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Bertolín-Colilla M, Garin-Boronat O, Siebenhaar F, Maurer M, Pujol R, Giménez-Arnau A. Translation and Cultural Adaptation of the German Mastocytosis Quality of Life Questionnaire (MC-QoL) Into Spanish. Actas Dermo-Sifiliográficas (English Edition) 2020. [DOI: 10.1016/j.adengl.2020.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Bertolín-Colilla M, Garin-Boronat O, Siebenhaar F, Maurer M, Pujol RM, Giménez-Arnau AM. Translation and Cultural Adaptation of the German Mastocytosis Quality of Life Questionnaire (MC-QoL) into Spanish. Actas Dermosifiliogr (Engl Ed) 2020; 111:243-248. [PMID: 31987469 DOI: 10.1016/j.ad.2019.11.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 11/18/2019] [Accepted: 11/20/2019] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Mastocytosis encompasses a spectrum of disorders in which different organs and tissues are affected by the clonal expansion of mast cells. The skin is one of the most frequently affected organs. The clinical manifestations of mastocytosis are linked to the release of proinflammatory mediators, and the impact of this disorder on patient quality of life has been described in various studies. The Mastocytosis Quality of Life Questionnaire (MC-QoL), which was recently developed in Germany and now also exists in English, is an important tool for evaluating the psychosocial impact of this disease. OBJECTIVE To create a Spanish version of the MC-QoL that was culturally equivalent to the original German questionnaire. MATERIAL AND METHODS The adaptation process, which involved forward translation, cognitive interviews, and back translation, was conducted in accordance with the principles of good practice for the translation and cultural adaptation of patient-reported measures of the International Society for Pharmacoeconomics and Outcomes Research. The MC-QoL contains 27 items in 4 domains: symptoms, emotions, social life/functioning, and skin. RESULTS The first version of the Spanish questionnaire, obtained by forward translation from German, was tested in cognitive interviews, after which 3 items were modified to make them easier to understand. The German back translation of the Spanish questionnaire was analyzed by the authors of the original MC-QoL, who modified 1 item they considered to have lost specificity in the adaptation process. The definitive Spanish MC-QoL was then produced following minor modifications agreed on with the German authors. CONCLUSION We have produced a cultural adaptation of the MC-QoL in Spanish that can be used in routine clinical practice to obtain a more complete picture of the impact of mastocytosis on patient quality of life.
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Affiliation(s)
- M Bertolín-Colilla
- Departamento de Dermatología, Hospital del Mar, Parc de Salut Mar, IMIM, Universitat Autònoma de Barcelona
| | - O Garin-Boronat
- Grupo de Investigación en Servicios Sanitarios, Instituto Hospital del Mar de Investigaciones Médicas
| | - F Siebenhaar
- Departamento de Dermatología y Alergia, Allergie-Centrum-Charité, Charité-Universitätsmedizin, Berlín, Alemania
| | - M Maurer
- Departamento de Dermatología y Alergia, Allergie-Centrum-Charité, Charité-Universitätsmedizin, Berlín, Alemania
| | - R M Pujol
- Departamento de Dermatología, Hospital del Mar, Parc de Salut Mar, IMIM, Universitat Autònoma de Barcelona
| | - A M Giménez-Arnau
- Departamento de Dermatología, Hospital del Mar, Parc de Salut Mar, IMIM, Universitat Autònoma de Barcelona.
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Altrichter S, Staubach P, Pasha M, Rasmussen H, Singh B, Chang A, Kamboj A, Bernstein J, Siebenhaar F, Maurer M. P152 CLINICAL ACTIVITY OF AK002, AN ANTI-SIGLEC-8 ANTIBODY, IN MULTIPLE FORMS OF UNCONTROLLED CHRONIC URTICARIA. Ann Allergy Asthma Immunol 2019. [DOI: 10.1016/j.anai.2019.08.256] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Siebenhaar F, Sander B, Ho LHT, Ellrich A, Maurer M, Weller K. Development and validation of the mastocytosis activity score. Allergy 2018; 73:1489-1496. [PMID: 29405310 DOI: 10.1111/all.13425] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2018] [Indexed: 12/14/2022]
Abstract
BACKGROUND Mastocytosis is a heterogeneous disease characterized by a clonal expansion of mast cells in various organs. The vast majority of patients suffer from signs and symptoms caused by mediator release from mast cells. Although the disease burden is high, there is currently no specific and validated instrument to measure and monitor signs and symptoms in patients with mastocytosis. OBJECTIVE To develop and validate a disease-specific tool to measure and monitor the activity of signs and symptoms in patients with mastocytosis, the Mastocytosis Activity Score (MAS). METHODS Nineteen potential MAS items were developed in a combined approach consisting of semi-structured patient interviews, expert input and literature research. Item selection was performed by impact analysis with 76 patients followed by a review for face validity. The resulting MAS was tested for validity, reliability and influence factors. In parallel, a US American English version of the MAS was developed. RESULTS A total of 68 mastocytosis patients took part in the MAS validation study. The final 9-item MAS was found to have a three-domain structure ("skin," "gastrointestinal tract" and "other"), a valid total score and an excellent test-retest reliability. Multiple regression analysis revealed that disease duration, age or gender is not a significant determinant of the MAS results. CONCLUSIONS The MAS is a disease-specific, valid and reliable patient-reported outcome measure for adult patients with cutaneous and indolent systemic mastocytosis. It may serve as a valuable tool to measure and monitor mastocytosis activity, both, in clinical trials and in routine care.
