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Sang X, Lu J, Tan L, Zeng J, Wang D, Guo A, Tang S, Zeng Q, Liu W, Gao L. The Circadian Rhythm of Itching among 241 Adults with Atopic Dermatitis: A Cross-sectional Study. Acta Derm Venereol 2024; 104:adv35427. [PMID: 39101338 DOI: 10.2340/actadv.v104.35427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 06/10/2024] [Indexed: 08/06/2024] Open
Abstract
The pattern of itching in patients with atopic dermatitis has not been systematically studied. Therefore, this study aimed to assess the pattern of itching in adults with atopic dermatitis using questionnaires to assess for a circadian rhythm of itching in participating patients at a single institution (n = 241). A self-report questionnaire was used to assess circadian rhythm and intensity of itching in patients. In addition, the patients' disease severity (Eczema Area and Severity Index [EASI]) and quality of life (Dermatology Life Quality Index [DLQI]) were assessed. Itching occurred most frequently (74.69%) and with the greatest severity (62.66%) between 20:00 and 00:00, and the least number of patients (25.31%) experienced itching between 04:00 and 08:00. The DLQI and EASI scores both correlated with the average and maximum itch intensity (r = 0.582, r = 0.533, respectively; r = 0.539, r = 0.517, respectively; p < 0.001). The DLQI and EASI scores were associated with average itch intensity (B = 0.179, B = 0.204, respectively; 95% CI: 0.112 to 0.246, 95% CI: 0.096 to 0.313, respectively; p < 0.001), and the EASI score was associated with males and family history (B = 0.285, B = 0.287, respectively; 95% CI: 0.094 to 0.476, 95% CI: 0.096 to 0.478, respectively; p = 0.003). Adult patients with atopic dermatitis exhibited a circadian rhythm of itching; these study results could positively impact treatment approaches.
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Affiliation(s)
- Xiaoxue Sang
- Xiangya Nursing School, Central South University, Changsha, Hunan, China
| | - Jianyun Lu
- The Third Xiangya Hospital, Central South University, Changsha, Hunan, China; Medical Ozone Research Center of Central South University, Changsha, Hunan, China
| | - Lina Tan
- The Third Xiangya Hospital, Central South University, Changsha, Hunan, China; Medical Ozone Research Center of Central South University, Changsha, Hunan, China
| | - Jinrong Zeng
- The Third Xiangya Hospital, Central South University, Changsha, Hunan, China; Medical Ozone Research Center of Central South University, Changsha, Hunan, China
| | - Dan Wang
- The Third Xiangya Hospital, Central South University, Changsha, Hunan, China; Medical Ozone Research Center of Central South University, Changsha, Hunan, China
| | - Aiyuan Guo
- The Third Xiangya Hospital, Central South University, Changsha, Hunan, China; Medical Ozone Research Center of Central South University, Changsha, Hunan, China
| | - Siyuan Tang
- Xiangya Nursing School, Central South University, Changsha, Hunan, China
| | - Qian Zeng
- Xiangya Nursing School, Central South University, Changsha, Hunan, China
| | - Wei Liu
- Xiangya Nursing School, Central South University, Changsha, Hunan, China
| | - Lihua Gao
- The Third Xiangya Hospital, Central South University, Changsha, Hunan, China; Medical Ozone Research Center of Central South University, Changsha, Hunan, China.
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Oh SJ, Nguyen TT, Seo Y, Park HJ, Ahn JS, Shin YY, Kang BJ, Jang M, Park J, Jeong JH, Kim HS. Sustained release of stem cell secretome from nano-villi chitosan microspheres for effective treatment of atopic dermatitis. Int J Biol Macromol 2024:134344. [PMID: 39089545 DOI: 10.1016/j.ijbiomac.2024.134344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 07/01/2024] [Accepted: 07/29/2024] [Indexed: 08/04/2024]
Abstract
Canine atopic dermatitis (AD) arises from hypersensitive immune reactions. AD symptoms entail severe pruritus and skin inflammation, with frequent relapses. Consequently, AD patients require continuous management, imposing financial burdens and mental fatigue on pet owners. In this study, we aimed to investigate the therapeutic relevance of secretome from canine adipose tissue-derived mesenchymal stem cells (MSCs), especially after encapsulation in nano-villi chitosan microspheres (CS-MS) to expect improved efficacy. Conditioned media (CM) from MSCs significantly inhibited the proliferation of splenocytes, induced the generation of regulatory T cells, and decreased mast cell degranulation. We found that beneficial soluble factors known to reduce AD symptoms, including transforming growth factor-beta 1, were detectable after sequential concentration and lyophilization of CM. The CS-MS, developed by a phase inversion regeneration method, showed high loading and sustained release of the secretome. Local injection of secretome-loaded CS-MS (ST/SC-MS) effectively reduced clinical severity compared to groups treated with secretome. Histological analysis revealed that ST/SC-MS potently suppressed epidermal hyperplasia, immunocyte infiltration and mast cell activation in the lesion. Taken together, this study presents a novel therapeutic approach exhibiting more potent and prolonged immunoregulatory efficacy of MSC secretome for canine AD treatment.
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Affiliation(s)
- Su-Jeong Oh
- Department of Oral Biochemistry, Dental and Life Science Institute, Pusan National University, Yangsan 50612, Republic of Korea; Department of Life Science in Dentistry, School of Dentistry, Pusan National University, Yangsan 50612, Republic of Korea; Education and Research Team for Life Science on Dentistry, Pusan National University, Yangsan 50612, Republic of Korea
| | - Tiep Tien Nguyen
- College of Pharmacy, Keimyung University, Daegu 42601, Republic of Korea; Department of Precision Medicine, School of Medicine, Sungkyunkwan University, Suwon 16419, Republic of Korea
| | - Yoojin Seo
- Department of Oral Biochemistry, Dental and Life Science Institute, Pusan National University, Yangsan 50612, Republic of Korea
| | - Hee-Jeong Park
- Department of Oral Biochemistry, Dental and Life Science Institute, Pusan National University, Yangsan 50612, Republic of Korea; Department of Life Science in Dentistry, School of Dentistry, Pusan National University, Yangsan 50612, Republic of Korea; Education and Research Team for Life Science on Dentistry, Pusan National University, Yangsan 50612, Republic of Korea
| | - Ji-Su Ahn
- Department of Oral Biochemistry, Dental and Life Science Institute, Pusan National University, Yangsan 50612, Republic of Korea
| | - Ye Young Shin
- Stem Cell and Regenerative Bioengineering Institute, Global R&D Center, Kangstem Biotech Co. Ltd., Seoul 08590, Republic of Korea
| | - Byung-Jae Kang
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University, Seoul, 08826, Republic of Korea; BK21 FOUR Future Veterinary Medicine Leading Education and Research Center, Seoul National University, Seoul, 08826, Republic of Korea
| | - Min Jang
- Department of Veterinary Surgery, College of Veterinary Medicine, Kyungpook National University, Daegu 41566, Republic of Korea
| | - Junhyeung Park
- Department of Precision Medicine, School of Medicine, Sungkyunkwan University, Suwon 16419, Republic of Korea
| | - Jee-Heon Jeong
- Department of Precision Medicine, School of Medicine, Sungkyunkwan University, Suwon 16419, Republic of Korea.
| | - Hyung-Sik Kim
- Department of Oral Biochemistry, Dental and Life Science Institute, Pusan National University, Yangsan 50612, Republic of Korea; Department of Life Science in Dentistry, School of Dentistry, Pusan National University, Yangsan 50612, Republic of Korea; Education and Research Team for Life Science on Dentistry, Pusan National University, Yangsan 50612, Republic of Korea.
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Geng RSQ, Sibbald RG. Atopic Dermatitis: Clinical Aspects and Treatments. Adv Skin Wound Care 2024; 37:346-352. [PMID: 38899816 DOI: 10.1097/asw.0000000000000161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2024]
Abstract
GENERAL PURPOSE To review issues related to atopic dermatitis, including its classification, clinical presentation, potential triggers, and treatment options. TARGET AUDIENCE This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and registered nurses with an interest in skin and wound care. LEARNING OBJECTIVES/OUTCOMES After participating in this educational activity, the participant will:1. Synthesize a differential diagnosis for atopic dermatitis (AD).2. Explain the classification of AD cases.3. Select triggers or exacerbating factors for AD.4. Explain pharmacologic and nonpharmacologic treatment options for patients with AD.
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Huang P, Wen F, Wu Q, Zhang P, Li Q. The causal effect of atopic dermatitis on lung cancer: A Mendelian randomization study. Skin Res Technol 2024; 30:e13841. [PMID: 38965791 PMCID: PMC11224128 DOI: 10.1111/srt.13841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2024] [Accepted: 06/17/2024] [Indexed: 07/06/2024]
Abstract
BACKGROUND Growing evidence has shown that atopic dermatitis (AD) may decrease lung cancer (LC) risk. However, the causality between the two diseases is inconsistent and controversial. Therefore, we explored the causal relationship between AD and different histological subtypes of LC by using the Mendelian randomization (MR) method. MATERIALS AND METHODS We conducted the MR study based on summary statistics from the genome-wide association studies (GWAS) of AD (10,788 cases and 30,047 controls) and LC (29,266 cases and 56,450 controls). Instrumental variables (IVs) were obtained after removing SNPs associated with potential confounders. We employed inverse-variance weighted (IVW), MR-Egger, and weighted median methods to pool estimates, and performed a comprehensive sensitivity analysis. RESULTS The results of the IVW method suggested that AD may decrease the risk of developing lung adenocarcinoma (LUAD) (OR = 0.91, 95% CI: 0.85-0.97, P = 0.007). Moreover, no causality was identified between AD and overall LC (OR = 0.96, 95% CI: 0.91-1.01, P = 0.101), lung squamous cell carcinoma (LUSC) (OR = 1.04, 95% CI: 0.96-1.036, P = 0.324), and small cell lung carcinoma (SCLC) (OR = 0.95, 95% CI: 0.82-1.10, P = 0.512). A comprehensive sensitivity test showed the robustness of our results. CONCLUSION The present study indicates that AD may decrease the risk of LUAD in the European population, which needs additional investigations to identify the potential molecular mechanisms.
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Affiliation(s)
- Peng Huang
- Division of Abdominal Tumor Multimodality TreatmentCancer CenterWest China HospitalSichuan UniversityChengduSichuanChina
- Department of Medical OncologyCancer CenterWest China HospitalSichuan UniversityChengduSichuanChina
| | - Feng Wen
- Department of Medical OncologyCancer CenterWest China HospitalSichuan UniversityChengduSichuanChina
- Department of Radiation OncologyCancer CenterWest China HospitalSichuan UniversityChengduSichuanChina
| | - QiuJi Wu
- Division of Abdominal Tumor Multimodality TreatmentCancer CenterWest China HospitalSichuan UniversityChengduSichuanChina
- Department of Medical OncologyCancer CenterWest China HospitalSichuan UniversityChengduSichuanChina
| | - PengFei Zhang
- Gastric Cancer CenterDivision of Medical OncologyCancer CenterWest China HospitalSichuan UniversityChengduSichuanChina
| | - Qiu Li
- Division of Abdominal Tumor Multimodality TreatmentCancer CenterWest China HospitalSichuan UniversityChengduSichuanChina
- Department of Medical OncologyCancer CenterWest China HospitalSichuan UniversityChengduSichuanChina
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Skin Challenges for Young and Older Persons-Atopic Dermatitis and Pressure Injuries. Adv Skin Wound Care 2024; 37:342. [PMID: 38899813 DOI: 10.1097/asw.0000000000000171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2024]
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Trzeciak M, Rudnicka L, Arenberger P, Engin B, L'vov A, Alper S, Alpsoy E, Benáková N, Bobko S, Borlu M, Czarnecka-Operacz M, Elisyutina O, Ergun T, Ertam I, Fedenko E, Filipovská O, Fomina D, Gadzhigoroeva A, Kojanová M, Lesiak A, Michenko A, Murashkin N, Owczarek W, Özkaya E, Plzáková Z, Reich A, Selerova M, Gurbuz BA. Disease burden, clinical management and unmet treatment need of patients with moderate to severe atopic dermatitis; consensus statements, insights and practices from CERTADE (Central/Eastern EU, Russia, Turkiye AD Experts) Delphi panel. Front Med (Lausanne) 2024; 11:1402493. [PMID: 38962737 PMCID: PMC11220254 DOI: 10.3389/fmed.2024.1402493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Accepted: 05/27/2024] [Indexed: 07/05/2024] Open
Abstract
Background There is limited insight into the current disease burden and everyday clinical management of moderate-to- severe AD in Poland, Czechia, Russia, and Turkiye. Therefore, this study aimed to get information-driven insights regarding the current disease burden and clinical management of patients with moderate-to-severe AD with common and differentiating aspects of the patient journey and establish a consensus. Methods In this modified 2-round Delphi panel, 133 questions were asked in total to 27 dermatologists. A consensus was achieved when 70% of the panel members strongly agreed or agreed (or strongly disagreed or disagreed) with an item. Statements with <40% agreement dropped from the Delphi rounds and were not repeated. Results The results state that AD has a significant impact on the quality of life for both patients and their families with social and economic consequences in these countries. While there were significant dissimilarities regarding the current treatment approach by preference order and treatment duration among participants, there was also a high percentage of consensus on literature and guideline-based statements. Current topical therapies and the immune response modifiers were not found to be sufficient by panelists to cover the therapeutic needs of patients with moderate-to-severe AD. Moreover, panelists highlighted the significant burden of adverse events with the off-label use of currently available immunosuppressants. Conclusions These results underlined that there is a significant disease burden with an unmet treatment need for patients with moderate-to-severe AD in Poland, Czechia, Russia, and Turkiye.
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Affiliation(s)
- Magdalena Trzeciak
- Department of Dermatology, Venereology and Allergology, Medical University of Gdańsk, Gdańsk, Poland
| | - Lidia Rudnicka
- Department of Dermatology, Medical University of Warsaw, Warsaw, Poland
| | - Petr Arenberger
- Department of Dermatovenerology, Third Faculty of Medicine, Charles University of Prague, Prague, Czechia
| | - Burhan Engin
- Department of Dermatology and Venerology, Cerrahpaşa Medical Faculty, Istanbul University-Cerrahpaşa, İstanbul, Türkiye
| | - Andrey L'vov
- Department of Dermatology, Federal State Budgetary Institution of Continuing Professional Education “Central State Medical Academy”, Moscow, Russia
- Department of Dermatology, Medical Research and Educational Center, Lomonosov Moscow State University, Moscow, Russia
| | - Sibel Alper
- Department of Dermatology and Venereology, Koç University, İstanbul, Türkiye
| | - Erkan Alpsoy
- Department of Dermatology and Venereology, Akdeniz University, Antalya, Türkiye
| | - Nina Benáková
- Department of Dermatovenereology, 1st Medical Faculty, Charles University, Prague, Czechia
| | - Svetlana Bobko
- Moscow Scientific and Practical Centre of Dermatovenereology and Cosmetology, Moscow, Russia
| | - Murat Borlu
- Department of Dermatology and Venereology, Erciyes University, Kayseri, Türkiye
| | | | | | - Tulin Ergun
- Department of Dermatology, Marmara University, İstanbul, Türkiye
| | - Ilgen Ertam
- Department of Dermatology, Ege University, İzmir, Türkiye
| | - Elena Fedenko
- NRC Institute of Immunology FMBA of Russia, Moscow, Russia
| | - Olga Filipovská
- Department of Dermatology, Hospital in Ústí nad Labem, Ústí nad Labem, Czechia
| | - Daria Fomina
- Centre of Allergy and Immunology, Clinical State Hospital 52, Moscow Ministry of Healthcare, Moscow, Russia
- Department of Dermatology, I. M. Sechenov Moscow Medical University, Moscow, Russia
| | - Aida Gadzhigoroeva
- Moscow Scientific and Practical Centre of Dermatovenereology and Cosmetology, Moscow, Russia
| | - Martina Kojanová
- Department of Dermatovenereology, 1st Medical Faculty, Charles University, Prague, Czechia
| | - Aleksandra Lesiak
- Dermatology and Venereology Clinic, Medical University, Łodź, Poland
| | - Anna Michenko
- Department of Dermatology, Federal State Budgetary Institution of Continuing Professional Education “Central State Medical Academy”, Moscow, Russia
- Department of Dermatology, Medical Research and Educational Center, Lomonosov Moscow State University, Moscow, Russia
| | - Nikolay Murashkin
- Department of Dermatology, Federal State Autonomous Institution, Scientific Centre of Children's Health of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Witold Owczarek
- Department of Dermatology, Military Institute of Medicine, Warsaw, Poland
| | - Esen Özkaya
- Istanbul Faculty of Medicine, Department of Dermatology and Venereology, Istanbul University, İstanbul, Türkiye
| | - Zuzana Plzáková
- Department of Dermatovenereology, 1st Medical Faculty, Charles University, Prague, Czechia
| | - Adam Reich
- Department of Dermatology, University of Rzeszow, Rzeszów, Poland
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Zhou J, Wu P, Cai W, Lu J, Guo Y, Teng Y, Tong J, Gao G, Yan S, Tao F, Huang K. The impact of maternal anxiety during pregnancy on children's eczema and allergic rhinitis: The Ma'anshan birth cohort study. J Psychosom Res 2024; 181:111621. [PMID: 38636299 DOI: 10.1016/j.jpsychores.2024.111621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 02/15/2024] [Accepted: 02/19/2024] [Indexed: 04/20/2024]
Abstract
OBJECTIVE The objective of this study was to investigate the associations between maternal exposure to anxiety during pregnancy and the susceptibility of offspring to eczema and allergic rhinitis and the possibility of sensitivity periods and cumulative effects. METHODS The study's sample consisted of 3160 mother-child pairs from the Ma'anshan Birth Cohort Study. Maternal anxiety was repeatedly measured in the 1st, 2nd, and 3rd trimesters of pregnancy using the Chinese version of the Pregnancy-Related Anxiety Scale. Information regarding children's eczema and allergic rhinitis diagnoses was collected through parental reports at 12, 24, 36 and 48 months of age. Binary logistic regression models were used for statistical analysis and corrected for multiple comparisons using the false discovery rate (FDR) method. RESULTS Children whose mothers experienced anxiety throughout pregnancy had the highest odds of developing total eczema (aOR 1.45, 95% CI 1.02-2.07) and total allergic rhinitis (aOR 1.67, 95% CI 1.17-2.37) between the ages of 6 and 48 months. The higher the trajectory of the maternal anxiety scores throughout pregnancy, the higher the odds of total eczema (aOR 1.65, 95% CI 1.14-2.40) and allergic rhinitis (aOR 1.84, 95% CI 1.28-2.66) in their offspring. The association between maternal anxiety and children's eczema was mainly concentrated in the first 24 months, whereas the association with allergic rhinitis was mainly concentrated in the 36-48 months. CONCLUSION Maternal anxiety during any trimester of pregnancy, especially with a consistently high trajectory of anxiety scores, was associated with higher odds of children's eczema and allergic rhinitis.
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Affiliation(s)
- Jixing Zhou
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei 230032, Anhui Province, China; Key Laboratory of Population Health Across Life Cycle (AHMU), MOE, Hefei 230032, China; NHC Key Laboratory of study on abnormal gametes and reproductive tract, Hefei 230032, Anhui Province, China; Anhui Provincial Key Laboratory of Environment and Population Health Across the Life Course, Hefei 230032, Anhui Province, China
| | - Pengui Wu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei 230032, Anhui Province, China; Key Laboratory of Population Health Across Life Cycle (AHMU), MOE, Hefei 230032, China; NHC Key Laboratory of study on abnormal gametes and reproductive tract, Hefei 230032, Anhui Province, China; Anhui Provincial Key Laboratory of Environment and Population Health Across the Life Course, Hefei 230032, Anhui Province, China
| | - Wenjing Cai
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei 230032, Anhui Province, China; Key Laboratory of Population Health Across Life Cycle (AHMU), MOE, Hefei 230032, China; NHC Key Laboratory of study on abnormal gametes and reproductive tract, Hefei 230032, Anhui Province, China; Anhui Provincial Key Laboratory of Environment and Population Health Across the Life Course, Hefei 230032, Anhui Province, China
| | - Jingru Lu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei 230032, Anhui Province, China; Key Laboratory of Population Health Across Life Cycle (AHMU), MOE, Hefei 230032, China; NHC Key Laboratory of study on abnormal gametes and reproductive tract, Hefei 230032, Anhui Province, China; Anhui Provincial Key Laboratory of Environment and Population Health Across the Life Course, Hefei 230032, Anhui Province, China
| | - Yufan Guo
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei 230032, Anhui Province, China; Key Laboratory of Population Health Across Life Cycle (AHMU), MOE, Hefei 230032, China; NHC Key Laboratory of study on abnormal gametes and reproductive tract, Hefei 230032, Anhui Province, China; Anhui Provincial Key Laboratory of Environment and Population Health Across the Life Course, Hefei 230032, Anhui Province, China
| | - Yuzhu Teng
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei 230032, Anhui Province, China; Key Laboratory of Population Health Across Life Cycle (AHMU), MOE, Hefei 230032, China; NHC Key Laboratory of study on abnormal gametes and reproductive tract, Hefei 230032, Anhui Province, China; Anhui Provincial Key Laboratory of Environment and Population Health Across the Life Course, Hefei 230032, Anhui Province, China
| | - Juan Tong
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei 230032, Anhui Province, China; Key Laboratory of Population Health Across Life Cycle (AHMU), MOE, Hefei 230032, China; NHC Key Laboratory of study on abnormal gametes and reproductive tract, Hefei 230032, Anhui Province, China; Anhui Provincial Key Laboratory of Environment and Population Health Across the Life Course, Hefei 230032, Anhui Province, China
| | - Guopeng Gao
- Maternal and Child Health Care Center of Ma'anshan, No 24 Jiashan Road, Ma'anshan 243011, Anhui Province, China
| | - Shuangqin Yan
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei 230032, Anhui Province, China; Maternal and Child Health Care Center of Ma'anshan, No 24 Jiashan Road, Ma'anshan 243011, Anhui Province, China
| | - Fangbiao Tao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei 230032, Anhui Province, China; Key Laboratory of Population Health Across Life Cycle (AHMU), MOE, Hefei 230032, China; NHC Key Laboratory of study on abnormal gametes and reproductive tract, Hefei 230032, Anhui Province, China; Anhui Provincial Key Laboratory of Environment and Population Health Across the Life Course, Hefei 230032, Anhui Province, China
| | - Kun Huang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei 230032, Anhui Province, China; Key Laboratory of Population Health Across Life Cycle (AHMU), MOE, Hefei 230032, China; NHC Key Laboratory of study on abnormal gametes and reproductive tract, Hefei 230032, Anhui Province, China; Anhui Provincial Key Laboratory of Environment and Population Health Across the Life Course, Hefei 230032, Anhui Province, China.
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Yue C, Hu Y, Yu J, Zhou H, Zhou P, Hu J, Wang X, Gu L, Li Y, Feng Y, Zeng F, Zhao F, Li G, Zhao Q, Zhang C, Zheng H, Wu W, Cui X, Huang N, Wang Z, Cui K, Li J. IL-38 Aggravates Atopic Dermatitis via Facilitating Migration of Langerhans cells. Int J Biol Sci 2024; 20:3094-3112. [PMID: 38904012 PMCID: PMC11186352 DOI: 10.7150/ijbs.93843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 05/17/2024] [Indexed: 06/22/2024] Open
Abstract
Atopic dermatitis (AD) is a common inflammation skin disease that involves dysregulated interplay between immune cells and keratinocytes. Interleukin-38 (IL-38), a poorly characterized IL-1 family cytokine, its role and mechanism in the pathogenesis of AD is elusive. Here, we show that IL-38 is mainly secreted by epidermal keratinocytes and highly expressed in the skin and downregulated in AD lesions. We generated IL-38 keratinocyte-specific knockout mice (K14Cre/+-IL-38f/f ) and induced AD models by 2,4-dinitrofluorobenzene (DNFB). Unexpectedly, after treatment with DNFB, K14Cre/+-IL-38f/f mice were less susceptible to cutaneous inflammation of AD. Moreover, keratinocyte-specific deletion of IL-38 suppressed the migration of Langerhans cells (LCs) into lymph nodes which results in disturbed differentiation of CD4+T cells and decreased the infiltration of immune cells into AD lesions. LCs are a type of dendritic cell that reside specifically in the epidermis and regulate immune responses. We developed LC-like cells in vitro from mouse bone marrow (BM) and treated with recombined IL-38. The results show that IL-38 depended on IL-36R, activated the phosphorylated expression of IRAK4 and NF-κB P65 and upregulated the expression of CCR7 to promoting the migration of LCs, nevertheless, the upregulation disappeared with the addition of IL-36 receptor antagonist (IL-36RA), IRAK4 or NF-κB P65 inhibitor. Furthermore, after treatment with IRAK4 inhibitors, the experimental AD phenotypes were alleviated and so IRAK4 is considered a promising target for the treatment of inflammatory diseases. Overall, our findings indicated a potential pathway that IL-38 depends on IL-36R, leading to LCs migration to promote AD by upregulating CCR7 via IRAK4/NF-κB and implied the prevention and treatment of AD, supporting potential clinical utilization of IRAK4 inhibitors in AD treatment.
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Affiliation(s)
- Chengcheng Yue
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, and Collaborative Innovation Center for Biotherapy, 1 Keyuan 4th Road, Gaopeng Street, Chengdu, Sichuan 610041, China
| | - Yawen Hu
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, and Collaborative Innovation Center for Biotherapy, 1 Keyuan 4th Road, Gaopeng Street, Chengdu, Sichuan 610041, China
| | - Jiadong Yu
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, and Collaborative Innovation Center for Biotherapy, 1 Keyuan 4th Road, Gaopeng Street, Chengdu, Sichuan 610041, China
| | - Hong Zhou
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, and Collaborative Innovation Center for Biotherapy, 1 Keyuan 4th Road, Gaopeng Street, Chengdu, Sichuan 610041, China
| | - Pei Zhou
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, and Collaborative Innovation Center for Biotherapy, 1 Keyuan 4th Road, Gaopeng Street, Chengdu, Sichuan 610041, China
| | - Jing Hu
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, and Collaborative Innovation Center for Biotherapy, 1 Keyuan 4th Road, Gaopeng Street, Chengdu, Sichuan 610041, China
| | - Xiaoyan Wang
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, and Collaborative Innovation Center for Biotherapy, 1 Keyuan 4th Road, Gaopeng Street, Chengdu, Sichuan 610041, China
| | - Linna Gu
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, and Collaborative Innovation Center for Biotherapy, 1 Keyuan 4th Road, Gaopeng Street, Chengdu, Sichuan 610041, China
| | - Ya Li
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, and Collaborative Innovation Center for Biotherapy, 1 Keyuan 4th Road, Gaopeng Street, Chengdu, Sichuan 610041, China
| | - Yuting Feng
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, and Collaborative Innovation Center for Biotherapy, 1 Keyuan 4th Road, Gaopeng Street, Chengdu, Sichuan 610041, China
| | - Fanlian Zeng
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, and Collaborative Innovation Center for Biotherapy, 1 Keyuan 4th Road, Gaopeng Street, Chengdu, Sichuan 610041, China
| | - Fulei Zhao
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, and Collaborative Innovation Center for Biotherapy, 1 Keyuan 4th Road, Gaopeng Street, Chengdu, Sichuan 610041, China
| | - Guolin Li
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, and Collaborative Innovation Center for Biotherapy, 1 Keyuan 4th Road, Gaopeng Street, Chengdu, Sichuan 610041, China
| | - Qixiang Zhao
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, and Collaborative Innovation Center for Biotherapy, 1 Keyuan 4th Road, Gaopeng Street, Chengdu, Sichuan 610041, China
| | - Chen Zhang
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, and Collaborative Innovation Center for Biotherapy, 1 Keyuan 4th Road, Gaopeng Street, Chengdu, Sichuan 610041, China
| | - Huaping Zheng
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, and Collaborative Innovation Center for Biotherapy, 1 Keyuan 4th Road, Gaopeng Street, Chengdu, Sichuan 610041, China
| | - Wenling Wu
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, and Collaborative Innovation Center for Biotherapy, 1 Keyuan 4th Road, Gaopeng Street, Chengdu, Sichuan 610041, China
| | - Xinai Cui
- CDUTCM-KEELE Joint Health and Medical Sciences Institute, Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, China
| | - Nongyu Huang
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, and Collaborative Innovation Center for Biotherapy, 1 Keyuan 4th Road, Gaopeng Street, Chengdu, Sichuan 610041, China
| | - Zhen Wang
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, and Collaborative Innovation Center for Biotherapy, 1 Keyuan 4th Road, Gaopeng Street, Chengdu, Sichuan 610041, China
- Department of Liver Surgery & Liver Transplantation, West China Hospital, Sichuan University and Collaborative Innovation Center of Biotherapy, 37 Guo Xue Road, Chengdu, Sichuan 610041, China
| | - Kaijun Cui
- Department of Cardiology, West China Hospital, Sichuan University, 37 Guoxue Road, Chengdu, Sichuan 610041, China
| | - Jiong Li
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, and Collaborative Innovation Center for Biotherapy, 1 Keyuan 4th Road, Gaopeng Street, Chengdu, Sichuan 610041, China
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Ma L, Tao X, Liu S, Cheng H, Fang R, Zhao Y, Cha A, Encinas GA, Zhou Y, Deng Y, Zhang J. Efficacy and Safety of Crisaborole Ointment 2% in Chinese Patients Aged ≥ 2 Years with Mild to Moderate Atopic Dermatitis. Dermatol Ther (Heidelb) 2024; 14:1229-1243. [PMID: 38748345 PMCID: PMC11116293 DOI: 10.1007/s13555-024-01156-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 04/03/2024] [Indexed: 05/24/2024] Open
Abstract
INTRODUCTION Atopic dermatitis (AD) is a chronic immuno-inflammatory skin disease. Crisaborole ointment, 2%, is a nonsteroidal phosphodiesterase 4 inhibitor approved for the treatment of mild to moderate AD. This post hoc analysis assesses the efficacy and safety of crisaborole in Chinese patients aged ≥ 2 years with mild to moderate AD. METHODS We evaluated the efficacy and safety of crisaborole in Chinese patients from the vehicle-controlled, phase 3 CrisADe CLEAR study. Patients were randomly assigned 2:1 to receive crisaborole or vehicle twice daily, respectively, for 28 days. The primary endpoint was percent change from baseline in Eczema Area and Severity Index (EASI) total score at day 29. Key secondary endpoints were improvement in Investigator's Static Global Assessment (ISGA), ISGA success, and change from baseline in weekly average Peak Pruritus Numerical Rating Scale (PP-NRS) score. Adverse events were documented. RESULTS Of 391 patients in the overall study, 237 were from China, 157 assigned to crisaborole and 80 assigned to vehicle. A greater reduction in percent change from baseline in EASI total score at day 29 was shown in the crisaborole vs. vehicle group (least squares mean [LSM]: -66.34 [95% (confidence interval) CI -71.55 to -61.12] vs. -50.18 [95% CI -58.02 to -42.34]). Response rates for achievement of ISGA improvement (43.2% [95% CI 35.4-51.1] vs. 33.4% [95% CI 22.5-44.2]) and ISGA success (31.7% [95% CI 24.3-39.0] vs. 21.5% [95% CI 12.1-30.9]) at day 29 were higher in the crisaborole vs. vehicle group. A greater reduction in change from baseline in weekly average PP-NRS score at week 4 was observed in the crisaborole vs. vehicle group (LSM: -1.98 [95% CI -2.34 to -1.62] vs. -1.08 [95% CI -1.63 to -0.53]). No new safety signals were observed. CONCLUSION Crisaborole was effective and well tolerated in Chinese patients aged ≥ 2 years with mild to moderate AD. TRIAL REGISTRATION ClinicalTrials.gov, NCT04360187.
