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Hui-Beckman JW, Leung DYM. Physical influences on the skin barrier and pathogenesis of allergy. Curr Opin Pediatr 2023; 35:656-662. [PMID: 37650580 DOI: 10.1097/mop.0000000000001289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
PURPOSE OF REVIEW As the incidence of allergic conditions has increased in recent decades, the effects of climate change have been implicated. There is also increased knowledge on the effects of other physical influences, such as scratching and Staphylococcus aureus . The skin barrier is the first line of defense to the external environment, so understanding the ways that these factors influence skin barrier dysfunction is important. RECENT FINDINGS Although the impact on environmental exposures has been well studied in asthma and other allergic disorders, there is now more literature on the effects of temperature, air pollution, and detergents on the skin barrier. Factors that cause skin barrier dysfunction include extreme temperatures, air pollution (including greenhouse gases and particulate matter), wildfire smoke, pollen, scratching, S. aureus, and detergents. SUMMARY Understanding the ways that external insults affect the skin barrier is important to further understand the mechanisms in order to inform the medical community on treatment and prevention measures for atopic conditions.
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Zhang R, Weschler LB, Ye J, Wang Z, Deng Q, Li B, HuaQian, Zhao Z, Zhang Y, Huang S, Hong C. Associations between home environmental factors and childhood eczema and related symptoms in different cities in China. Heliyon 2023; 9:e21718. [PMID: 38027650 PMCID: PMC10661510 DOI: 10.1016/j.heliyon.2023.e21718] [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: 08/19/2023] [Revised: 10/24/2023] [Accepted: 10/26/2023] [Indexed: 12/01/2023] Open
Abstract
Previous studies have shown significant associations between home environmental factors and childhood eczema. However, few studies have compared how associations differ in different regions. This study investigated associations between home environmental factors and childhood eczema ever, and related symptoms including itchy rash (IR) and being awakened by itchy rash at night (awake by IR) in 4 cities located in different regions of China, based on cross-sectional investigations during 2010-2012. We used two-step analysis to explore the associations between influencing factors and eczema/related symptoms: first, group Least Absolute Shrinkage and Selection Operator (LASSO) was conducted to identify important factors among a list of candidates; then, the associations in total study population and in each city were estimated using logistic regression. We found these home environmental factors to be risk factors for eczema or related symptoms: large residence size, shared room, air cleaner at home, abnormal smell, perceived dry air, visible mold or damp stains, cooking with coal or wood, painted wall, incense, mice, new furniture during pregnancy, abnormal smell at birth, window condensation at birth and environmental tobacco smoke at birth. Environmental protective factors were rural house location and window ventilation. Associations of factors with eczema/related symptoms differed across cities. For example, air conditioning was protective for eczema in Beijing and awakening by IR in Shanghai with ORs of 0.70 (95%CI: 0.52, 0.95) and 0.33 (95%CI: 0.14, 0.81) respectively, but not significant in other cities. Our results have implications for improving home environments to reduce the risk of childhood eczema/related symptoms in different regions of China.
