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Lim JJ, Lim SW, Reginald K, Say Y, Liu MH, Chew FT. Association of frequent intake of trans fatty acids and saturated fatty acids in diets with increased susceptibility of atopic dermatitis exacerbation in young Chinese adults: A cross-sectional study in Singapore/Malaysia. SKIN HEALTH AND DISEASE 2024; 4:e330. [PMID: 39104637 PMCID: PMC11297457 DOI: 10.1002/ski2.330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 11/17/2023] [Accepted: 12/24/2023] [Indexed: 08/07/2024]
Abstract
Background & Objective Numerous evidence has attributed diets with a high fatty acids (FAs) intake to be associated with atopic dermatitis (AD) development. Therefore, this study investigated the association between intake frequencies of five dietary FAs and AD exacerbations among young Chinese adults from Singapore and Malaysia. Methods A validated International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire was investigator-administered to 13,561 subjects to collect information on socioeconomic, anthropometric, dietary and lifestyles habits, and personal/family medical histories. Six novel dietary indices were derived to analyse the associations between total FAs, trans fatty acids (TFAs), saturated fatty acids (SFAs), monounsaturated fatty acids, linoleic acids, and alpha-linolenic acids in diets and AD exacerbation. Synergy factor (SF) analysis was used to identify interactions between the dietary FAs to influence disease susceptibility. Results In our multivariable model adjusted for age, gender, BMI, parental eczema, and lifestyle factors, a diet high in total estimated FAs was strongly associated with AD (Adjusted Odds Ratio (AOR): 1.227; 95% Confidence Interval (CI): 1.054-1.429; adjusted p-value <0.01). Particularly, high estimated total TFAs and SFAs were significantly associated with AD exacerbations including chronic and current moderate-to-severe AD. The association between TFAs and AD remained strong even controlled for the total FAs in diets and false discovery rate corrected (AOR: 1.516; 95% CI: 1.094-2.097; adjusted p-value <0.05). Similarly, having a high SFAs in diets was associated with AD (AOR: 1.581; 95% CI: 1.106-2.256; adjusted p-value <0.05) independently on the total FAs in diets. FAs in diets do not interact to influence AD. Conclusion Overall, these results highlighted an association between high dietary TFAs and SFAs and AD exacerbations in an Asian population.
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Affiliation(s)
- Jun Jie Lim
- Department of Biological SciencesFaculty of ScienceNational University of SingaporeSingaporeSingapore
| | - Sing Wei Lim
- Department of Biological SciencesFaculty of ScienceNational University of SingaporeSingaporeSingapore
| | - Kavita Reginald
- Department of Biological SciencesFaculty of ScienceNational University of SingaporeSingaporeSingapore
- Department of Biological SciencesSchool of Medicine and Life SciencesSunway UniversityPetaling JayaMalaysia
| | - Yee‐How Say
- Department of Biological SciencesFaculty of ScienceNational University of SingaporeSingaporeSingapore
- Department of Biological SciencesSchool of Medicine and Life SciencesSunway UniversityPetaling JayaMalaysia
- Department of Biomedical ScienceFaculty of ScienceUniversiti Tunku Abdul Rahman (UTAR)KamparMalaysia
| | - Mei Hui Liu
- Department of Food Science & TechnologyFaculty of ScienceNational University of SingaporeSingaporeSingapore
| | - Fook Tim Chew
- Department of Biological SciencesFaculty of ScienceNational University of SingaporeSingaporeSingapore
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Harbottle Z, Nötzel A, Golding MA, Bhamra M, Kopsch I, Wilking E, Jonsson M, Abrams EM, Halbrich MA, Simons E, Roos LE, Keddy-Grant JA, Gerstner TV, St-Vincent JA, Ekström S, Protudjer JLP. Infantile atopic dermatitis - increasing severity predicts negative impacts on maternal and infant sleep: a mixed methods study. ALLERGY, ASTHMA, AND CLINICAL IMMUNOLOGY : OFFICIAL JOURNAL OF THE CANADIAN SOCIETY OF ALLERGY AND CLINICAL IMMUNOLOGY 2024; 20:21. [PMID: 38519963 PMCID: PMC10960393 DOI: 10.1186/s13223-024-00883-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 02/28/2024] [Indexed: 03/25/2024]
Abstract
BACKGROUND While the impacts of atopic dermatitis (AD) on maternal and child sleep outcomes have been previously explored, less is known about the associations between infantile AD and sleep quality and quantity. OBJECTIVE To describe the perceived causes of AD-associated maternal sleep disturbances and the association between AD severity and infant sleep outcomes. METHODS Mothers with infants aged < 19 months old with a diagnosis of AD were recruited from social media and medical clinics in Winnipeg, Canada between October 2021 and May 2022. Infant AD severity was classified using maternal-reported data on the Patient-Oriented Scoring Atopic Dermatitis tool (PO-SCORAD). Quantitative data were collected via a series of questionnaires with a subset of mothers subsequently completing semi-structured interviews. Quantitative and qualitative data were integrated in the discussion. RESULTS Mothers of infants with moderate/severe AD (6/12) were more likely to report their infant suffering from a higher degree of sleeplessness (i.e., ≥ 5 on a scale of 0-10) over the past 48 h compared to mothers of infants with mild AD (0/18). This was supported by qualitative findings where mothers described how their infant's sleep quality and quantity worsened with AD severity. Additionally, 7/32 mothers reported that their child's AD, regardless of severity, disturbed their sleep. Maternal sleep loss was most commonly attributed to infant itching (6/7), followed by worry (4/7). CONCLUSION Infantile AD severity was associated with worse sleep outcomes for both mothers and infants. We propose that maternal and infantile sleep quality and quantity can be improved by reducing AD severity through adherence to topical treatments.
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Affiliation(s)
- Zoe Harbottle
- Department of Pediatrics and Child Health, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada
- Children's Hospital Research Institute of Manitoba, 501G-715 McDermot Avenue, Winnipeg, MB, Canada
- Department of Food and Human Nutritional Sciences, Faculty of Agricultural and Food Sciences, University of Manitoba, Winnipeg, MB, Canada
| | | | - Michael A Golding
- Department of Pediatrics and Child Health, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada
- Children's Hospital Research Institute of Manitoba, 501G-715 McDermot Avenue, Winnipeg, MB, Canada
| | - Manvir Bhamra
- Department of Pediatrics and Child Health, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada
- Children's Hospital Research Institute of Manitoba, 501G-715 McDermot Avenue, Winnipeg, MB, Canada
- Department of Food and Human Nutritional Sciences, Faculty of Agricultural and Food Sciences, University of Manitoba, Winnipeg, MB, Canada
| | | | | | - Marina Jonsson
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Centre for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - Elissa M Abrams
- Children's Hospital Research Institute of Manitoba, 501G-715 McDermot Avenue, Winnipeg, MB, Canada
- Department of Pediatrics and Child Health, Section of Allergy and Clinical Immunology, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada
- Division of Allergy and Immunology, Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Michelle A Halbrich
- Department of Pediatrics and Child Health, Section of Allergy and Clinical Immunology, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Elinor Simons
- Children's Hospital Research Institute of Manitoba, 501G-715 McDermot Avenue, Winnipeg, MB, Canada
- Department of Pediatrics and Child Health, Section of Allergy and Clinical Immunology, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada
- Children's Allergy & Asthma Education Centre, Health Sciences Centre Winnipeg, Winnipeg, MB, Canada
| | - Leslie E Roos
- Children's Hospital Research Institute of Manitoba, 501G-715 McDermot Avenue, Winnipeg, MB, Canada
- Department of Psychology, Faculty of Arts, University of Manitoba, Winnipeg, MB, Canada
| | - Jill A Keddy-Grant
- Department of Pediatrics and Child Health, Section of Dermatology, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Thomas V Gerstner
- Department of Pediatrics and Child Health, Section of Allergy and Clinical Immunology, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Jo-Anne St-Vincent
- Children's Allergy & Asthma Education Centre, Health Sciences Centre Winnipeg, Winnipeg, MB, Canada
| | - Sandra Ekström
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Centre for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - Jennifer L P Protudjer
- Department of Pediatrics and Child Health, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada.
