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Rychlik K, Sternicka J, Zabłotna M, Nowicki RJ, Bieniaszewski L, Purzycka-Bohdan D. The Prevalence of Demodex spp. Infestation in Dermatological Patients in Northern Poland. Life (Basel) 2024; 14:1196. [PMID: 39337978 PMCID: PMC11433365 DOI: 10.3390/life14091196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2024] [Revised: 09/17/2024] [Accepted: 09/19/2024] [Indexed: 09/30/2024] Open
Abstract
The presence of Demodex spp. mites on the skin is a common phenomenon in the human population. In most people, it is an asymptomatic infestation, but in some patients, it can contribute to the occurrence of diseases such as demodicosis, rosacea, or blepharitis, as well as non-specific symptoms. In this study, the results of tests assessing the presence of Demodex spp. by direct microscopic examination (DME) in 2508 patients from northern Poland with the suspicion of demodicosis were retrospectively analyzed. A total of 3684 tests were performed. Among them, only 1585 (43.02%) revealed the presence of Demodex spp., while 2099 (56.98%) were negative. It was shown that in the analyzed population of patients with clinical suspicion of demodicosis, the degree of confirmation of the presence of Demodex spp. positively correlated with the patient's age (p = 0.001) and the mite was mainly found on the edges of eyelids and on the facial skin. Additionally, in men, the presence of Demodex was more often confirmed than in women (p = 0.004). In conclusion, the proper diagnosis of demodicosis still constitutes an important clinical problem due to the non-specificity of symptoms and the low confirmation of clinical suspicions of infestation by DME, especially in lower age groups.
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Affiliation(s)
- Katarzyna Rychlik
- Department of Dermatology, Venereology and Allergology, Medical University of Gdańsk, University Clinical Centre, 80-214 Gdańsk, Poland
- Mycology Outpatient Clinic, University Clinical Centre, 80-214 Gdańsk, Poland
| | - Julia Sternicka
- Department of Dermatology, Venereology and Allergology, Medical University of Gdańsk, University Clinical Centre, 80-214 Gdańsk, Poland
| | - Monika Zabłotna
- Department of Dermatology, Venereology and Allergology, Medical University of Gdańsk, University Clinical Centre, 80-214 Gdańsk, Poland
| | - Roman J Nowicki
- Department of Dermatology, Venereology and Allergology, Medical University of Gdańsk, University Clinical Centre, 80-214 Gdańsk, Poland
- Mycology Outpatient Clinic, University Clinical Centre, 80-214 Gdańsk, Poland
| | - Leszek Bieniaszewski
- Clinical Physiology Unit, Medical Simulation Centre, Medical University of Gdańsk, 80-210 Gdańsk, Poland
| | - Dorota Purzycka-Bohdan
- Department of Dermatology, Venereology and Allergology, Medical University of Gdańsk, University Clinical Centre, 80-214 Gdańsk, Poland
- Clinical Physiology Unit, Medical Simulation Centre, Medical University of Gdańsk, 80-210 Gdańsk, Poland
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2
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Kelly PA, McHugo GP, Scaife C, Peters S, Stevenson ML, McKay JS, MacHugh DE, Saez IL, Breathnach R. Unveiling the Role of Endoplasmic Reticulum Stress Pathways in Canine Demodicosis. Parasite Immunol 2024; 46:e13033. [PMID: 38607285 DOI: 10.1111/pim.13033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 02/29/2024] [Accepted: 03/08/2024] [Indexed: 04/13/2024]
Abstract
Canine demodicosis is a prevalent skin disease caused by overpopulation of a commensal species of Demodex mite, yet its precise cause remains unknown. Research suggests that T-cell exhaustion, increased immunosuppressive cytokines, induction of regulatory T cells and increased expression of immune checkpoint inhibitors may contribute to its pathogenesis. This study aimed to gain a deeper understanding of the molecular changes occurring in canine demodicosis using mass spectrometry and pathway enrichment analysis. The results indicate that endoplasmic reticulum stress promotes canine demodicosis through regulation of three linked signalling pathways: eIF2, mTOR, and eIF4 and p70S6K. These pathways are involved in the modulation of Toll-like receptors, most notably TLR2, and have been shown to play a role in the pathogenesis of skin diseases in both dogs and humans. Moreover, these pathways are also implicated in the promotion of immunosuppressive M2 phenotype macrophages. Immunohistochemical analysis, utilising common markers of dendritic cells and macrophages, verified the presence of M2 macrophages in canine demodicosis. The proteomic analysis also identified immunological disease, organismal injury and abnormalities and inflammatory response as the most significant underlying diseases and disorders associated with canine demodicosis. This study demonstrates that Demodex mites, through ER stress, unfolded protein response and M2 macrophages contribute to an immunosuppressive microenvironment, thereby assisting in their proliferation.
