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Binsaleh AY, Bahaa MM, Elmasry TA, Elberri EI, Kotkata FA, El-Khateeb E, Kamal M, El-samongy MA, Hamouda AO, Alghamdi AM, Alrubia S, Salahuddin MM, Eltantawy N. A randomized controlled trial comparing tacrolimus versus hydrocortisone for the treatment of atopic dermatitis in children: new perspectives on interferon gamma-induced protein and growth-related oncogene-α. Front Med (Lausanne) 2024; 11:1399305. [PMID: 39114823 PMCID: PMC11303293 DOI: 10.3389/fmed.2024.1399305] [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: 03/11/2024] [Accepted: 06/26/2024] [Indexed: 08/10/2024] Open
Abstract
Introduction Atopic dermatitis (AD) is a type of chronic inflammatory disorder that affects children. Aim To investigate whether hydrocortisone or tacrolimus could be more effective for treating AD in children. Patients and methods This clinical randomized investigation included 100 children with AD who met the eligibility criteria. AD patients were recruited from Tanta University's Dermatology Department and divided into two groups (n = 50)., For four months, group 1 (the hydrocortisone group) received topical hydrocortisone cream. Group 2 received topical tacrolimus for four months. A dermatologist evaluated the patients at the start and four months after the treatment had been initiated to measure serum concentrations of neutrophil chemoattractant growth-related oncogene-α (GRO-α), interferon gamma induced protein 10 (IP-10), tumor necrosis factor alpha (TNF-α), vascular adhesion molecule 1 (VCAM-1), intercellular adhesion molecule 1 (ICAM-1). All patients were examined using the modified Eczema Area and Severity Index (mEASI) score. Results Tacrolimus group showed a significant reduction in serum levels of all measured biomarkers (p < 0.05) when compared to its baseline and when compared to the hydrocortisone group. Both groups displayed a significant decline in mEASI score in comparison with their baseline values (p < 0.05). Conclusion In children with AD, tacrolimus reduces inflammatory biomarkers better than hydrocortisone, suggesting its potential as a more effective treatment option. Clinical trial registration https://clinicaltrials.gov, identifier NCT05607901.
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Affiliation(s)
- Ammena Y. Binsaleh
- Department of Pharmacy Practice, College of Pharmacy, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Mostafa M. Bahaa
- Pharmacy Practice Department, Faculty of Pharmacy, Horus University, New Damietta, Egypt
| | - Thanaa A. Elmasry
- Pharmacology and Toxicology Department, Faculty of Pharmacy, Tanta University, Tanta, Egypt
| | - Eman I. Elberri
- Clinical Pharmacy Department, Faculty of Pharmacy, Tanta University, Tanta, Egypt
| | - Fedaa A. Kotkata
- Clinical Pharmacy Department, Faculty of Pharmacy, Tanta University, Tanta, Egypt
| | - Eman El-Khateeb
- Clinical Pharmacy Department, Faculty of Pharmacy, Tanta University, Tanta, Egypt
| | - Marwa Kamal
- Department of Clinical Pharmacy, Faculty of Pharmacy, Fayoum University, Faiyum, Egypt
| | | | - Amir O. Hamouda
- Department of Biochemistry and Pharmacology, Faculty of Pharmacy, Horus University, New Damietta, Egypt
| | - Amira M. Alghamdi
- Department of Biochemistry, Faculty of Science, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Sarah Alrubia
- Department of Pharmaceutical Chemistry, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Muhammed M. Salahuddin
- Department of Biochemistry and Pharmacology, Faculty of Pharmacy, Horus University, New Damietta, Egypt
| | - Nashwa Eltantawy
- Department of Pharmacy Practice, Faculty of Pharmacy, Heliopolis University, Cairo, Egypt
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Gomułka K, Wójcik E, Szepietowski JC. Serum Levels of Eosinophil-Derived Neurotoxin, Platelet-Activating Factor and Vascular Endothelial Growth Factor in Adult Patients with Atopic Dermatitis-A Pilot Study. Biomedicines 2022; 10:biomedicines10123109. [PMID: 36551865 PMCID: PMC9775762 DOI: 10.3390/biomedicines10123109] [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: 10/21/2022] [Revised: 11/25/2022] [Accepted: 11/29/2022] [Indexed: 12/03/2022] Open
Abstract
Atopic dermatitis (AD) is a chronic, highly pruritic, relapsing-remitting inflammatory skin disease. The etiology of AD has not been fully explained yet and complex interactions of various small molecules are still being taken into account. The aim of this research was to investigate the serum eosinophil-derived neurotoxin (EDN), platelet activating factor (PAF) and vascular endothelial growth factor (VEGF) concentrations in relation to the disease severity and pruritus intensity in adult patients with AD. This pilot study was performed on 30 participants (15 patients with AD and 15 healthy controls). Blood samples were taken to examine the serum levels of EDN, PAF and VEGF using the enzyme-linked immunosorbent assay (ELISA) test. The severity of disease was assessed by the Scoring Atopic Dermatitis (SCORAD) index. The intensity of pruritus, as a subjective symptom, was determined by the Visual Analogue Scale (VAS). Obtained results revealed that the EDN (p = 0.016) and VEGF (p = 0.032), but not PAF (p = 0.841) concentrations were significantly higher in patients with AD compared with those of the control group. There was positive correlation between the EDN level and the SCORAD index in patients with AD (r = -0.9, p = 0.037) which was not found for the PAF and VEGF levels. Circulating EDN, PAF and VEGF levels were not significantly correlated with the severity of pruritus. Our results suggest that the END and VEGF serum levels are significantly increased in patients with AD compared to control group. Moreover, EDN might be useful to reflect the severity of symptoms.
