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Stephan Y, Müller HH, Kühnert M, Meinhold-Heerlein I, Ibrahimi G, Reitz M, Schemmann H, Oehmke F, Köhler S, Renz H. The effect of early skin-to-skin contact after cesarean section on breastfeeding duration and development of atopic-allergic diseases. Eur J Midwifery 2024; 8:EJM-8-04. [PMID: 38269325 PMCID: PMC10807137 DOI: 10.18332/ejm/176213] [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: 07/28/2023] [Revised: 11/29/2023] [Accepted: 12/01/2023] [Indexed: 01/26/2024] Open
Abstract
INTRODUCTION Breastfeeding to strengthen the immune system suggests allergy prevention as a possible option. The connection between breastfeeding and the development of atopic-allergic diseases is being discussed. The primary aim of this work was to investigate an association of the first early skin-to-skin contact following cesarean section with the development of atopic diseases within the 1st year of life. METHODS The present study was conducted as a bicentric prospective cohort study in central Germany with a 15-month recruitment period. Data collection was by telephone interviews with a follow-up of 12 months. The statistical evaluation procedure was based on a hierarchical test of the association of early skin-to-skin contact between mother and child with the two main outcome measures. The primary outcome is the duration of breastfeeding. The second outcome is the onset of atopic-allergic disease within the 1st year of life. RESULTS Mothers breastfed longer if they had skin-to-skin contact within the first 30 minutes postpartum [χ²(df=5) = 19.020, p=0.002], if they breastfed their newborns early immediately after birth (p<0.001), and if the first skin-to-skin contact lasted more than one hour [χ²(df=4) = 19.617, p<0.001]. Regarding atopic-allergic diseases, no significant effects of skin-to-skin contact were found in relation to disease development. Regarding breastfeeding, no significant effects of atopic-allergic diseases could be detected either. CONCLUSIONS The results of this study reflect the benefits of skin-to-skin contact in the context of breastfeeding and atopic disease. The current scientific knowledge regarding skin contact and the development of atopic-allergic diseases should be extended and deepened.
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Affiliation(s)
- Yvonne Stephan
- Institute of Laboratory Medicine and Pathobiochemistry Molecular Diagnostics, Philipps University Marburg, Marburg, Germany
- Faculty of Health, Technische Hochschule Mittelhessen, University of Applied Sciences, Giessen, Germany
| | - Hans-Helge Müller
- Institute of Laboratory Medicine and Pathobiochemistry Molecular Diagnostics, Philipps University Marburg, Marburg, Germany
| | - Maritta Kühnert
- Department of Obstetrics and Gynecology, Division of Obstetrics, University Hospital Giessen and Marburg GmbH, Marburg, Germany
| | - Ivo Meinhold-Heerlein
- Department of Obstetrics and Gynecology, University Hospital Giessen and Marburg GmbH, Giessen, Germany
| | - Gentiana Ibrahimi
- Department of Obstetrics and Gynecology, University Hospital Giessen and Marburg GmbH, Giessen, Germany
| | - Maleen Reitz
- Department of Obstetrics and Gynecology, University Hospital Giessen and Marburg GmbH, Giessen, Germany
| | - Hannah Schemmann
- Institute of Laboratory Medicine and Pathobiochemistry Molecular Diagnostics, Philipps University Marburg, Marburg, Germany
| | - Frank Oehmke
- Department of Obstetrics and Gynecology, University Hospital Giessen and Marburg GmbH, Giessen, Germany
| | - Siegmund Köhler
- Department of Obstetrics and Gynecology, Division of Obstetrics, University Hospital Giessen and Marburg GmbH, Marburg, Germany
| | - Harald Renz
- Institute of Laboratory Medicine and Pathobiochemistry Molecular Diagnostics, Philipps University Marburg, Marburg, Germany
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Sach TH, Onoja M, Clarke H, Santer M, Muller I, Becque T, Stuart B, Hooper J, Steele M, Wilczynska S, Ridd MJ, Roberts A, Ahmed A, Yardley L, Little P, Greenwell K, Sivyer K, Nuttall J, Griffiths G, Lawton S, Langan SM, Howells L, Leighton P, Williams HC, Thomas KS. Cost-effectiveness of two online interventions supporting self-care for eczema for parents/carers and young people. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2024:10.1007/s10198-023-01649-9. [PMID: 38194207 DOI: 10.1007/s10198-023-01649-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 11/14/2023] [Indexed: 01/10/2024]
Abstract
OBJECTIVE To estimate the cost-effectiveness of online behavioral interventions (EczemaCareOnline.org.uk) designed to support eczema self-care management for parents/carers and young people from an NHS perspective. METHODS Two within-trial economic evaluations, using regression-based approaches, adjusting for baseline and pre-specified confounder variables, were undertaken alongside two independent, pragmatic, parallel group, unmasked randomized controlled trials, recruiting through primary care. Trial 1 recruited 340 parents/carers of children aged 0-12 years and Trial 2 337 young people aged 13-25 years with eczema scored ≥ 5 on Patient-Oriented Eczema Measure (POEM). Participants were randomized (1:1) to online intervention plus usual care or usual care alone. Resource use, collected via medical notes review, was valued using published unit costs in UK £Sterling 2021. Quality-of-life was elicited using proxy CHU-9D in Trial 1 and self-report EQ-5D-5L in Trial 2. RESULTS The intervention was dominant (cost saving and more effective) with a high probability of cost-effectiveness (> 68%) in most analyses. The exception was the complete case cost-utility analysis for Trial 1 (omitting participants with children aged < 2), with adjusted incremental cost savings of -£34.15 (95% CI - 104.54 to 36.24) and incremental QALYs of - 0.003 (95% CI - 0.021 to 0.015) producing an incremental cost per QALY of £12,466. In the secondary combined (Trials 1 and 2) cost-effectiveness analysis, the adjusted incremental cost was -£20.35 (95% CI - 55.41 to 14.70) with incremental success (≥ 2-point change on POEM) of 10.3% (95% CI 2.3-18.1%). CONCLUSION The free at point of use online eczema self-management intervention was low cost to run and cost-effective. TRIAL REGISTRATION This trial was registered prospectively with the ISRCTN registry (ISRCTN79282252). URL www.EczemaCareOnline.org.uk .
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Affiliation(s)
- Tracey H Sach
- Health Economics Group, Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, NR4 7TJ, UK.