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Affiliation(s)
- Pamela A Kelly
- UCD School of Veterinary Medicine, University College Dublin, Dublin, 4, Ireland
| | - Gillian P McHugo
- UCD School of Agriculture and Food Science, University College Dublin, Dublin, 4, Ireland
| | - Caitriona Scaife
- Proteomics Core, Mass Spectrometry Resource, UCD Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Dublin, 4, Ireland
| | - Susan Peters
- UCD School of Veterinary Medicine, University College Dublin, Dublin, 4, Ireland
| | - M Lynn Stevenson
- School of Biodiversity, One Health and Veterinary Medicine, Bearsden, University of Glasgow, Glasgow, UK
| | | | - David E MacHugh
- UCD School of Agriculture and Food Science, University College Dublin, Dublin, 4, Ireland
- UCD Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Dublin, 4, Ireland
| | - Irene Lara Saez
- UCD Charles Institute of Dermatology, University College Dublin, Dublin, 4, Ireland
| | - Rory Breathnach
- UCD School of Veterinary Medicine, University College Dublin, Dublin, 4, Ireland
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3
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Linn C, O’Malley A, Khatri K, Wright EM, Sebagh D, Grbić M, Kowal K, Chruszcz M. Microscopic Menaces: The Impact of Mites on Human Health. Int J Mol Sci 2024; 25:3675. [PMID: 38612486 PMCID: PMC11011512 DOI: 10.3390/ijms25073675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 03/20/2024] [Accepted: 03/21/2024] [Indexed: 04/14/2024] Open
Abstract
Mites are highly prevalent arthropods that infest diverse ecological niches globally. Approximately 55,000 species of mites have been identified but many more are yet to be discovered. Of the ones we do know about, most go unnoticed by humans and animals. However, there are several species from the Acariformes superorder that exert a significant impact on global human health. House dust mites are a major source of inhaled allergens, affecting 10-20% of the world's population; storage mites also cause a significant allergy in susceptible individuals; chiggers are the sole vectors for the bacterium that causes scrub typhus; Demodex mites are part of the normal microfauna of humans and their pets, but under certain conditions populations grow out of control and affect the integrity of the integumentary system; and scabies mites cause one of the most common dermatological diseases worldwide. On the other hand, recent genome sequences of mites provide novel tools for mite control and the development of new biomaterial with applications in biomedicine. Despite the palpable disease burden, mites remain understudied in parasitological research. By better understanding mite biology and disease processes, researchers can identify new ways to diagnose, manage, and prevent common mite-induced afflictions. This knowledge can lead to improved clinical outcomes and reduced disease burden from these remarkably widespread yet understudied creatures.
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Affiliation(s)
- Christina Linn
- Department of Biochemistry and Molecular Biology, Michigan State University, East Lansing, MI 48824, USA; (C.L.); (A.O.); (K.K.); (E.M.W.); (D.S.)
| | - Andrea O’Malley
- Department of Biochemistry and Molecular Biology, Michigan State University, East Lansing, MI 48824, USA; (C.L.); (A.O.); (K.K.); (E.M.W.); (D.S.)
| | - Kriti Khatri
- Department of Biochemistry and Molecular Biology, Michigan State University, East Lansing, MI 48824, USA; (C.L.); (A.O.); (K.K.); (E.M.W.); (D.S.)
| | - Elaine M. Wright
- Department of Biochemistry and Molecular Biology, Michigan State University, East Lansing, MI 48824, USA; (C.L.); (A.O.); (K.K.); (E.M.W.); (D.S.)
| | - Dylan Sebagh
- Department of Biochemistry and Molecular Biology, Michigan State University, East Lansing, MI 48824, USA; (C.L.); (A.O.); (K.K.); (E.M.W.); (D.S.)
| | - Miodrag Grbić
- Department of Biology, University of Western Ontario, London, ON N6A 5B7, Canada;
| | - Krzysztof Kowal
- Department of Allergology and Internal Medicine, Medical University of Bialystok, 15-276 Bialystok, Poland;
- Department of Experimental Allergology and Immunology, Medical University of Bialystok, 15-276 Bialystok, Poland
| | - Maksymilian Chruszcz
- Department of Biochemistry and Molecular Biology, Michigan State University, East Lansing, MI 48824, USA; (C.L.); (A.O.); (K.K.); (E.M.W.); (D.S.)
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4
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Sánchez-Pellicer P, Eguren-Michelena C, García-Gavín J, Llamas-Velasco M, Navarro-Moratalla L, Núñez-Delegido E, Agüera-Santos J, Navarro-López V. Rosacea, microbiome and probiotics: the gut-skin axis. Front Microbiol 2024; 14:1323644. [PMID: 38260914 PMCID: PMC10800857 DOI: 10.3389/fmicb.2023.1323644] [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: 10/18/2023] [Accepted: 12/26/2023] [Indexed: 01/24/2024] Open
Abstract
Rosacea is an inflammatory skin disease involving diverse symptoms with a variable clinical progress which can severely impact the patient's quality of life as well as their mental health. The pathophysiological model of rosacea involves an unbalanced immune system predisposed to excessive inflammation, in addition to vascular and nervous alterations, being certain cutaneous microorganisms' triggers of the symptoms onset. The gut-skin axis explains a bidirectional interaction between skin and gut microbiota in some inflammatory skin diseases such as atopic dermatitis, psoriasis, or rosacea. The introduction and consolidation of the next-generation sequencing in recent years has provided unprecedented information about the microbiome. However, the characterization of the gut and skin microbiota and the impact of the gut-skin axis in patients with rosacea has been little explored, in contrast to other inflammatory skin diseases such as atopic dermatitis or psoriasis. Furthermore, the clinical evolution of patients with rosacea is not always adequate and it is common for them to present a sustained symptomatology with frequent flare-ups. In this context, probiotic supplementation could improve the clinical evolution of these patients as happens in other pathologies. Through this review we aim to establish and compile the basics and directions of current knowledge to understand the mechanisms by which the microbiome influences the pathogenesis of rosacea, and how modulation of the skin and gut microbiota could benefit these patients.
