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Pavlenko D, Todurga Seven Z, Bystrom L, Markan A, Verpile R, Ishida H, Akiyama T. Crisaborole Inhibits Itch and Pain by Preventing Neutrophil Infiltration in a Mouse Model of Atopic Dermatitis. Acta Derm Venereol 2023; 103:adv13382. [PMID: 37605895 PMCID: PMC10461178 DOI: 10.2340/actadv.v103.13382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 06/19/2023] [Indexed: 08/23/2023] Open
Abstract
Crisaborole, a phosphodiesterase 4 (PDE4) inhibitor, has been approved for the treatment of mild to moderate atopic dermatitis. Atopic dermatitis is often associated with increased pain. Using a mouse model, this study investigated whether crisaborole suppresses pain associated with atopic dermatitis and the potential mechanisms underlying it. The mouse model for atopic dermatitis was developed by repeatedly applying MC903. MC903-treated mice had increased spontaneous scratching (itch-related behaviour) and wiping behaviour (pain-related behaviour). Crisaborole was topically applied to the cheek skin of MC903-treated mice, and it reduced both itch- and pain-related behaviours in these mice. Immunofluorescence staining revealed that crisaborole reduced neutrophil infiltration and interaction of neutrophils with sensory neurones. Intradermal injection of S100A8/A9, proinflammatory neutrophil mediator, enhanced not only itch-related behaviours evoked by histamine or chloroquine, but also pain-related behaviours evoked by capsaicin. Calcium imaging of mouse dorsal root ganglion neurones revealed that pretreatment with S100A8/A9 significantly increased calcium responses to histamine and capsaicin, and the proportion of chloroquine-sensitive neurones. These findings suggest that the PDE4 inhibitor reduces itch and pain, in part by inhibiting infiltration of S100A8/A9-containing neutrophils in a mouse model of MC903-induced atopic dermatitis.
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Affiliation(s)
- Darya Pavlenko
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, Miami Itch Center, University of Miami Miller School of Medicine, Miami, USA
| | - Zeynep Todurga Seven
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, Miami Itch Center, University of Miami Miller School of Medicine, Miami, USA
- Department of Medical Pharmacology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Lauren Bystrom
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, Miami Itch Center, University of Miami Miller School of Medicine, Miami, USA
| | - Anika Markan
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, Miami Itch Center, University of Miami Miller School of Medicine, Miami, USA
| | - Rebecca Verpile
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, Miami Itch Center, University of Miami Miller School of Medicine, Miami, USA
| | - Hirotake Ishida
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, Miami Itch Center, University of Miami Miller School of Medicine, Miami, USA
| | - Tasuku Akiyama
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, Miami Itch Center, University of Miami Miller School of Medicine, Miami, USA
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Murashkin NN, Namazova-Baranova LS, Makarova SG, Ivanov RA, Grigorev SG, Fedorov DV, Ambarchian ET, Epishev RV, Materikin AI, Opryatin LA, Savelova AA. Observational study of pimecrolimus 1% cream for prevention of transcutaneous sensitization in children with atopic dermatitis during their first year of life. Front Pediatr 2023; 11:1102354. [PMID: 37181420 PMCID: PMC10167287 DOI: 10.3389/fped.2023.1102354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 03/24/2023] [Indexed: 05/16/2023] Open
Abstract
Introduction Epidermal barrier dysfunction in children with atopic dermatitis can cause transcutaneous sensitization to allergens and allergic diseases. We evaluated the effectiveness of an early-intervention algorithm for atopic dermatitis treatment, utilizing pimecrolimus for long-term maintenance therapy, in reducing transcutaneous sensitization in infants. Method This was a single-center cohort observational study that enrolled children aged 1-4 months with family history of allergic diseases, moderate-to-severe atopic dermatitis, and sensitization to ≥ 1 of the investigated allergens. Patients who sought medical attention at atopic dermatitis onset (within 10 days) were group 1 "baseline therapy with topical glucocorticoids with subsequent transition to pimecrolimus as maintenance therapy"; patients who sought medical attention later were group 2 "baseline and maintenance therapy with topical glucocorticoids, without subsequent use of pimecrolimus". Sensitization class and level of allergen-specific immunoglobulin E were determined at baseline, and 6 and 12 months of age. Atopic dermatitis severity was evaluated using the Eczema Area and Severity Index score at baseline and 6, 9 and 12 months of age. Results Fifty-six and 52 patients were enrolled in groups 1 and 2, respectively. Compared with group 2, group 1 demonstrated a lower level of sensitization to cow's milk protein, egg white and house dust mite allergen at 6 and 12 months of age, and a more pronounced decrease in atopic dermatitis severity at 6, 9 and 12 months of age. No adverse events occurred. Discussion The pimecrolimus-containing algorithm was effective in treating atopic dermatitis and prophylaxis of early forms of allergic diseases in infants. Trial registration https://clinicaltrials.gov/ NCT04900948, retrospectively registered, 25 May 2021.
