
- Global Parents for Eczema Research, Santa Barbara, California, USA
| | - Peck Y Ong
- Division of Clinical Immunology and Allergy, Department of Pediatrics, Children's Hospital Los Angeles, University of Southern California, Los Angeles, California, USA
| | - Ian A Myles
- Epithelial Therapeutics Unit, National Institute of Allergy and Infectious Disease, National Institutes of Health, Bethesda, Maryland, USA
| | - Jonathan I Silverberg
- School of Medicine and Health Sciences, George Washington University, Washington, District of Columbia, USA
| | - Korey Capozza
- Global Parents for Eczema Research, Santa Barbara, California, USA
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4
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Su J, Gu X, Li J, Tao J, Kang X, Wu B, Shan S, Ang X, Chen X, Xiao Y, Shen M. Atopic dermatitis is associated with abnormal stool form: a population-based cross-sectional study in college students. Arch Dermatol Res 2023; 315:2057-2064. [PMID: 36917250 DOI: 10.1007/s00403-023-02567-9] [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: 08/10/2022] [Revised: 11/28/2022] [Accepted: 02/01/2023] [Indexed: 03/16/2023]
Abstract
BACKGROUND Atopic dermatitis (AD) is a chronic inflammatory skin disorder. Bristol Stool Form Scale (BSFS) is a widely used stool scoring method that could indirectly reflect intestinal function. OBJECTIVES To evaluate the associations of AD with BSFS. METHODS This was a population-based cross-sectional study of freshmen in five universities of China. AD diagnosis was performed by dermatologists according to the guideline from the American Academy of Dermatology. BSFS and covariates were collected through an online questionnaire survey. Chronic itch scores were assessed by the numeric rating scales and grouped into quartiles (Q). Mixed logistic regression models were used. Subgroup analysis was conducted by covariates. P value < 0.05 was considered statistically significant. RESULTS The prevalence of hard stools and loose stools were 8.9% and 7.6%, respectively (20,049 participants). After adjusting covariates, AD was significantly associated with hard stools (OR = 1.38, P < 0.001) and loose stools (OR = 1.24, P = 0.037). In subgroup analysis of hard stool, a stronger effect was observed in intake of milk (> 3 days/week), yogurt (> 3 days/week), pork (< 1 day/week), and higher itch scores (Q4). CONCLUSION This study found the relationship between AD and abnormal stool forms, and the association with hard stools might be modified by dietary factor.
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Affiliation(s)
- Juan Su
- Department of Dermatology, Hunan Key Laboratory of Skin Cancer and Psoriasis, Hunan Engineering Research Center of Skin Health and Disease, Xiangya Hospital, Central South University, 110 Xiangya Road, Changsha, 410008, Hunan, China
- National Engineering Research Center of Personalized Diagnostic and Therapeutic Technology, Changsha, China
| | - Xiaoyu Gu
- Department of Dermatology, Hunan Key Laboratory of Skin Cancer and Psoriasis, Hunan Engineering Research Center of Skin Health and Disease, Xiangya Hospital, Central South University, 110 Xiangya Road, Changsha, 410008, Hunan, China
- National Engineering Research Center of Personalized Diagnostic and Therapeutic Technology, Changsha, China
| | - Ji Li
- Department of Dermatology, Hunan Key Laboratory of Skin Cancer and Psoriasis, Hunan Engineering Research Center of Skin Health and Disease, Xiangya Hospital, Central South University, 110 Xiangya Road, Changsha, 410008, Hunan, China
| | - Juan Tao
- Department of Dermatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaojing Kang
- Department of Dermatology, People's Hospital of Xinjiang Uygur Autonomous Region, Urumchi, Xinjiang, China
| | - Bin Wu
- Department of Dermatology, The Affiliated People's Hospital of Inner Mongolia Medical University, Hohhot, China
| | - Shijun Shan
- Department of Dermatology, Xiang'an Hospital, Xiamen University, Xiamen, China
| | - Xiaohui Ang
- Department of Dermatology, Zhongshan Hospital, Xiamen University, Xiamen, China
| | - Xiang Chen
- Department of Dermatology, Hunan Key Laboratory of Skin Cancer and Psoriasis, Hunan Engineering Research Center of Skin Health and Disease, Xiangya Hospital, Central South University, 110 Xiangya Road, Changsha, 410008, Hunan, China.
- National Engineering Research Center of Personalized Diagnostic and Therapeutic Technology, Changsha, China.
| | - Yi Xiao
- Department of Dermatology, Hunan Key Laboratory of Skin Cancer and Psoriasis, Hunan Engineering Research Center of Skin Health and Disease, Xiangya Hospital, Central South University, 110 Xiangya Road, Changsha, 410008, Hunan, China.
| | - Minxue Shen
- Department of Dermatology, Hunan Key Laboratory of Skin Cancer and Psoriasis, Hunan Engineering Research Center of Skin Health and Disease, Xiangya Hospital, Central South University, 110 Xiangya Road, Changsha, 410008, Hunan, China.
- National Engineering Research Center of Personalized Diagnostic and Therapeutic Technology, Changsha, China.
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China.
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Cortés H, Cariño-Calvo L, Reyes-Hernández OD, Rojas-Márquez M, Magaña JJ, Vizcaino-Dorado PA, Villegas-Vazquez EY, Quintas-Granados LI, Jiménez-Islas E, Cortés-Mollinedo VA, Leyva-Gómez G, González-Del Carmen M. High Levels of Anxiety, Depression, Risk of Suicide, and Implications for Treatment in Patients with Lamellar Ichthyosis. Healthcare (Basel) 2023; 11:2071. [PMID: 37510511 PMCID: PMC10380064 DOI: 10.3390/healthcare11142071] [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: 06/14/2023] [Revised: 07/18/2023] [Accepted: 07/18/2023] [Indexed: 07/30/2023] Open
Abstract
Lamellar ichthyosis (LI) is a genodermatosis that injures the structure and function of the skin, affecting the appearance and self-esteem of patients, which may seriously impair their mental health and quality of life. In the present study, we determined anxiety, depression, and suicidal risk levels in patients with LI through the Beck anxiety and depression inventories (BAI and DBI-II, respectively) and the SAD PERSONS scale (SPS). We observed that anxiety, depression, and suicidal ideation were strongly associated with the LI (Cramér's V = 0.429, 0.594, and 0.462, respectively). Furthermore, patients with LI showed a significant increase in the scores of anxiety, depression, and suicidal risk (p = 0.011, <0.001, and 0.001, respectively) compared to individuals without the disease. Additionally, the suicide risk increased even more in patients who presented comorbidity of anxiety and depression than in patients who presented only anxiety or depression (p = 0.02). Similarly, the increase in the BAI scores correlated with the score observed on the SPS. Our results indicate that patients with LI have higher levels of anxiety and depression compared to individuals without the disease, which could be associated with suicidal risk. Therefore, the collaborative involvement of skin and mental health professionals is necessary to manage patients with LI appropriately. We believe that psychiatric studies and individual evaluations must be performed in LI patients to determine a treatment that, in addition to reducing skin symptoms, focuses on reducing the levels of depression and anxiety and improving the quality of life to reduce the risk of suicide.