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Affiliation(s)
- Pedro Sánchez-Pellicer
- MiBioPath Research Group, Faculty of Medicine, Catholic University of Murcia (UCAM), Guadalupe, Spain
| | | | | | - Mar Llamas-Velasco
- Department of Dermatology, Hospital Universitario de La Princesa, Madrid, Spain
| | - Laura Navarro-Moratalla
- MiBioPath Research Group, Faculty of Medicine, Catholic University of Murcia (UCAM), Guadalupe, Spain
| | - Eva Núñez-Delegido
- MiBioPath Research Group, Faculty of Medicine, Catholic University of Murcia (UCAM), Guadalupe, Spain
| | - Juan Agüera-Santos
- MiBioPath Research Group, Faculty of Medicine, Catholic University of Murcia (UCAM), Guadalupe, Spain
| | - Vicente Navarro-López
- MiBioPath Research Group, Faculty of Medicine, Catholic University of Murcia (UCAM), Guadalupe, Spain
- Infectious Diseases Unit, Department of Internal Medicine, University Hospital of Vinalopó-Fisabio, Elche, Spain
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5
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Yürekli A, Pektaş SD, Alataş ET, Aydoğdu CT, Daşgin D. A new method in demodex imaging: Shining demodex in the dark field mode of the new generation digital light microscope. Skin Res Technol 2023; 29:e13361. [PMID: 37632177 PMCID: PMC10363850 DOI: 10.1111/srt.13361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 05/15/2023] [Indexed: 08/27/2023]
Affiliation(s)
- Aslan Yürekli
- Muğla Sıtkı Koçman University Training and Research Hospital Dermatology DepartmentMuğlaTurkey
| | - Suzan Demir Pektaş
- Muğla Sıtkı Koçman University Medical Faculty Dermatology DepartmentMuğlaTurkey
| | - Emine Tuğba Alataş
- Muğla Sıtkı Koçman University Medical Faculty Dermatology DepartmentMuğlaTurkey
| | - Ceyda Tetik Aydoğdu
- Muğla Sıtkı Koçman University Training and Research Hospital Dermatology DepartmentMuğlaTurkey
| | - Dilek Daşgin
- Muğla Sıtkı Koçman University Training and Research Hospital Dermatology DepartmentMuğlaTurkey
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6
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Kelly PA, Browne J, Peters S, Bell F, McKay JS, Lara-Saez I, Breathnach R. Gene expression analysis of Canine Demodicosis; A milieu promoting immune tolerance. Vet Parasitol 2023; 319:109954. [PMID: 37163871 DOI: 10.1016/j.vetpar.2023.109954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 05/03/2023] [Accepted: 05/04/2023] [Indexed: 05/12/2023]
Abstract
Canine demodicosis is a common skin disease seen in companion animal practice that results from an overpopulation of the commensal Demodex mite species. Common predisposing factors to the development of canine demodicosis include immunosuppressive diseases, such as neoplasia and hypothyroidism, and administration of immunosuppressive therapies, such as corticosteroids. Despite this, the pathogenesis of development of canine demodicosis remains unclear. Previous studies have implicated a role for increased expression of toll like receptor 2 (TLR2), increased production of interleukin (IL)-10) and T cell exhaustion. Here, we investigate gene expression of formalin fixed paraffin embedded skin samples from twelve cases of canine demodicosis in comparison to twelve healthy controls, using a 770 gene panel (NanoString Canine IO Panel). Results show an increase in the T cell population, specifically Th1 and Treg cells in dogs with demodicosis. In addition, while there is an upregulation of immunosuppressive cytokines such as IL-10 and IL-13, there is also an upregulation of immune check point molecules including PD-1/PD-L1 and CTLA-4. These findings suggest that Demodex spp. mites are modulating the host immune system to their advantage through upregulation of several immune tolerance promoting pathways.
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Affiliation(s)
- Pamela A Kelly
- University College Dublin, School of Veterinary Medicine, Belfield, Dublin 4, Ireland.
| | - John Browne
- University College Dublin, School of Agriculture and Food Science, Belfield, Dublin 4, Ireland
| | - Susan Peters
- University College Dublin, School of Veterinary Medicine, Belfield, Dublin 4, Ireland
| | - Frazer Bell
- University of Glasgow, School of Biodiversity, One Health and Veterinary Medicine, Bearsden, Glasgow G61 1QH, United Kingdom
| | - Jennifer S McKay
- IDEXX Laboratories, Grange House, Sandbeck Way, Wetherby LS22 7DN, United Kingdom
| | - Irene Lara-Saez
- Charles Institute of Dermatology, University College Dublin, Belfield, Dublin 4, Ireland
| | - Rory Breathnach
- University College Dublin, School of Veterinary Medicine, Belfield, Dublin 4, Ireland
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7
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Rieger A, Just FT, Michelakaki E, Eddicks L, Gager AM, Schöl H, Gohl C, Steinmetz HW, Blutke AF, Denk D. Demodex carolliae in a colony of Seba's short-tailed bats (Carollia perspicillata): clinical, pathological and parasitological findings. J Comp Pathol 2023; 203:5-12. [PMID: 37119605 DOI: 10.1016/j.jcpa.2023.03.185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Revised: 02/13/2023] [Accepted: 03/29/2023] [Indexed: 05/01/2023]
Abstract
Seba's short-tailed bats (Carollia perspicillata) are a frugivorous species native to Central and South America. Despite their importance as a reservoir for zoonotic pathogens and their popularity in zoological collection and as research models, there are relatively few reports on non-zoonotic diseases of bats. Mites of the genus Demodex are obligate commensals of the skin of a range of mammals, are highly host-specific and are not associated with clinical disease when present in low numbers. However, infestation with high numbers can result in severe or even fatal disease and substantially affect the well-being of the animals. The clinical, pathological and parasitological findings in 12 Seba's short-tailed bats with demodicosis from a colony kept at Munich Zoo Hellabrunn between 1992 and 2021 are described in this report. From 2002, skin lesions became apparent on the head, especially the periocular region, nose and ears, as well as the genital area of some animals. In advanced cases, skin changes were also present on the abdomen, back and extremities. Gross findings typically included alopecia and thickening of the skin, with the formation of papules, reflecting cystically dilated hair follicles containing myriads of demodecid mites. Histologically, lesions were characterized by a paucicellular lymphocytic dermatitis and folliculitis with perifollicular fibrosis, epidermal hyperplasia, orthokeratotic hyperkeratosis and disproportionately high numbers of intrafollicular arthropods. Demodex carolliae was identified morphologically by light, phase-contrast and electron microscopy. Further characterization was achieved by extraction of parasitic DNA and partial gene sequencing of two mitochondrial genes, 16S rDNA and cox1. This is the first clinicopathological description of generalized demodicosis in Seba's short-tailed bats and includes the first molecular characterization of D. carolliae with provision of a GenBank entry.
