1
|
Lim JJ, Lim SW, Reginald K, Say Y, Liu MH, Chew FT. Association of frequent intake of trans fatty acids and saturated fatty acids in diets with increased susceptibility of atopic dermatitis exacerbation in young Chinese adults: A cross-sectional study in Singapore/Malaysia. SKIN HEALTH AND DISEASE 2024; 4:e330. [PMID: 39104637 PMCID: PMC11297457 DOI: 10.1002/ski2.330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 11/17/2023] [Accepted: 12/24/2023] [Indexed: 08/07/2024]
Abstract
Background & Objective Numerous evidence has attributed diets with a high fatty acids (FAs) intake to be associated with atopic dermatitis (AD) development. Therefore, this study investigated the association between intake frequencies of five dietary FAs and AD exacerbations among young Chinese adults from Singapore and Malaysia. Methods A validated International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire was investigator-administered to 13,561 subjects to collect information on socioeconomic, anthropometric, dietary and lifestyles habits, and personal/family medical histories. Six novel dietary indices were derived to analyse the associations between total FAs, trans fatty acids (TFAs), saturated fatty acids (SFAs), monounsaturated fatty acids, linoleic acids, and alpha-linolenic acids in diets and AD exacerbation. Synergy factor (SF) analysis was used to identify interactions between the dietary FAs to influence disease susceptibility. Results In our multivariable model adjusted for age, gender, BMI, parental eczema, and lifestyle factors, a diet high in total estimated FAs was strongly associated with AD (Adjusted Odds Ratio (AOR): 1.227; 95% Confidence Interval (CI): 1.054-1.429; adjusted p-value <0.01). Particularly, high estimated total TFAs and SFAs were significantly associated with AD exacerbations including chronic and current moderate-to-severe AD. The association between TFAs and AD remained strong even controlled for the total FAs in diets and false discovery rate corrected (AOR: 1.516; 95% CI: 1.094-2.097; adjusted p-value <0.05). Similarly, having a high SFAs in diets was associated with AD (AOR: 1.581; 95% CI: 1.106-2.256; adjusted p-value <0.05) independently on the total FAs in diets. FAs in diets do not interact to influence AD. Conclusion Overall, these results highlighted an association between high dietary TFAs and SFAs and AD exacerbations in an Asian population.
Collapse
Affiliation(s)
- Jun Jie Lim
- Department of Biological SciencesFaculty of ScienceNational University of SingaporeSingaporeSingapore
| | - Sing Wei Lim
- Department of Biological SciencesFaculty of ScienceNational University of SingaporeSingaporeSingapore
| | - Kavita Reginald
- Department of Biological SciencesFaculty of ScienceNational University of SingaporeSingaporeSingapore
- Department of Biological SciencesSchool of Medicine and Life SciencesSunway UniversityPetaling JayaMalaysia
| | - Yee‐How Say
- Department of Biological SciencesFaculty of ScienceNational University of SingaporeSingaporeSingapore
- Department of Biological SciencesSchool of Medicine and Life SciencesSunway UniversityPetaling JayaMalaysia
- Department of Biomedical ScienceFaculty of ScienceUniversiti Tunku Abdul Rahman (UTAR)KamparMalaysia
| | - Mei Hui Liu
- Department of Food Science & TechnologyFaculty of ScienceNational University of SingaporeSingaporeSingapore
| | - Fook Tim Chew
- Department of Biological SciencesFaculty of ScienceNational University of SingaporeSingaporeSingapore
| |
Collapse
|
2
|
Lim JJ, Liu MH, Chew FT. Dietary Interventions in Atopic Dermatitis: A Comprehensive Scoping Review and Analysis. Int Arch Allergy Immunol 2024; 185:545-589. [PMID: 38442688 DOI: 10.1159/000535903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 12/18/2023] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND This scoping review aims to critically assess gaps in the current literature on atopic dermatitis (AD) by evaluating the overall effectiveness of dietary interventions. Through a comprehensive analysis that follows the Preferred Reporting Item for Systematic Review and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines, we conducted a thorough search on the Web of Science database in May 2023 using specific search strategies to identify all relevant studies on the research topic. SUMMARY A total of 104 full-text articles were included for review. Our synthesis identified seven notable categories of dietary interventions for AD, showcasing the diversity of interventions utilized. This includes vitamin supplementation, probiotic and prebiotic supplementation, dietary fat, biological compounds, foods from natural sources, major nutrients, and diet-related approaches. Further analyses stratified by targeted populations revealed a predominant focus on pediatrics, particularly in probiotic supplementation, and on adults, with an emphasis on vitamin D and E supplementation. KEY MESSAGES Despite most dietary interventions demonstrating overall effectiveness in improving AD severity and its subjective symptoms, several significant gaps were identified. There was a scarcity of studies on adults and whole-diet interventions, a prevalence of short-term interventions, heterogeneity in study outcomes, designs, and population, occasional disparity between statistical significance and clinical relevance, and a lack of a comprehensive multidisciplinary approach. Nonetheless, these findings offer valuable insights for future AD research, guiding additional evidence-driven dietary interventions and informing healthcare professionals, researchers, and individuals, advancing both understanding and management of AD.
Collapse
Affiliation(s)
- Jun Jie Lim
- Department of Biological Sciences, Faculty of Science, National University of Singapore, Singapore, Singapore
| | - Mei Hui Liu
- Department of Food Science and Technology, Faculty of Science, National University of Singapore, Singapore, Singapore
| | - Fook Tim Chew
- Department of Biological Sciences, Faculty of Science, National University of Singapore, Singapore, Singapore
| |
Collapse
|
3
|
Huang IH, Chung WH, Wu PC, Chen CB. JAK-STAT signaling pathway in the pathogenesis of atopic dermatitis: An updated review. Front Immunol 2022; 13:1068260. [PMID: 36569854 PMCID: PMC9773077 DOI: 10.3389/fimmu.2022.1068260] [Citation(s) in RCA: 48] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 11/22/2022] [Indexed: 12/13/2022] Open
Abstract
Atopic dermatitis (AD) is a chronic, inflammatory, pruritic form of dermatosis with heterogeneous manifestations that can substantially affect patients' quality of life. AD has a complex pathogenesis, making treatment challenging for dermatologists. The Janus kinase (JAK)-signal transducer and activator of transcription (STAT) pathway plays a central role in modulating multiple immune axes involved in the immunopathogenesis of AD. In particular, Th2 cytokines, including interleukin (IL)-4, IL-5, IL-13, IL-31, and thymic stromal lymphopoietin, which contribute to the symptoms of chronic inflammation and pruritus in AD, are mediated by JAK-STAT signal transduction. Furthermore, JAK-STAT is involved in the regulation of the epidermal barrier and the modulation of peripheral nerves related to the transduction of pruritus. Targeting the JAK-STAT pathway may attenuate these signals and show clinical efficacy through the suppression of various immune pathways associated with AD. Topical and oral JAK inhibitors with variable selectivity have emerged as promising therapeutic options for AD. Notably, topical ruxolitinib, oral upadacitinib, and oral abrocitinib were approved by the U.S. Food and Drug Administration for treating patients with AD. Accordingly, the present study reviewed the role of JAK-STAT pathways in the pathogenesis of AD and explored updated applications of JAK inhibitors in treating AD.