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Affiliation(s)
- Lin Ma
- Department of Dermatology, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, Beijing, China
| | - Xiaohua Tao
- Department of Dermatology, Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang, China
| | - Sujun Liu
- Department of Dermatology, Hangzhou Third People's Hospital, Hangzhou, Zhejiang, China
| | - Hao Cheng
- Department of Dermatology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Ruihua Fang
- Department of Dermatology, Guangzhou First People's Hospital, Guangzhou, Guangdong, China
| | - Yan Zhao
- Department of Dermatology, Peking University People's Hospital, Beijing, 100044, China
| | - Amy Cha
- Pfizer Inc., New York, NY, USA
| | | | - Yangmei Zhou
- Clinical Development, Pfizer R&D China, Shanghai, China
| | | | - Jianzhong Zhang
- Department of Dermatology, Peking University People's Hospital, Beijing, 100044, China.
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10
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Lv JJ, Kong XM, Zhao Y, Li XY, Guo ZL, Zhang YJ, Cheng ZH. Global, regional and national epidemiology of allergic disorders in children from 1990 to 2019: findings from the Global Burden of Disease study 2019. BMJ Open 2024; 14:e080612. [PMID: 38589255 PMCID: PMC11015187 DOI: 10.1136/bmjopen-2023-080612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 03/25/2024] [Indexed: 04/10/2024] Open
Abstract
OBJECTIVE This modelling study aimed to estimate the burden for allergic diseases in children during a period of 30 years. DESIGN Population-based observational study. MAIN OUTCOMES AND MEASURES The data on the incidence, mortality and disability-adjusted life years (DALYs) for childhood allergic diseases, such as atopic dermatitis (AD) and asthma, were retrieved from the Global Burden of Disease study 2019 online database. This data set spans various groups, including different regions, ages, genders and Socio-Demographic Indices (SDI), covering the period from 1990 to 2019. RESULTS In 2019, there were approximately 81 million children with asthma and 5.6 million children with AD worldwide. The global incidence of asthma in children was 20 million. Age-standardised incidence rates showed a decrease of 4.17% for asthma, from 1075.14 (95% uncertainty intervals (UI), 724.63 to 1504.93) per 100 000 population in 1990 to 1030.33 (95% UI, 683.66 to 1449.53) in 2019. Similarly, the rates for AD decreased by 5.46%, from 594.05 (95% UI, 547.98 to 642.88) per 100 000 population in 1990 to 561.61 (95% UI, 519.03 to 608.29) in 2019. The incidence of both asthma and AD was highest in children under 5 years of age, gradually decreasing with age. Interestingly, an increase in SDI was associated with a rise in the incidence of both conditions. However, the mortality rate and DALYs for asthma showed a contrasting trend. CONCLUSIONS Over the past three decades, there has been a worldwide increase in new asthma and AD cases, even though mortality rates have significantly declined. However, the prevalence of these allergic diseases among children varies considerably across regions, countries and age groups. This variation highlights the need for precise prevalence assessments. These assessments are vital in formulating effective strategies for prevention and treatment.
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Affiliation(s)
- Jia-Jie Lv
- Department of Neurosurgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Xiang-Meng Kong
- Department of Cardiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Yan Zhao
- Department of Neurosurgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, Shanghai, People's Republic of China
- Department of Nursing, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Xin-Yu Li
- Department of Neurosurgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, Shanghai, People's Republic of China
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Zhi-Lin Guo
- Department of Neurosurgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Yuan-Jie Zhang
- Department of Neurosurgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Zhi-Hua Cheng
- Department of Neurosurgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, Shanghai, People's Republic of China
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11
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Bernstein JA, Wymer L, Nye M, Vesper S. The relationship between childhood atopic dermatitis and asthma in an under resourced community. Allergy Asthma Proc 2024; 45:108-111. [PMID: 38449008 PMCID: PMC11057361 DOI: 10.2500/aap.2024.45.230093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2024]
Abstract
Background: Atopic dermatitis (AD) is an inflammatory skin disease caused by allergen exposures and estimated to affect ∼20% of children. Children in urban areas have a higher prevalence of AD compared with those living outside of urban areas. AD is believed to lead to asthma development as part of the "atopic march." Objective: Our objective was to determine the sequential and chronological relationships between AD and asthma for children in an under-resourced community. Methods: The progression from AD to asthma in the under-resourced, urban community of Sun Valley, Colorado, was examined by assessing Medicaid data for the years 2016 to 2019 for a diagnosis of AD or asthma in children 6 and 7 years old. Results: Pearson correlations between AD and asthma diagnoses were significant only with respect to AD at age 6 years compared with asthma 1 year later, at age 7 years. Conclusion: By studying a susceptible community with a consistent but mixed genetic background, we found sequential and chronological links between AD and asthma.
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Affiliation(s)
- Jonathan A. Bernstein
- Department of Internal Medicine, Division of Immunology/Allergy Section, College of Medicine, University of Cincinnati, Cincinnati, Ohio, United States of America
| | - Larry Wymer
- United States Environmental Protection Agency, 26 W. Martin Luther King Drive, Cincinnati, Ohio, United States of America
| | - Michael Nye
- United States Environmental Protection Agency, Denver, Colorado, United States of America
| | - Stephen Vesper
- United States Environmental Protection Agency, 26 W. Martin Luther King Drive, Cincinnati, Ohio, United States of America
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12
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Lu MY, Shobnam N, Livinski AA, Saksena S, Salters D, Biete M, Myles IA. Examining allergy related diseases in Africa: A scoping review protocol. PLoS One 2024; 19:e0297949. [PMID: 38377144 PMCID: PMC10878524 DOI: 10.1371/journal.pone.0297949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 01/11/2024] [Indexed: 02/22/2024] Open
Abstract
During recent decades, allergy related diseases have emerged as a growing area of concern in developing regions of the world, including Africa. Worldwide prevalence of allergic diseases has grown to an estimated 262 million for asthma, 400 million for allergic rhinitis (or hay fever), 171 million with atopic dermatitis (or eczema), and over 200 million for food allergy. In Africa, considerable variability exists in the data surrounding prevalence at the continent-wide, regional, and study site levels. Furthermore, research conducted in many rural areas and underdeveloped countries in Africa remains limited, and presently, little has been done to characterize and map the extremely heterogeneous body of literature which confounds research efforts. This scoping review will seek to identify studies examining the prevalence, management strategies, outcomes, and associated risk factors for allergy related diseases in Africa. The Joanna Briggs Institute's scoping review methods will be followed, and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Review (PRISMA-ScR) was used for writing the protocol. Four databases (Embase, Global Health, PubMed, African Journals Online) will be searched for literature published from 2003 to 2023 in any language. Title and abstract screening and full-text screening will be completed by two independent reviewers using Covidence; conflicts resolved by a third reviewer. Data will be extracted using Covidence by two reviewers independently. To report the results, we will follow the PRISMA-ScR checklist and report descriptive statistics and a narrative summary.
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Affiliation(s)
- Max Yang Lu
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Nadia Shobnam
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Alicia A. Livinski
- National Institutes of Health Library, Office of Research Services, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Sarini Saksena
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Dylan Salters
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Michelle Biete
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Ian A. Myles
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, United States of America
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13
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Rewerska B, Sher LD, Alpizar S, Pauser S, Pulka G, Mozaffarian N, Salhi Y, Martinet C, Jabert W, Gudi G, CA V, GN S, Macoin J, Anstett V, Turrini R, Doucey MA, Blein S, Konto C, Machkova M. Phase 2b randomized trial of OX40 inhibitor telazorlimab for moderate-to-severe atopic dermatitis. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. GLOBAL 2024; 3:100195. [PMID: 38187863 PMCID: PMC10770725 DOI: 10.1016/j.jacig.2023.100195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Revised: 08/16/2023] [Accepted: 08/21/2023] [Indexed: 01/09/2024]
Abstract
Background Telazorlimab is a humanized anti-OX40 monoclonal antibody being studied for treatment of T-cell-mediated diseases. Objective This randomized, placebo-controlled, phase 2b dose-range finding study investigated efficacy, safety, pharmacokinetics, and immunogenicity of telazorlimab in subjects with atopic dermatitis. Methods In this 2-part study (NCT03568162), adults (≥18 years) with moderate-to-severe disease were randomized to various regimens of subcutaneous telazorlimab or placebo for 16 weeks' blinded treatment, followed by 38 weeks' open-label treatment and 12 weeks' drug-free follow-up. Telazorlimab treatment groups (following a loading dose) in part 1 were 300 mg every 2 weeks; 300 mg every 4 weeks; or 75 mg every 4 weeks. Part 2 evaluated telazorlimab 600 mg every 2 weeks. The primary end point was percentage change from baseline in Eczema Area and Severity Index (EASI) at week 16. Safety assessments included incidence of treatment-emergent adverse events. Results The study randomized 313 subjects in part 1 and 149 in part 2. At 16 weeks, the least squares mean percentage change from baseline in EASI was significantly greater in subjects receiving telazorlimab 300 mg every 2 weeks (part 1) and 600 mg every 2 weeks (part 2) versus placebo (-54.4% vs -34.2% for part 1 and -59.0% vs -41.8% for part 2, P = .008 for both). Telazorlimab was well tolerated, with similar distribution of adverse events between telazorlimab- and placebo-treated subjects in both part 1 and part 2. Conclusion Telazorlimab, administered subcutaneously at 300 mg every 2 weeks or 600 mg every 2 weeks following a loading dose, was well tolerated and induced significant and progressive clinical improvement in adults with moderate-to-severe atopic dermatitis.
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Affiliation(s)
| | | | - Sady Alpizar
- Clinical Research Trials of Florida Inc, Tampa, Fla
| | - Sylvia Pauser
- KliFOs—Klinische Forschung Osnabrück, Osnabrück, Germany
| | - Grazyna Pulka
- School of Medicine, Jagiellonian University Medical College, Krakow, Poland
| | | | | | | | | | | | - Vinu CA
- Ichnos Sciences, New York, NY
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14
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von Kobyletzki L, Henrohn D, Ballardini N, Neary MP, Ortsäter G, Rieem Dun A, Geale K, Lindberg I, Theodosiou G, Neregård P, De Geer A, Cha A, Cappelleri JC, Thyssen JP. Comorbidities in childhood atopic dermatitis: A population-based study. J Eur Acad Dermatol Venereol 2024; 38:354-364. [PMID: 37824103 DOI: 10.1111/jdv.19569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 08/29/2023] [Indexed: 10/13/2023]
Abstract
BACKGROUND Atopic dermatitis (AD) is a chronic inflammatory skin disease that is associated with allergic comorbidities. However, studies examining comorbidities in childhood AD are incomplete, which may contribute to suboptimal care. OBJECTIVE The objective was to compare the risk of developing different allergic and non-allergic comorbidities among children with AD to that of a matched non-AD reference cohort in Sweden. METHODS This was a nationwide population-based cohort study using longitudinal data from primary and specialist care registers. Patients with AD were identified by confirmed diagnosis in primary or specialist care. The non-AD reference cohort was randomly drawn from the general population and matched 1:1 with the AD patients. The risk of developing the following conditions was evaluated: hypersensitivity and allergic disorders, neurological disorders, psychiatric disorders, infections, immunological and inflammatory disorders, Type 1 diabetes (T1D), endocrine and metabolic disorders, skeletal disorders, ocular disorders and malignancies. RESULTS This study included 165,145 patients with AD (mild-to-moderate [n = 126,681] and severe [n = 38,464]) and an equally sized reference cohort. Patients with AD displayed a higher risk of developing comorbid conditions for all investigated categories, except for T1D and skeletal disorders, compared with the reference cohort. The highest risk compared with the reference cohort was observed for hypersensitivity and allergic disorders (hazard ratio [HR]: 3.87), followed by malignancies (HR: 2.53) and immunological and inflammatory disorders (HR: 2.36). Patients with AD also had higher risk of developing multiple comorbidities (≥2). The risk of comorbidity onset increased alongside AD severity and patients with active AD were associated with increased risk of comorbidity onset compared with patients in remission. CONCLUSIONS The clinical burden of AD is substantial for children with AD and patients are at an increased risk of developing several comorbid conditions extending beyond the atopic march. Our results also showed a positive association between worsening severity of AD and an increased risk of comorbidity onset.
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Affiliation(s)
- Laura von Kobyletzki
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Lund, Sweden
| | - Dan Henrohn
- Inflammation and Immunology, Pfizer AB, Stockholm, Sweden
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Natalia Ballardini
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Dermatology and Sexual Health, Södersjukhuset, Stockholm, Sweden
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - Maureen P Neary
- Inflammation and Immunology, Pfizer Inc., Collegeville, Pennsylvania, USA
| | | | | | - Kirk Geale
- Quantify Research AB, Stockholm, Sweden
- Dermatology and Venereology, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | | | | | - Petra Neregård
- Inflammation and Immunology, Pfizer AB, Stockholm, Sweden
| | - Anna De Geer
- Inflammation and Immunology, Pfizer AB, Stockholm, Sweden
| | - Amy Cha
- Inflammation and Immunology, Pfizer Inc., New York, New York, USA
| | - Joseph C Cappelleri
- Global Biometrics and Data Management (Statistics), Pfizer Inc., Groton, Connecticut, USA
| | - Jacob P Thyssen
- Department of Dermatology and Venereology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
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15
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Pitlick MM, Johnson S, Mullakary RM, Taneja V, Joshi AY. Multi-Site Microbiome Composition in Atopic Dermatitis: A Case-Control Study. Ann Dermatol 2024; 36:53-55. [PMID: 38325434 PMCID: PMC10861306 DOI: 10.5021/ad.22.117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 01/06/2023] [Accepted: 04/11/2023] [Indexed: 02/09/2024] Open
Affiliation(s)
| | - Stephen Johnson
- Division of Computational Biology, Mayo Clinic, Rochester, MN, USA
| | | | - Veena Taneja
- Department of Immunology, Mayo Clinic, Rochester, MN, USA
| | - Avni Y Joshi
- Division of Allergic Diseases, Mayo Clinic, Rochester, MN, USA.
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16
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Wan J. Changes in the epidemiology of atopic dermatitis: putting them into context. Br J Dermatol 2024; 190:143-144. [PMID: 37952163 DOI: 10.1093/bjd/ljad443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 12/04/2023] [Indexed: 11/14/2023]
Affiliation(s)
- Joy Wan
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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17
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Af Klinteberg M, Winberg A, Andersson M, Rönmark E, Hedman L. Decreasing prevalence of atopic dermatitis in Swedish schoolchildren: three repeated population-based surveys. Br J Dermatol 2024; 190:191-198. [PMID: 37776301 DOI: 10.1093/bjd/ljad370] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 09/18/2023] [Accepted: 09/21/2023] [Indexed: 10/02/2023]
Abstract
BACKGROUND The prevalence of atopic dermatitis (AD) has increased over several decades and now affects about one-fifth of all children in high-income countries (HICs). While the increase continues in lower-income countries, the prevalence of AD might have reached a plateau in HICs. OBJECTIVES To investigate trends in the prevalence of AD and atopic comorbidity in schoolchildren in Sweden. METHODS The study population consisted of three cohorts of children (median age 8 years) in Norrbotten, Sweden, for 1996 (n = 3430), 2006 (n = 2585) and 2017 (n = 2785). An identical questionnaire that included questions from the International Study of Asthma and Allergies in Childhood (ISAAC) protocol was used in all three cohorts. Trends in AD prevalence were estimated, as well as trends in atopic comorbidity. AD prevalence was estimated both according to the ISAAC definition of AD and by adding the reported diagnosis by a physician (D-AD). RESULTS The prevalence of AD decreased in the last decade, from 22.8% (1996) and 21.3% (2006) to 16.3% (2017; P < 0.001). The prevalence of D-AD was lower, but the same pattern of decrease was seen, from 9.3% (1996) and 9.4% (2006) to 5.7% (2017; P < 0.001). In all three cohorts, AD was more common among girls than boys (18.9% vs. 13.8% in 2017; P < 0.001). Children from the mountain inlands had a higher prevalence of AD than children from coastal cities (22.0% vs. 15.1% in 2017; P < 0.001). In comparing D-AD, there were no significant differences between the sexes or between inland or coastal living. Concomitant asthma increased over the years from 12.2% (1996) to 15.8% (2006) to 23.0% (2017; P < 0.001). Concomitant allergic rhinitis and allergic sensitization increased from 1996 (15.0% and 27.5%) to 2006 (24.7% and 49.5%) but then levelled off until 2017 (21.0% and 46.7%). CONCLUSIONS The prevalence of AD among schoolchildren in Sweden decreased over the study period, whereas atopic comorbidity among children with AD increased. Although a decrease was seen, AD is still common and the increase in atopic comorbidity among children with AD, especially the increase in asthma, is concerning.