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Affiliation(s)
- Alexandra Rieger
- Institute of Veterinary Pathology, Center for Clinical Veterinary Medicine, Ludwig-Maximilians-Universität München, Veterinaerstr. 13, 80539 Munich, Germany
| | - Frank T Just
- Department for Pathology, Parasitology and Bee Diseases, Bavarian Health and Food Safety Authority, Veterinaerstrasse 2, 85764 Oberschleissheim, Germany
| | - Effrosyni Michelakaki
- Institute of Veterinary Pathology, Center for Clinical Veterinary Medicine, Ludwig-Maximilians-Universität München, Veterinaerstr. 13, 80539 Munich, Germany
| | - Lina Eddicks
- Institute of Veterinary Pathology, Center for Clinical Veterinary Medicine, Ludwig-Maximilians-Universität München, Veterinaerstr. 13, 80539 Munich, Germany
| | - Anna M Gager
- Institute of Veterinary Pathology, Center for Clinical Veterinary Medicine, Ludwig-Maximilians-Universität München, Veterinaerstr. 13, 80539 Munich, Germany
| | - Heidrun Schöl
- Institute of Veterinary Pathology, Center for Clinical Veterinary Medicine, Ludwig-Maximilians-Universität München, Veterinaerstr. 13, 80539 Munich, Germany
| | - Christine Gohl
- Münchener Tierpark Hellabrunn AG, Tierparkstr. 30, 81543 Munich, Germany
| | | | - Andreas F Blutke
- Institute of Veterinary Pathology, Center for Clinical Veterinary Medicine, Ludwig-Maximilians-Universität München, Veterinaerstr. 13, 80539 Munich, Germany
| | - Daniela Denk
- Institute of Veterinary Pathology, Center for Clinical Veterinary Medicine, Ludwig-Maximilians-Universität München, Veterinaerstr. 13, 80539 Munich, Germany.
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8
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Kelly PA, McKay JS, Maguire D, Jones M, Roberts L, Powell F, Breathnach R. A retrospective study of cases of canine demodicosis submitted to a commercial diagnostic laboratory servicing the United Kingdom and Ireland (2017-2018) part 2; Aerobic culture and antimicrobial susceptibility results. Res Vet Sci 2022; 153:92-98. [PMID: 36334407 DOI: 10.1016/j.rvsc.2022.10.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 10/25/2022] [Accepted: 10/26/2022] [Indexed: 11/06/2022]
Abstract
Clinical diagnostic reports from 508 cases of canine demodicosis diagnosed either by histological or skin scraping analysis from a United Kingdom Accreditation Service (UKAS) accredited veterinary diagnostic laboratory servicing the United Kingdom (UK) and Ireland were evaluated. Of the 508 cases, 284 had skin swabs submitted for culture on the same day the skin biopsy and/or skin scraping were obtained. Dogs with juvenile-onset (JO) demodicosis represented 57.4% of these cases, whilst adult-onset (AO) cases comprised 42.6%. The data revealed that overgrowth of pathogenic bacteria was more common in AO demodicosis cases (75.2%) in comparison to the JO cases (57%). Adult-onset cases also had increased involvement of bacteria belonging to multiple genera and/or yeast (28.9%) in comparison to JO cases (18.4%). Pruritus was significantly associated with an overgrowth of Staphylococcus pseudintermedius (p < 0.001). Resistance to one or more antimicrobial classes was noted in S. pseudintermedius isolates from 56.3% of JO cases with 10.3% of these cases being classified as Multi-Drug Resistant (MDR). Similarly, 51.9% of S. pseudintermedius isolates from the AO cases were noted to be resistant to one or more antimicrobial class with 8.6% of these cases being considered MDR. Cephalosporins were the most frequently administered antimicrobial class noted in submission histories, followed by the penicillin and fluoroquinolone classes. Whilst our findings reveal a high prevalence of concurrent overgrowth of pathogenic bacteria warranting therapeutic intervention in canine demodicosis, the presence of resistance within isolates highlights the need for prudent selection and targeted use of antimicrobial therapy that encompass the key principles of antimicrobial stewardship.
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Affiliation(s)
- Pamela A Kelly
- University College Dublin Veterinary Hospital, School of Veterinary Medicine, Belfield, Dublin 4, Ireland.
| | - Jennifer S McKay
- IDEXX Laboratories, Grange House, Sandbeck Way, Wetherby LS22 7DN, United Kingdom.
| | - David Maguire
- IDEXX Laboratories, Grange House, Sandbeck Way, Wetherby LS22 7DN, United Kingdom.
| | - Matthew Jones
- IDEXX Laboratories, Grange House, Sandbeck Way, Wetherby LS22 7DN, United Kingdom.
| | - Larry Roberts
- IDEXX Laboratories, Grange House, Sandbeck Way, Wetherby LS22 7DN, United Kingdom.
| | - Frank Powell
- The Charles Institute of Dermatology, University College Dublin, Belfield, Dublin 4, Ireland; The Mater Misericordiae University Hospital, Eccles St, Dublin 7, Ireland.
| | - Rory Breathnach
- University College Dublin Veterinary Hospital, School of Veterinary Medicine, Belfield, Dublin 4, Ireland.
