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Obi A, Rothenberg-Lausell C, Levit S, Del Duca E, Guttman-Yassky E. Proteomic alterations in patients with atopic dermatitis. Expert Rev Proteomics 2024:1-11. [PMID: 38753434 DOI: 10.1080/14789450.2024.2350938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 03/31/2024] [Indexed: 05/18/2024]
Abstract
INTRODUCTION Atopic Dermatitis (AD) is the most common inflammatory skin disease with a complex and multifactorial pathogenesis. The use of proteomics in understanding AD has yielded the discovery of novel biomarkers and may further expand therapeutic options. AREAS COVERED This review summarizes the most recent proteomic studies and the methodologies used in AD. It describes novel biomarkers that may monitor disease course and therapeutic response. The review also highlights skin and blood biomarkers characterizing different AD phenotypes and differentiates AD from other inflammatory skin disorders. A literature search was conducted by querying Scopus, Google Scholar, Pubmed/Medline, and Clinicaltrials.gov up to June 2023. EXPERT OPINION The integration of proteomics into research efforts in atopic dermatitis has broadened our understanding of the molecular profile of AD through the discovery of new biomarkers. In addition, proteomics may contribute to the development of targeted treatments ultimately improving personalized medicine. An increasing number of studies are utilizing proteomics to explore this heterogeneous disease.
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Affiliation(s)
- Ashley Obi
- Department of Dermatology and Laboratory of Inflammatory Skin Diseases, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Camille Rothenberg-Lausell
- Department of Dermatology and Laboratory of Inflammatory Skin Diseases, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Sophia Levit
- Department of Dermatology and Laboratory of Inflammatory Skin Diseases, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ester Del Duca
- Department of Dermatology and Laboratory of Inflammatory Skin Diseases, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Emma Guttman-Yassky
- Department of Dermatology and Laboratory of Inflammatory Skin Diseases, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Li CY, Chang WC, Chen MH, Tu PC, Chen TL, Chen CC, Chang YT, Chen YY, Bai YM. Correlation of Disease Severity, Proinflammatory Cytokines, and Reduced Brain Gray Matter Volumes in Patients with Atopic Dermatitis. Dermatitis 2024. [PMID: 38634841 DOI: 10.1089/derm.2023.0340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2024]
Abstract
Background: Atopic dermatitis (AD) is a chronic inflammatory skin disease. However, few studies have investigated brain changes associated with chronic inflammation. We hypothesized that chronic inflammation might be related to brain structural alterations in patients with AD. Objectives: To investigate the association between disease severity (Eczema Area and Severity Index [EASI]), proinflammatory cytokines, and differences in brain gray matter (GM) volume in patients with AD. Methods: Nineteen patients with AD and 19 age- and sex-matched healthy subjects were enrolled. All participants underwent clinical assessment and brain magnetic resonance imaging. Voxel-based morphometry was performed to analyze GM volume differences. Results: Patients with AD exhibited significantly decreased GM volume in many brain regions, such as bilateral precentral gyrus, right frontal pole, and right middle temporal gyrus (P < 0.001), compared with healthy subjects. Notably, in patients with AD, the GM volume in right middle temporal gyrus was negatively associated with both EASI score and proinflammatory cytokines (sIL-2R [soluble interleukin 2 receptor] and TNF-α receptor-1), whereas the GM volume in left precentral gyrus was negatively associated with both EASI score and proinflammatory cytokines (sIL-2R and CRP). Conclusion: Patients with AD demonstrated significant brain GM volume reduction in many brain regions, which is related to disease severity and proinflammatory cytokines.
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Affiliation(s)
- Cheng-Yuan Li
- From the Department of Dermatology, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Dermatology, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Wan-Chen Chang
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Biomedical Engineering, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Mu-Hong Chen
- Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Pei-Chi Tu
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan
- Institute of Philosophy of Mind and Cognition, National Yang-Ming University, Taipei, Taiwan
| | - Tai-Li Chen
- From the Department of Dermatology, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Dermatology, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Chih-Chiang Chen
- From the Department of Dermatology, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Dermatology, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yun-Ting Chang
- From the Department of Dermatology, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Dermatology, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - You-Yin Chen
- Department of Biomedical Engineering, National Yang Ming Chiao Tung University, Taipei, Taiwan
- The Ph.D. Program for Neural Regenerative Medicine, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
| | - Ya-Mei Bai
- Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
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Kim JH, Lee E, Ha EK, Shin J, Lee GC, Rha YH, Han MY. Cascade of atopic dermatitis comorbidities in children after birth for 15 years. Allergy 2024; 79:153-163. [PMID: 37843069 DOI: 10.1111/all.15917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 09/07/2023] [Accepted: 09/16/2023] [Indexed: 10/17/2023]
Abstract
BACKGROUND Individuals with atopic dermatitis often develop other conditions. OBJECTIVE This study aimed to determine how atopic dermatitis comorbidities develop in children over time. METHODS This population-based administrative cohort study used national health insurance data. We traced individuals born in Korea between 2002 and 2003 to 2018. The date of initial atopic dermatitis diagnosis was set as the index date. Fifty-three childhood comorbidities of atopic dermatitis were identified as outcomes of interest by performing a comprehensive literature search and comparing the prevalence of diagnostic codes in children with and without atopic dermatitis. Four control children per individual in the atopic dermatitis group were randomly matched based on sex and index date. The association between atopic dermatitis and the development of each specified disease was assessed using proportional hazard assumption, followed by mapping of the temporal sequences of interconnected comorbidities. RESULTS The atopic dermatitis and control groups contained 67,632 and 270,528 individuals, respectively. The median age at the index date was 10 months, whereas the median follow-up period was 15 years. Twenty diseases that were associated with a higher risk of atopic dermatitis were identified and a chain of interconnected conditions created. The progression began in childhood with febrile seizures, constipation, and asthma, and was later associated with the emergence of food allergy, allergic rhinitis, psychiatric disorders, and autoimmune diseases. CONCLUSION Our study highlights the temporal nature of atopic dermatitis comorbidities in children, and indicates that an understanding of the comorbidities may inform its clinical management and treatment.
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Affiliation(s)
- Ju Hee Kim
- Department of Pediatrics, Kyung Hee University School of Medicine, Seoul, Korea
| | - Eun Lee
- Department of Pediatrics, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Eun Kyo Ha
- Department of Pediatrics, Kangnam Sacred Heart Hospital, Seoul, Korea
| | - Jeewon Shin
- Department of Pediatrics, Bundang CHA Medical Center, CHA University School of Medicine, Seongnam, Korea
| | - Gi Chun Lee
- Department of Computer Science and Engineering, Konkuk University, Seoul, Korea
| | - Yeong Ho Rha
- Department of Pediatrics, Kyung Hee University School of Medicine, Seoul, Korea
| | - Man Yong Han
- Department of Pediatrics, Bundang CHA Medical Center, CHA University School of Medicine, Seongnam, Korea
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Li B, Fuxench ZC. Atopic Dermatitis: Disease Background and Risk Factors. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2024; 1447:11-19. [PMID: 38724780 DOI: 10.1007/978-3-031-54513-9_2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2024]
Abstract
Multiple risk factors have been associated with the development of atopic dermatitis (AD). Recent advances in understanding the role of genetics in this disease have been made, with discovery of the filaggrin (FLG) gene as the most notable so far. In addition to FLG gene mutations as a risk factor for AD, a positive family history of atopic or allergic disease in either parent has been shown to confer a greater risk of developing AD. Atopic dermatitis usually presents early in life and is thought to represent the initial step in the "atopic march," which is characterized by the development of other atopic diseases later in life such as asthma, allergic rhinitis, and/or rhinoconjunctivitis, food allergies, and hay fever. Other comorbid diseases that have been associated with AD include increase risk of viral and bacterial skin infections, neuropsychiatric diseases such as attention-deficit hyperactivity disorders (ADHD), and autistic spectrum disorder (ASD). Patients with AD have also been found to have worse sleep quality overall compared to patients without AD. In this chapter, we will discuss the risk factors associated with development of atopic dermatitis as well as the most commonly reported comorbidities in patients with this disease.
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Affiliation(s)
- Becky Li
- Department of Dermatology, Howard University School of Medicine, Washington, DC, USA
| | - Zelma Chiesa Fuxench
- Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
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Man MQ, Yang S, Mauro TM, Zhang G, Zhu T. Link between the skin and autism spectrum disorder. Front Psychiatry 2023; 14:1265472. [PMID: 37920540 PMCID: PMC10619695 DOI: 10.3389/fpsyt.2023.1265472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Accepted: 09/28/2023] [Indexed: 11/04/2023] Open
Abstract
Autism spectrum disorder (ASD) is a common neurological disorder. Although the etiologies of ASD have been widely speculated, evidence also supports the pathogenic role of cutaneous inflammation in autism. The prevalence of ASD is higher in individuals with inflammatory dermatoses than in those without inflammatory diseases. Anti-inflammation therapy alleviates symptoms of ASD. Recent studies suggest a link between epidermal dysfunction and ASD. In the murine model, mice with ASD display epidermal dysfunction, accompanied by increased expression levels of proinflammatory cytokines in both the skin and the brain. Children with ASD, which develops in their early lifetime, also exhibit altered epidermal function. Interestingly, improvement in epidermal function alleviates some symptoms of ASD. This line of evidence suggests a pathogenic role of cutaneous dysfunction in ASD. Either an improvement in epidermal function or effective treatment of inflammatory dermatoses can be an alternative approach to the management of ASD. We summarize here the current evidence of the association between the skin and ASD.
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Affiliation(s)
- Mao-Qiang Man
- Dermatology Hospital, Southern Medical University, Guangzhou, China
- Department of Dermatology, University of California, San Francisco, CA, United States
- Dermatology Service, San Francisco VA Medical Center,San Francisco, CA, United States
| | - Shuyun Yang
- Department of Dermatology, The People’s Hospital of Baoshan, Baoshan, China
| | - Theodora M. Mauro
- Department of Dermatology, University of California, San Francisco, CA, United States
- Dermatology Service, San Francisco VA Medical Center,San Francisco, CA, United States
| | - Guoqiang Zhang
- Department of Dermatology, The First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Tingting Zhu
- Department of Dermatology, The First Affiliated Hospital of Soochow University, Suzhou, China
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Del Duca E, Renert-Yuval Y, Pavel AB, Mikhaylov D, Wu J, Lefferdink R, Fang M, Sheth A, Blumstein A, Facheris P, Estrada YD, Rangel SM, Krueger JG, Paller AS, Guttman-Yassky E. Proteomic characterization of atopic dermatitis blood from infancy to adulthood. J Am Acad Dermatol 2023; 88:1083-1093. [PMID: 36773824 PMCID: PMC10231669 DOI: 10.1016/j.jaad.2022.12.050] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 10/10/2022] [Accepted: 12/11/2022] [Indexed: 02/12/2023]
Abstract
BACKGROUND Patients with atopic dermatitis (AD) have systemic biomarker dysregulation that differs by age group; however, the proteomic characteristics of these age-based changes are unknown. OBJECTIVE To profile blood proteins of patients with AD across different age groups versus age-appropriate controls. METHODS Using the Olink high-throughput proteomic platform, we profiled 375 serum proteins of 20 infants (age, 0-5 years), 39 children (age, 6-11 years), 21 adolescents (age, 12-17 years), and 20 adults (age, ≥18 years) with moderate-to-severe AD and 83 age-appropriate controls. RESULTS Each group presented a distinct systemic proteomic signature. Th2-related proteins were increased in infant AD and further intensified with age through adolescence and adulthood (interleukin 4/CCL13/CCL17). In contrast, Th1 axis down-regulation was detected in infants with AD and gradually reversed to increased Th1 products (interferon γ/CXCL9/CXCL10/CCL2) in patients with AD from childhood to adulthood. Despite their short disease duration, infants already had evidence of systemic inflammation, with significant upregulation of innate immunity (interleukin 17C/ interleukin-1RN), T-cell activation/migration (CCL19), Th2 (CCL13/CCL17), and Th17 (PI3) proteins. Adults with AD present unique upregulation of cardiovascular proteins related to coagulation and diabetes. LIMITATIONS Cross-sectional observational study with a single time point. CONCLUSION Systemic immune signatures of AD are age-specific beyond the shared Th2 immune activation. These data advocate for precision medicine approaches based on age-specific AD profiles.
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Affiliation(s)
- Ester Del Duca
- Department of Dermatology and Laboratory of Inflammatory Skin Diseases, Icahn School of Medicine at Mount Sinai, New York; Department of Dermatology, University of Magna Graecia, Catanzaro, Italy
| | - Yael Renert-Yuval
- Laboratory for Investigative Dermatology, the Rockefeller University, New York, New York
| | - Ana B Pavel
- Department of Dermatology and Laboratory of Inflammatory Skin Diseases, Icahn School of Medicine at Mount Sinai, New York; Department of Biomedical Engineering, University of Mississippi, University, Mississippi
| | - Daniela Mikhaylov
- Department of Dermatology and Laboratory of Inflammatory Skin Diseases, Icahn School of Medicine at Mount Sinai, New York
| | - Jianni Wu
- Department of Dermatology and Laboratory of Inflammatory Skin Diseases, Icahn School of Medicine at Mount Sinai, New York
| | - Rachel Lefferdink
- Department of Dermatology and Paediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Milie Fang
- Department of Dermatology and Paediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Anjani Sheth
- Department of Dermatology and Paediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Alli Blumstein
- Department of Dermatology and Paediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Paola Facheris
- Department of Dermatology and Laboratory of Inflammatory Skin Diseases, Icahn School of Medicine at Mount Sinai, New York; Department of Biomedical Science, Humanitas University, Pieve Emanuele, Italy
| | - Yeriel D Estrada
- Department of Dermatology and Laboratory of Inflammatory Skin Diseases, Icahn School of Medicine at Mount Sinai, New York
| | - Stephanie M Rangel
- Department of Dermatology and Paediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - James G Krueger
- Laboratory for Investigative Dermatology, the Rockefeller University, New York, New York
| | - Amy S Paller
- Department of Dermatology and Paediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
| | - Emma Guttman-Yassky
- Department of Dermatology and Laboratory of Inflammatory Skin Diseases, Icahn School of Medicine at Mount Sinai, New York; Laboratory for Investigative Dermatology, the Rockefeller University, New York, New York.
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Tsai SJ, Hsu JW, Huang KL, Bai YM, Su TP, Chen TJ, Chen MH. Autism spectrum disorder and periodontitis risk: A cohort study of 38,203 adolescents. J Am Dent Assoc 2023; 154:479-485. [PMID: 37097276 DOI: 10.1016/j.adaj.2023.02.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 02/24/2023] [Accepted: 02/27/2023] [Indexed: 04/26/2023]
Abstract
BACKGROUND People with autism spectrum disorder (ASD) may have poor oral health status because they often experience challenges with daily oral hygiene and have inadequate access to oral health care services. This study explored periodontitis risk in adolescents with ASD compared with those who did not have a diagnosis of ASD. METHODS Data from 2001 through December 31, 2011 from the Taiwan National Health Insurance Research Database on 3,473 adolescents with ASD and 34,730 age- and sex-matched people who did not have a diagnosis of ASD were obtained, and subsequent periodontitis was identified from enrollment through December 31, 2011. RESULTS Adolescents with ASD (hazard ratio, 2.01; 95% CI, 1.84 to 2.20) were more likely to develop periodontitis at follow-up than those who did not have a diagnosis of ASD. Findings remained consistent in subanalyses stratified by sex and intellectual disability. People with ASD had periodontitis onset at an earlier mean (SD) age than those who did not have a diagnosis of ASD (17.97 [3.12] vs 21.86 [2.28] years; P < .001). CONCLUSIONS ASD is an independent risk factor for subsequent periodontitis development. PRACTICAL IMPLICATIONS Oral health should be closely monitored in adolescents with ASD. Future investigation of the common pathogenesis between periodontitis and ASD is warranted.
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Abstract
INTRODUCTION The relationship between atopic dermatitis and atopic diseases such as food allergies, asthma, and allergic rhinitis in terms of co-occurrence, underlying mechanisms, and therapy is well documented. There is increasing evidence that atopic dermatitis is associated with non-atopic comorbidities such as cardiac, autoimmune, and neuropsychological comorbidities, as well as cutaneous and extracutaneous infections, establishing atopic dermatitis as a systemic disease. AREAS COVERED The authors reviewed evidence on atopic and non-atopic comorbidities of atopic dermatitis. A literature search was conducted in PubMed for peer-reviewed articles published until October 2022. EXPERT OPINION Atopic and non-atopic diseases coexist with atopic dermatitis more often than would be expected by chance. The effect of biologics and small molecules on atopic and non-atopic comorbidities may contribute to a better understanding of the relationship between atopic dermatitis and its comorbidities. Their relationship needs to be explored further to dismantle the underlying mechanism and move toward an atopic dermatitis endotype-based therapeutic approach.
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Affiliation(s)
- Caroline Gewiss
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Matthias Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
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Kim JH, Yi YY, Ha EK, Cha HR, Han MY, Baek HS. Neurodevelopment at 6 years of age in children with atopic dermatitis. Allergol Int 2023; 72:116-127. [PMID: 36058807 DOI: 10.1016/j.alit.2022.08.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 07/17/2022] [Accepted: 07/26/2022] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Few studies have reported an association between atopic dermatitis and cognitive impairment in children. Therefore, we evaluated the association between atopic dermatitis (AD) and neurodevelopmental dysfunction in children. METHODS We analyzed 2,395,966 children born between 2008 and 2012 in Korea. All data were acquired from the databases of the Korean National Health Insurance System. AD was defined as five or more diagnoses before age 24 months. The outcome was suspected neurodevelopmental dysfunction in the gross motor skill, fine motor skill, cognition, language, sociality, and self-care domains of the Korean Developmental Screening Test for Infants and Children at age 6 years. The positive control outcome was defined as attention deficit hyperactive disorder (ADHD). The associations were assessed using ordinal logistic regression, adjusting for asthma and allergic rhinitis. RESULTS Among the eligible children, 89,452 and 30,557 were allocated to the control and AD groups, respectively. In the weighted data, the AD group showed a higher risk of suspected neurodevelopmental dysfunction in the total score (weighted adjusted odds ratio [95% CI] 1.10 [1.05-1.16]), gross motor skills (1.14 [1.04-1.25]), and fine motor skills (1.15 [1.06-1.25]) than the control group. The AD with steroids or hospitalization groups showed an increased risk of suspected neurodevelopmental dysfunction. In addition, the AD group showed a significant association with mental retardation, psychological development disorder, and behavioral and emotional disorders as well as ADHD. CONCLUSIONS AD before age 2 years may be associated with an increased risk of neurodevelopmental dysfunction including gross and fine motor skills in the young childhood period.
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Affiliation(s)
- Ju Hee Kim
- Department of Pediatrics, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea
| | - Yoon Young Yi
- Department of Pediatrics, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea
| | - Eun Kyo Ha
- Department of Pediatrics, Hallym University Kangnam Sacred Heart Hospital, Seoul, South Korea
| | - Hey Ryung Cha
- Department of Data Science, Sejong University College of Software Convergence, Seoul, South Korea
| | - Man Yong Han
- Department of Pediatrics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, South Korea.
| | - Hey-Sung Baek
- Department of Pediatrics, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea.
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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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Yasuda H, Tsutsui T. Metallomics analysis for early assessment and individualized intervention of neurodevelopmental disorders. METALLOMICS : INTEGRATED BIOMETAL SCIENCE 2022; 14:6695310. [PMID: 36087072 DOI: 10.1093/mtomcs/mfac067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 07/28/2022] [Indexed: 11/12/2022]
Abstract
The children today are in the midst of the epidemic of neurodevelopmental disorders. In this metallomics study for the scalp hair samples of total 2550 children with autistic disorders (2108 males and 442 females aged 0-15 year), it was demonstrated that near one half of the infantile individuals aged 0-3 year are suffering from zinc deficiency and toxic metal burdens. Zinc level correlated closely to the index of zinc/iron ratio more than zinc/copper ratio. Furthermore, there were significant relationships between zinc deficiency and toxic metal burdens such as lead and aluminum which were inversely associated with not only zinc level but also zinc/iron ratio with higher regression coefficients of r = -0.486 and -0.551 (p < 0.00001), respectively. High-significant inverse association was detected between zinc and molybdenum concentration (r = -0.509) and also between zinc/iron ratio and molybdenum (r = -0.548). These findings suggest that infantile zinc deficiency relates to the high burdens of not only toxic but also some essential metals such as molybdenum, iron and manganese and that these various mineral imbalances play principal roles to the etiology of neurodevelopmental disorders. We expect that the early assessment and intervention of the mineral imbalances (or dis-homeostasis) in individual child open an avenue for evidence-based individualized treatment of neurodevelopmental disorders and also of the comorbid immune disorders, in near future.
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Affiliation(s)
- Hiroshi Yasuda
- La Belle Vie Research Laboratory, Tokyo; Japan.,Institute of Nature and Environmental Technology, Kanazawa University, Kanazawa, Japan
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Grosse SD, Nichols P, Nyarko K, Maenner M, Danielson ML, Shea L. Heterogeneity in Autism Spectrum Disorder Case-Finding Algorithms in United States Health Administrative Database Analyses. J Autism Dev Disord 2022; 52:4150-4163. [PMID: 34581918 PMCID: PMC9077262 DOI: 10.1007/s10803-021-05269-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/01/2021] [Indexed: 12/19/2022]
Abstract
Strengthening systems of care to meet the needs of individuals with autism spectrum disorder (ASD) is of growing importance. Administrative data provide advantages for research and planning purposes, including large sample sizes and the ability to identify enrollment in insurance coverage and service utilization of individuals with ASD. Researchers have employed varying strategies to identify individuals with ASD in administrative data. Differences in these strategies can limit the comparability of results across studies. This review describes implications of the varying strategies that have been employed to identify individuals with ASD in US claims databases, with consideration of the strengths and limitations of each approach.
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Affiliation(s)
- Scott D Grosse
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 4770 Buford Highway NE, Mail Stop S106-4, Atlanta, GA, 30341, USA.
| | - Phyllis Nichols
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 4770 Buford Highway NE, Mail Stop S106-4, Atlanta, GA, 30341, USA
| | - Kwame Nyarko
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 4770 Buford Highway NE, Mail Stop S106-4, Atlanta, GA, 30341, USA
| | - Matthew Maenner
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 4770 Buford Highway NE, Mail Stop S106-4, Atlanta, GA, 30341, USA
| | - Melissa L Danielson
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 4770 Buford Highway NE, Mail Stop S106-4, Atlanta, GA, 30341, USA
| | - Lindsay Shea
- Policy and Analytics Center, A.J. Drexel Autism Institute, Drexel University, Philadelphia, PA, USA
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Hong RP, Hou YY, Xu XJ, Lang JD, Jin YF, Zeng XF, Zhang X, Tian G, You X. The Difference of Gut Microbiota and Their Correlations With Urinary Organic Acids Between Autistic Children With and Without Atopic Dermatitis. Front Cell Infect Microbiol 2022; 12:886196. [PMID: 35800387 PMCID: PMC9253573 DOI: 10.3389/fcimb.2022.886196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 05/16/2022] [Indexed: 11/13/2022] Open
Abstract
Autism is a kind of biologically based neurodevelopmental condition, and the coexistence of atopic dermatitis (AD) is not uncommon. Given that the gut microbiota plays an important role in the development of both diseases, we aimed to explore the differences of gut microbiota and their correlations with urinary organic acids between autistic children with and without AD. We enrolled 61 autistic children including 36 with AD and 25 without AD. The gut microbiota was sequenced by metagenomic shotgun sequencing, and the diversity, compositions, and functional pathways were analyzed further. Urinary organic acids were assayed by gas chromatography–mass spectrometry, and univariate/multivariate analyses were applied. Spearman correlation analysis was conducted to explore their relationships. In our study, AD individuals had more prominent gastrointestinal disorders. The alpha diversity of the gut microbiota was lower in the AD group. LEfSe analysis showed a higher abundance of Anaerostipes caccae, Eubacterium hallii, and Bifidobacterium bifidum in AD individuals, with Akkermansia muciniphila, Roseburia intestinalis, Haemophilus parainfluenzae, and Rothia mucilaginosa in controls. Meanwhile, functional profiles showed that the pathway of lipid metabolism had a higher proportion in the AD group, and the pathway of xenobiotics biodegradation was abundant in controls. Among urinary organic acids, adipic acid, 3-hydroxyglutaric acid, tartaric acid, homovanillic acid, 2-hydroxyphenylacetic acid, aconitic acid, and 2-hydroxyhippuric acid were richer in the AD group. However, only adipic acid remained significant in the multivariate analysis (OR = 1.513, 95% CI [1.042, 2.198], P = 0.030). In the correlation analysis, Roseburia intestinalis had a negative correlation with aconitic acid (r = -0.14, P = 0.02), and the latter was positively correlated with adipic acid (r = 0.41, P = 0.006). Besides, the pathway of xenobiotics biodegradation seems to inversely correlate with adipic acid (r = -0.42, P = 0.18). The gut microbiota plays an important role in the development of AD in autistic children, and more well-designed studies are warranted to explore the underlying mechanism.