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Affiliation(s)
- Nikolay N. Murashkin
- National Medical Research Center for Children’s Health, Moscow, Russia
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
- Central State Medical Academy of the Presidential Administration of the Russian Federation, Moscow, Russia
- Research Institute for Pediatrics and Children’s Health Protection, Federal National Public Healthcare Institution “Central Clinical Hospital of the Russian Academy of Sciences”, Ministry of Science and Higher Education, Moscow, Russia
| | - Leyla S. Namazova-Baranova
- Research Institute for Pediatrics and Children’s Health Protection, Federal National Public Healthcare Institution “Central Clinical Hospital of the Russian Academy of Sciences”, Ministry of Science and Higher Education, Moscow, Russia
- Pirogov Russian National Research Medical University, Moscow, Russia
| | | | - Roman A. Ivanov
- National Medical Research Center for Children’s Health, Moscow, Russia
| | - Stepan G. Grigorev
- Kirov Military Medical Academy, St Petersburg, Russia
- Pediatric Infectious Disease Clinical Research Center of the Federal Medical Biological Agency, St Petersburg, Russia
| | - Dmitri V. Fedorov
- National Medical Research Center for Children’s Health, Moscow, Russia
| | - Eduard T. Ambarchian
- National Medical Research Center for Children’s Health, Moscow, Russia
- Research Institute for Pediatrics and Children’s Health Protection, Federal National Public Healthcare Institution “Central Clinical Hospital of the Russian Academy of Sciences”, Ministry of Science and Higher Education, Moscow, Russia
| | - Roman V. Epishev
- National Medical Research Center for Children’s Health, Moscow, Russia
- Research Institute for Pediatrics and Children’s Health Protection, Federal National Public Healthcare Institution “Central Clinical Hospital of the Russian Academy of Sciences”, Ministry of Science and Higher Education, Moscow, Russia
| | | | | | - Alena A. Savelova
- National Medical Research Center for Children’s Health, Moscow, Russia
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Kim YW, Ko EA, Jung SC, Lee D, Seo Y, Kim S, Kim JH, Bang H, Zhou T, Ko JH. Transcriptomic insight into the translational value of two murine models in human atopic dermatitis. Sci Rep 2021; 11:6616. [PMID: 33758305 PMCID: PMC7988112 DOI: 10.1038/s41598-021-86049-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 03/10/2021] [Indexed: 12/12/2022] Open
Abstract
This study sought to develop a novel diagnostic tool for atopic dermatitis (AD). Mouse transcriptome data were obtained via RNA-sequencing of dorsal skin tissues of CBA/J mice affected with contact hypersensitivity (induced by treatment with 1-chloro-2,4-dinitrobenzene) or brush stimulation-induced AD-like skin condition. Human transcriptome data were collected from German, Swedish, and American cohorts of AD patients from the Gene Expression Omnibus database. edgeR and SAM algorithms were used to analyze differentially expressed murine and human genes, respectively. The FAIME algorithm was then employed to assign pathway scores based on KEGG pathway database annotations. Numerous genes and pathways demonstrated similar dysregulation patterns in both the murine models and human AD. Upon integrating transcriptome information from both murine and human data, we identified 36 commonly dysregulated differentially expressed genes, which were designated as a 36-gene signature. A severity score (AD index) was applied to each human sample to assess the predictive power of the 36-gene AD signature. The diagnostic power and predictive accuracy of this signature were demonstrated for both AD severity and treatment outcomes in patients with AD. This genetic signature is expected to improve both AD diagnosis and targeted preclinical research.
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Affiliation(s)
- Young-Won Kim
- Department of Physiology, College of Medicine, Chung-Ang University, Seoul, 06974, Korea
| | - Eun-A Ko
- Department of Physiology, School of Medicine, Jeju National University, Jeju, 63243, Korea
| | - Sung-Cherl Jung
- Department of Physiology, School of Medicine, Jeju National University, Jeju, 63243, Korea
| | - Donghee Lee
- Department of Physiology, College of Medicine, Chung-Ang University, Seoul, 06974, Korea
| | - Yelim Seo
- Department of Physiology, College of Medicine, Chung-Ang University, Seoul, 06974, Korea
| | - Seongtae Kim
- Department of Physiology, College of Medicine, Chung-Ang University, Seoul, 06974, Korea
| | - Jung-Ha Kim
- Department of Family Medicine, College of Medicine, Chung-Ang University Hospital, Seoul, 06973, Korea
| | - Hyoweon Bang
- Department of Physiology, College of Medicine, Chung-Ang University, Seoul, 06974, Korea
| | - Tong Zhou
- Department of Physiology and Cell Biology, University of Nevada, Reno School of Medicine, Reno, NV, 89557, USA.
| | - Jae-Hong Ko
- Department of Physiology, College of Medicine, Chung-Ang University, Seoul, 06974, Korea.