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9
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Kelly PA, McKay JS, Maguire D, Jones M, Roberts L, Powell F, Breathnach R. A retrospective study of cases of canine demodicosis submitted to a commercial diagnostic laboratory servicing the United Kingdom and Ireland (2017-2018): Part 1 - Signalment, lesion distribution, treatments, and concurrent diseases. Res Vet Sci 2022; 153:99-104. [PMID: 36334408 DOI: 10.1016/j.rvsc.2022.10.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 10/25/2022] [Accepted: 10/26/2022] [Indexed: 11/06/2022]
Abstract
Canine demodicosis, due to an overpopulation of Demodex spp. mites, remains one of the most common dermatological diseases encountered in small animal practice. The aims of this study were to interrogate submitted histories and diagnostic report results from a large cohort of dogs (n = 508) diagnosed with demodicosis either through histological analysis or the finding of Demodex spp. mites on skin scrapings by a UKAS accredited commercial laboratory servicing the United Kingdom (UK) and Ireland in the years 2017 and 2018. The main findings revealed that short-coated breeds were more likely to develop juvenile-onset (JO) demodicosis, whereas medium- and long-coated breeds were more likely to develop adult-onset (AO) disease. Pododemodicosis was reported more commonly in adult, long-coated breeds. Skin scrapings were positive in only 83.3% of samples that had a corresponding positive biopsy result; this finding highlights the necessity to perform further diagnostic tests if demodicosis remains clinically suspected despite a negative skin scraping result. Concurrent underlying diseases, potentially associated with immunosuppression, were reported in 42/221 (19%) of dogs with AO demodicosis. Serum allergy and Sarcoptes ELISA assays were positive in individual animals in both the JO and AO groups; the clinical significance of these latter findings requires careful interpretation in dogs with confirmed demodicosis.
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Affiliation(s)
- Pamela A Kelly
- University College Dublin Veterinary Hospital, School of Veterinary Medicine, Belfield, Dublin 4, Ireland; The Charles Institute of Dermatology, University College Dublin, Belfield, Dublin 4, Ireland.
| | - Jennifer S McKay
- IDEXX Laboratories, Grange House, Sandbeck Way, Wetherby LS22 7DN, United Kingdom.
| | - David Maguire
- IDEXX Laboratories, Grange House, Sandbeck Way, Wetherby LS22 7DN, United Kingdom.
| | - Matthew Jones
- IDEXX Laboratories, Grange House, Sandbeck Way, Wetherby LS22 7DN, United Kingdom.
| | - Larry Roberts
- IDEXX Laboratories, Grange House, Sandbeck Way, Wetherby LS22 7DN, United Kingdom.
| | - Frank Powell
- The Charles Institute of Dermatology, University College Dublin, Belfield, Dublin 4, Ireland; The Mater Misericordiae University Hospital, Eccles St, Dublin 7, Ireland.
| | - Rory Breathnach
- University College Dublin Veterinary Hospital, School of Veterinary Medicine, Belfield, Dublin 4, Ireland.
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10
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Hu XM, Li ZX, Zhang DY, Yang YC, Zheng SY, Zhang Q, Wan XX, Li J, Yang RH, Xiong K. Current research and clinical trends in rosacea pathogenesis. Heliyon 2022; 8:e10874. [PMID: 36276718 PMCID: PMC9578998 DOI: 10.1016/j.heliyon.2022.e10874] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 07/30/2022] [Accepted: 09/27/2022] [Indexed: 11/05/2022] Open
Abstract
Background Rosacea is a common and complex chronic inflammatory skin disorder, the pathophysiology and etiology of which remain unclear. Recently, significant new insights into rosacea pathogenesis have enriched and reshaped our understanding of the disorder. A systematic analysis based on current studies will facilitate further research on rosacea pathogenesis. Objective To establish an international core outcome and knowledge system of rosacea pathogenesis and develop a challenge, trend and hot spot analysis set for research and clinical studies on rosacea using bibliometric analysis and data mining. Methods A search of the WoS, and PubMed, MEDLINE, Embase and Cochrane collaboration databases was conducted to perform visual bibliometric and data analysis. Results A total of 2,654 studies were used for the visualization and 302 of the 6,769 outcomes for data analysis. It reveals an increased trend line in the field of rosacea, in which its fast-growing pathogenesis attracted attention closely related to risk, comorbidity and therapeutic strategies. The rosacea pathogenesis has undergone the great development on immunology, microorganisms, genes, skin barriers and neurogenetics. The major of studies have focused on immune and microorganisms. And keyword visualization and data analyses demonstrated the cross-talk between cells or each aspect of pathogenesis, such as gene-gene or gene-environment interactions, and neurological mechanisms associated with the rosacea phenotype warrant further research. Limitations Inherent limitations of bibliometrics; and reliance on research and retrospective studies. Conclusions The understanding of rosacea's pathogenesis has been significantly enhanced with the improved technology and multidisciplinary integration, but high-quality, strong evidence in favor of genomic and neurogenic requires further research combined with a better understanding of risks and comorbidities to guide clinical practice.
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Affiliation(s)
- Xi-Min Hu
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, 410008, China,Department of Anatomy and Neurobiology, School of Basic Medical Science, Central South University, Changsha, 410013, China
| | - Zhi-Xin Li
- Xiangya School of Medicine, Central South University, Changsha, 410013, China
| | - Dan-Yi Zhang
- Xiangya School of Medicine, Central South University, Changsha, 410013, China
| | - Yi-Chao Yang
- Xiangya School of Medicine, Central South University, Changsha, 410013, China
| | - Sheng-Yuan Zheng
- Xiangya School of Medicine, Central South University, Changsha, 410013, China
| | - Qi Zhang
- Department of Anatomy and Neurobiology, School of Basic Medical Science, Central South University, Changsha, 410013, China
| | - Xin-Xing Wan
- Department of Endocrinology, Third Xiangya Hospital, Central South University, Changsha, 410013, China
| | - Ji Li
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, 410008, China,Hunan Key Laboratory of Aging Biology, Xiangya Hospital, Central South University, Changsha, 410008, China,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, 410008, China,Corresponding author.
| | - Rong-Hua Yang
- Department of Burn and Plastic Surgery, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, 510180, China,Corresponding author.
| | - Kun Xiong
- Department of Anatomy and Neurobiology, School of Basic Medical Science, Central South University, Changsha, 410013, China,Hunan Key Laboratory of Ophthalmology, Xiangya Hospital, Central South University, Changsha, 410008, China,Key Laboratory of Emergency and Trauma, Ministry of Education, College of Emergency and Trauma, Hainan Medical University, Haikou, 571199, China,Corresponding author.