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Affiliation(s)
- Ruosu Zhang
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, 100191, China
| | | | - Jin Ye
- School of Energy and Power, Jiangsu University of Science and Technology, Zhenjiang, 212100, China
| | - Zhaokun Wang
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, 100191, China
| | - Qihong Deng
- School of Public Health, Zhengzhou University, Zhengzhou, China
| | - Baizhan Li
- Key Laboratory of Three Gorges Reservoir Region's Eco-Environment, Chongqing University, Chongqing 400030, China
| | - HuaQian
- School of Energy & Environment, Southeast University, Nanjing 210096, China
| | - Zhuohui Zhao
- School of Public Health, Fudan University, Shanghai 200032, China
| | - Yinping Zhang
- Department of Building Science, Tsinghua University, Beijing 100084, China
| | - Shaodan Huang
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, 100191, China
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, China
| | - Chuan Hong
- Department of Biostatistics & Bioinformatics, School of Medicine, Duke University, North Carolina, USA
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Hu Q, Shi X, Wang D, Huang Y, Gao J, Guan H, Ren H, Lin X, Lu Z, Tong S, Yang G, Liu S. Effects of climate and environment on migratory old people with allergic diseases in China: Protocol for a Sanya cohort study. Heliyon 2023; 9:e21949. [PMID: 38045199 PMCID: PMC10692782 DOI: 10.1016/j.heliyon.2023.e21949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 10/27/2023] [Accepted: 11/01/2023] [Indexed: 12/05/2023] Open
Abstract
Background Several studies have reported that the mountain climate can alleviate asthma, however, the effect of tropical climate on migratory elderly, especially in people with respiratory or allergic diseases is unknown. Objectives This cohort study aims to explore impact of climate and environmental changes on allergic diseases in migratory old people. Methods In this prospective cohort study, we recruited 750 older migratory people, the majority of whom were homeowners to minimize the risk of loss to follow up. The study's inclusion criteria were elderly individuals had moved from northern China to Sanya and suffered from either asthma or allergic diseases. Prior to participation, these individuals provided informed consent and underwent baseline assessment. Subsequently, they will be followed for three years. A face-to-face interview was conducted to gather information regarding their living environment and habits. Trained investigators administered the questionnaires and performed physical examinations including height, weight, and blood pressure, while a professional respiratory doctor conducted pulmonary function tests. Blood samples were promptly tested routine blood test, liver function, kidney function, glucose, triglyceride, allergens, and inflammatory factors. Climate and environmental data were obtained from Sanya Meteorological Bureau and Ecological Environment Bureau, respectively. We primarily compared the differences of participants with asthma or allergic diseases between northern China and Sanya in southern China by Chi-square test, t-test or Wilcoxon rank-sum test. Findings A total of 750 participants were recruited in this cohort from fourteen communities. All participants were surveyed questionnaires about health and family environment, underwent physical examinations, and collected biological samples for laboratory examinations. Novelty This is the first study to evaluate the effects of tropical climate and environment on elderly migrants from cold regions. This study has important implication for the health tourism and aging health, especially for the elderly migrants who suffered the respiratory and allergic diseases. Furthermore, this cohort study establishes a solid foundation for investigating the influence of environmental changes on elderly migrants with allergic diseases.
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Affiliation(s)
- Qian Hu
- Department of Hospital Infection, Hainan Branch, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Sanya, 572022, China
| | - Xiufeng Shi
- Department of Hospital Infection, Hainan Branch, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Sanya, 572022, China
| | - Dan Wang
- Department of Science and Education, Hainan Branch, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Sanya, 572022, China
| | - Yongzhen Huang
- Department of Hospital Infection, Hainan Branch, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Sanya, 572022, China
| | - Jiashi Gao
- Department of Science and Education, Hainan Branch, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Sanya, 572022, China
| | - Haidao Guan
- Department of Science and Education, Hainan Branch, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Sanya, 572022, China
| | - Han Ren
- Department of Hospital Management, Hainan Branch, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Sanya, 572022, China
| | - Xiaoya Lin
- Big Data Center, Hainan Branch, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Sanya, 572022, China
| | - Zhaoui Lu