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Affiliation(s)
- F. Siebenhaar
- Interdisciplinary Mastocytosis Center Charité; Department of Dermatology and Allergy; Charité - Universitätsmedizin Berlin; Berlin Germany
| | - B. Sander
- Interdisciplinary Mastocytosis Center Charité; Department of Dermatology and Allergy; Charité - Universitätsmedizin Berlin; Berlin Germany
| | - L. H. T. Ho
- Interdisciplinary Mastocytosis Center Charité; Department of Dermatology and Allergy; Charité - Universitätsmedizin Berlin; Berlin Germany
| | - A. Ellrich
- Interdisciplinary Mastocytosis Center Charité; Department of Dermatology and Allergy; Charité - Universitätsmedizin Berlin; Berlin Germany
| | - M. Maurer
- Interdisciplinary Mastocytosis Center Charité; Department of Dermatology and Allergy; Charité - Universitätsmedizin Berlin; Berlin Germany
| | - K. Weller
- Interdisciplinary Mastocytosis Center Charité; Department of Dermatology and Allergy; Charité - Universitätsmedizin Berlin; Berlin Germany
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Broesby‐Olsen S, Vestergaard H, Mortz CG, Jensen B, Havelund T, Hermann AP, Siebenhaar F, Møller MB, Kristensen TK, Bindslev‐Jensen C. Omalizumab prevents anaphylaxis and improves symptoms in systemic mastocytosis: Efficacy and safety observations. Allergy 2018; 73:230-238. [PMID: 28662309 DOI: 10.1111/all.13237] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/24/2017] [Indexed: 01/27/2023]
Abstract
BACKGROUND Patients with systemic mastocytosis (SM) may suffer from mast cell (MC) mediator-related symptoms insufficiently controlled by conventional therapy. Omalizumab is an established treatment in other MC-driven diseases, but experiences in SM are limited. OBJECTIVE To assess the efficacy and safety of omalizumab in SM. METHODS In our patient cohort, we evaluated all SM patients treated with omalizumab. A physician global assessment of type and severity of symptoms was performed at baseline, at 3 and 6 months and at latest follow-up. Quality of life was assessed by visual analogue scale. S-tryptase and KIT D816V allele burden were monitored. RESULTS A total of 14 adult SM patients (10 ISM, 2 BMM, 1 SSM, and 1 ASM-AHN) received omalizumab with a median duration of 17 months (range: 1-73 months). One patient was excluded due to concomitant cytoreductive therapy. In the remaining 13 patients, we observed a significant reduction in symptoms, with complete symptom control in five (38.5%), major response in three (23.1%), and a partial response in three (23.1%) patients, whereas two patients (15.4%) withdrew due to subjective side-effects at first dose. The treatment was most effective for recurrent anaphylaxis and skin symptoms, less for gastrointestinal, musculoskeletal, and neuropsychiatric symptoms. Patient-reported quality of life showed significant improvement. No significant changes in s-tryptase/KIT D816V allele burden were observed. No severe adverse events were recorded. CONCLUSIONS Omalizumab appears to be a promising treatment option in SM, effectively preventing anaphylaxis and improving chronic MC mediator-related symptoms, insufficiently controlled by conventional therapy. Controlled studies are needed to substantiate findings.