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Affiliation(s)
- Krzysztof Gomułka
- Clinical Department of Internal Medicine, Pneumology and Allergology, Wroclaw Medical University, 50-369 Wroclaw, Poland
- Correspondence:
| | - Ewa Wójcik
- Clinical Department of Dermatology, Venerology and Allergology, Wroclaw Medical University, 50-368 Wroclaw, Poland
| | - Jacek Cezary Szepietowski
- Clinical Department of Dermatology, Venerology and Allergology, Wroclaw Medical University, 50-368 Wroclaw, Poland
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Kiwan AH, Mohamed HAK, Hashim OAEA, Abd-Elraheem SI, Alkhrsawy AM. Pro-Inflammatory versus Anti-Inflammatory cytokines in atopic dermatitis patients: A case control study. J Cosmet Dermatol 2022; 21:6163-6168. [PMID: 35751139 DOI: 10.1111/jocd.15182] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 06/10/2022] [Accepted: 06/21/2022] [Indexed: 12/27/2022]
Abstract
Atopic dermatitis (AD) is a chronic relapsing inflammatory skin disorder with significant morbidity and impairment of life quality. Prevalence is increasing around the world; therefore, intensive research is ongoing to understand the mechanisms of development of AD and offer new treatment options for AD patients. AIMS To investigate the association between Inflammatory (IL-17, TNF-α, IFN-γ) versus anti-Inflammatory Cytokines (IL-35, TGF-β) in AD patients. PATIENTS AND METHODS A case control study included 40 AD patients and 20 age- and sex-matched healthy subjects. Cases were subjected to full history taking and full dermatological examination. The assessment of disease severity was conducted by using SCORAD score. Assessment of inflammatory (IL-17, TNF-α, IFN-γ) and anti-Inflammatory Cytokines (IL-35, TGF-β) was performed by using ELISA technique. RESULTS The mean level of TNF-α, IL-17 was statistically significantly higher in the AD cases as compared with the control group. The mean level of TGF-β, Il-35, and IFN-γ was statistically significantly lower in the Atopic dermatitis cases as compared with the control group. There was statistically significant strong positive correlation between TNF-α with SCORAD score and IL-17 while there was statistically significant strong negative correlation between TNF-α with TGF-β and IL-35. There was statistically significant strong positive correlation between IL-17 with SCORAD score and TNF-α while there was statistically significant strong negative correlation between IL-17 with TGF-β and IL-35. CONCLUSION The current results could be used as a clue for the utilization of inflammatory (IL-17, TNF-α, IFN-γ) versus anti-inflammatory Cytokines (IL-35, TGF-β) in AD as a diagnostic biomarker for severity of cases with Atopic dermatitis. IL-17 plays an important role in the pathogenesis of AD, and IL-17 blocker may be used as a potential future treatment of AD.
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Affiliation(s)
- Azza Hamada Kiwan
- Damietta Dermatology and Leprosy Hospital, Ministry of Health and Population, Damietta, Egypt
| | - Hassan Abou Khodair Mohamed
- Dermatology, Venereology and Andrology Department, Faculty of Medicine, Al-Azhar University, Damietta, Egypt
| | - Osama Abd El-Azim Hashim
- Dermatology, Venereology and Andrology Department, Faculty of Medicine, Al-Azhar University, Damietta, Egypt
| | | | - Amr Mohamed Alkhrsawy
- Clinical pathology department, Faculty of Medicine, Al-Azhar University, Damietta, Egypt
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Moosbrugger-Martinz V, Leprince C, Méchin MC, Simon M, Blunder S, Gruber R, Dubrac S. Revisiting the Roles of Filaggrin in Atopic Dermatitis. Int J Mol Sci 2022; 23:5318. [PMID: 35628125 PMCID: PMC9140947 DOI: 10.3390/ijms23105318] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 05/03/2022] [Accepted: 05/06/2022] [Indexed: 12/31/2022] Open
Abstract
The discovery in 2006 that loss-of-function mutations in the filaggrin gene (FLG) cause ichthyosis vulgaris and can predispose to atopic dermatitis (AD) galvanized the dermatology research community and shed new light on a skin protein that was first identified in 1981. However, although outstanding work has uncovered several key functions of filaggrin in epidermal homeostasis, a comprehensive understanding of how filaggrin deficiency contributes to AD is still incomplete, including details of the upstream factors that lead to the reduced amounts of filaggrin, regardless of genotype. In this review, we re-evaluate data focusing on the roles of filaggrin in the epidermis, as well as in AD. Filaggrin is important for alignment of keratin intermediate filaments, control of keratinocyte shape, and maintenance of epidermal texture via production of water-retaining molecules. Moreover, filaggrin deficiency leads to cellular abnormalities in keratinocytes and induces subtle epidermal barrier impairment that is sufficient enough to facilitate the ingress of certain exogenous molecules into the epidermis. However, although FLG null mutations regulate skin moisture in non-lesional AD skin, filaggrin deficiency per se does not lead to the neutralization of skin surface pH or to excessive transepidermal water loss in atopic skin. Separating facts from chaff regarding the functions of filaggrin in the epidermis is necessary for the design efficacious therapies to treat dry and atopic skin.