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Reda AM, Elgendi A, Ebraheem AI, Aldraibi MS, Qari MS, Abdulghani MMR, Luger T. A practical algorithm for topical treatment of atopic dermatitis in the Middle East emphasizing the importance of sensitive skin areas. J DERMATOL TREAT 2018; 30:366-373. [PMID: 30222017 DOI: 10.1080/09546634.2018.1524823] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Background There is a need for safe, effective treatment for atopic dermatitis (AD) in the Middle East. Objective To propose a practical algorithm for the treatment of AD throughout the Middle East. Methods An international panel of six experts from the Middle East and one from Europe developed the algorithm. The practical treatment guide was based on a review of published guidelines on AD, an evaluation of relevant literature published up to August 2016 and local treatment practices. Results Patients with an acute mild-to-moderate disease flare on sensitive body areas should apply the topical calcineurin inhibitor (TCI), pimecrolimus 1% cream twice daily until clearance. For other body locations, a TCI, either pimecrolimus 1% cream, tacrolimus 0.03% ointment in children or 0.1% ointment in adults, should be applied twice daily until clearance. Emollients should be used as needed. Patients experiencing acute severe disease flares should apply a topical corticosteroid (TCS) according to their label for a few days to reduce inflammation. After clinical improvement, pimecrolimus for sensitive skin areas or TCIs for other body locations should be used until there is a complete resolution of lesions. Conclusions These recommendations are expected to optimize AD management in patients across the Middle East.
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Affiliation(s)
- Ashraf M Reda
- a Mediclinic Welcare Hospital , Dubai , United Arab Emirates
| | | | | | - Mohammed S Aldraibi
- d Department of Dermatology, King Fahad Armed Forces Hospital , Jeddah , Saudi Arabia
| | | | | | - Thomas Luger
- f Dermatology Clinic , University of Münster , Münster , Germany
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Zhu Q, Li F, Wang J, Ma J, Sheng X. Upregulation of calprotectin in mild IgE-mediated ovalbumin hypersensitivity. Oncotarget 2018; 8:37342-37354. [PMID: 28454097 PMCID: PMC5514913 DOI: 10.18632/oncotarget.16954] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Accepted: 03/27/2017] [Indexed: 12/14/2022] Open
Abstract
Calprotectin, also known as S100A8/A9, has been linked to gut inflammation caused by IgE-mediated food hypersensitivities, but the pathophysiologic abnormalities it causes remain to be determined. We created a mild food hypersensitivity model through oral gavage of ovalbumin in Norway brown rats without using immune adjuvant. Changes in the levels of calprotectin and inflammation-associated cytokines were then observed over time. We found that fecal calprotectin as well as jejunal and liver TLR4, TNF-α, NF-κB, IL-1β, and IL-6 were upregulated in hypersensitive rats. Additionally, the influence of calprotectin on CD4+ T and dendritic cells was observed by co-culturing CD4+ T cells with dendritic cells, which revealed a shift toward increased Th2 T cells in calprotectin-treated cultures. These results suggest that calprotectin, along with other inflammatory factors, promotes the inflammation seen in mild food allergy.