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11
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Paichitrojjana A, Chalermchai T. Comparison of in vitro Killing Effect of N, N-Diethyl-Meta-Toluamide (DEET) versus Permethrin on Demodex folliculorum. Clin Cosmet Investig Dermatol 2022; 15:1301-1307. [PMID: 35847418 PMCID: PMC9278725 DOI: 10.2147/ccid.s376454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 07/06/2022] [Indexed: 11/23/2022]
Abstract
Background There is no single effective treatment for demodicosis; successful treatment requires a multimodal approach. Relapse or recurrence of demodicosis is relatively high, making the therapy challenging. Several reports have documented the successful treatment of demodicosis with acaricidal agents, which aimed at reducing the excessive number of Demodex mites and improving the patients' symptoms. Reports of irritation and resistance to topical acaricidal agents have led to the search for effective alternative treatments. Materials and Methods A total of 100 standardized skin surface biopsy (SSSB) biopsy slides from 100 patients with demodicosis were randomly divided into five groups, each with 20 slides exposed to immersion oil, N, N-diethyl-meta-toluamide (DEET) 5%, 10%, 20%, and permethrin 1%, respectively. The microscopic evaluation started immediately after the test agents exposed the mites. The survival time (ST) was defined as the interval between the first exposure of Demodex folliculorum to the test agents to the time the movements ceased. Results The differences between the median ST of DEET 5% (44 min), 10% (22 min), and 20% (14 min) were significant when compared to the negative control group (240 min) with p<0.001, <0.001, <0.001, respectively. While the median ST of permethrin 1% (42 min) was not significantly different from the median ST of DEET 5% (p=0.7395). Conclusion This study demonstrated the dose-related acaricidal effect of DEET on D. folliculorum. The survival times of DEET 5%, 10%, and 20% were significantly shorter than the negative control (immersion oil). DEET 5% had a comparable in vitro killing effect as permethrin 1%. Further in vivo studies are necessary to determine the clinical efficacy in patients with demodicosis.
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Affiliation(s)
- Anon Paichitrojjana
- School of Anti-Aging and Regenerative Medicine, Mae Fah Luang University, Bangkok, Thailand
| | - Thep Chalermchai
- School of Anti-Aging and Regenerative Medicine, Mae Fah Luang University, Bangkok, Thailand
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12
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Smith G, Manzano-Marín A, Reyes-Prieto M, Antunes CSR, Ashworth V, Goselle ON, Jan AAA, Moya A, Latorre A, Perotti MA, Braig HR. Human follicular mites: Ectoparasites becoming symbionts. Mol Biol Evol 2022; 39:msac125. [PMID: 35724423 PMCID: PMC9218549 DOI: 10.1093/molbev/msac125] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 05/23/2022] [Accepted: 05/31/2022] [Indexed: 12/13/2022] Open
Abstract
Most humans carry mites in the hair follicles of their skin for their entire lives. Follicular mites are the only metazoans tha continuously live on humans. We propose that Demodex folliculorum (Acari) represents a transitional stage from a host-injuring obligate parasite to an obligate symbiont. Here, we describe the profound impact of this transition on the genome and physiology of the mite. Genome sequencing revealed that the permanent host association of D. folliculorum led to an extensive genome reduction through relaxed selection and genetic drift, resulting in the smallest number of protein-coding genes yet identified among panarthropods. Confocal microscopy revealed that this gene loss coincided with an extreme reduction in the number of cells. Single uninucleate muscle cells are sufficient to operate each of the three segments that form each walking leg. While it has been assumed that the reduction of the cell number in parasites starts early in development, we identified a greater total number of cells in the last developmental stage (nymph) than in the terminal adult stage, suggesting that reduction starts at the adult or ultimate stage of development. This is the first evolutionary step in an arthropod species adopting a reductive, parasitic or endosymbiotic lifestyle. Somatic nuclei show underreplication at the diploid stage. Novel eye structures or photoreceptors as well as a unique human host melatonin-guided day/night rhythm are proposed for the first time. The loss of DNA repair genes coupled with extreme endogamy might have set this mite species on an evolutionary dead-end trajectory.
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Affiliation(s)
- Gilbert Smith
- School of Natural Sciences, Bangor University, Bangor, Wales, United Kingdom
| | - Alejandro Manzano-Marín
- Centre for Microbiology and Environmental Systems Science (CMESS), University of Vienna, Vienna, Austria
| | - Mariana Reyes-Prieto
- Institute of Integrative Systems Biology (I2Sysbio), Universitat de València and Spanish Research Council (CSIC), València, Spain
- Foundation for the Promotion of Health and Biomedical Research of the Valencian Community (FISABIO), València, Spain
| | | | - Victoria Ashworth
- School of Natural Sciences, Bangor University, Bangor, Wales, United Kingdom
| | - Obed Nanjul Goselle
- School of Natural Sciences, Bangor University, Bangor, Wales, United Kingdom
| | | | - Andrés Moya
- Institute of Integrative Systems Biology (I2Sysbio), Universitat de València and Spanish Research Council (CSIC), València, Spain
- Foundation for the Promotion of Health and Biomedical Research of the Valencian Community (FISABIO), València, Spain
- Center for Networked Biomedical Research in Epidemiology and Public Health (CIBEResp), Madrid, Spain
| | - Amparo Latorre
- Institute of Integrative Systems Biology (I2Sysbio), Universitat de València and Spanish Research Council (CSIC), València, Spain
- Foundation for the Promotion of Health and Biomedical Research of the Valencian Community (FISABIO), València, Spain
- Center for Networked Biomedical Research in Epidemiology and Public Health (CIBEResp), Madrid, Spain
| | - M Alejandra Perotti
- School of Biological Sciences, University of Reading, Reading, United Kingdom
| | - Henk R Braig
- School of Natural Sciences, Bangor University, Bangor, Wales, United Kingdom
- Institute and Museum of Natural Sciences, National University of San Juan, San Juan, Argentina
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13
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Li X, Lam NSK, Yang L, Liang A, Long XX, Guo J, Zhong S. Demodex density increases after adalimumab therapy in ankylosing spondylitis: a pilot study. Parasitology 2022; 149:1-19. [PMID: 35431017 DOI: 10.1017/s0031182022000348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractDemodex infestation and density changes remain one of the main challenges in some clinical settings. Tumour necrosis factor-α (TNF-α) inhibitors have been recommended as a first-line treatment for ankylosing spondylitis (AS). However, there have been no studies investigating the impact of TNF-α inhibitor adalimumab on changes in the Demodex density in patients with AS. The aim of this study was to investigate Demodex density changes before and after adalimumab treatment and analyse the relationship between the Demodex density and clinical characteristics in AS. It was found that the Demodex density was positively correlated with age and C-reactive protein levels and the number of Demodex mites could increase after adalimumab treatment in AS.