- Department of Pediatric Surgery, Hainan Branch, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Sanya, 572022, China
| | - Shilu Tong
- Department of Clinical Epidemiology and Biostatistics, Children Health Advocacy Institute, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200127, China
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
| | - Guiyan Yang
- Department of Hospital Management, Hainan Branch, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Sanya, 572022, China
| | - Shijian Liu
- Big Data Center, Hainan Branch, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Sanya, 572022, China
- Department of Clinical Epidemiology and Biostatistics, Children Health Advocacy Institute, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200127, China
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Zhang F, Li Y, Ren W, Li S. Establishment of clinical evaluation criteria for scalp seborrheic dermatitis. J Cosmet Dermatol 2023; 22:3042-3046. [PMID: 37170659 DOI: 10.1111/jocd.15804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 04/10/2023] [Accepted: 04/23/2023] [Indexed: 05/13/2023]
Abstract
PURPOSE To evaluate the three symptom indicators of scalp seborrheic dermatitis (SSD), namely scalp flaking, maximum erythema area, and pruritus, to develop a "16-point scale," to explore its relationship with the severity of SSD, and verify the reliability of the 16-point scale. METHOD A dermatologist evaluated patients with SSD using a 16-point scale, and statistically analyzed the collected data with the help of SPSS 26.0 software. The measurement data are expressed as (mean ± SD), and the intergroup comparison was done using a non-parametric test. We performed the correlation analysis using the bivariate correlation analysis method, and the relationship among non-normal distribution data variables were analyzed using Spearman's correlation coefficient. p < 0.05 indicated that the difference was statistically significant. RESULTS The total score of the "16-point scale" strongly correlated with the severity of disease, where scalp flaking had the strongest correlation. As compared with a single score, the correlation of the total score with the severity of disease was higher. The scoring range for mild patients was (0, 5], that for moderate patients was (5, 9], and that for severe patients was (9, 16]. CONCLUSION A "16-point scale", consisting of items for adherent scalp flaking (0-10), maximum erythema area (0-3), and pruritus (0-3), was used to score the patients with SSD, and the total score was strongly correlated with and differentiated the severity of SSD. Recommended evaluation criteria: a total score of 0-5 points indicates mild SSD, 6-9 points indicates moderate SSD, 10-16 points indicates severe SSD. These criteria can help to standardize disease diagnosis and treatment, and efficacy assessment.
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Affiliation(s)
- Fan Zhang
- Hair Medical Research Center, Department of Dermatology and Venereology, Beijing Jishuitan Hospital, Beijing, China
| | - Yuanhong Li
- School of Clinical Medicine, Peking University School of Medicine, Beijing, China
| | - Wei Ren
- School of Clinical Medicine, Peking University School of Medicine, Beijing, China
| | - Shurun Li
- School of Clinical Medicine, Peking University School of Medicine, Beijing, China
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Pan Z, Dai Y, Akar-Ghibril N, Simpson J, Ren H, Zhang L, Hou Y, Wen X, Chang C, Tang R, Sun JL. Impact of Air Pollution on Atopic Dermatitis: A Comprehensive Review. Clin Rev Allergy Immunol 2023; 65:121-135. [PMID: 36853525 DOI: 10.1007/s12016-022-08957-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/14/2022] [Indexed: 03/01/2023]
Abstract
Air pollution is associated with multiple health problems worldwide, contributing to increased morbidity and mortality. Atopic dermatitis (AD) is a common allergic disease, and increasing evidence has revealed a role of air pollution in the development of atopic dermatitis. Air pollutants are derived from several sources, including harmful gases such as nitrogen dioxide (NO2), sulfur dioxide (SO2), and carbon monoxide (CO), as well as particulate matter (PM) of various sizes, and bioaerosols. Possible mechanisms linking air pollution to atopic dermatitis include damage to the skin barrier through oxidative stress, increased water loss, physicochemical injury, and an effect on skin microflora. Furthermore, oxidative stress triggers immune dysregulation, leading to enhanced sensitization to allergens. There have been multiple studies focusing on the association between various types of air pollutants and atopic dermatitis. Since there are many confounders in the current research, such as climate, synergistic effects of mixed pollutants, and diversity of study population, it is not surprising that inconsistencies exist between different studies regarding AD and air pollution. Still, it is generally accepted that air pollution is a risk factor for AD. Future studies should focus on how air pollution leads to AD as well as effective intervention measures.