- Primary Care Research Centre, Faculty of Medicine, Population Sciences and Medical Education, University of Southampton, Aldermoor Close, Southampton, SO16 5ST, UK.
| | - Mary Onoja
- Health Economics Group, Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, NR4 7TJ, UK
| | - Holly Clarke
- Health Economics Group, Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, NR4 7TJ, UK
| | - Miriam Santer
- Primary Care Research Centre, Faculty of Medicine, Population Sciences and Medical Education, University of Southampton, Aldermoor Close, Southampton, SO16 5ST, UK
| | - Ingrid Muller
- Primary Care Research Centre, Faculty of Medicine, Population Sciences and Medical Education, University of Southampton, Aldermoor Close, Southampton, SO16 5ST, UK
| | - Taeko Becque
- Primary Care Research Centre, Faculty of Medicine, Population Sciences and Medical Education, University of Southampton, Aldermoor Close, Southampton, SO16 5ST, UK
| | - Beth Stuart
- Primary Care Research Centre, Faculty of Medicine, Population Sciences and Medical Education, University of Southampton, Aldermoor Close, Southampton, SO16 5ST, UK
- Pragmatic Trials Unit, Wolfson Institute of Population Health, Queen Mary University of London, Yvonne Carter Building, 58 Turner Street, London, E1 2AB, UK
| | - Julie Hooper
- Primary Care Research Centre, Faculty of Medicine, Population Sciences and Medical Education, University of Southampton, Aldermoor Close, Southampton, SO16 5ST, UK
| | - Mary Steele
- Primary Care Research Centre, Faculty of Medicine, Population Sciences and Medical Education, University of Southampton, Aldermoor Close, Southampton, SO16 5ST, UK
| | - Sylvia Wilczynska
- King's Clinical Trial Unit, King's College London, Institute of Psychiatry, Psychology and Neuroscience, 16 De Crespigny Park, London, SE5 8AB, UK
| | - Matthew J Ridd
- Centre for Academic Primary Care, Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK
| | - Amanda Roberts
- Patient and Public Contributor, Centre of Evidence Based Dermatology, School of Medicine, University of Nottingham, Applied Health Services Research Building (Building Number 42), University Park, Nottingham, NG7 2RD, UK
| | - Amina Ahmed
- Patient and Public Contributor, Centre of Evidence Based Dermatology, School of Medicine, University of Nottingham, Applied Health Services Research Building (Building Number 42), University Park, Nottingham, NG7 2RD, UK
| | - Lucy Yardley
- Centre for Clinical and Community Applications of Health Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
| | - Paul Little
- Primary Care Research Centre, Faculty of Medicine, Population Sciences and Medical Education, University of Southampton, Aldermoor Close, Southampton, SO16 5ST, UK
| | - Kate Greenwell
- Primary Care Research Centre, Faculty of Medicine, Population Sciences and Medical Education, University of Southampton, Aldermoor Close, Southampton, SO16 5ST, UK
- Centre for Clinical and Community Applications of Health Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
- School of Psychological Science, University of Bristol, 12A Priory Rd, Bristol, BS8 1TU, UK
| | - Katy Sivyer
- Centre for Clinical and Community Applications of Health Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
- School of Psychological Science, University of Bristol, 12A Priory Rd, Bristol, BS8 1TU, UK
| | - Jacqui Nuttall
- Southampton Clinical Trial Unit, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Gareth Griffiths
- Southampton Clinical Trial Unit, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Sandra Lawton
- Dermatology, The Rotherham NHS Foundation Trust, Rotherham, UK
| | - Sinéad M Langan
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Laura Howells
- Centre of Evidence Based Dermatology, School of Medicine, University of Nottingham, Applied Health Services Research Building (Building Number 42), University Park, Nottingham, NG7 2RD, UK
| | - Paul Leighton
- Centre of Evidence Based Dermatology, School of Medicine, University of Nottingham, Applied Health Services Research Building (Building Number 42), University Park, Nottingham, NG7 2RD, UK
| | - Hywel C Williams
- Centre of Evidence Based Dermatology, School of Medicine, University of Nottingham, Applied Health Services Research Building (Building Number 42), University Park, Nottingham, NG7 2RD, UK
| | - Kim S Thomas
- Centre of Evidence Based Dermatology, School of Medicine, University of Nottingham, Applied Health Services Research Building (Building Number 42), University Park, Nottingham, NG7 2RD, UK
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Bangert C, Loesche C, Skvara H, Fölster-Holst R, Lacour JP, Jones J, Burnett P, Novak N, Stingl G. IgE Depletion with Ligelizumab Does Not Significantly Improve Clinical Symptoms in Patients with Moderate-to-Severe Atopic Dermatitis. J Invest Dermatol 2023; 143:1896-1905.e8. [PMID: 37004878 DOI: 10.1016/j.jid.2023.01.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 01/22/2023] [Accepted: 01/26/2023] [Indexed: 04/03/2023]
Abstract
BACKGROUND The value, if any, of anti-IgE approaches in the treatment of atopic dermatitis has not been fully clarified. Studies using the anti-IgE omalizumab have yielded conflicting results. OBJECTIVE Antibodies with an IgE-suppressive capacity stronger than omalizumab might be more efficacious. STUDY DESIGN We assessed the safety and efficacy of the high-affinity anti-IgE antibody ligelizumab (280 mg, subcutaneous, every other week) in 22 adult patients with moderate-to-severe atopic dermatitis in a placebo and active (cyclosporine A) controlled, randomized, multicenter, double-blind clinical trial for 12 weeks. RESULTS We found that ligelizumab treatment resulted in either complete (patients with baseline IgE < 1,500 IU/ml) or partial (baseline IgE > 1,500 IU/ml) suppression of serum and cell-bound IgE as well as of allergic skin prick tests. On the other hand, ligelizumab-as opposed to cyclosporine A-was not significantly superior to placebo in inducing Eczema Area and Severity Index 50 response or significantly reducing pruritus and sleep disturbance. Interestingly though, patients with high baseline IgE exhibited a slightly but not significantly better treatment response than those with low baseline IgE. CONCLUSION Our study shows that an immunologically efficacious anti-IgE approach is not clearly superior to placebo in treating atopic dermatitis. Larger studies are needed to determine whether certain patient subgroups may benefit from this strategy. TRIAL REGISTRATION The study was registered in 2011 at clinicaltrialsregister.eu, EudraCT Number 2011-002112-84.