- Children's Hospital Research Institute of Manitoba, 501G-715 McDermot Avenue, Winnipeg, MB, Canada.
- Department of Food and Human Nutritional Sciences, Faculty of Agricultural and Food Sciences, University of Manitoba, Winnipeg, MB, Canada.
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
- George and Fay Yee Centre for Healthcare Innovation, Winnipeg, MB, Canada.
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Liu Z, Shi Z, Deng Y. Clinical features and biomarker differences of severe intrinsic and extrinsic atopic dermatitis. Cutan Ocul Toxicol 2024; 43:97-103. [PMID: 38258428 DOI: 10.1080/15569527.2023.2300782] [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: 08/08/2023] [Accepted: 12/27/2023] [Indexed: 01/24/2024]
Abstract
OBJECTIVES Atopic dermatitis (AD) can be classified into intrinsic AD(IAD) and extrinsic AD(EAD). However, the differences in clinical features and pathogenesis between these two subtypes of AD are currently unclear. This study aimed to analyse the differences in clinical features and peripheral blood biomarkers between Chinese patients with severe IAD and EAD in order to elucidate the physiopathogenesis of AD. MATERIALS AND METHODS A total of 316 hospitalised patients definitively diagnosed with severe AD were included in this study. There were 72 cases of severe IAD and 244 cases of severe EAD. The clinical features of the patients were recorded in details. Serum total IgE, IgA, IgG, IgM, complementC3/C4, peripheral blood cell counts, lactate dehydrogenase (LDH), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), IL-2R, IL-6, IL-8, and TNF-α in AD patients and 60 age-matched healthy controls were analysed. IAD and EAD had similar severity/Scoring Atopic Dermatitis (SCORAD) scores. RESULTS Compared with healthy controls, IAD patients had significantly higher total IgE, eosinophils, monocytes, LDH, CRP, IL-2R, IL-6, IL-8 and TNF-α, and lower IgM and C4. EAD patients had significantly higher total IgE, IgA, eosinophils, white blood cell (WBC) counts, neutrophils, monocytes, basophils, LDH, CRP, IL-2R, IL-6, IL-8, TNF-α and lower IgM than healthy controls. IAD patients had a higher percentage of rural/urban living and female/male, a shorter course of disease and lower total IgE, eosinophils, WBC counts, neutrophils, monocytes, basophils, LDH, IgG and C4 than EAD patients. SCORAD scores, eosinophils, LDH expression levels increased with total IgE uniquely in patients with EAD. CONCLUSIONS IAD and EAD exhibit specific clinical features and molecular changes. IAD has a more complex physiopathogenesis, and deserves further investigation.
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Affiliation(s)
- Zhong Liu
- Department of Dermatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Department of Dermatology, Traditional Chinese and Western Medicine Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zeqi Shi
- Department of Dermatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yunhua Deng
- Department of Dermatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Lee GW, Kim K, Kim SJ, Shin K, Kim H, Ko HC, Kim MB, Kim B. Therapeutic Effect of Dupilumab on Systemic and Vascular Inflammation in Adults with Severe Atopic Dermatitis: Feasibility Study Using 18F-Fluorodeoxyglucose Positron Emission Tomography-Computed Tomography. Acta Derm Venereol 2023; 103:adv5320. [PMID: 37219501 DOI: 10.2340/actadv.v103.5320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 04/06/2023] [Indexed: 05/24/2023] Open
Abstract
Atopic dermatitis (AD) is an inflammatory skin disease associated with increased systemic and vascular inflammation. Although dupilumab has been proven to be effective against severe AD, imaging studies analysing its inflammation-reducing effect have rarely been reported. The aim of this study was to evaluate the effect of dupilumab on systemic and vascular inflammation in adult patients with severe AD, using 18F-fluorodeoxyglucose positron emission tomography-computed tomography (18F-FDG PET/CT). A total of 33 adult patients with severe AD and 25 healthy controls underwent 18F-FDG PET/CT at baseline. Patients on dupilumab treatment underwent 18F-FDG PET/CT again after achieving a 75% reduction from baseline on the Eczema Area and Severity Index (EASI-75). Patients with AD exhibited increased 18F-FDG uptake values in the liver, spleen, pancreas, and carotid artery compared with healthy controls. However, compared with baseline, there was no statistically significant difference in 18F-FDG uptake in major organs and arteries after achieving EASI-75 with dupilumab treatment. In conclusion, while dupilumab treatment resulted in a significant clinical improvement and reduced serum inflammatory markers in adult patients with severe AD, no changes in systemic and vascular inflammation were observed on 18F-FDG PET/CT imaging.
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Affiliation(s)
- Gi-Wook Lee
- Department of Dermatology, School of Medicine, Pusan National University Hospital, Busan, Korea
| | - Keunyoung Kim
- Department of Nuclear Medicine, Pusan National University Hospital, Busan, Korea
| | - Seong-Jang Kim
- Department of Nuclear Medicine, Pusan National University Hospital, Busan, Korea
| | - Kihyuk Shin
- Department of Dermatology, School of Medicine, Pusan National University Hospital, Busan, Korea
| | - Hoonsoo Kim
- Department of Dermatology, School of Medicine, Pusan National University Hospital, Busan, Korea
| | - Hyun-Chang Ko
- Department of Dermatology, School of Medicine, Pusan National University Hospital, Busan, Korea
| | - Moon-Bum Kim
- Department of Dermatology, School of Medicine, Pusan National University Hospital, Busan, Korea
| | - Byungsoo Kim
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea.
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Gether L, Storgaard H, Kezic S, Jakasa I, Hartmann B, Skov-Jeppesen K, Holst JJ, Pedersen AJ, Forman J, van Hall G, Sørensen OE, Skov L, Røpke MA, Knop FK, Thyssen JP. Effects of topical corticosteroid versus tacrolimus on insulin sensitivity and bone homeostasis in adults with atopic dermatitis-A randomized controlled study. Allergy 2023. [PMID: 36824052 DOI: 10.1111/all.15690] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 01/06/2023] [Accepted: 01/24/2023] [Indexed: 02/25/2023]
Abstract
INTRODUCTION Topical corticosteroids (TCS), used to treat atopic dermatitis (AD), have been associated with type 2 diabetes and osteoporosis in epidemiological studies, possibly explained by systemic absorption. OBJECTIVES We examined whether intensive daily whole-body TCS treatment over 2 weeks followed by twice weekly application for 4 weeks could elicit insulin resistance and increase bone resorption in adults with AD. METHODS A randomized parallel-group double-blind double-dummy non-corticosteroid-based active comparator study design was completed in Copenhagen, Denmark. Thirty-six non-obese, non-diabetic adults with moderate-to-severe AD were randomized to whole-body treatment with betamethasone 17-valerate 0.1% plus a vehicle once daily or tacrolimus 0.1% twice daily after washout. Insulin sensitivity assessed by the hyperinsulinemic-euglycemic clamp combined with tracer infusions and biomarkers of bone formation (P1NP) and resorption (CTX) were evaluated at baseline, after 2 weeks of daily treatment and after further 4 weeks of twice-weekly maintenance treatment. RESULTS AD severity improved with both treatments and systemic inflammation was reduced. After 2 weeks, we observed similar increase in peripheral insulin sensitivity with use of betamethasone (n = 18) and tacrolimus (n = 18). Bone resorption biomarker, CTX, was unchanged, while bone formation marker, P1NP, decreased after betamethasone treatment after both 2 and 6 weeks but remained unchanged in the tacrolimus arm. CONCLUSIONS Whole-body treatment with TCS leads to systemic exposure but appears not to compromise glucose metabolism during short-term use, which may be a result of reduced systemic inflammatory activity. The negative impact on bone formation could be regarded an adverse effect of TCS.
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Affiliation(s)
- Lise Gether
- Center for Clinical Metabolic Research, Herlev-Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
- Department of Dermatology and Allergy, Copenhagen Research Group for Inflammatory Skin (CORGIS), Herlev-Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
- LEO Pharma A/S, Ballerup, Denmark
| | - Heidi Storgaard
- Center for Clinical Metabolic Research, Herlev-Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
- Steno Diabetes Center Copenhagen, Copenhagen, Denmark
| | - Sanja Kezic
- Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Ivone Jakasa
- Department of Chemistry and Biochemistry, Laboratory for Analytical Chemistry, Faculty of Food Technology and Biotechnology, University of Zagreb, Zagreb, Croatia
| | - Bolette Hartmann
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Kirsa Skov-Jeppesen
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jens J Holst
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | | | - Julie Forman
- Section of Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Gerrit van Hall
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Clinical Metabolomics Core Facility, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | | | - Lone Skov
- Department of Dermatology and Allergy, Copenhagen Research Group for Inflammatory Skin (CORGIS), Herlev-Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Mads A Røpke
- LEO Pharma A/S, Ballerup, Denmark
- Department of Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark
| | - Filip K Knop
- Center for Clinical Metabolic Research, Herlev-Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jacob Pontoppidan Thyssen
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Dermatology and Venereology, Bispebjerg-Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
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Jishna P, Dominic S. Acute Phase Reactants: Relevance in Dermatology. Indian Dermatol Online J 2022; 14:1-8. [PMID: 36776186 PMCID: PMC9910534 DOI: 10.4103/idoj.idoj_174_21] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 07/03/2022] [Accepted: 07/24/2022] [Indexed: 12/30/2022] Open
Abstract
Acute phase reactants (APRs) are a heterogeneous group of plasma proteins whose concentration either increases or decreases by at least 25% during an inflammatory process. The conditions that commonly lead to acute phase response are infection, trauma, burns, tissue infarction, inflammatory conditions, and advanced malignancy. APRs are elevated in all infective conditions. In skin and soft tissue infection, the levels of erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) help to predict the severity of infection. Procalcitonin can be used to differentiate between viral and bacterial infections. During active stages of systemic lupus erythematosus (SLE), ESR is elevated, but CRP either remains normal or shows only moderate elevation. In the case of superadded bacterial infection in SLE, CRP is elevated. In SLE, ferritin levels are elevated during the active stage of the disease. Serum amyloid antigen (SAA) and CRP levels are significantly higher in patients with early and late stages of diffuse systemic sclerosis. Elevated levels of serum ferritin are seen in rheumatoid arthritis and adult-onset Still's disease. CRP, SAA, and α2-macroglobulin (α 2M) are elevated in active psoriasis. In severe psoriasis, the ferritin-iron ratio is elevated. In drug-induced maculopapular rash, drug-induced hyperaemic vasculitis, and severe drug-induced cutaneous adverse reactions, CRP levels are elevated during the active stages. Neoplastic diseases in general are accompanied by increased serum ferritin. Further detailed studies are required to explore the clinical significance of APRs in dermatology and the scope of their possible application as a diagnostic tool.
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Affiliation(s)
- Pulpadathil Jishna
- Department of Dermatology, Government Medical College, Kozhikode, Kerala, India,Address for correspondence: Dr. Pulpadathil Jishna, Department of Dermatology, Govt. Medical College Kozhikode - 673008, Kerala, India. E-mail:
| | - Swapna Dominic
- Department of Dermatology, Government Medical College, Kozhikode, Kerala, India
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7
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Lee SH, Bae Y, Park YL. Clinical Implication of Serum Adiponectin Levels in Adult Patients with Atopic Dermatitis. J Clin Med 2022; 11:6255. [PMID: 36362483 PMCID: PMC9656570 DOI: 10.3390/jcm11216255] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 10/19/2022] [Accepted: 10/20/2022] [Indexed: 04/17/2024] Open
Abstract
Atopic dermatitis (AD) is characterized by chronic, relapsing, pruritic inflammatory skin disease. Adiponectin has been reported to have anti-inflammatory effects not only on metabolic disorders but also on various inflammatory disorders. The study aimed to validate adiponectin as a potential biomarker for AD disease severity and treatment response. Seventy-five patients with AD and 28 healthy volunteers were enrolled in the study. Patient information, including Eczema Area and Severity Index (EASI) scores and pruritus numeric rating scales (NRSs), were collected. An enzyme linked immunosorbent assay (ELISA) was conducted to measure levels of serum adiponectin. Additionally, sera of patients treated with dupilumab were collected and measured at 16 and 52 weeks from baseline. Serum adiponectin levels were significantly lower in moderate and severe AD patients than in the control and mild AD patients. Serum adiponectin level was negatively correlated with the EASI score and pruritus NRS. However, no significant changes were observed according to biologic treatment for AD. Low serum adiponectin levels are associated with moderate to severe AD, suggesting a potential role for adiponectin as a biomarker for severity assessment of AD.
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Affiliation(s)
- Sul-Hee Lee
- Department of Dermatology, Soon Chun Hyang University Bucheon Hospital, Bucheon 14584, Korea
| | - Youin Bae
- Department of Dermatology, College of Medicine, Hallym University, Hallym University Dongtan Sacred Heart Hospital, Hwaseong 18450, Korea
| | - Young-Lip Park
- Department of Dermatology, Soon Chun Hyang University Bucheon Hospital, Bucheon 14584, Korea
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Mastraftsi S, Vrioni G, Bakakis M, Nicolaidou E, Rigopoulos D, Stratigos AJ, Gregoriou S. Atopic Dermatitis: Striving for Reliable Biomarkers. J Clin Med 2022; 11:jcm11164639. [PMID: 36012878 PMCID: PMC9410433 DOI: 10.3390/jcm11164639] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 08/02/2022] [Accepted: 08/07/2022] [Indexed: 11/16/2022] Open
Abstract
Atopic dermatitis (AD) is a highly heterogeneous inflammatory disease regarding both its pathophysiology and clinical manifestations. However, it is treated according to the “one-size-fits-all” approach, which may restrict response to treatment. Thus, there is an unmet need for the stratification of patients with AD into distinct endotypes and clinical phenotypes based on biomarkers that will contribute to the development of precision medicine in AD. The development of reliable biomarkers that may distinguish which patients with AD are most likely to benefit from specific targeted therapies is a complex procedure and to date none of the identified candidate biomarkers for AD has been validated for use in routine clinical practice. Reliable biomarkers in AD are expected to improve diagnosis, evaluate disease severity, predict the course of disease, the development of comorbidities, or the therapeutic response, resulting in effective and personalized treatment of AD. Among the studied AD potential biomarkers, thymus and activation-regulated chemokine/C-C motif ligand 17 (TARC/CCL17) has the greatest evidence-based support for becoming a reliable biomarker in AD correlated with disease severity in both children and adults. In this review, we present the most prominent candidate biomarkers in AD and their suggested use.
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Affiliation(s)
- Styliani Mastraftsi
- 1st Department of Dermatology and Venereology, Andreas Sygros Hospital for Skin and Venereal Diseases, Medical School, National and Kapodistrian University of Athens, 16121 Athens, Greece
- Correspondence: ; Tel.: +30-6974819341
| | - Georgia Vrioni
- 1st Department of Dermatology and Venereology, Andreas Sygros Hospital for Skin and Venereal Diseases, Medical School, National and Kapodistrian University of Athens, 16121 Athens, Greece
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Michail Bakakis
- 1st Department of Dermatology and Venereology, Andreas Sygros Hospital for Skin and Venereal Diseases, Medical School, National and Kapodistrian University of Athens, 16121 Athens, Greece
| | - Electra Nicolaidou
- 1st Department of Dermatology and Venereology, Andreas Sygros Hospital for Skin and Venereal Diseases, Medical School, National and Kapodistrian University of Athens, 16121 Athens, Greece
| | - Dimitrios Rigopoulos
- 1st Department of Dermatology and Venereology, Andreas Sygros Hospital for Skin and Venereal Diseases, Medical School, National and Kapodistrian University of Athens, 16121 Athens, Greece
| | - Alexander J. Stratigos
- 1st Department of Dermatology and Venereology, Andreas Sygros Hospital for Skin and Venereal Diseases, Medical School, National and Kapodistrian University of Athens, 16121 Athens, Greece
| | - Stamatios Gregoriou
- 1st Department of Dermatology and Venereology, Andreas Sygros Hospital for Skin and Venereal Diseases, Medical School, National and Kapodistrian University of Athens, 16121 Athens, Greece
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The Use of Real-World Data to Evaluate the Association Between Atopic Dermatitis and Cardiovascular Disease: A Retrospective Claims Analysis. Dermatol Ther (Heidelb) 2021; 11:1707-1715. [PMID: 34449070 PMCID: PMC8484421 DOI: 10.1007/s13555-021-00587-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 07/27/2021] [Indexed: 10/30/2022] Open
Abstract
INTRODUCTION Atopic dermatitis (AD) is a systemic inflammatory condition that may increase the risk of cardiovascular disease (CVD); however, ongoing debate exists surrounding its direct association. We aimed to elucidate whether AD contributes to a higher incidence of CVD and major adverse cardiovascular events (MACE) in adult patients with AD, independent of metabolic disorders. METHODS We retrospectively analyzed a large US-based population of patients with AD (≥ 18 years of age). Logistic regression estimated the risk of CVD and MACE in adult patients with AD, independent of metabolic disorders (including diabetes, hypertension, and obesity). RESULTS The odds ratio (OR; 95% confidence interval [CI]) for patients without metabolic disorders was 1.25 (1.13, 1.39) for CVD and 1.22 (1.01, 1.47) for MACE. The OR (95% CI) for AD patients with metabolic disorders was 1.09 (1.07, 1.12) for CVD and 1.14 (1.09, 1.18) for MACE. This trend was even more pronounced after long-term follow-up (≥ 3 years). Lifestyle and health behavioral factors of the subjects were not available in the dataset. The lack of control for these factors could potentially confound our results. CONCLUSIONS Atopic dermatitis may contribute to the risk of developing CVD and MACE in adults, independent of metabolic disorders.
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Ha EK, Kim JH, Yon DK, Lee SW, Kim MA, Lee KS, Sung M, Jee HM, Shin YH, Han MY. Association of serum lipopolysaccharide-binding protein level with sensitization to food allergens in children. Sci Rep 2021; 11:2143. [PMID: 33495502 PMCID: PMC7835372 DOI: 10.1038/s41598-020-79241-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 10/19/2020] [Indexed: 12/31/2022] Open
Abstract
Lipopolysaccharide (LPS)-binding protein (LBP) is an acute-phase reactant that mediates innate immune responses triggered by LPS. Recent studies indicated a positive correlation of circulating LBP level with chronic low-grade inflammation, a condition present in many non-communicable diseases. We determined the association of serum LBP concentration with allergic sensitization in a general pediatric population. Serum LBP was measured in a sample of children (n = 356; mean age = 9.6 ± 0.2 years) in this population-based cross-sectional study. Skin prick tests (SPTs) were performed to assess allergic sensitization to 22 common inhalant and food allergens. One hundred and seven children (30.1%) were nonsensitized, 160 (44.9%) were monosensitized, and 89 (25.0%) were polysensitized. Children who were mono- or polysensitized had a significantly higher median serum LBP level (25.5 ng/mL, inter-quartile range [IQR] 20.3-30.7) than those who were nonsensitized (20.3 ng/mL, IQR = 14.81-25.8, P < 0.0001). Multivariate logistic regression analysis with adjustment for confounders indicated that serum LBP level was positively associated with allergic sensitization overall (adjusted odds ratio [aOR] 1.041; 95% CI 1.007-1.076, P = 0.016), with sensitization to food allergens in particular (aOR 1.080, 95% CI 1.029-1.133, P = 0.002), but not with sensitization to aeroallergens (aOR 1.010, 95% CI 0.982-1.040, P = 0.467). LBP level was not associated with allergic diseases after adjustment. We suggest the possibility of sensitization to food allergens may be related to gut-derived low-grade inflammation, and large sized longitudinal investigations are needed to elucidate the relationship.
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Affiliation(s)
- Eun Kyo Ha
- Department of Pediatris, Hallym University Kangnam Sacred Heart Hospital, Seoul, Republic of Korea
| | - Ju Hee Kim
- Department of Pediatrics, CHA Bundang Medical Center, CHA University School of Medicine, CHA University, 351 Yatap-dong, Bundang-gu, Seongnam, Gyonggi-do, 13496, Republic of Korea
| | - Dong Keon Yon
- Department of Pediatrics, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Seung Won Lee
- Department of Data Science, Sejong University College of Software Convergence, Seoul, Republic of Korea
| | - Mi Ae Kim
- Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea
| | - Kyung Suk Lee
- Department of Pediatrics, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Republic of Korea
| | - Myongsoon Sung
- Department of Pediatrics, Soon Chun Hyang University Gumi Hospital, Soon Chun Hyang University College of Medicine, Gumi-si, Republic of Korea
| | - Hye Mi Jee
- Department of Pediatrics, CHA Bundang Medical Center, CHA University School of Medicine, CHA University, 351 Yatap-dong, Bundang-gu, Seongnam, Gyonggi-do, 13496, Republic of Korea
| | - Youn Ho Shin
- Deparment of Pediatrics, CHA Gangnam Medical Center, CHA University School of Medicine, CHA University, 566 Nonhyeon-ro, Gangnam-gu, Seoul, 06135, Republic of Korea.
| | - Man Yong Han
- Department of Pediatrics, CHA Bundang Medical Center, CHA University School of Medicine, CHA University, 351 Yatap-dong, Bundang-gu, Seongnam, Gyonggi-do, 13496, Republic of Korea.