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Affiliation(s)
- Ru-ping Hong
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yue-ying Hou
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Xin-jie Xu
- Medical Science Research Center, Research Center for Translational Medicine, Department of Scientific Research, Peking Union Medical College Hospital, Beijing, China
| | | | | | - Xiao-feng Zeng
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- Key Laboratory of Rheumatology & Clinical Immunology, Ministry of Education, Beijing, China
- National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Beijing, China
| | - Xuan Zhang
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- Key Laboratory of Rheumatology & Clinical Immunology, Ministry of Education, Beijing, China
- National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Beijing, China
| | - Geng Tian
- Geneis Beijing Co., Ltd., Beijing, China
| | - Xin You
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- Key Laboratory of Rheumatology & Clinical Immunology, Ministry of Education, Beijing, China
- National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Beijing, China
- Autism Special Fund, Peking Union Medical Foundation, Beijing, China
- *Correspondence: Xin You,
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14
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Nemet S, Asher I, Yoles I, Baevsky T, Sthoeger Z. Early childhood allergy linked with development of attention deficit hyperactivity disorder and autism spectrum disorder. Pediatr Allergy Immunol 2022; 33:10.1111/pai.13819. [PMID: 35754118 PMCID: PMC9328193 DOI: 10.1111/pai.13819] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 04/14/2022] [Accepted: 05/25/2022] [Indexed: 12/20/2022]
Abstract
BACKGROUND Previous studies reported controversial results regarding the association between allergic disorders and attention deficit hyperactivity disorder (ADHD)/autism spectrum disorder (ASD). The aim of this article was to investigate whether allergic disorders are associated with ADHD/ASD in a large cohort of pediatric patients. METHODS A retrospective study using the pediatric (0-18 year) database (ICD-9-CM codes) of Clalit Health Services during the years (2000-2018). Diagnosis of all disorders was made by specialist physicians. RESULTS A total of 117 022 consecutive non-selective allergic children diagnosed with one or more allergic disorder (asthma, rhinitis, conjunctivitis, skin, food, or drug allergy) and 116 968 non-allergic children were enrolled to our study. The mean follow-up period was 11 ± 6 years. The presence of allergic disorders in early childhood (mean age of allergic diagnosis 4.5 ± 4.3 years) in boys as well as in girls significantly increased the risk to develop ADHD (O.R 2.45, CI 2.39-2.51; p < .0001), ASD (O.R 1.17, CI 1.08-1.27; p < .0001), or both ADHD + ASD (O.R 1.5, CI 1.35-1.79; p < .0001). Children with more than one allergic comorbidity revealed a much higher risk. In a multivariable analysis (adjusted for age at study entry, number of yearly visits, and gender), the risk of allergic children to develop ADHD and ADHD + ASD, but not ASD alone, remained significantly higher. CONCLUSION Allergic disorder in early childhood significantly increased the risk to develop ADHD, and to a less extend ASD, in later life.
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Affiliation(s)
- Shay Nemet
- Clinical Immunology Allergy and AIDS Center, Kaplan Medical Center, Rehovot, Israel
| | - Ilan Asher
- Clinical Immunology Allergy and AIDS Center, Kaplan Medical Center, Rehovot, Israel
| | | | | | - Zev Sthoeger
- Clinical Immunology Allergy and AIDS Center, Kaplan Medical Center, Rehovot, Israel
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15
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Associations between Allergic and Autoimmune Diseases with Autism Spectrum Disorder and Attention-Deficit/Hyperactivity Disorder within Families: A Population-Based Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084503. [PMID: 35457368 PMCID: PMC9025211 DOI: 10.3390/ijerph19084503] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 04/05/2022] [Accepted: 04/07/2022] [Indexed: 02/04/2023]
Abstract
Autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) are commonly comorbid with allergic and autoimmune diseases in children. The aim of the current study was to investigate the association between children’s and first-degree relatives’ (i.e., mother, father, and full sibling) allergic and autoimmune diseases and children’s ASD and ADHD. We enrolled participants from Taiwan’s Maternal and Child Health Database. We used the Cox regression model to examine the associations of familial, siblings’ and children’s allergic and autoimmune diseases with children’s ASD and/or ADHD. In total, we included 1,386,260 children in the current study. We found the significant association between familial allergic or autoimmune disease and development of ASD or ADHD among children. We also identified the predominant impact of familial aggregation on the above associations. The associations between some parental diagnoses of autoimmune or allergic diseases in children’s ASD and/or ADHD were stronger in mothers than those in fathers. Early assessment of the possibility of ASD and ADHD is required for children who have a parent with an allergic or autoimmune disease.
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16
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Mishra SK. The Role of CNTNAP2 in Itch Sensation. J Invest Dermatol 2022; 142:251-253. [PMID: 34310948 PMCID: PMC8688288 DOI: 10.1016/j.jid.2021.07.152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 05/27/2021] [Accepted: 07/05/2021] [Indexed: 01/03/2023]
Affiliation(s)
- Santosh K. Mishra
- CORRESPONDING AUTHOR: Dr. Santosh K. Mishra, 1060 William Moore Drive, Raleigh, NC 27607,
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17
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Autism spectrum disorders and atopic dermatitis: a new perspective from country-based prevalence data. Clin Mol Allergy 2021; 19:27. [PMID: 34930274 PMCID: PMC8691085 DOI: 10.1186/s12948-021-00166-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 12/02/2021] [Indexed: 11/10/2022] Open
Abstract
Recently, a continuous growth for both neurodevelopmental and atopic diseases' incidence was seen throughout the world. Notably, autism spectrum disorders (ASD) and atopic dermatitis (AD) attracted the attention of clinicians and scientists for their impact on the quality of life of patients, starting during childhood. Despite a number of hypotheses about common pathogenesis between the two disorders, uncertainty is still present, and data coming from various parts of the world are contradictory. Fortunately, works recently published have brought useful material for comparative analysis to the benefit of the scientific community, making large scale, country-based perspectives methodologically viable. In light of that, the present study took into account uniform data, available from country-based registries or related publications, dealing with the prevalence of the two conditions around the world, and tried to setup a simple correlation analysis between the two. According to such data, the growth of AD and ASD prevalence appear uncorrelated, leading to hypothesise that, if a common etiopathological pathway exists between the two conditions, they are likely to interact to each other due to a complex interplay of co-morbidities, genes and environmental players not enough explained by a simple correlation analysis. Such facts are worth investigation in future research.
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18
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Yamaguchi C, Ebara T, Futamura M, Ohya Y, Asano M. Do allergic clinical manifestations increase the risk of behavioral problems in children? A cross-sectional study. Pediatr Allergy Immunol 2021; 32:1646-1653. [PMID: 34002884 DOI: 10.1111/pai.13542] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 05/08/2021] [Accepted: 05/10/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Children with allergic clinical manifestations tend to have behavioral or emotional problems such as hyperactivity or worse mental health. However, previous studies on this association did not adequately adjust for confounders like parenting stress, demographic characteristics, or allergy presentation. This study aimed to investigate the relationship between childhood allergic clinical manifestations and behavioral problems, adjusting for confounders such as demographic characteristics, parenting stress, and allergy-related variables. METHODS We conducted an online cross-sectional survey among caregivers of children aged 2-6 years (n = 633). The Strengths and Difficulties Questionnaire (SDQ) was used to determine children's behavioral characteristics as the primary outcome. Allergic clinical manifestations, wheeze, rash, and nose symptoms were the exposure variables. Associations were estimated using logistic regression analyses with propensity scores to adjust for confounders. RESULTS We analyzed 633 caregivers of children aged 2-6 years (valid rate, 61.5%). Univariate analyses showed that wheezing was associated with conduct problems (odds ratio [OR] = 1.48, 95% confidence interval [CI]:1.01-2.16), a behavioral component of the SDQ. Rash was also associated with hyperactivity (OR = 1.62, 95% CI: 1.02-2.57). Furthermore, nose symptoms were associated with conduct problems (OR = 1.65, 95% CI:1.16-2.33) and emotional symptoms (OR=1.62, 95% CI:1.06-2.45). After adjusting for potential confounders, wheezing (adjusted OR = 1.69, 95% CI:1.04-2.75) and nose symptoms (adjusted OR = 1.56, 95% CI: 1.05-2.34) remained associated with conduct problems. CONCLUSIONS This study revealed that a history of wheezing and nose symptoms in children is associated with an increased risk of behavioral problems, in particular, conduct problems.
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Affiliation(s)
- Chikae Yamaguchi
- Department of Community Health Nursing, Nagoya City University Graduate School of Nursing, Nagoya, Japan
| | - Takeshi Ebara
- Department of Occupational and Environmental Health, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Masaki Futamura
- Division of Pediatrics, National Hospital Organization Nagoya Medical Center
| | - Yukihiro Ohya
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan
| | - Midori Asano
- Department of Integrated Health Sciences, Nursing Sciences, Nagoya University Graduate School of Medicine, Nagoya, Japan
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19
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Kittel-Schneider S, Arteaga-Henriquez G, Vasquez AA, Asherson P, Banaschewski T, Brikell I, Buitelaar J, Cormand B, Faraone SV, Freitag CM, Ginsberg Y, Haavik J, Hartman CA, Kuntsi J, Larsson H, Matura S, McNeill RV, Ramos-Quiroga JA, Ribases M, Romanos M, Vainieri I, Franke B, Reif A. Non-mental diseases associated with ADHD across the lifespan: Fidgety Philipp and Pippi Longstocking at risk of multimorbidity? Neurosci Biobehav Rev 2021; 132:1157-1180. [PMID: 34757108 DOI: 10.1016/j.neubiorev.2021.10.035] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 10/24/2021] [Accepted: 10/25/2021] [Indexed: 12/16/2022]
Abstract
Several non-mental diseases seem to be associated with an increased risk of ADHD and ADHD seems to be associated with increased risk for non-mental diseases. The underlying trajectories leading to such brain-body co-occurrences are often unclear - are there direct causal relationships from one disorder to the other, or does the sharing of genetic and/or environmental risk factors lead to their occurring together more frequently or both? Our goal with this narrative review was to provide a conceptual synthesis of the associations between ADHD and non-mental disease across the lifespan. We discuss potential shared pathologic mechanisms, genetic background and treatments in co-occurring diseases. For those co-occurrences for which published studies with sufficient sample sizes exist, meta-analyses have been published by others and we discuss those in detail. We conclude that non-mental diseases are common in ADHD and vice versa and add to the disease burden of the patient across the lifespan. Insufficient attention to such co-occurring conditions may result in missed diagnoses and suboptimal treatment in the affected individuals.
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Affiliation(s)
- Sarah Kittel-Schneider
- Center of Mental Health, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Würzburg, Margarete-Höppel-Platz 1, D-97080 Würzburg, Germany; Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Goethe University, Heinrich-Hoffmann-Str. 10, D-60528 Frankfurt am Main, Germany.