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Affiliation(s)
- Christine Bangert
- Department of Dermatology, Medical University of Vienna, Vienna, Austria.
| | - Christian Loesche
- Novartis Pharma AG, Novartis Institutes for BioMedical Research, Basel, Switzerland
| | - Hans Skvara
- Department of Dermatology, Medical University of Vienna, Vienna, Austria; Department of Dermatology, Landesklinikum Wiener Neustadt, Wiener Neustadt, Austria
| | - Regina Fölster-Holst
- Department of Dermatology, University Hospital of Schleswig-Holstein, Kiel, Germany
| | - Jean-Philippe Lacour
- Department of Dermatology, University Hospital L'Archet, University of Côte d'Azur, Nice, France
| | - Julie Jones
- Novartis Pharma AG, Novartis Institutes for BioMedical Research, Basel, Switzerland
| | | | - Natalija Novak
- Department of Dermatology and Allergology, University Hospital of Bonn, Bonn, Germany
| | - Georg Stingl
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
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Hoel ST, Wiik J, Carlsen KC, Endre KM, Gudmundsdóttir HK, Haugen G, Hoyer A, Jonassen CM, LeBlanc M, Nordlund B, Rudi K, Skjerven HO, Staff AC, Hedlin G, Söderhäll C, Vettukattil R, Aaneland H, Rehbinder EM. Birth mode is associated with development of atopic dermatitis in infancy and early childhood. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. GLOBAL 2023; 2:100104. [PMID: 37779526 PMCID: PMC10509990 DOI: 10.1016/j.jacig.2023.100104] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 01/15/2023] [Accepted: 02/05/2023] [Indexed: 10/03/2023]
Abstract
Background Birth by caesarean section (CS) is associated with development of allergic diseases, but its role in the development of atopic dermatitis (AD) is less convincing. Objective Our primary aim was to determine if birth mode was associated with AD in 3-year-olds and secondarily to determine if birth mode was associated with early onset and/or persistent AD in the first 3 years of life. Methods We included 2129 mother-child pairs from the Scandinavian population-based prospective PreventADALL cohort with information on birth mode including vaginal birth, either traditional (81.3%) or in water (4.0%), and CS before (6.3%) and after (8.5%) onset of labor. We defined early onset AD as eczema at 3 months and AD diagnosis by 3 years of age. Persistent AD was defined as eczema both in the first year and at 3 years of age, together with an AD diagnosis by 3 years of age. Results AD was diagnosed at 3, 6, 12, 24, and/or 36 months in 531 children (25%). Compared to vaginal delivery, CS was overall associated with increased odds of AD by 3 years of age, with adjusted odds ratio (95% confidence interval) of 1.33 (1.02-1.74), and higher odds of early onset AD (1.63, 1.06-2.48). The highest odds for early onset AD were observed in infants born by CS after onset of labor (1.83, 1.09-3.07). Birth mode was not associated with persistent AD. Conclusion CS was associated with increased odds of AD by 3 years of age, particularly in infants presenting with eczema at 3 months of age.
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Affiliation(s)
- Sveinung T. Hoel
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Johanna Wiik
- Department of Gynecology and Obstetrics, Østfold Hospital Trust, Kalnes, Norway
- Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Obstetrics and Gynecology, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
| | - Karin C.L. Carlsen
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Division of Pediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Kim M.A. Endre
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Dermatology and Vaenerology, Oslo University Hospital, Oslo, Norway
| | - Hrefna Katrín Gudmundsdóttir
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Division of Pediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Guttorm Haugen
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
| | - Angela Hoyer
- Astrid Lindgren Children’s Hospital, Karolinska University Hospital, Stockholm, Sweden
- Department of Women’s and Children’s Health, Karolinska Institute, Stockholm, Sweden
| | - Christine Monceyron Jonassen
- Centre for Laboratory Medicine, Østfold Hospital Trust, Grålum, Norway
- Department of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences, Ås, Norway
| | - Marissa LeBlanc
- Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
| | - Björn Nordlund
- Astrid Lindgren Children’s Hospital, Karolinska University Hospital, Stockholm, Sweden
- Department of Women’s and Children’s Health, Karolinska Institute, Stockholm, Sweden
| | - Knut Rudi
- Faculty of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences, Ås, Norway
| | - Håvard O. Skjerven
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Division of Pediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Anne Cathrine Staff
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Division of Obstetrics and Gynaecology, Oslo University Hospital, Oslo, Norway
| | - Gunilla Hedlin
- Astrid Lindgren Children’s Hospital, Karolinska University Hospital, Stockholm, Sweden
- Department of Women’s and Children’s Health, Karolinska Institute, Stockholm, Sweden
| | - Cilla Söderhäll
- Astrid Lindgren Children’s Hospital, Karolinska University Hospital, Stockholm, Sweden
- Department of Women’s and Children’s Health, Karolinska Institute, Stockholm, Sweden
| | - Riyas Vettukattil
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Division of Pediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Hilde Aaneland
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Division of Pediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Eva M. Rehbinder
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Dermatology and Vaenerology, Oslo University Hospital, Oslo, Norway
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Effect of a Novel E3 Probiotics Formula on the Gut Microbiome in Atopic Dermatitis Patients: A Pilot Study. Biomedicines 2022; 10:biomedicines10112904. [PMID: 36428472 PMCID: PMC9687608 DOI: 10.3390/biomedicines10112904] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 11/03/2022] [Accepted: 11/09/2022] [Indexed: 11/16/2022] Open
Abstract
Atopic dermatitis (AD) has been shown to be closely related to gut dysbiosis mediated through the gut−skin axis, and thus the gut microbiome has recently been explored as a potential therapeutic target for the treatment of AD. Contrasting and varying efficacy have been reported since then. In order to investigate the determining factor of probiotics responsiveness in individuals with AD, we initiated the analysis of 41 AD patients with varying disease severity in Hong Kong, whereas the severity was assessed by Eczema Area and Severity Index (EASI) by board certified dermatologist. 16S rRNA sequencing on the fecal samples from AD patients were performed to obtain the metagenomics profile at baseline and after 8 weeks of oral administration of a novel E3 probiotics formula (including prebiotics, probiotics and postbiotics). While EASI of the participants were significantly lower after the probiotics treatment (p < 0.001, paired Wilcoxon signed rank), subjects with mild AD were found to be more likely to respond to the probiotics treatment. Species richness among responders regardless of disease severity were significantly increased (p < 0.001, paired Wilcoxon signed rank). Responders exhibited (1) elevated relative abundance of Clostridium, Fecalibacterium, Lactobacillus, Romboutsia, and Streptococcus, (2) reduced relative abundance of Collinsella, Bifidobacterium, Fusicatenibacter, and Escherichia-Shigella amid orally-intake probiotics identified using the machine learning algorithm and (3) gut microbiome composition and structure resembling healthy subjects after probiotics treatment. Here, we presented the gut microbiome dynamics in AD patients after the administration of the E3 probiotics formula and delineated the unique gut microbiome signatures in individuals with AD who were responding to the probiotics. These findings could guide the future development of probiotics use for AD management.