Collapse
Affiliation(s)
- I-Hsin Huang
- Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Linkou, Taipei, and Keelung, Taoyuan, Taiwan,Department of Dermatology, Chang Gung Memorial Hospital, Linkou, Taipei and Keelung, Taiwan,Research Center of Big Data and Meta-analysis, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Wen-Hung Chung
- Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Linkou, Taipei, and Keelung, Taoyuan, Taiwan,Department of Dermatology, Chang Gung Memorial Hospital, Linkou, Taipei and Keelung, Taiwan,Cancer Vaccine and Immune Cell Therapy Core Laboratory, Chang Gung Memorial Hospital, Linkou, Taiwan,Chang Gung Immunology Consortium, Chang Gung Memorial Hospital, Linkou, and Chang Gung University, Taoyuan, Taiwan,Department of Dermatology, Xiamen Chang Gung Hospital, Xiamen, China,Xiamen Chang Gung Allergology Consortium, Xiamen, Xiamen Chang Gung Hospital, Xiamen, China,College of Medicine, Chang Gung University, Taoyuan, Taiwan,Whole-Genome Research Core Laboratory of Human Diseases, Chang Gung Memorial Hospital, Keelung, Taiwan,Immune-Oncology Center of Excellence, Chang Gung Memorial Hospital, Linkou, Taiwan,Genomic Medicine Core Laboratory, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Po-Chien Wu
- Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Linkou, Taipei, and Keelung, Taoyuan, Taiwan,Department of Dermatology, Chang Gung Memorial Hospital, Linkou, Taipei and Keelung, Taiwan,Research Center of Big Data and Meta-analysis, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Chun-Bing Chen
- Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Linkou, Taipei, and Keelung, Taoyuan, Taiwan,Department of Dermatology, Chang Gung Memorial Hospital, Linkou, Taipei and Keelung, Taiwan,Cancer Vaccine and Immune Cell Therapy Core Laboratory, Chang Gung Memorial Hospital, Linkou, Taiwan,Chang Gung Immunology Consortium, Chang Gung Memorial Hospital, Linkou, and Chang Gung University, Taoyuan, Taiwan,Department of Dermatology, Xiamen Chang Gung Hospital, Xiamen, China,Xiamen Chang Gung Allergology Consortium, Xiamen, Xiamen Chang Gung Hospital, Xiamen, China,College of Medicine, Chang Gung University, Taoyuan, Taiwan,Whole-Genome Research Core Laboratory of Human Diseases, Chang Gung Memorial Hospital, Keelung, Taiwan,Immune-Oncology Center of Excellence, Chang Gung Memorial Hospital, Linkou, Taiwan,Genomic Medicine Core Laboratory, Chang Gung Memorial Hospital, Linkou, Taiwan,Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan,School of Medicine, National Tsing Hua University, Hsinchu, Taiwan,*Correspondence: Chun-Bing Chen,
| |
Collapse
|
4
|
Cabalín C, Pérez-Mateluna G, Iturriaga C, Camargo CA, Borzutzky A. Oral vitamin D modulates the epidermal expression of the vitamin D receptor and cathelicidin in children with atopic dermatitis. Arch Dermatol Res 2022; 315:761-770. [PMID: 36273083 DOI: 10.1007/s00403-022-02416-1] [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: 05/03/2022] [Accepted: 10/13/2022] [Indexed: 11/29/2022]
Abstract
Although vitamin D (VD) is known to have multiple effects on the skin and immunity, its effects on atopic dermatitis (AD) severity remain unclear. We investigated whether oral cholecalciferol (VD3) supplementation changes stratum corneum expression of the vitamin D receptor (vdr), and the epidermal alarmins Cathelicidin Antimicrobial Peptide (camp/LL-37) and Thymic Stromal Lymphopoietin (tslp) in children with AD. We conducted an open-label supplementation study with weekly oral VD3 for six weeks in children with AD. Serum 25-hydroxyvitamin D (25OHD), lesional Staphylococcus aureus colonization, and AD severity evaluated by SCORAD index were evaluated before and after supplementation. Tape stripping (TS) was performed on non-lesional and lesional skin to measure mRNA expression of vdr, camp, and tslp through RT-qPCR and LL-37 peptide by ELISA. Twenty-two children with moderate-severe AD received weekly oral VD3 for six weeks. Total serum 25OHD increased from 45.1 ± 23 to 93.5 ± 24.3 nmoL/L (p < 0.0001), while SCORAD decreased from 41.4 ± 13.5 to 31.5 ± 15.8 (p < 0.0001). After treatment, epidermal gene expression of camp increased significantly in non-lesional (p = 0.014) and lesional (p = 0.0007) tape stripping samples, while vdr only increased in lesional skin samples (p < 0.0001). LL-37 peptide increased significantly only in lesional skin samples (p = 0.008). Gene expression of tslp did not change after oral VD3 treatment. In children with AD, oral VD3 supplementation was associated with improved VD status and AD severity, as well as increased VDR and Cathelicidin expression in lesional skin, which provide mechanistic clues on its effects.
Collapse
Affiliation(s)
- Carolina Cabalín
- Translational Allergy and Immunology Laboratory, Department of Pediatric Infectious Diseases and Immunology, School of Medicine, Pontificia Universidad Católica de Chile, Marcoleta 446, 8330034, Santiago, Chile
| | - Guillermo Pérez-Mateluna
- Translational Allergy and Immunology Laboratory, Department of Pediatric Infectious Diseases and Immunology, School of Medicine, Pontificia Universidad Católica de Chile, Marcoleta 446, 8330034, Santiago, Chile
| | - Carolina Iturriaga
- Translational Allergy and Immunology Laboratory, Department of Pediatric Infectious Diseases and Immunology, School of Medicine, Pontificia Universidad Católica de Chile, Marcoleta 446, 8330034, Santiago, Chile
| | - Carlos A Camargo
- Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Arturo Borzutzky
- Translational Allergy and Immunology Laboratory, Department of Pediatric Infectious Diseases and Immunology, School of Medicine, Pontificia Universidad Católica de Chile, Marcoleta 446, 8330034, Santiago, Chile. .,Millennium Institute on Immunology and Immunotherapy, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
| |
Collapse
|
5
|
Thirion F, Guilly S, Fromentin S, Plaza Oñate F, Alvarez AS, Le Chatelier E, Pons N, Levenez F, Quinquis B, Ehrlich S, Doré J, Martin R, Seité S. Changes in Gut Microbiota of Patients with Atopic Dermatitis During Balneotherapy. Clin Cosmet Investig Dermatol 2022; 15:163-176. [PMID: 35140493 PMCID: PMC8818552 DOI: 10.2147/ccid.s342104] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 01/13/2022] [Indexed: 11/23/2022]
Abstract
Introduction Balneotherapy (BT) is the treatment of disease through the use of thermal spring water (TSW). It has been used for centuries and remains a popular form of treatment for dermatologic diseases such as atopic dermatitis (AD). Recent findings highlighted the role of the gut microbiota in AD and the possible crosstalk between gut and skin microbiomes in this pathology. Nevertheless, changes in the composition of the gut microbiota after balneotherapy remain to be elucidated. Methods A total of 96 patients, with moderate to severe AD according to the SCORAD, were enrolled. Stool samples were collected prior and post a 3-week balneotherapy at the thermal care center of La Roche-Posay (France). Composition of the gut microbiota was assessed by shotgun metagenomic sequencing. Results Species associated with high gut microbiota richness tended to correlate negatively with disease severity (SCORAD) and positively with SCORAD reduction, while species associated with low richness displayed the opposite pattern. Relative abundance of 23 species was significantly altered during BT, these changes being significantly associated with SCORAD reduction during BT, suggesting that gut microbiota composition and AD progression were associated through the treatment. Microbial functions related to gut-brain axis such as GABA and tryptophan metabolism were also altered by the treatment. Long-standing AD patients exhibited a better gut microbial profile than recently diagnosed patients, with higher MSP richness and species associated with SCORAD reduction. Conclusion In patients with AD, clinical disease parameters such as SCORAD or disease duration are intricately linked to the gut microbiota composition. SCORAD reduction occurring during BT was also associated with gut microbiota. The gut-brain-skin axis via neurotransmitter such as GABA should be further studied in diseases such as AD.