| | - Gara Arteaga-Henriquez
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain; Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR), Universitat Autonoma de Barcelona, Barcelona, Catalonia, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Madrid, Spain; Department of Psychiatry and Forensic Medicine, Universitat Autonoma de Barcelona, Barcelona, Catalonia, Spain
| | - Alejandro Arias Vasquez
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, PO Box 9101, 6500 HB Nijmegen, the Netherlands; Departments of Psychiatry and Human Genetics, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Phil Asherson
- Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, SE5 8AF, London, UK
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Heidelberg University, Medical Faculty Mannheim, Mannheim, Germany
| | - Isabell Brikell
- National Centre for Register-based Research, Department of Economics and Business Economics Aarhus BSS, Aarhus University, Fuglesangs Allé 26, DK-8210 Aarhus V, Aarhus, Denmark; iPSYCH - The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Copenhagen and Aarhus, Denmark; Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Box 281, 171 77, Stockholm, Sweden
| | - Jan Buitelaar
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands; Karakter Child and Adolescent Psychiatry University Center, Nijmegen, the Netherlands
| | - Bru Cormand
- Departament de Genètica, Microbiologia i Estadística, Facultat de Biologia, Universitat de Barcelona, Catalonia, Spain; Institut de Biomedicina de la Universitat de Barcelona (IBUB), Catalonia, Spain; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Spain; Institut de Recerca Sant Joan de Déu (IR-SJD), Esplugues de Llobregat, Catalonia, Spain
| | - Stephen V Faraone
- Departments of Psychiatry and of Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Christine M Freitag
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, Deutschordenstraße 50, D-60528 Frankfurt am Main, Germany
| | - Ylva Ginsberg
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Norra Stationsgatan 69, SE-113 64 Stockholm, Sweden
| | - Jan Haavik
- Bergen Center of Brain Plasticity, Division of Psychiatry, Haukeland University Hospital, Postboks 1400, 5021 Bergen, Norway; Department of Biomedicine, University of Bergen, Bergen, Norway
| | - Catharina A Hartman
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), PO Box 30.001, 9700 RB, Groningen, the Netherlands
| | - Jonna Kuntsi
- Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, SE5 8AF, London, UK
| | - Henrik Larsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Box 281, 171 77, Stockholm, Sweden; Örebro University, School of Medical Sciences, Campus USÖ, S-701 82 Örebro, Sweden
| | - Silke Matura
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Goethe University, Heinrich-Hoffmann-Str. 10, D-60528 Frankfurt am Main, Germany
| | - Rhiannon V McNeill
- Center of Mental Health, Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Würzburg, Margarete-Höppel-Platz 1, D-97080 Würzburg, Germany
| | - J Antoni Ramos-Quiroga
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain; Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR), Universitat Autonoma de Barcelona, Barcelona, Catalonia, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Madrid, Spain; Department of Psychiatry and Forensic Medicine, Universitat Autonoma de Barcelona, Barcelona, Catalonia, Spain
| | - Marta Ribases
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain; Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR), Universitat Autonoma de Barcelona, Barcelona, Catalonia, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Madrid, Spain; Departament de Genètica, Microbiologia i Estadística, Facultat de Biologia, Universitat de Barcelona, Catalonia, Spain
| | - Marcel Romanos
- Center of Mental Health, Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatic Medicine, University Hospital of Würzburg, Margarete-Höppel-Platz 1, D-97080 Würzburg, Germany
| | - Isabella Vainieri
- Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, SE5 8AF, London, UK
| | - Barbara Franke
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, PO Box 9101, 6500 HB Nijmegen, the Netherlands; Departments of Psychiatry and Human Genetics, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Goethe University, Heinrich-Hoffmann-Str. 10, D-60528 Frankfurt am Main, Germany
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Inflammation, Anxiety, and Stress in Attention-Deficit/Hyperactivity Disorder. Biomedicines 2021; 9:biomedicines9101313. [PMID: 34680430 PMCID: PMC8533349 DOI: 10.3390/biomedicines9101313] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 08/26/2021] [Accepted: 08/27/2021] [Indexed: 12/11/2022] Open
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a prevalent and serious neurodevelopmental disorder characterized by symptoms of inattention and/or hyperactivity/impulsivity. Chronic and childhood stress is involved in ADHD development, and ADHD is highly comorbid with anxiety. Similarly, inflammatory diseases and a pro-inflammatory state have been associated with ADHD. However, while several works have studied the relationship between peripheral inflammation and stress in affective disorders such as depression or bipolar disorder, fewer have explored this association in ADHD. In this narrative review we synthetize evidence showing an interplay between stress, anxiety, and immune dysregulation in ADHD, and we discuss the implications of a potential disrupted neuroendocrine stress response in ADHD. Moreover, we highlight confounding factors and limitations of existing studies on this topic and critically debate multidirectional hypotheses that either suggest inflammation, stress, or anxiety as a cause in ADHD pathophysiology or inflammation as a consequence of this disease. Untangling these relationships will have diagnostic, therapeutic and prognostic implications for ADHD patients.
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21
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Shin KO, Crumrine DA, Kim S, Lee Y, Kim B, Abuabara K, Park C, Uchida Y, Wakefield JS, Meyer JM, Jeong S, Park BD, Park K, Elias PM. Phenotypic overlap between atopic dermatitis and autism. BMC Neurosci 2021; 22:43. [PMID: 34157971 PMCID: PMC8218496 DOI: 10.1186/s12868-021-00645-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 06/01/2021] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Autism, a childhood behavioral disorder, belongs to a large suite of diseases, collectively referred to as autism spectrum disorders (ASD). Though multifactorial in etiology, approximately 10% of ASD are associated with atopic dermatitis (AD). Moreover, ASD prevalence increases further as AD severity worsens, though these disorders share no common causative mutations. We assessed here the link between these two disorders in the standard, valproic acid mouse model of ASD. In prior studies, there was no evidence of skin involvement, but we hypothesized that cutaneous involvement could be detected in experiments conducted in BALB/c mice. BALB/c is an albino, laboratory-bred strain of the house mouse and is among the most widely used inbred strains used in animal experimentation. METHODS We performed our studies in valproic acid (VPA)-treated BALB/c hairless mice, a standard mouse model of ASD. Mid-trimester pregnant mice received a single intraperitoneal injection of either valproic acid sodium salt dissolved in saline or saline alone on embryonic day 12.5 and were housed individually until postnatal day 21. Only the brain and epidermis appeared to be affected, while other tissues remain unchanged. At various postnatal time points, brain, skin and blood samples were obtained for histology and for quantitation of tissue sphingolipid content and cytokine levels. RESULTS AD-like changes in ceramide content occurred by day one postpartum in both VPA-treated mouse skin and brain. The temporal co-emergence of AD and ASD, and the AD phenotype-dependent increase in ASD prevalence correlated with early appearance of cytokine markers (i.e., interleukin [IL]-4, 5, and 13), as well as mast cells in skin and brain. The high levels of interferon (IFN)γ not only in skin, but also in brain likely account for a significant decline in esterified very-long-chain N-acyl fatty acids in brain ceramides, again mimicking known IFNγ-induced changes in AD. CONCLUSION Baseline involvement of both AD and ASD could reflect concurrent neuro- and epidermal toxicity, possibly because both epidermis and neural tissues originate from the embryonic neuroectoderm. These studies illuminate the shared susceptibility of the brain and epidermis to a known neurotoxin, suggesting that the atopic diathesis could be extended to include ASD.
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Affiliation(s)
- Kyong-Oh Shin
- Department of Food Science/Nutrition, & Convergence Program of Material Science for Medicine/Pharmaceutics, and the Korean Institute of Nutrition, Hallym University, Chuncheon, South Korea
| | - Debra A Crumrine
- Dept. of Dermatology, University of California, NCIRE, and Veterans Affairs Medical Center, 4150 Clement Street, MS 190, San Francisco, CA, 94121, USA
| | - Sungeun Kim
- Department of Food Science/Nutrition, & Convergence Program of Material Science for Medicine/Pharmaceutics, and the Korean Institute of Nutrition, Hallym University, Chuncheon, South Korea
| | - Yerin Lee
- Department of Food Science/Nutrition, & Convergence Program of Material Science for Medicine/Pharmaceutics, and the Korean Institute of Nutrition, Hallym University, Chuncheon, South Korea
| | - Bogyeong Kim
- Department of Food Science/Nutrition, & Convergence Program of Material Science for Medicine/Pharmaceutics, and the Korean Institute of Nutrition, Hallym University, Chuncheon, South Korea
| | - Katrina Abuabara
- Department of Dermatology, University of San Francisco, San Francisco, CA, USA
| | - Chaehyeong Park
- Dept. of Dermatology, University of California, NCIRE, and Veterans Affairs Medical Center, 4150 Clement Street, MS 190, San Francisco, CA, 94121, USA
| | - Yoshikazu Uchida
- Dept. of Dermatology, University of California, NCIRE, and Veterans Affairs Medical Center, 4150 Clement Street, MS 190, San Francisco, CA, 94121, USA
| | - Joan S Wakefield
- Dept. of Dermatology, University of California, NCIRE, and Veterans Affairs Medical Center, 4150 Clement Street, MS 190, San Francisco, CA, 94121, USA
| | - Jason M Meyer
- Dept. of Dermatology, University of California, NCIRE, and Veterans Affairs Medical Center, 4150 Clement Street, MS 190, San Francisco, CA, 94121, USA
| | - Sekyoo Jeong
- Dept of Cosmetic Science, Seowon University, Cheongju, South Korea
| | - Byeong Deog Park
- Sphingobrain Inc., San Francisco, CA, USA
- Dr. Raymond Laboratories, Inc, Englewood Cliffs, NJ, USA
| | - Kyungho Park
- Department of Food Science/Nutrition, & Convergence Program of Material Science for Medicine/Pharmaceutics, and the Korean Institute of Nutrition, Hallym University, Chuncheon, South Korea.
| | - Peter M Elias
- Dept. of Dermatology, University of California, NCIRE, and Veterans Affairs Medical Center, 4150 Clement Street, MS 190, San Francisco, CA, 94121, USA.
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22
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Saccaro LF, Schilliger Z, Dayer A, Perroud N, Piguet C. Inflammation, anxiety, and stress in bipolar disorder and borderline personality disorder: A narrative review. Neurosci Biobehav Rev 2021; 127:184-192. [PMID: 33930472 DOI: 10.1016/j.neubiorev.2021.04.017] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 04/11/2021] [Accepted: 04/18/2021] [Indexed: 11/30/2022]
Abstract
Bipolar disorder (BD) and borderline personality disorder (BPD) are serious and prevalent psychiatric diseases that share common phenomenological characteristics: symptoms (such as anxiety, affective lability or emotion dysregulation), neuroimaging features, risk factors and comorbidities. While several studies have focused on the link between stress and peripheral inflammation in other affective disorders such as anxiety or depression, fewer have explored this relationship in BD and BPD. This review reports on evidence showing an interplay between immune dysregulation, anxiety and stress, and how an altered acute neuroendocrine stress response may exist in these disorders. Moreover, we highlight limitations and confounding factors of these existing studies and discuss multidirectional hypotheses that either suggest inflammation or stress and anxiety as the primum movens in BD and BPD pathophysiology, or inflammation as a consequence of the pathophysiology of these diseases. Untangling these associations and implementing a transdiagnostic approach will have diagnostic, therapeutic and prognostic implications for BD and BPD patients.
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Affiliation(s)
- L F Saccaro
- Department of Clinical Neurosciences, Division of Neurology, Geneva University Hospital, University of Geneva, Geneva, Switzerland
| | - Z Schilliger
- Centre for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital, Prilly-Lausanne, Switzerland
| | - A Dayer
- Psychiatry Department, Faculty of Medicine, University of Geneva, Geneva, Switzerland; Neuroscience Department, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - N Perroud
- Psychiatry Department, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - C Piguet
- Psychiatry Department, Faculty of Medicine, University of Geneva, Geneva, Switzerland; Child and Adolescent Psychiatry Division, Geneva University Hospital, Geneva, Switzerland.
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23
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Chua RXY, Tay MJY, Ooi DSQ, Siah KTH, Tham EH, Shek LPC, Meaney MJ, Broekman BFP, Loo EXL. Understanding the Link Between Allergy and Neurodevelopmental Disorders: A Current Review of Factors and Mechanisms. Front Neurol 2021; 11:603571. [PMID: 33658968 PMCID: PMC7917177 DOI: 10.3389/fneur.2020.603571] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 12/30/2020] [Indexed: 12/17/2022] Open
Abstract
Both allergic diseases and neurodevelopmental disorders are non-communicable diseases (NCDs) that not only impact on the quality of life and but also result in substantial economic burden. Immune dysregulation and inflammation are typical hallmarks in both allergic and neurodevelopmental disorders, suggesting converging pathophysiology. Epidemiological studies provided convincing evidence for the link between allergy and neurodevelopmental diseases such as attention-deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). Possible factors influencing the development of these disorders include maternal depression and anxiety, gestational diabetes mellitus, maternal allergic status, diet, exposure to environmental pollutants, microbiome dysbiosis, and sleep disturbances that occur early in life. Moreover, apart from inflammation, epigenetics, gene expression, and mitochondrial dysfunction have emerged as possible underlying mechanisms in the pathogenesis of these conditions. The exploration and understanding of these shared factors and possible mechanisms may enable us to elucidate the link in the comorbidity.
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Affiliation(s)
- Regena Xin Yi Chua
- Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Michelle Jia Yu Tay
- Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Delicia Shu Qin Ooi
- Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, National University Health System, Singapore, Singapore
| | - Kewin Tien Ho Siah
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Division of Gastroenterology & Hepatology, University Medicine Cluster, National University Hospital, Singapore, Singapore
| | - Elizabeth Huiwen Tham
- Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, National University Health System, Singapore, Singapore.,Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (ASTAR), Singapore, Singapore
| | - Lynette Pei-Chi Shek
- Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, National University Health System, Singapore, Singapore.,Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (ASTAR), Singapore, Singapore
| | - Michael J Meaney
- Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (ASTAR), Singapore, Singapore.,Ludmer Centre for Neuroinformatics and Mental Health and Department of Psychiatry, McGill University, Montréal, QC, Canada
| | - Birit F P Broekman
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (ASTAR), Singapore, Singapore.,Department of Psychiatry, Onze Lieve Vrouwe Gasthuis and Amsterdam University Medical Centre, VU University Medical Center, Amsterdam, Netherlands
| | - Evelyn Xiu Ling Loo
- Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (ASTAR), Singapore, Singapore
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24
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Vittrup I, Andersen YMF, Droitcourt C, Skov L, Egeberg A, Fenton MC, Mina-Osorio P, Boklage S, Thyssen JP. Association between hospital-diagnosed atopic dermatitis and psychiatric disorders and medication use in childhood. Br J Dermatol 2021; 185:91-100. [PMID: 33454962 DOI: 10.1111/bjd.19817] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/13/2021] [Indexed: 01/21/2023]
Abstract
BACKGROUND While adult atopic dermatitis (AD) is associated with anxiety and depression, and paediatric AD is linked to attention deficit hyperactivity disorder (ADHD), the relationship between AD in childhood and other psychiatric disorders is largely unknown. OBJECTIVES To determine the relationship between AD and diagnosis and treatment of psychiatric disorders in children. METHODS All Danish children born between 1 January 1995 and 31 December 2012 with a hospital diagnosis of AD (n = 14 283) were matched 1 : 10 with children without a hospital diagnosis of AD. Endpoints were psychotropic medication use, hospital diagnoses of depression, anxiety, ADHD, or self-harming behaviour, accidental/suicidal death, and consultation with a psychiatrist or psychologist. RESULTS Significant associations were observed between hospital-diagnosed AD and antidepressant [adjusted hazard ratio (aHR) 1·19, 95% confidence interval (CI) 1·04-1·36], anxiolytic (aHR 1·72, 95% CI 1·57-1·90), and centrally acting sympathomimetic (aHR 1·29, 95% CI 1·18-1·42) medication use. Consultation with a psychiatrist (aHR 1·33, 95% CI 1·16-1·52) or psychologist (aHR 1·25, 95% CI 1·11-1·41) was also associated with AD. No association with a hospital diagnosis of depression (aHR 0·58, 95% CI 0·21-1·56), anxiety (aHR 1·47, 95% CI 0·98-2·22) or self-harming behaviour (aHR 0·88, 95% CI 0·27-2·88) was observed, but a diagnosis of ADHD (aHR 1·91, 95% CI 1·56-2·32) was significantly associated with AD. The absolute risks were generally low. CONCLUSIONS The increased risk of treatment, but not of a hospital diagnosis of psychiatric disorders in children with hospital-diagnosed AD, suggests that psychiatric issues in children with AD could be of a transient, reversible or mild-moderate nature.
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Affiliation(s)
- I Vittrup
- Department of Dermatology and Allergy, University of Copenhagen, Hellerup, Denmark.,Copenhagen Research Group for Inflammatory Skin (CORGIS), Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
| | - Y M F Andersen
- Department of Dermatology and Allergy, University of Copenhagen, Hellerup, Denmark.,Copenhagen Research Group for Inflammatory Skin (CORGIS), Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
| | - C Droitcourt
- Department of Dermatology and Allergy, University of Copenhagen, Hellerup, Denmark.,Copenhagen Research Group for Inflammatory Skin (CORGIS), Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark.,Department of Dermatology, CHU Rennes, F35000, Rennes, France.,University of Rennes, EA 7449 REPERES 'Pharmacoepidemiology and Health Services Research', F35000, Rennes, France
| | - L Skov
- Department of Dermatology and Allergy, University of Copenhagen, Hellerup, Denmark.,Copenhagen Research Group for Inflammatory Skin (CORGIS), Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
| | - A Egeberg
- Department of Dermatology and Allergy, University of Copenhagen, Hellerup, Denmark.,Copenhagen Research Group for Inflammatory Skin (CORGIS), Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
| | - M C Fenton
- Formerly Sanofi Genzyme, Cambridge, MA, USA
| | - P Mina-Osorio
- Formerly Regeneron Pharmaceuticals, Tarrytown, NY, USA
| | - S Boklage
- Formerly Regeneron Pharmaceuticals, Tarrytown, NY, USA
| | - J P Thyssen
- Department of Dermatology and Venereology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
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25
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Gagliano A, Galati C, Ingrassia M, Ciuffo M, Alquino MA, Tanca MG, Carucci S, Zuddas A, Grossi E. Pediatric Acute-Onset Neuropsychiatric Syndrome: A Data Mining Approach to a Very Specific Constellation of Clinical Variables. J Child Adolesc Psychopharmacol 2020; 30:495-511. [PMID: 32460516 DOI: 10.1089/cap.2019.0165] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Objectives: Pediatric acute onset neuropsychiatric syndrome (PANS) is a clinically heterogeneous disorder presenting with: unusually abrupt onset of obsessive compulsive disorder (OCD) or severe eating restrictions, with at least two concomitant cognitive, behavioral, or affective symptoms such as anxiety, obsessive-compulsive behavior, and irritability/depression. This study describes the clinical and laboratory variables of 39 children (13 female and 26 male) with a mean age at recruitment of 8.6 years (standard deviation 3.1). Methods: Using a mathematical approach based on Artificial Neural Networks, the putative associations between PANS working criteria, as defined at the NIH in July 2010 (Swedo et al. 2012), were explored by the Auto Contractive Map (Auto-CM) system, a mapping method able to compute the multidimensional association of strength of each variable with all other variables in predefined dataset. Results: The PANS symptoms were strictly linked to one another on the semantic connectivity map, shaping a central "diamond" encompassing anxiety, irritability/oppositional defiant disorder symptoms, obsessive-compulsive symptoms, behavioral regression, sensory motor abnormalities, school performance deterioration, sleep disturbances, and emotional lability/depression. The semantic connectivity map also showed the aggregation between PANS symptoms and laboratory and clinical variables. In particular, the emotional lability/depression resulted as a highly connected hub linked to autoimmune disease in pregnancy, allergic and atopic disorders, and low Natural Killer percentage. Also anxiety symptoms were shown to be strongly related with recurrent infectious disease remarking the possible role of infections as a risk factor for PANS. Conclusion: Our data mining approach shows a very specific constellation of symptoms having strong links to laboratory and clinical variables consistent with PANS feature.
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Affiliation(s)
- Antonella Gagliano
- Child & Adolescent Neuropsychiatry Unit, Department of Biomedical Sciences, University of Cagliari, & "G. Brotzu" Hospital Trust, Cagliari, Italy
- Funding: The authors received no specific funding
| | - Cecilia Galati
- Division of Child Neurology and Psychiatry, Department of Paediatrics, University of Messina, Messina, Italy
- Funding: The authors received no specific funding
| | - Massimo Ingrassia
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
- Funding: The authors received no specific funding
| | - Massimo Ciuffo
- Department of Cognitive Psychological Pedagogical Sciences and Cultural Studies, University of Messina, Messina, Italy
- Funding: The authors received no specific funding
| | - Maria Ausilia Alquino
- Division of Child Neurology and Psychiatry, Department of Paediatrics, University of Messina, Messina, Italy
- Funding: The authors received no specific funding
| | - Marcello G Tanca
- Child & Adolescent Neuropsychiatry Unit, Department of Biomedical Sciences, University of Cagliari, & "G. Brotzu" Hospital Trust, Cagliari, Italy
- Funding: The authors received no specific funding
| | - Sara Carucci
- Child & Adolescent Neuropsychiatry Unit, Department of Biomedical Sciences, University of Cagliari, & "G. Brotzu" Hospital Trust, Cagliari, Italy
- Funding: The authors received no specific funding
| | - Alessandro Zuddas
- Child & Adolescent Neuropsychiatry Unit, Department of Biomedical Sciences, University of Cagliari, & "G. Brotzu" Hospital Trust, Cagliari, Italy
- Funding: The authors received no specific funding
| | - Enzo Grossi
- Autism Research Unit, Villa Santa Maria Foundation, Tavernerio, Italy
- Funding: The authors received no specific funding
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26
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Abstract
Atopic dermatitis is associated with an increased risk of asthma (10 to 30% according to age), allergic rhinitis and conjunctivitis and food allergy. Other comorbidiies are globally lest frequent than in psoriasis. There is no increased risk of solid cancer. Smoking is a major confounding factor that has to be taken into account. Obesity and metabolic syndrome are more frequent and there is a moderately increased cardiovascular risk in severe forms of atopic dermatitis. There is a clear-cut increased risk of vitiligo and alopecia areata and a lower risk of other auto-immune diseases, including type I diabetes in children. There is a higher risk of cutaneous but not extra-cutaneous bacterial and viral infections, and increased frequency of contact dermatitis and urticaria. Severe atopic dermatitis is associated with psychiatric comorbidities, like attention disorders/hyperactivity, depression and suicidal ideas. © 2019 Elsevier Masson SAS. All rights reserved.
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Affiliation(s)
- B Cribier
- Clinique dermatologique, Hôpitaux universitaires et université de Strasbourg, 1, place de l'Hôpital, 67091 Strasbourg Cedex, France.
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27
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Feng LJ, Chen AW, Luo XY, Wang H. Increased attention deficit/hyperactivity and oppositional defiance symptoms of 6-12 years old Chinese children with atopic dermatitis. Medicine (Baltimore) 2020; 99:e20801. [PMID: 32569226 PMCID: PMC7310892 DOI: 10.1097/md.0000000000020801] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Atopic dermatitis (AD), a prevalent chronic skin disease in children, has been associated with psychosocial illness and reduced quality of life because of severe itching and sleep deprivation. Previous studies have found a consistent association between AD and attention deficit hyperactivity disorder (ADHD). However, little is known about this relationship in Chinese children with AD.To investigate co-occurrence of ADHD symptoms, oppositional defiant disorder (ODD) symptoms, and the relevant risk factors of AD, as well as its impact on the quality of life in Chinese school-aged children with AD.Outpatients aged 6 to 12 years with confirmed AD and healthy controls matched for age were randomly included in this study from October 2018 to October 2019. AD severity was evaluated using the Severity Scoring of Atopic Dermatitis scale (SCORAD). Inattention, hyperactivity, and oppositional defiant symptoms were evaluated by using the Swanson, Nolan and Pelham IV Teacher and Parent 26-Item Rating Scale (SNAP-IV) questionnaires and quality of life was evaluated using the Children's Dermatology Life Quality Index (CDLQI).The study included 89 AD patients and 184 healthy controls. AD patients were more likely to have ADHD symptoms (10.1% vs. 3.8%; P = .04) and ODD symptoms (5.6% vs 0%; P < .001) than controls, especially hyperactive/impulsive (P = .03). The severity of itching and sleep loss in AD patients were positively correlated with inattention (P = .03; P < .001), hyperactivity/impulsiveness (P = .01; P = .03), and oppositional defiance scores (P < .01; P = .04). Sleep loss in AD patients was independently associated with an increased risk of ADHD symptoms (OR, 1.78; 95% CI, 1.07-2.98; P = .03). The mean CDLQI scores of AD patients were 6.98 ± 5.02, and CDLQI scores were significantly higher in AD patients with ADHD symptoms than in those without ADHD symptoms (11.44 vs. 6.48; P = .01).AD is a prevalent chronic condition associated with an increased likelihood of ADHD symptoms and ODD symptoms in school-aged children. Sleep deprivation caused by AD may be a risk factor for ADHD. AD affects quality of life, especially in patients with ADHD symptoms. AD patients with symptoms of inattention and hyperactivity should be evaluated for ADHD.
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Affiliation(s)
- Ling-jie Feng
- Pediatric Dermatology, Children's Hospital of Chongqing Medical University
- Ministry of Education Key Laboratory of Child Development and Disorders
| | - An-wei Chen
- Pediatric Dermatology, Children's Hospital of Chongqing Medical University
- National Clinical Research Center for Child Health and Disorders
| | - Xiao-yan Luo
- Pediatric Dermatology, Children's Hospital of Chongqing Medical University
- National Clinical Research Center for Child Health and Disorders
- China International Science and Technology Cooperation base of Child development and Critical Disorders, Chongqing, China
| | - Hua Wang
- Pediatric Dermatology, Children's Hospital of Chongqing Medical University
- Ministry of Education Key Laboratory of Child Development and Disorders
- National Clinical Research Center for Child Health and Disorders
- China International Science and Technology Cooperation base of Child development and Critical Disorders, Chongqing, China
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28
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Tsai TY, Chao YC, Hsieh CY, Huang YC. Association Between Atopic Dermatitis and Autism Spectrum Disorder: A Systematic Review and Meta-analysis. Acta Derm Venereol 2020; 100:adv00146. [PMID: 32399577 PMCID: PMC9137390 DOI: 10.2340/00015555-3501] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/28/2020] [Indexed: 11/16/2022] Open
Abstract
is missing (Short communication).
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Affiliation(s)
- Tsung-Yu Tsai
- Department of Dermatology, Wan Fang Hospital, Taipei Medical University, 116 Taipei, Taiwan
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29
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Xie Q, Chan CL, Chan CH. The wounded self-lonely in a crowd: A qualitative study of the voices of children living with atopic dermatitis in Hong Kong. HEALTH & SOCIAL CARE IN THE COMMUNITY 2020; 28:862-873. [PMID: 31828879 PMCID: PMC7187464 DOI: 10.1111/hsc.12917] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/08/2019] [Revised: 10/27/2019] [Accepted: 11/25/2019] [Indexed: 06/10/2023]
Abstract
Atopic dermatitis (AD) imposes significant physical and psychosocial burdens on affected children. However, little has been done to learn from the subjective experiences, perspectives and emotions of children living with AD. Their voices are not heard in healthcare settings. This study aims to share these children's voices and provide a deep understanding of the subjective experiences of children living with AD. We conducted qualitative research by conducting semi-structured interviews and analysing the drawings of 17 children in Hong Kong aged between 8 and 12 years who were diagnosed with AD. Using a phenomenological approach, we transcribed, coded and described the interviews. We found that for the children in this study, living with AD meant contending with an accumulation of challenges and crises. At the individual level, the essential experience of living with AD manifested a vicious cycle of skin and mental issues. At the family level, conflicts between children and parents concerning AD management coexisted with parental support. The children commonly experienced bullying and isolation in school and discrimination and stigmatisation in their neighbourhood, thereby making living with AD a traumatic experience. The synergy between individual and environmental factors contributed to shaping an incapable and wounded "self" living with AD. Based on our findings, we propose a child-centred biopsychosocial framework for understanding the living experiences of children with AD. This study suggests different practice strategies for healthcare professionals working with the individual challenges experienced by children living with AD and the challenges these children experience in their family, school, and neighbourhood. The needs of these children should be addressed through an integrated, holistic approach for improving their long-term health outcomes.
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Affiliation(s)
- Qian‐Wen Xie
- School of Public AffairsZhejiang UniversityHangzhouZhejiangChina
| | - Cecilia Lai‐wai Chan
- Department of Social Work and Social AdministrationThe University of Hong KongHong KongHong Kong
| | - Celia Hoi‐yan Chan
- Department of Social Work and Social AdministrationThe University of Hong KongHong KongHong Kong
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30
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Li DK, Chen H, Ferber JR, Hirst AK, Odouli R. Association Between Maternal Exposure to Magnetic Field Nonionizing Radiation During Pregnancy and Risk of Attention-Deficit/Hyperactivity Disorder in Offspring in a Longitudinal Birth Cohort. JAMA Netw Open 2020; 3:e201417. [PMID: 32207831 PMCID: PMC7093768 DOI: 10.1001/jamanetworkopen.2020.1417] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
IMPORTANCE An association between maternal exposure to magnetic field (MF) nonionizing radiation during pregnancy and the risk of attention-deficit/hyperactivity disorder (ADHD) has been reported in both animal and human studies. OBJECTIVES To determine whether maternal exposure to high levels of MF nonionizing radiation is associated with an increased risk of ADHD in offspring by using more accurate measurements of MF nonionizing radiation levels and physician-diagnosed ADHD, rather than self-reports, and to determine whether the association differs for the subtypes of ADHD with or without immune-related comorbidities. DESIGN, SETTING, AND PARTICIPANTS A longitudinal birth cohort study was conducted at Kaiser Permanente Northern California among 1482 mother-child pairs whose mothers were participants of an existing birth cohort and whose level of exposure to MF nonionizing radiation was captured during pregnancy in 2 studies conducted from October 1, 1996, to October 31, 1998, and from May 1, 2006, to February 29, 2012. The offspring were followed up from May 1, 1997, to December 31, 2017. EXPOSURE All participating women wore a monitoring meter for 24 hours during pregnancy to capture the level of exposure to MF nonionizing radiation from any sources. MAIN OUTCOMES AND MEASURES Physician-diagnosed ADHD and immune-related comorbidities of asthma or atopic dermatitis up to 20 years of age in offspring captured in the Kaiser Permanente Northern California electronic medical record from May 1, 1997, to December 31, 2017. Confounders were ascertained during in-person interviews during pregnancy. RESULTS Among the 1454 mother-child pairs (548 white [37.7%], 110 African American [7.6%], 325 Hispanic [22.4%], 376 Asian or Pacific Islander [25.9%], and 95 other or unknown [6.5%]; mean [SD] maternal age, 31.4 [5.4] years]), 61 children (4.2%) had physician-diagnosed ADHD. Using Cox proportional hazards regression to account for follow-up time and confounders, compared with children whose mothers had a low level of exposure to MF nonionizing radiation during pregnancy, children whose mothers were exposed to higher levels of MF nonionizing radiation had more than twice the risk of ADHD (adjusted hazard ratio [aHR], 2.01; 95% CI, 1.06-3.81). The association was stronger for ADHD that persisted into adolescence (≥12 years of age), with an aHR of 3.38 (95% CI, 1.43-8.02). When the subtypes of ADHD were examined, the association existed primarily for ADHD with immune-related comorbidities (asthma or atopic dermatitis), with an aHR of 4.57 (95% CI, 1.61-12.99) for all ADHD cases and an aHR of 8.27 (95% CI, 1.96-34.79) for persistent cases of ADHD. CONCLUSIONS AND RELEVANCE Consistent with the emerging literature, this study suggests that in utero exposure to high levels of MF nonionizing radiation was associated with an increased risk of ADHD, especially ADHD with immune-related comorbidity. The findings should spur more research to examine the biological association of in utero MF exposure with risk of ADHD in offspring, given that almost everyone is exposed to it.
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Affiliation(s)
- De-Kun Li
- Division of Research, Kaiser Foundation Research Institute, Kaiser Permanente, Oakland, California
| | - Hong Chen
- Division of Research, Kaiser Foundation Research Institute, Kaiser Permanente, Oakland, California
| | - Jeannette R. Ferber
- Division of Research, Kaiser Foundation Research Institute, Kaiser Permanente, Oakland, California
| | - Andrew K. Hirst
- Division of Research, Kaiser Foundation Research Institute, Kaiser Permanente, Oakland, California
| | - Roxana Odouli
- Division of Research, Kaiser Foundation Research Institute, Kaiser Permanente, Oakland, California
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31
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Bridgman AC, Fitzmaurice C, Dellavalle RP, Karimkhani Aksut C, Grada A, Naghavi M, Manafi N, Olagunju AT, Olagunju TO, Somayaji R, Drucker AM. Canadian Burden of Skin Disease From 1990 to 2017: Results From the Global Burden of Disease 2017 Study [Formula: see text]. J Cutan Med Surg 2020; 24:161-173. [PMID: 31994902 PMCID: PMC7109598 DOI: 10.1177/1203475420902047] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Background Skin diseases can have high morbidity that can be costly to society and individuals. To date, there has been no comprehensive assessment of the burden of skin disease in Canada. Objectives To evaluate the burden of 18 skin and subcutaneous diseases from 1990 to 2017 in Canada using the Global Burden of Disease (GBD) data. Methods The 2017 GBD study measures health loss from 359 diseases and injuries in 195 countries; we evaluated trends in population health in Canada from 1990 to 2017 using incidence, prevalence, mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life years (DALYs). Data are presented as rates (per 100 000), counts, or percent change with the uncertainty interval in brackets. Results From 1990 to 2017 for all skin diseases, DALY rates increased by 8% to 971 per 100 000 (674-1319), YLD rates increased by 8% to 897 per 100 000 (616-1235), YLL rates increased by 4% to 74 per 100 000 (53-89), and death rates increased by 18% to 5 per 100 000 (3-6). DALY rates for melanoma increased by 2% to 54 per 100 000 (39-68), for keratinocyte carcinoma by 14% to 17 per 100 000 (16-19), and for skin and subcutaneous disease by 8% to 900 per 100 000 (619-1233). The observed over expected ratios were higher for skin and subcutaneous disease (1.37) and keratinocyte carcinoma (1.17) and were lower for melanoma (0.73). Conclusions The burden of skin disease has increased in Canada since 1990. These results can be used to guide health policy regarding skin disease in Canada.
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Affiliation(s)
| | - Christina Fitzmaurice
- 7284 Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.,Division of Hematology, University of Washington, Seattle, WA, USA.,Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Robert P Dellavalle
- 12226 School of Medicine, University of Colorado Denver, Aurora, CO, USA.,Dermatology Service, US Department of Veterans Affairs (VA), Denver, CO, USA.,129263 Department of Dermatology, University of Colorado School of Medicine, Denver, CO
| | - Chante Karimkhani Aksut
- Dermatology Service, US Department of Veterans Affairs (VA), Denver, CO, USA.,129263 Department of Dermatology, University of Colorado School of Medicine, Denver, CO
| | - Ayman Grada
- 12259 School of Medicine, Boston University, Boston, MA, USA
| | - Mohsen Naghavi
- 7284 Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Navid Manafi
- 440827 Ophthalmology Department, Iran University of Medical Sciences, Tehran, Iran.,Ophthalmology Department, University of Manitoba, Winnipeg, MB, Canada
| | - Andrew T Olagunju
- 62703 Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.,Department of Psychiatry, University of Lagos, Lagos, Nigeria
| | - Tinuke O Olagunju
- 62703 Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada
| | - Ranjani Somayaji
- 2129 Department of Medicine, University of Calgary, Calgary, AB, Canada.,Department of Medicine, University of Washington, Seattle, WA, USA
| | - Aaron M Drucker
- Division of Dermatology, University of Toronto, Toronto, ON, Canada.,7985 Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada
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Dai YX, Tai YH, Chang YT, Chen TJ, Chen MH. Increased Risk of Atopic Diseases in the Siblings of Patients with Autism Spectrum Disorder: A Nationwide Population-Based Cohort Study. J Autism Dev Disord 2020; 49:4626-4633. [PMID: 31435817 DOI: 10.1007/s10803-019-04184-w] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Several studies have shown a strong association between atopic diseases and autism spectrum disorder (ASD). However, the risk of atopic diseases in individuals having ASD-affected siblings has never been investigated. This nationwide population-based cohort study included 2762 individuals with ASD-affected siblings and 11,048 controls. Diagnoses of atopic diseases, including asthma, atopic dermatitis, allergic rhinitis, and allergic conjunctivitis, were ascertained from 1996 or the birth data to the end of 2011. Individuals with ASD-affected siblings had a higher risk for asthma, atopic dermatitis, allergic rhinitis, allergic conjunctivitis, and multiple atopic diseases compared with controls. In conclusion, individuals with ASD-affected siblings were more likely than were the controls to develop atopic diseases, suggesting shared familial mechanisms underlying the two conditions.
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Affiliation(s)
- Ying-Xiu Dai
- Department of Dermatology, Taipei Veterans General Hospital, Taipei, Taiwan.,School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Ying-Hsuan Tai
- School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Department of Anesthesiology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.,Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yun-Ting Chang
- Department of Dermatology, Taipei Veterans General Hospital, Taipei, Taiwan.,School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Tzeng-Ji Chen
- School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Mu-Hong Chen
- School of Medicine, National Yang-Ming University, Taipei, Taiwan. .,Department of Psychiatry, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd, Beitou District, Taipei, 11217, Taiwan, ROC.
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Xie QW, Dai X, Tang X, Chan CHY, Chan CLW. Risk of Mental Disorders in Children and Adolescents With Atopic Dermatitis: A Systematic Review and Meta-Analysis. Front Psychol 2019; 10:1773. [PMID: 31447731 PMCID: PMC6691144 DOI: 10.3389/fpsyg.2019.01773] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Accepted: 07/16/2019] [Indexed: 12/30/2022] Open
Abstract
Assessing the psychological effects on children and adolescents of suffering atopic dermatitis (AD) is essential, when planning successful management. This study aimed to systematically review the literature regarding risk of mental disorders in children and adolescents with, or without, AD; and to explore confounders. We identified potentially relevant studies from EMBASE, MEDLINE, PsycINFO, ERIC, the British Nursing Index, the Family and Society Studies Worldwide, the Social Work Abstracts, and the Sociological Abstracts from inception to Sep 30, 2018. Investigators independently screened titles and abstracts, and then full-texts. Investigators independently extracted data from included studies. Meta-analyses using random-effects models were performed, reporting odds ratios (ORs; 95% CIs). Thirty-seven studies (n = 2,068,911 children/ adolescents) were included. Meta-analysis of 35 studies found that children and adolescents with AD had significantly higher risk of total mental disorders than those without AD (OR = 1.652; 95% CI, 1.463-1.864). There was no significant difference in risks for ADHD (OR = 1.563; 95% CI, 1.382-1.769); sleep disorders (OR = 2.100; 95% CI, 1.322-3.336); anxiety (OR = 1.339; 95% CI, 1.062-1.687); depression (OR = 1.402 95% CI, 1.256-1.565); conduct disorder (OR = 1.494 95% CI, 1.230-1.815); or ASD (OR = 2.574; 95% CI, 1.469-4.510; Q b = 8.344, p = 0.138). Race/ethnicity of child, target of comparison, type of studies, representativeness of the sample, measures of AD and mental disorders were significant moderators for total mental disorders. Integrated, holistic, multidisciplinary management of pediatric AD is significantly important, which emphasizes the well-being of the whole person.
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Affiliation(s)
- Qian-Wen Xie
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong
| | - Xiaolu Dai
- Department of Social Work and Social Administration, Changsha Social Work College, Changsha, China
| | - Xinfeng Tang
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong
| | - Celia H. Y. Chan
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong
| | - Cecilia L. W. Chan
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong
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Factors Associated with Atopic Dermatitis and Allergic Rhinitis among Residents of Two Municipal Areas in South Korea. ACTA ACUST UNITED AC 2019; 55:medicina55050131. [PMID: 31083640 PMCID: PMC6572473 DOI: 10.3390/medicina55050131] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 03/24/2019] [Accepted: 05/08/2019] [Indexed: 01/16/2023]
Abstract
Background and Objectives: The growing burden and deleterious health consequences of allergic diseases, especially of allergic rhinitis (AR) and atopic dermatitis (AD), in developed countries remains an important public health issue. The current study aimed to assess the prevalence and to identify the risk factors of atopic dermatitis and allergic rhinitis among residents of Pohang-Si and Yeongdeok-Gun, two municipal areas in South Korea. Materials and Methods: A cross-sectional study was conducted in both municipal areas between 12 November and 13 December 2017. A total of 302 subjects were recruited from 100 households (25 apartments and 25 houses in each municipality), by system extraction according to district code numbers. Data were collected using International Study of Asthma and Allergies in Childhood (ISAAC) Standard Questionnaires for children and a health questionnaire for adults. Risk factors were identified by multivariate logistic regression analysis. Results: Of the 302 study participants, 12.9% and 25.5% had AD and AR, respectively. The significant factors associated with AD by multivariate logistic regression analysis were age ≥19 years (aOR (adjusted odds ratio) 6.9; 95% CI (confidence interval) (2.9–16.37)), residence in Pohang-Si (aOR 2.5; 95% CI (1.18–5.53)), and family history of allergic disease (aOR 2.3; 95% CI (1.09–4.9)). Similarly, the significant factors associated with AR were male gender (aOR 2.3; 95% CI (1.24–4.42)), age ≥19 years (aOR 4.4; 95% CI (2.28–8.48)), residence in Pohang-Si (aOR 2.8; 95% CI (1.51–5.37)), and family history of allergic disease (aOR 6.7; 95% CI (3.50–12.82)). Conclusion: The present study shows that age ≥19 years, residence in Pohang-Si, and family history of allergic disease are risk factors for AD and AR, and that, additionally, male gender is a risk factor of AR. Understanding the risk factors of allergic diseases can aid the design and implementation of evidence-specific strategies to reduce the long-standing problems associated with allergic disease.
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Hsu PC, Lo YC, Wu PY, Chiu JW, Jeng MJ. The relationship of seasonality and the increase in urinary tract infections among hospitalized patients with spinal cord injury. J Chin Med Assoc 2019; 82:401-406. [PMID: 31058713 DOI: 10.1097/jcma.0000000000000040] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Urinary tract infection (UTI) is the most frequent complication in patients who have spinal cord injury (SCI). The occurrence rate of UTI in this type of hospitalized patients was correlated to seasonality, age, and gender. METHODS Patients hospitalized during the 4-year study period with underlying SCI were identified from Taiwan's National Health Insurance Research Database. Patients with a discharge diagnosis of UTI were identified as those with SCI and UTI; they were divided into the following four age groups: <18 years, 18 to 44 years, 45 to 64 years, and ≥65 years. The gender, monthly number of cases, major complication rate, seasonal differences, and odds ratios (ORs) of associated factors were analyzed. RESULTS Data of 30 149 hospitalized patients diagnosed with SCI were retrieved. SCI and UTI were diagnosed in 3405 (11.3%) patients, of them 2296 were males (67.4%) and 1109 were females (32.6%). The UTI occurrence rate in hospitalized SCI patients was higher in males (11.8%) than in females (10.4%) (OR: 1.24; 95% CI: 1.15-1.34); it was highest in the ≥65-year-old age group (12.8%) and lowest in the <18-year-old age group (5.8%) (OR: 2.51; 95% CI: 1.83-3.44). The UTI occurrence rate varied from 7% to 18%, and it was highest in the summer (13.0% ± 2.6%) and lowest in the winter (10.2% ± 1.9%) (OR: 1.27; 95% CI: 1.15-1.40). Acute pyelonephritis was the most common complication in SCI and UTI cases. CONCLUSION The mean occurrence rate of UTI in hospitalized SCI patients was 11.3%; it was higher in males, in patients aged ≥65 years, and in the summer. Therefore, physicians should pay attention to the occurrence of UTI in aged male patients with SCI, especially in the summer.
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Affiliation(s)
- Po-Cheng Hsu
- Department of Physical Medicine and Rehabilitation, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Yu-Cheng Lo
- Department of Pediatrics, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Pediatrics, Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Pin-Yi Wu
- Department of Physical Medicine and Rehabilitation, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Jan-Wei Chiu
- Department of Physical Medicine and Rehabilitation, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Mei-Jy Jeng
- Department of Pediatrics, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Pediatrics, Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
- Institute of Emergency and Critical Care Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
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Atefi N, Rohaninasab M, Shooshtari M, Behrangi E, Mehran G, Goodarzi A, Moghadam SS, Shakoei S. The Association between Attention-Deficit/Hyperactivity Disorder and Atopic Dermatitis: A Study among Iranian Children. Indian J Dermatol 2019; 64:451-455. [PMID: 31896842 PMCID: PMC6862371 DOI: 10.4103/ijd.ijd_458_18] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Background The co-occurrence of attention-deficit/hyperactivity disorder (ADHD) with atopic dermatitis (AD) has been well described in some recent association studies; however, we did not have any perspective on this relationship in our country. Aim and Objective Hence, the present study aimed to assess the prevalence of ADHD in children with AD. Materials and Methods This cross-sectional study was performed on 95 consecutive children and adolescents (aged 4-18 years) who were referred to dermatology clinics at the two hospitals in Tehran during 2017 with atopic dermatitis. The evidence of atopy was assessed using the 2003 National Survey of Children's Health. The diagnosis of ADHD was based on the Conner Rating Scale. The sleep disorder was also assessed by the Pittsburg sleep quality questionnaire. Results The prevalence of hyperactivity and attention deficit in our AD patients was 20.0% and 29.47%, respectively. Furthermore, patients with sleep problem were significantly more likely to have hyperactivity disorder (odds ratio [OR]: 2.91, 95% confidence interval [CI]: 1.04-8.16, P = 0.04). According to the results of multiple logistic regression analyses, flexor involvement was the only predictor of hyperactivity disorder in the final model. The univariate and multivariate analyses showed that having attention deficit was associated with having cheek involvement (OR = 3.63, 95% CI: 1.44-9.14, P = 0.01) and sleep problem (OR = 3.68, 95% CI: 1.45-9.33, P = 0.01). Conclusion It seems that neurocognitive disturbances due to sleep restriction in AD children may be one of the main trigger, especially for attention deficit.
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Affiliation(s)
- Najmolsadat Atefi
- Department of Dermatology, Rasoul-e-Akram Hospital, Iran University of Medical Science, Tehran, Iran
| | - Masoumeh Rohaninasab
- Department of Dermatology, Rasoul-e-Akram Hospital, Iran University of Medical Science, Tehran, Iran
| | - Mitra Shooshtari
- School of Behavioral Sciences and Mental Health, Mental Health Research Center, Tehran Institute of Psychiatry, Iran University of Medical Sciences, Tehran, Iran
| | - Elham Behrangi
- Department of Dermatology, Rasoul-e-Akram Hospital, Iran University of Medical Science, Tehran, Iran
| | - Golnaz Mehran
- Department of Dermatology, Rasoul-e-Akram Hospital, Iran University of Medical Science, Tehran, Iran
| | - Azade Goodarzi
- Department of Dermatology, Rasoul-e-Akram Hospital, Iran University of Medical Science, Tehran, Iran
| | - Sadaf Sajedi Moghadam
- Department of Dermatology, Rasoul-e-Akram Hospital, Iran University of Medical Science, Tehran, Iran
| | - Safoura Shakoei
- Department of Dermatology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Kuniyoshi Y, Kikuya M, Miyashita M, Yamanaka C, Ishikuro M, Obara T, Metoki H, Nakaya N, Nagami F, Tomita H, Hozawa A, Tsuji I, Kure S, Yaegashi N, Yamamoto M, Kuriyama S. Severity of eczema and mental health problems in Japanese schoolchildren: The ToMMo Child Health Study. Allergol Int 2018; 67:481-486. [PMID: 29661500 DOI: 10.1016/j.alit.2018.02.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Revised: 02/07/2018] [Accepted: 02/15/2018] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The association between eczema and mental health problems in schoolchildren has been underexplored. We aimed to investigate this association with the validated questionnaires. METHODS Of 46,648 invited children, we analyzed 9954 (21.3%) in the 2nd to the 8th grades from the ToMMo Child Health Study conducted in 2014 and 2015, a cross-sectional survey in Miyagi Prefecture, Japan. We defined eczema status as "normal," "mild/moderate," or "severe," based on the presence of persistent flexural eczema and sleep disturbance, according to the International Study of Asthma and Allergies in Childhood (ISAAC) Eczema Symptom Questionnaire. Clinical ranges of Strengths and Difficulties Questionnaire (SDQ) total difficulties scores and four SDQ subcategories of emotional symptoms, conduct problems, hyperactivity/inattention, and peer problems were defined as scores ≥16, ≥5, ≥5, ≥7, and ≥5, respectively. RESULTS The mean SDQ total difficulties score significantly increased as eczema status worsened (all P ≤ 0.004 for trend). The OR of scores in the clinical range for SDQ total difficulties were 1.51 (95% CI, 1.31-1.74) for mild/moderate eczema and 2.63 (95% CI, 1.91-3.63) for severe eczema (P < 0.001 for trend), adjusted for sex, school grade, current wheeze, and disaster-related factors, using normal eczema as a reference. The association between severity of eczema and four SDQ subcategories showed a similar trend (all P ≤ 0.017 for trend). CONCLUSIONS We found a significant association between severity of eczema and mental health problems. The presence of eczema was associated with four SDQ subcategories.
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Affiliation(s)
- Yasutaka Kuniyoshi
- Department of Disaster Public Health, International Research Institute of Disaster Science, Tohoku University, Sendai, Japan
| | - Masahiro Kikuya
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan; Department of Molecular Epidemiology, Graduate School of Medicine, Tohoku University, Sendai, Japan.
| | - Masako Miyashita
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan; Department of Molecular Epidemiology, Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Chizuru Yamanaka
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan; Department of Molecular Epidemiology, Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Mami Ishikuro
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan; Department of Molecular Epidemiology, Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Taku Obara
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan; Department of Molecular Epidemiology, Graduate School of Medicine, Tohoku University, Sendai, Japan; Department of Pharmaceutical Sciences, Tohoku University Hospital, Sendai, Japan
| | - Hirohito Metoki
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan; Division of Public Health, Hygiene and Epidemiology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Naoki Nakaya
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan; Department of Personalized Prevention and Epidemiology, Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Fuji Nagami
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Hiroaki Tomita
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan; Department of Disaster Psychiatry, International Research Institute of Disaster Science, Tohoku University, Sendai, Japan
| | - Atsushi Hozawa
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan; Department of Personalized Prevention and Epidemiology, Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Ichiro Tsuji
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan; Department of Public Health & Forensic Medicine, Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Shigeo Kure
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan; Department of Pediatrics, Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Nobuo Yaegashi
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan; Department of Obstetrics and Gynecology, Graduate School of Medicine, Tohoku University, Sendai, Japan; Department of Obstetrics and Gynecology, Tohoku University Hospital, Sendai, Japan
| | - Masayuki Yamamoto
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan; Department of Medical Biochemistry, Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Shinichi Kuriyama
- Department of Disaster Public Health, International Research Institute of Disaster Science, Tohoku University, Sendai, Japan; Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan; Department of Molecular Epidemiology, Graduate School of Medicine, Tohoku University, Sendai, Japan
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Xu G, Snetselaar LG, Jing J, Liu B, Strathearn L, Bao W. Association of Food Allergy and Other Allergic Conditions With Autism Spectrum Disorder in Children. JAMA Netw Open 2018; 1:e180279. [PMID: 30646068 PMCID: PMC6324407 DOI: 10.1001/jamanetworkopen.2018.0279] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
IMPORTANCE The prevalence of autism spectrum disorder (ASD) in US children has increased during the past decades. Immunologic dysfunction has recently emerged as a factor associated with ASD. Although children with ASD are more likely to have gastrointestinal disorders, little is known about the association between food allergy and ASD. OBJECTIVE To examine the association of food allergy and other allergic conditions with ASD in US children. DESIGN, SETTING, AND PARTICIPANTS This population-based, cross-sectional study used data from the National Health Interview Survey collected between 1997 and 2016. The data analysis was performed in 2018. All eligible children aged 3 to 17 years were included. Food allergy, respiratory allergy, and skin allergy were defined based on an affirmative response in the questionnaire by a parent or guardian. MAIN OUTCOMES AND MEASURES Reported ASD diagnosed by a physician or other health professional. RESULTS This analysis included 199 520 children (unweighted mean [SD] age, 10.21 [4.41] years; 102 690 boys [51.47%]; 55 476 Hispanic [27.80%], 97 200 non-Hispanic white [48.72%], 30 760 non-Hispanic black [15.42%], and 16 084 non-Hispanic other race [8.06%]). Among them, 8734 (weighted prevalence, 4.31%) had food allergy, 24 555 (12.15%) had respiratory allergy, and 19 399 (9.91%) had skin allergy. A diagnosis of ASD was reported in 1868 children (0.95%). The weighted prevalence of reported food, respiratory, and skin allergies was higher in children with ASD (11.25%, 18.73%, and 16.81%, respectively) compared with children without ASD (4.25%, 12.08%, and 9.84%, respectively). In analyses adjusting for age, sex, race/ethnicity, family highest education level, family income level, geographical region, and mutual adjustment for other allergic conditions, the associations between allergic conditions and ASD remained significant. The odds ratio (OR) of ASD increased in association with food allergy (OR, 2.29; 95% CI, 1.87-2.81), respiratory allergy (OR, 1.28; 95% CI, 1.10-1.50), and skin allergy (OR, 1.50; 95% CI, 1.28-1.77) when comparing children with these conditions and those without. CONCLUSIONS AND RELEVANCE In a nationally representative sample of US children, a significant and positive association of common allergic conditions, in particular food allergy, with ASD was found. Further investigation is warranted to elucidate the causality and underlying mechanisms.
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Affiliation(s)
- Guifeng Xu
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City
- Center for Disabilities and Development, University of Iowa Stead Family Children’s Hospital, Iowa City
| | - Linda G. Snetselaar
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City
| | - Jin Jing
- Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, Guangzhou, China
| | - Buyun Liu
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City
| | - Lane Strathearn
- Center for Disabilities and Development, University of Iowa Stead Family Children’s Hospital, Iowa City
- Division of Developmental and Behavioral Pediatrics, Stead Family Department of Pediatrics, University of Iowa Carver College of Medicine, Iowa City
| | - Wei Bao
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City
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Schmitt J, Buske-Kirschbaum A, Tesch F, Trikojat K, Stephan V, Abraham S, Bauer A, Nemat K, Plessow F, Roessner V. Increased attention-deficit/hyperactivity symptoms in atopic dermatitis are associated with history of antihistamine use. Allergy 2018; 73:615-626. [PMID: 28975640 DOI: 10.1111/all.13326] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/26/2017] [Indexed: 12/20/2022]
Abstract
BACKGROUND Epidemiologic evidence indicates a relevant association between atopic dermatitis (AD) and attention-deficit/hyperactivity disorder (ADHD). Underlying mechanisms and ways to best identify subgroups of AD patients at risk for ADHD are poorly understood. AIMS OF THE STUDY To compare sociodemographic, clinical and psychosocial characteristics of children with AD, ADHD, comorbid AD/ADHD and age-matched healthy controls and to investigate aspects of AD related to ADHD symptoms. METHODS Applying a factorial design, we investigated 4 groups of children aged 6-12 years: AD-only (ie, without ADHD), ADHD-only (ie, without AD), AD + ADHD and healthy controls (HC; ie, no AD/no ADHD). Using validated instruments, ADHD symptoms and other behavioural problems, quality of life, parenting stress and sleeping problems were compared between groups. In children with AD-only, clinical signs (objective SCORAD), symptoms (POEM, VAS pruritus, VAS sleeping problems) and previous treatment of AD were assessed to investigate disease patterns related to ADHD symptoms. RESULTS Compared to HC (n = 47), children with AD-only (n = 42), ADHD-only (n = 34) and comorbid AD + ADHD (n = 31) had significantly increased behavioural problems and decreased quality of life. Children with AD-only had significantly higher levels of ADHD symptoms than HC. In children with AD-only, previous use of antihistamines was significantly associated with increased ADHD symptoms (OR 1.88; 95% CI 1.04-3.39). Current clinical signs and AD symptoms were unrelated to the level of ADHD symptoms. CONCLUSIONS Even if the clinical diagnosis of ADHD is excluded, children with AD show increased levels of ADHD symptoms. Further investigations need to determine whether early antihistamine exposure is a major risk factor for ADHD or a surrogate for previous AD severity and/or associated sleeping problems.
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Affiliation(s)
- J. Schmitt
- Center for Evidence-based Healthcare; Medizinische Fakultät Carl Gustav Carus; TU Dresden; Dresden Germany
- University Allergy Center; University Hospital Carl Gustav Carus; TU Dresden; Dresden Germany
| | | | - F. Tesch
- Center for Evidence-based Healthcare; Medizinische Fakultät Carl Gustav Carus; TU Dresden; Dresden Germany
| | - K. Trikojat
- Department of Biopsychology; TU Dresden; Dresden Germany
| | - V. Stephan
- Center for Evidence-based Healthcare; Medizinische Fakultät Carl Gustav Carus; TU Dresden; Dresden Germany
| | - S. Abraham
- University Allergy Center; University Hospital Carl Gustav Carus; TU Dresden; Dresden Germany
- Department of Dermatology; University Hospital Carl Gustav Carus; TU Dresden; Dresden Germany
| | - A. Bauer
- University Allergy Center; University Hospital Carl Gustav Carus; TU Dresden; Dresden Germany
- Department of Dermatology; University Hospital Carl Gustav Carus; TU Dresden; Dresden Germany
| | - K. Nemat
- University Allergy Center; University Hospital Carl Gustav Carus; TU Dresden; Dresden Germany
| | - F. Plessow
- Neuroendocrine Unit; Massachusetts General Hospital; Boston MA USA
- Department of Medicine; Harvard Medical School; Boston MA USA
| | - V. Roessner
- Child and Adolescent Psychiatry; University Hospital Carl Gustav Carus; TU Dresden; Dresden Germany
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Tzeng NS, Chang HA, Chung CH, Kao YC, Chang CC, Yeh HW, Chiang WS, Chou YC, Chang SY, Chien WC. Increased Risk of Psychiatric Disorders in Allergic Diseases: A Nationwide, Population-Based, Cohort Study. Front Psychiatry 2018; 9:133. [PMID: 29740354 PMCID: PMC5928780 DOI: 10.3389/fpsyt.2018.00133] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 03/28/2018] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND/OBJECTIVE Allergic diseases, such as bronchial asthma, allergic rhinitis, atopic dermatitis, and psychiatric disorders, are major health issues. There have been reports that allergic diseases were associated with depression or anxiety disorders. This study aimed to investigate the association between these allergic diseases and the risk of developing overall psychiatric disorders in patients from Taiwan. METHODS This cohort study used the database of the Taiwan National Health Insurance Program. A total of 186,588 enrolled patients, with 46,647 study subjects who had suffered from allergic diseases, and 139,941 controls matched for sex and age, from the Longitudinal Health Insurance Dataset of 2000-2015, were selected from a sub-dataset of the National Health Insurance Research Database. Fine and Gray's competing risk model analysis was used to explore the hazard ratio (HR), and 95% confidence interval, for the risk of allergic diseases being associated with the risk of developing psychiatric disorders during the 15 years of follow-up. RESULTS Of the study subjects, 5,038 (10.8%) developed psychiatric disorders when compared to 9,376 (6.7%) in the control group, with significant difference (p < 0.001). Fine and Gray's competing risk model analysis revealed that the adjusted HR was 1.659 (95% CI = 1.602-1.717, p < 0.001). In this study, we found that the groups of atopic dermatitis alone and the allergic rhinitis + atopic dermatitis were associated with a lower risk of psychiatric disorders, but all the other four groups, such as bronchial asthma alone, allergic rhinitis alone, bronchial asthma + allergic rhinitis, bronchial asthma + atopic dermatitis, and the combination of all these three allergic diseases, were associated with a higher risk of psychiatric disorders. CONCLUSION Allergic diseases are therefore associated with a 1.66-fold increased hazard of psychiatric disorders in Taiwan.
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Affiliation(s)
- Nian-Sheng Tzeng
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan.,Student Counseling Center, National Defense Medical Center, Taipei, Taiwan
| | - Hsin-An Chang
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan.,Student Counseling Center, National Defense Medical Center, Taipei, Taiwan
| | - Chi-Hsiang Chung
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.,Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Taiwan.,School of Public Health, National Defense Medical Center, Taipei, Taiwan
| | - Yu-Chen Kao
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan.,Department of Psychiatry, Tri-Service General Hospital, Song-Shan Branch, National Defense Medical Center, Taipei, Taiwan
| | - Chuan-Chia Chang
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Hui-Wen Yeh
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan.,Institute of Bioinformatics and Systems Biology, National Chiao Tung University, Hsin-Chu, Taiwan.,Department of Nursing, Tri-Service General Hospital, School of Nursing, National Defense Medical Center, Taipei, Taiwan.,Department of Nursing, Kang-Ning University (Taipei Campus), Taipei, Taiwan
| | - Wei-Shan Chiang
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Yu-Ching Chou
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
| | - Shan-Yueh Chang
- Division of Chest and Critical Medicine, Department of Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan.,Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Wu-Chien Chien
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.,Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Taiwan.,Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan
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41
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Boguniewicz M, Alexis AF, Beck LA, Block J, Eichenfield LF, Fonacier L, Guttman-Yassky E, Paller AS, Pariser D, Silverberg JI, Lebwohl M. Expert Perspectives on Management of Moderate-to-Severe Atopic Dermatitis: A Multidisciplinary Consensus Addressing Current and Emerging Therapies. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2017; 5:1519-1531. [PMID: 28970084 DOI: 10.1016/j.jaip.2017.08.005] [Citation(s) in RCA: 119] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Revised: 07/24/2017] [Accepted: 08/07/2017] [Indexed: 12/17/2022]
Abstract
Atopic dermatitis (AD) is a common, chronic, relapsing, inflammatory skin disease that affects children and adults. Until recently, the only Food and Drug Administration-approved systemic treatment option for patients with moderate-to-severe AD was systemic steroids, which are not recommended by current guidelines and are commonly associated with disease rebound. Instead, clinicians choose from several off-label immunosuppressants, which can have serious adverse effects. A significant number of these patients go untreated. Research on the immunopathogenesis of AD has paved the way for new, targeted, systemic therapies for moderate-to-severe AD. In early 2017, the Food and Drug Administration approved dupilumab for adults with moderate-to-severe AD whose disease is not adequately controlled with topical therapies. Although the national guidelines can be very helpful to clinicians, the process for updating them does not allow for timely incorporation of novel therapies. A steering committee of AD experts, including dermatologists, allergists, and a patient advocacy group representative, developed recommendations on the basis of a literature review and expert opinion to help clinicians understand how new therapies fit into the current treatment paradigm and to provide practical recommendations for assessing AD severity, treatment response, and treatment failure.
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Affiliation(s)
- Mark Boguniewicz
- Division of Allergy-Immunology, Department of Pediatrics, National Jewish Health and University of Colorado School of Medicine, Denver, Colo.
| | - Andrew F Alexis
- Department of Dermatology, Skin of Color Center, Mount Sinai St Luke's and Mount Sinai West, New York, NY
| | - Lisa A Beck
- Department of Dermatology, University of Rochester Medical Center, Rochester, NY
| | - Julie Block
- National Eczema Association, San Rafael, Calif
| | - Lawrence F Eichenfield
- Departments of Dermatology and Pediatrics, University of California, San Diego, Calif; Rady Children's Hospital San Diego, San Diego, Calif
| | - Luz Fonacier
- Section of Allergy and Clinical Immunology, Department of Medicine, NYU Winthrop-University Hospital, Mineola, NY
| | - Emma Guttman-Yassky
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Amy S Paller
- Departments of Dermatology and Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Ill
| | - David Pariser
- Department of Dermatology, Eastern Virginia Medical School and Virginia Clinical Research, Inc, Norfolk, Va
| | - Jonathan I Silverberg
- Departments of Dermatology, Preventive Medicine and Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Ill
| | - Mark Lebwohl
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY
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42
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von Kobyletzki LB, Beckman L, Smirnova J, Smeeth L, Williams HC, McKee M, Abuabara K, Langan SM. Eczema and educational attainment: a systematic review. Br J Dermatol 2017; 177:e47-e49. [PMID: 27995605 DOI: 10.1111/bjd.15242] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- L B von Kobyletzki
- Department of Public Health Sciences, Karlstad University, Karlstad, Sweden.,Lund University, Skåne University Hospital, Department of Dermatology, Malmö, Sweden
| | - L Beckman
- Department of Public Health Sciences, Karlstad University, Karlstad, Sweden
| | - J Smirnova
- Department of Public Health Sciences, Karlstad University, Karlstad, Sweden
| | - L Smeeth
- London School of Hygiene and Tropical Medicine, London, U.K
| | - H C Williams
- Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, U.K
| | - M McKee
- London School of Hygiene and Tropical Medicine, London, U.K.,European Observatory on Health Systems and Policies, London, U.K
| | - K Abuabara
- University of California, San Francisco, CA, U.S.A
| | - S M Langan
- London School of Hygiene and Tropical Medicine, London, U.K.,St John's Institute of Dermatology, London, U.K
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