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Aksoy H, Altıntaş Kakşi S, Gönüllü Ö, Aslan Kayıran M, Erdemir VA. Biologic therapy increases Demodex density in psoriasis patients. Int J Dermatol 2024; 63:1193-1199. [PMID: 38650106 DOI: 10.1111/ijd.17161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 01/29/2024] [Accepted: 03/20/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND Demodex density is known to increase in various immunosuppressive conditions. The relationship between biologic therapy and Demodex density remains unknown. We aimed to investigate whether the density of Demodex mites is higher in psoriasis patients treated with biologic agents compared to treatment-naive or topically treated patients. METHODS A cross-sectional study was conducted, comparing psoriasis patients receiving biologic therapy (n = 34) with controls (n = 33). Demodex density was assessed using the standardized skin surface biopsy technique (SSSB). Statistical analysis was performed to compare the densities and prevalence of demodicosis between the two groups. RESULTS Demodex density was significantly higher in the biologic therapy group compared to the control group on the right cheek (7.29 vs. 0.12/cm2; P = 0.001), left cheek (8.15 vs. 0.24/cm2; P = 0.002), and whole face (average of all four regions: 5.50 vs. 0.80/cm2; P = 0.001). The prevalence of demodicosis was significantly higher in the biologic therapy group on the forehead (35.3% vs. 12.1%; P = 0.043), right cheek (41.2% vs. 0%; P < 0.001), and left cheek (44.1% vs. 0%; P < 0.001). The frequency of cases with demodicosis in at least one localization was higher in the biological therapy group compared to the control group (61.8% vs. 15.2%; P < 0.001). CONCLUSIONS Psoriasis patients receiving biologic therapy had a higher Demodex density and prevalence of demodicosis compared to controls. Biologics may lead to an increase in Demodex density by blocking specific cytokines, such as interleukin-17 and tumor necrosis factor-α, which play a role in immunity against Demodex. Further research is needed to explore the impact of different biological agents on Demodex density.
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Affiliation(s)
- Hasan Aksoy
- Department of Dermatology, Istanbul Medeniyet University Prof. Dr. Suleyman Yalcin City Hospital, İstanbul, Turkey
| | - Sümeyye Altıntaş Kakşi
- Department of Dermatology, Istanbul Medeniyet University Prof. Dr. Suleyman Yalcin City Hospital, İstanbul, Turkey
| | - Öykü Gönüllü
- Department of Dermatology, Istanbul Medeniyet University Prof. Dr. Suleyman Yalcin City Hospital, İstanbul, Turkey
| | - Melek Aslan Kayıran
- Department of Dermatology, Istanbul Medeniyet University Prof. Dr. Suleyman Yalcin City Hospital, İstanbul, Turkey
| | - Vefa A Erdemir
- Department of Dermatology, Istanbul Medeniyet University Prof. Dr. Suleyman Yalcin City Hospital, İstanbul, Turkey
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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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Zhang XE, Zheng P, Ye SZ, Ma X, Liu E, Pang YB, He QY, Zhang YX, Li WQ, Zeng JH, Guo J. Microbiome: Role in Inflammatory Skin Diseases. J Inflamm Res 2024; 17:1057-1082. [PMID: 38375021 PMCID: PMC10876011 DOI: 10.2147/jir.s441100] [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: 10/10/2023] [Accepted: 01/23/2024] [Indexed: 02/21/2024] Open
Abstract
As the body's largest organ, the skin harbors a highly diverse microbiota, playing a crucial role in resisting foreign pathogens, nurturing the immune system, and metabolizing natural products. The dysregulation of human skin microbiota is implicated in immune dysregulation and inflammatory responses. This review delineates the microbial alterations and immune dysregulation features in common Inflammatory Skin Diseases (ISDs) such as psoriasis, rosacea, atopic dermatitis(AD), seborrheic dermatitis(SD), diaper dermatitis(DD), and Malassezia folliculitis(MF).The skin microbiota, a complex and evolving community, undergoes changes in composition and function that can compromise the skin microbial barrier. These alterations induce water loss and abnormal lipid metabolism, contributing to the onset of ISDs. Additionally, microorganisms release toxins, like Staphylococcus aureus secreted α toxins and proteases, which may dissolve the stratum corneum, impairing skin barrier function and allowing entry into the bloodstream. Microbes entering the bloodstream activate molecular signals, leading to immune disorders and subsequent skin inflammatory responses. For instance, Malassezia stimulates dendritic cells(DCs) to release IL-12 and IL-23, differentiating into a Th17 cell population and producing proinflammatory mediators such as IL-17, IL-22, TNF-α, and IFN-α.This review offers new insights into the role of the human skin microbiota in ISDs, paving the way for future skin microbiome-specific targeted therapies.