Collapse
Affiliation(s)
- Florence Thirion
- University Paris-Saclay, INRAE, MGP, Jouy-en-Josas, 78350, France
| | - Susie Guilly
- University Paris-Saclay, INRAE, MGP, Jouy-en-Josas, 78350, France
| | | | | | | | | | - Nicolas Pons
- University Paris-Saclay, INRAE, MGP, Jouy-en-Josas, 78350, France
| | - Florence Levenez
- University Paris-Saclay, INRAE, MGP, Jouy-en-Josas, 78350, France
| | - Benoît Quinquis
- University Paris-Saclay, INRAE, MGP, Jouy-en-Josas, 78350, France
| | | | - Joel Doré
- University Paris-Saclay, INRAE, MGP, Jouy-en-Josas, 78350, France.,University Paris-Saclay, INRAE, AgroParisTech, Micalis Institute, Jouy-en-Josas, France
| | | | - Sophie Seité
- La Roche-Posay Dermatological Laboratories, Levallois-Perret, France
| |
Collapse
|
6
|
Could Modifying the Skin Microbiome, Diet, and Lifestyle Help with the Adverse Skin Effects after Stopping Long-Term Topical Steroid Use? ALLERGIES 2021. [DOI: 10.3390/allergies2010001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
We set up this preliminary study to begin to evaluate one main question: could strengthening the microbiome have potential benefits for the skin condition of patients suffering with adverse effects after stopping long-term topical steroid use? We aim to turn it into a much larger study if the results show the interventions might help. After commonly being prescribed for eczema, cessation of topical steroid use, especially after long periods of inappropriate use, can leave lasting adverse effects on the body and skin, known by some as topical steroid withdrawal (TSW). This preliminary study involved seven human participants suffering with skin problems associated with TSW who approached Dr. Anja Gijsberts-Veens of their own volition because they were interested in more natural recovery methods. Five completed the study in full. Progress in skin condition was tracked by self-assessed symptom severity questionnaires filled out at the beginning and end of the five-month study. The skin microbiome was addressed by using a 100% natural product shown in previous work to significantly increase skin microbiome biodiversity. Three participants implemented dietary changes and supplementation in response to guidance after fecal sample analysis, with the aim of improving gut microbiome health. The average improvement in skin symptoms for all participants was 40%, and average symptom improvement ranged from 14% for Patient 5 to 92% for Patient 1. On average, the participants saw an improvement in 85% of their symptoms and stagnation or regression in 11% and 4%, respectively. Our results suggest that the interventions used might improve the skin condition of TSW patients, but the small sample size and the lack of a control group mean that more definitive conclusions should be reserved for our follow-up work, which addresses these issues. We also aim to swab the skin of participants to assess the effect on the skin microbiome from skin and gut treatments, as well as including a more in-depth analysis of skin and gut microbiomes.
Collapse
|
7
|
Sainz T, Pignataro V, Bonifazi D, Ravera S, Mellado MJ, Pérez-Martínez A, Escudero A, Ceci A, Calvo C. Human Microbiome in Children, at the Crossroad of Social Determinants of Health and Personalized Medicine. CHILDREN (BASEL, SWITZERLAND) 2021; 8:children8121191. [PMID: 34943387 PMCID: PMC8700538 DOI: 10.3390/children8121191] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 11/28/2021] [Accepted: 12/08/2021] [Indexed: 06/14/2023]
Abstract
The evolving field of microbiome research offers an excellent opportunity for biomarker identification, understanding drug metabolization disparities, and improving personalized medicine. However, the complexities of host-microbe ecological interactions hinder clinical transferability. Among other factors, the microbiome is deeply influenced by age and social determinants of health, including environmental factors such as diet and lifestyle conditions. In this article, the bidirectionality of social and host-microorganism interactions in health will be discussed. While the field of microbiome-related personalized medicine evolves, it is clear that social determinants of health should be mitigated. Furthermore, microbiome research exemplifies the need for specific pediatric investigation plans to improve children's health.
Collapse
Affiliation(s)
- Talía Sainz
- Hospital La Paz, Pº Castellana 261, 28046 Madrid, Spain; (M.J.M.); (A.P.-M.); (A.E.); (C.C.)
- La Paz Hospital Reserach Institute (IdiPAZ), Pº Castellana 261, 28046 Madrid, Spain
- CIBER de Enfermedades Infecciosas (CIBERInfec), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
| | - Valeria Pignataro
- Consorzio per Valutazioni Biologiche e Farmacologiche, Via N. Putignani n. 178, 70122 Bari, Italy; (V.P.); (D.B.); (A.C.)
| | - Donato Bonifazi
- Consorzio per Valutazioni Biologiche e Farmacologiche, Via N. Putignani n. 178, 70122 Bari, Italy; (V.P.); (D.B.); (A.C.)
- TEDDY European Network of Excellence for Paediatric Research, Via Luigi Porta 14, 27100 Pavia, Italy
| | - Simona Ravera
- PHArmaceutical Research Management SRL, Via Albert Einstein, 26900 Lodi, Italy;
| | - María José Mellado
- Hospital La Paz, Pº Castellana 261, 28046 Madrid, Spain; (M.J.M.); (A.P.-M.); (A.E.); (C.C.)
- La Paz Hospital Reserach Institute (IdiPAZ), Pº Castellana 261, 28046 Madrid, Spain
- CIBER de Enfermedades Infecciosas (CIBERInfec), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- TEDDY European Network of Excellence for Paediatric Research, Via Luigi Porta 14, 27100 Pavia, Italy
| | - Antonio Pérez-Martínez
- Hospital La Paz, Pº Castellana 261, 28046 Madrid, Spain; (M.J.M.); (A.P.-M.); (A.E.); (C.C.)
- La Paz Hospital Reserach Institute (IdiPAZ), Pº Castellana 261, 28046 Madrid, Spain
- Departamento de Pediatría, Universidad Autónoma de Madrid (UAM), 28049 Madrid, Spain
| | - Adela Escudero
- Hospital La Paz, Pº Castellana 261, 28046 Madrid, Spain; (M.J.M.); (A.P.-M.); (A.E.); (C.C.)
- La Paz Hospital Reserach Institute (IdiPAZ), Pº Castellana 261, 28046 Madrid, Spain
| | - Adriana Ceci
- Consorzio per Valutazioni Biologiche e Farmacologiche, Via N. Putignani n. 178, 70122 Bari, Italy; (V.P.); (D.B.); (A.C.)