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Affiliation(s)
- S. Broesby‐Olsen
- Department of Dermatology and Allergy Centre Odense Research Centre for Anaphylaxis (ORCA) Odense University Hospital Odense Denmark
| | - H. Vestergaard
- Department of Haematology Odense University Hospital Odense Denmark
| | - C. G. Mortz
- Department of Dermatology and Allergy Centre Odense Research Centre for Anaphylaxis (ORCA) Odense University Hospital Odense Denmark
| | - B. Jensen
- Department of Dermatology and Allergy Centre Odense Research Centre for Anaphylaxis (ORCA) Odense University Hospital Odense Denmark
| | - T. Havelund
- Department of Gastroenterology Odense University Hospital Odense Denmark
| | - A. P. Hermann
- Department of Endocrinology Odense University Hospital Odense Denmark
| | - F. Siebenhaar
- Department of Dermatology and Allergy Interdisciplinary Mastocytosis Center Charité Charité‐Universitätsmedizin Berlin Berlin Germany
| | - M. B. Møller
- Department of Pathology Odense University Hospital Odense Denmark
| | - T. K. Kristensen
- Department of Pathology Odense University Hospital Odense Denmark
| | - C. Bindslev‐Jensen
- Department of Dermatology and Allergy Centre Odense Research Centre for Anaphylaxis (ORCA) Odense University Hospital Odense Denmark
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Bonnekoh H, Ohanyan T, Lenze D, Krause K, Maurer M, Zuberbier T, Siebenhaar F. Development of tripe palms and soles in a patient with long pre-existing systemic mastocytosis and newly developed non-small cell lung cancer. J Eur Acad Dermatol Venereol 2017; 32:e151-e153. [PMID: 29055165 DOI: 10.1111/jdv.14648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- H Bonnekoh
- Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - T Ohanyan
- Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - D Lenze
- Department of Pathology, Laboratory of Molecular Pathology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - K Krause
- Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - M Maurer
- Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - T Zuberbier
- Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - F Siebenhaar
- Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Berlin, Germany
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Munoz M, Arestova Y, Siebenhaar F, Maurer M. 501 Mechanisms of mast cell and T cell interactions during skin infections. J Invest Dermatol 2017. [DOI: 10.1016/j.jid.2017.07.697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Staubach P, Zuberbier T, Vestergaard C, Siebenhaar F, Toubi E, Sussman G. Controversies and challenges in the management of chronic urticaria. J Eur Acad Dermatol Venereol 2017; 30 Suppl 5:16-24. [PMID: 27286499 DOI: 10.1111/jdv.13696] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Accepted: 03/31/2016] [Indexed: 11/29/2022]
Abstract
This supplement reports proceedings of the second international Global Urticaria Forum, which was held in Berlin, Germany in November 2015. Despite the clear international guideline, there remain a number of controversies and challenges in the management of patients with chronic urticaria (CU). As a result of major advancements in urticaria over the past 4 years, the current EAACI/GA(2) LEN/EDF/WAO urticaria guideline treatment algorithm requires updating. Case studies from patients with chronic spontaneous urticaria (CSU) [also called chronic idiopathic urticaria (CIU)], chronic inducible urticaria (CIndU) or diseases and syndromes related to CU are useful in describing and exploring challenges in disease management. Case studies of specific CSU patient populations such as children with CU or patients with angio-edema but no hives also require consideration as potentially challenging groups with unmet needs. The current EAACI/GA(2) LEN/EDF/WAO urticaria guideline provides a general framework for the management of patients with CU but, as these cases highlight, a personalized approach based on the expert knowledge of the physician may be required.
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Affiliation(s)
- P Staubach
- Department of Dermatology, University Medical Center, Mainz, Germany
| | - T Zuberbier
- Department of Dermatology and Allergy, Allergie-Centrum-Charité, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - C Vestergaard
- Department of Dermatology and Venereology, Aarhus University, Aarhus, Denmark
| | - F Siebenhaar
- Department of Dermatology and Allergy, Allergie-Centrum-Charité, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - E Toubi
- Division of Allergy and Clinical Immunology, Bnai-Zion Medical Center, Haifa, Israel
| | - G Sussman
- Division of Allergy and Clinical Immunology, St. Michael's Hospital and University of Toronto, Toronto, ON, Canada
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Maurer M, Church MK, Marsland AM, Sussman G, Siebenhaar F, Vestergaard C, Broom B. Questions and answers in chronic urticaria: where do we stand and where do we go? J Eur Acad Dermatol Venereol 2017; 30 Suppl 5:7-15. [PMID: 27286498 DOI: 10.1111/jdv.13695] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Accepted: 03/31/2016] [Indexed: 11/28/2022]
Abstract
This supplement reports proceedings of the second international Global Urticaria Forum, which was held in Berlin, Germany in November 2015. In 2011, a report of the GA(2) LEN task force on urticaria outlined important and unanswered questions in chronic urticaria (CU). These included, but were not limited to, questions on the epidemiology and course of chronic spontaneous urticaria (CSU) [also called chronic idiopathic urticaria (CIU)], the resources allocated for the diagnosis and treatment of CSU, whether patients with angioedema as an isolated symptom can be regarded as a subgroup of CSU, and the efficacy and long-term safety of therapies. Many of these questions have been addressed by recent studies. Some of the answers obtained raise new questions. Here, we summarize some of the key insights on CU obtained over recent years, and we discuss old and new unmet needs and how to address them with future studies. We need to analyze the influence of recent advances in understanding of the burden of CU on patients and society, disease management and the CU patient journey. Our increased understanding of urticarial pathophysiology and consideration of the patient as a whole will need to be translated to better treatment algorithms and protocols. Actions to address these challenges include the 5th International Consensus Meeting on Urticaria, which will take place later this year. The formation of a global network of Urticaria Centers of Reference and Excellence over the next few years has also been proposed, with the aim of providing consistent excellence in urticaria management and a clear referral route, furthering knowledge of urticaria through additional research and educating/promoting awareness of urticaria.
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Affiliation(s)
- M Maurer
- Department of Dermatology and Allergy, Allergie-Centrum-Charité, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - M K Church
- Department of Dermatology and Allergy, Allergie-Centrum-Charité, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - A M Marsland
- Salford Royal NHS Foundation Trust, Manchester Academic Health Science Center, University of Manchester, Manchester, UK
| | - G Sussman
- Division of Allergy and Clinical Immunology, St Michael's Hospital and University of Toronto, Toronto, ON, Canada
| | - F Siebenhaar
- Department of Dermatology and Allergy, Allergie-Centrum-Charité, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - C Vestergaard
- Department of Dermatology and Venereology, Aarhus University Hospital, Aarhus, Denmark
| | - B Broom
- Department of Immunology, Auckland City Hospital, Auckland, New Zealand
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Maurer M, Rietzler M, Burghardt R, Siebenhaar F. The male beard hair and facial skin - challenges for shaving. Int J Cosmet Sci 2017; 38 Suppl 1:3-9. [PMID: 27212465 DOI: 10.1111/ics.12328] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 04/01/2016] [Indexed: 11/27/2022]
Abstract
The challenge of shaving is to cut the beard hair as closely as possible to the skin without unwanted effects on the skin. To achieve this requires the understanding of beard hair and male facial skin biology as both, the beard hair and the male facial skin, contribute to the difficulties in obtaining an effective shave without shaving-induced skin irritation. Little information is available on the biology of beard hairs and beard hair follicles. We know that, in beard hairs, the density, thickness, stiffness, as well as the rates of elliptical shape and low emerging angle, are high and highly heterogeneous. All of this makes it challenging to cut it, and shaving techniques commonly employed to overcome these challenges include shaving with increased pressure and multiple stroke shaving, which increase the probability and extent of shaving-induced skin irritation. Several features of male facial skin pose problems to a perfect shave. The male facial skin is heterogeneous in morphology and roughness, and male skin has a tendency to heal slower and to develop hyperinflammatory pigmentation. In addition, many males exhibit sensitive skin, with the face most often affected. Finally, the hair follicle is a sensory organ, and the perifollicular skin is highly responsive to external signals including mechanical and thermal stimulation. Perifollicular skin is rich in vasculature, innervation and cells of the innate and adaptive immune system. This makes perifollicular skin a highly responsive and inflammatory system, especially in individuals with sensitive skin. Activation of this system, by shaving, can result in shaving-induced skin irritation. Techniques commonly employed to avoid shaving-induced skin irritation include shaving with less pressure, pre- and post-shave skin treatment and to stop shaving altogether. Recent advances in shaving technology have addressed some but not all of these issues. A better understanding of beard hairs, beard hair follicles and male facial skin is needed to develop novel and better approaches to overcome the challenge of shaving. This article covers what is known about the physical properties of beard hairs and skin and why those present a challenge for blade and electric shaving, respectively.
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Affiliation(s)
- M Maurer
- Department of Dermatology and Allergy, Allergie-Centrum-Charité, