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Wang Y, Hou J, Tsui JCC, Wang L, Zhou J, Chan UK, Lo CJY, Siu PLK, Loo SKF, Tsui SKW. Unique Gut Microbiome Signatures among Adult Patients with Moderate to Severe Atopic Dermatitis in Southern Chinese. Int J Mol Sci 2023; 24:12856. [PMID: 37629036 PMCID: PMC10454836 DOI: 10.3390/ijms241612856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 08/10/2023] [Accepted: 08/13/2023] [Indexed: 08/27/2023] Open
Abstract
Imbalance of the immune system caused by alterations of the gut microbiome is considered to be a critical factor in the pathogenesis of infant eczema, but the exact role of the gut microbiome in adult atopic dermatitis (AD) patients remains to be clarified. To investigate the differences of the gut microbiome between adult AD patients and healthy individuals, stool samples of 234 adults, containing 104 AD patients and 130 healthy subjects, were collected for 16S rRNA gene amplicon. Altered structure and metabolic dysfunctions of the gut microbiome were identified in adult AD patients. Our results illustrated that the adult AD patients were more likely to have allergies, particularly non-food allergies. In addition, the gut microbiome composition of the AD and normal groups were considerably different. Moreover, Romboutsia and Clostridi-um_sensu_stricto_1 was enriched in the normal group, whereas Blautia, Butyricicoccus, Lachnoclostridium, Eubacterium_hallii_group, Erysi-pelatoclostridium, Megasphaera, Oscillibacter, and Flavonifractor dominated in the AD group. Additionally, purine nucleotide degradation pathways were significantly enriched in the AD group, and the enrichment of proteinogenic amino acid biosynthesis pathways was found in the normal group. This study provides insights into new therapeutic strategies targeting the gut microbiome for AD and evidence for the involvement of the gut-skin axis in AD patients.
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Affiliation(s)
- Yiwei Wang
- School of Biomedical Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong; (Y.W.); (L.W.)
| | - Jinpao Hou
- School of Biomedical Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong; (Y.W.); (L.W.)
- Centre for Microbial Genomics and Proteomics, The Chinese University of Hong Kong, Hong Kong
| | - Joseph Chi-Ching Tsui
- Microbiome Research Centre, BioMed Laboratory Company Limited, Hong Kong; (J.C.-C.T.); (J.Z.); (U.K.C.)
| | - Lin Wang
- School of Biomedical Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong; (Y.W.); (L.W.)
| | - Junwei Zhou
- Microbiome Research Centre, BioMed Laboratory Company Limited, Hong Kong; (J.C.-C.T.); (J.Z.); (U.K.C.)
| | - Un Kei Chan
- Microbiome Research Centre, BioMed Laboratory Company Limited, Hong Kong; (J.C.-C.T.); (J.Z.); (U.K.C.)
| | - Claudia Jun Yi Lo
- Microbiome Research Centre, BioMed Laboratory Company Limited, Hong Kong; (J.C.-C.T.); (J.Z.); (U.K.C.)
| | - Pui Ling Kella Siu
- Microbiome Research Centre, BioMed Laboratory Company Limited, Hong Kong; (J.C.-C.T.); (J.Z.); (U.K.C.)
| | - Steven King Fan Loo
- Microbiome Research Centre, BioMed Laboratory Company Limited, Hong Kong; (J.C.-C.T.); (J.Z.); (U.K.C.)
- Hong Kong Institute of Integrative Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
- Dermatology Centre, CUHK Medical Centre, The Chinese University of Hong Kong, Hong Kong
| | - Stephen Kwok Wing Tsui
- School of Biomedical Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong; (Y.W.); (L.W.)
- Centre for Microbial Genomics and Proteomics, The Chinese University of Hong Kong, Hong Kong
- Microbiome Research Centre, BioMed Laboratory Company Limited, Hong Kong; (J.C.-C.T.); (J.Z.); (U.K.C.)
- Hong Kong Bioinformatics Centre, The Chinese University of Hong Kong, Hong Kong
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Giovannini M, Bolis M, Barni S, Liccioli G, Sarti L, Morelli S, Pontone M, Pessina B, Tomei L, Valleriani C, Novembre E, Mori F. Pearls and Pitfalls of Weaning an Infant with Severe Atopic Dermatitis and Sensitization/Allergy to Food. J Clin Med 2023; 12:3889. [PMID: 37373584 DOI: 10.3390/jcm12123889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 05/21/2023] [Accepted: 05/23/2023] [Indexed: 06/29/2023] Open
Abstract
Atopic dermatitis (AD) is a common chronic inflammatory skin disorder in childhood. Skin barrier impairment exposes infants to food allergens, potentially causing sensitization followed by IgE-mediated food allergy. We describe the case of an infant with severe AD in whom several sensitizations to foods are detected, with consequently difficult weaning, and a history of anaphylaxis to cashew nut. Foods for which skin tests were negative were introduced into the infant's diet. Then, when AD control was managed, oral food challenges (OFCs) for foods to which the patient was sensitized, with the exception of cashew nut, were performed. The simultaneous presence of sensitization toward multiple foods made it difficult to introduce them using classic OFC. Therefore, it was decided to perform the low-dose, gradual controlled OFC. This led to an introduction of sensitized foods into the infant's diet, with the exception of cashew nut, avoiding allergic reactions. Absolute recommendations on how, when, and where to perform OFCs with allergenic food to which the child with AD is sensitized are lacking so far. In our opinion, OFCs and the subsequent ntroduction of allergenic foods should be individualized, evaluating some factors such as their social and nutritional importance, the patient's age and clinical phenotype (including the history of anaphylaxis), and the sensitization profile. There is agreement on the fact that the dietary approach in children with moderate-severe AD should no longer include a strict elimination diet. We believe that an early, gradual controlled introduction of all allergenics to identify the amount of food tolerated in the absence of reactions, even if low dose, may improve patients' and families' quality of life. However, even if discussing a vast relevant literature, the limitation of our work is that we describe the management of a single patient. Extensive and high-quality research is needed in this field to improve the available evidence in the area.
