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Xie Y, Lv S, Luo S, Chen Y, Du M, Xu Y, Yang D. The correlation between corona virus disease 2019 and alopecia areata: a literature review. Front Immunol 2024; 15:1347311. [PMID: 39021569 PMCID: PMC11251897 DOI: 10.3389/fimmu.2024.1347311] [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: 11/30/2023] [Accepted: 05/01/2024] [Indexed: 07/20/2024] Open
Abstract
Corona virus disease 2019(COVID-19) is one of the most serious respiratory pandemic diseases threatening human health for centuries. Alopecia areata (AA) is a sudden patchy hair loss, an autoimmune disease, which seriously affects the image and mental health of patients. Evidence shows that the risk of autoimmune diseases significantly increases after COVID-19, and is positively correlated with the severity, with a significant increase in the risk of alopecia in those over 40 years old. The relationship between COVID-19 and AA has become a hot topic of current research. Strengthening the research on the correlation between COVID-19 and AA can help to identify and protect susceptible populations at an early stage. This article reviews the research progress on the epidemiological background of COVID-19 and AA, the situation and possible mechanisms of AA induced by COVID-19 or COVID-19 vaccination, and potential treatment methods.
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Affiliation(s)
- Ying Xie
- School of Clinical Medicine, Beijing University of Chinese Medicine, Beijing, China
- Department of Dermatology, China-Japan Friendship Hospital, Beijing, China
| | - Shuying Lv
- School of Clinical Medicine, Beijing University of Chinese Medicine, Beijing, China
- Department of Dermatology, China-Japan Friendship Hospital, Beijing, China
| | - Sha Luo
- Department of Dermatology, The First Affiliated Hospital of Hunan University of Chinese Medicine, Changsha, China
| | - Yuxuan Chen
- School of Clinical Medicine, Beijing University of Chinese Medicine, Beijing, China
- Department of Dermatology, China-Japan Friendship Hospital, Beijing, China
| | - Meijiao Du
- School of Clinical Medicine, Beijing University of Chinese Medicine, Beijing, China
- Department of Dermatology, China-Japan Friendship Hospital, Beijing, China
| | - Yonglong Xu
- School of Clinical Medicine, Beijing University of Chinese Medicine, Beijing, China
- Department of Dermatology, China-Japan Friendship Hospital, Beijing, China
| | - Dingquan Yang
- Department of Dermatology, China-Japan Friendship Hospital, Beijing, China
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Qiu X, Luo W, Li H, Li T, Huang Y, Huang Q, Zhou R. A Traditional Chinese Medicine, Zhenqi Granule, Potentially Alleviates Dextran Sulfate Sodium-Induced Mouse Colitis Symptoms. BIOLOGY 2024; 13:427. [PMID: 38927307 PMCID: PMC11200386 DOI: 10.3390/biology13060427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Revised: 05/31/2024] [Accepted: 06/05/2024] [Indexed: 06/28/2024]
Abstract
Ulcerative colitis (UC) is an inflammatory bowel disease that causes chronic inflammation in the large intestine. The etiology of UC is complex and incompletely understood, with potential contributing factors including genetic susceptibility, environmental influences, immune dysregulation, and gut barrier dysfunction. Despite available therapeutic drugs, the suboptimal cure rate for UC emphasizes the necessity of developing novel therapeutics. Traditional Chinese Medicine (TCM) has attracted great interest in the treatment of such chronic inflammatory diseases due to its advantages, such as multi-targets and low side effects. In this study, a mouse model of Dextran Sulfate Sodium (DSS)-induced acute colitis was established and the efficacy of Zhenqi Granule, a TCM preparation composed of the extractives from Astragali Radix and Fructus Ligustri Lucidi, was evaluated. The results showed that treatment with Zhenqi Granule prior to or post-DSS induction could alleviate the symptoms of colitis, including weight loss, diarrhea, hematochezia, colon length shortening, and pathological damage of colon tissues of the DSS-treated mice. Further, network pharmacology analysis showed that there were 98 common targets between the active components of Zhenqi Granule and the targets of UC, and the common targets were involved in the regulation of inflammatory signaling pathways. Our results showed that Zhenqi Granule had preventive and therapeutic effects on acute colitis in mice, and the mechanism may be that the active components of Zhenqi Granule participated in the regulation of inflammatory response. This study provided data reference for further exploring the mechanism of Zhenqi Granule and also provided potential treatment strategies for UC.