- TEDDY European Network of Excellence for Paediatric Research, Via Luigi Porta 14, 27100 Pavia, Italy
| | - Cristina Calvo
- Hospital La Paz, Pº Castellana 261, 28046 Madrid, Spain; (M.J.M.); (A.P.-M.); (A.E.); (C.C.)
- La Paz Hospital Reserach Institute (IdiPAZ), Pº Castellana 261, 28046 Madrid, Spain
- CIBER de Enfermedades Infecciosas (CIBERInfec), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
- Departamento de Pediatría, Universidad Autónoma de Madrid (UAM), 28049 Madrid, Spain
| |
Collapse
|
8
|
Fanfaret IS, Boda D, Ion LM, Hosseyni D, Leru P, Ali S, Corcea S, Bumbacea R. Probiotics and prebiotics in atopic dermatitis: Pros and cons (Review). Exp Ther Med 2021; 22:1376. [PMID: 34650624 PMCID: PMC8506923 DOI: 10.3892/etm.2021.10811] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 08/16/2021] [Indexed: 12/17/2022] Open
Abstract
Atopic dermatitis (AD) represents a chronic inflammatory skin condition in which the skin barrier is impaired; thus, the permeability is increased. Hence, there is a greater risk of allergic sensitization, as well as a higher pH and lower protection against resident microbes. Since this condition is currently increasing among children, it requires further study, as little is known regarding the pathogenesis that makes the skin prone to chronic relapsing inflammation. Trying to standardize the data regarding the use of prebiotics and probiotics in AD, we encountered tremendous variability in the literature data. Literature abounds in conflicting data: studies regarding prophylactic and therapeutic applications, different types of strains and dosages, applications in young children up to 5 years of age and above, usage of probiotics alone, prebiotics alone or synbiotics combined. There are also conflicting data regarding the outcome of these studies; some confirming a positive effect of prebiotics, probiotics or synbiotics and some showing no efficacy at all. The articles were divided into those assessing probiotics or prebiotics alone and a combination of the two, with studies showing a positive effect and studies proving no efficacy at all. We tried to critically analyze those articles showing weak and strong points. In summary, the most studied probiotics were the strains of Lactobacilli and Bifidobacteria. The Severity Scoring of Atopic Dermatitis (SCORAD) index was used to measure the efficacy of the treatment. Most studies compared their results with a placebo group and the efficacy when seen in moderate to severe forms of AD in patients with other allergic diseases present. However, the results are difficult to interpret, as in many studies the authors suggest that the disease may have a tendency to improve in time in some groups of patients.
Collapse
Affiliation(s)
| | - Daniel Boda
- Dermatology Department, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania.,Pediatrics Department, 'Ponderas' Academic Hospital, 014142 Bucharest, Romania
| | - Laura Mihaela Ion
- Pediatrics Department, 'Ponderas' Academic Hospital, 014142 Bucharest, Romania
| | - Daniela Hosseyni
- Public Health Department, Harvard T.H. Chan School of Public Health, ECPE, PPCR Program, Boston, MA 02115, USA
| | - Poliana Leru
- Internal Medicine, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Selda Ali
- Allergy Department, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania.,Allergy Department, 'Dr. Carol Davila' Clinical Nephrology Hospital, 010731 Bucharest, Romania
| | - Sabina Corcea
- Allergy Department, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Roxana Bumbacea
- Allergy Department, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania.,Allergy Department, 'Dr. Carol Davila' Clinical Nephrology Hospital, 010731 Bucharest, Romania
| |
Collapse
|
9
|
Graubard R, Perez-Sanchez A, Katta R. Stress and Skin: An Overview of Mind Body Therapies as a Treatment Strategy in Dermatology. Dermatol Pract Concept 2021; 11:e2021091. [PMID: 34631261 DOI: 10.5826/dpc.1104a91] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/22/2021] [Indexed: 01/24/2023] Open
Abstract
Stress has multiple and wide-ranging physiologic and clinical impacts on skin disease. This has led to an interest in mind body therapies as potential adjunct treatments for skin disease. The stress response results in the activation of the endocrine, neurologic, and immune systems, with a resulting cascade of impacts, that are both systemic and cutaneous. The 2 main arms of the stress response are the sympathetic nervous system and the hypothalamic-pituitary-adrenal axis. The resultant release of cortisol, catecholamines, and neuropeptides has multiple effects. Clinically, these have been shown to increase skin inflammation, increase itching, impair skin barrier function, impair wound healing, and suppress immunity. Mind body therapies are those that focus on the interaction between the mind and the body, with the goal to influence physical function and impact health. These have been shown to ameliorate some of the harmful physiologic changes attributed to stress or to reduce harmful behaviors. In some cases, such as with biofeedback, they may also result in beneficial physiologic changes. Treatments such as meditation, biofeedback, hypnosis, guided imagery, and others have been evaluated in the treatment of skin disease and have shown some benefits. Although randomized controlled trials are limited, these interventions have shown beneficial effects on itching, psychosocial outcomes, and even skin severity. These interventions have been evaluated in diseases such as atopic dermatitis, psoriasis, trichotillomania, and others. Given the potential benefits, improvements in psychosocial outcomes, and a low risk profile, referral to qualified practitioners or multidisciplinary clinics should be considered for some patients.
Collapse
Affiliation(s)
| | | | - Rajani Katta
- Baylor College of Medicine, Houston, TX, USA.,McGovern Medical School at the University of Texas Houston, USA
| |
Collapse
|
10
|
Stefanovic N, Irvine AD, Flohr C. The Role of the Environment and Exposome in Atopic Dermatitis. CURRENT TREATMENT OPTIONS IN ALLERGY 2021; 8:222-241. [PMID: 34055570 PMCID: PMC8139547 DOI: 10.1007/s40521-021-00289-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/16/2021] [Indexed: 12/23/2022]
Abstract
Purpose of review Atopic dermatitis (AD) is a chronic inflammatory skin disorder affecting up to 20% of children and up to 5% of adults worldwide, contributing to significant disease-related morbidity in this patient cohort. Its aetiopathogenesis is underpinned by multiple factors, including genetic susceptibility, skin barrier defects, a skewed cutaneous immune response and microbiome perturbation in both the skin and the gut. In this review, we aim to examine the biological effects of key environmental exposures (the sum of which is termed the “exposome”) at the population, community and individual levels in order to describe their effect on AD pathogenesis. Recent findings It is now understood that as well as considering the type of environmental exposure with regard to its effect on AD pathogenesis, the dosage and timing of the exposure are both critical domains that may lead to either exacerbation or amelioration of disease. In this review, we consider the effects of population-wide exposures such as climate change, migration and urbanization; community-specific exposures such as air pollution, water hardness and allergic sensitisation; and individual factors such as diet, microbiome alteration, psychosocial stress and the impact of topical and systemic therapy. Summary This review summarises the interaction of the above environmental factors with the other domains of AD pathogenesis, namely, the inherent genetic defects, the skin barrier, the immune system and the cutaneous and gut microbiota. We specifically emphasise the timing and dosage of exposures and its effect on the cellular and molecular pathways implicated in AD.