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Affiliation(s)
- Mattia Giovannini
- Allergy Unit, Meyer Children's Hospital IRCCS, 50139 Florence, Italy
- Department of Health Sciences, University of Florence, 50139 Florence, Italy
| | - Marta Bolis
- Pediatrics Clinic, ASST-Spedali Civili of Brescia, 25123 Brescia, Italy
| | - Simona Barni
- Allergy Unit, Meyer Children's Hospital IRCCS, 50139 Florence, Italy
| | - Giulia Liccioli
- Allergy Unit, Meyer Children's Hospital IRCCS, 50139 Florence, Italy
| | - Lucrezia Sarti
- Allergy Unit, Meyer Children's Hospital IRCCS, 50139 Florence, Italy
| | - Susanna Morelli
- Allergy Unit, Meyer Children's Hospital IRCCS, 50139 Florence, Italy
| | - Matteo Pontone
- Allergy Unit, Meyer Children's Hospital IRCCS, 50139 Florence, Italy
- Department of Health Sciences, University of Florence, 50139 Florence, Italy
| | - Benedetta Pessina
- Allergy Unit, Meyer Children's Hospital IRCCS, 50139 Florence, Italy
- Department of Health Sciences, University of Florence, 50139 Florence, Italy
| | - Leonardo Tomei
- Allergy Unit, Meyer Children's Hospital IRCCS, 50139 Florence, Italy
- Department of Health Sciences, University of Florence, 50139 Florence, Italy
| | - Claudia Valleriani
- Immunology Laboratory, Meyer Children's Hospital IRCCS, 50139 Florence, Italy
| | - Elio Novembre
- Department of Health Sciences, University of Florence, 50139 Florence, Italy
| | - Francesca Mori
- Allergy Unit, Meyer Children's Hospital IRCCS, 50139 Florence, Italy
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Amin MM, Elkady HM. Prevalence of common sensitizing aeroallergens in patients with atopic dermatitis. Cytokine 2023; 162:156087. [PMID: 36470066 DOI: 10.1016/j.cyto.2022.156087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 10/26/2022] [Accepted: 11/12/2022] [Indexed: 12/03/2022]
Abstract
BACKGROUND Atopic dermatitis (AD), a skin disease burden worldwide, is a complex, multifactorial, chronic inflammatory disease. Prevalence of AD is increasing in developing countries and identifying the causative allergens is a major challenge. Aeroallergens are shown to aggravate atopic dermatitis. PURPOSE Explore the prevalence of aeroallergens sensitization in patients with AD and its possible relation with AD severity. METHODS Cross-sectional study of 132 patients diagnosed to have atopic dermatitis. Atopy was detected by serum specific IgE to a panel of the most encountered aeroallergens. RESULTS From the 132 patients, elevated specific IgE was detected in 72.7 % from which 59.1 % were mild and 86.4 % are moderate/severe as well as 15.9 % are mono-sensitized and 54.5 % are poly-sensitized with poly-sensitization being more in severe cases compared to mild cases (68.2 % vs 4.5 %). Regarding specific IgE to different aeroallergens, the most prevalent were Dermatophagoides pteronyssinus (50 %), followed by Dermatophagoides farinae (34.1 %), Birch pollen (20.5 %), cat epithelium (18.2 %) Regweed (15.9 %), and Cockroach (9.1 %). However, moderate to severe cases were more sensitized to candida (p = 0.012), mix grass pollen (p = 0.002), ragweed (0.00), mite (p = 0.037) and cat epithelium (p = 0.007). CONCLUSION Dermatophagoides pteronyssinus, Dermatophagoides farinae, Birch pollen, cat epithelium Regweed and Cockroach are the most frequent sensitizing aeroallergens in atopic dermatitis.
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Affiliation(s)
- Mariam M Amin
- Department of Internal Medicine, Allergy and Clinical Immunology, Ain Shams University, Cairo, Egypt.
| | - Hossam M Elkady
- Department of Internal Medicine, Allergy and Clinical Immunology, Ain Shams University, Cairo, Egypt
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Németh D, Temesvári E, Holló P, Pónyai G. Preservative Contact Hypersensitivity among Adult Atopic Dermatitis Patients. Life (Basel) 2022; 12:life12050715. [PMID: 35629382 PMCID: PMC9147108 DOI: 10.3390/life12050715] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 04/28/2022] [Accepted: 05/05/2022] [Indexed: 01/19/2023] Open
Abstract
Atopic dermatitis (AD) is a chronic inflammatory disease characterised by an impaired skin barrier. The prolonged use of topical preparations containing medications, emollients, fragrances and preservatives may increase the risk of contact hypersensitivity (CHS). In the Allergy Outpatient Unit of the Department of Dermatology, Venereology and Dermatooncology of Semmelweis University, 5790 adult patients were patch tested between 2007–2021 with the European Environmental Baseline Series according to international standards. Among all the tested adult patients, 723 had preservative CHS (PCHS) and 639 had AD. Among the 723 PCHS patients, 68 (9.4%) had AD; the female to male ratio was 3:1 in this group. Out of 639 AD patients, 68 had PCHS (10.6%). In the AD-PCHS group, 83.8% had CHS to methylisothiazolinone (MI) (tested from 2014), 36.8% to Kathon CG®, 16.2% to methyldibromo-glutaronitrile, 11.8% to paraben, 7.4% to formaldehyde, 4.4% to para-tert-butylphenol-formaldehyde resin and 1.5% to Quaternium-15. The most common concomitant PCHS combination was Kathon CG® + MI. Most patients (32.4%) belonged to the age group of 21–30, and skin symptoms affected mostly the limbs and face. The most common other concomitant allergens were nickel, lanolin alcohol and balsam of Peru. Preservatives (especially MI and Kathon CG®) are important contact allergens in adult AD, mostly among young women. The rate of AD in the PCHS group and the rate of PCHS in the AD group is remarkable; thus, the role of PCHS should be highlighted in the topical therapy and in the prevention of possible AD exacerbations.
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Affiliation(s)
- Dominik Németh
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 41 Mária Street, 1085 Budapest, Hungary; (E.T.); (P.H.); (G.P.)
- Károly Rácz Doctoral School of Clinical Medicine, Semmelweis University, 26 Üllői Street, 1085 Budapest, Hungary
- Correspondence: ; Tel.: +36-20-476311; Fax: +36-1267-6974
| | - Erzsébet Temesvári
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 41 Mária Street, 1085 Budapest, Hungary; (E.T.); (P.H.); (G.P.)
| | - Péter Holló
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 41 Mária Street, 1085 Budapest, Hungary; (E.T.); (P.H.); (G.P.)
| | - Györgyi Pónyai
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 41 Mária Street, 1085 Budapest, Hungary; (E.T.); (P.H.); (G.P.)
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Chong AC, Chwa WJ, Ong PY. Aeroallergens in Atopic Dermatitis and Chronic Urticaria. Curr Allergy Asthma Rep 2022; 22:67-75. [PMID: 35362938 DOI: 10.1007/s11882-022-01033-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/07/2022] [Indexed: 01/18/2023]
Abstract
PURPOSE OF REVIEW While aeroallergens are a well-established trigger of asthma and allergic rhinitis, their role in allergic skin diseases such as atopic dermatitis and chronic urticaria remains controversial. This paper reviews the pathophysiology and clinical evidence for aeroallergens in these allergic skin diseases and summarizes current strategies for evaluation and management. RECENT FINDINGS Current evidence implicates aeroallergens as triggers of cutaneous reactions in atopic dermatitis. Direct skin contact is the likely route of trigger. Aeroallergens may also trigger chronic urticaria, though mechanistic studies are limited. These allergens may cross the skin barrier and directly trigger neurons to release substance P, resulting in mast cell degranulation and dumping of histamine and prostaglandin D2. Many studies link aeroallergen sensitization to chronic urticaria, and case reports suggest the utility of avoidance strategies. The role of aeroallergens as a trigger is clear in atopic dermatitis and becoming emergent in chronic urticaria. Skin prick testing or serum-specific immunoglobulin E testing may be used to determine sensitivities. Management at this time centers on avoidance, and further studies are necessary to evaluate the efficacy of aeroallergen immunotherapy for both conditions.
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Affiliation(s)
- Albert C Chong
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Won Jong Chwa
- Saint Louis University School of Medicine, Saint Louis University, Saint Louis, MO, USA
| | - Peck Y Ong
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA. .,Division of Clinical Immunology and Allergy, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
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Tokura Y, Hayano S. Subtypes of atopic dermatitis: From phenotype to endotype. Allergol Int 2022; 71:14-24. [PMID: 34344611 DOI: 10.1016/j.alit.2021.07.003] [Citation(s) in RCA: 69] [Impact Index Per Article: 34.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 06/21/2021] [Indexed: 12/20/2022] Open
Abstract
Atopic dermatitis (AD) is a heterogenous disorder and can be classified into different types. Stratification of subtypes may enable personalized medicine approaches. AD can be categorized into the IgE-high, extrinsic subtype and the IgE-normal, intrinsic subtype. While extrinsic AD is the major subtype possessing skin barrier impairment (high incidence of filaggrin mutations), intrinsic AD occupies about 20% of AD with female dominance and preserved barrier. Extrinsic AD exhibits protein allergy and food allergy, but intrinsic AD shows metal allergy possibly in association with suprabasin deficiency. In particular, accumulated knowledge of food allergy has more clearly characterized extrinsic AD. European American (EA) and Asian AD subtypes have been also proposed. Asian patients with AD are characterized by a unique blended immune dysregulation and barrier feature phenotype between EA patients with AD and those with psoriasis. In another ethnic study, filaggrin loss-of-function mutations are not prevalent in African American patients with AD, and Th1/Th17 attenuation and Th2/Th22 skewing were seen in these patients. Recent endotype classification provides new insights for AD and other allergic disorders. Endotype is defined as the molecular mechanisms underlying the visible features/phenotype. Endotype repertoire harbors activation of type 2 cytokines, type 1 cytokines, and IL-17/IL-22, impairment of epidermal barrier, and abnormalities of intercellular lipids. Classification of endotype has been attempted with serum markers. These lines of evidence indicate a need for personalized or precision medicine appropriate for each subtype of AD.
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Clinical Features of Contact Dermatitis. Contact Dermatitis 2021. [DOI: 10.1007/978-3-030-36335-2_15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Yun MY, Park KS, Yoon KA, Choi HJ. Leaf extracts of <i>Nandina domestica</i> Thunb ameliorate atopic dermatitis in NC/Nga mice treated with 1-chloro-2,4-dinitrobenzene (DNCB). AIMS BIOENGINEERING 2021. [DOI: 10.3934/bioeng.2021014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Ingordo V, Cazzaniga S, Naldi L, Perrucci S, Barbierato M, Crociata F, Cusano F. Atopic dermatitis in young adult Italian males: persistent and adult-onset varieties did not clinically differ, as for allergological variables. GIORN ITAL DERMAT V 2019; 155:724-732. [PMID: 30650956 DOI: 10.23736/s0392-0488.18.06239-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The prevalence of adult atopic dermatitis (AD) in general population range from 2.6% to 8% according to objective diagnosis in selected groups of people. The adult-onset AD is the clinical form arising de novo in adulthood. The aim of this study was to detect retrospectively the prevalence of AD in Italian general population, examining a sample of young Italian males affected by AD, which was representative of people of same sex and age, and to point out the clinical and allergological differences between the persistent and adult-onset form. METHODS 198,730 potential male conscripts were visited in Italian Navy and Air Force Recruitment's Centers in Taranto to evaluate their fitness to recruitment. All the young men who showed eczema were referred to Italian Navy Hospital. The diagnosis of AD was stated according to Hanifin and Rajka's criteria. All the patients were patch and prick tested. RESULTS One hundred twenty-four cases of AD were diagnosed, with a prevalence of 6.2 cases for 10,000 subjects (95% CI: 5.2-7.4). The subjects with the persistent form were 68 (75.6%; 95% CI: 66.7-84.4) vs. 26 patients with the adult-onset form (21.0%; 95% CI: 13.8-28.1). No statistical difference in clinical and allergological variables was showed between the persistent and adult-onset AD. CONCLUSIONS The prevalence of adult AD in a large sample of young males - representative of the general population of same age and sex - is appreciably lower than the rates previously reported. No clinical feature or allergological variable discriminate between persistent vs. adult-onset varieties.