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Affiliation(s)
- Qingling Zhu
- Department of Child and Adolescent Healthcare, MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 200092, Shanghai, China
| | - Feng Li
- Department of Child and Adolescent Healthcare, MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 200092, Shanghai, China
| | - Junli Wang
- Department of Child and Adolescent Healthcare, MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 200092, Shanghai, China
| | - Jingqiu Ma
- Department of Child and Adolescent Healthcare, MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 200092, Shanghai, China
| | - Xiaoyang Sheng
- Department of Child and Adolescent Healthcare, MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 200092, Shanghai, China
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White AG, Santoro D, Ahrens K, Marsella R. Single blinded, randomized, placebo-controlled study on the effects of ciclosporin on cutaneous barrier function and immunological response in atopic beagles. Vet Immunol Immunopathol 2018; 197:93-101. [PMID: 29475513 DOI: 10.1016/j.vetimm.2018.02.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Revised: 12/19/2017] [Accepted: 02/02/2018] [Indexed: 11/17/2022]
Abstract
Ciclosporin (CsA) is a common treatment for canine atopic dermatitis (cAD). cAD is a very common skin disease with a multifactorial pathogenesis due to complex interactions between the host and the environment. The purpose of this study was to describe the physical and immunological effects of CsA in cAD using a canine model of AD. Fourteen beagles were enrolled; seven received CsA orally every 24 h for 28 days, and seven received placebo. All dogs were exposed to relevant allergens, house dust mite solution, one day prior to treatment and once weekly thereafter for 28 consecutive days. Canine atopic dermatitis extent and severity index-03 (CADESI-03) and skin biopsies were performed on day 0, 14, and 28. Quantitative RT-PCR was used to determine levels of cutaneous cytokines and barrier function markers. Indirect immunofluorescence was used to determine protein expression and distribution of nuclear messengers, barrier function and inflammatory [thymic stromal lymphopoietin (TSLP)] markers. The data were tested for normality and then the upaired two samples Student's t-test and the repeated measurements ANOVA, followed by the Dunnett's Multiple Comparison Test as post-hoc analysis, were performed. A P value of <0.05 was considered statistically significant. A significant decrease in CADESI-03 occurred for the treatment group compared to placebo (p = 0.023) on day 28. On day 14, a significant increase in TSLP protein expression [p = 0.019 (placebo); p = 0.02 (CsA)] and a significant decrease in Transforming Growth Factor (TGF)-β mRNA [p = 0.01 (placebo); p = 0.015 (CsA)] were noted in both groups compared to baseline. On day 28, a significant increase in canine beta defensin (cBD)103 [p = 0.012 (placebo)] and cBD3-like mRNAs [p = 0.044 (placebo)], and filaggrin [p = 0.035 (CsA)] and TSLP protein expressions [p = 0.0092 (CsA)] were seen compared to baseline. In contrast, a significant decrease in mRNA of Tumor Necrosis factor (TNF)-α [p = 0.013 (CsA)], Interleukin (IL)-10 [p = 0.038 (CsA)], TGF-β [p = 0.017 (CsA)], and caspase 14 [p = 0.014 (CsA)] was seen on day 28 compared to baseline. Comparison of the groups revealed no significant effect on skin immunologic milieu or barrier markers despite evident improvement of physical signs in the treatment group. Although this study confirmed the usefulness of CsA for the treatment of cAD, a clear involvement of CsA on some of the currently known immunological alterations present in cAD was not determined. However, it is important to note that there was no measurable exacerbation of skin barrier dysfunction secondary to CsA administration in this model.
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Affiliation(s)
- Amelia G White
- Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, 1220 Wire Road, Auburn, AL, 36849, USA.
| | - Domenico Santoro
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, 2015 SW 16th Ave., P.O. Box 100126, Gainesville, FL, 32610, USA
| | - Kim Ahrens
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, 2015 SW 16th Ave., P.O. Box 100126, Gainesville, FL, 32610, USA
| | - Rosanna Marsella
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, 2015 SW 16th Ave., P.O. Box 100126, Gainesville, FL, 32610, USA
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Niyonsaba F, Kiatsurayanon C, Chieosilapatham P, Ogawa H. Friends or Foes? Host defense (antimicrobial) peptides and proteins in human skin diseases. Exp Dermatol 2017; 26:989-998. [PMID: 28191680 DOI: 10.1111/exd.13314] [Citation(s) in RCA: 104] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/08/2017] [Indexed: 12/14/2022]
Abstract
Host defense peptides/proteins (HDPs), also known as antimicrobial peptides/proteins (AMPs), are key molecules in the cutaneous innate immune system. AMPs/HDPs historically exhibit broad-spectrum killing activity against bacteria, enveloped viruses, fungi and several parasites. Recently, AMPs/HDPs were shown to have important biological functions, including inducing cell proliferation, migration and differentiation; regulating inflammatory responses; controlling the production of various cytokines/chemokines; promoting wound healing; and improving skin barrier function. Despite the fact that AMPs/HDPs protect our body, several studies have hypothesized that these molecules actively contribute to the pathogenesis of various skin diseases. For example, AMPs/HDPs play crucial roles in the pathological processes of psoriasis, atopic dermatitis, rosacea, acne vulgaris, systemic lupus erythematosus and systemic sclerosis. Thus, AMPs/HDPs may be a double-edged sword, promoting cutaneous immunity while simultaneously initiating the pathogenesis of some skin disorders. This review will describe the most common skin-derived AMPs/HDPs (defensins, cathelicidins, S100 proteins, ribonucleases and dermcidin) and discuss the biology and both the positive and negative aspects of these AMPs/HDPs in skin inflammatory/infectious diseases. Understanding the regulation, functions and mechanisms of AMPs/HDPs may offer new therapeutic opportunities in the treatment of various skin disorders.
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Affiliation(s)
- François Niyonsaba
- Atopy (Allergy) Research Center, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Faculty of International Liberal Arts, Juntendo University, Tokyo, Japan
| | - Chanisa Kiatsurayanon
- Atopy (Allergy) Research Center, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Department of Dermatology and Allergology, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Department of Medical Services, Institute of Dermatology, Ministry of Public Health, Bangkok, Thailand
| | - Panjit Chieosilapatham
- Atopy (Allergy) Research Center, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Department of Dermatology and Allergology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Hideoki Ogawa
- Atopy (Allergy) Research Center, Juntendo University Graduate School of Medicine, Tokyo, Japan
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Oliva M, Renert-Yuval Y, Guttman-Yassky E. The 'omics' revolution: redefining the understanding and treatment of allergic skin diseases. Curr Opin Allergy Clin Immunol 2016; 16:469-76. [PMID: 27490125 DOI: 10.1097/aci.0000000000000306] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE OF REVIEW To evaluate how the genomic, transcriptomic, and proteomic profiles of allergic skin diseases, like atopic dermatitis and allergic contact dermatitis, contribute to their understanding and promote their therapeutic development. RECENT FINDINGS The '-omics' revolution has facilitated the quantification of inflammatory skin diseases at the molecular level, expanding our understanding of disease pathogenesis. It has also greatly expanded once-limited treatment options and improved the ability to define posttreatment improvements, beyond clinical scores. The findings on the genomic/transcriptomic level are also complemented by proteomic data, contributing to the understanding of the later changes taking place in the final stages of protein formation. Atopic dermatitis is defined as a Th2/Th22 polarized disease with some contributions of Th17 and Th1 pathways. In atopic dermatitis, studies of biologics and small molecules, targeting specific pathways upregulated in atopic dermatitis, seem to provide well tolerated alternatives to conventional immunosuppressive therapies (i.e. corticosteroids and cyclosporine A), particularly for severe patients. Allergic contact dermatitis is defined as having Th1/Th17-centered inflammation, especially with nickel-induced disease, but additional pathways, including Th2 and Th22, are upregulated with other allergens (i.e. fragrance). SUMMARY Supplementing studies of allergic skin diseases with '-omics' approaches are transforming the pathogenic understanding, diagnosis and, perhaps, also the treatment of these diseases.
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Affiliation(s)
- Margeaux Oliva
- aDepartment of Dermatology and the Laboratory for Inflammatory Skin Diseases, Icahn School of Medicine at Mount Sinai, New York, New York, USA bDepartment of Dermatology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel cLaboratory for Investigative Dermatology, The Rockefeller University, New York, New York, USA *Margeaux Oliva and Yael Renert-Yuval contributed equally to the article
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Bianchi P, Theunis J, Casas C, Villeneuve C, Patrizi A, Phulpin C, Bacquey A, Redoulès D, Mengeaud V, Schmitt AM. Effects of a New Emollient-Based Treatment on Skin Microflora Balance and Barrier Function in Children with Mild Atopic Dermatitis. Pediatr Dermatol 2016; 33:165-71. [PMID: 27001317 PMCID: PMC5071726 DOI: 10.1111/pde.12786] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND/OBJECTIVES The use of emollients is widely recommended for the management of atopic dermatitis (AD), especially between flares. An imbalance of skin microflora is suspected of playing a key role in exacerbations of AD. Our aim was to evaluate the effect of a new emollient balm on clinical parameters (SCORing Atopic Dermatitis [SCORAD], xerosis, pruritus), skin barrier function (transepidermal water loss and loricrin, filaggrin, corneodesmosin, and involucrin expression], skin microflora biodiversity, and Staphylococcus aureus and Staphylococcus epidermidis balance in children with mild AD. METHODS Fifty-four children (1-4 yrs old) were enrolled in this randomized, controlled study. Subjects applied a hygiene product and the emollient balm (emollient group, n = 28) or the hygiene product only (control group, n = 26) twice a day for 28 days. RESULTS We found improvement in favor of the emollient group in SCORAD (p < 0.001), pruritus (p = 0.06), and xerosis (p = 0.06) after 28 days of application. Moreover, transepidermal water loss decreased in the emollient group by 34% (p = 0.06) and involucrin expression by 37% (p = 0.001) at day 28 from baseline in association with improvement in barrier function, whereas other barrier-specific proteins did not vary. S. aureus increased significantly in the control group only (6.5 times, p = 0.01), whereas S. epidermidis remained stable in both groups. The Shannon index (H' = 2.3) did not vary with treatment in either group. CONCLUSION Twice-daily application of a new emollient balm in children with mild AD protected the skin from S. aureus proliferation and preserved microflora biodiversity.
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Affiliation(s)
- Pascale Bianchi
- European Center for Skin Research, Pierre Fabre Dermo-Cosmétique, Toulouse, France
| | - Jennifer Theunis
- European Center for Skin Research, Pierre Fabre Dermo-Cosmétique, Toulouse, France
| | - Christiane Casas
- European Center for Skin Research, Pierre Fabre Dermo-Cosmétique, Toulouse, France
| | - Cecile Villeneuve
- European Center for Skin Research, Pierre Fabre Dermo-Cosmétique, Toulouse, France
| | - Annalisa Patrizi
- Department of Dermatology, University of Bologna, Bologna, Italy
| | - Chloe Phulpin
- European Center for Skin Research, Pierre Fabre Dermo-Cosmétique, Toulouse, France
| | - Adeline Bacquey
- European Center for Skin Research, Pierre Fabre Dermo-Cosmétique, Toulouse, France
| | - Daniel Redoulès
- European Center for Skin Research, Pierre Fabre Dermo-Cosmétique, Toulouse, France
| | - Valerie Mengeaud
- European Center for Skin Research, Pierre Fabre Dermo-Cosmétique, Toulouse, France
| | - Anne-Marie Schmitt
- European Center for Skin Research, Pierre Fabre Dermo-Cosmétique, Toulouse, France
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10
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Danby SG, Chittock J, Brown K, Albenali LH, Cork MJ. The effect of tacrolimus compared with betamethasone valerate on the skin barrier in volunteers with quiescent atopic dermatitis. Br J Dermatol 2015; 170:914-21. [PMID: 24328907 DOI: 10.1111/bjd.12778] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/07/2013] [Indexed: 12/21/2022]
Abstract
BACKGROUND Atopic dermatitis (AD) is an inflammatory skin disease arising as a result of immune system and skin barrier defects. Topical corticosteroids are safe and effective treatments for AD, when used in short courses. Prolonged use is associated with skin barrier damage. Topical calcineurin inhibitors are alternative immune-modulating treatments for AD purported to have no negative effects on the skin barrier. OBJECTIVES To compare the effects of betamethasone valerate 0·1% cream (BMVc) and tacrolimus 0·1% ointment (TACo) on the skin barrier. METHODS Twenty volunteers with quiescent AD (no active signs for 6 months) participated in a randomized observer-blind study, wherein BMVc was applied to one forearm and TACo to the other, twice daily for 4 weeks. The biophysical/biological properties of the stratum corneum were assessed before and after treatment. Nine volunteers with active disease and 10 with healthy skin were assessed at untreated sites. RESULTS BMVc significantly reduced skin barrier function, integrity and cohesion, and the levels of pyrrolidone carboxylic acid (PCA) and urocanic acid (UCA) towards the subclinical barrier defect observed in patients with AD (nonlesional sites). TACo preserved skin barrier function, integrity, cohesion and PCA and UCA levels, while significantly increasing skin hydration to levels comparable with healthy skin. Both treatments reduced skin surface pH and trypsin-like protease activity, with TACo doing so to a significantly greater degree. CONCLUSION In quiescent AD, 4 weeks of BMVc treatment adversely affected the biophysical properties of the skin and reduced the levels of natural moisturizing factor, whereas TACo improved the condition of the skin barrier.
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Affiliation(s)
- S G Danby
- The Academic Unit of Dermatology Research, Department of Infection and Immunity, Faculty of Medicine, Dentistry and Health, The University of Sheffield Medical School, Beech Hill Road, Sheffield, S10 2RX, U.K
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Meier NT, Haslam IS, Pattwell DM, Zhang GY, Emelianov V, Paredes R, Debus S, Augustin M, Funk W, Amaya E, Kloepper JE, Hardman MJ, Paus R. Thyrotropin-releasing hormone (TRH) promotes wound re-epithelialisation in frog and human skin. PLoS One 2013; 8:e73596. [PMID: 24023889 PMCID: PMC3759422 DOI: 10.1371/journal.pone.0073596] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2012] [Accepted: 07/29/2013] [Indexed: 01/09/2023] Open
Abstract
There remains a critical need for new therapeutics that promote wound healing in patients suffering from chronic skin wounds. This is, in part, due to a shortage of simple, physiologically and clinically relevant test systems for investigating candidate agents. The skin of amphibians possesses a remarkable regenerative capacity, which remains insufficiently explored for clinical purposes. Combining comparative biology with a translational medicine approach, we report the development and application of a simple ex vivo frog (Xenopus tropicalis) skin organ culture system that permits exploration of the effects of amphibian skin-derived agents on re-epithelialisation in both frog and human skin. Using this amphibian model, we identify thyrotropin-releasing hormone (TRH) as a novel stimulant of epidermal regeneration. Moving to a complementary human ex vivo wounded skin assay, we demonstrate that the effects of TRH are conserved across the amphibian-mammalian divide: TRH stimulates wound closure and formation of neo-epidermis in organ-cultured human skin, accompanied by increased keratinocyte proliferation and wound healing-associated differentiation (cytokeratin 6 expression). Thus, TRH represents a novel, clinically relevant neuroendocrine wound repair promoter that deserves further exploration. These complementary frog and human skin ex vivo assays encourage a comparative biology approach in future wound healing research so as to facilitate the rapid identification and preclinical testing of novel, evolutionarily conserved, and clinically relevant wound healing promoters.
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Affiliation(s)
- Natalia T. Meier
- Department of Dermatology, University of Luebeck, Luebeck, Germany
- Department of Pathology, University of Luebeck, Luebeck, Germany
| | - Iain S. Haslam
- The Dermatology Centre, Salford Royal NHS Foundation Trust and Institute of Inflammation and Repair, School of Translational Medicine, University of Manchester, Manchester, United Kingdom
- * E-mail:
| | - David M. Pattwell
- The Dermatology Centre, Salford Royal NHS Foundation Trust and Institute of Inflammation and Repair, School of Translational Medicine, University of Manchester, Manchester, United Kingdom
| | - Guo-You Zhang
- Department of Dermatology, University of Luebeck, Luebeck, Germany
- Department of Hand and Plastic Surgery, the Second Affiliated Hospital of Wenzhou Medical College, Wenzhou, Zhejiang Province, China
| | | | - Roberto Paredes
- The Healing Foundation Centre, Faculty of Life Sciences, University of Manchester, Manchester, United Kingdom
| | - Sebastian Debus
- Department of Vascular Surgery, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Matthias Augustin
- Center for Dermatological Research, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | | | - Enrique Amaya
- The Healing Foundation Centre, Faculty of Life Sciences, University of Manchester, Manchester, United Kingdom
| | | | - Matthew J. Hardman
- The Healing Foundation Centre, Faculty of Life Sciences, University of Manchester, Manchester, United Kingdom
| | - Ralf Paus
- Department of Dermatology, University of Luebeck, Luebeck, Germany
- The Dermatology Centre, Salford Royal NHS Foundation Trust and Institute of Inflammation and Repair, School of Translational Medicine, University of Manchester, Manchester, United Kingdom
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12
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Abstract
Skin barrier dysfunction exists in both human and canine atopic dermatitis, leading to increased water loss and potentially facilitating allergen penetration and sensitization. Both lipid (e.g. ceramides) and protein (e.g. filaggrin) abnormalities have been described. Some are genetically inherited (e.g. filaggrin mutations are one of the major risk factors in humans) and some are secondary and linked to inflammation. In humans, numerous studies have shown efficacy of emollients and moisturizers in barrier restoration, and this approach has been for years the mainstay of therapy. Recently, this strategy has shown promise as a preventative function. In veterinary medicine, evidence regarding skin barrier impairment is rapidly building. Decreased ceramides and filaggrin (in some subsets of dogs) have been described. Altered metabolism of ceramides has also been proposed. Despite these preliminary data and the availability of products marketed to improve the skin barrier, evidence regarding the clinical benefit of skin repair intervention is still limited. Preliminary studies have demonstrated that topical application of fatty acids and ceramides and systemic administration of fatty acids improve lipid deficiencies in the skin of dogs with atopic dermatitis, but limited clinical evidence exists. Disease remission in humans is paralleled by an improved skin barrier, both with calcineurin inhibitors and glucocorticoids. In veterinary medicine, a preliminary study on ciclosporin and prednisone failed to detect significant improvement of water loss, while successful immunotherapy correlated with an improved skin barrier. Controlled, large studies are needed to address the question of which skin repair approach is clinically most effective and whether this can be used as a preventative strategy.
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Affiliation(s)
- Rosanna Marsella
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, 2015 SW 16th Avenue, University of Florida, Gainesville, FL 32610, USA.
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13
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Ma Y, Gong H, Wen Y. Nucleic acid-based non-invasive prenatal diagnosis of genetic skin diseases: are we ready? Exp Dermatol 2013; 22:392-5. [PMID: 23711062 DOI: 10.1111/exd.12156] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/17/2013] [Indexed: 01/02/2023]
Abstract
The discovery of circulating fetal nucleic acids is a great step on the way of developing non-invasive prenatal diagnosis (NIPD) for genetic disorders. Here, we briefly discuss the current applications of circulating fetal nucleic acids in genetic testing for different kinds of hereditary diseases with an emphasis on using circulating cell-free fetal DNA in diagnosis of monogenic disorders. As the genetic skin disorders impair the quality of life at different levels, we next discuss some ethical issues in NIPD for genetic skin diseases of various severities and in particular, the responsibility of doctors and parents, respectively, in the prenatal genetic testing.