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Affiliation(s)
- Verena Moosbrugger-Martinz
- Department of Dermatology, Venereology and Allergology, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria; (V.M.-M.); (S.B.); (R.G.)
| | - Corinne Leprince
- Toulouse Institute for Infectious and Inflammatory Diseases (Infinity), Toulouse University, CNRS UMR5051, Inserm UMR1291, UPS, 31059 Toulouse, France; (C.L.); (M.-C.M.); (M.S.)
| | - Marie-Claire Méchin
- Toulouse Institute for Infectious and Inflammatory Diseases (Infinity), Toulouse University, CNRS UMR5051, Inserm UMR1291, UPS, 31059 Toulouse, France; (C.L.); (M.-C.M.); (M.S.)
| | - Michel Simon
- Toulouse Institute for Infectious and Inflammatory Diseases (Infinity), Toulouse University, CNRS UMR5051, Inserm UMR1291, UPS, 31059 Toulouse, France; (C.L.); (M.-C.M.); (M.S.)
| | - Stefan Blunder
- Department of Dermatology, Venereology and Allergology, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria; (V.M.-M.); (S.B.); (R.G.)
| | - Robert Gruber
- Department of Dermatology, Venereology and Allergology, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria; (V.M.-M.); (S.B.); (R.G.)
| | - Sandrine Dubrac
- Department of Dermatology, Venereology and Allergology, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria; (V.M.-M.); (S.B.); (R.G.)
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Mazrier H, Vogelnest LJ, Taylor RM, Williamson P. Altered plasma cytokines in dogs with atopic dermatitis. Vet Dermatol 2021; 33:131-e38. [PMID: 34817106 PMCID: PMC9299684 DOI: 10.1111/vde.13044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 08/06/2021] [Accepted: 09/01/2021] [Indexed: 01/28/2023]
Abstract
BACKGROUND Canine (Canis lupus familiaris) atopic dermatitis (AD) shares similar clinical signs to human AD. The abnormal immune response of AD is orchestrated by T lymphocytes, and may include variable involvement of cytokines, regulatory T (Treg) cells, eosinophils, mast cells and other immune components. Helper T (Th)2 cytokines often predominate initially, followed by Th1 cytokines in more chronic phases. HYPOTHESIS/OBJECTIVES Pro-inflammatory and Treg cytokines have been shown to play a role in human AD, yet their importance is not clear in canine AD. Hence, this study aimed to measure the concentrations of cytokines/chemokines not traditionally associated with Th1/Th2 response. ANIMALS Canine AD patients (n = 27), compared to control dogs (n = 11). METHODS AND MATERIALS A total of 19 plasma cytokines were assayed using canine specific multiplex immuno-assays. RESULTS The plasma concentrations of CXC Motif Chemokine Ligand 8 (CXCL8), interleukin (IL)-7 and IL-15 cytokines were elevated in canine AD patients, compared to control dogs. In addition, stem-cell factor (SCF) concentrations were reduced in the plasma of canine AD patients compared to control dogs. Distinct cytokine profiles were found in dogs belonging to the Staffordshire breeds, a group with increased risk of AD. In particular, granulocyte-macrophage colony-stimulating factor (GM-CSF) had significantly elevated concentrations. CONCLUSIONS AND CLINICAL RELEVANCE Some of the plasma cytokine alterations in canine AD described here, particularly of IL-7, have not been reported previously. Monitoring these distinctive cytokine alterations could be useful for diagnosis and monitoring of canine AD in dogs.
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Affiliation(s)
- Hamutal Mazrier
- Sydney School of Veterinary Science, Faculty of Science, The University of Sydney, NSW, 2006, Australia
| | - Linda J Vogelnest
- Sydney School of Veterinary Science, Faculty of Science, The University of Sydney, NSW, 2006, Australia
| | - Rosanne M Taylor
- Sydney School of Veterinary Science, Faculty of Science, The University of Sydney, NSW, 2006, Australia
| | - Peter Williamson
- Sydney School of Veterinary Science, Faculty of Science, The University of Sydney, NSW, 2006, Australia.,School of Life and Environmental Sciences, Faculty of Science, The University of Sydney, NSW, 2006, Australia
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Sutaria N, Alphonse MP, Marani M, Parthasarathy V, Deng J, Wongvibulsin S, Williams K, Roh YS, Choi J, Bordeaux Z, Pritchard T, Dillen C, Semenov YR, Kwatra MM, Archer NK, Garza LA, Dong X, Kang S, Kwatra SG. Cluster analysis of circulating plasma biomarkers in prurigo nodularis reveals a distinct systemic inflammatory signature in African Americans. J Invest Dermatol 2021; 142:1300-1308.e3. [PMID: 34717952 PMCID: PMC9038640 DOI: 10.1016/j.jid.2021.10.011] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 09/21/2021] [Accepted: 10/04/2021] [Indexed: 01/26/2023]
Abstract
Patients with prurigo nodularis (PN) suffer from intractable itch and dramatic reduction in quality of life. While there is significant clinical heterogeneity in the presentation of PN, disease endotypes remain unknown. We assayed circulating plasma cytokine concentrations in PN patients (n=20) along with matched healthy controls and utilized an unsupervised machine learning algorithm to identify disease endotypes. We found two distinct clusters of PN patients with non-inflammatory (Cluster 1) and inflammatory (Cluster 2) plasma profiles. Cluster 2 had more African-Americans (82%, n=9 vs. 33%, n=3; P=0.028), higher worst-itch numeric rating scale scores (9.5±0.9 vs. 8.3±1.2; P=0.036), and lower quality of life as reflected by higher Dermatology Life Quality Index scores (21.9±6.4 vs. 13.0±4.1; P=0.015). In addition, Cluster 1 had a higher rate of myelopathy (67%, n=6 vs. 18%, n=2; P=0.028). Compared to Cluster 1, Cluster 2 had higher levels of IL-1α, IL-4, IL-5, IL-6, IL-10, IL-17A, IL-22, IL-25, and IFN-α. With population-level analysis, African-American PN patients had higher erythrocyte sedimentation rate, C-reactive protein, ferritin, eosinophils, and lower transferrin than Caucasian PN patients. These findings indicate discrete clusters of PN patients with plasma biomarker profiles corresponding to distinct demographic and clinical characteristics, potentially allowing for precision medicine approaches to treat PN.
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Affiliation(s)
- Nishadh Sutaria
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD
| | | | - Melika Marani
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Varsha Parthasarathy
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Junwen Deng
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Shannon Wongvibulsin
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Kyle Williams
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Youkyung Sophie Roh
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Justin Choi
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Zachary Bordeaux
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Thomas Pritchard
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Carly Dillen
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Yevgeniy R Semenov
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts; Department of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts
| | - Madan M Kwatra
- Department of Anesthesiology, Duke University School of Medicine, Durham, NC
| | - Nathan K Archer
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Luis A Garza
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Xinzhong Dong
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD; The Solomon H. Snyder Department of Neuroscience, Center for Sensory Biology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Sewon Kang
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Shawn G Kwatra
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD.
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JAK1/2 inhibition impairs the development and function of inflammatory dendritic epidermal cells in atopic dermatitis. J Allergy Clin Immunol 2020; 147:2202-2212.e8. [PMID: 33338537 DOI: 10.1016/j.jaci.2020.11.041] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 10/14/2020] [Accepted: 11/10/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND Janus kinase (JAK) inhibitors are a new class of therapeutic compounds for dermatological diseases. In atopic dermatitis (AD), data of clinical phase III trials show rapid improvement of pruritus and significant reduction of inflammation within the first weeks with a favorable safety profile. However, their mode of action in AD is not fully understood. OBJECTIVES In our study, we investigate the effect of different JAK inhibitors on cell differentiation, phenotype, and function of inflammatory dendritic epidermal cells (IDECs). METHODS We analyzed the JAK expression in IDEC from ex vivo skin and in vitro generated IDECs using flow cytometry and PCR. Further, we studied in vitro the effect of different JAK inhibitors on IDEC cell differentiation, phenotype, and maturation. RESULTS IDECs express JAK1 and JAK2 ex vivo and in vitro. We found that JAK1 and JAK2 were upregulated during the differentiation from monocytes to IDECs. Conversely, JAK2 inhibition by ruxolitinib (JAK1/2 inhibitor) or BMS-911543 (JAK2 inhibitor) abrogated the differentiation from monocytes into IDECs. Differentiated IDECs can redifferentiate into a more monocyte-like phenotype in the presence of ruxolitinib or BMS-911543. Furthermore, we showed that concomitant inhibition of JAK1/2 rather than blocking JAK1 or JAK2 alone, impaired maturation and the release of proinflammatory cytokines on lipopolysaccharide stimulation. CONCLUSIONS Our results suggest that inhibition of JAK1/2 impairs IDEC differentiation and function. We provide new insight into the mode of action of JAK inhibitors in AD and highlight the role of JAK1/2 inhibitors for the treatment of patients with AD.
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Prakoeswa CRS, Bonita L, Karim A, Herwanto N, Umborowati MA, Setyaningrum T, Hidayati AN, Surono IS. Beneficial effect of Lactobacillus plantarum IS-10506 supplementation in adults with atopic dermatitis: a randomized controlled trial. J DERMATOL TREAT 2020; 33:1491-1498. [PMID: 33040631 DOI: 10.1080/09546634.2020.1836310] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
INTRODUCTION Although the therapeutic effects of probiotics in atopic dermatitis (AD) are known, the limited findings in adults are inconsistent. Lactobacillus plantarum (LP) IS-10506 was found to improve AD symptoms due to its immunomodulatory effects. OBJECTIVE To assess the Scoring Atopic Dermatitis Index (SCORAD), the serum immunoglobulin E (IgE), interleukin (IL)-4, interferon-gamma (IFN-γ), forkhead box P3 (Foxp3+), and IL-17 levels in adults with mild and moderate AD after LP IS-10506 supplementation. METHODS A randomized double-blind placebo-controlled trial comparing the microencapsulated probiotic (2 × 1010 CFU/day) and placebo (skim milk-Avicel) was conducted at an outpatient clinic on 30 adults with mild and moderate AD. The patients were divided into 2 groups with 15 patients each: intervention and control. RESULT The SCORAD score was significantly lower in the probiotic than the placebo group on the 8th week. The IL-4 and IL-17 levels were significantly lower in the probiotic than the placebo group. The IFN-γ and Foxp3+ levels were significantly higher in the probiotic than the placebo group. However, the IgE levels remained significantly unchanged. CONCLUSION The administration of LP IS-10506 is effective for alleviating AD symptoms in adults owing to its immunomodulatory effects.
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Affiliation(s)
- C R S Prakoeswa
- Faculty of Medicine, Department of Dermatology and Venereology, Dr. Soetomo Teaching Hospital, Universitas Airlangga, Surabaya, Indonesia
| | - L Bonita
- Faculty of Medicine, Department of Dermatology and Venereology, Dr. Soetomo Teaching Hospital, Universitas Airlangga, Surabaya, Indonesia
| | - A Karim
- Faculty of Medicine, Department of Dermatology and Venereology, Dr. Soetomo Teaching Hospital, Universitas Airlangga, Surabaya, Indonesia
| | - N Herwanto
- Faculty of Medicine, Department of Dermatology and Venereology, Dr. Soetomo Teaching Hospital, Universitas Airlangga, Surabaya, Indonesia
| | - M A Umborowati
- Faculty of Medicine, Department of Dermatology and Venereology, Dr. Soetomo Teaching Hospital, Universitas Airlangga, Surabaya, Indonesia
| | - T Setyaningrum
- Faculty of Medicine, Department of Dermatology and Venereology, Dr. Soetomo Teaching Hospital, Universitas Airlangga, Surabaya, Indonesia
| | - A N Hidayati
- Faculty of Medicine, Department of Dermatology and Venereology, Dr. Soetomo Teaching Hospital, Universitas Airlangga, Surabaya, Indonesia
| | - I S Surono
- Faculty of Engineering, Food Technology Department, Bina Nusantara University, Jakarta, Indonesia
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Correlation of Blood FoxP3+ Regulatory T Cells and Disease Activity of Atopic Dermatitis. J Immunol Res 2019; 2019:1820182. [PMID: 31637264 PMCID: PMC6766093 DOI: 10.1155/2019/1820182] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Accepted: 08/30/2019] [Indexed: 12/25/2022] Open
Abstract
Objectives To investigate CD4+CD25+FoxP3+ T regulatory cells (Tregs) in the peripheral blood of patients with atopic dermatitis (AD) and its correlation with disease severity. Methods Blood samples from 79 AD patients before and after four-week conventional treatment were collected. Cell counts of CD4+CD25+FoxP3+Tregs, CD4+CD25+FoxP3-T effector cells (Teffs), and CD4+IL-10+Tregs were analyzed by flow cytometry. Serum levels of IL-4, IL-10, IL-12, IL-13, IFN-γ, and TGF-β were measured by ELISA. Results The pretreatment cell count of CD4+CD25+FoxP3+Tregs positively correlated with disease severity in all patients (P < 0.0001). However, when that correlation was rechecked based on the treatment response, a much stronger correlation of that was found in those patients with remission after treatment, while no correlation of that was found in patients without remission. Both the cell count and proportions of peripheral CD4+CD25+FoxP3+Tregs and CD4+CD25+FoxP3-Teffs reduced significantly after treatment in patients with remission, but remained unchanged in patients without remission. The cell count and proportion of CD4+IL-10+Tregs did not change after treatment in both groups. In patients with remission, serum levels of IL-4 and IL-13 significantly reduced (all P < 0.05); IL-12 and IFN-γ levels increased significantly (all P < 0.05); IL-10 and TGF-β levels remained unchanged after treatment. None of those cytokine levels changed in patients without remission. Conclusions CD4+CD25+FoxP3+Tregs is associated with AD development and severity in some patients but not in others. AD maybe divided into CD4+CD25+FoxP3+Treg-associated subtype, which CD4+CD25+FoxP3+Treg is parallel to the activity of AD, and nonassociated subtype, which CD4+CD25+FoxP3+Treg is not related. This subgroup difference may contribute partly to the nonidentical markers that have been found in AD and should be studied further.
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Man MQ, Yang B, Elias PM. Benefits of Hesperidin for Cutaneous Functions. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2019; 2019:2676307. [PMID: 31061668 PMCID: PMC6466919 DOI: 10.1155/2019/2676307] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Accepted: 03/19/2019] [Indexed: 12/13/2022]
Abstract
Hesperidin is a bioflavonoid, with high concentration in citrus fruits. In addition to its well-known benefits for cardiovascular function, type II diabetes, and anti-inflammation, recent studies have demonstrated multiple benefits of hesperidin for cutaneous functions, including wound healing, UV protection, anti-inflammation, antimicrobial, antiskin cancer, and skin lightening. In addition, hesperidin enhances epidermal permeability barrier homeostasis in both normal young and aged skin. The mechanisms by which hesperidin benefits cutaneous functions are attributable to its antioxidant properties, inhibition of MAPK-dependent signaling pathways, and stimulation of epidermal proliferation, differentiation, and lipid production. Because of its low cost, wide availability, and superior safety, hesperidin could prove useful for the management of a variety of cutaneous conditions.
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Affiliation(s)
- Mao-Qiang Man
- Dermatology Hospital, Southern Medical University, Guangzhou 510091, China
- Department of Dermatology, University of California San Francisco and Veterans Affairs Medical Center, San Francisco, CA 94121, USA
| | - Bin Yang
- Dermatology Hospital, Southern Medical University, Guangzhou 510091, China
| | - Peter M. Elias
- Department of Dermatology, University of California San Francisco and Veterans Affairs Medical Center, San Francisco, CA 94121, USA
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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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Purushothaman B, Arumugam P, Song JM. A Novel Catecholopyrimidine Based Small Molecule PDE4B Inhibitor Suppresses Inflammatory Cytokines in Atopic Mice. Front Pharmacol 2018; 9:485. [PMID: 29867490 PMCID: PMC5958743 DOI: 10.3389/fphar.2018.00485] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Accepted: 04/24/2018] [Indexed: 01/23/2023] Open
Abstract
Degradation of cyclic adenosine mono phosphate (cAMP) by phosphodiesterase-4B (PDE-4B) in the inflammatory cells leads to elevated expression of inflammatory cytokines in inflammatory cells. Suppression of cytokines has proved to be beneficial in the treatment of atopic dermatitis (AD). Henceforth, application of PDE4B specific inhibitor to minimize the degradation of cAMP can yield better results in the treatment of AD. PDE4B specific inhibitor with a limited side effect is highly warranted. Herein, we synthesized a novel PDE4 inhibitor, compound 2 comprising catecholopyrimidine core functionalized with trifluoromethyl (-CF3) group. PDE4B inhibitory potential and specificity of novel compounds were evaluated by PDE inhibitor assay. In vivo efficacy of the compounds was analyzed using DNCB-induced NC/Nga mice. IgE, CD4+ T-helper cell infiltration, and cytokine profiles were analyzed by ELISA and immunohistochemistry techniques. Toluidine blue staining was performed for mast cell count. PDE4 inhibitor assay confirmed that compound 2 specifically inhibits PDE4B. In vivo analysis with DNCB-induced NC/Nga mice confirmed that compound 2 suppressed the levels of pro-inflammatory cytokines such as TNF-α, IL-4, IL-5, and IL-17. Furthermore, compound 2 significantly reduced the infiltrative CD4+ T-helper cells, mast cells and IgE levels in atopic tissue. The in vitro and in vivo data suggested that compound 2 specifically inhibit the PDE4B and the symptoms of the AD in atopic mice. Compound 2 might constitute a good candidate molecule for the treatment of AD.
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Affiliation(s)
| | | | - Joon Myong Song
- College of Pharmacy, Seoul National University, Seoul, South Korea
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Domínguez-Hüttinger E, Christodoulides P, Miyauchi K, Irvine AD, Okada-Hatakeyama M, Kubo M, Tanaka RJ. Mathematical modeling of atopic dermatitis reveals “double-switch” mechanisms underlying 4 common disease phenotypes. J Allergy Clin Immunol 2017; 139:1861-1872.e7. [DOI: 10.1016/j.jaci.2016.10.026] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 10/07/2016] [Accepted: 10/26/2016] [Indexed: 12/22/2022]
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14
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A computational model to predict severity of atopic eczema from 30 serum proteins. J Allergy Clin Immunol 2016; 138:1207-1210.e2. [PMID: 27315765 DOI: 10.1016/j.jaci.2016.04.018] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Revised: 02/04/2016] [Accepted: 04/19/2016] [Indexed: 11/24/2022]
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Bellodi-Schmidt F, Shah KN. Beyond Psoriasis: Novel Uses for Biologic Response Modifiers in Pediatric Dermatology. Pediatr Dermatol 2016; 33:18-27. [PMID: 26607958 DOI: 10.1111/pde.12707] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Dermatologists have witnessed the increasing availability of novel biologic response modifiers for the treatment of inflammatory and autoimmune diseases in recent years. The most common dermatologic indication for the use of biologic response modifiers in adults is psoriasis, but the U.S. Food and Drug Administration has not approved any of these agents for use in any dermatologic disease in children with the exception of omalizumab, and as such, use in this population is considered off-label. In this review, we focus on the use of these agents in children to treat inflammatory skin diseases other than psoriasis, including atopic dermatitis, hidradenitis suppurativa, pemphigus vulgaris, bullous pemphigoid, and toxic epidermal necrolysis, with an emphasis on the use of etanercept, infliximab, rituximab, omalizumab, and ustekinumab. By highlighting novel uses of these agents, particularly for the treatment of dermatologic conditions for which optimal therapies are yet to be established, we hope to raise awareness of the potential use of this class of medications to treat inflammatory skin diseases in children.
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Affiliation(s)
- Fernanda Bellodi-Schmidt
- Division of Dermatology, Cincinnati Children's Hospital, Cincinnati, Ohio.,Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, Ohio
| | - Kara N Shah
- Division of Dermatology, Cincinnati Children's Hospital, Cincinnati, Ohio.,Department of Dermatology, College of Medicine, University of Cincinnati, Cincinnati, Ohio.,Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, Ohio
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16
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Samochocki Z, Bogaczewicz J, Sysa-Jędrzejowska A, McCauliffe DP, Kontny E, Wozniacka A. Expression of vascular endothelial growth factor and other cytokines in atopic dermatitis, and correlation with clinical features. Int J Dermatol 2015; 55:e141-6. [DOI: 10.1111/ijd.13132] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Revised: 05/03/2015] [Accepted: 06/10/2015] [Indexed: 11/29/2022]
Affiliation(s)
| | - Jarosław Bogaczewicz
- Department of Dermatology and Venereology; Medical University of Lodz; Lodz Poland
| | | | - Daniel P. McCauliffe
- Department of Dermatology; University of North Carolina; Chapel Hill NC USA
- Private Practice; Rutland VT USA
| | - Ewa Kontny
- Department of Pathophysiology and Immunology; Institute of Rheumatology; Warsaw Poland
| | - Anna Wozniacka
- Department of Dermatology and Venereology; Medical University of Lodz; Lodz Poland
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Lee NR, Kim JH, Park HY, Yoon NY, Ahn SK. Periadnexal mucin as an additional histopathologic feature of chronic eczematous dermatitis. Ann Dermatol 2015; 27:133-41. [PMID: 25834351 PMCID: PMC4377401 DOI: 10.5021/ad.2015.27.2.133] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2013] [Revised: 06/25/2014] [Accepted: 07/07/2014] [Indexed: 11/21/2022] Open
Abstract
Background Cutaneous mucinoses are a heterogeneous group of disorders characterized by an abnormal amount of mucin in the skin. However, the pathomechanism of an excessive mucin deposition in the skin is still unknown. Eczematous dermatitis is sub-classified histologically into acute, subacute, and chronic variants. The characteristic histopathologic findings for chronic eczema are variable. However, periadnexal mucin deposition is not known as a feature of chronic eczema. Objective To evaluate the presence of periadnexal mucin deposition in chronic eczematous dermatitis. Methods We analyzed the skin biopsy specimens from 36 patients who were pathologically diagnosed with chronic eczematous dermatitis. Alcian blue, colloidal iron, and periodic acid-Schiff stains were used to evaluate the mucin deposition in histologic sections. Two dermatologists and two dermatopathologists evaluated the degree of mucin deposition using a 4-point scale. Results Various amounts of mucin deposition were observed in the periadnexal area of patients who were diagnosed with chronic eczema. Mucin deposition was more visible after staining with mucin-specific stains. Evaluation of the staining analysis scores revealed that the staining intensities were significantly higher in patients with chronic eczema than age- and site-matched controls (normal, acute to subacute eczema, and psoriasis vulgaris). Conclusion Periadnexal mucin (secondary mucinoses) may be an additional finding of chronic eczematous dermatitis.