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Affiliation(s)
- Hernán Cortés
- Laboratorio de Medicina Genómica, Departamento de Genómica, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Ciudad de México 14389, Mexico
| | | | - Octavio D Reyes-Hernández
- Laboratorio de Biología Molecular del Cáncer, UMIEZ, FES Zaragoza, Universidad Nacional Autónoma de México, Ciudad de México 09230, Mexico
| | - Martín Rojas-Márquez
- Hospital Psiquiátrico Infantil Dr. Juan N. Navarro, Secretaría de Salud, Ciudad de México 14080, Mexico
| | - Jonathan J Magaña
- Laboratorio de Medicina Genómica, Departamento de Genómica, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Ciudad de México 14389, Mexico
| | - Pablo A Vizcaino-Dorado
- Laboratorio de Medicina Genómica, Departamento de Genómica, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Ciudad de México 14389, Mexico
| | - Edgar Y Villegas-Vazquez
- Laboratorio de Farmacogenética, UMIEZ, FES Zaragoza, Universidad Nacional Autónoma de México, Ciudad de México 09230, Mexico
| | | | - Elizabeth Jiménez-Islas
- Departamento de Farmacia, Facultad de Química, Universidad Nacional Autónoma de México, Ciudad de México 04510, Mexico
| | | | - Gerardo Leyva-Gómez
- Departamento de Farmacia, Facultad de Química, Universidad Nacional Autónoma de México, Ciudad de México 04510, Mexico
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6
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Hung WK, Tung TH, Wang TY, Liao SC, Chi CC. Risk for incident suicidality among psoriasis patients: a systematic review and meta-analysis. Arch Dermatol Res 2023; 315:455-465. [PMID: 35960352 DOI: 10.1007/s00403-022-02377-5] [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: 03/04/2022] [Revised: 06/11/2022] [Accepted: 08/01/2022] [Indexed: 11/02/2022]
Abstract
Previous meta-analyses have produced conflicting conclusions about suicidality risk among psoriasis patients. We aimed to update the evidence on the risk for the whole continuum of incident suicidality in psoriasis patients. We performed an update systematic review and meta-analysis and searched CENTRAL, PubMed, and Embase from January 1, 2017 to August 14, 2021 for relevant new cohort studies and incorporated new studies into our previous systematic review. Random-effects model meta-analysis was used to obtain pooled hazard ratio (HR) with 95% confidence interval (CI). Subgroup analysis was conducted according to age and disease severity. A total of 12 studies were included in this meta-analysis. We detected no significant differences in the risk for incident completed suicide (HR 1.33, 95% CI 0.91-1.95), suicide attempt (HR 1.22, 95% CI 0.96-1.56), suicidal behavior (HR 1.08, 95% CI 0.98-1.19), and suicide ideation (HR 1.74, 95% CI 0.99-3.06) between psoriasis patients and non-psoriatic controls. In the subgroup analysis based on age, an increased risk for incident suicide ideation was observed in pediatric subgroup (HR 1.50, 95% CI 1.12-2.03). The updated evidence suggests no increased risk for whole continuum of incident suicidality spectrum in psoriasis patients but an increased risk for incident suicide ideation among pediatric psoriasis patients. Involving mental health professionals may be crucial in psoriasis management especially in young patients.
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Affiliation(s)
- Wei-Kai Hung
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou, 5, Fuxing St, Guishan Dist, Taoyuan, 33305, Taiwan
| | - Tao-Hsin Tung
- Evidence-Based Medicine Center, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Zhejiang, China
| | - Tzu-Yu Wang
- Department of Dermatology, Far Eastern Memorial Hospital, New Taipei, Taiwan
- Department of Applied Cosmetology, Lee-Ming Institute of Technology, New Taipei, Taiwan
| | - Shih-Cheng Liao
- Department of Psychiatry, College of Medicine, National Taiwan University Hospital, Taipei, Taiwan
- Department of Psychiatry, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu, Taiwan
- Division of Psychosomatic Medicine, Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
| | - Ching-Chi Chi
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou, 5, Fuxing St, Guishan Dist, Taoyuan, 33305, Taiwan.
- College of Medicine, Chang Gung University, Taoyuan, Taiwan.
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7
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Silverberg JI, Guttman-Yassky E, Thaçi D, Irvine AD, Stein Gold L, Blauvelt A, Simpson EL, Chu CY, Liu Z, Gontijo Lima R, Pillai SG, Seneschal J. Two Phase 3 Trials of Lebrikizumab for Moderate-to-Severe Atopic Dermatitis. N Engl J Med 2023; 388:1080-1091. [PMID: 36920778 DOI: 10.1056/nejmoa2206714] [Citation(s) in RCA: 49] [Impact Index Per Article: 49.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
BACKGROUND Lebrikizumab, a high-affinity IgG4 monoclonal antibody targeting interleukin-13, prevents the formation of the interleukin-4Rα-interleukin-13Rα1 heterodimer receptor signaling complex. METHODS We conducted two identically designed, 52-week, randomized, double-blind, placebo-controlled, phase 3 trials; both trials included a 16-week induction period and a 36-week maintenance period. Eligible patients with moderate-to-severe atopic dermatitis (adults [≥18 years of age] and adolescents [12 to <18 years of age, weighing ≥40 kg]) were randomly assigned in a 2:1 ratio to receive either lebrikizumab at a dose of 250 mg (loading dose of 500 mg at baseline and week 2) or placebo, administered subcutaneously every 2 weeks. Outcomes for the induction period were assessed up to 16 weeks and are included in this report. The primary outcome was an Investigator's Global Assessment (IGA) score of 0 or 1 (indicating clear or almost clear skin; range, 0 to 4 [severe disease]) with a reduction (indicating improvement) of at least 2 points from baseline at week 16. Secondary outcomes included a 75% improvement in the Eczema Area and Severity Index score (EASI-75 response) and assessments of itch and of itch interference with sleep. Safety was also assessed. RESULTS In trial 1, the primary outcome was met in 43.1% of 283 patients in the lebrikizumab group and in 12.7% of 141 patients in the placebo group (P<0.001); an EASI-75 response occurred in 58.8% and 16.2%, respectively (P<0.001). In trial 2, the primary outcome was met in 33.2% of 281 patients in the lebrikizumab group and in 10.8% of 146 patients in the placebo group (P<0.001); an EASI-75 response occurred in 52.1% and 18.1%, respectively (P<0.001). Measures of itch and itch interference with sleep indicated improvement with lebrikizumab therapy. The incidence of conjunctivitis was higher among patients who received lebrikizumab than among those who received placebo. Most adverse events during the induction period were mild or moderate in severity and did not lead to trial discontinuation. CONCLUSIONS In the induction period of two phase 3 trials, 16 weeks of treatment with lebrikizumab was effective in adolescents and adults with moderate-to-severe atopic dermatitis. (Funded by Dermira; ADvocate1 and ADvocate2 ClinicalTrials.gov numbers, NCT04146363 and NCT04178967, respectively.).
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Affiliation(s)
- Jonathan I Silverberg
- From the Department of Dermatology, George Washington University School of Medicine and Health Sciences, Washington, DC (J.I.S.); the Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York (E.G.-Y.); the Institute and Comprehensive Center for Inflammation Medicine, University of Lübeck, Lübeck, Germany (D.T.); the Department of Clinical Medicine, Trinity College Dublin, Dublin (A.D.I.); Dermatology Clinical Research, Henry Ford Health System, Detroit (L.S.G.); Oregon Medical Research Center (A.B.), and the Department of Dermatology, Oregon Health and Science University (E.L.S.) - both in Portland; the Department of Dermatology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei (C.-Y.C.); Eli Lilly, Indianapolis (Z.L., R.G.L., S.G.P.); and the Department of Dermatology and Pediatric Dermatology, National Reference Center for Rare Skin Disorders, Hospital Saint-André, Bordeaux University, Centre National de la Recherche Scientifique, ImmunoConcept, Unité Mixte de Recherche 5164, Bordeaux, France (J.S.)
| | - Emma Guttman-Yassky
- From the Department of Dermatology, George Washington University School of Medicine and Health Sciences, Washington, DC (J.I.S.); the Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York (E.G.-Y.); the Institute and Comprehensive Center for Inflammation Medicine, University of Lübeck, Lübeck, Germany (D.T.); the Department of Clinical Medicine, Trinity College Dublin, Dublin (A.D.I.); Dermatology Clinical Research, Henry Ford Health System, Detroit (L.S.G.); Oregon Medical Research Center (A.B.), and the Department of Dermatology, Oregon Health and Science University (E.L.S.) - both in Portland; the Department of Dermatology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei (C.-Y.C.); Eli Lilly, Indianapolis (Z.L., R.G.L., S.G.P.); and the Department of Dermatology and Pediatric Dermatology, National Reference Center for Rare Skin Disorders, Hospital Saint-André, Bordeaux University, Centre National de la Recherche Scientifique, ImmunoConcept, Unité Mixte de Recherche 5164, Bordeaux, France (J.S.)