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Affiliation(s)
- Xuegang Li
- Department of Rheumatology, the Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, People's Republic of China
| | - Nelson Siu Kei Lam
- Faculty of Health and Sciences, the University of Adelaide, Adelaide, South Australia, Australia
- Department of Psychiatry, Lyell McEwin Hospital, Elizabeth, South Australia, Australia
- Department of Medicine, Monash University, Clayton, Victoria, Australia
| | - Li Yang
- Department of Dermatology, the Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, People's Republic of China
| | - Anqi Liang
- Department of Rheumatology, the Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, People's Republic of China
| | - Xin Xin Long
- Faculty of Health and Sciences, the University of Adelaide, Adelaide, South Australia, Australia
| | - Junli Guo
- Department of Nephrology, Zhuhai People's Hospital (Zhuhai hospital affiliated with Jinan University), Zhuhai, People's Republic of China
| | - Shuping Zhong
- Department of Rheumatology, the Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, People's Republic of China
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14
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Forton FM. Rosacea, an infectious disease: why rosacea with papulopustules should be considered a demodicosis. A narrative review. J Eur Acad Dermatol Venereol 2022; 36:987-1002. [DOI: 10.1111/jdv.18049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 02/22/2022] [Indexed: 11/28/2022]
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15
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Erdal B, Albayrak H. Investigation of the Prevalence of Demodex spp. in Dermatological Diseases. TURKIYE PARAZITOLOJII DERGISI 2022; 46:54-59. [PMID: 35232707 DOI: 10.4274/tpd.galenos.2021.93685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVE An increase in the counts of the Demodex mites that exist in the microbiota of healthy individuals may lead to some dermatological diseases. This study aimed to investigate the prevalence of Demodex spp. among patients diagnosed with acne vulgaris, rosacea, perioral dermatitis, seborrheic dermatitis, eczema, and pityriasis folliculorum and the relationship between the demographic and clinical data of such patients and Demodex. METHODS This study included 144 patients (70 with acne vulgaris, 6 with pityriasis folliculorum, 15 with seborrheic dermatitis, 39 with rosacea, 8 with eczema, and 6 with perioral dermatitis) and 73 healthy subjects. We evaluated Demodex positivity using the standard superficial skin biopsy method in all groups. The presence of more than five Demodex mites per square centimeter was considered positive at the diagnosis. RESULTS Of the 144 patients included in the study, 107 (74.3%) were female, and 37 (25.7%) were male, while 40 (54.8%) of the 73 healthy subjects were female, and 33 (45.2%) were male. Twenty-one patients (14.5%) and five of the healthy subjects (6.8%) tested positive for Demodex. We found that Demodex positivity rates in the rosacea and acne vulgaris groups were higher than in the control group. However, this level was not statistically significant (p>0.05). We found the highest positivity rate among the patient groups in the pityriasis folliculorum (4/6, 66.7%), rosacea (8/39, 20.5%), and perioral dermatitis (1/6, 16.7%) groups. Lastly, we found no statistically significant relationship between the demographic and clinical characteristics of the groups and Demodex positivity (p>0.05). CONCLUSION The present study is the only study that investigated Demodex positivity in six different dermatological diseases. Based on the results, we believe that investigating Demodex spp. positivity in dermatological diseases such as acne vulgaris, rosacea, and pityriasis folliculorum would be beneficial for early diagnosis and treatment.
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Affiliation(s)
- Berna Erdal
- Tekirdağ Namık Kemal Üniversitesi Tıp Fakültesi, Tıbbi Mikrobiyoloji Anabilim Dalı, Tekirdağ, Türkiye
| | - Hülya Albayrak
- Tekirdağ Namık Kemal Üniversitesi Tıp Fakültesi, Deri ve Zührevi Hastalıkları Anabilim Dalı, Tekirdağ, Türkiye
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16
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Gutiérrez B, Soto R, Catalán A, Araya JE, Fuentes M, González J. Demodex folliculorum (Trombidiformes: Demodicidae) and Demodex brevis Prevalence in an Extreme Environment of Chile. JOURNAL OF MEDICAL ENTOMOLOGY 2021; 58:2067-2074. [PMID: 34331059 DOI: 10.1093/jme/tjab120] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Indexed: 06/13/2023]
Abstract
The prevalence of mites of the genus Demodex and their associations with host age, gender, workplace, and comorbid skin and ocular conditions were studied in participants in Antofagasta, Chile, which is in a region with an extreme environment. We examined 680 participants aged 18-88 yr using standardized surface skin biopsies. Among them, Demodex had a prevalence of 13.5 % (95% confidence interval, 10.88-16.17). A slightly higher prevalence was observed in males (51.1%; 95% confidence interval, 40.9-61.3; nonsignificant) and participants in the 69-88 yr age group (50.0%; 95% confidence interval, 23.8-76.2; P < 0.05). Regarding the species involved, Demodex folliculorum was found in 89.1% (CI 82.7-95.5) of cases, while D. brevis was found in the remaining 10.9% of cases. A higher prevalence (25.0% CI 16.1-33.91) was observed in participants who worked indoors in generally enclosed and dust-rich environments (such as theaters, libraries, and administrative offices). There was also a strong association between Demodex prevalence and conjunctival hyperemia, with 35.9% (95% confidence interval, 9.1-35; OR 17.9) of the Demodex positive participants having this pathology compared to 10.3% of the noninfested participants. In summary, the prevalence of Demodex in Antofagasta, Chile (13.5%) was toward the lower end of the range reported among other regions around the world. Environmental factors such as exposure to the sun (including ultraviolet rays) or environmental pollution may affect the mites. In addition, Demodex genetics (related to virulence) and the ocular or skin microbiota may positively or negatively influence infestation and pathology.