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Ahmad K, Kabir E, Ormsby GM, Khanam R. Are wheezing, asthma and eczema in children associated with mother's health during pregnancy? Evidence from an Australian birth cohort. ACTA ACUST UNITED AC 2021; 79:193. [PMID: 34749801 PMCID: PMC8577022 DOI: 10.1186/s13690-021-00718-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Accepted: 10/25/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND This study investigated the prevalence of wheezing, asthma, and eczema among Australian children using longitudinal data from birth to 15 years of age. This study also examined the association between maternal health status during pregnancy and their offspring's respiratory and allergic morbidities using sex-segregated data. METHODS This study used data from the Longitudinal Study of Australian Children (LSAC) where approximately 5000 children of a birth cohort across Australia were surveyed in 2004. These children were followed biennially in eight waves up to their age of 15 years until 2018. The status of the children's wheezing, asthma, and eczema were reported by the mothers upon doctors' diagnosis (for asthma) or self-assessment (for wheezing or eczema). Binomial logistic regression models were used to analyse associations between maternal health during pregnancy and their children's health outcomes. RESULTS Asthma prevalence among 0-1-year aged children was 11.7%, increased to 15.4% when the children were 10-11 years old, and then decreased to 13.6% when they were 14-15 years old. Wheezing and eczema were most prevalent when the children were 2-3 years old (26.0 and 17.8% respectively) and were least prevalent when the children were 14-15 years old (7.3 and 9.5% respectively). Maternal asthma, smoking during pregnancy, and pre-pregnancy obesity were significantly associated with an increased risk of wheezing and asthma in Australian children. Childhood eczema was associated only with maternal asthma. These associations were stronger among male children up to age 10-11 and during adolescence (12-15 years of age), female children were more prone to wheezing, asthma, and eczema. CONCLUSION This is a comprehensive longitudinal study of Australian children (0-15 years of age) to assess the prevalence (with sex-specific differences) of wheezing, asthma and eczema as well as the association between these respiratory and allergic morbidities and maternal health during pregnancy. The study findings suggest that careful medical and obstetric monitoring, improved specific age-sex wise risk factor prevention for children and health promotion for pregnant women would help protect child health.
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Affiliation(s)
- Kabir Ahmad
- School of Business, Faculty of Business, Education, Law and Arts, and Centre for Health Research, University of Southern Queensland, Toowoomba, Australia. .,Research Unit, Purple Informatics, Dhaka, Bangladesh. .,Present Address: School of Business, Faculty of Business, Education, Law and Arts, and Centre for Health Research, University of Southern Queensland, Toowoomba, Australia.
| | - Enamul Kabir
- School of Sciences, Faculty of Health, Engineering and Sciences, and Centre for Health Research, University of Southern Queensland, Toowoomba, Australia
| | - Gail M Ormsby
- Independent Researcher, Professional Studies, Faculty of Business, Education, Law and Arts, University of Southern Queensland, Toowoomba, Australia
| | - Rasheda Khanam
- School of Business, Faculty of Business, Education, Law and Arts, and Centre for Health Research, University of Southern Queensland, Toowoomba, Australia
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Zhou M, Sui H. Effect of total glucosides of paeony on the changes of IL-4 and ICAM-1 levels in eczema mouse model serum. Exp Ther Med 2018; 17:1545-1550. [PMID: 30783420 PMCID: PMC6364213 DOI: 10.3892/etm.2018.7122] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Accepted: 11/14/2018] [Indexed: 12/29/2022] Open
Abstract
Effect of total glucosides of paeony on the changes of IL-4 and ICAM-1 levels in eczema mouse model serum was investigated. A total of 38 KM mice of SPF grade were divided into 3 groups: the control group (n=10), the model group (n=15) and the treatment group (n=13). The pathological model of chronic eczema in mouse right ear was induced using dinitrochlorobenzene acetone solution. Two ears of mice in the control group and the left ear of mice in the model and treatment groups were smeared with acetone as control. The mice in the treatment group were treated by administration with total glucoside of paeony. The changes of IL-4 and ICAM-1 levels were measured using caudal vein blood collection. The mouse ear weight was measured and the relationship among IL-4 and ICAM-1 levels, ear thickness and treatment time was analyzed. Mouse ear thickness in the model group was higher than that in the treatment and control groups (P<0.05). The weight of the mouse right ear in the model and treatment groups was significantly higher than that of the left ear (P<0.05). Furthermore, The IL-4 and ICAM-1 levels of mice in the model group were higher than that in the treatment and control groups (P<0.05). The IL-4 and ICAM-1 levels of mice in the model and treatment groups increased compared to that before modeling (P<0.05). The IL-4 and ICAM-1 levels of mice were positively correlated with ear thickness in the model group (r=0.865, P=0.002; r=0.833, P=0.009). In addition, the IL-4 level of mice was positively correlated with the ICAM-1 level in the model group (r=0.812, P=0.014). Finally, IL-4 and ICAM-1 may be involved in the pathologic process of chronic eczema. Therefore, the study showed that the total glucosides of paeony may play a role in the treatment of chronic eczema by regulating the IL-4 and ICAM-1 levels.
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Affiliation(s)
- Meihua Zhou
- Department of Dermatology, The People's Hospital of Danyang, Zhenjiang, Jiangsu 212300, P.R. China
| | - Hongfeng Sui
- Department of Dermatology, The People's Hospital of Danyang, Zhenjiang, Jiangsu 212300, P.R. China
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Bin Huraib G, Al Harthi F, Arfin M, Al-Sugheyr M, Rizvi S, Al-Asmari A. Cytokine Gene Polymorphisms in Saudi Patients With Atopic Dermatitis: A Case-Control Study. Biomark Insights 2018; 13:1177271918777760. [PMID: 29887728 PMCID: PMC5989047 DOI: 10.1177/1177271918777760] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Accepted: 04/20/2018] [Indexed: 12/28/2022] Open
Abstract
The cause of atopic dermatitis (AD) is multifactorial and a number of genes including cytokines have been involved. We genotyped 315 subjects for polymorphisms in TNF-α and TNF-β and IL-10 genes. Patients had significantly higher frequency of GA genotype of TNF-α (−308 G/A) than healthy controls. Patients with AD and controls had similar distribution of A and G alleles. Genotype AA was found in 7.11% of controls while completely absent in cases. The frequencies of genotypes GG and AA of TNF-β (+252 A/G) polymorphism were higher whereas the frequency of genotype GA was significantly lower in patients than the controls. The frequencies of genotypes GG and AA of IL-10 (1082 G/A) polymorphism were significantly increased whereas genotype GA was decreased in patients than the controls. It is concluded that TNF-α (−308 G/A), TNF-β (+252 A/G), and IL-10 (−1082 G/A) polymorphisms are linked with the susceptibility of AD in Saudis and can be a risk factor.
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Affiliation(s)
- Ghaleb Bin Huraib
- Department of Dermatology, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Fahad Al Harthi
- Department of Dermatology, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Misbahul Arfin
- Scientific Research Center, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Mohammed Al-Sugheyr
- Department of Dentistry, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Sadaf Rizvi
- Scientific Research Center, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
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Genuneit J, Seibold AM, Apfelbacher CJ, Konstantinou GN, Koplin JJ, La Grutta S, Logan K, Perkin MR, Flohr C. Overview of systematic reviews in allergy epidemiology. Allergy 2017; 72:849-856. [PMID: 28052339 DOI: 10.1111/all.13123] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/01/2017] [Indexed: 12/12/2022]
Abstract
BACKGROUND There is a substantial body of evidence on the epidemiology of allergic conditions, which has advanced the understanding of these conditions. We aimed to systematically identify systematic reviews and meta-analyses on the epidemiology of allergic diseases to assess what has been studied comprehensively and what areas might benefit from further research. METHODS We searched PubMed and EMBASE up to 12/2014 for systematic reviews on epidemiological research on allergic diseases. We indexed diseases and topics covered and extracted data on the search characteristics of each systematic review. RESULTS The search resulted in 3991 entries after removing duplicates, plus 20 other items found via references and conference abstracts; 421 systematic reviews were relevant and included in this overview. The majority contained some evidence on asthma (72.9%). Allergic rhinitis, atopic eczema and food hypersensitivity were covered in 15.7%, 24.5% and 9.0%, respectively. Commonly studied risk factors for atopic eczema included dietary and microbial factors, while for asthma, pollution and genetic factors were often investigated in systematic reviews. There was some indication of differing search characteristics across topics. CONCLUSION We present a comprehensive overview with an indexed database of published systematic reviews in allergy epidemiology. We believe that this clarifies where most research interest has focussed and which areas could benefit from further research. We propose that this effort is updated every few years to include the most recently published evidence and to extend the search to an even broader list of hypersensitivity/allergic disorders.
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Affiliation(s)
- J. Genuneit
- Institute of Epidemiology and Medical Biometry; Ulm University; Ulm Germany
| | - A. M. Seibold
- Institute of Epidemiology and Medical Biometry; Ulm University; Ulm Germany
| | - C. J. Apfelbacher
- Institute of Epidemiology and Preventive Medicine; University of Regensburg; Regensburg Germany
| | - G. N. Konstantinou
- Department of Allergy and Clinical Immunology; 424 General Military Training Hospital; Thessaloniki Greece
| | - J. J. Koplin
- Murdoch Children's Research Institute; University of Melbourne; Melbourne VIC Australia
| | - S. La Grutta
- National Research Council of Italy; Institute of Biomedicine and Molecular Immunology; Palermo Italy
| | - K. Logan
- Children's Allergies Department; Division of Asthma, Allergy and Lung Biology; King's College London; London UK
| | - M. R. Perkin
- Population Health Research Institute; St George's, University of London; London UK
| | - C. Flohr
- Unit for Population-Based Dermatology Research; St John's Institute of Dermatology; King's College London and Guy's and St Thomas’ NHS Foundation; London UK
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10
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Cai SCS, Li W, Tian EAL, Allen JC, Tey HL. Topical calcineurin inhibitors in eczema and cancer association: A cohort study. J DERMATOL TREAT 2016; 27:531-537. [PMID: 27049893 DOI: 10.3109/09546634.2016.1163317] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Cancer risk associated with topical calcineurin inhibitors (TCIs) remains unclear. OBJECTIVE To evaluate the association between TCIs and cancer among patients with atopic and endogenous eczema. METHODS Incident cancers were identified from the National Cancer Registry. Data were analyzed using the Cox proportional hazards model to estimate hazard ratios (HRs) and 95% confidence intervals. RESULTS 880 unique cases of cancer developed in 66 176 patients from 2004 to 2012. The adjusted HRs for overall malignancy were 0.82 (95%CI 0.44-1.39) for tacrolimus-exposed and 1.30 (95%CI 0.59-2.45) for pimecrolimus-exposed. The only significant cancer association observed was lymphoid leukemia among the tacrolimus-exposed: HR 7.58 (95%CI 1.64-25.8). All affected patients had young-onset B-cell leukemia. Subgroup analysis of pediatric patients (≤16 years) showed significant association between tacrolimus use and B-cell leukemia: HR 26.4 (95%CI 4.77-146). CONCLUSIONS In this first Asian study on the risk of TCIs and malignancies, we do not find an association between use of tacrolimus and pimecrolimus in atopic and endogenous eczema and the overall development of malignancies. However, the use of topical tacrolimus was found to be associated with the development of B-cell acute lymphoid leukemia in pediatric eczema patients; further studies are required to investigate if a true association indeed occurs.
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Affiliation(s)
| | - W Li
- b Centre for Quantitative Medicine, Duke-NUS Graduate Medical School , Singapore
| | | | - J C Allen
- b Centre for Quantitative Medicine, Duke-NUS Graduate Medical School , Singapore
| | - H L Tey
- a National Skin Centre , Singapore.,c Lee Kong Chian School of Medicine , Singapore
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11
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Scientific evidence for health effects attributed to the consumption of probiotics and prebiotics: an update for current perspectives and future challenges. Br J Nutr 2015; 114:1993-2015. [PMID: 26443321 DOI: 10.1017/s0007114515003864] [Citation(s) in RCA: 109] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Probiotics and prebiotics, mainly commercialised as food ingredients and also as supplements, are considered highly profitable niche markets. However, in recent years, the food industry has suffered from a series of health claim restrictions on probiotics and prebiotics in many parts of the world, including those made by the European Food Safety Authority. Therefore, we reviewed the core benefits of probiotic and prebiotic consumption on health. A number of studies have examined the prevention and/or management of intestinal infections, respiratory tract infections, CVD, osteoporosis, urogenital infections, cavities, periodontal disease and halitosis, allergic reactions, inflammatory bowel disease and irritable bowel syndrome and Helicobacter pylori gastric infections. In fact, a deeper understanding of the mechanisms involved in human microbiota and immune system modulation by probiotics and prebiotics relies on continuous efforts to establish suitable biomarkers of health and diseases risk factors for the design of clinical trials required for health claim approval. In spite of the promising results, the performance of large, long-term, well-planned, well-aligned clinical studies is crucial to provide more reliability and a more solid basis for the outcomes achieved and to support the potential use of probiotics and prebiotics in clinical practice.