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Affiliation(s)
- Vito Ingordo
- Centro Studi GISED, Bergamo, Italy - .,Health Local Unit Taranto, District n. 6, Outpatients' Department of Dermatology, Taranto, Italy -
| | - Simone Cazzaniga
- Centro Studi GISED, Bergamo, Italy.,Department of Dermatology, Inselspital University Hospital of Bern, Bern, Switzerland
| | - Luigi Naldi
- Centro Studi GISED, Bergamo, Italy.,Department of Dermatology, San Bortolo Hospital, AUSL 8 Berica, Vicenza, Italy
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Veien NK. Clinical Features of Contact Dermatitis. Contact Dermatitis 2019. [DOI: 10.1007/978-3-319-72451-5_15-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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11
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Jaworek AK, Szafraniec K, Jaworek M, Doniec Z, Zalewski A, Kurzawa R, Wojas-Pelc A, Pokorski M. Cat Allergy as a Source Intensification of Atopic Dermatitis in Adult Patients. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2019; 1251:39-47. [PMID: 31749134 DOI: 10.1007/5584_2019_451] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Atopic dermatitis (AD) is characterized by exacerbations and remissions of eczematous skin, underlain by impaired skin barrier and aberrant Th2-type and Th-22 cytokine production. A number of allergens, in particular contact with fur animals, may aggravate the disease. This study seeks to define the influence of having a regular contact with a pet cat at home on the severity of symptoms and signs of AD. We addressed the issue using the SCORing Atopic Dermatitis (SCORAD) and visual analog (VAS) scores to assess the intensity of pruritus and by measuring the blood content of specific IgE and IL-4, IL-13, and IL-22 cytokines. The study group consisted of 47 adult patients suffering from AD since childhood, 18 of whom declared having regular contact with a cat and the remaining 29 who denied it. There also was a control group consisted of 16 healthy volunteers with no AD signs. The SCORAD and VAS scores were significantly higher in patients in contact with a cat than in those without it (median SCORAD 61.0 vs. 50.4 and VAS 9.0 vs. 4.0 points, respectively). The sIgE of a majority of patients (94.4%) in contact with a cat was in Class V-VI, compared with just a few patients (3.4%) with no such contact, having sIgE in the same classes (p < 0.001). Significant correlations were revealed between SCORAD and VAS scores and the class level of serum sIgE value. In addition, IL-22 was a single elevated cytokine, only in the patients in contact with a cat, and it correlated with pruritus severity. The results of the study underline the need to beware of the cat fur allergen, and they stress forethought and caution in acquiring and keeping a pet cat by patients suffering from AD.
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Affiliation(s)
| | - Krystyna Szafraniec
- Department of Epidemiology and Population Studies, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, Cracow, Poland
| | - Magdalena Jaworek
- Department of Physiotherapy, Faculty of Health Sciences, Jagiellonian University Medical College, Cracow, Poland
| | - Zbigniew Doniec
- Department of Pneumology, Institute of Tuberculosis and Lung Disorders, Rabka, Poland
| | - Adam Zalewski
- Student Scientific Group, Department of Dermatology, Jagiellonian University Medical College, Cracow, Poland
| | - Ryszard Kurzawa
- Department of Allergology and Pneumology, Institute of Tuberculosis and Lung Disorders, Rabka, Poland
| | - Anna Wojas-Pelc
- Department of Dermatology, Jagiellonian University Medical College, Cracow, Poland
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Botoni LS, Torres SMF, Koch SN, Heinemann MB, Costa‐Val AP. Comparison of demographic data, disease severity and response to treatment, between dogs with atopic dermatitis and atopic‐like dermatitis: a retrospective study. Vet Dermatol 2018; 30:10-e4. [DOI: 10.1111/vde.12708] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2018] [Indexed: 02/06/2023]
Affiliation(s)
- Larissa S. Botoni
- Department of Veterinary Clinical Sciences and Surgery Universidade Federal de Minas Gerais 6627 Antônio Carlos Ave Belo Horizonte 31270‐901 Brazil
| | - Sheila M. F. Torres
- Department of Veterinary Clinical Sciences University of Minnesota 1365 Gortner Avenue Saint Paul MN 55108 USA
| | - Sandra N. Koch
- Department of Veterinary Clinical Sciences University of Minnesota 1365 Gortner Avenue Saint Paul MN 55108 USA
| | - Marcos B. Heinemann
- Department of Preventive Veterinary Medicine and Animal Health Universidade de São Paulo 87 Prof. Dr. Orlando Marques de Paiva Ave São Paulo 05508‐270 Brazil
| | - Adriane P. Costa‐Val
- Department of Veterinary Clinical Sciences and Surgery Universidade Federal de Minas Gerais 6627 Antônio Carlos Ave Belo Horizonte 31270‐901 Brazil
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Allergic phenotypes in adult patients with atopic dermatitis, determined with the ISAC test (ImmunoCAP ISAC). Postepy Dermatol Alergol 2018; 35:351-359. [PMID: 30206446 PMCID: PMC6130141 DOI: 10.5114/ada.2018.77664] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Accepted: 08/02/2017] [Indexed: 11/21/2022] Open
Abstract
Introduction Atopic dermatitis (AD) is a chronic inflammatory dermatosis, often with a concomitant allergy. The ImmunoCAP ISAC (Immuno Solid-Phase Allergen Chip) test is a novel method to determine the allergenic phenotype in a given patient. Aim In this study, we used the ImmunoCAP ISAC test to analyze allergic phenotypes in adult patients with AD. Material and methods The study included 19 adult patients with AD. The severity of AD was assessed using SCORAD index. Serum concentrations of total IgE were determined by means fluoro-enzyme immunoassay (FEIA). The levels of asIgE were measured with the ImmunoCAP ISAC kits. Results Positive results of the ISAC test were documented in 84.2% of the study subjects. All patients synthesized asIgE against species-specific respiratory allergens; major components of animal allergens (57.87%), tree pollen allergens (47.3%), grass pollen allergens (42.1%), dust mite allergens (26.3%) and major allergen of mugwort (26.3%). 47.3% of the subjects were sensitive to cross-reactive allergenic components, most often proteins of the lipocalin family (57.8%), followed by PR-10 (26.3%), PR-14 (21%) and PR-5 proteins (21%). asIgE against species-specific allergens were found in 10.5% of the study subjects. No statistically significant relationships were observed between the severity or duration of AD and the prevalence and levels of asIgE against the allergens included in the ISAC panel. However, duration of AD correlated significantly with the serum concentration of total IgE. Conclusions The ISAC test is suitable for determination of the allergenic phenotype in a given patient, and as such has an unquestioned diagnostic and therapeutic value.
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Abstract
Atopic dermatitis is a complex, systemic inflammatory disorder associated with a variety of clinical features. The original criteria of Hanifin and Rajka include major criteria and a list of about two dozen minor criteria however, even the minor criteria do not include some features of atopic dermatitis noted less commonly but still seen with some frequency. This contribution first reviews the common clinical appearance of atopic dermatitis in infancy, childhood, and adulthood, as well as the less typical appearances, including lichenoid atopic dermatitis; juvenile plantar dermatosis; nummular-type atopic dermatitis; follicular atopic dermatitis; alopecia of atopic dermatitis; eczema coxsackium; and psoriasiform, perineal, and lip licker's dermatitis. The clinician will be able to recognize and treat rarer forms of atopic dermatitis and incorporate this into their daily practice.
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Dou X, Kim J, Ni C, Shao Y, Zhang J. Atopy patch test with house dust mite in Chinese patients with atopic dermatitis. J Eur Acad Dermatol Venereol 2016; 30:1522-6. [PMID: 27329364 DOI: 10.1111/jdv.13655] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2015] [Accepted: 02/15/2016] [Indexed: 01/28/2023]
Affiliation(s)
- X. Dou
- Department of Dermatology; Peking University Shenzhen Hospital; Shenzhen Guangdong China
| | - J. Kim
- Department of Dermatology; Huashan Hospital Fudan University; Shanghai China
| | - C.Y. Ni
- Department of Dermatology; Huashan Hospital Fudan University; Shanghai China
| | - Y. Shao
- Department of Dermatology; Peking University Shenzhen Hospital; Shenzhen Guangdong China
| | - J. Zhang
- Department of Dermatology; Peking University Shenzhen Hospital; Shenzhen Guangdong China
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Yamaguchi H, Kabashima-Kubo R, Bito T, Sakabe JI, Shimauchi T, Ito T, Hirakawa S, Hirasawa N, Ogasawara K, Tokura Y. High frequencies of positive nickel/cobalt patch tests and high sweat nickel concentration in patients with intrinsic atopic dermatitis. J Dermatol Sci 2013; 72:240-5. [PMID: 24035598 DOI: 10.1016/j.jdermsci.2013.07.009] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2013] [Revised: 07/29/2013] [Accepted: 07/29/2013] [Indexed: 11/30/2022]
Abstract
BACKGROUND Atopic dermatitis (AD) is classified into extrinsic AD with high serum IgE levels and impaired barrier, and intrinsic AD with low serum IgE levels and unimpaired barrier. Intrinsic AD has a lower frequency of FLG mutations and a higher frequency of circulating Th1 cells, implying that non-protein antigens, represented by metals, may be an exacerbation factor in intrinsic AD. OBJECTIVE To investigate metal allergy in intrinsic AD. METHODS Enrolled in this study were 86 Japanese AD patients seen in three university hospitals, consisting of 55 extrinsic and 31 intrinsic AD patients. Patch testing was performed, focusing on nickel, cobalt, and chrome, in parallel with other 14 metals. FLG mutations were analyzed in 49 patients (extrinsic, 29; intrinsic, 20). In 17 patients (extrinsic, 12; intrinsic, 5), sweat was collected from the forearms by exercise, and the concentration of nickel was fluorometrically measured. RESULTS Nickel, cobalt, and chrome were the major positive metals. Intrinsic AD showed significantly higher percentages of positive reactions than extrinsic AD to nickel (intrinsic 41.9% vs extrinsic 16.4%, P=0.019) and cobalt (38.7% vs 10.9%, P=0.005). There was no significant difference between FLG mutation-bearing and non-bearing patients. The concentration of nickel was higher in the sweat of intrinsic AD than extrinsic AD patients (333.8 vs 89.4ng/g, P=0.0005) and inversely correlated with serum IgE levels. CONCLUSIONS Nickel and cobalt allergy may be involved in intrinsic AD. Given that the metals are excreted through sweat, intrinsic AD might be exaggerated by highly metal-containing sweat.
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Affiliation(s)
- Hayato Yamaguchi
- Department of Dermatology, Hamamatsu University School of Medicine, Japan
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17
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de Bruin Weller MS, Rockmann H, Knulst AC, Bruijnzeel-Koomen CAFM. Evaluation of the adult patient with atopic dermatitis. Clin Exp Allergy 2013; 43:279-91. [PMID: 23414536 DOI: 10.1111/cea.12030] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Atopic dermatitis (AD) is a chronic inflammatory skin disease with a large impact on quality of life of the patients and their families. In most cases, the diagnosis of AD can easily be made based on (family) history and clinical examination. If necessary, a practical set of diagnostic criteria such as the UK diagnostic criteria can be used. During the diagnostic phase, it is important to pay attention to atopic comorbidity, such as allergic airway disease (allergic asthma and/or rhinitis), allergic eye disease (atopic (kerato) conjunctivitis) and immediate-type food allergy. This will not have direct consequences for the treatment of AD, but may be important for the overall well-being of the patient. Psychological factors, such as family circumstances, work/school performance and lifestyle factors should also be explored. Severity scoring using properly validated scoring lists may not be necessary for the diagnosis, however, is recommended for monitoring therapy. Simple scoring systems, such as TIS and IGA are easy to perform in daily practice. Several flare factors in AD, such as exposure to irritants or UV light, can be identified by history and clinical examination: in individual cases, additional diagnostic tests may sometimes be useful to confirm clinical suspicion. There is only limited evidence that allergen exposure to aeroallergens and/or food allergens influences AD severity. Therefore, routine allergen testing is not necessary for diagnosis and treatment of AD. The decision to perform allergen tests mainly depends on atopic comorbidity.
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Affiliation(s)
- M S de Bruin Weller
- Department of Dermatology & Allergology, University Medical Centre Utrecht, Utrecht, The Netherlands.
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18
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Yanaba K, Kamata M, Asano Y, Tada Y, Sugaya M, Kadono T, Tedder TF, Sato S. CD19 expression in B cells regulates atopic dermatitis in a mouse model. THE AMERICAN JOURNAL OF PATHOLOGY 2013; 182:2214-22. [PMID: 23583649 DOI: 10.1016/j.ajpath.2013.02.042] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2012] [Revised: 02/12/2013] [Accepted: 02/21/2013] [Indexed: 12/19/2022]
Abstract
Atopic dermatitis is an inflammatory cutaneous disorder characterized by dry skin and relapsing eczematous skin lesions. Besides antibody production, the contribution of B cells to the pathogenesis of atopic dermatitis is unclear. In mice, repeated epicutaneous sensitization with ovalbumin induces inflamed skin lesions resembling human atopic dermatitis and therefore serves as an experimental model for this condition. To investigate the role of B cells in a murine model of atopic dermatitis, ovalbumin-sensitized allergic skin inflammation was assessed in mice lacking CD19. In ovalbumin-sensitized skin from CD19-deficient mice, the number of eosinophils and CD4(+) T cells was reduced, and both epidermal and dermal thickening were decreased. Following in vitro stimulation with ovalbumin, CD19 deficiency significantly reduced the proliferation of CD4(+), but not CD8(+), T cells from spleen and draining lymph nodes. Furthermore, splenocytes and draining lymph node cells from ovalbumin-sensitized CD19-deficient mice secreted significantly less IL-4, IL-13, and IL-17 than ovalbumin-sensitized wild-type mice. These results suggest that CD19 expression in B cells plays a critical role in antigen-specific CD4(+) T-cell proliferation and T helper 2 and 17 responses in a murine model of atopic dermatitis. Furthermore, the present findings may have implications for B-cell-targeted therapies for the treatment of atopic dermatitis.
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Affiliation(s)
- Koichi Yanaba
- Department of Dermatology, Faculty of Medicine, University of Tokyo, Tokyo, Japan.
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Thyssen JP, Johansen JD, Linneberg A, Menné T, Engkilde K. The association between contact sensitization and atopic disease by linkage of a clinical database and a nationwide patient registry. Allergy 2012; 67:1157-64. [PMID: 22765654 DOI: 10.1111/j.1398-9995.2012.02863.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/25/2012] [Indexed: 11/26/2022]
Abstract
BACKGROUND Experimental studies have shown that individuals with atopic dermatitis are likely to have suppressed contact sensitivity secondary to their disease whereas some clinical and epidemiological studies have shown that individuals with atopic dermatitis might have a higher prevalence of contact sensitization than controls. The objective was to study the association between contact sensitization and, respectively, atopic dermatitis and asthma using clinical databases. METHODS Record linkage of two different registers was performed: (i) a tertiary hospital register of dermatitis patient's patch tested for contact sensitivity and (ii) the Danish National Patient Register containing nationwide hospital discharge diagnoses and outpatient contacts. RESULTS An inverse association was found between contact sensitization and, respectively, presumed severe atopic dermatitis (OR, 0.70; 95% CI, 0.61-0.81) and asthma (OR, 0.61; 95% CI, 0.42-0.90) when linkage was performed. Inverse associations were found for all groups of chemicals and metals except for sensitization to fragrances and topical drugs where positive associations were identified. A significant positive association between fragrance sensitization and presumed mild-moderate atopic dermatitis was also found when data from hospital register only were used, suggesting an overall higher prevalence of fragrance sensitization in patients with atopic dermatitis. CONCLUSIONS Our findings support that patients with severe atopic dermatitis and asthma have an overall lower prevalence of contact sensitization when compared with controls, whereas mild-to-moderate disease does not suppress contact sensitization. The prevalence of contact sensitization to fragrance chemicals was higher in patients with atopic dermatitis. Patients should be instructed to avoid scented moisturizers and products containing highly sensitizing substances.
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Affiliation(s)
- J. P. Thyssen
- Department of Dermato-Allergology, National Allergy Research Centre; Copenhagen University Hospital Gentofte; Hellerup; Denmark
| | - J. D. Johansen
- Department of Dermato-Allergology, National Allergy Research Centre; Copenhagen University Hospital Gentofte; Hellerup; Denmark
| | - A. Linneberg
- Research Centre for Prevention and Health; Copenhagen University Hospital Glostrup; Glostrup; Denmark
| | - T. Menné
- Department of Dermato-Allergology, National Allergy Research Centre; Copenhagen University Hospital Gentofte; Hellerup; Denmark
| | - K. Engkilde
- Department of Dermato-Allergology, National Allergy Research Centre; Copenhagen University Hospital Gentofte; Hellerup; Denmark
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Visscher MO, Randall Wickett R. Hand hygiene compliance and irritant dermatitis: a juxtaposition of healthcare issues. Int J Cosmet Sci 2012; 34:402-15. [DOI: 10.1111/j.1468-2494.2012.00733.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2012] [Accepted: 06/05/2012] [Indexed: 12/14/2022]
Affiliation(s)
| | - R. Randall Wickett
- The James L. Winkle College of Pharmacy; University of Cincinnati; Cincinnati; OH; 45267; U.S.A
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21
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Kabashima-Kubo R, Nakamura M, Sakabe JI, Sugita K, Hino R, Mori T, Kobayashi M, Bito T, Kabashima K, Ogasawara K, Nomura Y, Nomura T, Akiyama M, Shimizu H, Tokura Y. A group of atopic dermatitis without IgE elevation or barrier impairment shows a high Th1 frequency: possible immunological state of the intrinsic type. J Dermatol Sci 2012; 67:37-43. [PMID: 22591815 DOI: 10.1016/j.jdermsci.2012.04.004] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2011] [Revised: 03/15/2012] [Accepted: 04/10/2012] [Indexed: 12/11/2022]
Abstract
BACKGROUND Atopic dermatitis (AD) can be classified into the major extrinsic type with high serum IgE levels and impaired barrier, and the minor intrinsic type with normal IgE levels and unimpaired barrier. OBJECTIVE To characterize the intrinsic type of Japanese AD patients in the T helper cell polarization in relation to the barrier condition. METHODS Enrolled in this study were 21 AD patients with IgE<200kU/L (IgE-low group; 82.5±59.6kU/L) having unimpaired barrier, and 48 AD patients with IgE>500kU/L (IgE-high group; 8.050±10.400kU/L). We investigated filaggrin gene (FLG) mutations evaluated in the eight loci common to Japanese patients, circulating Th1, Th2 and Th17 cells by intracellular cytokine staining and flow cytometry, and blood levels of CCL17/TARC, IL-18, and substance P by ELISA. RESULTS The incidence of FLG mutations was significantly lower in the IgE-low group (10.5%) than the IgE-high group (44.4%) (normal individuals, 3.7%). The percentage of IFN-γ-producing Th1, but not Th2 or Th17, was significantly higher in the IgE-low than IgE-high group. Accordingly, Th2-attracting chemokine CCL17/TARC, was significantly lower in the IgE-low than the IgE-high group. There were no differences between them in serum IL-18 levels, or the plasma substance P levels or its correlation with pruritus. CONCLUSION The IgE-low group differed from the IgE-high group in that it had much less FLG mutations, increased frequency of Th1 cells, and lower levels of CCL17. In the intrinsic type, non-protein antigens capable of penetrating the unimpaired barrier may induce a Th1 eczematous response.
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Affiliation(s)
- Rieko Kabashima-Kubo
- Department of Dermatology, University of Occupational and Environmental Health, Kitakyushu, Japan
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Juliá-Serdá G, Cabrera-Navarro P, Acosta-Fernández O, Martín-Pérez P, García-Bello MA, Antó-Boqué J. Prevalence of sensitization to Blomia tropicalis among young adults in a temperate climate. J Asthma 2012; 49:349-54. [PMID: 22486531 DOI: 10.3109/02770903.2012.672611] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND There are no previous population-based studies assessing the prevalence of Blomia tropicalis (BT). This investigation analyzes the prevalence of sensitization to BT and its contribution to asthma and related diseases among young adults in the Canary Islands. MATERIAL AND METHODS From a random sample of 9506 adults, aged between 20 and 44, who had previously answered a short respiratory questionnaire, a further 20% random sample was drawn. All participants filled in an extensive questionnaire, and they underwent spirometry and bronchial hyperresponsiveness (BHR) test and skin testing to several allergens as well as the determination of total IgE and specific IgE. RESULTS The prevalence of positive skin tests to BT was 13.8% (95% confidence interval [CI] 10.6-17.9%) and that of BT-specific IgE 17.9% (95% CI 14.2-24.5%). Sensitization to BT (positive skin tests or positive specific IgE) was 20.9% (95% CI 16.9-25.5%). Most of the subjects sensitized to BT were also sensitized to Dermatophagoides pteronissimus; however, only 7% displayed monosensitization to BT. Among subjects who exhibited BHR, sensitization to BT reached 46.7% (95% CI 32.7-60.9%), among those with asthma 50% (95% CI 26.8-73.2%), in subjects with rhinitis 37.2% (95% CI 28.1-47.6%), and in those suffering from dermatitis 25.9% (95% CI 18.7-34.5%). A strong association of BT sensitization with BHR and asthma before and after 15 years was found. CONCLUSION The prevalence of sensitization to BT among young adults in the Canary Islands is high, and it displays a close relationship with allergic respiratory diseases and dermatitis.
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Affiliation(s)
- Gabriel Juliá-Serdá
- Department of Pulmonology, University of Las Palmas, Las Palmas de Gran Canaria, Canary Islands, Spain.
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23
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Abstract
Retrospective studies demonstrate that the prevalence of skin sensitization does not significantly differ between atopic and non-atopic patients. In children and adolescents the risk for sensitization seems to occur independently from AD. According to the results of a recent study, AD patients are overrepresented in the group of polysensitized patients. IgE-mediated sensitization as well as an early onset of AD and duration of the disease have been identified as possible risk factors for skin sensitization to contact allergens. A defective permeability barrier with increased epidermal water loss is a hallmark of AD and contributes to sensitization against common allergens. A highly significant association between FLG mutations and the risk of early onset, severe, persistent AD and an increased risk for asthma has been shown in several studies. A more recent study revealed an association between FLG mutations and increased nickel sensitization, but not other contact allergens. However, further large prospective studies with well-characterized patients are necessary to clarify the correlation between impaired skin barrier, atopic dermatitis and allergic contact dermatitis.
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Affiliation(s)
- M Niebuhr
- Klinik für Dermatologie, Allergologie und Venerologie, Medizinische Hochschule Hannover.
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Doutre MS, Beylot-Barry M. À propos de quelques visages rouges. Ann Dermatol Venereol 2011; 138 Suppl 2:S148-53. [DOI: 10.1016/s0151-9638(11)70080-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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26
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Vakirlis E, Lazaridou E, Tzellos TG, Gerou S, Chatzidimitriou D, Ioannides D. Investigation of cytokine levels and their association with SCORAD index in adults with acute atopic dermatitis. J Eur Acad Dermatol Venereol 2011; 25:409-16. [PMID: 21371129 DOI: 10.1111/j.1468-3083.2010.03800.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Atopic dermatitis (AD) is a chronic inflammatory skin disease with increasing frequency over the last decades, especially in adults. Cytokines orchestrate atopic skin inflammation. Objectives The aim of this study was to compare serum levels of cytokines in adult patients with acute AD (AD1) with other groups of AD patients and controls and investigate the possible association between such cytokines and disease severity. METHODS We measured cytokine levels using flow cytometry in 21 adult patients with acute AD, 12 adults with chronic AD, 10 children with acute AD and 10 healthy adults. RESULTS Flow cytometry analysis of cytokines revealed that interleukin 10 (IL-10), IL-6, interferon γ (IFN-γ) and IL-4 levels were significantly decreased in AD1 group compared with controls, whereas IL-2 and tumour necrosis factor (TNF) did not differ. Comparison of AD1 group with adults chronic phase group showed that IgE, eosinophil and IL-2 levels remained unaltered, whereas IL-10, IL-6, IFN-γ, IL-4 and TNF were significantly decreased. SCORAD and IgE levels were significantly increased, IL-10, IL-6 and IFN-γ were decreased and TNF, IL-2, IL-4 and eosinophil levels remained unchanged in AD1 group compared with children acute phase group. Within AD1 group correlation analysis revealed that IgE and TNF levels were significantly associated with AD severity. Coefficient of determination analysis revealed that TNF and IgE levels could explain 49.14% and 35.28% of the variance of SCORAD. CONCLUSIONS These data indicate that serum IgE and TNF levels correlate with AD severity and that serum cytokines are downregulated in AD1 group. Further studies are clearly needed to elucidate cytokines' role in adults with AD.
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Affiliation(s)
- E Vakirlis
- Departments of Dermatology and Venereology Microbiology, School of Medicine, Aristotle University of Thessaloniki, Greece.
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Davis JA, Visscher MO, Wickett RR, Hoath SB. Role of TNF-α polymorphism -308 in neurosensory irritation. Int J Cosmet Sci 2011; 33:105-12. [DOI: 10.1111/j.1468-2494.2010.00597.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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28
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Clinical Features. Contact Dermatitis 2011. [DOI: 10.1007/978-3-642-03827-3_15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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29
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Reginald K, Westritschnig K, Werfel T, Heratizadeh A, Novak N, Focke-Tejkl M, Hirschl AM, Leung DYM, Elisyutina O, Fedenko E, Valenta R. Immunoglobulin E antibody reactivity to bacterial antigens in atopic dermatitis patients. Clin Exp Allergy 2010; 41:357-69. [PMID: 21155910 DOI: 10.1111/j.1365-2222.2010.03655.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Atopic dermatitis (AD) is a chronic inflammatory skin disease affecting up to 20% children and 9% adults world-wide. AD patients are often sensitized against a broad variety of allergens and more than 90% of them suffer from skin superinfections with Staphylococcus aureus. OBJECTIVE In this study, we searched for the presence of specific IgE antibodies against S. aureus and Escherichia coli antigens in AD patients. METHODS Sera from AD patients (n=79), patients suffering only from allergic rhinoconjunctivitis (n=41) or allergic asthma (n=37) were tested for IgE reactivity to nitrocellulose-blotted S. aureus, E. coli and gut bacterial antigens. IgE-reactive bacterial antigens were affinity purified and identified by mass spectrometry. RESULTS More than 30% of AD patients but not patients suffering only from allergic rhinoconjunctivitis and asthma or non-allergic persons exhibited IgE binding to several protein antigens among them DNA-binding and ribosomal proteins and flagellin. Patients with severe skin manifestations showed more frequently IgE reactivity to S. aureus compared with AD patients with mild symptoms. Positive immediate and late skin test reactions could be induced in sensitized AD patients with S. aureus extract. CONCLUSION AND CLINICAL RELEVANCE Specific IgE reactivities against a variety of bacterial antigens were observed in a subgroup comprising a third of AD patients and may contribute to allergic inflammation.