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Affiliation(s)
- Xue-Er Zhang
- Chengdu University of Traditional Chinese Medicine, Chengdu, 6610075, People’s Republic of China
| | - Pai Zheng
- Chengdu University of Traditional Chinese Medicine, Chengdu, 6610075, People’s Republic of China
| | - Sheng-Zhen Ye
- Chengdu University of Traditional Chinese Medicine, Chengdu, 6610075, People’s Republic of China
- Department of Dermatology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 6610072, People’s Republic of China
| | - Xiao Ma
- State Key Laboratory of Southwestern Chinese Medicine Resources, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, People’s Republic of China
| | - E Liu
- Chengdu University of Traditional Chinese Medicine, Chengdu, 6610075, People’s Republic of China
| | - Yao-Bin Pang
- Chengdu University of Traditional Chinese Medicine, Chengdu, 6610075, People’s Republic of China
| | - Qing-Ying He
- Chengdu University of Traditional Chinese Medicine, Chengdu, 6610075, People’s Republic of China
| | - Yu-Xiao Zhang
- Chengdu University of Traditional Chinese Medicine, Chengdu, 6610075, People’s Republic of China
| | - Wen-Quan Li
- Chengdu University of Traditional Chinese Medicine, Chengdu, 6610075, People’s Republic of China
| | - Jin-Hao Zeng
- TCM Regulating Metabolic Diseases Key Laboratory of Sichuan Province, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, People’s Republic of China
| | - Jing Guo
- Department of Dermatology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 6610072, People’s Republic of China
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Aksoy H, Aslan Kayıran M, Dede Y, Altıntaş Kakşi S, Erdemir VA. The effect of phototherapy on Demodex density: a case-control study. Int J Dermatol 2024; 63:201-206. [PMID: 38234255 DOI: 10.1111/ijd.17002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Revised: 11/18/2023] [Accepted: 12/15/2023] [Indexed: 01/19/2024]
Abstract
BACKGROUND Human Demodex mites, Demodex folliculorum and Demodex brevis, are microorganisms that reside in the pilosebaceous units, usually without causing symptoms. Phototherapy has been linked to demodicosis in previous studies. We aimed to determine whether there was an increase in the frequency of demodicosis and Demodex density after 20 phototherapy sessions. METHODS A case-control study was conducted with 32 participants who received narrowband ultraviolet B or ultraviolet A-1 therapy for various dermatological indications. Standardized skin surface biopsies were performed before and after phototherapy to assess Demodex density. The presence of Demodex-related skin conditions was assessed before phototherapy. A statistical analysis was performed to compare the Demodex densities and prevalence of demodicosis between the baseline and 20th session of phototherapy. RESULTS No significant change was observed in Demodex density after 20 sessions of phototherapy. The average Demodex density before treatment was 2.75 ± 4.48 (/cm2 ), and after treatment, it was 2.85 ± 4.81 (/cm2 ), indicating no significant difference (P = 0.879). The percentage of patients with demodicosis in at least one region of the face was 28.1% (9/32) before treatment, and after treatment, it was 31.3% (10/32), with no significant difference (P = 1.00). CONCLUSIONS Our findings contradict previous studies that suggested an increased Demodex density and demodicosis prevalence after phototherapy. The data from previous studies are open to debate due to their selected samples, designs, and interpretations regarding the phototherapy-immunosuppression-Demodex relationship. Larger-scale longitudinal studies conducted on a homogeneous sample are warranted to better understand the relationship between phototherapy and demodicosis.
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Affiliation(s)
- Hasan Aksoy
- Department of Dermatology, Istanbul Medeniyet University Prof. Dr. Suleyman Yalcin City Hospital, İstanbul, Turkey
| | - Melek Aslan Kayıran
- Department of Dermatology, Istanbul Medeniyet University Prof. Dr. Suleyman Yalcin City Hospital, İstanbul, Turkey
| | - Yeşim Dede
- Department of Dermatology, Istanbul Medeniyet University Prof. Dr. Suleyman Yalcin City Hospital, İstanbul, Turkey
| | - Sümeyye Altıntaş Kakşi
- Department of Dermatology, Istanbul Medeniyet University Prof. Dr. Suleyman Yalcin City Hospital, İstanbul, Turkey
| | - Vefa A Erdemir
- Department of Dermatology, Istanbul Medeniyet University Prof. Dr. Suleyman Yalcin City Hospital, İstanbul, Turkey
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Schwarz L, Herb V, Dürlinger S, Martin V, Poláková N, Horvath-Ungerböck C, Brunthaler R, Knecht C, Dippel M, Pikalo J, Ladinig A, Joachim A, Fuehrer HP. Demodicosis in a Kunekune pig and molecular characterisation of porcine demodectic mites involved: a case report. Parasit Vectors 2024; 17:32. [PMID: 38267960 PMCID: PMC10807167 DOI: 10.1186/s13071-023-06101-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 12/17/2023] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND In January 2021, a female 1-year-old Kunekune was presented at the University Clinic for Swine with severe reduction of the field of vision resulting in prolonged reaction time when targeting barriers, due to moderate to severe thickening of the skin around both orbits also affecting the eyelids. METHODS Clinical examination revealed skin hyperplasia, nodular enlargement of the skin pores of the axillar and inguinal region. Ophthalmologists decided to remove parts of the thickened periocular skin, followed by histopathological examination. RESULTS Once large amounts of demodectic mites were detected by histopathology, demodicosis could be diagnosed and treatment of the pig was started using sarolaner. Morphological and molecular analyses were performed. Histopathological and parasitological exams led to the aetiological diagnosis of demodicosis in the affected Kunekune pig. Severe skin lesions were revealed to be the consequence of an infestation with Demodex sp. Morphological analyses confirmed the involvement of D. phylloides. Molecular characterization indicated a Demodex species closely related to mites documented in wild boar - most probably D. phylloides for which no explicit sequences are available in GenBank yet. Treatment with sarolaner (2.6 mg/kg) resulted in a substantial regression of skin lesions, already detectable 1 month after first treatment. CONCLUSIONS Demodicosis is a very rare disease in pigs that is most probably related to an impaired immune response to the mites. Demodectic mange should be included in the list of differential diagnoses in cases of periocular alterations of the skin of pigs.
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Affiliation(s)
- Lukas Schwarz
- Department for Farm Animals and Veterinary Public Health, University Clinic for Swine, University of Veterinary Medicine Vienna, Vienna, Austria.
| | - Verena Herb
- Clinical Unit of Small Animal Surgery, Ophthalmology, Department for Companion Animals and Horses, University Clinic for Small Animals, University of Veterinary Medicine Vienna, Vienna, Austria
- Fachtierärzte Althangrund, Vienna, Austria
| | - Sophie Dürlinger
- Department for Farm Animals and Veterinary Public Health, University Clinic for Swine, University of Veterinary Medicine Vienna, Vienna, Austria
| | - Vera Martin
- Department for Farm Animals and Veterinary Public Health, University Clinic for Swine, University of Veterinary Medicine Vienna, Vienna, Austria
| | - Nina Poláková
- Clinical Unit of Internal Medicine Small Animals, Dermatology, Department for Companion Animals and Horses, University Clinic for Small Animals, University of Veterinary Medicine Vienna, Vienna, Austria
| | - Christa Horvath-Ungerböck
- Clinical Unit of Internal Medicine Small Animals, Dermatology, Department for Companion Animals and Horses, University Clinic for Small Animals, University of Veterinary Medicine Vienna, Vienna, Austria
| | - Rene Brunthaler
- Department of Pathobiology, Institute of Pathology, University of Veterinary Medicine Vienna, Vienna, Austria
| | - Christian Knecht
- Department for Farm Animals and Veterinary Public Health, University Clinic for Swine, University of Veterinary Medicine Vienna, Vienna, Austria
| | - Maximiliane Dippel
- Department for Farm Animals and Veterinary Public Health, University Clinic for Swine, University of Veterinary Medicine Vienna, Vienna, Austria
| | - Jutta Pikalo
- Department of Pathobiology, Institute of Parasitology, University of Veterinary Medicine Vienna, Vienna, Austria
| | - Andrea Ladinig
- Department for Farm Animals and Veterinary Public Health, University Clinic for Swine, University of Veterinary Medicine Vienna, Vienna, Austria
| | - Anja Joachim
- Department of Pathobiology, Institute of Parasitology, University of Veterinary Medicine Vienna, Vienna, Austria
| | - Hans-Peter Fuehrer
- Department of Pathobiology, Institute of Parasitology, University of Veterinary Medicine Vienna, Vienna, Austria
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6
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Hobi S, Barrs VR, Bęczkowski PM. Dermatological Problems of Brachycephalic Dogs. Animals (Basel) 2023; 13:2016. [PMID: 37370526 DOI: 10.3390/ani13122016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 06/01/2023] [Accepted: 06/13/2023] [Indexed: 06/29/2023] Open
Abstract
Brachycephalic dogs are not only affected by brachycephalic obstructive airway syndrome (BOAS), but are also frequently referred to veterinary dermatologists for skin conditions, with English bulldogs and pugs particularly over-represented. Some skin diseases, such as skin fold dermatitis, are directly associated with the abnormal anatomic conformation of brachycephalic dogs, while for others, such as atopic dermatitis and viral pigmented plaques, there is an underlying genetic basis or a general predisposition. Anatomic alterations associated with brachycephaly, leading to fold formation of the skin and stenosis of the ear canal, together with primary immunodeficiencies described in some breeds, favor the development of pyoderma, Malassezia dermatitis, and otitis externa/media. In addition, the frequently neglected but often lifelong dermatological problems of brachycephalic dogs are an important consideration when discussing genetic and medical conditions affecting the welfare of those dogs. Here we review the current state of knowledge concerning dermatological problems in brachycephalic dogs and combine it with clinical experience in the management of these challenging disorders.
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Affiliation(s)
- Stefan Hobi
- Department of Veterinary Clinical Sciences, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Kowloon Tong, Hong Kong SAR, China
| | - Vanessa R Barrs
- Department of Veterinary Clinical Sciences, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Kowloon Tong, Hong Kong SAR, China
- Centre for Animal Health and Welfare, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Kowloon Tong, Hong Kong SAR, China
| | - Paweł M Bęczkowski
- Department of Veterinary Clinical Sciences, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Kowloon Tong, Hong Kong SAR, China
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Chudzicka-Strugała I, Gołębiewska I, Brudecki G, Elamin W, Zwoździak B. Demodicosis in Different Age Groups and Alternative Treatment Options-A Review. J Clin Med 2023; 12:jcm12041649. [PMID: 36836184 PMCID: PMC9961532 DOI: 10.3390/jcm12041649] [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: 01/08/2023] [Revised: 01/26/2023] [Accepted: 02/01/2023] [Indexed: 02/22/2023] Open
Abstract
Infestation with Demodex mites is a common occurrence, especially in adults and the elderly. More recent attention has been paid to the presence of Demodex spp. mites in children, even ones without comorbidities. It causes both dermatological and ophthalmological problems. The presence of Demodex spp. is often asymptomatic, thus it is suggested to include parasitological investigation tests in dermatological diagnostics, in addition to bacteriological analysis. Literature reports show that Demodex spp. are related to the pathogenesis of numerous dermatoses, including rosacea or demodicosis gravis, and common eye pathologies reported by patients such as dry eye syndrome or ocular surface inflammatory conditions, such as blepharitis, chalazia, Meibomian gland dysfunction, and keratitis. Treatment of patients is a challenge and is usually prolonged, therefore it is important to carefully diagnose and properly select the therapy regimen for the treatment to be successful, and with minimal side effects, especially for young patients. Apart from the use of essential oils, research is ongoing for new alternative preparations active against Demodex sp. Our review was focused on the analysis of the current literature data on the available agents in the treatment of demodicosis in adults and children.
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Affiliation(s)
- Izabela Chudzicka-Strugała
- Department of Medical Microbiology, Poznan University of Medical Sciences, Rokietnicka 10, 60-806 Poznan, Poland
| | - Iwona Gołębiewska
- Earth and Life Institute (ELI), Université Catholique de Louvain, Croix du Sud 2, 1348 Louvain-La-Neuve, Belgium
- Correspondence:
| | - Grzegorz Brudecki
- Group 42 (Healthcare), Masdar City, Abu Dhabi P.O. Box 112778, United Arab Emirates
| | - Wael Elamin
- Group 42 (Healthcare), Masdar City, Abu Dhabi P.O. Box 112778, United Arab Emirates
| | - Barbara Zwoździak
- Department of Medical Microbiology, Poznan University of Medical Sciences, Rokietnicka 10, 60-806 Poznan, Poland
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Bendezu-Quispe G, Rojas-Zevallos J, Rosales-Rimache J. Type 2 Diabetes Mellitus and Demodex folliculorum Infestation: A Cross-Sectional Study in Peruvian Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13582. [PMID: 36294163 PMCID: PMC9603340 DOI: 10.3390/ijerph192013582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 09/27/2022] [Accepted: 10/01/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Demodex folliculorum is a mite that causes human demodicosis, which is characterized by producing lesions on the face, and its infestation could be associated with factors that alter the immune response, including Type 2 Diabetes (T2D). This study aimed to evaluate the relationship between T2D and D. folliculorum infestation in patients attended at a hospital in Peru in 2021. METHODS A cross-sectional study enrolling patients who were classified according to the presence (n = 100) and absence (n = 100) of T2D was conducted. Information was obtained on age, sex, domestic animal husbandry, and symptoms and signs associated with demodicosis. Demodicosis was determined to be present when counts of D. folliculorum greater than five mites per cm2 were found in superficial facial skin biopsies. RESULTS A frequency of demodicosis in 76 and 35 patients with and without T2D, respectively, was observed. In the multivariate analysis adjusted for confounders age, sex, and domestic animal husbandry, T2D was found to be associated with D. folliculorum infestation (PR: 2.13; 95% CI95: 1.42-3.19). CONCLUSIONS T2D was associated with D. folliculorum infestation. In this sense, it is important to strengthen surveillance to identify of D. folliculorum infestation in people with T2D.
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Paichitrojjana A. Demodex: the worst enemies are the ones that used to be friends. Dermatol Reports 2022; 14:9339. [PMID: 36199896 PMCID: PMC9527693 DOI: 10.4081/dr.2022.9339] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Accepted: 08/23/2021] [Indexed: 12/02/2022] Open
Abstract
Demodex mites are common ectoparasites of the human pilosebaceous units. Most adults are infested with Demodex mites without clinical symptoms. Demodex mite will only become a pathogenic organism when there is an abnormal increase in the number of Demodex mite density. This situation happens when the equilibrium between Demodex mites, skin microenvironment and human immunity system changes. Demodex infestation can cause multiple skin disorders, which are grouped under the term demodicosis or demodicidosis. Clinical manifestations of demodicosis can mimic other known skin diseases such as folliculitis, rosacea, perioral dermatitis, which is why it is often misdiagnosed. Diagnosis criteria consists of relevant correlation of suspected clinical skin lesions, confirmed by the presence of abnormal proliferation of Demodex mites and by clinical cure after acaricidal treatment together with normalization of Demodex mite density. Dermatologists should be aware that demodicosis is not an uncommon skin disease, and there are still many unknowns about it that should be researched further.
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10
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Vargo CL, Banovic F. Localized Demodicosis in a Dog After Fluticasone Propionate Treatment for Chronic Bronchitis. Top Companion Anim Med 2021; 45:100578. [PMID: 34400383 DOI: 10.1016/j.tcam.2021.100578] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 07/08/2021] [Accepted: 08/10/2021] [Indexed: 11/28/2022]
Abstract
An 11-year-old, castrated male Shetland Sheepdog presented for a 3-week history of localized nonpruritic alopecia and scaling affecting the peri-nasal region. The dog was being managed for several comorbidities, including chronic bronchitis successfully controlled with the chronic administration of inhaled fluticasone propionate. The physical examination was unremarkable aside from erythema, symmetrical alopecia, scaling and follicular casts affecting the peri-nasal region. Deep skin scrapings and histopathological examination from the lesional skin revealed several live demodex mites consistent with Demodex canis. Transcriptome analysis of lesional skin demonstrated significant downregulation of several cytokines involved in the T helper (Th) 2 and Th17 pathway with moderate upregulation of Th1 cytokine IFN-γ and T-cell recruitment chemokine CXCL10. The dog was immediately treated with oral fluralaner. Clinical signs of demodicosis resolved after 8 weeks and a trichogram was negative for live and/or dead demodex mites. The dog has remained on twice-daily administration of inhaled fluticasone and oral fluralaner every 3 months for 15 months without a demodicosis relapse, in addition to medication to manage the dog's comorbidities. To the author's knowledge, this is the first case of localized demodicosis caused by an inhaled glucocorticoid in a dog.
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Affiliation(s)
- Cheryl L Vargo
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
| | - Frane Banovic
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USA.
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Shamriz O, Lev A, Simon AJ, Barel O, Javasky E, Matza-Porges S, Shaulov A, Davidovics Z, Toker O, Somech R, Zlotogorski A, Molho-Pessach V, Tal Y. Chronic demodicosis in patients with immune dysregulation: An unexpected infectious manifestation of Signal transducer and activator of transcription (STAT)1 gain-of-function. Clin Exp Immunol 2021; 206:56-67. [PMID: 34114647 DOI: 10.1111/cei.13636] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 05/22/2021] [Accepted: 06/08/2021] [Indexed: 12/24/2022] Open
Abstract
Signal transducer and activator of transcription (STAT)1 heterozygous gain-of-function (GOF) mutations are known to induce immune dysregulation and chronic mucocutaneous candidiasis (CMCC). Previous reports suggest an association between demodicosis and STAT1 GOF. However, immune characterization of these patients is lacking. Here, we present a retrospective analysis of patients with immune dysregulation and STAT1 GOF who presented with facial and ocular demodicosis. In-depth immune phenotyping and functional studies were used to characterize the patients. We identified five patients (three males) from two non-consanguineous Jewish families. The mean age at presentation was 11.11 (range = 0.58-24) years. Clinical presentation included CMCC, chronic demodicosis and immune dysregulation in all patients. Whole-exome and Sanger sequencing revealed a novel heterozygous c.1386C>A; p.S462R STAT1 GOF mutation in four of the five patients. Immunophenotyping demonstrated increased phosphorylated signal transducer and activator of transcription in response to interferon-α stimuli in all patients. The patients also exhibited decreased T cell proliferation capacity and low counts of interleukin-17-producing T cells, as well as low forkhead box protein 3+ regulatory T cells. Specific antibody deficiency was noted in one patient. Treatment for demodicosis included topical ivermectin and metronidazole. Demodicosis may indicate an underlying primary immune deficiency and can be found in patients with STAT1 GOF. Thus, the management of patients with chronic demodicosis should include an immunogenetic evaluation.
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Affiliation(s)
- Oded Shamriz
- Allergy and Clinical Immunology Unit, Department of Medicine, Hadassah Medical Organization, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.,The Lautenberg Center for Immunology and Cancer Research, Institute of Medical Research Israel-Canada, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Atar Lev
- Pediatric Department A and Immunology Service, Jeffrey Modell Foundation Center, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Amos J Simon
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Sheba Cancer Research Center and Institute of Hematology, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
| | - Ortal Barel
- Sheba Cancer Research Center and Institute of Hematology, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel.,The Genomic Unit, Sheba Cancer Research Center, Sheba Medical Center, Ramat Gan, Israel.,Sheba Medical Center, Wohl Institute of Translational Medicine, Ramat Gan, Israel
| | - Elisheva Javasky
- Sheba Cancer Research Center and Institute of Hematology, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel.,The Genomic Unit, Sheba Cancer Research Center, Sheba Medical Center, Ramat Gan, Israel.,Sheba Medical Center, Wohl Institute of Translational Medicine, Ramat Gan, Israel
| | - Sigal Matza-Porges
- Department of Human Genetics, Institute for Medical Research the Hebrew University of Jerusalem,, Jerusalem, Israel.,Department of Biotechnology, Hadassah Academic College, Jerusalem, Israel
| | - Adir Shaulov
- Department of Hematology, Hadassah Medical Organization, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Zev Davidovics
- Gastroenterology Unit, Department of Pediatrics, Hadassah Medical Organization, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Ori Toker
- Allergy and Clinical Immunology Unit, Shaare Zedek Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Raz Somech
- Pediatric Department A and Immunology Service, Jeffrey Modell Foundation Center, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Abraham Zlotogorski
- Pediatric Dermatology Service, Department of Dermatology, Hadassah Medical Organization, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Vered Molho-Pessach