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12
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Misery L, Ansolabehere X, Grandfils N, Georgescu V, Taieb C. Nine-year follow-up of children with atopic dermatitis by general practitioners. Dermatology 2014; 228:344-9. [PMID: 24662194 DOI: 10.1159/000358296] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2013] [Accepted: 01/03/2014] [Indexed: 11/19/2022] Open
Abstract
The frequency of associated comorbidity and the cost of treatments in patients with atopic dermatitis (AD) followed up in primary care settings are poorly known. We carried out a retrospective cohort study on a longitudinal electronic medical records database of patients consulting a panel of general practitioners in France. All subjects with AD diagnosed during the first year of life were selected and matched with infants without the disease according to sex (1,163 vs. 1,163). Subjects were followed up for 9 years. Associated diseases, drug consumptions and available medical costs were detailed. Comparisons between subjects and controls were carried out. Subjects with AD had more comorbidities than others, especially in respiratory and ophthalmic system organs. The number of prescribed treatments in the field of skin diseases as well as overall medical costs (general practitioner consultations and prescribed drugs) were higher among atopic subjects, but differences were attenuated with age.
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Affiliation(s)
- Laurent Misery
- Department of Dermatology, University Hospital of Brest, Brest, France
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13
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Charman CR, Venn AJ, Ravenscroft JC, Williams HC. Translating Patient-Oriented Eczema Measure (POEM) scores into clinical practice by suggesting severity strata derived using anchor-based methods. Br J Dermatol 2013; 169:1326-32. [PMID: 24024631 PMCID: PMC3920642 DOI: 10.1111/bjd.12590] [Citation(s) in RCA: 191] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/13/2013] [Indexed: 12/02/2022]
Abstract
BACKGROUND The Patient-Oriented Eczema Measure (POEM) is a validated, patient-derived assessment measure for monitoring atopic eczema severity, although further information on how different POEM scores translate into disease severity categories is needed for clinical trials, epidemiological research and audit. OBJECTIVES We sought to determine the relationship between Patient-Oriented Eczema Measure (POEM) scores (range 0-28) and two Global Questions (GQ1 and 2) concerning patients'/parents' views of the overall severity of their/their child's atopic eczema, in order to stratify POEM scores into five severity bands. METHODS POEM scores and GQs were completed by 300 patients from general practice and 700 patients from dermatology outpatient clinics, including 300 adults aged ≥ 16 years and 700 children. RESULTS The mean POEM score was 13·6 (range 0-28), and standard deviation (SD) was 7·2. Mean GQ1/GQ2 scores were 2·1/2·1, respectively (range 0-4 and SD 1·1 for both). The mean, mode and median of the GQ scores for each POEM score were used to devise possible POEM bandings. The proposed banding for POEM scores are: 0-2 (clear/almost clear); 3-7 (mild); 8-16 (moderate); 17-24 (severe); 25-28 (very severe), kappa coefficient 0·46. CONCLUSIONS Severity banding of the POEM will allow more clinically meaningful use in everyday clinical practice and as a core outcome measure in future atopic eczema research.
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Affiliation(s)
- CR Charman
- Department of Dermatology, Royal Devon and Exeter HospitalExeter, U.K
| | - AJ Venn
- Division of Epidemiology and Public Health, University of NottinghamNottingham, U.K
| | - JC Ravenscroft
- Centre of Evidence Based Dermatology, University of NottinghamNottingham, U.K
| | - HC Williams
- Centre of Evidence Based Dermatology, University of NottinghamNottingham, U.K
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14
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DiNicola C, Kekevian A, Chang C. Integrative medicine as adjunct therapy in the treatment of atopic dermatitis--the role of traditional Chinese medicine, dietary supplements, and other modalities. Clin Rev Allergy Immunol 2013; 44:242-53. [PMID: 22661238 DOI: 10.1007/s12016-012-8315-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Atopic dermatitis (AD) is becoming increasingly prevalent in the pediatric population, with rates reportedly as high as 18-25 %. Westernized medicine has traditionally used a combination of emollients, antihistamines, corticosteroids, and immunomodulating agents to combat this often frustrating disease. Of late, integrative medicine has become the subject of more research as concerns grow regarding prolonged use of corticosteroids and their side effects in pediatric patients. Probiotics have been extensively studied to define their role in the treatment and prevention of AD in children. Unfortunately, results are varying showing significant improvement in some patients but not all. With regard to prevention, studies show that the use of probiotics during pregnancy does decrease the incidence of AD in children. Prebiotics and synbiotics are also a conceivable option for prevention of AD. A number of studies on Chinese herbal medicine have been performed, with a collective result of symptom improvement and decreased levels of inflammatory cytokines. However, there were reports of asymptomatic transaminitis in a few patients that warrant further testing. While the herbs tested in more recent randomized clinical trials were free from corticosteroids, a previous study showed high levels of dexamethasone in unlabeled herbal eczema creams. Vitamins and minerals have also been suggested as an alternative treatment of AD. Studies however have not yet demonstrated improvement of AD with vitamin or mineral supplementation. Topical vitamin B(12) is the exception to this; however, no topical vitamin B(12) preparation is available for use. Finally, relaxation techniques are also being investigated as adjunctive methods of treatment, but well-designed scientific studies are lacking.
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Affiliation(s)
- C DiNicola
- Division of Allergy, Asthma and Immunology, Thomas Jefferson University, Wilmington, DE, USA
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15
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von Kobyletzki LB, Berner A, Carlstedt F, Hasselgren M, Bornehag CG, Svensson A. Validation of a parental questionnaire to identify atopic dermatitis in a population-based sample of children up to 2 years of age. Dermatology 2013; 226:222-6. [PMID: 23796755 DOI: 10.1159/000349983] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2012] [Accepted: 02/07/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Validated eczema questionnaires have been available for schoolchildren only, but the incidence of atopic dermatitis (AD) is highest during infancy. OBJECTIVE To validate a parental questionnaire to identify AD in children up to 2 years of age. METHODS Parents of 476 children answered a written questionnaire prior to an examination by a physician. Sensitivity, specificity, predictive values and test-retest reliability of the questionnaire were assessed. RESULTS A total of 245 (51%) girls and 231 (49%) boys, aged 1-24 months, with and without physician-diagnosed AD participated. Seventy-one children (15%) had physician-diagnosed AD. Validation of the questionnaire by comparisons with physicians' diagnoses showed a sensitivity of 0.87 (95% confidence interval, CI, 0.77-0.94) and a specificity of 0.98 (95% CI, 0.96-0.99). The positive predictive value was 0.90 (95% CI, 0.80-0.96) and the negative predictive value was 0.98 (95% CI, 0.96-0.99). CONCLUSION The questionnaire identified AD in children aged 0-2 years with high accuracy.
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Affiliation(s)
- L B von Kobyletzki
- Department of Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden.
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16
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Torley D, Futamura M, Williams HC, Thomas KS. What's new in atopic eczema? An analysis of systematic reviews published in 2010-11. Clin Exp Dermatol 2013; 38:449-56. [DOI: 10.1111/ced.12143] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/07/2013] [Indexed: 02/03/2023]
Affiliation(s)
- D. Torley
- Alan Lyell Centre for Dermatology; Southern General Hospital Glasgow; Glasgow; UK
| | | | - H. C. Williams
- Centre of Evidence Based Dermatology; University of Nottingham; Nottingham; UK
| | - K. S. Thomas
- Centre of Evidence Based Dermatology; University of Nottingham; Nottingham; UK
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17
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Orfali RL, Shimizu MM, Takaoka R, Zaniboni MC, Ishizaki AS, Costa AA, Tiba APL, Sato MN, Aoki V. Atopic dermatitis in adults: clinical and epidemiological considerations. Rev Assoc Med Bras (1992) 2013; 59:270-5. [PMID: 23680276 DOI: 10.1016/j.ramb.2012.12.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2012] [Revised: 10/29/2012] [Accepted: 12/03/2012] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVE Atopic dermatitis (AD) is a chronic inflammatory disease causing intense pruritus, and with typical clinical features. There are few epidemiological studies concerning AD in adults, as well as little information about its prognostic. The aim of this study was to evaluate the clinical and epidemiological course of adults with AD. METHODS 80 patients aged above 18 years (mean age=29 years) were selected (30 males and 50 females) and interviewed about hospitalization, systemic corticoid usage, age of AD onset, and personal and/or familial history of atopy. Disease severity was evaluated through the Scoring Atopic Dermatitis (SCORAD) tool. Laboratory examination included IgE serum levels and eosinophil blood count. RESULTS 71 out of 80 patients referred association with respiratory symptoms (18 had asthma, 17 had rhinitis, and 36 had both conditions); nine out of 80 patients denied any respiratory disease. AD patients were divided in mild (n=25), moderate (n=30), and severe (n=25); 56% had one or more hospitalizations due to AD. A positive association was found between IgE serum levels, eosinophil blood count, and disease severity. CONCLUSION Adult AD represents a clinical challenge that needs to be better characterized, since it can be misdiagnosed and interferes with the patient's social and personal life. The association of skin and respiratory atopic disease is frequent, and laboratory parameters such as circulating IgE levels and eosinophil blood count may be helpful to assess disease severity.
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Affiliation(s)
- Raquel Leão Orfali
- Department of Dermatology, Medical School, Universidade de São Paulo USP, São Paulo, SP, Brazil
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18
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Futamura M, Thomas KS, Grindlay DJC, Doney EJ, Torley D, Williams HC. Mapping systematic reviews on atopic eczema--an essential resource for dermatology professionals and researchers. PLoS One 2013; 8:e58484. [PMID: 23505516 PMCID: PMC3594299 DOI: 10.1371/journal.pone.0058484] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2012] [Accepted: 02/05/2013] [Indexed: 01/31/2023] Open
Abstract
Background Many research studies have been published on atopic eczema and these are often summarised in systematic reviews (SRs). Identifying SRs can be time-consuming for health professionals, and researchers. In order to facilitate the identification of important research, we have compiled an on-line resource that includes all relevant eczema reviews published since 2000. Methods SRs were searched for in MEDLINE (Ovid), EMBASE (Ovid), PubMed, the Cochrane Database of Systematic Reviews, DARE and NHS Evidence. Selected SRs were assessed against the pre-defined eligibility criteria and relevant articles were grouped by treatment category for the included interventions. All identified systematic reviews are included in the Global Resource of EczemA Trials (GREAT) database (www.greatdatabase.org.uk) and key clinical messages are summarised here. Results A total of 128 SRs reviews were identified, including three clinical guidelines. Of these, 46 (36%) were found in the Cochrane Library. No single database contained all of the SRs found. The number of SRs published per year has increased substantially over the last thirteen years, and reviews were published in a variety of clinical journals. Of the 128 SRs, 1 (1%) was on mechanism, 37 (29%) were on epidemiology, 40 (31%) were on eczema prevention, 29 (23%) were on topical treatments, 31 (24%) were on systemic treatments, and 24 (19%) were on other treatments. All SRs included searches of MEDLINE in their search methods. One hundred six SRs (83%) searched more than one electronic database. There were no language restrictions reported in the search methods of 52 of the SRs (41%). Conclusions This mapping of atopic eczema reviews is a valuable resource. It will help healthcare practitioners, guideline writers, information specialists, and researchers to quickly identify relevant up-to-date evidence in the field for improving patient care.
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Affiliation(s)
- Masaki Futamura
- Centre of Evidence Based Dermatology, University of Nottingham, King's Meadow Campus, Nottingham, United Kingdom.