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Affiliation(s)
- Xiuxiu Qiu
- State Key Laboratory of Agricultural Microbiology, College of Veterinary Medicine, Huazhong Agricultural University, Wuhan 430070, China; (X.Q.); (W.L.); (H.L.); (T.L.); (Y.H.)
| | - Wentao Luo
- State Key Laboratory of Agricultural Microbiology, College of Veterinary Medicine, Huazhong Agricultural University, Wuhan 430070, China; (X.Q.); (W.L.); (H.L.); (T.L.); (Y.H.)
| | - Haotian Li
- State Key Laboratory of Agricultural Microbiology, College of Veterinary Medicine, Huazhong Agricultural University, Wuhan 430070, China; (X.Q.); (W.L.); (H.L.); (T.L.); (Y.H.)
| | - Tingting Li
- State Key Laboratory of Agricultural Microbiology, College of Veterinary Medicine, Huazhong Agricultural University, Wuhan 430070, China; (X.Q.); (W.L.); (H.L.); (T.L.); (Y.H.)
| | - Yaxue Huang
- State Key Laboratory of Agricultural Microbiology, College of Veterinary Medicine, Huazhong Agricultural University, Wuhan 430070, China; (X.Q.); (W.L.); (H.L.); (T.L.); (Y.H.)
| | - Qi Huang
- State Key Laboratory of Agricultural Microbiology, College of Veterinary Medicine, Huazhong Agricultural University, Wuhan 430070, China; (X.Q.); (W.L.); (H.L.); (T.L.); (Y.H.)
- International Research Center for Animal Disease, Ministry of Science & Technology of China, Wuhan 430070, China
- The Cooperative Innovation Center of Sustainable Pig Production, Wuhan 430070, China
| | - Rui Zhou
- State Key Laboratory of Agricultural Microbiology, College of Veterinary Medicine, Huazhong Agricultural University, Wuhan 430070, China; (X.Q.); (W.L.); (H.L.); (T.L.); (Y.H.)
- International Research Center for Animal Disease, Ministry of Science & Technology of China, Wuhan 430070, China
- The Cooperative Innovation Center of Sustainable Pig Production, Wuhan 430070, China
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Gök AM, Aşkın Ö, Serdaroğlu S, Kutlubay Z. Retrospective Analysis of the Effect of Comorbid Atopic Dermatitis on the Treatment Response to Topical Immunotherapy in Pediatric Alopecia Areata Patients. Dermatol Pract Concept 2024; 14:dpc.1401a6. [PMID: 38364396 PMCID: PMC10869029 DOI: 10.5826/dpc.1401a6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/30/2023] [Indexed: 02/18/2024] Open
Abstract
INTRODUCTION Alopecia areata is an organ-specific autoimmune disease. In addition, treatment options are limited in pediatric patients. Topical immunotherapy treatment may be preferred, especially in pediatric patients with severe and/or refractory alopecia areata. OBJECTIVES In this study, it was aimed to examine the effect of atopic dermatitis, which is one of the poor prognostic factors in pediatric alopecia areata, on topical immunotherapy treatment. METHODS The data of patients aged 18 years and younger who received at least 20 sessions of topical immunotherapy with the diagnosis of alopecia areata in our clinic between January 2018 and December 2020 were analyzed. RESULTS A total of 139 patients were included in the study. The mean age of the patients was 10.29 years, 67 (48.20%) of the patients were female, 72 (51.80%) were male, 24 (17.26%) of the patients had mild disease, 115 of them (82.73%) had severe disease. Atopic dermatitis accompanying alopecia areata was detected in 38 of the patients. Inadequate response was obtained in 60 (43.17%) patients and adequate response was obtained in 79 (56.83%) patients with topical immunotherapy treatment. In addition, the presence of atopic dermatitis in the patient group with inadequate response to treatment was found to be statistically significantly higher than the patient group with adequate response to treatment. CONCLUSIONS Topical immunotherapy treatment was found to be effective in 56.83% of pediatric alopecia areata patients included in the study. Our study showed that questioning pediatric alopecia areata patients for atopic dermatitis before topical immunotherapy treatment can predict the response to treatment.