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Affiliation(s)
- Noo Ri Lee
- Department of Dermatology, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Jae-Hong Kim
- Department of Dermatology, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Hwa-Young Park
- Department of Dermatology, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Na Young Yoon
- Department of Dermatology, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Sung Ku Ahn
- Department of Dermatology, Yonsei University Wonju College of Medicine, Wonju, Korea. ; Institute of Lifestyle Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
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18
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IgE-mediated sensitization to malassezia in atopic dermatitis: more common in male patients and in head and neck type. Dermatitis 2015; 25:120-6. [PMID: 24819285 DOI: 10.1097/der.0000000000000040] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Atopic dermatitis (AD) is a common chronic inflammatory skin disease. Malassezia, the predominant skin microbiota fungus, is considered to exacerbate AD, especially in a subset of patients with head and neck type AD (HNAD). In the present study, the relationship between AD and sensitization to Malassezia antigens was investigated. METHODS We assessed 173 patients with AD. The severity of eczema was determined with Eczema Area and Severity Index (EASI); the type of AD, namely, head and neck type, was reported as well. The total serum IgE and specific IgE to Malassezia were determined and correlated with clinical picture of AD, sex, age, and the EASI. RESULTS Total IgE was elevated in 77.7% of patients. Specific IgE to Malassezia was positive (≥0.35 kU/L) in 49.1% of patients. Men were significantly more often sensitized to Malassezia antigen (58% of men vs 42% of women; P value, 0.04). Concurrently, 58% of patients with HNAD versus 42% non-HNAD patients had higher levels of specific IgE to Malassezia, this difference being nearly significant (P value, 0.06). Patients with atopy were also more frequently sensitized to Malassezia. No significant relationship between EASI and the level of total IgE or specific IgE to Malassezia was observed. CONCLUSIONS In our population, IgE-mediated sensitization was found in up to 49% of all patients with AD, most common in men and in head and neck type.
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Curative effect of BCG-polysaccharide nuceic acid on atopic dermatitis in mice. ASIAN PAC J TROP MED 2014; 7:913-7. [DOI: 10.1016/s1995-7645(14)60161-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2014] [Revised: 09/10/2014] [Accepted: 10/15/2014] [Indexed: 11/15/2022] Open
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Eichenfield LF, Tom WL, Chamlin SL, Feldman SR, Hanifin JM, Simpson EL, Berger TG, Bergman JN, Cohen DE, Cooper KD, Cordoro KM, Davis DM, Krol A, Margolis DJ, Paller AS, Schwarzenberger K, Silverman RA, Williams HC, Elmets CA, Block J, Harrod CG, Smith Begolka W, Sidbury R. Guidelines of care for the management of atopic dermatitis: section 1. Diagnosis and assessment of atopic dermatitis. J Am Acad Dermatol 2013; 70:338-51. [PMID: 24290431 DOI: 10.1016/j.jaad.2013.10.010] [Citation(s) in RCA: 713] [Impact Index Per Article: 64.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2013] [Revised: 10/03/2013] [Accepted: 10/05/2013] [Indexed: 10/26/2022]
Abstract
Atopic dermatitis (AD) is a chronic, pruritic, inflammatory dermatosis that affects up to 25% of children and 2% to 3% of adults. This guideline addresses important clinical questions that arise in the management and care of AD, providing updated and expanded recommendations based on the available evidence. In this first of 4 sections, methods for the diagnosis and monitoring of disease, outcomes measures for assessment, and common clinical associations that affect patients with AD are discussed. Known risk factors for the development of disease are also reviewed.
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Affiliation(s)
- Lawrence F Eichenfield
- Division of Pediatric and Adolescent Dermatology, Rady Children's Hospital San Diego, San Diego, California
| | - Wynnis L Tom
- Division of Pediatric and Adolescent Dermatology, Rady Children's Hospital San Diego, San Diego, California
| | - Sarah L Chamlin
- Department of Dermatology, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
| | - Steven R Feldman
- Department of Dermatology, Wake Forest University Health Sciences, Winston-Salem, North Carolina
| | - Jon M Hanifin
- Department of Dermatology, Oregon Health and Science University, Portland, Oregon
| | - Eric L Simpson
- Department of Dermatology, Oregon Health and Science University, Portland, Oregon
| | - Timothy G Berger
- Department of Dermatology, University of California San Francisco, San Francisco, California
| | - James N Bergman
- Department of Dermatology and Skin Science, University of British Columbia, Vancouver, British Columbia, Canada
| | - David E Cohen
- Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York
| | - Kevin D Cooper
- Department of Dermatology, Case Western University, Cleveland, Ohio
| | - Kelly M Cordoro
- Department of Dermatology, University of California San Francisco, San Francisco, California
| | - Dawn M Davis
- Department of Dermatology, Mayo Clinic, Rochester, Minnesota
| | - Alfons Krol
- Department of Dermatology, Oregon Health and Science University, Portland, Oregon
| | - David J Margolis
- Department of Biostatistics and Epidemiology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
| | - Amy S Paller
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | | | | | - Hywel C Williams
- Centre of Evidence-Based Dermatology, Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom
| | - Craig A Elmets
- Department of Dermatology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Julie Block
- National Eczema Association, San Rafael, California
| | | | | | - Robert Sidbury
- Department of Dermatology, Seattle Children's Hospital, Seattle, Washington
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Bieber T. Atopic dermatitis 2.0: from the clinical phenotype to the molecular taxonomy and stratified medicine. Allergy 2012; 67:1475-82. [PMID: 23106343 DOI: 10.1111/all.12049] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2012] [Indexed: 11/29/2022]
Abstract
Atopic dermatitis (AD) is a paradigmatic inflammatory chronic skin disease. As for other chronic skin diseases, (i) the spectrum of the clinical phenotype and severity as well as (ii) the genetic background and (iii) the underlying mechanisms strongly suggest a high degree of pathophysiological heterogeneity yet leading to a similar clinical pattern, that is, the eczematous skin lesion, but showing distinct progression patterns. This review suggests to exploit the recent knowledge about AD for a novel approach proposing a tentative first molecular taxonomy of this disease based on the genotype and endophenotype. The consequences in terms of personalized prevention and management are delineated.