- Pediatric Dermatology Service, Department of Dermatology, Hadassah Medical Organization, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Yuval Tal
- Allergy and Clinical Immunology Unit, Department of Medicine, Hadassah Medical Organization, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
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12
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Xu N, Bai X, Liu Y, Yang Y, Tang B, Shi HN, Vallee I, Boireau P, Liu X, Liu M. The Anti-Inflammatory Immune Response in Early Trichinella spiralis Intestinal Infection Depends on Serine Protease Inhibitor-Mediated Alternative Activation of Macrophages. THE JOURNAL OF IMMUNOLOGY 2021; 206:963-977. [PMID: 33495238 DOI: 10.4049/jimmunol.2000290] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 12/22/2020] [Indexed: 12/21/2022]
Abstract
Trichinella spiralis is recognized for its ability to regulate host immune responses via excretory/secretory (ES) products. Serine protease inhibitors (serpins) play an important role in ES product-mediated immunoregulatory effects during T. spiralis infection. In this study, the immunoregulatory properties of a serpin derived from T. spiralis (Ts-serpin) were explored in BALB/c mice. The results showed that naturally occurring Ts-serpin was detected in the stichosomes of muscle larvae and adult worms. Moreover, enhancing (by injection of a soluble-expressed recombinant Ts-serpin [rTs-serpin]) or blocking (by passive immunization with anti-rTs-serpin serum) the effects of Ts-serpin changed the levels of cytokines related to inflammation induced by T. spiralis infection in the serum, mesenteric lymph nodes, and peritoneal cavity, which then led to a change in the adult worm burden in early T. spiralis infection. Moreover, the phenotypic changes in peritoneal macrophages were found to be related to Ts-serpin-mediated immunoregulation. Furthermore, a STAT6 activation mechanism independent of IL-4Rα has been found to regulate protein-mediated alternative activation of bone marrow-derived macrophages and mimic the immunoregulatory role of Ts-serpin in T. spiralis infection. Finally, the anti-inflammatory properties of rTs-serpin and bone marrow-derived macrophage alternative activation by rTs-serpin were demonstrated using a trinitrobenzene sulfonic acid-induced inflammatory bowel disease model. In summary, a protein-triggered anti-inflammatory mechanism was found to favor the survival of T. spiralis in the early stage of infection and help to elucidate the immunoregulatory effects of T. spiralis on the host immune response.
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Affiliation(s)
- Ning Xu
- Key Laboratory of Zoonosis Research, Ministry of Education, Institute of Zoonosis, College of Veterinary Medicine, Jilin University, Changchun 130062, China
| | - Xue Bai
- Key Laboratory of Zoonosis Research, Ministry of Education, Institute of Zoonosis, College of Veterinary Medicine, Jilin University, Changchun 130062, China
| | - Yan Liu
- Key Laboratory of Zoonosis Research, Ministry of Education, Institute of Zoonosis, College of Veterinary Medicine, Jilin University, Changchun 130062, China
| | - Yaming Yang
- Yunnan Institute of Parasitic Diseases, Pu'er City, Yunnan 665000, China
| | - Bin Tang
- Key Laboratory of Zoonosis Research, Ministry of Education, Institute of Zoonosis, College of Veterinary Medicine, Jilin University, Changchun 130062, China
| | - Hai Ning Shi
- Mucosal Immunology and Biology Research Center, Massachusetts General Hospital, Charlestown, MA 02129; and
| | - Isabelle Vallee
- UMR de Biologie Moléculaire et d'Immunologie Parasitaires, Agence Nationale de Sécurité Sanitaire de l'Alimentation, de l'Environnement et du Travail, École Nationale Vétérinaire d'Alfort, Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement, Université Paris-Est, Laboratoire de Santé Animale, 94706 Maisons-Alfort, France
| | - Pascal Boireau
- UMR de Biologie Moléculaire et d'Immunologie Parasitaires, Agence Nationale de Sécurité Sanitaire de l'Alimentation, de l'Environnement et du Travail, École Nationale Vétérinaire d'Alfort, Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement, Université Paris-Est, Laboratoire de Santé Animale, 94706 Maisons-Alfort, France
| | - Xiaolei Liu
- Key Laboratory of Zoonosis Research, Ministry of Education, Institute of Zoonosis, College of Veterinary Medicine, Jilin University, Changchun 130062, China;
| | - Mingyuan Liu
- Key Laboratory of Zoonosis Research, Ministry of Education, Institute of Zoonosis, College of Veterinary Medicine, Jilin University, Changchun 130062, China;
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