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Affiliation(s)
- Yonghui Ma
- Institute for Science, Ethics and Innovation, University of Manchester, Manchester, UK
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14
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Ramot Y, Sugawara K, Zákány N, Tóth BI, Bíró T, Paus R. A novel control of human keratin expression: cannabinoid receptor 1-mediated signaling down-regulates the expression of keratins K6 and K16 in human keratinocytes in vitro and in situ. PeerJ 2013; 1:e40. [PMID: 23638377 PMCID: PMC3628749 DOI: 10.7717/peerj.40] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2012] [Accepted: 01/28/2013] [Indexed: 12/23/2022] Open
Abstract
Cannabinoid receptors (CB) are expressed throughout human skin epithelium. CB1 activation inhibits human hair growth and decreases proliferation of epidermal keratinocytes. Since psoriasis is a chronic hyperproliferative, inflammatory skin disease, it is conceivable that the therapeutic modulation of CB signaling, which can inhibit both proliferation and inflammation, could win a place in future psoriasis management. Given that psoriasis is characterized by up-regulation of keratins K6 and K16, we have investigated whether CB1 stimulation modulates their expression in human epidermis. Treatment of organ-cultured human skin with the CB1-specific agonist, arachidonoyl-chloro-ethanolamide (ACEA), decreased K6 and K16 staining intensity in situ. At the gene and protein levels, ACEA also decreased K6 expression of cultured HaCaT keratinocytes, which show some similarities to psoriatic keratinocytes. These effects were partly antagonized by the CB1-specific antagonist, AM251. While CB1-mediated signaling also significantly inhibited human epidermal keratinocyte proliferation in situ, as shown by K6/Ki-67-double immunofluorescence, the inhibitory effect of ACEA on K6 expression in situ was independent of its anti-proliferative effect. Given recent appreciation of the role of K6 as a functionally important protein that regulates epithelial wound healing in mice, it is conceivable that the novel CB1-mediated regulation of keratin 6/16 revealed here also is relevant to wound healing. Taken together, our results suggest that cannabinoids and their receptors constitute a novel, clinically relevant control element of human K6 and K16 expression.
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Affiliation(s)
- Yuval Ramot
- Department of Dermatology, University of Luebeck, Luebeck, Germany.,Department of Dermatology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Koji Sugawara
- Department of Dermatology, University of Luebeck, Luebeck, Germany.,Department of Dermatology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Nóra Zákány
- Department of Dermatology, University of Luebeck, Luebeck, Germany.,DE-MTA "Lendület" Cellular Physiology Research Group, Department of Physiology, MHSC, RCMM, University of Debrecen, Debrecen, Hungary
| | - Balázs I Tóth
- DE-MTA "Lendület" Cellular Physiology Research Group, Department of Physiology, MHSC, RCMM, University of Debrecen, Debrecen, Hungary.,Laboratory of Ion Channel Research and TRP Research Platform Leuven (TRPLe), Department of Cellular and Molecular Medicine, KU Leuven, Leuven, Belgium
| | - Tamás Bíró
- DE-MTA "Lendület" Cellular Physiology Research Group, Department of Physiology, MHSC, RCMM, University of Debrecen, Debrecen, Hungary
| | - Ralf Paus
- Department of Dermatology, University of Luebeck, Luebeck, Germany.,Institute of Inflammation and Repair, and Dermatology Centre, University of Manchester, Manchester, UK
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15
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Kerkhoff C, Voss A, Scholzen TE, Averill MM, Zänker KS, Bornfeldt KE. Novel insights into the role of S100A8/A9 in skin biology. Exp Dermatol 2012; 21:822-6. [PMID: 22882537 DOI: 10.1111/j.1600-0625.2012.01571.x] [Citation(s) in RCA: 82] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/30/2012] [Indexed: 12/28/2022]
Abstract
S100A8 and S100A9 belong to the damage-associated molecular pattern molecules. They are upregulated in a number of inflammatory skin disorders. Owing to their abundance in myeloid cells, the main function of S100A8/A9 has been attributed to their role in inflammatory cells. However, it is becoming increasingly clear that they also exert important roles in epithelial cells. In this review, we discuss the context-dependent function of S100A8/A9 in epithelial cells and their impact on wound healing, psoriasis and other skin diseases.
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Affiliation(s)
- Claus Kerkhoff
- Fraunhofer Institute for Cell Therapy and Immunology, Department of Immunology, AG EXIM, Rostock, Germany.
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