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Affiliation(s)
- Zhouxian Pan
- Allergy Department, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
- Allergy Department, Beijing Key Laboratory of Precision Medicine for Diagnosis and Treatment of Allergic Diseases, National Clinical Research Center for Dermatologic and Immunologic Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
| | - Yimin Dai
- Eight-Year Clinical Medicine System, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
| | - Nicole Akar-Ghibril
- Division of Immunology, Allergy and Rheumatology, Joe DiMaggio Children's Hospital, Memorial Healthcare System, Hollywood, FL, 33021, USA
| | - Jessica Simpson
- Division of Immunology, Allergy and Rheumatology, Joe DiMaggio Children's Hospital, Memorial Healthcare System, Hollywood, FL, 33021, USA
| | - Huali Ren
- Department of Allergy, Beijing Electric Power Hospital of State Grid Company of China, Electric Power Teaching Hospital of Capital Medical University, Beijing, 100073, China
| | - Lishan Zhang
- Allergy Department, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
- Allergy Department, Beijing Key Laboratory of Precision Medicine for Diagnosis and Treatment of Allergic Diseases, National Clinical Research Center for Dermatologic and Immunologic Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
| | - Yibo Hou
- Allergy Department, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
- Allergy Department, Beijing Key Laboratory of Precision Medicine for Diagnosis and Treatment of Allergic Diseases, National Clinical Research Center for Dermatologic and Immunologic Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
| | - Xueyi Wen
- Allergy Department, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
- Allergy Department, Beijing Key Laboratory of Precision Medicine for Diagnosis and Treatment of Allergic Diseases, National Clinical Research Center for Dermatologic and Immunologic Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
| | - Christopher Chang
- Division of Immunology, Allergy and Rheumatology, Joe DiMaggio Children's Hospital, Memorial Healthcare System, Hollywood, FL, 33021, USA.
- Division of Rheumatology, Allergy and Clinical Immunology, University of California, Davis, Davis, CA, 95616, USA.
| | - Rui Tang
- Allergy Department, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China.
- Allergy Department, Beijing Key Laboratory of Precision Medicine for Diagnosis and Treatment of Allergic Diseases, National Clinical Research Center for Dermatologic and Immunologic Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China.
| | - Jin-Lyu Sun
- Allergy Department, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China.
- Allergy Department, Beijing Key Laboratory of Precision Medicine for Diagnosis and Treatment of Allergic Diseases, National Clinical Research Center for Dermatologic and Immunologic Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China.
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Wen J, Weng J, Lu W, Tao X, Cheng H, Tang Y. The Expression of Plasmacytoid Dendritic Cells and TLR7/9-MyD88-IRAKs Pathway in Chronic Eczema Lesions. Clin Cosmet Investig Dermatol 2023; 16:1079-1087. [PMID: 37123625 PMCID: PMC10145378 DOI: 10.2147/ccid.s405491] [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: 02/03/2023] [Accepted: 04/13/2023] [Indexed: 05/02/2023]
Abstract
Purpose To investigate the expression of Plasmacytoid Dendritic Cells (pDCs) and TLR7/9-MyD88-IRAKs pathway in chronic eczema lesions. Patients and Methods Lesional tissues and the surrounding healthy tissues were collected from 25 individuals with chronic eczema, and immunohistochemistry was used to detect and comparatively analyze the expression profile of CD123, CD2AP, toll-like receptor 7 (TLR7), toll-like receptor 9 (TLR9) along with interleukin-1 receptor-associated kinase 1 (IRAK1) and interferon regulatory factor 7 (IRF7) in signaling pathways. Results The positive rates of CD2AP + pDC and CD123 + pDC in lesional tissues were significantly elevated compared to the surrounding healthy tissues (P < 0.05). They were distributed in both the epidermal and dermal layers of the lesional tissue, but the majority were in the dermal layer. The TLR7, TLR9, IRAK1 and IRF7 were more expressed in dermal layers of the lesional tissue with higher positive rates of expression compared to the surrounding healthy tissues (P < 0.05). IRAK1 and IRF7 were expressed in a small amount in the epidermal layer with higher positive rates of expression than in the surrounding healthy tissues (P < 0.05), while the positive rates of TLR7 and TLR9 expression in the epidermal layer were not statistically different from those in the surrounding healthy tissues (P > 0.05). Conclusion PDC and TLR7/9-MyD88-IRAKs pathways are actively expressed in chronic eczema lesions and may be involved in pathogenesis and disease progression.
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Affiliation(s)
- Jiamin Wen
- Department of Dermatology, People’s Hospital of Tiantai County, Zhejiang University, Taizhou, People’s Republic of China
| | - Jitian Weng
- School of Public Health, Hangzhou Normal University, Zhejiang University, Hangzhou, People’s Republic of China
| | - Wei Lu
- Center for Plastic & Reconstructive Surgery, Department of Dermatology, Zhejiang Provincial People’s Hospital, Affiliated People’s Hospital, Hangzhou Medical College, Zhejiang UniversityHangzhou310014People’s Republic of China
| | - Xiaohua Tao
- Center for Plastic & Reconstructive Surgery, Department of Dermatology, Zhejiang Provincial People’s Hospital, Affiliated People’s Hospital, Hangzhou Medical College, Zhejiang UniversityHangzhou310014People’s Republic of China
| | - Hao Cheng
- Department of Dermatology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, People’s Republic of China
| | - Yi Tang
- Center for Plastic & Reconstructive Surgery, Department of Dermatology, Zhejiang Provincial People’s Hospital, Affiliated People’s Hospital, Hangzhou Medical College, Zhejiang UniversityHangzhou310014People’s Republic of China
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Liu B, Fang XY, Yan YL, Wu J, Lv XJ, Zhang J, Qi LW, Qian TT, Cai YY, Fan YG, Ye DQ. Short-term effect of ambient temperature and ambient temperature changes on the risk of warts outpatient visits in Hefei, China: a retrospective time-series study. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:19342-19355. [PMID: 36239885 DOI: 10.1007/s11356-022-23522-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 10/05/2022] [Indexed: 06/16/2023]
Abstract
Concerns are growing about the adverse health effects of ambient temperature and ambient temperature changes. However, the association between ambient temperature and ambient temperature changes on the risk of warts outpatient visits is poorly understood. Our study used the distributed lag non-linear model (DLNM) aimed to evaluate the association between ambient temperature, ambient temperature changes (including temperature change between neighboring days (TCN) and diurnal temperature range (DTR)), and warts outpatient visits. We also performed subgroup analyses in order to find susceptible populations by gender and age groups. The maximum relative risk (RR) of low ambient temperature (0 °C) for warts outpatient visits was 1.117 (95% CI: 1.041-1.198, lag 04 days), and the maximum RR of high ambient temperature (32 °C) for warts outpatient visits was 1.318 (95% CI: 1.083-1.605, lag 07 days). The large temperature drop (TCN = - 3 °C) decreased the risk of warts visits, with the lowest RR value at the cumulative exposure of lag 7 days (RR = 0.888, 95% CI: 0.822-0.959), and the large temperature rise (TCN = 2 °C) increased the risk of warts visits, with the highest RR value at the cumulative exposure of lag 7 days (RR = 1.080, 95% CI: 1.022-1.142). Overall, both low and high ambient temperatures and large temperature rise can increase the risk of warts visits, while large temperature drop is a protective factor for warts visits. However, we did not find any association between DTR and warts visits. Furthermore, subgroup analyses showed that males and the young (0-17 years old) were more sensitive to low and high ambient temperatures, and the elderly (≥ 65 years old) were more susceptible to TCN. The results may provide valuable evidence for reducing the disease burden of warts in the future.
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Affiliation(s)
- Bo Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Mei-Shan Road, Hefei, Anhui, China
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China
| | - Xin-Yu Fang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Mei-Shan Road, Hefei, Anhui, China
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China
| | - Yu-Lu Yan
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Mei-Shan Road, Hefei, Anhui, China
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China
| | - Jun Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Medical University, Dongguan, Guangdong, China
| | - Xiao-Jie Lv
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Mei-Shan Road, Hefei, Anhui, China
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China
| | - Jie Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Mei-Shan Road, Hefei, Anhui, China
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China
| | - Liang-Wei Qi
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Mei-Shan Road, Hefei, Anhui, China
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China
| | - Ting-Ting Qian
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Mei-Shan Road, Hefei, Anhui, China
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China
| | - Yu-Yu Cai
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Mei-Shan Road, Hefei, Anhui, China
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China
| | - Yin-Guang Fan
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Mei-Shan Road, Hefei, Anhui, China
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China
| | - Dong-Qing Ye
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Mei-Shan Road, Hefei, Anhui, China.
- Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China.