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Subramanian M. Zoonotic disease risk and the bushmeat trade: assessing awareness among hunters and traders in Sierra Leone. ECOHEALTH 2012; 9:471-482. [PMID: 23408099 DOI: 10.1007/s10393-012-0807-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2011] [Revised: 10/10/2012] [Accepted: 11/15/2012] [Indexed: 06/01/2023]
Abstract
The bushmeat industry has been a topic of increasing importance among both conservationists and public health officials for its influence on zoonotic disease transmission and animal conservation. While the association between infectious diseases and the bushmeat trade is well established in the research community, risk perception among bushmeat hunters and traders has not been well characterized. I conducted surveys of 123 bushmeat hunters and traders in rural Sierra Leone to investigate hunting practices and awareness of zoonotic disease risk associated with the bushmeat trade. Twenty-four percent of bushmeat hunters and traders reported knowledge of disease transmission from animals to humans. Formal education did not significantly affect awareness of zoonotic disease transmission. Individuals who engaged exclusively in preparation and trading of bushmeat were more likely to accidentally cut themselves compared to those who primarily engaged in bushmeat hunting (P < 0.001). In addition, women involved in the bushmeat trade were at greater risk of exposing themselves to potential zoonotic pathogens through accidental self-cutting compared to men (P < 0.01). This study collected preliminary information on risk perception among bushmeat hunters that could guide the creation of a future public health-based education program to minimize zoonotic disease transmission risk among vulnerable communities.
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Shams K, Grindlay DJC, Williams HC. What’s new in atopic eczema? An analysis of systematic reviews published in 2009-2010. Clin Exp Dermatol 2011; 36:573-7; quiz 577-8. [DOI: 10.1111/j.1365-2230.2011.04078.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Tennis P, Gelfand JM, Rothman KJ. Evaluation of cancer risk related to atopic dermatitis and use of topical calcineurin inhibitors. Br J Dermatol 2011; 165:465-73. [PMID: 21466537 DOI: 10.1111/j.1365-2133.2011.10363.x] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Cases of lymphoma or cutaneous cancer have been observed following use of topical calcineurin inhibitors (TCIs), but it is unclear whether TCI use increases cancer risk. We used published literature to assess the extent to which atopic dermatitis (AD) or TCI use is associated with lymphoma, melanoma, basal cell carcinoma and squamous cell carcinoma. We searched the literature and summarized the results of all studies that provided data on the absolute or relative frequency of any malignancy among patients with AD or eczema or among patients using TCIs. The relative risk for all lymphoma in broad populations of AD or eczema ranged from 0·7 to 1·8. Available data on lymphoma following TCI use were inconsistent and insufficient to draw a conclusion about the causal role of TCIs. We found no evidence indicating that melanoma or nonmelanoma skin cancer is associated with TCI use. A bias analysis showed that cutaneous T-cell lymphomas initially misdiagnosed and treated as AD would lead to overestimation of the association between TCI use and lymphoma. However, there are only sparse data on specific malignancies among TCI-treated patients. The short duration of typical TCI exposure hinders conclusions about longer exposure. There is insufficient evidence in the epidemiological literature to infer whether TCIs do or do not cause malignancy.
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Affiliation(s)
- P Tennis
- RTI Health Solutions, Research Triangle Park, NC 27709, USA.
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Batchelor JM, Grindlay DJC, Williams HC. What's new in atopic eczema? An analysis of systematic reviews published in 2008 and 2009. Clin Exp Dermatol 2011; 35:823-7; quiz 827-8. [PMID: 20649899 DOI: 10.1111/j.1365-2230.2010.03901.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
This review summarizes clinically important findings from nine systematic reviews of the causes, treatment and prevention of atopic eczema (AE) published between August 2008 and August 2009. Two systematic reviews concluded that there is a strong and consistent association between filaggrin (FLG) mutations and development of eczema. The associations between FLG mutations and atopic sensitization, rhinitis and asthma are weaker than between FLG mutations and eczema, especially if those who also have eczema are excluded. The relationship between transforming growth factor levels in breast milk and eczema development is still unclear. A further systematic review found no strong evidence of a protective effect of exclusive breastfeeding for at least 3 months against eczema, even in those with a positive family history of atopy. Based on a systematic review and meta-analysis of six randomized controlled trials, supplementation with omega-3 and omega-6 oils is unlikely to play an important role in the primary prevention of eczema or allergic diseases in general. There is little evidence to support dietary restrictions of certain foods in unselected children with AE. There is also little evidence to suggest a clinically useful benefit from using probiotics in patients with established eczema. A systematic review of topical pimecrolimus and tacrolimus added little additional information to previous reviews, and did not provide any new data on long-term safety. Both of these drugs work in AE, and may reduce flares and usage of topical corticosteroids; however, there is still uncertainty about how they compare with topical corticosteroids.
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García-Gavín J, Armario-Hita J, Fernández-Redondo V, Fernández-Vozmediano J, Sánchez-Pérez J, Silvestre J, Uter W, Giménez-Arnau A. Epidemiología del eczema de contacto en España. Resultados de la Red Española de Vigilancia en Alergia de Contacto (REVAC) durante el año 2008. ACTAS DERMO-SIFILIOGRAFICAS 2011; 102:98-105. [DOI: 10.1016/j.ad.2010.10.015] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2010] [Revised: 10/15/2010] [Accepted: 10/17/2010] [Indexed: 11/17/2022] Open
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Children and adolescents' health-related quality of life in relation to eczema, asthma and hay fever: results from a population-based cross-sectional study. Qual Life Res 2011; 20:1295-305. [PMID: 21347571 DOI: 10.1007/s11136-011-9868-9] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/08/2011] [Indexed: 12/21/2022]
Abstract
PURPOSE Several studies have looked at the relationship between childhood atopic disease and health-related quality of life (HRQoL), but existing research is limited by selected populations, small samples or lack to consider each of the three atopic conditions simultaneously. METHODS Impact of 4-week and 12-month occurrences of the three conditions on HRQoL were analysed by the use of complex sample general linear models alone and adjusted for the other atopic conditions, sociodemographics and mental health in a population-based sample (n = 6,518) of children and adolescents aged 11-17. RESULTS In univariate analyses, total HRQoL was significantly impacted by eczema and hay fever but not asthma with stronger effects for 4-week occurrence. In multivariate analyses, 12-month occurrence of hay fever and 4-week occurrence of eczema and hay fever significantly impacted on total HRQoL. Although most of the variance in HRQoL was explained by mental health, independent effects of the atopic conditions remained. CONCLUSION Atopic conditions impact HRQoL over and above mental health. When analysing the relationship between atopic conditions and HRQoL, it is important to consider more immediate versus less immediate effects of the conditions. Extent of impairment and the domains affected appear to vary when different time intervals are used.
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Epidemiology of Contact Dermatitis in Spain. Results of the Spanish Surveillance System on Contact Allergies for the Year 2008. ACTAS DERMO-SIFILIOGRAFICAS 2011. [DOI: 10.1016/s1578-2190(11)70766-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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