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Affiliation(s)
- Th. Bieber
- Department of Dermatology and Allergy; University of Bonn; Bonn; Germany
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22
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Samochocki Z, Alifier M, Bodera P, Jeziorkowska R, Rosiak E, Jurkiewicz B, Glińska O, Gliński W, Stankiewicz W. T-regulatory cells in severe atopic dermatitis: alterations related to cytokines and other lymphocyte subpopulations. Arch Dermatol Res 2012; 304:795-801. [PMID: 22968402 PMCID: PMC3505524 DOI: 10.1007/s00403-012-1290-9] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2012] [Revised: 08/14/2012] [Accepted: 08/29/2012] [Indexed: 11/28/2022]
Abstract
The changes in lymphocyte subpopulations in atopic dermatitis (AD) concern also T-regulatory cells. We investigated the expression of various surface receptors on CD3+CD4+CD25highFoxP3+ T-regulatory cells and the activation CD28+ receptor and the inhibitory CD152+ receptor on helper/inducer as well as cytotoxic/suppressor T cells. Peripheral blood lymphocytes of 15 AD patients and 20 healthy subjects were analyzed by flow cytometry using monoclonal antibodies. The concentrations of IL-6, IL-10 and TGF-β were determined in the serum and the supernatant of ConA-stimulated CD4+ lymphocytes. In AD patients the percentage of CD4+CD25highFoxP3+ as well as CD3+CD8+ cells increased, which positively correlated with SCORAD index (r = 0.55, p = 0.03). The concentrations of IL-10 in the CD4+ lymphocyte culture supernatants and the concentrations of TGF-β in the sera and the supernatant negatively correlated with the severity of AD (p < 0.01, r = −0.63; p < 0.02, r = −0.64 and p < 0.03, r = −0.58, respectively), whereas the serum concentration of IL-6 correlated positively (p < 0.003, r = 0.71). The regulatory cells expressed more CD62L and CD134 surface markers but less CD95. Reduced expression of the apoptotic CD95 receptor suggests that survival time of these cells is prolonged. Since CD62L and CD134 were upregulated, the enhanced modulatory effect of CD4+CD25highFoxP3+ cells seemed to be suggested, which may result in increased co-expression of CD28/CD152 on both CD4+ and CD8+ subpopulations.
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Savinko T, Matikainen S, Saarialho-Kere U, Lehto M, Wang G, Lehtimäki S, Karisola P, Reunala T, Wolff H, Lauerma A, Alenius H. IL-33 and ST2 in atopic dermatitis: expression profiles and modulation by triggering factors. J Invest Dermatol 2012; 132:1392-400. [PMID: 22277940 DOI: 10.1038/jid.2011.446] [Citation(s) in RCA: 277] [Impact Index Per Article: 23.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
In the acute phase of atopic dermatitis (AD), T-helper type 2 (Th2) cytokines characterize the inflammatory response in the skin. IL-33 is a new tissue-derived cytokine, which is mainly expressed by cells of barrier tissues, and is known to activate Th2 lymphocytes, mast cells, and eosinophils. IL-33 signals through a receptor complex consisting of IL-33-specific receptor ST2 and a co-receptor IL-1RAcP. As IL-33 is known to promote Th2-type immunity, we examined expression profiles of IL-33 and its receptor components in human AD skin, in the murine model of AD, and in various cell models. We found increased expression of IL-33 and ST2 in AD skin after allergen or staphylococcal enterotoxin B (SEB) exposure, as well as in the skin of 22-week-old filaggrin-deficient mice. In addition, skin fibroblasts, HaCaT keratinocytes, primary macrophages, and HUVEC endothelial cells efficiently produced IL-33 in response to the combined stimulation of tumor necrosis factor-α and IFN-γ, which was further enhanced by a mimetic of double-stranded RNA. Finally, the increased expression of IL-33 and ST2 caused by irritant, allergen, or SEB challenge was suppressed by topical tacrolimus treatment. These results suggest an important role for IL-33-ST2 interaction in AD and highlight the fact that bacterial and viral infections may increase the production of IL-33.
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Affiliation(s)
- Terhi Savinko
- Unit of Immunotoxicology, Finnish Institute of Occupational Health, Helsinki, Finland
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Current world literature. Curr Opin Pediatr 2011; 23:700-7. [PMID: 22068136 DOI: 10.1097/mop.0b013e32834dda34] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Brandt EB, Sivaprasad U. Th2 Cytokines and Atopic Dermatitis. JOURNAL OF CLINICAL & CELLULAR IMMUNOLOGY 2011; 2:110. [PMID: 21994899 PMCID: PMC3189506 DOI: 10.4172/2155-9899.1000110] [Citation(s) in RCA: 425] [Impact Index Per Article: 32.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Atopic dermatitis (AD), a chronic relapsing inflammatory skin disease, is increasing in prevalence around the world. Intensive research is ongoing to understand the mechanisms involved in the development of AD and offer new treatment options for patients suffering from AD. In this review, we highlight the importance of allergic Th2 responses in the development of the disease and summarize relevant literature, including genetic studies, studies of human skin and mechanistic studies on keratinocytes and mouse models of AD. We discuss the importance of the skin barrier and review recent findings on the pro-Th2 cytokines TSLP, IL-25, and IL-33, notably their ability to polarize dendritic cells and promote Th2 responses. After a brief update on the contribution of different T-cell subsets to AD, we focus on Th2 cells and the respective contributions of each of the Th2 cytokines (IL-4, IL-13, IL-5, IL-31, and IL-10) to AD. We conclude with a brief discussion of the current gaps in our knowledge and technical limitations.
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Affiliation(s)
- Eric B. Brandt
- Division of Asthma Research, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, 45229, USA
| | - Umasundari Sivaprasad
- Division of Asthma Research, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, 45229, USA
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