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Affiliation(s)
- Maja Af Klinteberg
- Department of Public Health and Clinical Medicine, Dermatology and Venereology, Umeå University, Umeå, Sweden
| | - Anna Winberg
- Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden
| | - Martin Andersson
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, The OLIN Unit, Umeå University, Umeå, Sweden
| | - Eva Rönmark
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, The OLIN Unit, Umeå University, Umeå, Sweden
| | - Linnea Hedman
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, The OLIN Unit, Umeå University, Umeå, Sweden
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18
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Roh YJ, Choi YH, Shin SH, Lee MK, Won YJ, Lee JH, Cho BS, Park KY, Seo SJ. Adipose tissue-derived exosomes alleviate particulate matter-induced inflammatory response and skin barrier damage in atopic dermatitis-like triple-cell model. PLoS One 2024; 19:e0292050. [PMID: 38241278 PMCID: PMC10798485 DOI: 10.1371/journal.pone.0292050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 09/11/2023] [Indexed: 01/21/2024] Open
Abstract
Recently, particulate matter (PM) has been shown to exacerbate atopic dermatitis (AD) by inducing an inflammatory response. Meanwhile, several studies revealed that exosomes derived from adipose tissue-derived mesenchymal stem cells promote wound healing and alleviate inflammation via their regenerative and immunomodulatory capacities. Our study aimed to investigate the effects of human adipose tissue-derived mesenchymal stem cell-derived (ASC)-exosomes in PM-induced AD. An AD-like triple-cell model was established by treating human keratinocytes, dermal fibroblasts, and mast cells with polyinosinic:polycytidylic acid (Poly I:C) and interleukin 1 alpha (IL-1α). The effects of PM and ASC-exosomes on the expression of pro-inflammatory cytokines and skin barrier proteins were examined using quantitative real-time polymerase chain reaction, western blotting, and immunofluorescence. PM increased pro-inflammatory cytokines (IL-6, IL-1β, and IL-1α) and decreased the anti-inflammatory cytokine IL-10, while the mRNA expression of skin barrier proteins (loricrin and filaggrin) decreased. However, when the cells were treated with ASC-exosomes, the PM-induced effects on pro-inflammatory cytokines and skin barrier proteins were reversed. Our results confirmed that PM-induced inflammation and skin barrier damage were alleviated by ASC-exosomes in our AD-like triple-cell model. These data suggest that ASC-exosomes can serve as a therapeutic agent for PM-exacerbated AD.
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Affiliation(s)
- Yoon Jin Roh
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea
| | - Yong Hee Choi
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea
| | - Sun Hye Shin
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea
| | - Mi-Kyung Lee
- Department of Laboratory Medicine, Chung-Ang University College of Medicine, Seoul, Korea
| | - Yu Jin Won
- ExoCoBio Exosome Institute (EEI), ExoCoBio Inc., Seoul, Korea
| | - Jun Ho Lee
- ExoCoBio Exosome Institute (EEI), ExoCoBio Inc., Seoul, Korea
| | - Byong Seung Cho
- ExoCoBio Exosome Institute (EEI), ExoCoBio Inc., Seoul, Korea
| | - Kui Young Park
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea
| | - Seong Jun Seo
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea
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19
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Kang KM, Han JH, Kim KS, Kim EK, Shin Y, Park JH, Kim H, Kim NY, Kim YG, Kim H, Park H, Kim YM, Kee SJ, Kim SJ, Kim HS, Kim YC. Chlorophyll a and novel synthetic derivatives alleviate atopic dermatitis by suppressing Th2 cell differentiation via IL-4 receptor modulation. Clin Immunol 2024; 258:109852. [PMID: 38029848 DOI: 10.1016/j.clim.2023.109852] [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: 04/30/2023] [Revised: 10/14/2023] [Accepted: 11/08/2023] [Indexed: 12/01/2023]
Abstract
Atopic dermatitis (AD) treatment has largely relied on non-specific broad immunosuppressants despite their long-term toxicities until the approval of dupilumab, which blocks IL-4 signaling to target Th2 cell responses. Here, we report the discovery of compound 4aa, a novel compound derived from the structure of chlorophyll a, and the efficacy of chlorophyll a to alleviate AD symptoms by oral administration in human AD patients. 4aa downregulated GATA3 and IL-4 in differentiating Th2 cells by potently blocking IL-4 receptor dimerization. In the murine model, oral administration of 4aa reduced the clinical severity of symptoms and scratching behavior by 76% and 72%, respectively. Notably, the elevated serum levels of Th2 cytokines reduced to levels similar to those in the normal group after oral administration of 4aa. Additionally, the toxicological studies showed favorable safety profiles and good tolerance. In conclusion, 4aa may be applied for novel therapeutic developments for patients with AD.
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Affiliation(s)
- Koon Mook Kang
- School of Life Sciences, Gwangju Institute of Science and Technology, 123 Cheomdangwagi-ro, Buk-gu, Gwangju 61005, Republic of Korea
| | - Jung-Hyun Han
- School of Life Sciences, Gwangju Institute of Science and Technology, 123 Cheomdangwagi-ro, Buk-gu, Gwangju 61005, Republic of Korea
| | - Kyeong Seok Kim
- School of Pharmacy, Sungkyunkwan University, 2066 Seobu-ro, Jangan-gu, Suwon-si, Gyeonggi-do 16419, Republic of Korea
| | - Eun Kyung Kim
- Department of Pharmacy, College of Pharmacy and Institute of Pharmaceutical Science and Technology, Hanyang University, 55 Hanyangdaehak-ro, Sangnok-gu, Ansan-si, Gyeonggi-do 15588, Republic of Korea
| | - Youna Shin
- School of Life Sciences, Gwangju Institute of Science and Technology, 123 Cheomdangwagi-ro, Buk-gu, Gwangju 61005, Republic of Korea
| | - Jae Hyeon Park
- School of Pharmacy, Sungkyunkwan University, 2066 Seobu-ro, Jangan-gu, Suwon-si, Gyeonggi-do 16419, Republic of Korea
| | - Hyeon Kim
- R&D Center, Huons co. Ltd., 55 Hanyangdaehak-ro, Sangnok-gu, Ansan-si, Gyeonggi-do 15588, Republic of Korea
| | - Na Yoon Kim
- College of Pharmacy, Dankook University, 119 Dandae-ro, Dongnam-gu, Cheonan-si, Chungcheongnam-do 31116, Republic of Korea
| | - Yoon Gyoon Kim
- College of Pharmacy, Dankook University, 119 Dandae-ro, Dongnam-gu, Cheonan-si, Chungcheongnam-do 31116, Republic of Korea
| | - Hyunjun Kim
- R&D Center, Huons co. Ltd., 55 Hanyangdaehak-ro, Sangnok-gu, Ansan-si, Gyeonggi-do 15588, Republic of Korea
| | - Hyunjin Park
- R&D Center, Huons co. Ltd., 55 Hanyangdaehak-ro, Sangnok-gu, Ansan-si, Gyeonggi-do 15588, Republic of Korea
| | - Young-Mi Kim
- Department of Pharmacy, College of Pharmacy and Institute of Pharmaceutical Science and Technology, Hanyang University, 55 Hanyangdaehak-ro, Sangnok-gu, Ansan-si, Gyeonggi-do 15588, Republic of Korea
| | - Seung-Jung Kee
- Department of Laboratory Medicine, Chonnam National University Hospital, 42 Jebong-ro, Dong-gu, Gwangju 61469, Republic of Korea
| | - Seong-Jin Kim
- Department of Dermatology, Chonnam National University Hospital, 42 Jebong-ro, Dong-gu, Gwangju 61469, Republic of Korea.
| | - Hyung Sik Kim
- School of Pharmacy, Sungkyunkwan University, 2066 Seobu-ro, Jangan-gu, Suwon-si, Gyeonggi-do 16419, Republic of Korea.
| | - Yong-Chul Kim
- School of Life Sciences, Gwangju Institute of Science and Technology, 123 Cheomdangwagi-ro, Buk-gu, Gwangju 61005, Republic of Korea.
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20
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Tian J, Zhang D, Yang Y, Huang Y, Wang L, Yao X, Lu Q. Global epidemiology of atopic dermatitis: a comprehensive systematic analysis and modelling study. Br J Dermatol 2023; 190:55-61. [PMID: 37705227 DOI: 10.1093/bjd/ljad339] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 07/16/2023] [Accepted: 09/06/2023] [Indexed: 09/15/2023]
Abstract
BACKGROUND Atopic dermatitis (AD) is the leading cause of the global burden from skin disease; no study has provided global and country-specific epidemiological estimates of AD. OBJECTIVES To quantify global, regional and country-specific estimates of the epidemiology of AD. METHODS A comprehensive search for epidemiological studies in AD was conducted in four electronic databases (PubMed, Embase, Web of Science and China National Knowledge Infrastructure). A Bayesian hierarchical linear mixed model was constructed to calculate epidemiological estimates of AD considering the heterogeneity of regions, countries, type of diagnoses and age strata. RESULTS In total, 344 studies met the inclusion criteria. Incidence varied substantially with the location and age of the surveyed participants. The global prevalence of AD and the population affected by AD were estimated to be 2.6% [95% uncertainty interval (UI) 1.9-3.5] and 204.05 million people, respectively. Around 101.27 million adults and 102.78 million children worldwide have AD, corresponding to prevalence rates of 2.0% (95% UI 1.4-2.6) and 4.0% (95% UI 2.8-5.3), respectively. Females were more likely to suffer from AD than males: the global prevalence of AD in females was 2.8% (95% UI 2.0-3.7%) and affected 108.29 million people, while in males the corresponding estimates were 2.4% (95% UI 1.7-3.3%) and 95.76 million people. CONCLUSIONS Epidemiological AD data are lacking in 41.5% of countries worldwide. The epidemiology of AD varies substantially with age and sex and is distributed unequally across geographical regions.
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Affiliation(s)
- Jingru Tian
- Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
- Key Laboratory of Basic and Translational Research on Immune-Mediated Skin Diseases, Chinese Academy of Medical Sciences, Nanjing, China
- Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Nanjing, China
| | - Dingyao Zhang
- Graduate Program in Biological and Biomedical Sciences
- Program in Computational Biology and Bioinformatics
| | - Yi Yang
- Department of Nuclear Medicine, Xiangya Hospital, Central South University, Changsha, China
| | - Yaqing Huang
- Department of Pathology, Yale University, New Haven, CT, USA
| | - Lu Wang
- Department of Dermatology, Hunan Key Laboratory of Medical Epigenomics, the Second Xiangya Hospital, Central South University, Changsha, China
| | - Xu Yao
- Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
| | - Qianjin Lu
- Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
- Key Laboratory of Basic and Translational Research on Immune-Mediated Skin Diseases, Chinese Academy of Medical Sciences, Nanjing, China
- Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Nanjing, China
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21
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Kim MS, Kong D, Han M, Roh K, Koo H, Lee S, Kang KS. Canine amniotic membrane-derived mesenchymal stem cells ameliorate atopic dermatitis through regeneration and immunomodulation. Vet Res Commun 2023; 47:2055-2070. [PMID: 37421548 DOI: 10.1007/s11259-023-10155-5] [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: 03/30/2023] [Accepted: 06/19/2023] [Indexed: 07/10/2023]
Abstract
Mesenchymal stem cells (MSCs) are a promising tool for treating immune disorders. However, the immunomodulatory effects of canine MSCs compared with other commercialized biologics for treating immune disorders have not been well studied. In this study we investigated the characteristics and immunomodulatory effects of canine amnion membrane (cAM)-MSCs. We examined gene expression of immune modulation and T lymphocytes from activated canine peripheral blood mononuclear cell (PBMC) proliferation. As a result, we confirmed that cAM-MSCs upregulated immune modulation genes (TGF-β1, IDO1 and PTGES2) and suppressed the proliferation capacity of T cells. Moreover, we confirmed the therapeutic effect of cAM-MSCs compared with oclacitinib (OCL), the most commonly used Janus kinase (JAK) inhibitor, as a treatment for canine atopic dermatitis (AD) using a mouse AD model. As a result, we confirmed that cAM-MSCs with PBS treatment groups (passage 4, 6 and 8) compared with PBS only (PBS) though scores of dermatologic signs, tissue pathologic changes and inflammatory cytokines were significantly reduced. In particular, cAM-MSCs were more effective than OCL in the recovery of wound dysfunction, regulation of mast cell activity and expression level of immune modulation protein. Interestingly, subcutaneous injection of cAM-MSCs induced weight recovery, but oral administration of oclacitinib induced weight loss as a side effect. In conclusion, this study suggests that cAM-MSCs can be developed as a safe canine treatment for atopic dermatitis without side effects through effective regeneration and immunomodulation.
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Affiliation(s)
- Min Soo Kim
- Adult Stem Cell Research Center, Research Institute for Veterinary Science, College of Veterinary Medicine, Seoul National University, Seoul, 08826, Republic of Korea
| | - Dasom Kong
- Adult Stem Cell Research Center, Research Institute for Veterinary Science, College of Veterinary Medicine, Seoul National University, Seoul, 08826, Republic of Korea
| | - Myounghee Han
- Department of Agricultural Biotechnology and Research Institute of Agriculture and Life Sciences, Seoul National University, Seoul, 08826, Republic of Korea
| | - Kyounghwan Roh
- Stem Cell and Regenerative Bioengineering Institute, Global R&D Center, Kangstem Biotech Co. Ltd, Ace Highend Tower 8, 84, Gasan digital 1-ro, Geumcheon-gu, Seoul, 08590, Republic of Korea
| | - Hojun Koo
- Smile Veterinary Clinic, Jungbu-daero, Cheoin-gu, yongin-si, Gyeonggi-do, 1510, Republic of Korea
| | - Seunghee Lee
- Stem Cell and Regenerative Bioengineering Institute, Global R&D Center, Kangstem Biotech Co. Ltd, Ace Highend Tower 8, 84, Gasan digital 1-ro, Geumcheon-gu, Seoul, 08590, Republic of Korea
| | - Kyung-Sun Kang
- Adult Stem Cell Research Center, Research Institute for Veterinary Science, College of Veterinary Medicine, Seoul National University, Seoul, 08826, Republic of Korea.
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22
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Guttman-Yassky E, Irvine AD, Brunner PM, Kim BS, Boguniewicz M, Parmentier J, Platt AM, Kabashima K. The role of Janus kinase signaling in the pathology of atopic dermatitis. J Allergy Clin Immunol 2023; 152:1394-1404. [PMID: 37536511 DOI: 10.1016/j.jaci.2023.07.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 06/06/2023] [Accepted: 07/20/2023] [Indexed: 08/05/2023]
Abstract
Atopic dermatitis (AD) is a heterogeneous, chronic, relapsing, inflammatory skin disease associated with considerable physical, psychological, and economic burden. The pathology of AD includes complex interactions involving abnormalities in immune and skin barrier genes, skin barrier disruption, immune dysregulation, microbiome disturbance, and other environmental factors. Many of the cytokines involved in AD pathology, including IL-4, IL-13, IL-22, IL-31, thymic stromal lymphopoietin, and IFN-γ, signal through the Janus kinase (JAK)-signal transducer and activation of transcription (STAT) pathway. The JAK family includes JAK1, JAK2, JAK3, and tyrosine kinase 2; the STAT family includes STAT1, STAT2, STAT3, STAT4, STAT5A/B, and STAT6. Activation of the JAK-STAT pathway has been implicated in the pathology of several immune-mediated inflammatory diseases, including AD. However, the exact mechanisms of JAK-STAT involvement in AD have not been fully characterized. This review aims to discuss current knowledge about the role of the JAK-STAT signaling pathway and, specifically, the role of JAK1 in the pathology and symptomology of AD.
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Affiliation(s)
- Emma Guttman-Yassky
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York.
| | | | - Patrick M Brunner
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York
| | - Brian S Kim
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York
| | - Mark Boguniewicz
- Department of Pediatrics, National Jewish Health and University of Colorado School of Medicine, Denver
| | | | | | - Kenji Kabashima
- Department of Dermatology, Graduate School of Medicine, Kyoto University, Kyoto
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23
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Alturki BA, Almutairi R, Al-Mutairi AG, Alrajhi D, Binyousef FH, Alzamil F. The Effects of Smoking on the Severity of Atopic Dermatitis in Saudi Arabia. Cureus 2023; 15:e50315. [PMID: 38205469 PMCID: PMC10777615 DOI: 10.7759/cureus.50315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/13/2023] [Indexed: 01/12/2024] Open
Abstract
Background Atopic dermatitis (AD) is a well-known inflammatory skin disease that is associated with a family history of other atopic diseases. Tobacco smoking has been found to affect AD as well as several other inflammatory skin diseases. In this study, we aimed to investigate this association and to elucidate the link between dose-dependent tobacco exposure and symptom severity. Methods This cross-sectional study was conducted on individuals from the general population of Riyadh, Saudi Arabia. Data were collected using an online questionnaire. All statistical analyses were performed using RStudio, version 1.1.363 (RStudio, PBC, Boston, Massachusetts, United States). Questions about the participants' age, sex, and occupational status were included. The participants were asked to report their daily handwashing habits and history of atopic diseases. Data on the smoking duration, number of cigarettes smoked per day, and passive exposure were collected. Results A total of 510 participants (41.3 %) reported having AD. Smoking was significantly associated with an increased prevalence of AD. The odds of having AD were 1.78 and 2.27 times higher in occasional smokers (odds ratio (OR) = 1.78, p < 0.05) and daily smokers (OR = 2.27, p < 0.001) than in non-smokers. Neither smoking frequency (p = 0.19) nor duration (p = 0.73) was significantly associated with AD prevalence. Conclusion Smoking is significantly associated with an increased prevalence of AD. Adults should be discouraged from smoking in order to prevent adult-onset AD. The level of nicotine exposure should be measured objectively in future studies.
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Affiliation(s)
- Basma A Alturki
- Dermatology, College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU
| | - Rahaf Almutairi
- Dermatology, College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU
| | - Atheer G Al-Mutairi
- Dermatology, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, SAU
| | - Danah Alrajhi
- Dermatology, College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU
| | | | - Fajer Alzamil
- Dermatology, College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU
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24
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Dhar S, De A, Saha A, Chitnis KR, Mane A, Dhoot D, Barkate H. Intermittent or Sequential Topical Tacrolimus in Atopic Dermatitis: Systematic Review and Meta-Analysis. Cureus 2023; 15:e50640. [PMID: 38229798 PMCID: PMC10789587 DOI: 10.7759/cureus.50640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/16/2023] [Indexed: 01/18/2024] Open
Abstract
Topical calcineurin inhibitors (TCIs) and topical corticosteroids (TCS) are the mainstays of flare management for atopic eczema or atopic dermatitis (AD). Tacrolimus (an immunomodulator), belongs to the class of calcineurin inhibitors, with promising efficacy in AD. We performed this systematic review to obtain an up-to-date coverage map of controlled clinical trials of sequential or intermittent treatments with TCI as a therapeutic intervention for AD. Articles of interest were retrieved from PubMed, Google Scholar, and EMBASE published between between January 2000 and March 2023. Key words were "calcineurin inhibitors," "corticosteroids," "atopic dermatitis," "pruritus," "sequential," "intermittent" and "consecutive" while fixed language search consisted of "Intermittent topical calcineurin inhibitors AND topical corticosteroids AND atopic dermatitis OR eczema" AD patients who were administered sequential and/or intermittent applications of TCI for management of atopic eczema were included. Outcome measures included but were not limited to Scoring of Atopic Dermatitis (SCORAD) and the Eczema Area Severity Score (EASI). Four clinical trials were considered for the purpose of review. A total of 101 patients with AD were analysed. The risk of bias was low in two studies, while the other two had an unclear risk of bias. Overall, pooled data from two trials revealed that sequential therapy with TCS/TCI was comparable to monotherapy or emollients, as the test for overall effect determined was non-significant with a p-value of 0.33. The two studies were highly heterogeneous, as indicated by a very high I2 of 92% and an extremely significant p-value (p=0.0005). Sequential therapy with TCS and TCIs was effective and well tolerated in the management of AD and it may be considered an important treatment approach during the initial period.
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Affiliation(s)
- Sandipan Dhar
- Dermatology, Institute of Child Health, Kolkata, IND
| | - Abhishek De
- Dermatology, Calcutta National Medical College and Hospital, Kolkata, IND
| | - Abhijit Saha
- Dermatology, Institute of Child Health, Kolkata, IND
| | - Kruttika R Chitnis
- Pharmacology and Therapeutics, Seth Gordhandas Sunderdas Medical College and King Edward Memorial Hospital, Mumbai, IND
- Global Medical Affairs, Glenmark Pharmaceuticals Limited, Mumbai, IND
| | - Abhishek Mane
- Global Medical Affairs, Glenmark Pharmaceuticals Limited, Mumbai, IND
| | - Dhiraj Dhoot
- Global Medical Affairs, Glenmark Pharmaceuticals Limited, Mumbai, IND
| | - Hanmant Barkate
- Global Medical Affairs, Glenmark Pharmaceuticals Limited, Mumbai, IND
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25
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Albogami MF, AlJomaie MS, Almarri SS, Al-Malki S, Tamur S, Aljaid M, Khayat A, Alzahrani A. Topical Corticosteroid Phobia Among Parents of Children with Atopic Dermatitis (Eczema)- A Cross-Sectional Study. Patient Prefer Adherence 2023; 17:2761-2772. [PMID: 37936715 PMCID: PMC10627058 DOI: 10.2147/ppa.s431719] [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: 08/23/2023] [Accepted: 10/26/2023] [Indexed: 11/09/2023] Open
Abstract
Background Anxiety about using topical corticosteroids (TCS) for childrens among parents and caretakers is a common cause of treatment failure and an overall decline in the child's quality of life. The purpose of this study was to examine the perspectives and worries of parents of Atopic dermatitis (AD) children regarding TCS. Additionally, we investigate the degree of phobia in relation to the use of the TCS. Materials and Methods A convenience sample of 301 parents of children who had been identified with atopic dermatitis from two hospitals in Taif city were enrolled in this study. Parents who chose to participate were sent a questionnaire measuring their level of fear of TCS using the TOPICOP© scale, which also included inquiries about their demographics and clinical characteristics. Multivariate analysis was used to determine what factors influence people's overall levels of fear. Results The median global TOPICOP score was 66.6% (IQR 60.4-75%), SD 12.83%, which showed that nearly two-thirds of the participants showed corticosteroid phobia. A multifactorial ANOVA model showed that parents who had a female child with AD and mothers who had experienced drug allergies had a significant influence on TOPICOP scores (P<0.05). Conclusion Topical corticosteroid phobia is widespread among parents of children patients with AD in Taif. Regarding the utilization of TCS, we place a strong emphasis on the significant role that physicians play as sources of reliable information and proper education.
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Affiliation(s)
| | - Muneer S AlJomaie
- Department of Pediatrics, Taif Children Hospital, Taif, Saudi Arabia
| | | | - Sultan Al-Malki
- Department of Pediatrics, College of Medicine, Taif University, Taif, Saudi Arabia
| | - Shadi Tamur
- Department of Pediatrics, College of Medicine, Taif University, Taif, Saudi Arabia
| | - Maryam Aljaid
- Department of Pediatrics, College of Medicine, Taif University, Taif, Saudi Arabia
| | - Abdullah Khayat
- Department of Pediatrics, College of Medicine, Taif University, Taif, Saudi Arabia
| | - Ahmad Alzahrani
- Department of Pediatrics, College of Medicine, Taif University, Taif, Saudi Arabia
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26
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Dartora VFC, Passos JS, Osorio B, Hung RC, Nguyen M, Wang A, Panitch A. Chitosan hydrogels with MK2 inhibitor peptide-loaded nanoparticles to treat atopic dermatitis. J Control Release 2023; 362:591-605. [PMID: 37660990 DOI: 10.1016/j.jconrel.2023.08.061] [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: 12/06/2022] [Revised: 08/05/2023] [Accepted: 08/31/2023] [Indexed: 09/05/2023]
Abstract
Atopic dermatitis (AD) is a chronic inflammatory skin disorder that lacks ideal long-term treatment options due to a series of side effects, such as skin atrophy, related to the most common treatment prescribed to manage moderate-to-severe AD. In this study, a cell-penetrating MK2 inhibitor peptide YARA (YARAAARQARAKALNRQGLVAA) was loaded into hollow thermo-responsive pNIPAM nanoparticles (NP), which were further incorporated into chitosan hydrogels (H-NP-YARA) to promote local drug delivery, improve moisture and the anti-inflammatory activity. The NPs exhibited high loading efficiency (>50%) and the hydrogel remained porous following NP incorporation as observed by scanning electron microscopy (SEM). Both nanoparticles and hydrogels were able to improve the release of YARA and sustained release to up to 120 h. The hydrogels and NPs delivered 2 and 4-fold more YARA into viable skin layers of porcine skin in vitro at 12 h post-application than the non-encapsulated compound in intact and impaired barrier conditions. Furthermore, the YARA-loaded NPs (NP-YARA) and H-NP-YARA treatment decreased the levels of inflammatory cytokines up to 20 time-fold compared with the non-treated group of human keratinocytes under inflammatory conditions. Consistent with the results in cell culture, the loading of YARA in NP reduced the levels of IL-1β, IL-6, and TNF-α up to 3.3 times in an ex vivo skin culture model after induction of inflammation. A further decrease of up to 17 times-fold was observed with H-NP-YARA treatment compared to the drug in solution. Our data collectively suggest that chitosan hydrogel containing YARA-loaded nanoparticles is a promising new formulation for the topical treatment of AD.
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Affiliation(s)
- Vanessa F C Dartora
- Biomedical Engineering Graduate Group, University of California Davis, Davis, CA, USA; Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, USA
| | - Julia Sapienza Passos
- Biomedical Engineering Graduate Group, University of California Davis, Davis, CA, USA; Institute of Biomedical Sciences, Department of Pharmacology, University of Sao Paulo, Brazil
| | - Blanca Osorio
- Biomedical Engineering Graduate Group, University of California Davis, Davis, CA, USA
| | - Ruei-Chun Hung
- Biomedical Engineering Graduate Group, University of California Davis, Davis, CA, USA; Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, USA
| | - Michael Nguyen
- Biomedical Engineering Graduate Group, University of California Davis, Davis, CA, USA
| | - Aijun Wang
- Biomedical Engineering Graduate Group, University of California Davis, Davis, CA, USA; Department of Surgery, University of California Davis, Sacramento, CA, USA; Institute for Pediatric Regenerative Medicine, Shriners Hospitals for Children, Sacramento, CA, USA
| | - Alyssa Panitch
- Biomedical Engineering Graduate Group, University of California Davis, Davis, CA, USA; Department of Surgery, University of California Davis, Sacramento, CA, USA; Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, USA.
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27
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Kaczmarska A, Kwiatkowska D, Skrzypek KK, Kowalewski ZT, Jaworecka K, Reich A. Pathomechanism of Pruritus in Psoriasis and Atopic Dermatitis: Novel Approaches, Similarities and Differences. Int J Mol Sci 2023; 24:14734. [PMID: 37834183 PMCID: PMC10573181 DOI: 10.3390/ijms241914734] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 09/24/2023] [Accepted: 09/27/2023] [Indexed: 10/15/2023] Open
Abstract
Pruritus is defined as an unpleasant sensation that elicits a desire to scratch. Nearly a third of the world's population may suffer from pruritus during their lifetime. This symptom is widely observed in numerous inflammatory skin diseases-e.g., approximately 70-90% of patients with psoriasis and almost every patient with atopic dermatitis suffer from pruritus. Although the pathogenesis of atopic dermatitis and psoriasis is different, the complex intricacies between several biochemical mediators, enzymes, and pathways seem to play a crucial role in both conditions. Despite the high prevalence of pruritus in the general population, the pathogenesis of this symptom in various conditions remains elusive. This review aims to summarize current knowledge about the pathogenesis of pruritus in psoriasis and atopic dermatitis. Each molecule involved in the pruritic pathway would merit a separate chapter or even an entire book, however, in the current review we have concentrated on some reports which we found crucial in the understanding of pruritus. However, the pathomechanism of pruritus is an extremely complex and intricate process. Moreover, many of these signaling pathways are currently undergoing detailed analysis or are still unexplained. As a result, it is currently difficult to take an objective view of how far we have come in elucidating the pathogenesis of pruritus in the described diseases. Nevertheless, considerable progress has been made in recent years.
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Affiliation(s)
- Agnieszka Kaczmarska
- Department of Dermatology, Institute of Medical Sciences, Medical College of Rzeszow University, 35-055 Rzeszów, Poland; (A.K.); (D.K.); (K.J.)
| | - Dominika Kwiatkowska
- Department of Dermatology, Institute of Medical Sciences, Medical College of Rzeszow University, 35-055 Rzeszów, Poland; (A.K.); (D.K.); (K.J.)
| | | | | | - Kamila Jaworecka
- Department of Dermatology, Institute of Medical Sciences, Medical College of Rzeszow University, 35-055 Rzeszów, Poland; (A.K.); (D.K.); (K.J.)
| | - Adam Reich
- Department of Dermatology, Institute of Medical Sciences, Medical College of Rzeszow University, 35-055 Rzeszów, Poland; (A.K.); (D.K.); (K.J.)
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28
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Moran MC, Brewer MG, Schlievert PM, Beck LA. S. aureus virulence factors decrease epithelial barrier function and increase susceptibility to viral infection. Microbiol Spectr 2023; 11:e0168423. [PMID: 37737609 PMCID: PMC10581065 DOI: 10.1128/spectrum.01684-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 07/03/2023] [Indexed: 09/23/2023] Open
Abstract
Individuals with atopic dermatitis (AD) are highly colonized by Staphylococcus aureus and are more susceptible to severe viral complications. We hypothesized that S. aureus secreted virulence factors may alter keratinocyte biology to enhance viral susceptibility through disruption of the skin barrier, impaired keratinocyte differentiation, and/or inflammation. To address this hypothesis, human keratinocytes were exposed to conditioned media from multiple S. aureus strains that vary in virulence factor production (USA300, HG003, and RN4220) or select purified virulence factors. We have identified the S. aureus enterotoxin-like superantigen SElQ, as a virulence factor of interest, since it is highly produced by USA300 and was detected on the skin of 53% of AD subjects (n = 72) in a study conducted by our group. Treatment with USA300 conditioned media or purified SElQ resulted in a significant increase in keratinocyte susceptibility to infection with vaccinia virus, and also significantly decreased barrier function. Importantly, we have previously demonstrated that keratinocyte differentiation influences susceptibility to viral infection, and our qPCR observations indicated that USA300 S. aureus and SElQ alter differentiation in keratinocytes. CRISPR/Cas9 was used to knock out CD40, a potential enterotoxin receptor on epithelial cells. We found that CD40 expression on keratinocytes was not completely necessary for SElQ-mediated responses, as measured by proinflammatory cytokine expression and barrier function. Together, these findings support that select S. aureus virulence factors, particularly SElQ, enhance the susceptibility of epidermal cells to viral infection, which may contribute to the increased cutaneous infections observed in individuals with AD. IMPORTANCE Staphylococcus aureus skin colonization and infection are frequently observed in individuals with atopic dermatitis. Many S. aureus strains belong to the clonal group USA300, and these strains produce superantigens including the staphylococcal enterotoxin-like Q (SElQ). Our studies highlight that SElQ may play a key role by altering keratinocyte differentiation and reducing barrier function; collectively, this may explain the AD-specific enhanced infection risk to cutaneous viruses. It is unclear what receptor mediates SElQ's effects on keratinocytes. We have shown that one putative surface receptor, CD40, was not critical for its effects on proinflammatory cytokine production or barrier function.
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Affiliation(s)
- Mary C. Moran
- Department of Dermatology, University of Rochester Medical Center, Rochester, New York, USA
- Department of Microbiology & Immunology, University of Rochester Medical Center, Rochester, New York, USA
| | - Matthew G. Brewer
- Department of Dermatology, University of Rochester Medical Center, Rochester, New York, USA
| | | | - Lisa A. Beck
- Department of Dermatology, University of Rochester Medical Center, Rochester, New York, USA
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Patumcharoenpol P, Kingkaw A, Nakphaichit M, Chatchatee P, Suratannon N, Panagiotou G, Vongsangnak W. Exploring Longitudinal Gut Microbiome towards Metabolic Functional Changes Associated in Atopic Dermatitis in Early Childhood. BIOLOGY 2023; 12:1262. [PMID: 37759661 PMCID: PMC10525566 DOI: 10.3390/biology12091262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 09/14/2023] [Accepted: 09/18/2023] [Indexed: 09/29/2023]
Abstract
Atopic dermatitis (AD) is a prevalent inflammatory skin disease that has been associated with changes in gut microbial composition in early life. However, there are limited longitudinal studies examining the gut microbiome in AD. This study aimed to explore taxonomy and metabolic functions across longitudinal gut microbiomes associated with AD in early childhood from 9 to 30 months of age using integrative data analysis within the Thai population. Our analysis revealed that gut microbiome diversity was not different between healthy and AD groups; however, significant taxonomic differences were observed. Key gut bacteria with short-chain fatty acids (SCFAs) production potentials, such as Anaerostipes, Butyricicoccus, Ruminococcus, and Lactobacillus species, showed a higher abundance in the AD group. In addition, metabolic alterations between the healthy and AD groups associated with vitamin production and host immune response, such as biosynthesis of menaquinol, succinate, and (Kdo)2-lipid A, were observed. This study serves as the first framework for monitoring longitudinal microbial imbalances and metabolic functions associated with allergic diseases in Thai children during early childhood.
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Affiliation(s)
- Preecha Patumcharoenpol
- Interdisciplinary Graduate Program in Bioscience, Faculty of Science, Kasetsart University, Bangkok 10900, Thailand; (P.P.); (A.K.)
| | - Amornthep Kingkaw
- Interdisciplinary Graduate Program in Bioscience, Faculty of Science, Kasetsart University, Bangkok 10900, Thailand; (P.P.); (A.K.)
| | - Massalin Nakphaichit
- Department of Biotechnology, Faculty of Agro-Industry, Kasetsart University, Bangkok 10900, Thailand;
| | - Pantipa Chatchatee
- Center of Excellence for Allergy and Clinical Immunology, Division of Allergy, Immunology and Rheumatology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand;
- King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok 10330, Thailand
| | - Narissara Suratannon
- Center of Excellence for Allergy and Clinical Immunology, Division of Allergy, Immunology and Rheumatology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand;
- King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok 10330, Thailand
| | - Gianni Panagiotou
- Microbiome Dynamics, Leibniz Institute for Natural Product Research and Infection Biology–Hans Knöll Institute, 07745 Jena, Germany;
- Faculty of Biological Sciences, Friedrich Schiller University, 07743 Jena, Germany
- Department of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Wanwipa Vongsangnak
- Department of Zoology, Faculty of Science, Kasetsart University, Bangkok 10900, Thailand
- Omics Center for Agriculture, Bioresources, Food, and Health, Kasetsart University (OmiKU), Bangkok 10900, Thailand
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30
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Sid Idris F, Anis Shaikh H, Vahora I, Moparthi KP, Al Rushaidi MT, Muddam M, Obajeun OA, Abaza A, Jaramillo AP, Hamid P. Maternal Diet and Infant Risk of Eczema and Food Allergy: A Systematic Review. Cureus 2023; 15:e45114. [PMID: 37842462 PMCID: PMC10569370 DOI: 10.7759/cureus.45114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 09/11/2023] [Indexed: 10/17/2023] Open
Abstract
A significant portion of the pediatric population is affected by allergy diseases, which have become a worldwide public health concern. Could maternal diet during pregnancy or breastfeeding influence allergy outcomes in offspring? If this cause-and-effect relationship exists, it will be simpler to design prevention strategies to reduce the incidence of allergic disorders in children, reduce costs to the public health system and to parents, and improve the quality of life of allergic children and their parents. In this systematic review, we will visit the literature from January 2019 to December 2022 to see if any relationship was found between maternal nutrition and its consequences on children's allergy occurrence. We will focus only on food allergy and eczema outcomes in the offspring. Also, we will summarize what was found to be protective or nonprotective to better control the outcomes if applied in the future.
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Affiliation(s)
- Faten Sid Idris
- Pediatrics, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Humna Anis Shaikh
- Pediatrics, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Ilma Vahora
- General Surgery, Saint George's University School of Medicine, Chicago, USA
- General Surgery, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Kiran Prasad Moparthi
- Medicine, SVS Medical College, Mahabubnagar, IND
- Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Majdah T Al Rushaidi
- Psychology, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - MeghanaReddy Muddam
- Medicine, SVS Medical College, Hyderabad, IND
- Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Omobolanle A Obajeun
- Pediatrics, Al Zahra Private Hospital, Dubai, ARE
- Pediatrics, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Abdelrahman Abaza
- Pathology, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Arturo P Jaramillo
- General Practice, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Pousette Hamid
- Neurology, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
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31
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Antó JM, Pearce N, Douwes J, Garcia-Aymerich J, Pembrey L, Richiardi L, Sunyer J. Why has epidemiology not (yet) succeeded in identifying the origin of the asthma epidemic? Int J Epidemiol 2023; 52:974-983. [PMID: 37004248 PMCID: PMC10396414 DOI: 10.1093/ije/dyad035] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 03/15/2023] [Indexed: 04/04/2023] Open
Affiliation(s)
- Josep M Antó
- ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain
- Hospital del Mar Medical Research Institute, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Neil Pearce
- Department of Non-communicable Disease Epidemiology and Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK
| | - Jeroen Douwes
- Research Centre for Hauora and Health, Massey University, Wellington, New Zealand
| | - Judith Garcia-Aymerich
- ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Lucy Pembrey
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK
| | - Lorenzo Richiardi
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin, and CPO-Piemonte, Torino, Italy
| | - Jordi Sunyer
- ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain
- Hospital del Mar Medical Research Institute, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
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32
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Shin YH, Hwang J, Kwon R, Lee SW, Kim MS, Shin JI, Yon DK. Global, regional, and national burden of allergic disorders and their risk factors in 204 countries and territories, from 1990 to 2019: A systematic analysis for the Global Burden of Disease Study 2019. Allergy 2023; 78:2232-2254. [PMID: 37431853 PMCID: PMC10529296 DOI: 10.1111/all.15807] [Citation(s) in RCA: 47] [Impact Index Per Article: 47.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 05/13/2023] [Accepted: 05/23/2023] [Indexed: 07/12/2023]
Abstract
BACKGROUND Asthma and atopic dermatitis (AD) are chronic allergic conditions, along with allergic rhinitis and food allergy and cause high morbidity and mortality both in children and adults. This study aims to evaluate the global, regional, national, and temporal trends of the burden of asthma and AD from 1990 to 2019 and analyze their associations with geographic, demographic, social, and clinical factors. METHODS Using data from the Global Burden of Diseases (GBD), Injuries, and Risk Factors Study 2019, we assessed the age-standardized prevalence, incidence, mortality, and disability-adjusted life years (DALYs) of both asthma and AD from 1990 to 2019, stratified by geographic region, age, sex, and socio-demographic index (SDI). DALYs were calculated as the sum of years lived with disability and years of life lost to premature mortality. Additionally, the disease burden of asthma attributable to high body mass index, occupational asthmagens, and smoking was described. RESULTS In 2019, there were a total of 262 million [95% uncertainty interval (UI): 224-309 million] cases of asthma and 171 million [95% UI: 165-178 million] total cases of AD globally; age-standardized prevalence rates were 3416 [95% UI: 2899-4066] and 2277 [95% UI: 2192-2369] per 100,000 population for asthma and AD, respectively, a 24.1% [95% UI: -27.2 to -20.8] decrease for asthma and a 4.3% [95% UI: 3.8-4.8] decrease for AD compared to baseline in 1990. Both asthma and AD had similar trends according to age, with age-specific prevalence rates peaking at age 5-9 years and rising again in adulthood. The prevalence and incidence of asthma and AD were both higher for individuals with higher SDI; however, mortality and DALYs rates of individuals with asthma had a reverse trend, with higher mortality and DALYs rates in those in the lower SDI quintiles. Of the three risk factors, high body mass index contributed to the highest DALYs and deaths due to asthma, accounting for a total of 3.65 million [95% UI: 2.14-5.60 million] asthma DALYs and 75,377 [95% UI: 40,615-122,841] asthma deaths. CONCLUSIONS Asthma and AD continue to cause significant morbidity worldwide, having increased in total prevalence and incidence cases worldwide, but having decreased in age-standardized prevalence rates from 1990 to 2019. Although both are more frequent at younger ages and more prevalent in high-SDI countries, each condition has distinct temporal and regional characteristics. Understanding the temporospatial trends in the disease burden of asthma and AD could guide future policies and interventions to better manage these diseases worldwide and achieve equity in prevention, diagnosis, and treatment.
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Affiliation(s)
| | - Jimin Hwang
- Department of Pediatrics, CHA University, Seoul, South Korea
- Department of Pediatrics, CHA Gangnam Medical Center, Seoul, South Korea
| | - Rosie Kwon
- Department of Epidemiology, Johns Hopkins University, Baltimore, MD, USA
- Department of Pediatrics, Yonsei University, Seoul, South Korea
| | - Seung Won Lee
- Center for Digital Health, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Min Seo Kim
- Department of Precision Medicine, Sungkyunkwan University, Suwon, South Korea
| | - GBD 2019 Allergic Disorders Collaborators
- Department of Genomics and Digital Health, Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Seoul, South Korea
- Public Health Center, Ministry of Health and Welfare, Wando, South Korea
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, South Korea
| | - Dong Keon Yon
- Center for Digital Health, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea
- Department of Pediatrics, Kyung Hee University College of Medicine, Seoul, South Korea
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Aponso S, Goon RHZ, Zhao X, Yew YW. Evaluating and comparing the clinical characteristics between adult-onset and childhood-onset atopic dermatitis in an Asian clinical cohort. Australas J Dermatol 2023; 64:368-377. [PMID: 37162207 DOI: 10.1111/ajd.14064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 03/31/2023] [Accepted: 04/16/2023] [Indexed: 05/11/2023]
Abstract
BACKGROUND Atopic dermatitis (AD) is one of the most prevalent chronic inflammatory skin conditions. We aimed to describe the clinical features of adult-onset and childhood-onset AD in a multi-ethnic Asian population. METHODS A retrospective study was performed of 188 patients with AD managed at a tertiary skin institution in Singapore. Patient demographics, clinical features and disease scores were analysed. RESULTS Clinical features related to pigmentary changes, such as orbital darkening and Dennie-Morgan folds were more prevalent among childhood-onset AD patients than in adult-onset AD patients. Similarly, features related to prolonged scratching or friction, such as anterior neck folds, perifollicular accentuation and infra-auricular/infranasal fissuring were also more prevalent in childhood-onset AD patients. Disease scores such as SCORAD and EASI were not different between patients with childhood versus adult-onset disease. CONCLUSION There were significant differences in clinical features between childhood-onset and adult-onset AD. Certain features are related to pigmentary changes and might be more accentuated in patients with skin of colour. Further studies are needed to understand how the different features might be clinically significant and related to the various AD endotypes and disease trajectories.
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Affiliation(s)
- Shashendra Aponso
- Department of Dermatology, Singapore General Hospital, Singapore, Singapore
| | - Rachel Hui Zhen Goon
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | | | - Yik Weng Yew
- National Skin Centre, Singapore, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
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Bratu D, Boda D, Caruntu C. Genomic, Epigenomic, Transcriptomic, Proteomic and Metabolomic Approaches in Atopic Dermatitis. Curr Issues Mol Biol 2023; 45:5215-5231. [PMID: 37367080 DOI: 10.3390/cimb45060331] [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: 05/09/2023] [Revised: 06/03/2023] [Accepted: 06/07/2023] [Indexed: 06/28/2023] Open
Abstract
Atopic dermatitis (AD) is a chronic inflammatory skin disease with a high prevalence in the developed countries. It is associated with atopic and non-atopic diseases, and its close correlation with atopic comorbidities has been genetically demonstrated. One of the main roles of genetic studies is to comprehend the defects of the cutaneous barrier due to filaggrin deficit and epidermal spongiosis. Recently, epigenetic studies started to analyze the influence of the environmental factors on gene expression. The epigenome is considered to be a superior second code that controls the genome, which includes alterations of the chromatin. The epigenetic changes do not alter the genetic code, however, changes in the chromatin structure could activate or inhibit the transcription process of certain genes and consequently, the translation process of the new mRNA into a polypeptide chain. In-depth analysis of the transcriptomic, metabolomic and proteomic studies allow to unravel detailed mechanisms that cause AD. The extracellular space and lipid metabolism are associated with AD that is independent of the filaggrin expression. On the other hand, around 45 proteins are considered as the principal components in the atopic skin. Moreover, genetic studies based on the disrupted cutaneous barrier can lead to the development of new treatments targeting the cutaneous barrier or cutaneous inflammation. Unfortunately, at present, there are no target therapies that focus on the epigenetic process of AD. However, in the future, miR-143 could be an important objective for new therapies, as it targets the miR-335:SOX axis, thereby restoring the miR-335 expression, and repairing the cutaneous barrier defects.
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Affiliation(s)
- Dalia Bratu
- Department of Dermatology, 'Colentina' Clinical Hospital, 020125 Bucharest, Romania
- Department of Dermatology, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Daniel Boda
- Department of Dermatology, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Department of Dermatology, 'Ponderas' Academic Hospital, 014142 Bucharest, Romania
- Department of Dermatology, "Prof. N.C. Paulescu" National Institute of Diabetes, Nutrition and Metabolic Diseases, 011233 Bucharest, Romania
| | - Constantin Caruntu
- Department of Dermatology, "Prof. N.C. Paulescu" National Institute of Diabetes, Nutrition and Metabolic Diseases, 011233 Bucharest, Romania
- Department of Physiology, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
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Lisik D, Ermis SSÖ, Ioannidou A, Milani GP, Nyassi S, Spolidoro GCI, Kankaanranta H, Goksör E, Wennergren G, Nwaru BI. Birth order, sibship size, and risk of atopic dermatitis, food allergy, and atopy: A systematic review and meta-analysis. Clin Transl Allergy 2023; 13:e12270. [PMID: 37357553 DOI: 10.1002/clt2.12270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 05/31/2023] [Indexed: 06/27/2023] Open
Abstract
BACKGROUND Atopic dermatitis and food allergy are two frequently concomitant manifestations of the presence of atopy. A substantial number of studies have been published on the association of birth order and sibship size (number of siblings) with atopic dermatitis, food allergy, and atopy. The present work is the first systematic synthesis of the existing literature on this topic. METHODS Fifteen databases were searched. Screening, data extraction, and quality assessment were performed by independent pairs. Comparable numerical data were statistically synthesized using random-effects robust variance estimation. RESULTS In total, 114 studies were included out of 8819 papers obtained from database searches. Birth order ≥2 versus 1 was associated with lower risk of ever atopic dermatitis (pooled risk ratio [RR] 0.91, 95% CI 0.84-0.98), current food allergy (RR 0.77, 95% CI 0.66-0.90), and positive skin prick test (SPT) to common aeroallergens (RR 0.86, 95% CI 0.77-0.97). Sibship size ≥2 versus 1 was associated with decreased risk of current atopic dermatitis (RR 0.90, 95% CI 0.83-0.98), ever atopic dermatitis (RR 0.92, 95% CI 0.86-0.97), and positive SPT to common aeroallergens (RR 0.88, 95% CI 0.83-0.92). No putative associations were seen regarding atopy assessed through allergen-specific immunoglobulin E with common allergens. CONCLUSION The presence of siblings and being second-born or later may decrease the lifetime risk of atopic dermatitis and food allergy, albeit marginally. Similar association was seen with SPT sensitization. However, significant protection was not found for IgE sensitization.
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Affiliation(s)
- Daniil Lisik
- Krefting Research Centre, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Saliha Selin Özuygur Ermis
- Krefting Research Centre, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Athina Ioannidou
- Krefting Research Centre, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Gregorio Paolo Milani
- Department of Clinical Science and Community Health, University of Milan, Milan, Italy
- Pediatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Sungkutu Nyassi
- Krefting Research Centre, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | | | - Hannu Kankaanranta
- Krefting Research Centre, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
- Tampere University Respiratory Research Group, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Department of Respiratory Medicine, Seinäjoki Central Hospital, Seinäjoki, Finland
| | - Emma Goksör
- Department of Pediatrics, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Göran Wennergren
- Krefting Research Centre, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
- Department of Pediatrics, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Bright Ibeabughichi Nwaru
- Krefting Research Centre, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
- Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden
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Ma L, Zhang L, Kobayashi M, Tao X, Qian Q, Cheng H, Liu S, Zhou Y, Chen Y, Zhang J. Efficacy and safety of crisaborole ointment in Chinese and Japanese patients aged ≥2 years with mild-to-moderate atopic dermatitis. J Dermatol 2023. [PMID: 37154471 DOI: 10.1111/1346-8138.16792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 03/08/2023] [Accepted: 03/10/2023] [Indexed: 05/10/2023]
Abstract
Atopic dermatitis is a chronic inflammatory skin disease with a significant impact on the overall wellbeing of patients and their families. Crisaborole ointment, 2%, is a nonsteroidal phosphodiesterase 4 inhibitor approved for the treatment of mild-to-moderate atopic dermatitis in multiple countries. However, in the key pivotal trials, a low proportion of the overall patient population was Asian, therefore the safety and efficacy of crisaborole in the Asian population with atopic dermatitis remains unclear. CrisADe CLEAR was a multicenter, randomized, double-blind, vehicle-controlled, phase 3 study (NCT04360187) to assess the efficacy and safety of crisaborole ointment in Chinese and Japanese patients aged ≥2 years with mild-to-moderate atopic dermatitis involving ≥5% treatable body surface area. Patients were randomly assigned 2:1 to receive crisaborole or vehicle twice daily for 28 days. The primary endpoint was percentage change from baseline in the Eczema Area and Severity Index total score at day 29. Additional endpoints were improvement and success per Investigator's Static Global Assessment score at day 29 and change from baseline on the Peak Pruritus Numerical Rating Scale at week 4. Safety was assessed using rates of treatment emergent adverse events, serious adverse events, and clinically significant changes in vital signs and clinical laboratory parameters. Crisaborole-treated patients showed a significantly greater reduction versus vehicle in percentage change from baseline in Eczema Area and Severity Index total score at day 29 (P = 0.0002). Response rates for achievement of Investigator's Static Global Assessment improvement and success at day 29 were significantly higher for patients treated with crisaborole versus vehicle (P = 0.0124 and P = 0.0078, respectively). Crisaborole-treated patients showed a significantly greater reduction versus vehicle in change from baseline on the Peak Pruritus Numerical Rating Scale at week 4 (P = 0.0009). No new safety signals were identified. Treatment with crisaborole was effective and well tolerated in Chinese and Japanese patients with mild-to-moderate atopic dermatitis.
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Affiliation(s)
- Lin Ma
- Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Litao Zhang
- Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital, Tianjin, China
| | | | - Xiaohua Tao
- Zhejiang Provincial People's Hospital, Zhejiang, China
| | - Qiufang Qian
- Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Hao Cheng
- Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Zhejiang, China
| | - Sujun Liu
- Hangzhou Third People's Hospital, Zhejiang, China
| | - Yangmei Zhou
- Clinical Development, Pfizer R&D China, Shanghai, China
| | - Yayuan Chen
- Clinical Development, Pfizer R&D China, Shanghai, China
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37
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Zheng H, Yang J, Feng Y, Duan H, Du L, Shu Q, Li H. Systematic exploration of eczema-associated paediatric diseases in a Chinese population of millions: A retrospective observation study. Clin Transl Allergy 2023; 13:e12249. [PMID: 37227416 DOI: 10.1002/clt2.12249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 04/12/2023] [Accepted: 04/21/2023] [Indexed: 05/26/2023] Open
Abstract
BACKGROUND Eczema is the most common form of dermatitis and also the starting point of atopic march. Although many eczema-associated allergic and immunologic disorders have been studied, there remains a gap in the systematic quantitative knowledge regarding the relationships between all childhood disorders and eczema. This study aimed to systematically explore eczema-associated childhood diseases using a real-world, long-term clinical dataset generated from millions of children in China. METHODS Data were collected at 8,907,735 outpatient healthcare visits from 2,592,147 children between January 1, 2013, and August 15, 2019, at the largest comprehensive pediatric medical center in Zhejiang Province of China. The period prevalence differences in various pediatric diseases between children with and without eczema were used to test the independence of various pediatric disorders and eczema using Fisher's exact test. Bonferroni correction was used to adjust the p value in multiple testing. Odds ratio >2 with 95% confidence interval not including 1 and adjusted p < 0.05 was used to identify eczema-associated diseases. RESULTS Overall, 234 pediatric disorders were identified from more than 6000 different pediatric disorders. An interactive eczema-associated disease map that has related quantitative epidemiological features called ADmap was published at http://pedmap.nbscn.org/admap. Thirty-six of these disease associations have not been reported in previous studies. CONCLUSION This systematic exploratory study confirmed the associations of many well-known diseases with eczema in Chinese children and also identified some novel and interesting associations. These results are valuable for the development of a comprehensive approach to the management of eczema in childhood.
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Affiliation(s)
- Huiwen Zheng
- Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Jian Yang
- College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou, China
| | - Yuqing Feng
- Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Huilong Duan
- College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou, China
| | - Lizhong Du
- Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Qiang Shu
- Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Haomin Li
- Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
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Martora F, Fabbrocini G, Megna M, Scalvenzi M, Battista T, Villani A, Potestio L. Teledermatology for Common Inflammatory Skin Conditions: The Medicine of the Future? Life (Basel) 2023; 13:life13041037. [PMID: 37109566 PMCID: PMC10146182 DOI: 10.3390/life13041037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 04/09/2023] [Accepted: 04/16/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic period revolutionized daily clinical practice. Several strategies were adopted by clinicians to avoid reducing treatment for diseases without the risk of spreading the infection. Among the adopted strategies, telemedicine played a key role. In this scenario, several tools were used, including e-mails, phone calls, video calls, support groups, and messages. Fortunately, the COVID-19 pandemic period seems to be at an end. However, the use of teledermatology appears to be an excellent strategy for the future as well. Indeed, several patients may benefit from teledermatology. OBJECTIVE In this manuscript, we aim to investigate the use of telemedicine in the dermatological field to point out how this tool may become the mainstay of future medicine. Only the use of teledermatology with common inflammatory skin conditions have been reported herein. MATERIALS AND METHODS Investigated manuscripts included metanalyses, reviews, letters to the editor, real-life studies, case series, and reports. Manuscripts were identified, screened, and extracted for relevant data following the PRISMA (preferred reporting items for systematic reviews and meta-analyses) guidelines. RESULTS A total of 121 records were identified from the analyzed databases. However, only 110 articles were assessed for eligibility. Finally, 92 articles were selected at the end of the literature research for our review. CONCLUSIONS Teledermatology should be considered as a viable option for the dermatologist for the future. We believe that the pandemic has strengthened this service, and this will allow for ever better development in the future. Guidelines regarding the use of teledermatology are required as well as additional improvements for the future.
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Affiliation(s)
- Fabrizio Martora
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, 80131 Napoli, Italy
| | - Gabriella Fabbrocini
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, 80131 Napoli, Italy
| | - Matteo Megna
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, 80131 Napoli, Italy
| | - Massimiliano Scalvenzi
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, 80131 Napoli, Italy
| | - Teresa Battista
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, 80131 Napoli, Italy
| | - Alessia Villani
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, 80131 Napoli, Italy
| | - Luca Potestio
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, 80131 Napoli, Italy
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Saheb Kashaf S, Harkins CP, Deming C, Joglekar P, Conlan S, Holmes CJ, Almeida A, Finn RD, Segre JA, Kong HH. Staphylococcal diversity in atopic dermatitis from an individual to a global scale. Cell Host Microbe 2023; 31:578-592.e6. [PMID: 37054678 PMCID: PMC10151067 DOI: 10.1016/j.chom.2023.03.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 12/08/2022] [Accepted: 03/10/2023] [Indexed: 04/15/2023]
Abstract
Atopic dermatitis (AD) is a multifactorial, chronic relapsing disease associated with genetic and environmental factors. Among skin microbes, Staphylococcus aureus and Staphylococcus epidermidis are associated with AD, but how genetic variability and staphylococcal strains shape the disease remains unclear. We investigated the skin microbiome of an AD cohort (n = 54) as part of a prospective natural history study using shotgun metagenomic and whole genome sequencing, which we analyzed alongside publicly available data (n = 473). AD status and global geographical regions exhibited associations with strains and genomic loci of S. aureus and S. epidermidis. In addition, antibiotic prescribing patterns and within-household transmission between siblings shaped colonizing strains. Comparative genomics determined that S. aureus AD strains were enriched in virulence factors, whereas S. epidermidis AD strains varied in genes involved in interspecies interactions and metabolism. In both species, staphylococcal interspecies genetic transfer shaped gene content. These findings reflect the staphylococcal genomic diversity and dynamics associated with AD.
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Affiliation(s)
- Sara Saheb Kashaf
- Microbial Genomics Section, Translational and Functional Genomics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD 20892, USA; European Molecular Biology Laboratory, European Bioinformatics Institute (EMBL-EBI), Wellcome Genome Campus, Hinxton CB10 1SD, UK
| | - Catriona P Harkins
- Microbial Genomics Section, Translational and Functional Genomics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD 20892, USA; Dermatology Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Clay Deming
- Microbial Genomics Section, Translational and Functional Genomics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Payal Joglekar
- Microbial Genomics Section, Translational and Functional Genomics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Sean Conlan
- Microbial Genomics Section, Translational and Functional Genomics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Cassandra J Holmes
- Dermatology Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Alexandre Almeida
- Department of Veterinary Medicine, University of Cambridge, Cambridge, UK
| | - Robert D Finn
- European Molecular Biology Laboratory, European Bioinformatics Institute (EMBL-EBI), Wellcome Genome Campus, Hinxton CB10 1SD, UK
| | - Julia A Segre
- Microbial Genomics Section, Translational and Functional Genomics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD 20892, USA.
| | - Heidi H Kong
- Dermatology Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, MD 20892, USA.
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Schmid-Grendelmeier P, Rapelanoro Rabenja F, Beshah AM, Ball MD, Dlova N, Faye O, Flohr C, Hsu C, Mavura D, Manuel RC, Ramarozatovo LS, Sendrasoa F, Wollenberg A, Ruiz Postigo JA, Taïeb A. How to integrate atopic dermatitis in the management of skin neglected tropical diseases in Sub-Saharan Africa? J Eur Acad Dermatol Venereol 2023; 37. [PMID: 37016962 DOI: 10.1111/jdv.19096] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 03/28/2023] [Indexed: 04/06/2023]
Affiliation(s)
- P Schmid-Grendelmeier
- International Society of Atopic Dermatitis, Davos, Switzerland
- World Allergy Organization, Milwaukee, Wisconsin, USA
- Allergy Unit, Department of Dermatology, University Hospital of Zurich, Zurich, Switzerland
- Christine Kühne Center for Allergy Research and Education CK-CARE, Davos, Switzerland
| | | | - A M Beshah
- WHO Regional Office for Africa, Brazzaville, Republic of the Congo
| | - M D Ball
- University of Nouakchott, Nawakshut, Mauritania
| | - N Dlova
- University of KwaZulu-Natal, Durban, South Africa
| | - O Faye
- Department of Dermatology, Faculty of Medicine and Odontostomatology, Bamako, Mali
| | - C Flohr
- International League of Dermatological Societies, London, UK
- St John's Institute of Dermatology, King's College London and Guy's & St Thomas'Hospitals, London, UK
| | - C Hsu
- University Hospital, Basel, Switzerland
| | - D Mavura
- Regional Dermatology Training Centre, Moshi, Tanzania
| | - R C Manuel
- Central Hospital of Maputo, Maputo, Mozambique
| | - L S Ramarozatovo
- Department of Dermatology, Antananarivo University, Antananarivo, Madagascar
| | - F Sendrasoa
- Department of Dermatology, Antananarivo University, Antananarivo, Madagascar
| | - A Wollenberg
- International Society of Atopic Dermatitis, Davos, Switzerland
- Department of Dermatology and Allergy, University Hospital, Ludwig-Maximilian University, Munich, Germany
- Department of Dermatology, Free University Brussels, University Hospital Brussels, Brussels, Belgium
| | | | - A Taïeb
- International Society of Atopic Dermatitis, Davos, Switzerland
- INSERM U 1312, University of Bordeaux, Bordeaux, France
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Thoma G, Duthaler RO, Waelchli R, Hauchard A, Bruno S, Strittmatter-Keller U, Orjuela Leon A, Viebrock S, Aichholz R, Beltz K, Grove K, Hoque S, Rudewicz PJ, Zerwes HG. Discovery and Characterization of the Topical Soft JAK Inhibitor CEE321 for Atopic Dermatitis. J Med Chem 2023; 66:2161-2168. [PMID: 36657024 DOI: 10.1021/acs.jmedchem.2c01977] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
The JAK kinases JAK1, JAK2, JAK3, and TYK2 play key roles in cytokine signaling. Activation of the JAK/STAT pathways is linked to many diseases involving the immune system, including atopic dermatitis. As systemic JAK inhibitor pharmacology is associated with side effects, topical administration to the skin has been considered to locally restrict the site of action. Several orally bioavailable JAK inhibitors repurposed for topical use have been recently approved or are in clinical development. Here, we disclose our clinical candidate CEE321, which is a potent pan JAK inhibitor in enzyme and cellular assays. In contrast to repurposed oral drugs, CEE321 does not display high potency in blood and has a high clearance in vivo. Therefore, we consider CEE321 to be a "soft drug". When applied topically to human skin that was stimulated with the cytokines IL4 and IL13 ex vivo, CEE321 potently inhibited biomarkers relevant to atopic dermatitis.
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Affiliation(s)
- Gebhard Thoma
- Global Discovery Chemistry, Novartis Institutes for Biomedical Research, 4002 Basel, Switzerland
| | - Rudolf O Duthaler
- Global Discovery Chemistry, Novartis Institutes for Biomedical Research, 4002 Basel, Switzerland
| | - Rudolf Waelchli
- Global Discovery Chemistry, Novartis Institutes for Biomedical Research, 4002 Basel, Switzerland
| | - Alice Hauchard
- Autoimmunity, Transplantation and Inflammation, Novartis Institutes for Biomedical Research, 4002 Basel, Switzerland
| | - Sandro Bruno
- Autoimmunity, Transplantation and Inflammation, Novartis Institutes for Biomedical Research, 4002 Basel, Switzerland
| | - Ulrike Strittmatter-Keller
- Autoimmunity, Transplantation and Inflammation, Novartis Institutes for Biomedical Research, 4002 Basel, Switzerland
| | - Anette Orjuela Leon
- Autoimmunity, Transplantation and Inflammation, Novartis Institutes for Biomedical Research, 4002 Basel, Switzerland
| | - Sabine Viebrock
- Autoimmunity, Transplantation and Inflammation, Novartis Institutes for Biomedical Research, 4002 Basel, Switzerland
| | - Reiner Aichholz
- PK Sciences, Novartis Institutes for BioMedical Research, 4002 Basel, Switzerland
| | - Karen Beltz
- PK Sciences, Novartis Institutes for BioMedical Research, 4002 Basel, Switzerland
| | - Kerri Grove
- Global Discovery Chemistry, Novartis Institutes for BioMedical Research, 5300 Chiron Way, Emeryville, California 94608, United States
| | - Shaila Hoque
- Global Discovery Chemistry, Novartis Institutes for BioMedical Research, 5300 Chiron Way, Emeryville, California 94608, United States
| | - Patrick J Rudewicz
- Global Discovery Chemistry, Novartis Institutes for BioMedical Research, 5300 Chiron Way, Emeryville, California 94608, United States
| | - Hans-Guenter Zerwes
- Autoimmunity, Transplantation and Inflammation, Novartis Institutes for Biomedical Research, 4002 Basel, Switzerland
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The proteome of hand eczema assessed by tape stripping. J Invest Dermatol 2023:S0022-202X(23)00071-4. [PMID: 36773646 DOI: 10.1016/j.jid.2022.12.024] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 12/22/2022] [Accepted: 12/24/2022] [Indexed: 02/11/2023]
Abstract
Hand eczema (HE) is a prevalent skin disease. However, classification of HE into different subtypes remains challenging. Limited number of prior studies have employed invasive biopsy-based strategies; yet, studies of the HE proteome using non-invasive tape stripping methodology have not been reported. In this study, we wanted to assess whether global proteomic analysis of skin tape strip samples can be used for sub-classification of HE patients. Tape strips were collected from patients with HE and healthy skin. Liquid chromatography-mass spectrometry (LC/MS) proteomics was performed, and the global protein expression was analyzed. We identified 2,919 proteins in stratum corneum-derived skin cells from tape strip samples. Compared to healthy skin, the lesional samples from HE patients exhibited increased expression of immune-related markers and a decreased expression of structural barrier proteins. The difference between HE subtypes was restricted to the lesional skin areas, and included an increased expression of skin barrier-related proteins independently of the concurrent AD. In conclusion we found, that the non-invasive tape strip method used in combination with LC/MS proteomics can be used for analysis of skin protein expression in HE patients. Thus, the method shows potential for assessing the proteomic differences between subtypes of HE, and biomarker discovery.