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Affiliation(s)
- Bessy Gutiérrez
- Molecular Parasitology Unit, Medical Technology Department, Faculty of Health Sciences, University of Antofagasta, Avenida Universidad de Antofagasta 02800, Antofagasta, Chile
| | - Rodrigo Soto
- Molecular Parasitology Unit, Medical Technology Department, Faculty of Health Sciences, University of Antofagasta, Avenida Universidad de Antofagasta 02800, Antofagasta, Chile
| | - Alejandro Catalán
- Molecular Parasitology Unit, Medical Technology Department, Faculty of Health Sciences, University of Antofagasta, Avenida Universidad de Antofagasta 02800, Antofagasta, Chile
| | - Jorge E Araya
- Molecular Parasitology Unit, Medical Technology Department, Faculty of Health Sciences, University of Antofagasta, Avenida Universidad de Antofagasta 02800, Antofagasta, Chile
| | - Margarita Fuentes
- Public Health Unit, Faculty of Medicine and Odontology, University of Antofagasta, Avenida Universidad de Antofagasta 02800, Antofagasta, Chile
| | - Jorge González
- Molecular Parasitology Unit, Medical Technology Department, Faculty of Health Sciences, University of Antofagasta, Avenida Universidad de Antofagasta 02800, Antofagasta, Chile
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17
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Yan Y, Yao Q, Lu Y, Shao C, Sun H, Li Y, Fu Y. Association Between Demodex Infestation and Ocular Surface Microbiota in Patients With Demodex Blepharitis. Front Med (Lausanne) 2020; 7:592759. [PMID: 33251239 PMCID: PMC7672197 DOI: 10.3389/fmed.2020.592759] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 10/13/2020] [Indexed: 12/11/2022] Open
Abstract
Purpose: The aim of this study was to compare the ocular microbial communities in humans with and without demodex blepharitis in order to elucidate the relationship between ocular microorganisms and demodex infestation. Methods: Bacterial 16S rRNA genes of conjunctival sac samples from 30 demodex blepharitis patients and 14 healthy controls were sequenced using a pyrosequencing method, and their bacterial community structures were compared by bioinformatics. Results: Bacterial community clustering of conjunctival sac in the demodex blepharitis group were significantly distinct from the healthy control group, with significantly higher relative abundances of Firmicutes and Corynebacterium at the phyla level, as well as higher abundances of Lactobacillus and Bifidobacterium at the genus level. The relative abundance of Staphylococcus epidermidis (0.07-2.27%) was positively correlated with the demodex amount and modified OSDI. The major potential factors contribute to demodex blepharitis were Bacilli, Firmicutes, Cyanobacteria, Lactobacillus and Streptophyta. Conclusions: Patients with demodex blepharitis have varying degrees of bacterial microbiota imbalance in the conjunctival sac. Demodex serving as vectors to transfer both skin and environmental flora might be the potential mechanism. In addition, the number and type of demodex affect the specific ocular surface bacteria, presenting as ocular discomfort and obvious signs of blepharitis.
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Affiliation(s)
- Yan Yan
- Department of Ophthalmology, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Qinke Yao
- Department of Ophthalmology, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Yang Lu
- Department of Ophthalmology, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Chunyi Shao
- Department of Ophthalmology, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Hao Sun
- Department of Ophthalmology, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Yimin Li
- Department of Ophthalmology, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
| | - Yao Fu
- Department of Ophthalmology, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Orbital Diseases and Ocular Oncology, Shanghai, China
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18
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The Pathogenic Role of Demodex Mites in Rosacea: A Potential Therapeutic Target Already in Erythematotelangiectatic Rosacea? Dermatol Ther (Heidelb) 2020; 10:1229-1253. [PMID: 33095403 PMCID: PMC7649190 DOI: 10.1007/s13555-020-00458-9] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Indexed: 12/15/2022] Open
Abstract
Rosacea is a common facial dermatosis but its definition and classification are still unclear, especially in terms of its links with demodicosis. Triggers of rosacea (ultraviolet light, heat, spicy foods, alcohol, stress, microbes) are currently considered to induce a cascading innate and then adaptive immune response that gets out of control. Recent histological and biochemical studies support the concept that this inflammatory response is a continuum, already present from the onset of the disease, even when no clinical signs of inflammation are visible. The Demodex mite is beginning to be accepted as one of the triggers of this inflammatory cascade, and its proliferation as a marker of rosacea; moreover, the papulopustules of rosacea can be effectively treated with topical acaricidal agents. Demodex proliferation appears to be a continuum process in rosacea, and may not be clinically visible at the onset of the disease. Molecular studies suggest that Demodex may induce tolerogenic dendritic cells and collaborate with vascular endothelial growth factor (VEGF) to induce T cell exhaustion and favor its own proliferation. These interactions among VEGF, Demodex, and immunity need to be explored further and the nosology of rosacea adapted accordingly. However, treating early rosacea, with only clinically visible vascular symptoms, with an acaricide may decrease early inflammation, limit potential flare-ups following laser treatment, and prevent the ultimate development of the papulopustules of rosacea. The effectiveness of this approach needs to be confirmed by prospective controlled clinical trials with long-term follow-up. Currently, the evidence suggests that patients with only vascular symptoms of rosacea should be carefully examined for the presence of follicular scales as signs of Demodex overgrowth or pityriasis folliculorum so that these patients, at least, can be treated early with an acaricidal cream.
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