Collapse
Affiliation(s)
| | - Alan D Irvine
- Department of Paediatric Dermatology, Children's Health Ireland at Crumlin, Dublin, Ireland.,National Children's Research Centre, Crumlin and Clinical Medicine, Trinity College Dublin, Dublin, Ireland
| | - Carsten Flohr
- Unit for Population-Based Dermatology Research, St John's Institute of Dermatology, Guy's & St Thomas' NHS Foundation Trust and King's College London, London, UK
| |
Collapse
|
11
|
Costache A, Berghi ON, Cergan R, Dumitru M, Neagos A, Popa LG, Giurcaneanu C, Vrinceanu D. Respiratory allergies: Salicaceae sensitization (Review). Exp Ther Med 2021; 21:609. [PMID: 33936266 DOI: 10.3892/etm.2021.10041] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 03/01/2021] [Indexed: 12/28/2022] Open
Abstract
Seasonal allergic rhinitis (SAR) is one of the most frequent chronic conditions of the modern world. Pollen carried by the wind from pollinated trees is a major source of SAR. Betulaceae, Oleaceae and Platanus are the most important sources of airway sensitization with regard to tree pollen and, therefore, they are included in the official recommendations of skin prick testing by different official societies. Salicaceae pollen is a moderate source of pollen sensitization. Conversely, large areas are covered with poplars and willows around the world. A number of studies from many countries showed that in some particular situations (large and compacted areas covered by Salicaceae, weather conditions, air pollution, urban ornamental vegetation), poplar and willow pollens may become of local importance in producing SAR. The aim of this review was to present a synthesis of information regarding Salicaceae pollen allergy showing that, if various unfavorable aspects are brought together, a minor problem (Salicaceae sensitization) can became a public health problem.
Collapse
Affiliation(s)
- Adrian Costache
- Department of Pathology, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Ovidiu Nicolae Berghi
- Department of Oncologic Dermatology, 'Elias' Emergency University Hospital, 011461 Bucharest, Romania
| | - Romica Cergan
- Department of Anatomy, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Mihai Dumitru
- Department of Anatomy, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Adriana Neagos
- ENT Department, 'George Emil Palade' University of Medicine, Pharmacy, Science and Technology of Târgu-Mureș, 540139 Târgu Mureș, Romania
| | - Liliana Gabriela Popa
- Department of Oncologic Dermatology, 'Elias' Emergency University Hospital, 011461 Bucharest, Romania
| | - Calin Giurcaneanu
- Department of Oncologic Dermatology, 'Elias' Emergency University Hospital, 011461 Bucharest, Romania
| | - Daniela Vrinceanu
- ENT Department, Bucharest Emergency University Hospital, 010271 Bucharest, Romania
| |
Collapse
|
12
|
Haidar L, Tamas TP, Stolz F, Patrascu RFP, Chen KW, Panaitescu C. Symptom patterns and comparison of diagnostic methods in ragweed pollen allergy. Exp Ther Med 2021; 21:525. [PMID: 33815598 PMCID: PMC8014962 DOI: 10.3892/etm.2021.9957] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 02/02/2021] [Indexed: 12/18/2022] Open
Abstract
The aim of the present study was to determine the pattern of symptoms of ragweed pollen-induced allergic disease in sensitized patients from Romania and to compare the molecular diagnosis of allergy with the skin prick test, in order to better characterize allergic patients and to guide therapy. A total of 97 subjects, including patients with ragweed pollen-induced allergic rhinoconjunctivitis with/without asthma, as well as healthy controls, were recruited prospectively in one ragweed pollen season, submitted to allergy questionnaires, skin prick tests and multiplex specific IgE (immunoglobulin E) measurement by ImmunoCAP ISAC (ImmunoCAP Immuno-Solid phase Allergy Chip) assay. A total of 83 patients were sensitized to ragweed pollen. Most patients (73%) were diagnosed with moderate-severe intermittent allergic rhinoconjunctivitis and 25% of the patients also had allergic asthma. The most common symptoms were watery rhinorrhea (91.57%), nasal obstruction (86.75%), and sneezing (85.54%). Most patients were polysensitized (62.65%), especially to other pollens, house dust mites and animal danders. Only 90% of the patients with positive skin prick test to ragweed pollen extract also had increased specific serum IgE to Amb a 1. Current options for specific molecular diagnosis of ragweed allergy are limited, as they only contain one or few of the sensitizing allergens present in ragweed pollen. An improved component-resolved diagnosis, using several ragweed pollen allergens, is required for better patient characterization and subsequent selection of an appropriate allergen immunotherapy product, thereby enabling a more personalized approach to the management of the ragweed-allergic patient.
Collapse
Affiliation(s)
- Laura Haidar
- Discipline of Physiology, Department III Functional Sciences, 'Victor Babes' University of Medicine and Pharmacy, 300041 Timisoara, Romania.,Centre for Gene and Cellular Therapies in The Treatment of Cancer-OncoGen, 'Pius Brinzeu' Clinical Emergency Hospital, 300723 Timisoara, Romania.,Center of Immuno-Physiology and Biotechnologies, 'Victor Babes' University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Tudor-Paul Tamas
- Discipline of Physiology, Department III Functional Sciences, 'Victor Babes' University of Medicine and Pharmacy, 300041 Timisoara, Romania.,Centre for Gene and Cellular Therapies in The Treatment of Cancer-OncoGen, 'Pius Brinzeu' Clinical Emergency Hospital, 300723 Timisoara, Romania
| | - Frank Stolz
- Department of Product Development, Biomay AG, A-1090 Vienna, Austria
| | - Raul Florian Petrisor Patrascu
- Discipline of Physiology, Department III Functional Sciences, 'Victor Babes' University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Kuan-Wei Chen
- Centre for Gene and Cellular Therapies in The Treatment of Cancer-OncoGen, 'Pius Brinzeu' Clinical Emergency Hospital, 300723 Timisoara, Romania
| | - Carmen Panaitescu
- Discipline of Physiology, Department III Functional Sciences, 'Victor Babes' University of Medicine and Pharmacy, 300041 Timisoara, Romania.,Centre for Gene and Cellular Therapies in The Treatment of Cancer-OncoGen, 'Pius Brinzeu' Clinical Emergency Hospital, 300723 Timisoara, Romania.,Center of Immuno-Physiology and Biotechnologies, 'Victor Babes' University of Medicine and Pharmacy, 300041 Timisoara, Romania
| |
Collapse
|
13
|
Kumar V. Going, Toll-like receptors in skin inflammation and inflammatory diseases. EXCLI JOURNAL 2021; 20:52-79. [PMID: 33510592 PMCID: PMC7838829 DOI: 10.17179/excli2020-3114] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Accepted: 01/04/2021] [Indexed: 02/06/2023]
Abstract
The Indian Ayurvedic physicians knew the concept of inflammation dating back to 1500 BC. The continuous progress in the immunology of inflammation has explained its undiscovered mechanisms. For example, the discovery of Toll-like receptor 4 (TLR4) in humans (1997) has revolutionized the field of infection biology and innate immunity. The laboratory mice have shown twelve TLRs and express TLR10 (CD290) as a disrupted pseudogene, and humans have ten functional TLRs. Now, it is well established that TLRs play a significant role in different infectious and inflammatory diseases. Skin inflammation and other associated inflammatory diseases, including atopic dermatitis (AD), acne vulgaris, and psoriasis, along with many skin cancers are major health problems all over the world. The continuous development in the immunopathogenesis of inflammatory skin diseases has opened the window of opportunity for TLRs in studying their role. Hence, the manuscript explores the role of different TLRs in the pathogenesis of skin inflammation and associated inflammatory diseases. The article starts with the concept of inflammation, its origin, and the impact of TLRs discovery on infection and inflammation biology. The subsequent section describes the burden of skin-associated inflammatory diseases worldwide and the effect of the geographical habitat of people affecting it. The third section explains skin as an immune organ and explains the expression of different TLRs on different skin cells, including keratinocytes, Langerhans cells (LCs), skin fibroblasts, and melanocytes. The fourth section describes the impact of TLRs on these cells in different skin-inflammatory conditions, including acne vulgaris, AD, psoriasis, and skin cancers. The article also discusses the use of different TLR-based therapeutic approaches as specific to these inflammatory skin diseases.