| | - Diamant Thaçi
- From the Department of Dermatology, George Washington University School of Medicine and Health Sciences, Washington, DC (J.I.S.); the Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York (E.G.-Y.); the Institute and Comprehensive Center for Inflammation Medicine, University of Lübeck, Lübeck, Germany (D.T.); the Department of Clinical Medicine, Trinity College Dublin, Dublin (A.D.I.); Dermatology Clinical Research, Henry Ford Health System, Detroit (L.S.G.); Oregon Medical Research Center (A.B.), and the Department of Dermatology, Oregon Health and Science University (E.L.S.) - both in Portland; the Department of Dermatology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei (C.-Y.C.); Eli Lilly, Indianapolis (Z.L., R.G.L., S.G.P.); and the Department of Dermatology and Pediatric Dermatology, National Reference Center for Rare Skin Disorders, Hospital Saint-André, Bordeaux University, Centre National de la Recherche Scientifique, ImmunoConcept, Unité Mixte de Recherche 5164, Bordeaux, France (J.S.)
| | - Alan D Irvine
- From the Department of Dermatology, George Washington University School of Medicine and Health Sciences, Washington, DC (J.I.S.); the Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York (E.G.-Y.); the Institute and Comprehensive Center for Inflammation Medicine, University of Lübeck, Lübeck, Germany (D.T.); the Department of Clinical Medicine, Trinity College Dublin, Dublin (A.D.I.); Dermatology Clinical Research, Henry Ford Health System, Detroit (L.S.G.); Oregon Medical Research Center (A.B.), and the Department of Dermatology, Oregon Health and Science University (E.L.S.) - both in Portland; the Department of Dermatology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei (C.-Y.C.); Eli Lilly, Indianapolis (Z.L., R.G.L., S.G.P.); and the Department of Dermatology and Pediatric Dermatology, National Reference Center for Rare Skin Disorders, Hospital Saint-André, Bordeaux University, Centre National de la Recherche Scientifique, ImmunoConcept, Unité Mixte de Recherche 5164, Bordeaux, France (J.S.)
| | - Linda Stein Gold
- From the Department of Dermatology, George Washington University School of Medicine and Health Sciences, Washington, DC (J.I.S.); the Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York (E.G.-Y.); the Institute and Comprehensive Center for Inflammation Medicine, University of Lübeck, Lübeck, Germany (D.T.); the Department of Clinical Medicine, Trinity College Dublin, Dublin (A.D.I.); Dermatology Clinical Research, Henry Ford Health System, Detroit (L.S.G.); Oregon Medical Research Center (A.B.), and the Department of Dermatology, Oregon Health and Science University (E.L.S.) - both in Portland; the Department of Dermatology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei (C.-Y.C.); Eli Lilly, Indianapolis (Z.L., R.G.L., S.G.P.); and the Department of Dermatology and Pediatric Dermatology, National Reference Center for Rare Skin Disorders, Hospital Saint-André, Bordeaux University, Centre National de la Recherche Scientifique, ImmunoConcept, Unité Mixte de Recherche 5164, Bordeaux, France (J.S.)
| | - Andrew Blauvelt
- From the Department of Dermatology, George Washington University School of Medicine and Health Sciences, Washington, DC (J.I.S.); the Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York (E.G.-Y.); the Institute and Comprehensive Center for Inflammation Medicine, University of Lübeck, Lübeck, Germany (D.T.); the Department of Clinical Medicine, Trinity College Dublin, Dublin (A.D.I.); Dermatology Clinical Research, Henry Ford Health System, Detroit (L.S.G.); Oregon Medical Research Center (A.B.), and the Department of Dermatology, Oregon Health and Science University (E.L.S.) - both in Portland; the Department of Dermatology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei (C.-Y.C.); Eli Lilly, Indianapolis (Z.L., R.G.L., S.G.P.); and the Department of Dermatology and Pediatric Dermatology, National Reference Center for Rare Skin Disorders, Hospital Saint-André, Bordeaux University, Centre National de la Recherche Scientifique, ImmunoConcept, Unité Mixte de Recherche 5164, Bordeaux, France (J.S.)
| | - Eric L Simpson
- From the Department of Dermatology, George Washington University School of Medicine and Health Sciences, Washington, DC (J.I.S.); the Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York (E.G.-Y.); the Institute and Comprehensive Center for Inflammation Medicine, University of Lübeck, Lübeck, Germany (D.T.); the Department of Clinical Medicine, Trinity College Dublin, Dublin (A.D.I.); Dermatology Clinical Research, Henry Ford Health System, Detroit (L.S.G.); Oregon Medical Research Center (A.B.), and the Department of Dermatology, Oregon Health and Science University (E.L.S.) - both in Portland; the Department of Dermatology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei (C.-Y.C.); Eli Lilly, Indianapolis (Z.L., R.G.L., S.G.P.); and the Department of Dermatology and Pediatric Dermatology, National Reference Center for Rare Skin Disorders, Hospital Saint-André, Bordeaux University, Centre National de la Recherche Scientifique, ImmunoConcept, Unité Mixte de Recherche 5164, Bordeaux, France (J.S.)
| | - Chia-Yu Chu
- From the Department of Dermatology, George Washington University School of Medicine and Health Sciences, Washington, DC (J.I.S.); the Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York (E.G.-Y.); the Institute and Comprehensive Center for Inflammation Medicine, University of Lübeck, Lübeck, Germany (D.T.); the Department of Clinical Medicine, Trinity College Dublin, Dublin (A.D.I.); Dermatology Clinical Research, Henry Ford Health System, Detroit (L.S.G.); Oregon Medical Research Center (A.B.), and the Department of Dermatology, Oregon Health and Science University (E.L.S.) - both in Portland; the Department of Dermatology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei (C.-Y.C.); Eli Lilly, Indianapolis (Z.L., R.G.L., S.G.P.); and the Department of Dermatology and Pediatric Dermatology, National Reference Center for Rare Skin Disorders, Hospital Saint-André, Bordeaux University, Centre National de la Recherche Scientifique, ImmunoConcept, Unité Mixte de Recherche 5164, Bordeaux, France (J.S.)
| | - Zhuqing Liu
- From the Department of Dermatology, George Washington University School of Medicine and Health Sciences, Washington, DC (J.I.S.); the Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York (E.G.-Y.); the Institute and Comprehensive Center for Inflammation Medicine, University of Lübeck, Lübeck, Germany (D.T.); the Department of Clinical Medicine, Trinity College Dublin, Dublin (A.D.I.); Dermatology Clinical Research, Henry Ford Health System, Detroit (L.S.G.); Oregon Medical Research Center (A.B.), and the Department of Dermatology, Oregon Health and Science University (E.L.S.) - both in Portland; the Department of Dermatology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei (C.-Y.C.); Eli Lilly, Indianapolis (Z.L., R.G.L., S.G.P.); and the Department of Dermatology and Pediatric Dermatology, National Reference Center for Rare Skin Disorders, Hospital Saint-André, Bordeaux University, Centre National de la Recherche Scientifique, ImmunoConcept, Unité Mixte de Recherche 5164, Bordeaux, France (J.S.)
| | - Renata Gontijo Lima
- From the Department of Dermatology, George Washington University School of Medicine and Health Sciences, Washington, DC (J.I.S.); the Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York (E.G.-Y.); the Institute and Comprehensive Center for Inflammation Medicine, University of Lübeck, Lübeck, Germany (D.T.); the Department of Clinical Medicine, Trinity College Dublin, Dublin (A.D.I.); Dermatology Clinical Research, Henry Ford Health System, Detroit (L.S.G.); Oregon Medical Research Center (A.B.), and the Department of Dermatology, Oregon Health and Science University (E.L.S.) - both in Portland; the Department of Dermatology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei (C.-Y.C.); Eli Lilly, Indianapolis (Z.L., R.G.L., S.G.P.); and the Department of Dermatology and Pediatric Dermatology, National Reference Center for Rare Skin Disorders, Hospital Saint-André, Bordeaux University, Centre National de la Recherche Scientifique, ImmunoConcept, Unité Mixte de Recherche 5164, Bordeaux, France (J.S.)