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Affiliation(s)
- Ayşe Mine Gök
- Şırnak State Hospital Dermatology Department, Şırnak, Turkey
| | - Özge Aşkın
- Istanbul University-Cerrahpaşa, Cerrahpaşa Medical Faculty, Dermatology Department, Istanbul, Turkey
| | - Server Serdaroğlu
- Istanbul University-Cerrahpaşa, Cerrahpaşa Medical Faculty, Dermatology Department, Istanbul, Turkey
| | - Zekayi Kutlubay
- Istanbul University-Cerrahpaşa, Cerrahpaşa Medical Faculty, Dermatology Department, Istanbul, Turkey
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Messenger AG, Harries M, Macbeth AE, Chiu WS, Holmes S, Tziotzios C, de Lusignan S. Alopecia areata and risk of common infections: a population-based cohort study. Clin Exp Dermatol 2023; 48:332-338. [PMID: 36702574 DOI: 10.1093/ced/llac106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 11/22/2022] [Accepted: 11/28/2022] [Indexed: 01/22/2023]
Abstract
BACKGROUND It is not known whether alopecia areata (AA) is associated with a greater or reduced risk for infection. AIM We undertook a population-based study exploring associations between AA and common infections. METHODS We extracted primary care records from the UK Oxford-Royal College of General Practitioners Research and Surveillance Centre database (trial registration: NCT04239521). The incidence of common and viral infection composite outcomes, and individual respiratory, gastrointestinal (GI), skin, urinary tract, genital and herpes infections, were compared in people with AA (AA group, n = 10 391) and a propensity-matched control group (n = 41 564). Adjusted hazard ratios (aHRs), controlling for sociodemographic and clinical covariates, and comorbidities were used to estimate the association between AA and each infection over 5 years. RESULTS The incidence (per 100 person-years) of common infections was slightly higher in the AA group [14.2, 95% confidence interval (CI) 13.8-14.6] than the control group (11.7, 95% CI 11.5-11.9). In adjusted analysis, positive associations were observed for composite outcomes (common infections aHR 1.13, 95% CI 1.09-1.17; viral infections aHR 1.11, 95% CI 1.07-1.16) and with respiratory tract, GI, skin and herpes simplex infections (aHR range 1.09-1.32). Excluding people in the control group without a recent consultation with their general practitioner showed no association between AA and infection (common infections aHR 1.01, 95% CI 0.98-1.05, viral infections aHR 0.99, 95% CI 0.95-1.03). CONCLUSIONS The association between AA and common infection may represent a higher propensity of people with AA to engage with healthcare services (and thereby to have infections recorded), rather than a true association between AA and infection. Overall our findings suggest that AA is not associated with a clinically significantly increased or decreased incidence of common infections.
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Affiliation(s)
| | - Matthew Harries
- The Dermatology Centre, Salford Royal Hospital, Northern Care Alliance NHS Foundation Trust, Salford, UK
- Centre for Dermatology Research, Manchester Academic Health Science Centre (MAHSC) & NIHR Manchester Biomedical Research Centre, University of Manchester, Manchester, UK
| | - Abby E Macbeth
- Department of Dermatology, Norfolk & Norwich University Hospitals NHS Foundation Trust, Norwich, UK
| | - Wing Sin Chiu
- Pfizer Ltd, Walton on the Hill, Tadworth, Surrey, UK
| | - Susan Holmes
- Alan Lyell Centre for Dermatology, Queen Elizabeth University Hospital, Glasgow, UK
| | - Christos Tziotzios
- St John's Institute of Dermatology, King's College London, Guys Hospital, London, UK
| | - Simon de Lusignan
- Nuffield Department of Primary Care Health Sciences, University of Oxford, UK
- Royal College of General Practitioners, Research and Surveillance Centre, London, UK
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Holmes S, Harries M, Macbeth AE, Chiu WS, de Lusignan S, Messenger AG, Tziotzios C. Alopecia areata and risk of atopic and autoimmune conditions: population-based cohort study. Clin Exp Dermatol 2023; 48:325-331. [PMID: 36689337 DOI: 10.1093/ced/llac104] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Revised: 11/16/2022] [Accepted: 11/28/2022] [Indexed: 01/22/2023]
Abstract
BACKGROUND Alopecia areata (AA) has features of both autoimmune and atopic pathogenesis, but information on the risk of people with AA developing autoimmune and atopic conditions is limited. OBJECTIVE To assess the prevalence and incidence of atopic and autoimmune conditions in people with AA. METHODS This was a population-based cohort study of 8051 adults with newly diagnosed AA (AA group) and 32 204 adults in the matched control group, using the UK Oxford-Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC) network primary care database, 2009-2018 (trial registration number: NCT04239521). Baseline prevalence of common atopic and autoimmune conditions, and risk of new-onset atopic and autoimmune disease, were estimated. RESULTS Atopic and autoimmune conditions were more prevalent in the AA group than the control group (atopic 37.2% vs. 26.7%, autoimmune 11.5% vs. 7.9%). The AA group were 43% more likely to develop any new-onset atopic condition [adjusted hazard ratio (aHR) 1.43. 95% confidence interval (CI) 1.28-1.61] and 45% more likely to develop any autoimmune condition (aHR 1.45, 95% CI 1.28-1.66) compared with the control group. When examining individual conditions, the AA group were at increased risk of atopic dermatitis (aHR 1.91, 95% CI 1.67-2.19), allergic rhinitis (aHR 1.32, 95% CI 1.14-1.54), autoimmune hypothyroidism (aHR 1.65, 95% CI 1.35-2.02), systemic lupus erythematosus (aHR 4.51, 95% CI 1.88-10.82) and vitiligo (aHR 2.39, 95% CI 1.49-3.82). There was no evidence for a higher incidence of other conditions examined. CONCLUSION People with AA have an increased burden of atopic and autoimmune comorbidity. This supports previous work suggesting that both T helper cell (Th)1 and Th2 immune responses may be implicated in the pathogenesis of AA.
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Affiliation(s)
- Susan Holmes
- Alan Lyell Centre for Dermatology, Queen Elizabeth University Hospital, Glasgow, UK
| | - Matthew Harries
- The Dermatology Centre, Salford Royal Hospital, Northern Care Alliance NHS Foundation Trust, Salford, UK
- Centre for Dermatology Research, Manchester Academic Health Science Centre (MAHSC) and NIHR Manchester Biomedical Research Centre, University of Manchester, Manchester, UK
| | - Abby E Macbeth
- Department of Dermatology, Norfolk & Norwich University Hospitals NHS Foundation Trust, Norwich, UK
| | - Wing S Chiu
- Pfizer Ltd, Walton on the Hill, Tadworth, Surrey, UK
| | - Simon de Lusignan
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
- Royal College of General Practitioners, Research and Surveillance Centre, London, UK
| | | | - Christos Tziotzios
- St John's Institute of Dermatology, King's College London, London, UK
- Guy's Hospital, London, UK
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Thompson AR, Eleftheriadou V, Nesnas J. The mental health associations of vitiligo: UK population-based cohort study. BJPsych Open 2022; 8:e190. [PMID: 36268886 PMCID: PMC9634603 DOI: 10.1192/bjo.2022.591] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Vitiligo is an acquired, autoimmune depigmenting skin disorder that may affect psychological well-being. AIMS To determine the risk and impact of psychological comorbidity in people with new-onset vitiligo. METHOD We conducted a retrospective observational study, using UK general practice data (2004-2020). Adults diagnosed with vitiligo (n = 7224) were matched 1:4 with controls (n = 28 880). Associations within 2 years of diagnosis were assessed for psychological conditions: recurrent depressive disorder (RDD), depressive episodes, non-phobia-related anxiety disorder, social phobia, adjustment disorder, substance misuse, self-harm and suicide attempts. Healthcare utilisation, time off work and unemployment within 1 year were compared in those with and without a mental health condition at vitiligo diagnosis. RESULTS At diagnosis, people with vitiligo had a similar prevalence of mental health conditions as controls, except for anxiety disorder (cases 7.9%, controls 7.0%; P = 0.014). Incident RDD and anxiety disorder were more common in people with vitiligo (RDD: adjusted hazard ratio (aHR) 1.25, 95% CI 1.01-1.55; anxiety disorder: aHR 1.23, 95% CI 1.00-1.51). Risk was highest in Black and minority ethnic individuals (RDD: aHR 1.72, 95% CI 1.06-2.79; depressive episodes: aHR 1.56, 95% CI 1.03-2.37). No association was found with other mental health conditions. People with vitiligo and psychological comorbidity had more primary care encounters, more time off workand higher unemployment. CONCLUSIONS People with vitiligo have a higher incidence of RDD and anxiety disorder than controls, and this risk increase may be greatest in Black and minority ethnic populations.