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Affiliation(s)
- K Reginald
- Department of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
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Katsarou A, Armenaka MC. Atopic dermatitis in older patients: particular points. J Eur Acad Dermatol Venereol 2010; 25:12-8. [DOI: 10.1111/j.1468-3083.2010.03737.x] [Citation(s) in RCA: 78] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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31
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Davis JA, Visscher MO, Wickett RR, Hoath SB. Influence of tumour necrosis factor-α polymorphism-308 and atopy on irritant contact dermatitis in healthcare workers. Contact Dermatitis 2010; 63:320-32. [PMID: 20731689 DOI: 10.1111/j.1600-0536.2010.01778.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Chronic irritant hand dermatitis is an issue for healthcare workers and may negatively impact infection control. OBJECTIVES We examined the effects of a G to A transition at position -308 on the tumour necrosis factor-α (TNF-α) gene on chronically damaged skin of healthcare workers during exposure and recovery from repetitive hand hygiene, after intensive treatment, and on the irritant response in normal skin. PATIENTS/MATERIALS/METHODS In 68 healthcare workers with irritant hand dermatitis, we genotyped TNF-α-308 and measured the epidermal response via quantitative digital imaging, erythema, dryness, and barrier integrity. RESULTS Excess hand erythema decreased with hand hygiene exposure and increased during time off for AA/GA genotypes, but had opposite effects for GG. AA/GA had smaller reductions in dryness with lotion treatment and larger reductions in excess erythema than GG. The atopic diathesis and heightened neurosensory irritation resulting from water and lactic acid significantly influenced the responses. Repeated exposure to water and sodium lauryl sulfate (0.05, 0.1%) produced higher erythema in normal skin for AA/GA than for GG. CONCLUSIONS This study provides evidence that the TNF-α polymorphism at -308 and an atopic history impact the severity of irritation and recovery from exposure and response to treatment for common hand skin products in both chronic irritant hand dermatitis and normal skin.
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Affiliation(s)
- Jennifer A Davis
- Division of Pharmaceutical Sciences, College of Pharmacy, University of Cincinnati, Cincinnati, OH, USA
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The diagnostic value of atopy patch testing and prick testing in atopic dermatitis: facts and controversies. Clin Dermatol 2010; 28:38-44. [PMID: 20082949 DOI: 10.1016/j.clindermatol.2009.03.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
We conducted a systematic Medline search of the literature (1998-2008) on the criteria for performing the skin prick test and atopy patch testing (APT) to determine their utility in atopic dermatitis (AD). The skin prick, scratch, and skin patch tests are performed to identify which allergen is causing eczematous skin symptoms in patients with AD, or sneezing, nasal congestion, itchy eyes, wheezing, skin rash, and swelling. Many allergens in foods, drugs, and environmental substances (eg, ragweed and fungus), as well as contact allergens, can elicit eczematous skin reactions after epicutaneous application. Because no gold standard exists for aeroallergen provocation in AD, the APT is currently used to evaluate allergen without comparison with another accurate and reliable method. The APT is presumed to reflect delayed-phase clinical reactions. Even with delayed onset of symptoms (more than 2 hours after food ingestion), APT findings were not consistent among AD children. The APT could be used in children with gastrointestinal reactions to foods as well as AD. After standardization, the APT may provide further diagnostic information in addition to the skin prick test and serum immunoglobulin E values and may be able to evaluate the actual clinical relevance of immunoglobulin E-mediated sensitizations for eczematous lesions. The European APT model used with standardization of allergen concentration and vehicle may provide an important diagnostic tool to select patients for avoidance and for procedures of allergen-specific immunotherapy, but the clinical relevance of positive APT reactions awaits standardized provocation and avoidance testing.
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Tokura Y. Extrinsic and intrinsic types of atopic dermatitis. J Dermatol Sci 2010; 58:1-7. [PMID: 20207111 DOI: 10.1016/j.jdermsci.2010.02.008] [Citation(s) in RCA: 221] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2010] [Revised: 02/08/2010] [Accepted: 02/09/2010] [Indexed: 10/19/2022]
Abstract
Atopic dermatitis (AD) can be categorized into the extrinsic and intrinsic types. Extrinsic or allergic AD shows high total serum IgE levels and the presence of specific IgE for environmental and food allergens, whereas intrinsic or non-allergic AD exhibits normal total IgE values and the absence of specific IgE. While extrinsic AD is the classical type with high prevalence, the incidence of intrinsic AD is approximately 20% with female predominance. The clinical features of intrinsic AD include relative late onset, milder severity, and Dennie-Morgan folds, but no ichthyosis vulgris or palmar hyperlinearity. The skin barrier is perturbed in the extrinsic, but not intrinsic type. Filaggrin gene mutations are not a feature of intrinsic AD. The intrinsic type is immunologically characterized by the lower expression of interleukin (IL) -4, IL-5, and IL-13, and the higher expression of interferon-gamma. It is suggested that intrinsic AD patients are not sensitized with protein allergens, which induce Th2 responses, but with other antigens, and metals might be one of the candidates of such antigens.
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Affiliation(s)
- Yoshiki Tokura
- Department of Dermatology, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu 807-8555, Japan.
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Current world literature. Curr Opin Allergy Clin Immunol 2009; 9:482-8. [PMID: 19690478 DOI: 10.1097/aci.0b013e3283312f84] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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35
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Current World Literature. Curr Opin Allergy Clin Immunol 2009; 9:574-8. [DOI: 10.1097/aci.0b013e328333c13c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Mori T, Ishida K, Mukumoto S, Yamada Y, Imokawa G, Kabashima K, Kobayashi M, Bito T, Nakamura M, Ogasawara K, Tokura Y. Comparison of skin barrier function and sensory nerve electric current perception threshold between IgE-high extrinsic and IgE-normal intrinsic types of atopic dermatitis. Br J Dermatol 2009; 162:83-90. [DOI: 10.1111/j.1365-2133.2009.09440.x] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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