Collapse
Affiliation(s)
- Vijay Kumar
- Children Health Clinical Unit, Faculty of Medicine and Biomedical Sciences, Mater Research, University of Queensland, ST Lucia, Brisbane, Queensland 4078, Australia
- School of Biomedical Sciences, Faculty of Medicine, University of Queensland, ST Lucia, Brisbane, Queensland 4078, Australia
| |
Collapse
|
14
|
Cernescu LD, Haidar L, Panaitescu C. Dendritic cell-CD4 + T cell interaction: The differential role of IL-4/IL-13 in serum IgE levels in house dust mite allergic patients. Exp Ther Med 2021; 21:95. [PMID: 33363606 PMCID: PMC7725010 DOI: 10.3892/etm.2020.9527] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 10/12/2020] [Indexed: 12/30/2022] Open
Abstract
Allergic asthma is a chronic airway inflammatory disorder triggered by inhalant allergens. Interleukin (IL)-4 and IL-13 play a main role in the generation of T helper cell type 2 (Th2) immune response, induction of immunoglobulin E (IgE) synthesis and persistence of airway inflammation. The aim of the present study was to investigate the influence of Dermatophagoides pteronyssinus allergen Der p 1, the major allergen of house dust mite, on the synthesis of IL-4 and IL-13 by monocyte-derived dendritic cells (DCs) and naive CD4+ T cells cocultured with DCs, as well as their role in the production of serum IgE, in house dust mite (HDM) allergic patients. Peripheral blood mononuclear cells (PBMCs) were isolated from venous blood of patients allergic to HDM and healthy donors and incubated with granulocyte-macrophage colony-stimulating factor (GM-CSF) and IL-4 to generate immature DCs. The obtained cells were stimulated for 24 h with Der p 1 to induce DC maturation, washed, and afterwards cocultured for 24 h with autologous naive CD4+ T cells. Culture supernatants were harvested for IL-4, IL-13 and IFN-γ level measurements. DCs stimulation with Der p 1 induced higher synthesis of IL-4 and IL-13 in HDM allergic patients, compared to healthy donors. The allergic group showed significant correlation between IL-13 production by Der p 1-pulsed DCs, and total serum IgE and IL-4 production of the same cells and Der p-specific IgE. To conclude, IL-4 and IL-13 are critically related to the regulation of serum IgE production in patients with allergic asthma. The relevance of these two cytokines in the pathophysiology of Th2 asthma endotype makes them an appropriate target in its management.
Collapse
Affiliation(s)
- Luminita Daniela Cernescu
- Discipline of Dermatovenerology, Department XIV Microbiology, ‘Victor Babes’ University of Medicine and Pharmacy Timisoara, Timisoara RO-300041, Romania
| | - Laura Haidar
- Discipline of Physiology, Department III Functional Sciences, ‘Victor Babes’ University of Medicine and Pharmacy Timisoara, Timisoara RO-300041, Romania
- County Emergency Clinical Hospital ‘Pius Brinzeu’ Timisoara-Centre for Gene and Cellular Therapies in The Treatment of Cancer OncoGen, Timisoara RO-300723, Romania
| | - Carmen Panaitescu
- Discipline of Physiology, Department III Functional Sciences, ‘Victor Babes’ University of Medicine and Pharmacy Timisoara, Timisoara RO-300041, Romania
- County Emergency Clinical Hospital ‘Pius Brinzeu’ Timisoara-Centre for Gene and Cellular Therapies in The Treatment of Cancer OncoGen, Timisoara RO-300723, Romania
| |
Collapse
|
15
|
Mutations of filament-aggregating protein gene in Romanian children diagnosed with atopic dermatitis. Exp Ther Med 2020; 20:212. [PMID: 33149776 PMCID: PMC7604754 DOI: 10.3892/etm.2020.9343] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 08/11/2020] [Indexed: 01/29/2023] Open
Abstract
Association of atopic dermatitis (AD) and several mutations of various genes of the immune system, in particular filament-aggregating protein gene (FLG) has been investigated in many studies. The association between defective FLG and AD in the Romanian population has not been assessed or published. The present study focused on the genetic background of AD, aiming to assess the prevalence of FLG mutations in Romanian patients with AD. Genetic background of AD was tested for common FLG-mutations: R501X, 2282del4, S3247X and R2447X. The study involved 48 Romanian Caucasian children aged between two months and six years diagnosed with AD, and 48 healthy volunteers; DNA extraction involved 50% of the patients to give samples by using buccal swabs and 50% by collection of whole blood samples. Genetic predisposition was evaluated based on family history, atopy history and profilaggrin genotyping. DNA extracted from blood samples was adequate to study FLG mutations, although no mutation was identified. Genetic factors do not have a unique critical role in AD; therefore, environmental factors unquestionably play an important role in this disease, but the clear-cut part that these factors trigger toward increasing the risk of AD in childhood is still obscure.
Collapse
|
16
|
Rotaru M, Iancu GM, Matran IM. Importance of food in the control of inflammation in atopic dermatitis. Exp Ther Med 2020; 20:206. [PMID: 33123235 DOI: 10.3892/etm.2020.9336] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 09/10/2020] [Indexed: 12/14/2022] Open
Abstract
Patients that suffer from inflammatory diseases need to pay special attention to nutrition. For this reason, it is very important to change the approach of both health professionals and food industry specialists. There must be a close collaboration, starting from research, the development phase of foods for special nutrition states. Our primary objective was to identify foods or potential dietary ingredients, which efficacy in the treatment of atopic dermatitis had been scientifically demonstrated in vitro, in vivo and clinically. Furthemore, our perspective is presented regarding the research and development of foods for special nutritional states in atopic dermatitis. The PubMed database was analyzed for the period 2018-2020, as well as the European Legislation regarding the appropriate requirements for the composition and knowledge applicable to foods destined for use in special medical purposes. The search criteria were 'chronic dermatitis', 'atopic dermatitis', 'psoriasis', 'alternative treatments', 'natural treatments', 'complementary treatments', 'treatments for chronic dermatitis'. We also looked for undesirable effects or side effects of the foods included in the research in order to treat atopic dermatitis. The results showed that prebiotics, probiotics and certain plant extracts had a high efficacy in controlling inflammation in atopic dermatitis. The food development research for special nutrition states (atopic dermatitis) involves a multidisciplinary team. We started with the establishment of the general objective and continued with the consultation of the PubMed, EMBASE and other databases, and with the in vitro, preclinical and/or clinical determination of the efficacy of new developed foods, that must be protected with patents. The development of foods for special nutrition states represents a solution for improving the quality of life of atopic dermatitis patients.