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Affiliation(s)
- Andrew R Thompson
- South Wales Clinical Psychology Training Programme, Department of Psychology, Cardiff University, Wales, UK
| | | | - John Nesnas
- Inflammation and Immunology, Medical Dermatology, Pfizer Ltd, UK
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Macbeth AE, Holmes S, Harries M, Chiu WS, Tziotzios C, de Lusignan S, Messenger AG, Thompson AR. The associated burden of mental health conditions in alopecia areata: A population-based study in UK primary care. Br J Dermatol 2022; 187:73-81. [PMID: 35157313 PMCID: PMC9542942 DOI: 10.1111/bjd.21055] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 12/24/2021] [Accepted: 02/08/2022] [Indexed: 11/28/2022]
Abstract
Background Alopecia areata (AA) is a common cause of nonscarring hair loss that can have a profound psychological impact. Objectives To assess the co‐occurrence of depression and anxiety in adults with AA compared with the general population, and to evaluate the mental health treatment burden and impact on time off work and unemployment. Methods In total, 5435 people with newly diagnosed AA in UK primary care were identified from the Oxford Royal College of General Practitioners Research and Surveillance Centre network database, and matched to 21 740 controls. In cases and controls, we compared the prevalence and incidence of depressive episodes, recurrent depressive disorder and anxiety disorder, rates of time off work and unemployment, and, in those with pre‐existing mental health conditions, rates of mental health‐related prescribing and referral rates. This observational was registered with ClinicalTrials.gov (NCT04239521). Results Depression and anxiety were more prevalent in people diagnosed with AA than in controls (P < 0·001). People with AA were also more likely to subsequently develop new‐onset depression and anxiety: adjusted hazard ratio (aHR) for recurrent depressive disorder 1·38 [95% confidence interval (CI) 1·13–1·69], depressive episodes aHR 1·30 (95% CI 1·04–1·62) and anxiety disorder aHR 1·33 (95% CI 1·09–1·63); to be issued time off work certificates (aHR 1·56, 95% CI 1·43–1·71); and to be recorded as unemployed (aHR 1·82, 95% CI 1·33–2·49). Higher rates of antidepressant prescribing were also seen in people with AA. Conclusions People with AA have higher rates of depression and anxiety than those without AA. This impacts deleteriously on mental health treatment burden, time off work and unemployment. Evidence‐based mental health treatment programmes are needed for people with AA.