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43
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Targeting Interleukin 13 for the Treatment of Atopic Dermatitis. Pharmaceutics 2023; 15:pharmaceutics15020568. [PMID: 36839890 PMCID: PMC9966769 DOI: 10.3390/pharmaceutics15020568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 01/24/2023] [Accepted: 02/06/2023] [Indexed: 02/10/2023] Open
Abstract
Atopic dermatitis (AD) is a common chronic inflammatory skin condition that has a significant impact on a patient's quality of life and requires ongoing management. Conventional topical and systemic therapies do not target specific components of AD pathogenesis and, therefore, have limited efficacy and may be associated with long-term toxicity. Thus, AD management is challenging, with a significant proportion of patients not achieving clear skin or a reduction in pruritus. There remains a large unmet need for effective therapeutic strategies with favorable safety profiles that can be used long-term in patients with refractory AD. The emergence of targeted biological and small molecule therapies has effectively broadened available treatment options for moderate-to-severe AD. Most recently, interleukin 13 (IL-13) inhibitors were shown to be efficacious and well-tolerated, with tralokinumab already approved for use in this patient population. It is important for dermatologists to be aware of the evidence behind this emerging class of biologic agents to guide treatment choices and improve outcomes in patients with AD. The main objective of this paper is to review the current literature regarding the efficacy and safety of current and emerging anti-IL-13 monoclonal antibodies, including tralokinumab, lebrikizumab, cendakimab, and eblasakimab, for the treatment of moderate-to-severe AD.
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44
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Chu CY, Yao TC, Shih IH, Yang CY, Chin CL, Ibrahim SBBK, Thevarajah S, Fon LK, Ho MHK, Mo CC, Yu CP, Loo SKF, Luger T. Pimecrolimus for the Treatment of Atopic Dermatitis in Infants: An Asian Perspective. Dermatol Ther (Heidelb) 2023; 13:717-727. [PMID: 36735214 PMCID: PMC9984644 DOI: 10.1007/s13555-022-00886-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 12/29/2022] [Indexed: 02/04/2023] Open
Abstract
Atopic dermatitis (AD) is a common chronic, multisystem inflammatory skin disease in pediatric patients. There has been an increase in the incidence of AD in the pediatric population of the Asia-Pacific region. Studies have shown that genetic, epigenetic, environmental and cultural factors may lead to differences in the clinical manifestation and prevalence of AD between races. Early treatment of AD is necessary to prevent the atopic march leading to comorbidities such as asthma and allergic rhinitis. Topical corticosteroids (TCS) are used as first-line therapy for the treatment of AD, but their long-term usage poses a risk to the patient's health. Pimecrolimus (1%) is a topical calcineurin inhibitor (TCI) that is indicated for the treatment of mild to moderate AD. Pimecrolimus has no apparent increase in adverse events compared to TCS, and it causes less of a burning sensation than tacrolimus. The safety and efficacy of pimecrolimus has been established through various clinical trials; yet, in many Asian countries, the use of pimecrolimus in infants is still restricted due to safety concerns. Based on the available evidence, the expert panel recommends pimecrolimus in infants between 3 months and 2 years of age in the Asian population.
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Affiliation(s)
- Chia-Yu Chu
- Department of Dermatology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Tsung-Chieh Yao
- Department of Pediatrics, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - I.-Hsin Shih
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan
| | - Chin-Yi Yang
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan ,Department of Dermatology, New Taipei Municipal TuCheng Hospital, New Taipei City, Taiwan
| | | | | | | | - Leong Kin Fon
- Pediatric Institute, Kuala Lumpur General Hospital, Kuala Lumpur, Malaysia
| | | | | | - Chow Pok Yu
- The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Steven King-Fan Loo
- The Hong Kong Institute of Integrative Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Thomas Luger
- Department of Dermatology, University of Muenster, Muenster, Germany.
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45
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Koch M, Kockmann T, Rodriguez E, Wehkamp U, Hiebert P, Ben-Yehuda Greenwald M, Stölzl D, Beer HD, Tschachler E, Weidinger S, Werner S, Auf dem Keller U. Quantitative Proteomics Identifies Reduced NRF2 Activity and Mitochondrial Dysfunction in Atopic Dermatitis. J Invest Dermatol 2023; 143:220-231.e7. [PMID: 36108803 DOI: 10.1016/j.jid.2022.08.048] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Revised: 08/04/2022] [Accepted: 08/25/2022] [Indexed: 01/25/2023]
Abstract
Atopic dermatitis is the most common inflammatory skin disease and is characterized by a deficient epidermal barrier and cutaneous inflammation. Genetic studies suggest a key role of keratinocytes in atopic dermatitis pathogenesis, but the alterations in the proteome that occur in the full epidermis have not been defined. Using a pressure-cycling technology and data-independent acquisition approach, we performed quantitative proteomics of epidermis from healthy volunteers and lesional and nonlesional patient skin. Results were validated by targeted proteomics using parallel reaction monitoring mass spectrometry and immunofluorescence staining. Proteins that were differentially abundant in the epidermis of patients with atopic dermatitis versus in healthy control reflect the strong inflammation in lesional skin and the defect in keratinocyte differentiation and epidermal stratification that already characterizes nonlesional skin. Most importantly, they reveal impaired activation of the NRF2-antioxidant pathway and reduced abundance of mitochondrial proteins involved in key metabolic pathways in the affected epidermis. Analysis of primary human keratinocytes with small interfering RNA‒mediated NRF2 knockdown revealed that the impaired NRF2 activation and mitochondrial abnormalities are partially interlinked. These results provide insight into the molecular alterations in the epidermis of patients with atopic dermatitis and identify potential targets for pharmaceutical intervention.
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Affiliation(s)
- Michael Koch
- Institute of Molecular Health Sciences, Department of Biology, ETH Zürich, Zürich, Switzerland
| | - Tobias Kockmann
- Functional Genomics Center Zurich, University of Zurich/ETH Zürich, Zürich, Switzerland
| | - Elke Rodriguez
- Department of Dermatology, Allergology and Venereology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Ulrike Wehkamp
- Department of Dermatology, Allergology and Venereology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Paul Hiebert
- Institute of Molecular Health Sciences, Department of Biology, ETH Zürich, Zürich, Switzerland
| | | | - Dora Stölzl
- Department of Dermatology, Allergology and Venereology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Hans-Dietmar Beer
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland
| | - Erwin Tschachler
- Research Division of Biology and Pathobiology of the Skin, Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - Stephan Weidinger
- Department of Dermatology, Allergology and Venereology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Sabine Werner
- Institute of Molecular Health Sciences, Department of Biology, ETH Zürich, Zürich, Switzerland
| | - Ulrich Auf dem Keller
- Department of Biotechnology and Biomedicine, Technical University of Denmark, Lyngby, Denmark.
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46
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Najera J, Hao J. Recent advance in mesenchymal stem cells therapy for atopic dermatitis. J Cell Biochem 2023; 124:181-187. [PMID: 36576973 DOI: 10.1002/jcb.30365] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 11/07/2022] [Accepted: 12/19/2022] [Indexed: 12/29/2022]
Abstract
Mesenchymal stem cells (MSCs) are multipotent cells found in a variety of tissues in the body, including but not limited to bone marrow, adipose tissue, umbilical cord, and umbilical cord blood. Given their immunomodulatory effect and ability to be readily isolated from several tissues, they have great potential to be used as a therapeutic agent in a variety of immune-mediated disorders. Atopic dermatitis (AD) is a persistent and relapsing immune skin condition that has recently become more common in several species such as humans, canines, equines, and felines. The use of MSCs to treat AD has piqued the great interest of researchers in recent years. In this article, we review the recent understanding of AD pathology and advances in preclinical and clinical studies of MSCs, MSCs-derived conditional media and exosomes as therapeutic tools to treat AD.
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Affiliation(s)
- Jonathan Najera
- College of Veterinary Medicine, Western University of Health Sciences, Pomona, California, USA.,Department of Biology, College of Science, California State University Polytechnic University, Pomona, California, USA
| | - Jijun Hao
- College of Veterinary Medicine, Western University of Health Sciences, Pomona, California, USA
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47
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Cui H, Mu Z. Prenatal Maternal Risk Factors Contributing to Atopic Dermatitis: A Systematic Review and Meta-Analysis of Cohort Studies. Ann Dermatol 2023; 35:11-22. [PMID: 36750454 PMCID: PMC9905861 DOI: 10.5021/ad.21.268] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 07/06/2022] [Accepted: 10/12/2022] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND The gestational risk factors predispose to the manifestation of early childhood atopic dermatitis (AD). OBJECTIVE We evaluated the association between modifiable and non-modifiable gestational and prenatal risk factors that affect the AD prevalence in children. METHODS We performed the systematic review and meta-analysis of cohort studies (n=27) in PubMed and EMBASE (2000~2021). A meta-analysis was performed using random-effects models to estimate pooled odds ratios (OR) or hazard ratio (HR). We performed a systematic review according to Preferred Reporting Item for Systematic Review and Meta-Analyses (PRISMA) guidelines and summarized cohort studies investigating gestational and prenatal risk factor those predispose to AD in off spring. Leading modifiable and non-modifiable were identified through ORs. Meta-analysis using the random effect model was also conducted to provide an overall estimate for several significant factors. RESULTS Among the non-modifiable risk factors gestational diabetes (7.2, 95% confidence interval [CI]: 1.4~34.5), maternal history of allergy (2.14, 95% CI: 1.54~2.97) and prenatal history of eczema (2.46, 95% CI: 1.0~5.8) were found as major determining risk factors in early manifestation of AD in children. Further, maternal exposure to industrial products (1.89, 95% CI: 1.10~3.16), exposure to antibiotics during pregnancy (3.59, 95% CI: 1.19~10.85) and passive smoking during pregnancy (2.60, 95% CI: 1.11~6.1) are leading causes of early AD manifestation. CONCLUSION Conclusively, both genetic and environmental factors play a pivotal role in early manifestation of AD. The better managing the environmental factors during gestational phase to the least can help curtail the prevalence of AD in children.
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Affiliation(s)
- Hong Cui
- Department of Dermatology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China.,National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China.
| | - Zhijuan Mu
- Department of Dermatology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China.,National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
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Challenges in the Use of the Treat-to-Target Strategy in Atopic Dermatitis in Latin America: A Case Series Review. Dermatol Ther (Heidelb) 2023; 13:661-672. [PMID: 36709473 PMCID: PMC9984613 DOI: 10.1007/s13555-023-00890-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 01/12/2023] [Indexed: 01/30/2023] Open
Abstract
INTRODUCTION Atopic dermatitis (AD) is a chronic, relapsing-remitting illness. In moderate-to-severe instances, recommendations urge patient-centered systemic therapy. Existing standards lack long-term treatment success requirements. A treat-to-target methodology was proposed for systemic therapy patients that requires global improvements to prompt decisions about treatment. METHODS We conducted an observational study between May 2021 and June 2022 in three Ecuadorian patients with severe AD who were treated with dupilumab to assess the clinical evolution and behavior of the subdomains evaluated by clinimetric tools. RESULTS Patients A and C satisfied disease-domain response criteria to dupilumab at 12 and 24 weeks, but B did not complete the algorithm objectives. Nonetheless, patient A improved AD severity, itching, bleeding, desquamation, sleep, daily activities, mood, emotions, sexual troubles, clothing, and sports subdomains. Patient B experienced reduced symptomatology, AD aggravation, daily activities impact, and work/study impairment. Patient C improved from severe to mild desquamation, itching, exudate, lichenification, and rough/dry skin. Sleep, shame, and study subdomains improved the most. CONCLUSION We provide a new operational construct for analyzing current patient-reported outcome measures (PROMs) and clinician-reported outcome measures (CROMs) based on subdomains to widen our understanding of the state of disease activity and make clinical decisions when the treat-to-target strategy is not attained.
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49
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Efficacy and Safety of JAK1 Inhibitor Abrocitinib in Atopic Dermatitis. Pharmaceutics 2023; 15:pharmaceutics15020385. [PMID: 36839707 PMCID: PMC9960033 DOI: 10.3390/pharmaceutics15020385] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 01/19/2023] [Accepted: 01/20/2023] [Indexed: 01/24/2023] Open
Abstract
Abrocitinib is a JAK1 selective inhibitor recently approved for the treatment of moderate-to-severe atopic dermatitis in adults. It has demonstrated efficacy and safety in several clinical trials, both in children and adults, in monotherapy, and compared with dupilumab. The expected EASI-75 response rate estimates at week 12 are 62.9% (95% CrI 42.5-79.9%) for abrocitinib 200 mg and 43.0% (95% CrI 24.8-64.0%) for abrocitinib 100 mg. Abrocitinib has shown a faster effect than dupilumab as regards early alleviation of itch. Because of the incomplete target selectivity of JAK inhibitors, when abrocitinib treatment is considered, laboratory screening is necessary, latent tuberculosis must be screened for, active infections are a contraindication, and special caution must be exerted in treating elderly patients and those predisposed to thromboembolic events. Even though recent meta-analyses of clinical trials have not shown that atopic dermatitis, or its treatment with JAK inhibitors or dupilumab, modify the risk of deep venous thrombosis or pulmonary embolism, long-term follow-up studies will better define the safety profile of abrocitinib.
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Matsui K, Kobayashi M, Nagano M, Matsuoka M. Effects of dual therapy with betamethasone and tetracycline in a NC/Nga mouse model of atopic dermatitis. JOURNAL OF PHARMACY & PHARMACEUTICAL SCIENCES : A PUBLICATION OF THE CANADIAN SOCIETY FOR PHARMACEUTICAL SCIENCES, SOCIETE CANADIENNE DES SCIENCES PHARMACEUTIQUES 2023; 26:11182. [PMID: 36942298 PMCID: PMC9990628 DOI: 10.3389/jpps.2023.11182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 01/10/2023] [Indexed: 01/21/2023]
Abstract
Purpose: Our previous study has demonstrated that tetracycline exerts excellent bactericidal activity against Staphylococcus aureus strains isolated from patients with atopic dermatitis (AD) while simultaneously inhibiting the development of T helper (Th) type 2 (Th2) cells. The present study was designed to evaluate the effectiveness of dual therapy with betamethasone and tetracycline for AD. Methods: Betametasone (0.1%) and tetracycline (3%) were topically administered to NC/Nga mice with AD-like skin lesions. Skin severity scores, histological changes to the lesioned skin, and serum IgE levels were assessed as indicators of therapeutic effectiveness. Results: Topical treatment with both drugs reduced the skin severity score more significantly than was the case with betamethasone alone or tetracycline alone. This was associated with a reduction in the degree of epidermal thickening, the density of cellular infiltration into the dermis, the mast cell count in the dermis and the serum IgE concentration. Furthermore, the degree of Th1/Th2 cell development in auricular lymph nodes and the S. aureus count on the lesioned skin were synergistically suppressed by simultaneous application of both drugs. Conclusion: The present results show that simultaneous topical application of betamethasone and tetracycline synergistically ameliorates AD-like skin lesions in NC/Nga mice. This suggests that dual therapy with betamethasone and tetracycline for AD lesions colonized by S. aureus might be one of the best options for inhibiting the development of both Th1 and Th2 cells and acting on superficially located S. aureus .
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