| | - Sreekumar G Pillai
- From the Department of Dermatology, George Washington University School of Medicine and Health Sciences, Washington, DC (J.I.S.); the Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York (E.G.-Y.); the Institute and Comprehensive Center for Inflammation Medicine, University of Lübeck, Lübeck, Germany (D.T.); the Department of Clinical Medicine, Trinity College Dublin, Dublin (A.D.I.); Dermatology Clinical Research, Henry Ford Health System, Detroit (L.S.G.); Oregon Medical Research Center (A.B.), and the Department of Dermatology, Oregon Health and Science University (E.L.S.) - both in Portland; the Department of Dermatology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei (C.-Y.C.); Eli Lilly, Indianapolis (Z.L., R.G.L., S.G.P.); and the Department of Dermatology and Pediatric Dermatology, National Reference Center for Rare Skin Disorders, Hospital Saint-André, Bordeaux University, Centre National de la Recherche Scientifique, ImmunoConcept, Unité Mixte de Recherche 5164, Bordeaux, France (J.S.)
| | - Julien Seneschal
- From the Department of Dermatology, George Washington University School of Medicine and Health Sciences, Washington, DC (J.I.S.); the Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York (E.G.-Y.); the Institute and Comprehensive Center for Inflammation Medicine, University of Lübeck, Lübeck, Germany (D.T.); the Department of Clinical Medicine, Trinity College Dublin, Dublin (A.D.I.); Dermatology Clinical Research, Henry Ford Health System, Detroit (L.S.G.); Oregon Medical Research Center (A.B.), and the Department of Dermatology, Oregon Health and Science University (E.L.S.) - both in Portland; the Department of Dermatology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei (C.-Y.C.); Eli Lilly, Indianapolis (Z.L., R.G.L., S.G.P.); and the Department of Dermatology and Pediatric Dermatology, National Reference Center for Rare Skin Disorders, Hospital Saint-André, Bordeaux University, Centre National de la Recherche Scientifique, ImmunoConcept, Unité Mixte de Recherche 5164, Bordeaux, France (J.S.)
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Reilev M, Jensen PB, Ranch LS, Egeberg A, Furu K, Gembert K, Hagg D, Haug U, Karlstad Ø, Reutfors J, Schäfer W, Schwartz S, Smits E, Holthius E, Herings R, Trifirò G, Kirchmayer U, Rosa AC, Belleudi V, Gini R, Støvring H, Hallas J. Methodology of the brodalumab assessment of hazards: a multicentre observational safety (BRAHMS) study. BMJ Open 2023; 13:e066057. [PMID: 36725094 PMCID: PMC9896233 DOI: 10.1136/bmjopen-2022-066057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
INTRODUCTION Safe and effective pharmacological treatment is of paramount importance for treating severe psoriasis. Brodalumab, a monoclonal antibody against interleukin (IL) 17 receptor A, was granted marketing authorisation in the EU in 2017. The European Medicines Agency requested a postauthorisation safety study of brodalumab to address potential safety issues raised during drug development regarding major adverse cardiovascular events, suicidal conduct, cancer and serious infections. METHODS AND ANALYSIS BRodalumab Assessment of Hazards: A Multinational Safety is a multicentre observational safety study of brodalumab running from 2017 to 2029 using population-based healthcare databases from Denmark, Sweden, Norway, Netherlands, Germany and three different centres in Italy. A distributed database network approach is used, such that only aggregate data are exchanged between sites.Two types of designs are used: a case-time-control design to study acute effects of transient treatment and a variation of the new user active comparator design to study the effects of transient or chronic treatment. As comparators, inhibitors of TNF-α, inhibitors of IL-12 and IL-23, and other inhibitors of cytokine IL-17A are included.In the self-controlled case-time-control design, the risk of developing the outcome of interest during periods of brodalumab use is compared within individuals to the risk in periods without use.In the active comparator cohort design, new users of brodalumab are identified and matched to new users of active comparators. Potential baseline confounders are adjusted for by using propensity score modelling. For outcomes that potentially require large cumulative exposure, an adapted active comparator design has been developed. ETHICS AND DISSEMINATION The study is approved by relevant authorities in Denmark, Norway, Sweden, the Netherlands, Germany and Italy in line with the relevant legislation at each site. Data confidentiality is secured by the distributed network approach. Results will be published in peer-reviewed journals. TRIAL REGISTRATION NUMBER EUPAS30280.
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Affiliation(s)
- Mette Reilev
- Clinical Pharmacology, Pharmacy and Environmental Medicine, University of Southern Denmark, Odense, Denmark
| | - Peter Bjødstrup Jensen
- Clinical Pharmacology, Pharmacy and Environmental Medicine, University of Southern Denmark, Odense, Denmark
| | - Lise Skov Ranch
- Biostatistics and Pharmacoepidemiology, LEO Pharma A/S, Ballerup, Denmark
| | - Alexander Egeberg
- Department of dermatology, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark
| | - Kari Furu
- Department of Chronic Diseases, Norwegian Institute of Public Helath, Oslo, Norway
| | - Karin Gembert
- Department of Medicine Solna, Centre for Pharmacoepidemiology, Karolinska Institute, Stockholm, Sweden
| | - David Hagg
- Department of Medicine Solna, Centre for Pharmacoepidemiology, Karolinska Institute, Stockholm, Sweden
| | - Ulrike Haug
- Clinical Epidemiology, Leibniz-Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany
- Faculty of Human and Health Science, University of Bremen, Bremen, Germany
| | - Øystein Karlstad
- Department of Chronic Diseases, Norwegian Institute of Public Helath, Oslo, Norway
| | - Johan Reutfors
- Department of Medicine Solna, Centre for Pharmacoepidemiology, Karolinska Institute, Stockholm, Sweden
| | - Wiebke Schäfer
- Clinical Epidemiology, Leibniz-Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany
| | - Sarina Schwartz
- Clinical Epidemiology, Leibniz-Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany
| | - Elisabeth Smits
- PHARMO Institute for Drug Outcomes Research, Utrecht, The Netherlands
| | - Emily Holthius
- PHARMO Institute for Drug Outcomes Research, Utrecht, The Netherlands
| | - Ron Herings
- PHARMO Institute for Drug Outcomes Research, Utrecht, The Netherlands
- Epidemiology and Data Science, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Gianluca Trifirò
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Ursula Kirchmayer
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | | | - Valeria Belleudi
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | - Rosa Gini
- Epidemiology Unit, Agenzia regionale di sanità della Toscana, Florence, Italy
| | - Henrik Støvring
- Clinical Pharmacology, Pharmacy and Environmental Medicine, University of Southern Denmark, Odense, Denmark
| | - Jesper Hallas
- Clinical Pharmacology, Pharmacy and Environmental Medicine, University of Southern Denmark, Odense, Denmark
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9
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Thyssen JP, Halling AS, Schmid-Grendelmeier P, Guttman-Yassky E, Silverberg JI. Comorbidities of atopic dermatitis-what does the evidence say? J Allergy Clin Immunol 2023; 151:1155-1162. [PMID: 36621338 DOI: 10.1016/j.jaci.2022.12.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 11/30/2022] [Accepted: 12/05/2022] [Indexed: 01/07/2023]
Abstract
Atopic dermatitis (AD) is a common disease that is associated with atopic and nonatopic comorbidities. There has been a growing interest in this area of AD, because presence or risk of comorbidities can in many ways impact the management of patients with AD. Thus, some treatments for AD may improve its comorbidities as well, whereas others may increase their risk. In this review article, we discuss various comorbidities of AD mostly on the basis of the results of recent multiple systematic reviews and meta-analyses to update readers about this rapidly developing area of dermatology. We emphasize the important information provided by studies presenting both relative risk and absolute risk, and show that AD is associated with, among others, atopic comorbidities such as asthma, rhinitis, and food allergy, nonatopic comorbidities such as ocular, psychiatric, infectious, endocrine, autoimmune, and cardiovascular diseases, and certain cancers. Clinicians need to be aware of these and be cognizant about positive and negative effects of existing and new treatments for AD.
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Affiliation(s)
- Jacob P Thyssen
- Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
| | - Anne-Sofie Halling
- Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
| | | | - Emma Guttman-Yassky
- Department of Dermatology and the Laboratory for Inflammatory Skin Diseases, Icahn School of Medicine at Mount Sinai, New York, NY
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10
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Wan J, Shin DB, Syed MN, Abuabara K, Lemeshow AR, Gelfand JM. Atopic dermatitis and risk of major neuropsychiatric disorders in children: A population-based cohort study. J Eur Acad Dermatol Venereol 2023; 37:114-122. [PMID: 36018560 PMCID: PMC9929490 DOI: 10.1111/jdv.18564] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 08/18/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Paediatric atopic dermatitis (AD) has been linked to neuropsychiatric comorbidities such as depression, anxiety and attention-deficit/hyperactivity disorder (ADHD). However, longitudinal data are limited, and the effect of AD severity on neuropsychiatric outcomes requires further characterization. OBJECTIVES To determine the risk of several major neuropsychiatric conditions in children with AD. METHODS We analysed UK health records data in a population-based cohort study. Each patient <18 years old with AD was matched to up to five unaffected patients on age, practice and index date. Treatments served as proxies for AD severity, which was analysed in a time-updated manner. Outcomes were incident anxiety, depression, bipolar disorder, schizophrenia, ADHD, autism, obsessive-compulsive disorder (OCD), suicidal ideation or attempt, and completed suicide. RESULTS A total of 409,431 children with AD (93.2% mild, 5.5% moderate, 1.3% severe) were compared to 1,809,029 children without AD. In Cox regression models adjusted for age, sex, socioeconomic status and other atopic comorbidities, no statistically significant relationships were observed between AD and incident anxiety (HR 1.01, 95% CI 0.99-1.03), ADHD (1.02, 0.97-1.06), autism (1.02, 0.98-1.06), bipolar disorder (1.08, 0.85-1.36), suicidal ideation/attempt (0.98, 0.95-1.01) or completed suicide (0.85, 0.64-1.14). Children with AD were less likely to develop depression (0.93, 0.91-0.95) or schizophrenia (0.72, 0.54-0.95) but more likely to develop OCD (1.26, 1.16-1.37). However, there was substantial variation by AD severity and age in both the direction and magnitude of effect for many of the neuropsychiatric conditions examined. CONCLUSIONS The was no substantial impact of AD on the overall risk of many neuropsychiatric conditions in children, but disease severity and age may be important modifying factors. Additional research is needed to further dissect the complex relationship between paediatric AD and neuropsychiatric comorbidities.
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Affiliation(s)
- Joy Wan
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Daniel B Shin
- Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Maha N Syed
- Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Katrina Abuabara
- Department of Dermatology, University of California San Francisco, San Francisco, California, USA
| | | | - Joel M Gelfand
- Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
- Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
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11
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Balato A, Zink A, Babino G, Buononato D, Kiani C, Eyerich K, Ziehfreund S, Scala E. The Impact of Psoriasis and Atopic Dermatitis on Quality of Life: A Literature Research on Biomarkers. LIFE (BASEL, SWITZERLAND) 2022; 12:life12122026. [PMID: 36556392 PMCID: PMC9782020 DOI: 10.3390/life12122026] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 11/23/2022] [Accepted: 12/01/2022] [Indexed: 12/12/2022]
Abstract
Psoriasis (PSO) and Atopic dermatitis (AD) are common inflammatory skin diseases that affect people of all ages globally. They negatively impact the quality of life (QoL) of patients in health-related aspects such as physical, psychological and mental functioning. Here, we conducted a review of studies relating to candidate biomarkers and indicators associated with QoL impairment in PSO and AD. Data research was performed using PUBMED and SCOPUS databases from inception to September 2022. Most of the included studies reported genomic or proteomic biomarkers associated with disease activity and QoL outcomes. Sociodemographic, clinical and therapeutic factors have also been implicated in deterioration of life quality in these patients. The inclusion of clinical characteristics, QoL impairment and co-diagnosis should be considered in drug development programs, since processing biomarkers based on an increased number of features in addition to drug class and disease will intensify the value of the biomarker itself, thereby maximizing the future clinical utility as a stratification tool.
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Affiliation(s)
- Anna Balato
- Dermatology Unit, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy
| | - Alexander Zink
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, 80802 Munich, Germany
- Unit of Dermatology, Karolinska University Hospital, 17176 Stockholm, Sweden
| | - Graziella Babino
- Dermatology Unit, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy
| | - Dario Buononato
- Dermatology Unit, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy
| | - Charlotte Kiani
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, 80802 Munich, Germany
| | - Kilian Eyerich
- Unit of Dermatology, Karolinska University Hospital, 17176 Stockholm, Sweden
- Department of Dermatology and Venereology, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, 79104 Freiburg, Germany
- Division of Dermatology and Venereology, Department of Medicine Solna, Center for Molecular Medicine, Karolinska Institutet, 17176 Stockholm, Sweden
| | - Stefanie Ziehfreund
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, 80802 Munich, Germany
| | - Emanuele Scala
- Department of Dermatology and Venereology, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, 79104 Freiburg, Germany
- Division of Dermatology and Venereology, Department of Medicine Solna, Center for Molecular Medicine, Karolinska Institutet, 17176 Stockholm, Sweden
- Correspondence:
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12
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Tong N, Zhang Y, Yang A, Dai X, Hao S. The potency of common proinflammatory cytokines measurement for revealing the risk and severity of anxiety and depression in psoriasis patients. J Clin Lab Anal 2022; 36:e24643. [PMID: 35944185 PMCID: PMC9459285 DOI: 10.1002/jcla.24643] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 07/21/2022] [Accepted: 07/25/2022] [Indexed: 11/17/2022] Open
Abstract
Objective Proinflammatory cytokines mediate anxiety and depression in various ways, such as immunity, inflammation, and the hypothalamic–pituitary–adrenal axis. This study intended to further explore the linkage of common proinflammatory cytokine levels with anxiety and depression in psoriasis patients. Methods Totally, 150 psoriasis patients and 50 healthy controls (HCs) were included; the serum samples were collected, then common proinflammatory cytokines were measured by ELISA. Hospital Anxiety and Depression Scale (HADS) was assessed. Results HADS‐anxiety (HADS‐A) score, HADS‐depression (HADS‐D) score, TNF‐α, IL‐1β, IL‐6, IL‐12, IL‐17A, and IL‐23 were all increased in psoriasis patients compared to HCs (all p < 0.05). In psoriasis patients, TNF‐α (p = 0.001), IL‐12 (p = 0.035), and IL‐17A (p < 0.001), but not IL‐1β (p = 0.255), IL‐6 (p = 0.248), and IL‐23 (p = 0.216), were positively linked to HADS‐A score. Meanwhile, TNF‐α (p = 0.007) and IL‐17A (p = 0.007) were enhanced in psoriasis patients with anxiety in contrast to those without anxiety; whereas IL‐1β (p = 0.178), IL‐6 (p = 0.360), IL‐12 (p = 0.239), and IL‐23 (p = 0.450) were not different. TNF‐α (p < 0.001), IL‐1β (p = 0.013), Il‐17A (p < 0.001), and IL‐23 (p = 0.023), but not IL‐6 (p = 0.143) and IL‐12 (p = 0.158), were positively linked to HADS‐D score. Concurrently, TNF‐α (p = 0.015), IL‐17A (p < 0.001), and IL‐23 (p = 0.017) were climbed in psoriasis patients with depression by comparison to those without depression; whereas IL‐1β (p = 0.113), IL‐6 (p = 0.237), IL‐12 (p = 0.660) did not differ. Conclusion TNF‐α, IL‐17A, and IL‐23 increments reflect anabatic anxiety and depression in psoriasis patients, uncovering the potency of proinflammatory cytokines measurement for monitoring or even preventing psoriasis patients' anxiety and depression.
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Affiliation(s)
- Nannan Tong
- Department of Dermatology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Yu Zhang
- Department of Dermatology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Anping Yang
- Department of Dermatology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Xiaoli Dai
- Department of Dermatology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Siyu Hao
- Department of Dermatology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China.,Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
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13
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Bu J, Ding R, Zhou L, Chen X, Shen E. Epidemiology of Psoriasis and Comorbid Diseases: A Narrative Review. Front Immunol 2022; 13:880201. [PMID: 35757712 PMCID: PMC9226890 DOI: 10.3389/fimmu.2022.880201] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 04/28/2022] [Indexed: 11/18/2022] Open
Abstract
Psoriasis is a chronic autoimmune inflammatory disease that remains active for a long period, even for life in most patients. The impact of psoriasis on health is not only limited to the skin, but also influences multiple systems of the body, even mental health. With the increasing of literature on the association between psoriasis and extracutaneous systems, a better understanding of psoriasis as an autoimmune disease with systemic inflammation is created. Except for cardiometabolic diseases, gastrointestinal diseases, chronic kidney diseases, malignancy, and infections that have received much attention, the association between psoriasis and more systemic diseases, including the skin system, reproductive system, and oral and ocular systems has also been revealed, and mental health diseases draw more attention not just because of the negative mental and mood influence caused by skin lesions, but a common immune-inflammatory mechanism identified of the two systemic diseases. This review summarizes the epidemiological evidence supporting the association between psoriasis and important and/or newly reported systemic diseases in the past 5 years, and may help to comprehensively recognize the comorbidity burden related to psoriasis, further to improve the management of people with psoriasis.
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Affiliation(s)
- Jin Bu
- Hospital for Skin Disease (Institute of Dermatology), Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
| | - Ruilian Ding
- Hospital for Skin Disease (Institute of Dermatology), Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
| | - Liangjia Zhou
- Hospital for Skin Disease (Institute of Dermatology), Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
| | - Xiangming Chen
- Sino-French Hoffmann Institute, School of Basic Medicine, The Second Affiliated Hospital, Guangzhou Medical University, Guangzhou, China
| | - Erxia Shen
- Sino-French Hoffmann Institute, School of Basic Medicine, The Second Affiliated Hospital, Guangzhou Medical University, Guangzhou, China
- The State Key Laboratory of Respiratory Disease, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China
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Scala E, Kaczmarczyk R, Zink A, Balato A, Amerio P, Argenziano G, Babino G, Bardazzi F, Bianchi L, Caldarola G, Campanati A, Chiricozzi A, Conti A, Damiani G, Dapavo P, De Simone C, Esposito M, Fabbrocini G, Fargnoli MC, Ferrara F, Fidanza R, Gualdi G, Guarneri C, Hansel K, Malagoli P, Malara G, Megna M, Micali G, Mugheddu C, Musumeci ML, Odorici G, Offidani A, Papaianni V, Pescitelli L, Prignano F, Raimondo A, Ribero S, Rongioletti F, Stingeni L, Trifirò C, Zanframundo S. Sociodemographic, clinical and therapeutic factors as predictors of life quality impairment in psoriasis: a cross‐sectional study in Italy. Dermatol Ther 2022; 35:e15622. [DOI: 10.1111/dth.15622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 04/25/2022] [Accepted: 06/03/2022] [Indexed: 12/01/2022]
Affiliation(s)
- Emanuele Scala
- Division of Dermatology and Venereology, Department of Medicine Solna, and Center for Molecular Medicine Karolinska Institutet Stockholm Sweden
| | - Robert Kaczmarczyk
- Technical University of Munich, School of Medicine, Department of Dermatology and Allergy Munich Germany
| | - Alexander Zink
- Technical University of Munich, School of Medicine, Department of Dermatology and Allergy Munich Germany
- Dermatology and Venerology Unit, Department of Medicine Solna Karolinska University Hospital Stockholm Sweden
| | - Anna Balato
- Dermatology Unit University of Campania “Luigi Vanvitelli” Naples Italy
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von Spreckelsen R, Gerdes S, Mrowietz U, Emmert H. Zugang und Inanspruchnahme psychosomatischer Versorgung aus ärztlicher Sicht: Eine qualitative Interviewstudie. AKTUELLE DERMATOLOGIE 2022. [DOI: 10.1055/a-1754-4332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Zusammenfassung
Hintergrund Chronisch entzündliche Hauterkrankungen sind häufig mit psychosozialen Beeinträchtigungen und einer reduzierten Lebensqualität vergesellschaftet. Ziel dieser Studie war es zu erfassen, wie spezialisiertes medizinisches Personal eines universitären Haut-Entzündungszentrums die Zugangswege und die Inanspruchnahme psychosomatischer Sondierungsgespräche oder Kurzzeitinterventionen bei PatientInnen mit chronisch entzündlichen Hauterkrankungen wahrnimmt.
Methoden Es wurden qualitative Erhebungen in Form von 10 Einzelinterviews mit medizinischem Personal durchgeführt, das zum Zeitpunkt der Befragung im Zentrum für entzündliche Hauterkrankungen der Uni-Hautklinik tätig war. Die Daten wurden inhaltsanalytisch mithilfe einer qualitativen Analysesoftware ausgewertet.
Ergebnisse Die Ergebnisse aus den geführten Einzelinterviews ergaben, dass die Einbindung einer psychosomatischen Versorgung innerhalb eines dermatologischen Entzündungszentrums vom ärztlichen Personal als durchweg positiv bewertet wurde. Die Option auf ein zeit- und zentrumsnahes Gesprächsangebot nimmt dabei eine besondere Rolle ein. Experten fühlen sich mit der ortsnahen Einbindung psychosomatischer Expertise sicherer im Umgang mit belasteten Patient*innen. Der holistische Ansatz scheint einen positiven Einfluss auf die individuelle Behandlung und die Beziehungsgestaltung mit den Patient*innen zu nehmen. Dabei zeigten sich keine wesentlichen Unterschiede im Geschlecht und über verschiedene Altersgruppen hinweg.
Diskussion Die Möglichkeit zur zentrumsnahen Anbindung von belasteten Patient*innen in Form von zusätzlichen psychosomatischen Sondierungsgesprächen wie auch dem Einsatz von adaptierten Kurzzeitinterventionen trägt zur holistischen Behandlung bei, scheint einen günstigen Einfluss auf den somatischen Behandlungsverlauf zu nehmen und unterstützt Ärzt*innen in ihrer Behandlung.
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Affiliation(s)
- Regina von Spreckelsen
- Zentrum für entzündliche Hauterkrankungen, Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Schleswig-Holstein (UKSH), Campus Kiel, Kiel
- Klinik für Psychotherapie und Psychosomatik, Universitätsklinikum Schleswig-Holstein (UKSH), Campus Kiel, Kiel
| | - Sascha Gerdes
- Zentrum für entzündliche Hauterkrankungen, Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Schleswig-Holstein (UKSH), Campus Kiel, Kiel
| | - Ulrich Mrowietz
- Zentrum für entzündliche Hauterkrankungen, Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Schleswig-Holstein (UKSH), Campus Kiel, Kiel
| | - Hila Emmert
- Zentrum für entzündliche Hauterkrankungen, Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Schleswig-Holstein (UKSH), Campus Kiel, Kiel
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16
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Zheng BW, Wang BY, Xiao WL, Sun YJ, Yang C, Zhao BT. Different molecular weight hyaluronic acid alleviates inflammation response in DNFB-induced mice atopic dermatitis and LPS-induced RAW 264.7 cells. Life Sci 2022; 301:120591. [PMID: 35513086 DOI: 10.1016/j.lfs.2022.120591] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 04/18/2022] [Accepted: 04/26/2022] [Indexed: 12/16/2022]
Abstract
AIMS Atopic dermatitis (AD) is an inflammatory chronic disease which severely interferes the life of patients. Hence, there is a great need for new therapies. Hyaluronic acid (HA) is an effective potential inflammation modifier; however, there is limited information about their implementation in inflammation therapies. This study aimed to evaluate the anti-inflammatory activities of HA and the influence of its molecular weight. MAIN METHODS Male C57BL/6 J mice were stimulated by 2,4-dinitrofluorobenzene to induce AD-like symptoms and immune response. The skin lesions and histopathological change, as well as levels of inflammatory factors were evaluated. RAW 264.7 mouse macrophages were treated with lipopolysaccharides (LPS) to induce inflammation. NO, IL-6, and TNF-α levels were detected through ELISA kits. KEY FINDINGS DNFB challenge induced mice AD symptoms including epidermal thickening, mast cell infiltration, Th2/Th1 immune response, skin lesions IL-4 and IFN-γ, and serum IgE elevation. HA treatment ameliorated such symptoms through the inhibition of PI3K/Akt signaling pathway. LPS induction stimulated the secretion of NO, IL-6, and TNF-α in RAW 264.7 cells, while HA pre-treatment reduced the concentration of the cytokines in cell supernatants. SIGNIFICANCE These findings give clear insight into the interaction between HA and inflammatory response, which can help guiding the utilization of HA in the AD therapies.
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Affiliation(s)
- Bo Wen Zheng
- Key Laboratory of Synthetic and Biological Colloids, Ministry of Education, School of Chemical and Material Engineering, Jiangnan University, Wuxi 214122, PR China; International Joint Research Center for Photo-responsive Molecules and Materials, School of Chemical and Material Engineering, Jiangnan University, Wuxi 214122, PR China
| | - Bin Ya Wang
- Key Laboratory of Synthetic and Biological Colloids, Ministry of Education, School of Chemical and Material Engineering, Jiangnan University, Wuxi 214122, PR China; International Joint Research Center for Photo-responsive Molecules and Materials, School of Chemical and Material Engineering, Jiangnan University, Wuxi 214122, PR China
| | - Wan Ling Xiao
- Key Laboratory of Synthetic and Biological Colloids, Ministry of Education, School of Chemical and Material Engineering, Jiangnan University, Wuxi 214122, PR China; International Joint Research Center for Photo-responsive Molecules and Materials, School of Chemical and Material Engineering, Jiangnan University, Wuxi 214122, PR China
| | - Ya Juan Sun
- Key Laboratory of Synthetic and Biological Colloids, Ministry of Education, School of Chemical and Material Engineering, Jiangnan University, Wuxi 214122, PR China; International Joint Research Center for Photo-responsive Molecules and Materials, School of Chemical and Material Engineering, Jiangnan University, Wuxi 214122, PR China
| | - Cheng Yang
- Key Laboratory of Synthetic and Biological Colloids, Ministry of Education, School of Chemical and Material Engineering, Jiangnan University, Wuxi 214122, PR China; International Joint Research Center for Photo-responsive Molecules and Materials, School of Chemical and Material Engineering, Jiangnan University, Wuxi 214122, PR China
| | - Bing Tian Zhao
- Key Laboratory of Synthetic and Biological Colloids, Ministry of Education, School of Chemical and Material Engineering, Jiangnan University, Wuxi 214122, PR China; International Joint Research Center for Photo-responsive Molecules and Materials, School of Chemical and Material Engineering, Jiangnan University, Wuxi 214122, PR China.
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17
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Fiedorowicz JG. Journal of psychosomatic research 2021 year in review. J Psychosom Res 2022; 153:110720. [PMID: 35051875 DOI: 10.1016/j.jpsychores.2022.110720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Jess G Fiedorowicz
- University of Ottawa, The Ottawa Hospital, Ottawa Hospital Research Institute, University of Ottawa Brain & Mind Research Institute, Canada.
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18
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Lada G, Chinoy H, Heal C, Warren RB, Talbot PS, Kleyn CE. Depression and suicidality in patients with psoriasis and the role of psoriatic arthritis; a cross-sectional study in a tertiary setting. J Acad Consult Liaison Psychiatry 2022; 63:372-383. [PMID: 35017124 DOI: 10.1016/j.jaclp.2021.12.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 12/20/2021] [Accepted: 12/28/2021] [Indexed: 12/25/2022]
Abstract
BACKGROUND Depression is overrepresented in psoriasis. However, it is not clear whether the presence of psoriatic arthritis (PsA) independently increases patients' depressive burden. Furthermore, current evidence regarding suicidality risk of psoriasis populations is conflicting and the role of PsA on suicidality outcomes in psoriasis is unknown. OBJECTIVES (i) To test whether PsA is associated with depression and lifetime suicidal ideation among patients with psoriasis; (ii) to capture different suicidal phenomena in these patients; and (iii) to investigate whether suicidality and depressive symptom severity are associated with clinical markers of psoriasis severity and chronicity. METHODS A cross-sectional survey of tertiary patients (n=219, aged 18-65 years) with dermatologist-confirmed chronic plaque psoriasis, of whom 84 had rheumatologist-confirmed PsA, was undertaken. The Hospital Anxiety and Depression Scale and Sheehan-Suicidality Tracking Scale were used to assess depression and lifetime suicidality respectively. RESULTS PsA presence was associated with depression in patients with psoriasis, independently of other physical comorbidities (adjusted Odds Ratio 2.92, 95% Confidence Interval 1.53-5.68). Furthermore, patients with PsA experienced significantly higher levels of anhedonia and anxiety, after controlling for psychiatric history. 48.8% of all participants reported lifetime suicidal ideation with or without intent; 21.3% reported suicidal planning and 9.4% suicide attempts. Lifetime suicidality prevalence did not differ between patients with and without PsA. Depressive symptom severity and lifetime suicidality scores were not associated with objective measures of psoriasis severity or treatment group. CONCLUSION These data suggest that joint involvement in psoriasis is associated with higher depressive burden. There is a need for routine depression screening among patients with psoriasis, in particular when PsA is present. Anhedonia appears to be a particularly relevant symptom in the depression phenotype of this population. We did not find a statistically significant association between PsA and suicidality. Nevertheless, suicidality rates in tertiary patients with psoriasis appear to be higher than in the general population. Suicidality monitoring is recommended to help in reducing future psychiatric morbidity and mortality in patients with psoriasis.
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Affiliation(s)
- Georgia Lada
- Dermatology Centre, Salford Royal NHS Foundation Trust, National Institute for Health Research Manchester Biomedical Research Centre, The University of Manchester, M6 8HD, UK; Division of Neuroscience and Experimental Psychology, Faculty of Biology, Medicine and Health, The University of Manchester, M13 9PL, UK.
| | - Hector Chinoy
- National Institute for Health Research Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, The University of Manchester, Manchester, UK
| | - Calvin Heal
- Centre for Biostatistics, School of Health Sciences, University of Manchester, Manchester, UK
| | - Richard B Warren
- Dermatology Centre, Salford Royal NHS Foundation Trust, National Institute for Health Research Manchester Biomedical Research Centre, The University of Manchester, M6 8HD, UK
| | - Peter S Talbot
- Division of Neuroscience and Experimental Psychology, Faculty of Biology, Medicine and Health, The University of Manchester, M13 9PL, UK; Greater Manchester Mental Health NHS Foundation Trust, Manchester UK
| | - C Elise Kleyn
- Dermatology Centre, Salford Royal NHS Foundation Trust, National Institute for Health Research Manchester Biomedical Research Centre, The University of Manchester, M6 8HD, UK
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19
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A Bibliometric Analysis of Atopic Dermatitis Research over the Past Three Decades and Future Perspectives. Healthcare (Basel) 2021; 9:healthcare9121749. [PMID: 34946474 PMCID: PMC8702046 DOI: 10.3390/healthcare9121749] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 12/10/2021] [Accepted: 12/14/2021] [Indexed: 12/24/2022] Open
Abstract
Atopic dermatitis (AD) has been increasing in prevalence over the past few decades; however, AD has never been analyzed using a bibliometric approach. We searched for AD studies in the dermatology and allergy category of the Web of Science and SCOPUS databases using the keywords "atopic dermatitis", "eczema", and "atopy". In total, 53,460 documents were retrieved. We analyzed annual publication trends and performed keyword and co-authorship network analyses. The annual number of AD publications has increased over the years. Asthma, food allergies, the skin barrier, IgE, and epidemiology have received extensive attention. The keywords 'allergic rhinitis', 'child(ren)', 'quality of life', and 'probiotics' have become more commonly used in recent years. AD research has been led by only a few countries, such as the USA, Germany, and the UK, and longstanding research topics such as asthma, allergy, and the immune system continue to be important. We suggest that global collaborations, research in developing countries, and research that is more holistic (thus exploring how genes, the immune system, the environment, and the microbiome together impact AD) are necessary.
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20
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Ferrucci SM, Tavecchio S, Angileri L, Surace T, Berti E, Buoli M. Factors Associated with Affective Symptoms and Quality of Life in Patients with Atopic Dermatitis. Acta Derm Venereol 2021; 101:adv00590. [PMID: 34518893 PMCID: PMC9455335 DOI: 10.2340/00015555-3922] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
The aim of this study was to detect demographic and clinical factors associated with affective symptoms and quality of life in patients with severe atopic dermatitis. First, one-way analyses of variance and correlations were performed to compare a large set of qualitative and quantitative clinical variables. Three final multivariable regression models were performed, with depression/anxiety subscales and Dermatology Life Quality Index scores as dependent variables, and the factors that were statistically significant on univariate analyses as independent ones. More severe anxiety symptoms and poorer quality of life (p < 0.01) were significantly associated with more severe depressive symptoms. Female sex and disturbed sleep (p = 0.03) were significantly associated with more severe anxiety. Finally, previous treatment with cyclosporine (p = 0.03) or methotrexate (p = 0.04), more severe depressive symptoms (p < 0.01), itch (p = 0.03), impaired sleep (p < 0.01) and perceived severity of dermatological illness (p < 0.01) were significant predictors of low quality of life. This study shows a complex interplay between the severity of atopic dermatitis, poor quality of life and presence of clinically relevant affective symptoms. These results will help dermatologists to identify patients who need psychiatric consultation within the framework of a multidisciplinary approach.
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Affiliation(s)
| | | | | | | | | | - Massimiliano Buoli
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, IT-20122, Milan, Italy.
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21
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Alenius H, Sinkko H, Moitinho-Silva L, Rodriguez E, Broderick C, Alexander H, Reiger M, Hjort Hjelmsø M, Fyhrquist N, Olah P, Bryce P, Smith C, Koning F, Eyerich K, Greco D, van den Bogaard EH, Neumann AU, Traidl-Hoffmann C, Homey B, Flohr C, Bønnelykke K, Stokholm J, Weidinger S. The power and potential of BIOMAP to elucidate host-microbiome interplay in skin inflammatory diseases. Exp Dermatol 2021; 30:1517-1531. [PMID: 34387406 DOI: 10.1111/exd.14446] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 07/02/2021] [Accepted: 08/02/2021] [Indexed: 11/27/2022]
Abstract
The two most common chronic inflammatory skin diseases are atopic dermatitis (AD) and psoriasis. The underpinnings of the remarkable degree of clinical heterogeneity of AD and psoriasis are poorly understood and, as a consequence, disease onset and progression are unpredictable and the optimal type and time-point for intervention are as yet unknown. The BIOMAP project is the first IMI (Innovative Medicines Initiative) project dedicated to investigating the causes and mechanisms of AD and psoriasis and to identify potential biomarkers responsible for the variation in disease outcome. The consortium includes 7 large pharmaceutical companies and 25 non-industry partners including academia. Since there is mounting evidence supporting an important role for microbial exposures and our microbiota as factors mediating immune polarization and AD and psoriasis pathogenesis, an entire work package is dedicated to the investigation of skin and gut microbiome linked to AD or psoriasis. The large collaborative BIOMAP project will enable the integration of patient cohorts, data and knowledge in unprecedented proportions. The project has a unique opportunity with a potential to bridge and fill the gaps between current problems and solutions. This review highlights the power and potential of BIOMAP project in the investigation of microbe-host interplay in AD and psoriasis.
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Affiliation(s)
- Harri Alenius
- Institute of Environmental Medicine, Karolinska Institutet, Box 210, 171 77, Stockholm, Sweden.,Human Microbiome Research Program (HUMI), Faculty of Medicine, University of Helsinki, Finland
| | - Hanna Sinkko
- Institute of Environmental Medicine, Karolinska Institutet, Box 210, 171 77, Stockholm, Sweden.,Human Microbiome Research Program (HUMI), Faculty of Medicine, University of Helsinki, Finland
| | - Lucas Moitinho-Silva
- Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany.,Institute of Clinical Molecular Biology, Kiel University, Kiel, Germany
| | - Elke Rodriguez
- Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Conor Broderick
- Unit for Population-Based Dermatology Research, St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust and King's College London, London, UK
| | - Helen Alexander
- Unit for Population-Based Dermatology Research, St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust and King's College London, London, UK
| | - Matthias Reiger
- Department of Environmental Medicine, Faculty of Medicine, University of Augsburg, Augsburg, Germany.,Institute of Environmental Medicine, Helmholtz Zentrum München, Augsburg, Germany.,Chair of Environmental Medicine, Technical University Munich, Munich, Germany
| | - Mathis Hjort Hjelmsø
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Nanna Fyhrquist
- Institute of Environmental Medicine, Karolinska Institutet, Box 210, 171 77, Stockholm, Sweden
| | - Peter Olah
- Department of Dermatology, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany.,Department of Dermatology, Venereology and Oncodermatology, Medical Faculty, University of Pécs, Hungary
| | - Paul Bryce
- Type 2 Inflammation & Fibrosis Cluster, Immunology & Inflammation Therapeutic Area, Sanofi US, Cambridge, MA, United States of America
| | - Catherine Smith
- St John's Institute of Dermatology, Kings College London, and Guys and St Thomas' NHS Foundation Trust, 9th Floor, Tower Wing, Guy's Hospital, Great Maze Pond, London, SE1 9RT, UK
| | - Frits Koning
- Department of Immunology, Leiden University Medical Centre (LUMC), Leiden, the Netherlands
| | - Kilian Eyerich
- Department of Medicine, Karolinska Institutet, Solna, Sweden
| | - Dario Greco
- Institute of Biotechnology, Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland.,Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Ellen H van den Bogaard
- Department of Dermatology, Radboud university medical center, Radboud Institute for Molecular Life Sciences, Nijmegen, The Netherlands
| | - Avidan U Neumann
- Department of Environmental Medicine, Faculty of Medicine, University of Augsburg, Augsburg, Germany.,Institute of Environmental Medicine, Helmholtz Zentrum München, Augsburg, Germany
| | - Claudia Traidl-Hoffmann
- Department of Environmental Medicine, Faculty of Medicine, University of Augsburg, Augsburg, Germany.,Institute of Environmental Medicine, Helmholtz Zentrum München, Augsburg, Germany.,Chair of Environmental Medicine, Technical University Munich, Munich, Germany.,CK CARE, Christine Kühne Center for Allergy Research and Education, Davos, Switzerland.,ZIEL - Institute for Food & Health, Technical University of Munich, Freising-Weihenstephan, Germany
| | - Bernhard Homey
- Department of Dermatology, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Carsten Flohr
- Unit for Population-Based Dermatology Research, St John's Institute of Dermatology, School of Basic and Medical Biosciences, King's College London, London, United Kingdom
| | - Klaus Bønnelykke
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Jakob Stokholm
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark.,Department of Food Science, University of Copenhagen, Frederiksberg, Denmark
| | - Stephan Weidinger
- Department of Dermatology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
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