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Affiliation(s)
- Abby E Macbeth
- Department of Dermatology, Norfolk & Norwich University Hospitals NHS Foundation Trust, Norwich, UK
| | - Susan Holmes
- Alan Lyell Centre for Dermatology, Queen Elizabeth University Hospital, Glasgow, UK
| | - Matthew Harries
- The Dermatology Centre, Salford Royal NHS Foundation Trust, Salford, Greater Manchester, UK; Centre for Dermatology Research, University of Manchester, MAHSC and NIHR Manchester Biomedical Research Centre, Manchester, UK
| | - Wing Sin Chiu
- Pfizer Ltd, Walton Oaks, Walton on the Hill, Tadworth, Surrey, KT20 7NS, UK
| | - Christos Tziotzios
- St. John's Institute of Dermatology, King's College London, London, Guy's Hospital, London, SE1 9RT, UK
| | - Simon de Lusignan
- Nuffield Department of Primary Care health Sciences, University of Oxford, UK; Royal College of General Practitioners, Research and Surveillance Centre, London, UK
| | - Andrew G Messenger
- Department of Dermatology, Royal Hallamshire Hospital, Sheffield, S10 2JF, UK
| | - Andrew R Thompson
- South Wales Clinical Psychology Training Programme, Department of Psychology, Cardiff University, 11th Floor, Tower Building, 70 Park Place Cardiff, CF10 3AT, Wales
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The Role of Nutrition in Immune-Mediated, Inflammatory Skin Disease: A Narrative Review. Nutrients 2022; 14:nu14030591. [PMID: 35276950 PMCID: PMC8840467 DOI: 10.3390/nu14030591] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 01/23/2022] [Accepted: 01/27/2022] [Indexed: 11/16/2022] Open
Abstract
Immune-mediated inflammatory skin diseases are characterized by a complex multifactorial etiology, in which genetic and environmental factors interact both in genesis and development of the disease. Nutrition is a complex and fascinating scenario, whose pivotal role in induction, exacerbation, or amelioration of several human diseases has already been well documented. However, owing to the complexity of immune-mediated skin disease clinical course and breadth and variability of human nutrition, their correlation still remains an open debate in literature. It is therefore important for dermatologists to be aware about the scientific basis linking nutrition to inflammatory skin diseases such as psoriasis, atopic dermatitis, hidradenitis suppurativa, bullous diseases, vitiligo, and alopecia areata, and whether changes in diet can influence the clinical course of these diseases. The purpose of this narrative review is to address the role of nutrition in immune-mediated inflammatory skin diseases, in light of the most recent and validate knowledge on this topic. Moreover, whether specific dietary modifications could provide meaningful implementation in planning a therapeutic strategy for patients is evaluated, in accordance with regenerative medicine precepts, a healing-oriented medicine that considers the whole person, including all aspects of the lifestyle.
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A Review of Safety Outcomes from Clinical Trials of Baricitinib in Rheumatology, Dermatology and COVID-19. Adv Ther 2022; 39:4910-4960. [PMID: 36063279 PMCID: PMC9443639 DOI: 10.1007/s12325-022-02281-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 07/21/2022] [Indexed: 01/30/2023]
Abstract
Baricitinib is an oral, selective inhibitor of Janus kinase (JAK)1/JAK2 that transiently and reversibly inhibits many proinflammatory cytokines. This mechanism is a key mediator in a number of chronic inflammatory diseases; accordingly, baricitinib has been studied and approved for the treatment of several rheumatological and dermatological disorders, as well as COVID-19. This narrative review summarises and discusses the safety profile of baricitinib across these diseases, with special focus on adverse events of special interest (AESI) for JAK inhibitors, using integrated safety data sets of clinical trial data, and puts findings into context with the underlying risk in the respective disease populations, using supporting literature. We show that rates of infection with baricitinib generally reflected the inherent risk of the disease populations being treated, with serious infections and herpes zoster being more frequent in rheumatic diseases than in dermatological disorders, and herpes simplex being reported particularly in atopic dermatitis. Similarly, rates of major adverse cardiovascular events (MACE), venous thromboembolism (VTE) and malignancies were generally within or below the ranges reported for the respective disease populations, thereby reflecting the underlying risk; these events were therefore more frequent in patients with rheumatic diseases than in those with dermatological disorders, the latter of whom generally had low absolute risk. AESI were usually more common in patients with risk factors specific for each event. When a population similar to that of ORAL Surveillance was considered, the incidence rate of MACE with baricitinib was numerically lower than that reported with tofacitinib and similar to that of tumour necrosis factor inhibitors. No safety concerns were observed in hospitalised patients with COVID-19 who received baricitinib for up to 14 days. Identifying the patterns and likelihoods of AEs that occur during treatment in large groups of patients with different diseases can help the physician and patient better contextualise the benefit-to-risk ratio for the individual patient.
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