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Wang T, Zhou Y, Li X, Gao S, Yang Q. Comparison of postoperative effectiveness of less invasive short external rotator sparing approach versus standard posterior approach for total hip arthroplasty. J Orthop Surg Res 2021; 16:46. [PMID: 33430904 PMCID: PMC7802290 DOI: 10.1186/s13018-020-02188-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 12/25/2020] [Indexed: 11/17/2022] Open
Abstract
Background Most of the studies assessing the corrective posterior total hip arthroplasty (THA) mainly focused on the mini-incision approach. Studies exploring the short external rotator sparing approach are rare. Therefore, this study aimed to compare the effectiveness of standard posterior approach and short external rotator sparing approach. Methods This prospective observational study included 126 patients who underwent THA in June 2017–June 2018. Patients were assigned to standard (standard posterior approach) and corrective (short external rotator sparing approach) groups based on the surgical method. Surgical data were recorded postoperatively. Postoperative hip joint recovery was assessed using the times to ambulation and independent stair use, and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, Harris score, and Oxford hip score (OHS) at 2 and 8 postoperative weeks. The visual analog scale (VAS) was used for postoperative pain assessment. Results Postoperative changes of creatine kinase (CK), myoglobin, CRP, and prosthesis position were similar in both groups (P > 0.05). However, intraoperative blood loss (P < 0.001) and postoperative 6-h drainage volume (P = 0.03), hospital stay, blood transfusion rate, and times to ambulation and independent stair use were significantly reduced in the corrective group. Postoperatively, Oxford, and WOMAC scores significantly decreased in both groups. After surgery, the VAS score was more overtly decreased in the corrective group compared with the standard group. Conclusions This study concluded that the less invasive short external rotator sparing approach for THA caused less damage, reducing perioperative blood loss, shortening functional recovery time, maintaining prosthesis stability, and improving postoperative pain.
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Affiliation(s)
- Tianbao Wang
- The Orthopedics Department, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, No. 365 Renmin East Road, Jinhua City, 321000, Zhejiang Province, China
| | - Yongwei Zhou
- The Orthopedics Department, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, No. 365 Renmin East Road, Jinhua City, 321000, Zhejiang Province, China
| | - Xiaofei Li
- The Orthopedics Department, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, No. 365 Renmin East Road, Jinhua City, 321000, Zhejiang Province, China
| | - Siqi Gao
- The Orthopedics Department, Wuyi TCM Hospital Medical Community, No.186 Wuyang East Road, Jinhua City, 321000, Zhejiang Province, China
| | - Qining Yang
- The Orthopedics Department, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, No. 365 Renmin East Road, Jinhua City, 321000, Zhejiang Province, China.
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Rossi M, Rovati C, Arisi M, Tomasi C, Calzavara-Pinton I, Venturini M, Calzavara-Pinton P. A Short Cycle of Narrow-Band UVB Phototherapy in the Early Phase of Dupilumab Therapy Can Provide a Quicker Improvement of Severe Atopic Dermatitis. Dermatology 2021; 237:407-415. [PMID: 33401279 DOI: 10.1159/000512456] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 10/20/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Since the best clinical response to dupilumab is achieved after 12-16 weeks, a combination therapy at the beginning of the treatment could be a helpful strategy to reach a faster response in patients with severe atopic dermatitis (AD). OBJECTIVES To quantify the benefit of a combination of dupilumab treatment with a short course of narrow-band ultraviolet B (NB-UVB) phototherapy. METHODS In the present pilot study adult patients suffering from severe AD were enrolled with a 2:1 ratio to receive treatment with dupilumab alone or dupilumab plus NB-UVB phototherapy, for 12 weeks. After the twelfth week, all patients received dupilumab only. A follow-up visit took place after 16 weeks. Both clinician-oriented and patient-oriented scores were assessed at baseline (T0) and after 4 (T1), 12 (T2) and 16 (T3) weeks. RESULTS Forty-five adult patients were enrolled in the study. Both treatment regimens were well tolerated and very effective on all measured scores (EASI, SCORAD, BSA, NRS of itching, NRS of sleep loss, DLQI, POEM and HADS), but the combined regimen led to a more robust clinical improvement of lesions and relief of symptoms after 4 weeks. However, after 12 and 16 weeks, the additional therapeutic effect of phototherapy weakened. CONCLUSION NB-UVB phototherapy can provide a faster remission of severe AD in the first few weeks of dupilumab therapy.
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Affiliation(s)
- Mariateresa Rossi
- Department of Dermatology, ASST Spedali Civili di Brescia, University of Brescia, Brescia, Italy
| | - Chiara Rovati
- Department of Dermatology, ASST Spedali Civili di Brescia, University of Brescia, Brescia, Italy,
| | - Mariachiara Arisi
- Department of Dermatology, ASST Spedali Civili di Brescia, University of Brescia, Brescia, Italy
| | - Cesare Tomasi
- Department of Experimental and Applied Medicine, ASST Spedali Civili di Brescia, University of Brescia, Brescia, Italy
| | - Irene Calzavara-Pinton
- Department of Dermatology, ASST Spedali Civili di Brescia, University of Brescia, Brescia, Italy
| | - Marina Venturini
- Department of Dermatology, ASST Spedali Civili di Brescia, University of Brescia, Brescia, Italy
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Ungar B, Pavel AB, Robson PM, Kaufman A, Pruzan A, Brunner P, Kaushik S, Krueger JG, Lebwohl MG, Mani V, Fayad ZA, Guttman-Yassky E. A Preliminary 18F-FDG-PET/MRI Study Shows Increased Vascular Inflammation in Moderate-to-Severe Atopic Dermatitis. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2020; 8:3500-3506. [PMID: 32721606 DOI: 10.1016/j.jaip.2020.07.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 06/20/2020] [Accepted: 07/14/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND Recent data suggest that patients with atopic dermatitis (AD) have increased systemic immune activation and cardiovascular risk. However, unlike psoriasis, evaluation of active vascular inflammation using state-of-the-art imaging is lacking in AD. OBJECTIVE To assess aortic and carotid vascular inflammation using 18F-fluorodeoxyglucose-positron emission tomography/magnetic resonance imaging (18F-FDG-PET/MRI) imaging in moderate-to-severe AD versus healthy individuals. METHODS A total of 27 patients with moderate-to-severe AD and 12 healthy controls were imaged using 18F-FDG-PET/MRI. Target-to-background ratio (TBR) values were calculated in multiple segments of the aorta and carotid vessels. RESULTS Patients with AD had elevated aortic max TBR (fold change [FCH] = 1.45, P = .057) versus healthy controls and significantly elevated mean TBR (FCH = 1.20; P < .05) in the right carotid (RC) arteries versus controls. When examining greatest focal inflammation (most diseased segment [MDS] TBR), patients with AD had higher aortic inflammation (FCH = 1.28; P = .052). AD clinical severity significantly correlated with C-reactive protein (ρ = 0.60, P < .01) and with RC mean TBR levels (ρ = 0.60, P = .04). Stratifying patients into moderate-to-severe and very severe AD showed greater RC mean TBR in patients with very severe AD versus controls (FCH = 1.31; P = .02) and versus patients with moderate/severe AD (FCH = 1.23, P = .05). Aortic inflammation was also significantly greater in patients with very severe AD versus controls (max TBR: FCH = 1.6, P = .04; MDS TBR: FCH = 1.73, P = .03). CONCLUSIONS This preliminary study is the first that establishes greater vascular (aorta and carotid) inflammation in moderate-to-severe AD versus healthy controls. Furthermore, very severe AD showed higher inflammation than both moderate/severe patients and healthy controls. Future studies with larger patient cohorts and evaluation before and after treatment are needed to determine the extent to which vascular inflammation in AD is modifiable.
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Affiliation(s)
- Benjamin Ungar
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Ana B Pavel
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Philip M Robson
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY; The BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Audrey Kaufman
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY; The BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Alison Pruzan
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY; The BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Patrick Brunner
- The Laboratory for Investigative Dermatology, The Rockefeller University, New York, NY
| | - Shivani Kaushik
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - James G Krueger
- The Laboratory for Investigative Dermatology, The Rockefeller University, New York, NY
| | - Mark G Lebwohl
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Venkatesh Mani
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY; The BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Zahi A Fayad
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY; The BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Emma Guttman-Yassky
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY; The Laboratory for Investigative Dermatology, The Rockefeller University, New York, NY; Department of Dermatology and the Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY.
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14
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Güneş H, Nazik H, Özkars MY, Parlak N, Yildiz A, Duyuran Ö, Yalçin BA. The assessment of skin sebum and moisture content of infants with atopic dermatitis. Turk J Med Sci 2020; 50:844-848. [PMID: 32283889 PMCID: PMC7379435 DOI: 10.3906/sag-1912-56] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Accepted: 04/07/2020] [Indexed: 11/03/2022] Open
Abstract
Background/aim Atopic dermatitis (AD) is a chronic, inflammatory skin disorder characterized by dry skin, pruritus and eczematous lesions. The aim of this study is to evaluate the skin moisture and sebum content of the infants with AD and its relationship between the disease severity. Materials and methods For this cross-sectional and case-control study we included 49 infants with AD aged between 2 and 24 months and 34 healthy infants with the same age and sex as a control group. Skin moisture and sebum content were measured by the bio- impedance method and recorded. Skin prick tests, total IgE levels and food-specific (milk, egg) IgE levels were performed. Results There was a significant difference between the groups in terms of mean skin moisture and sebum content percentage (P < 0.001, both). The mean skin moisture and sebum content were correlated with CRP in patients with AD (P < 0.01, r = –1.00, both), but we did not find any correlation between these parameters with the disease severity. Conclusion We found that skin moisture and sebum content were low even in unaffected areas in AD. The skin structure of these patients may contribute to the pathogenesis of the disease.
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Affiliation(s)
- Hatice Güneş
- Department of Pediatrics, Faculty of Medicine, Kahramanmaraş Sütçü İmam University, Kahramanmaraş, Turkey
| | - Hülya Nazik
- Department of Dermatology, Faculty of Medicine, Kahramanmaraş Sütçü İmam University, Kahramanmaraş, Turkey
| | - Mehmet Yaşar Özkars
- Division of Allergy and Immunology, Department of Pediatrics, Faculty of Medicine, Kahramanmaraş Sütçü İmam University, Kahramanmaraş, Turkey
| | - Nurgül Parlak
- Department of Pediatrics, Faculty of Medicine, Kahramanmaraş Sütçü İmam University, Kahramanmaraş, Turkey
| | - Ayten Yildiz
- Department of Pediatrics, Faculty of Medicine, Kahramanmaraş Sütçü İmam University, Kahramanmaraş, Turkey
| | - Ömer Duyuran
- Department of Pediatrics, Faculty of Medicine, Kahramanmaraş Sütçü İmam University, Kahramanmaraş, Turkey
| | - Bahaüddin Ahmed Yalçin
- Department of Pediatrics, Faculty of Medicine, Kahramanmaraş Sütçü İmam University, Kahramanmaraş, Turkey
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Liu X, Michael S, Bharti K, Ferrer M, Song MJ. A biofabricated vascularized skin model of atopic dermatitis for preclinical studies. Biofabrication 2020; 12:035002. [PMID: 32059197 DOI: 10.1088/1758-5090/ab76a1] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Three-dimensional (3D) biofabrication techniques enable the production of multicellular tissue models as assay platforms for drug screening. The increased cellular and physiological complexity in these 3D tissue models should recapitulate the relevant biological environment found in the body. Here we describe the use of 3D bioprinting techniques to fabricate skin equivalent tissues of varying physiological complexity, including human epidermis, non-vascularized and vascularized full-thickness skin tissue equivalents, in a multi-well platform to enable drug screening. Human keratinocytes, fibroblasts, and pericytes, and induced pluripotent stem cell-derived endothelial cells were used in the biofabrication process to produce the varying complexity. The skin equivalents exhibit the correct structural markers of dermis and epidermis stratification, with physiological functions of the skin barrier. The robustness, versatility and reproducibility of the biofabrication techniques are further highlighted by the generation of atopic dermatitis (AD)-disease like tissues. These AD models demonstrate several clinical hallmarks of the disease, including: (i) spongiosis and hyperplasia; (ii) early and terminal expression of differentiation proteins; and (iii) increases in levels of pro-inflammatory cytokines. We show the pre-clinical relevance of the biofabricated AD tissue models to correct disease phenotype by testing the effects of dexamethasone, an anti-inflammatory corticosteroid, and three Janus Kinase inhibitors from clinical trials for AD. This study demonstrates the development of a versatile and reproducible bioprinting approach to create human skin equivalents with a range of cellular complexity for disease modeling. In addition, we establish several assay readouts that are quantifiable, robust, AD relevant, and can be scaled up for compound screening. The results show that the cellular complexity of the tissues develops a more physiologically relevant AD disease model. Thus, the skin models in this study offer an in vitro approach for the rapid understanding of pathological mechanisms, and testing for efficacy of action and toxic effects of drugs.
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Affiliation(s)
- Xue Liu
- National Center for Advancing Translational Sciences, National Institute of Health, Rockville, MD, United States of America
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Czarnowicki T, He H, Canter T, Han J, Lefferdink R, Erickson T, Rangel S, Kameyama N, Kim HJ, Pavel AB, Estrada Y, Krueger JG, Paller AS, Guttman-Yassky E. Evolution of pathologic T-cell subsets in patients with atopic dermatitis from infancy to adulthood. J Allergy Clin Immunol 2019; 145:215-228. [PMID: 31626841 DOI: 10.1016/j.jaci.2019.09.031] [Citation(s) in RCA: 69] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2019] [Revised: 08/23/2019] [Accepted: 09/12/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND The circulating immune phenotype was defined in adults and young children with early atopic dermatitis (AD), but chronologic changes in the blood of infants and children with AD through adolescence have not been explored. OBJECTIVE We sought to compare immune activation and cytokine polarization in the blood of 0- to 5-year-old (n = 39), 6- to 11-year-old (n = 26), 12- to 17-year-old (n = 21) and 18-year-old or older (n = 43) patients with AD versus age-matched control subjects. METHODS Flow cytometry was used to measure IFN-γ, IL-9, IL-13, IL-17, and IL-22 cytokine levels in CD4+/CD8+ T cells, with inducible costimulator molecule and HLA-DR defining midterm and long-term T-cell activation, respectively, within skin-homing/cutaneous lymphocyte antigen (CLA)+ versus systemic/CLA- T cells. Unsupervised clustering differentiated patients based on their blood biomarker frequencies. RESULTS Although CLA+ TH1 frequencies were significantly lower in infants with AD versus all older patients (P < .01), frequencies of CLA+ TH2 T cells were similarly expanded across all AD age groups compared with control subjects (P < .05). After infancy, CLA- TH2 frequencies were increased in patients with AD in all age groups, suggesting systemic immune activation with disease chronicity. IL-22 frequencies serially increased from normal levels in infants to highly significant levels in adolescents and adults compared with levels in respective control subjects (P < .01). Unsupervised clustering aligned the AD profiles along an age-related spectrum from infancy to adulthood (eg, inducible costimulator molecule and IL-22). CONCLUSIONS The adult AD phenotype is achieved only in adulthood. Unique cytokine signatures characterizing individual pediatric endotypes might require age-specific therapies. Future longitudinal studies, comparing the profile of patients with cleared versus persistent pediatric AD, might define age-specific changes that predict AD clearance.
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Affiliation(s)
- Tali Czarnowicki
- Department of Dermatology and the Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY; Laboratory for Investigative Dermatology, Rockefeller University, New York, NY
| | - Helen He
- Department of Dermatology and the Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Talia Canter
- Departments of Dermatology and Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Ill
| | - Joseph Han
- Department of Dermatology and the Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Rachel Lefferdink
- Departments of Dermatology and Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Ill
| | - Taylor Erickson
- Departments of Dermatology and Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Ill
| | - Stephanie Rangel
- Departments of Dermatology and Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Ill
| | - Naoya Kameyama
- Department of Dermatology and the Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Hyun Je Kim
- Department of Dermatology and the Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Ana B Pavel
- Department of Dermatology and the Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Yeriel Estrada
- Department of Dermatology and the Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY
| | - James G Krueger
- Laboratory for Investigative Dermatology, Rockefeller University, New York, NY
| | - Amy S Paller
- Departments of Dermatology and Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Ill
| | - Emma Guttman-Yassky
- Department of Dermatology and the Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, NY.
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Choi HS, Jang HS, Kang KM, Choi BO. Symptom palliation of hypofractionated radiotherapy for patients with incurable inflammatory breast cancer. Radiat Oncol 2019; 14:110. [PMID: 31221161 PMCID: PMC6585064 DOI: 10.1186/s13014-019-1320-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 06/11/2019] [Indexed: 12/22/2022] Open
Abstract
Background Incurable inflammatory breast cancer (IBC) patients occasionally suffer from general symptoms such as breast pain, bleeding, ulceration, and discharge, and thus require palliative radiotherapy (RT). Hypofractionated RT has many advantages in palliative settings, but very few studies on IBC have been conducted. This study was conducted to evaluate the effects of hypofractionated RT on symptomatic IBC patients. Methods Twenty-two patients with IBC who underwent hypofractionated palliative RT between 2010 and 2016 were retrospectively analyzed. RT was performed at a total dose of 42.5–55 Gy with 2.5–3 Gy per fraction. The treatment effects were evaluated with respect to symptom improvement, tumor response, and treatment-related toxicity. Results The main symptoms that the patients complained of before RT were pain, bleeding, and discharge. According to the percentage of symptom relief compared with pre-RT symptoms, the number of patients with < 30, 30–70%, and ≥ 70% were 2 (9.1%), 7 (31.8%), and 13 (59.1%), respectively. Eighteen (81.8%) patients showed tumor response. No patient experienced grade 3 or higher acute or chronic toxicity during a median follow-up period of 13 months. In univariate analysis, symptom type was a significant factor for predicting the degree of symptom relief. Meanwhile, RT field and C-reactive protein increase were significant factors for predicting the incidence of radiation-induced skin toxicity. Conclusions Hypofractionated RT could safely and effectively relieve symptoms among incurable symptomatic IBC patients.
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Affiliation(s)
- Hoon Sik Choi
- Department of Radiation Oncology, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, 13 Samjungja-ro, Changwon, 51472, Republic of Korea
| | - Hong Seok Jang
- Department of Radiation Oncology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, South Korea
| | - Ki Mun Kang
- Department of Radiation Oncology, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, 13 Samjungja-ro, Changwon, 51472, Republic of Korea. .,Institute of Health Science, Gyeongsang National University, Jinju, Republic of Korea.
| | - Byung-Ock Choi
- Department of Radiation Oncology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, South Korea.
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Liu L, Luo Y, Zhou M, Lu Y, Xing M, Ru Y, Sun X, Chen X, Li S, Hong S, Wang S, Li F, Li B, Li X. Tripterygium agents for the treatment of atopic eczema: A Bayesian analysis of randomized controlled trials. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2019; 59:152914. [PMID: 30991183 DOI: 10.1016/j.phymed.2019.152914] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 02/24/2019] [Accepted: 04/02/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Atopic eczema is a common and recrudescent skin disorder. Tripterygium agents (TA), extracted from Tripterygium wilfordii hook F, a traditional Chinese medicine, have been used as a supplemental therapy for treating eczema empirically in recent years. PURPOSE To investigate the efficacy and safety of TA for treating atopic eczema. STUDY DESIGN Systematic review and Bayesian analysis. METHODS PubMed, Embase, Cochrane Central Register of Controlled Trials, CNKI, Chinese Scientific Journals Database, the Wan Fang Database, and Chinese Biomedicine databases were systematically searched from their respective inception dates to October 2, 2018. Randomized controlled trials (RCTs) related to TA used alone or in combination with other drugs were included. Meta-analysis was conducted by RevMan 5.3 software, and Bayesian analysis was performed in Stata 15.0 and R (V.3.4.0) package gemtc software. The Cochrane risk-of-bias tool and Jadad score were applied to assess the quality of all trials. RESULTS Thirteen trials involving 1385 patients were analyzed. Meta-analysis showed that, when treating atopic eczema patients, TA combined with other drugs were strongly synergistic (p < 0.00001). Among all combinations, the efficacy of TA combined with Diyin tablet (DYP) and topical glucocorticoids (TG) (RR: 0.06, 95%CI [0.01, 0.53]), as well as with compound glycyrrhizin (CG) (RR: 0.36, 95%CI [0.14,0.94]) was superior. Among the different combined medications, the best curative effect was achieved with TA combined with DYP and TG (98.2%), followed by TA combined with CG (85.3%), with TG (51.0%), or with Fuyang granule (FG) (49.9%). Reproductive system dysfunction was the main adverse events in patients treated with TA (RR: 6.23, 95%CI [1.12, 34.62]). Immunoglobulin E (IgE) levels were significantly decreased, after treatment with TA (p = 0.04). Subgroup analysis indicated no statistically significant difference in eczema-related cytokines (p = 0.44). Recurrence rates of using TA and other drugs were similar (p = 0.40). CONCLUSION TA appear to be effective in some therapies when treating patients with atopic eczema, but with apparent side effects. It cannot be concluded that TA can be generally used for eczema in the clinic, because of the small sample size. Further multi-center studies with large samples, and high-quality RCTs should be conducted to clarify the efficacy and safety of TA for treating eczema.
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Affiliation(s)
- Liu Liu
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China; Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China
| | - Ying Luo
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China; Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China
| | - Mi Zhou
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China; Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China
| | - Yi Lu
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China; Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China
| | - Meng Xing
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China; Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China
| | - Yi Ru
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China; Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China
| | - Xiaoying Sun
- Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai 201203, China
| | - Xi Chen
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China; Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China
| | - Su Li
- Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China
| | - Seokgyeong Hong
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China; Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China
| | - Shoumei Wang
- Department of Pathology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China
| | - Fulun Li
- Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China
| | - Bin Li
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China; Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China; Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai 201203, China.
| | - Xin Li
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China; Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China; Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai 201203, China.
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Bridgman AC, Qureshi AA, Li T, Tabung FK, Cho E, Drucker AM. Inflammatory dietary pattern and incident psoriasis, psoriatic arthritis, and atopic dermatitis in women: A cohort study. J Am Acad Dermatol 2019; 80:1682-1690. [PMID: 30797850 DOI: 10.1016/j.jaad.2019.02.038] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 02/04/2019] [Accepted: 02/14/2019] [Indexed: 12/16/2022]
Abstract
BACKGROUND Diet is a modulator of inflammation that might impact inflammatory skin diseases. OBJECTIVE To assess the relationship between pro-inflammatory dietary patterns and incident psoriasis, psoriatic arthritis (PsA), and atopic dermatitis (AD). METHODS We conducted cohort studies among women in the Nurses' Health Study II. The Empirical Dietary Inflammatory Pattern (EDIP) score was calculated at baseline and every 4 years. Incident psoriasis, PsA, and AD were assessed by validated self-report. We used multivariable-adjusted Cox proportional hazards models to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between EDIP quintiles and risk for psoriasis, PsA, and AD. RESULTS We had 85,185 participants in the psoriasis analysis and 63,443 in the AD analysis. There were 1432 cases of psoriasis, 262 cases of PsA, and 403 cases of AD. Pro-inflammatory dietary patterns were not associated with the risk for outcomes in multivariable models (all P values for trend >.05). HRs comparing the highest to the lowest EDIP quintile were 0.99 (95% CI 0.83-1.18) for psoriasis, 1.22 (95% CI 0.81-1.83) for PsA, and 0.96 (95% CI 0.69-1.34) for AD. LIMITATIONS Recall and self-report. CONCLUSION Our findings do not support dietary inflammatory potential as a risk factor for psoriasis, PsA, or AD.
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Affiliation(s)
| | - Abrar A Qureshi
- Department of Dermatology, Warren Alpert Medical School of Brown University, Providence, Rhode Island; Department of Dermatology, Rhode Island Hospital, Providence, Rhode Island; Department of Epidemiology, School of Public Health, Brown University, Providence, Rhode Island; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Tricia Li
- Department of Dermatology, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Fred K Tabung
- Division of Medical Oncology, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, Ohio; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Eunyoung Cho
- Department of Dermatology, Warren Alpert Medical School of Brown University, Providence, Rhode Island; Department of Epidemiology, School of Public Health, Brown University, Providence, Rhode Island; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Aaron M Drucker
- Department of Dermatology, Warren Alpert Medical School of Brown University, Providence, Rhode Island; Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Canada; Women's College Research Institute and Division of Dermatology, Department of Medicine, Women's College Hospital, Toronto, Canada.
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Davis JD, Bansal A, Hassman D, Akinlade B, Li M, Li Z, Swanson B, Hamilton JD, DiCioccio AT. Evaluation of Potential Disease-Mediated Drug-Drug Interaction in Patients With Moderate-to-Severe Atopic Dermatitis Receiving Dupilumab. Clin Pharmacol Ther 2018; 104:1146-1154. [PMID: 29498038 PMCID: PMC6282936 DOI: 10.1002/cpt.1058] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 02/16/2018] [Accepted: 02/17/2018] [Indexed: 12/25/2022]
Abstract
This open‐label drug–drug interaction study assessed whether blockade by dupilumab of interleukin (IL)‐4 and IL‐13 signaling affects the pharmacokinetics of drugs metabolized by cytochrome P450 (CYP450) enzymes. The pharmacokinetics of five CYP450 substrates given orally (midazolam, omeprazole, S‐warfarin, caffeine, and metoprolol, metabolized by CYP3A, CYP2C19, CYP2C9, CYP1A2, and CYP2D6, respectively) were evaluated before and 28 days after initiation of dupilumab treatment (subcutaneous 300 mg weekly) in 14 patients with moderate‐to‐severe atopic dermatitis. Dupilumab had no clinically relevant effects on the pharmacokinetics of CYP450 substrates, provided substantial clinical benefit, and was generally well tolerated. Only one serious adverse event was reported, an episode of systemic inflammatory response syndrome that resolved after treatment was discontinued. In summary, blockade of IL‐4/IL‐13 signaling in patients with type 2 inflammation does not appear to significantly affect CYP450 enzyme activities; the use of dupilumab in atopic dermatitis patients is unlikely to influence the pharmacokinetics of CYP450 substrates.
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Affiliation(s)
- John D Davis
- Regeneron Pharmaceuticals Inc., Tarrytown, New York, USA
| | - Ashish Bansal
- Regeneron Pharmaceuticals Inc., Tarrytown, New York, USA
| | | | | | - Meng Li
- Sanofi, Bridgewater, New Jersey, USA
| | - Zhaoyang Li
- Sanofi Genzyme, Cambridge, Massachusetts, USA
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Vekaria AS, Brunner PM, Aleisa AI, Bonomo L, Lebwohl MG, Israel A, Guttman-Yassky E. Moderate-to-severe atopic dermatitis patients show increases in serum C-reactive protein levels, correlating with skin disease activity. F1000Res 2017; 6:1712. [PMID: 29188018 PMCID: PMC5698919 DOI: 10.12688/f1000research.12422.2] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/22/2017] [Indexed: 12/30/2022] Open
Abstract
Background: Atopic dermatitis (AD), the most common chronic inflammatory skin disease, is evolving as a systemic disease, and associated systemic inflammation is possibly linked to increases in cardiovascular disease. Methods: We assessed levels of the inflammatory marker CRP in 59 patients with moderate-to-severe AD compared to matched healthy controls, and to determine correlation with skin disease severity. Clinical severity was measured using SCORing of Atopic Dermatitis (SCORAD) and body surface area (BSA). Control subjects (n=118), matched by age, gender, smoking status and ethnicity, were obtained from the National Health and Nutrition Survey (NHANES). Results: AD patients had significantly increased serum CRP levels compared to controls (0.7±1.0 vs. 0.4±0.7mg/dl; p=0.001), and 52.5% of them showed CRP levels >0.3mg/dl, predicting high cardiovascular risk. CRP levels were significantly correlated with both SCORAD (r=0.427, p=0.0008) and BSA (r=0.407, p=0.0015). IgE levels in AD were highly elevated (median 2903U/ml, IQR [234,10655]), but only weakly correlated with SCORAD (r=0.282, p=0.0427) and BSA (r=0.382, p=0.0052), but not with CRP levels. AD patients also showed increased LDH levels, but without significant correlations with disease severity (SCORAD, BSA) or CRP. Conclusions: Our study strongly supports CRP as a marker for disease severity in moderate-to-severe AD patients, further demonstrating its chronic systemic nature.
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Affiliation(s)
- Anjali S Vekaria
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Patrick M Brunner
- The Laboratory for Investigative Dermatology, The Rockefeller University, New York, NY, 10065, USA
| | - Ahmad I Aleisa
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Lauren Bonomo
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Mark G Lebwohl
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Ariel Israel
- Department of Family Medicine, Clalit Health Services, Jerusalem, 954323, Israel
| | - Emma Guttman-Yassky
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA.,The Laboratory for Investigative Dermatology, The Rockefeller University, New York, NY, 10065, USA
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