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Johansen CB, Egeberg A, Jimenez-Solem E, Skov L, Thomsen SF. Psoriasis and adverse pregnancy outcomes: A nationwide case-control study in 491,274 women in Denmark. JAAD Int 2022; 7:146-155. [PMID: 35497641 PMCID: PMC9043664 DOI: 10.1016/j.jdin.2022.03.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/01/2022] [Indexed: 01/04/2023] Open
Abstract
Background The chronic systemic inflammation associated with psoriasis supposedly creates an undesirable milieu for a pregnancy, resulting in an increased risk of adverse pregnancy outcomes (APOs). Objective To investigate the association between psoriasis and APOs as well as how the association differs according to psoriasis severity (mild and moderate-to-severe). Methods This nationwide register-based case-control study collected data from 1973 to 2017. Cases were APOs (spontaneous abortion, ectopic pregnancy [EP], intrauterine fetal death, and stillbirth). Singleton live births were controls. Adjusted logistic regression models were used for statistical analyses. Results In total, 42,041 (8.56%) APOs and 449,233 (91.44%) controls were included. EP was the only APO that was found to be statistically associated with psoriasis (odds ratio, 1.34; 95% CI, 1.06-1.68). Odds ratio for EP was the highest for women with moderate-to-severe psoriasis (odds ratio, 2.77; 95% CI, 1.13-6.76). The absolute risk of EP was 2.48% higher for women with moderate-to-severe psoriasis compared with women without psoriasis (3.98% vs 1.50%). Limitations No access to clinical data confirming psoriasis severity. Conclusion The present study found a significant association between EP and psoriasis (absolute risk of 3.98%). As EP is the leading cause of maternal morbidity and mortality in the first trimester of pregnancy, our findings call for particular care for women of reproductive age with psoriasis.
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Affiliation(s)
- Cæcilie Bachdal Johansen
- Department of Dermatology and Venereology, Bispebjerg And Frederiksberg Hospital, Copenhagen, Denmark
- Department of Clinical Pharmacology, Bispebjerg And Frederiksberg Hospital, Copenhagen, Denmark
- Correspondence to: Cæcilie Bachdal Johansen, MD, Department of Dermatology and Venereology, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Bispebjerg Bakke 23, Copenhagen NV DK-2400, Denmark.
| | - Alexander Egeberg
- Department of Dermatology and Venereology, Bispebjerg And Frederiksberg Hospital, Copenhagen, Denmark
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, Copenhagen, Denmark
| | - Espen Jimenez-Solem
- Department of Clinical Pharmacology, Bispebjerg And Frederiksberg Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Copenhagen Phase IV Unit (Phase4CPH), Department of Clinical Pharmacology and Center for Clinical Research and Prevention, Bispebjerg And Frederiksberg Hospital, Copenhagen, Denmark
| | - Lone Skov
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Simon Francis Thomsen
- Department of Dermatology and Venereology, Bispebjerg And Frederiksberg Hospital, Copenhagen, Denmark
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
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Arnone M, Takahashi MDF, Carvalho AVED, Bernardo WM, Bressan AL, Ramos AMC, Terena AC, Souza CDS, Nunes DH, Bortoletto MCDC, Oliveira MDFSPD, Neffá JM, Fieri LC, Azulay-Abulafia L, Felix PAO, Magalhaes RF, Romiti R, Jaime TJ. Diagnostic and therapeutic guidelines for plaque psoriasis - Brazilian Society of Dermatology. An Bras Dermatol 2019; 94:76-107. [PMID: 31166402 PMCID: PMC6544036 DOI: 10.1590/abd1806-4841.2019940211] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 01/28/2019] [Indexed: 02/07/2023] Open
Abstract
Psoriasis is a chronic inflammatory disease that affects 1.3% of the Brazilian
population. The most common clinical manifestations are erythematous, scaling
lesions that affect both genders and can occur on any anatomical site,
preferentially involving the knees, elbows, scalp and genitals. Besides the
impact on the quality of life, the systemic nature of the disease makes
psoriasis an independent risk factor for cardiovascular disease, especially in
young patients with severe disease. By an initiative of the Brazilian Society of
Dermatology, dermatologists with renowned clinical experience in the management
of psoriasis were invited to form a work group that, in a partnership with the
Brazilian Medical Association, dedicated themselves to create the Plaque
Psoriasis Diagnostic and Treatment Guidelines. The relevant issues for the
diagnosis (evaluation of severity and comorbidities) and treatment of plaque
psoriasis were defined. The issues generated a search strategy in the
Medline-PubMed database up to July 2018. Subsequently, the answers to the
questions of the recommendations were devised, and each reference selected
presented the respective level of recommendation and strength of scientific
evidence. The final recommendations for making up the final text were worded by
the coordinators.
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Affiliation(s)
- Marcelo Arnone
- Hospital das Clínicas, School of Medicine, Universidade de São Paulo, São Paulo, SP, Brazil
| | | | | | - Wanderley Marques Bernardo
- Center of Development of Medical Education, School of Medicine, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Aline Lopes Bressan
- Service of Dermatology, Hospital Universitário Pedro Ernesto, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Andrea Machado Coelho Ramos
- Service of Dermatology, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | | | - Cacilda da Silva Souza
- Department of Internal Medicine, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Daniel Holthausen Nunes
- Service of Dermatology, Hospital Universitário, Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil
| | | | | | - Jane Marcy Neffá
- Department of Medicine, Dermatology Clinic, Universidade Federal Fluminense, Niterói, RJ, Brazil
| | | | - Luna Azulay-Abulafia
- Faculty of Medical Sciences, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | | | - Renata Ferreira Magalhaes
- Department of Internal Medicine, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brazil
| | - Ricardo Romiti
- Hospital das Clínicas, School of Medicine, Universidade de São Paulo, São Paulo, SP, Brazil
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Suuberg A. Psychiatric and Developmental Effects of Isotretinoin (Retinoid) Treatment for Acne Vulgaris. CURRENT THERAPEUTIC RESEARCH 2019; 90:27-31. [PMID: 30828405 PMCID: PMC6383167 DOI: 10.1016/j.curtheres.2019.01.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/10/2018] [Accepted: 01/29/2019] [Indexed: 12/22/2022]
Abstract
BACKGROUND An association between isotretinoin (13-cis-retinoic acid, sold under trade names including Accutane [Hoffmann-La Roche Inc, Basel, Switzerland]) and birth defects, depression, and suicide is well documented but controversial. A link to psychosis and exacerbation of bipolar symptoms is less extensively addressed in the literature. OBJECTIVE Given recent conceptualization of psychotic disorders as neurodevelopmental, and current interest in possible shared etiology of different neurodevelopmental disorders such as psychosis, autism, and intellectual disability, this review concurrently examines the literature on developmental (primarily teratogenic) and psychiatric side effects of isotretinoin exposure. The goal of concurrent review is to identify shared mechanisms in the literature that may inform future efforts to clarify the neurocognitive and psychiatric effects of isotretinoin exposure at different developmental stages or given different genetic backgrounds. METHODS Literature was obtained by PubMed search for the term isotretinoin in combination with each of the terms psychosis, psychiatric, and teratogenic. Resulting articles met inclusion criteria for review if they addressed psychiatric side effects of isotretinoin treatment or the neurobehavioral teratology of isotretinoin. RESULTS The association of isotretinoin exposure with prenatal developmental toxicity is well established. Although numerous reports also link isotretinoin treatment with psychiatric side effects, this association remains controversial. CONCLUSIONS The extent to which isotretinoin influences pediatric and adult development and cognition, and whether and why certain individuals may be susceptible to psychiatric side effects, remains to be clarified. Curr Ther Res Clin Exp. 2019; 80:XXX-XXX).
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Stefanovic S, Zaffran S. Mechanisms of retinoic acid signaling during cardiogenesis. Mech Dev 2016; 143:9-19. [PMID: 28007475 DOI: 10.1016/j.mod.2016.12.002] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2016] [Revised: 11/29/2016] [Accepted: 12/12/2016] [Indexed: 10/20/2022]
Abstract
Substantial experimental and epidemiological data have highlighted the interplay between nutritional and genetic factors in the development of congenital heart defects. Retinoic acid (RA), a derivative of vitamin A, plays a key role during vertebrate development including the formation of the heart. Retinoids bind to RA and retinoid X receptors (RARs and RXRs) which then regulate tissue-specific genes. Here, we will focus on the roles of RA signaling and receptors in gene regulation during cardiogenesis, and the consequence of deregulated retinoid signaling on heart formation and congenital heart defects.
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Abstract
INTRODUCTION Sjögren-Larsson syndrome (SLS) is a rare neurocutaneous disease characterized by ichthyosis, spasticity, intellectual disability and a distinctive retinopathy. It is caused by inactivating mutations in ALDH3A2, which codes for fatty aldehyde dehydrogenase (FALDH) and results in abnormal metabolism of long-chain aliphatic aldehydes and alcohols. The potential disease mechanisms leading to symptoms include 1) accumulation of toxic fatty aldehydes that form covalent adducts with lipids and membrane proteins; 2) physical disruption of multi-lamellar membranes in skin and brain; 3) abnormal activation of the JNK cell signaling pathway; and 4) defective farnesol metabolism resulting in abnormal PPAR-α dependent gene expression. Currently, no effective pathogenesis-based therapy is available. AREAS COVERED The clinical, pathologic and genetic features of SLS are summarized. The biochemical abnormalities caused by deficient activity of FALDH are reviewed in the context of proposed pathogenic mechanisms and potential therapeutic interventions. EXPERT OPINION The most promising pharmacologic approach to SLS involves blocking the formation of potentially harmful fatty aldehyde adducts using aldehyde scavenging drugs, currently in phase 2 clinical trials. Other approaches needing further investigation include: 1) ALDH-specific activator drugs and PPAR-α agonists to increase mutant FALDH activity; 2) inhibitors of the JNK phosphorylation cascade; 3) antioxidants to decrease aldehyde load; 4) dietary lipid modification; and 5) gene therapy.
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Affiliation(s)
- William B Rizzo
- Department of Pediatrics, University of Nebraska Medical Center, Omaha, NE, USA
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Affiliation(s)
- Pengxiang Huang
- Metabolic Signaling and Disease Program, Sanford-Burnham Medical Research Institute, Orlando, FL 32827, USA
| | - Vikas Chandra
- Metabolic Signaling and Disease Program, Sanford-Burnham Medical Research Institute, Orlando, FL 32827, USA
| | - Fraydoon Rastinejad
- Metabolic Signaling and Disease Program, Sanford-Burnham Medical Research Institute, Orlando, FL 32827, USA
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Rouzès A, Jonville-Béra AP. Isotrétinoïne et grossesse : bilan français de 25 années de suivi. Therapie 2014; 69:53-63. [DOI: 10.2515/therapie/2014008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2013] [Accepted: 11/18/2013] [Indexed: 11/20/2022]
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Levenson D. Genetic modifier to chromatin may contribute to 22q11 deletion/VCF/DiGeorge syndrome variability: MOZ gene may also exacerbate effects of retinoic acid in genetic disorder. Am J Med Genet A 2012; 158A:vii-viii. [PMID: 23174944 DOI: 10.1002/ajmg.a.35798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Gómez E, Caamaño JN, Rodríguez A, De Frutos C, Facal N, Díez C. Bovine Early Embryonic Development and Vitamin A. Reprod Domest Anim 2006; 41 Suppl 2:63-71. [PMID: 16984470 DOI: 10.1111/j.1439-0531.2006.00770.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Vitamin A and its derivatives, collectively termed as retinoids, have been paid attention in recent years because of their effects in bovine reproduction. However, the role of retinoids in the pre-implantation period continues to be largely unexplored, in contrast to later stages of development. Retinoids control cell growth, differentiation and death through binding to specific nuclear receptors by retinoic acid and other active metabolites. This paper reviews how retinoids can influence early embryonic development in cattle through their influence on the follicle, the extrafollicular oocyte and the pre-implantation embryo itself.
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Affiliation(s)
- E Gómez
- Servicio Regional de Investigación y Desarrollo Agroalimentario, (SERIDA), Area de Genética y Reproducción, SERIDA, Asturias, Spain.
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De Santis M, Carducci B, Cavaliere AF, De Santis L, Straface G, Caruso A. Drug-induced congenital defects: strategies to reduce the incidence. Drug Saf 2002; 24:889-901. [PMID: 11735646 DOI: 10.2165/00002018-200124120-00003] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Approximately 1% of congenital anomalies relate to pharmacological exposure and are. in theory, preventable. Prevention consists of controlled administration of drugs known to have teratogenic properties (e.g. retinoids, thalidomide). When possible, prevention could take the form of the use of alternative pharmacological therapies during the pre-conception period for certain specific pathologies, selecting the most appropriate agent for use during pregnancy [e.g. haloperidol or a tricyclic antidepressant instead of lithium; anticonvulsant drug monotherapy in place of multitherapy; propylthiouracil instead of thiamazole (methimazole)], and substitution with the most suitable therapy during pregnancy (e.g. insulin in place of oral antidiabetics; heparin in place of oral anticoagulants; alpha-methyldopa instead of ACE inhibitors). Another strategy is the administration of drugs during pregnancy taking into account the pharmacological effects in relation to the gestation period (e.g. avoidance of chemotherapy during the first trimester, avoidance of nonsteroidal anti-inflammatory drugs in the third trimester, and avoidance of high doses of benzodiazepines in the period imminent to prepartum).
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Affiliation(s)
- M De Santis
- Department of Obstetrics and Gynaecology, Catholic University of Sacred Heart, Rome, Italy.
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Dos Santos AM, Vaillant C, Pedespan JM, Fontan D, Guillard JM. [Teratogenicity of isotretinoin]. Arch Pediatr 1998; 5:1046-7. [PMID: 9789644 DOI: 10.1016/s0929-693x(98)80112-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
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