Collapse
Affiliation(s)
- Maria Rotaru
- Department of Dermatology, Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania.,Clinic of Dermatology, County Clinical Emergency Hospital of Sibiu, 550245 Sibiu, Romania
| | - Gabriela Mariana Iancu
- Department of Dermatology, Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania.,Clinic of Dermatology, County Clinical Emergency Hospital of Sibiu, 550245 Sibiu, Romania
| | - Irina Mihaela Matran
- Faculty of Pharmacy, University of Medicine, Pharmacy, Science and Technology, 540142 Targu Mures, Romania
| |
Collapse
|
17
|
Bumbacea RS, Corcea SL, Ali S, Dinica LC, Fanfaret IS, Boda D. Mite allergy and atopic dermatitis: Is there a clear link? (Review). Exp Ther Med 2020; 20:3554-3560. [PMID: 32905207 DOI: 10.3892/etm.2020.9120] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 07/23/2020] [Indexed: 12/18/2022] Open
Abstract
Atopic dermatitis (AD) represents a widespread chronic skin disease associated with different atopic disorders and allergies. These associations, similar to overall AD pathophysiology, are entangled, multifactorial and they are yet to be clarified. IgE and non IgE mediated pathomechanisms appear to be implicated in AD. Allergens constitute key aspects in AD pathogenesis, as they may serve as trigger factors. This review emphasizes mainly house dust mites (HDM), as they are likely the most relevant airborne allergen for AD. Here we review in a concise form the mite allergens, the role of molecular diagnosis and the treatment strategies for HDM. Strategies of avoiding allergens, with a few exceptions, are not enough to control children's AD; recent studies show HDM avoidance procedures in diagnosed AD are insufficient. Regardless, some guidelines acknowledge the benefit of mattress and pillow covers in patients with dust mite sensitization that are unresponsive to optimal AD management. Most clinical trials investigating allergen-specific immunotherapy (AIT) as a potential treatment for AD were done with adult patients; a scarce number of studies looked into the efficacy of AIT as a treatment option in children suffering from AD, with conflicting data among them. One of the most feasible of these studies showed significant improvement of AD outcomes only in the mild/moderate group, but not in the severe group. Uncontrolled studies are hard to interpret, considering the natural history of remitting and relapsing of AD, in many of the patients, without clinical interventions. More AIT studies, especially pediatric studies, are required in order to either prove the reproducibility of positive results or to deny its effectiveness.
Collapse
Affiliation(s)
- Roxana Silvia Bumbacea
- Department of Allergy, 'Dr. Carol Davila' Nefrology Clinical Hospital, 010731 Bucharest, Romania.,Department of Allergy, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Sabina Loredana Corcea
- Department of Physiopathology and Immunology, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Selda Ali
- Department of Allergy, 'Dr. Carol Davila' Nefrology Clinical Hospital, 010731 Bucharest, Romania.,Department of Allergy, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Laura Cristina Dinica
- Department of Allergy, 'Dr. Carol Davila' Nefrology Clinical Hospital, 010731 Bucharest, Romania
| | - Ioan Serban Fanfaret
- Department of Pediatrics, Centre Hospitalier Régional d'Orléans, 45100 Orléans, France
| | - Daniel Boda
- Dermatology Research Laboratory, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania.,Carol Medical Center, 010626 Bucharest, Romania
| |
Collapse
|
18
|
Leru PM, Anton VF, Ureche C, Zurac S, Bratu O, Neagoe CD. Mast cell activation syndromes - evaluation of current diagnostic criteria and laboratory tools in clinical practice (Review). Exp Ther Med 2020; 20:2348-2351. [PMID: 32765713 DOI: 10.3892/etm.2020.8947] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 06/16/2020] [Indexed: 01/15/2023] Open
Abstract
Mast cell activation syndromes (MCAS) represent a heterogeneous clinical entity caused by episodic and severe mast cell activation, including primary and secondary mast cell disorders (MCDs). The group of primary or clonal MCDs refers to systemic mastocytosis, other clonal MCAS and hereditary hypertryptasemia, while the secondary MCAS is characterized by normal mast cells (MCs) which are activated by external triggers, such as allergens or physical stimuli. Another category of MCAS is the idiopathic form, when no trigger or genetic mutation can be identified. Symptoms of mast cell activation are due to release of specific mediators and can be seen in many diseases, such as allergies, with localized or systemic clinical manifestations. Confirmation of MCAS is based on diagnostic criteria proposed by an international group of experts and the best available evidence in this field. It is generally accepted that the clinical picture of MCAS is non-specific and there are few available laboratory tools, making it difficult for clinicians to identify and confirm this entity. The diagnosis is established after exclusion of other possible clinical entities in most of the cases. Therefore, the actual diagnostic criteria of MCASs, some relevant clinical aspects and laboratory tools used in clinical practice were reviewed.
Collapse
Affiliation(s)
- Polliana Mihaela Leru
- Family Medicine Department, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania.,Internal Medicine Clinic, 'Colentina' Clinical Hospital, 020125 Bucharest, Romania
| | - Vlad Florin Anton
- Internal Medicine Clinic, 'Colentina' Clinical Hospital, 020125 Bucharest, Romania
| | - Corina Ureche
- Internal Medicine Clinic, 'George Emil Palade' University of Medicine, Pharmacy, Science and Technology, 540139 Târgu Mureş, Romania
| | - Sabina Zurac
- Family Medicine Department, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania.,Department of Pathology, 'Colentina' Clinical Hospital, 020125 Bucharest, Romania
| | - Ovidiu Bratu
- Family Medicine Department, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania.,Urology Clinic, Central Military Emergency University Hospital, 010825 Bucharest, Romania.,Academy of Romanian Scientists, 050045 Bucharest, Romania
| | - Carmen Daniela Neagoe
- Internal Medicine and Gastroenterology Clinic, Emergency County Hospital, 200642 Craiova, Romania.,Gastroenterology Department, University of Medicine and Pharmacy, 200349 Craiova, Romania
| |
Collapse
|
19
|
Porumb-Andrese E, Vâță D, Postolică R, Stătescu L, Stătescu C, Grăjdeanu AI, Pătrașcu AI, Popescu IA, Solovastru LG. Association between personality type, affective distress profile and quality of life in patients with psoriasis vs. patients with cardiovascular disease. Exp Ther Med 2019; 18:4967-4973. [PMID: 31798718 PMCID: PMC6880473 DOI: 10.3892/etm.2019.7933] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Accepted: 07/23/2019] [Indexed: 12/22/2022] Open
Abstract
Common chronic conditions, such as cardiovascular diseases and psoriasis, are associated with increased psychological distress. Health-related quality of life and personality type in patients with these two diseases were evaluated, including the patient's ability to respond truthfully or his/her tendency to be introverted or extroverted. The subjects (n=63) responded to questionnaires including: SF-36 questionnaire, Eysenck test and the questionnaire of the affective distress profile designed to assess the subjective dimension of functional negative emotions, dysfunctional negative emotions and positive emotions. Psoriasis patients had significantly higher average scores of physical functions and limitations brought on by emotional problems. Emotional instability was common for both types of patients and anxiety was associated with a low level of education. Overall, we believe that it is necessary to include items evaluating the patients' affective profile and personality in the assessment protocols of these diseases. These items could help the clinician in identifying possible factors that signal worsening of the disease or of non-response to treatment.
Collapse
Affiliation(s)
- Elena Porumb-Andrese
- Department of Dermatology, University of Medicine and Pharmacy 'Gr. T. Popa', 700115 Iași, Romania.,Dermatology Clinic of The Clinical Emergency County Hospital 'Sf. Spiridon', 700111 Iași, Romania
| | - Dan Vâță
- Department of Dermatology, University of Medicine and Pharmacy 'Gr. T. Popa', 700115 Iași, Romania.,Dermatology Clinic of The Clinical Emergency County Hospital 'Sf. Spiridon', 700111 Iași, Romania
| | | | - Laura Stătescu
- Department of Dermatology, University of Medicine and Pharmacy 'Gr. T. Popa', 700115 Iași, Romania.,Dermatology Clinic of The Clinical Emergency County Hospital 'Sf. Spiridon', 700111 Iași, Romania
| | - Cristian Stătescu
- Cardiology Clinic of The Institute of Cardiovascular Diseases, 700503 Iași, Romania
| | - Alina-Ioana Grăjdeanu
- Department of Dermatology, University of Medicine and Pharmacy 'Gr. T. Popa', 700115 Iași, Romania
| | - Adriana Ionela Pătrașcu
- Dermatology Clinic of The Clinical Emergency County Hospital 'Sf. Spiridon', 700111 Iași, Romania
| | - Ioana Adriana Popescu
- Department of Dermatology, University of Medicine and Pharmacy 'Gr. T. Popa', 700115 Iași, Romania
| | - Laura Gheucă Solovastru
- Department of Dermatology, University of Medicine and Pharmacy 'Gr. T. Popa', 700115 Iași, Romania.,Dermatology Clinic of The Clinical Emergency County Hospital 'Sf. Spiridon', 700111 Iași, Romania
| |
Collapse
|
20
|
Maria Alexandra Stanescu A, Totan A, Mircescu D, Diaconescu S, Gabriel Bratu O, Fekete L, László Fekete G, Boda D, Cristina Diaconu C. Assessment of suicidal behavior in dermatology (Review). Exp Ther Med 2019; 20:73-77. [PMID: 32508997 DOI: 10.3892/etm.2019.8145] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Accepted: 10/21/2019] [Indexed: 12/21/2022] Open
Abstract
Many diseases that affect physical health can also affect mental health. Many of these diseases are studied in terms of quality of life, depression and suicidal behavior. Dermatological disorders, although having a strong impact on the individual's life, are less studied with regard to suicidal behavior. There is a need to approach several dermatological diseases from the perspective of suicidal behavior in order to intervene early with specific treatment or to prevent suicide. Psoriasis, acne, melanoma, atopic dermatitis and urticaria are scarcely studied from the point of view of suicidal behavior. In addition to these diseases, there are others that require attention in terms of suicidal behavior, such as vitiligo or oculocutaneous albinism, most probably due to a small number of people suffering from these diseases, research is almost non-existent in these cases. We want to draw attention to the importance of early detection of suicidal behavior in dermatological practice and to highlight the need for several studies on this subject.
Collapse
Affiliation(s)
| | - Alexandra Totan
- University of Medicine and Pharmacy 'Carol Davila', 050474 Bucharest, Romania
| | - Daniela Mircescu
- University of Medicine and Pharmacy 'Carol Davila', 050474 Bucharest, Romania
| | - Smaranda Diaconescu
- II Pediatric Surgery Clinic, 'St. Mary' Children Emergency Hospital, 700309 Iasi, Romania
| | - Ovidiu Gabriel Bratu
- University of Medicine and Pharmacy 'Carol Davila', 050474 Bucharest, Romania.,Urology Department, Emergency University Central Military Hospital, 010825 Bucharest, Romania
| | | | - Gyula László Fekete
- University of Medicine and Pharmacy, Dermatology Clinic, 530136 Targu Mures, Romania
| | - Daniel Boda
- University of Medicine and Pharmacy 'Carol Davila', Department of Dermatology, 050474 Bucharest, Romania
| | - Camelia Cristina Diaconu
- University of Medicine and Pharmacy 'Carol Davila', 050474 Bucharest, Romania.,Clinical Emergency Hospital of Bucharest, 020322 Bucharest, Romania
| |
Collapse
|
21
|
Kyriakou G, Glentis A. Skin in the game: Video-game-related cutaneous pathologies in adolescents. Int J Pediatr Adolesc Med 2019; 8:68-75. [PMID: 34084875 PMCID: PMC8144863 DOI: 10.1016/j.ijpam.2019.09.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2019] [Revised: 08/04/2019] [Accepted: 09/03/2019] [Indexed: 12/01/2022]
Abstract
Background Following the inception of video games and the subsequent development of progressive innovations in videogame technology, many reports of videogame-related dermatologic conditions soon emerged in literature. Children and adolescents, in particular, are among the most avid consumers of online digital entertainment. Methods In an effort to better detail the impacts of these cutaneous manifestations and provide recommendations for injury prevention as it relates to video games, we performed an extensive systems-based literature review pertaining to the clinical features, etiology, diagnosis, and treatment of reported cases of dermatoses resulting from the misuse of video games. Results A literature review using PubMed, SCOPUS, Ovid MEDLINE and EMBASE was performed. Hardware implicated in the reported cases include video games consoles, personal computers, laptop computers, mobile phones and tablets. The dermatologic conditions are primarily localized to the extremities, particularly the palms and fingers. The majority are associated with repetitive friction and trauma, as well as allergic contact sensitivities. For all cutaneous manifestations induced by video gaming, early recognition and removal of the offending agent was most often described as effective in symptom resolution. Conclusions The universal use and pervasive popularity of video games for recreational purposes present an emerging dermatological concern. As videogames become increasingly advanced and immersive, various cutaneous conditions arising from intensive gaming will likely become common over time. Consequently, it is critical that dermatologists consider video games with a high index of suspicion when encountering dermatological ailments in underage patients engaging in persistent gaming behavior.
Collapse
Affiliation(s)
- Georgia Kyriakou
- Department of Dermatology, University General Hospital of Patras, Rio, 265 04, Greece
| | - Apostolos Glentis
- Department of General Medicine, University General Hospital of Patras, Greece
| |
Collapse
|
22
|
Boda D, Tsatsakis A. The Second Conference of the Romanian Society of Immuno-Dermatology, Bucharest, September 27-29, 2018. Exp Ther Med 2019; 17:979-981. [PMID: 30679962 PMCID: PMC6327649 DOI: 10.3892/etm.2018.7067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Accepted: 12/06/2018] [Indexed: 11/25/2022] Open
Affiliation(s)
- Daniel Boda
- Dermatology Research Laboratory, ‘Carol Davila’ University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Aristidis Tsatsakis
- Deparment of Medicine, Laboratory of Toxicology, University of Crete, Heraklion 71003, Greece
| |
Collapse
|