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Fadadu RP, Abuabara K, Balmes JR, Hanifin JM, Wei ML. Air Pollution and Atopic Dermatitis, from Molecular Mechanisms to Population-Level Evidence: A Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2526. [PMID: 36767891 PMCID: PMC9916398 DOI: 10.3390/ijerph20032526] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 01/19/2023] [Accepted: 01/26/2023] [Indexed: 06/18/2023]
Abstract
Atopic dermatitis (AD) has increased in prevalence to become the most common inflammatory skin condition globally, and geographic variation and migration studies suggest an important role for environmental triggers. Air pollution, especially due to industrialization and wildfires, may contribute to the development and exacerbation of AD. We provide a comprehensive, multidisciplinary review of existing molecular and epidemiologic studies on the associations of air pollutants and AD symptoms, prevalence, incidence, severity, and clinic visits. Cell and animal studies demonstrated that air pollutants contribute to AD symptoms and disease by activating the aryl hydrocarbon receptor pathway, promoting oxidative stress, initiating a proinflammatory response, and disrupting the skin barrier function. Epidemiologic studies overall report that air pollution is associated with AD among both children and adults, though the results are not consistent among cross-sectional studies. Studies on healthcare use for AD found positive correlations between medical visits for AD and air pollutants. As the air quality worsens in many areas globally, it is important to recognize how this can increase the risk for AD, to be aware of the increased demand for AD-related medical care, and to understand how to counsel patients regarding their skin health. Further research is needed to develop treatments that prevent or mitigate air pollution-related AD symptoms.
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Affiliation(s)
- Raj P. Fadadu
- Department of Dermatology, University of California, San Francisco, CA 94115, USA
- Dermatology Service, San Francisco VA Health Care System, San Francisco, CA 94121, USA
- School of Public Health, University of California, Berkeley, CA 94720, USA
| | - Katrina Abuabara
- Department of Dermatology, University of California, San Francisco, CA 94115, USA
- School of Public Health, University of California, Berkeley, CA 94720, USA
| | - John R. Balmes
- School of Public Health, University of California, Berkeley, CA 94720, USA
- Division of Occupational and Environmental Medicine, University of California, San Francisco, CA 94143, USA
| | - Jon M. Hanifin
- Department of Dermatology, Oregon Health & Science University, Portland, OR 97239, USA
| | - Maria L. Wei
- Department of Dermatology, University of California, San Francisco, CA 94115, USA
- Dermatology Service, San Francisco VA Health Care System, San Francisco, CA 94121, USA
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9
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Huang Y, Song H, Wang Z, Cheng Y, Liu Y, Hao S, Li N, Wang Y, Wang Y, Zhang X, Sun B, Li Y, Yao X. Heat and outpatient visits of skin diseases – A multisite analysis in China, 2014–2018. Heliyon 2022; 8:e11203. [PMID: 36339999 PMCID: PMC9626933 DOI: 10.1016/j.heliyon.2022.e11203] [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: 07/03/2022] [Revised: 09/05/2022] [Accepted: 10/18/2022] [Indexed: 11/06/2022] Open
Abstract
Background Many studies have shown that various kinds of diseases were associated with the variation of ambient temperature. However, there’s only a scrap of evidence paying attention to the link between temperature and skin diseases, and no relevant national research was performed in China. Objective This study aimed to quantify the effect of heat on skin diseases and identify the vulnerable populations and areas in China. Methods Daily meteorological data, air pollutant data and outpatient data were collected from in 18 sites of China during 2014–2018. A time-series study with distributed lag nonlinear model and multivariate meta-analysis was applied to analyze the site-specific and pooled associations between daily mean temperature and daily outpatient visits of skin diseases by using the data of warm season (from June to September). Stratified analysis by age, sex and climate zones and subtypes of skin diseases were also conducted. Results We found a positive linear relationship between the ambient temperature and risk of skin diseases, with a 1.25% (95%CI: 0.34%, 2.16%) increase of risk of outpatient visits for each 1 °C increase in daily mean temperature during the warm season. In general, groups aged 18–44 years, males and people living in temperate climate regions were more susceptible to high temperature. Immune dysfunction including dermatitis and eczema were heat-sensitive skin diseases. Conclusions Our findings suggested that people should take notice of heat-related skin diseases and also provided some references about related health burden for strategy-makers. Targeted measures for vulnerable populations need to be taken to reduce disease burden, including monitoring and early warning systems, and sun-protection measures.
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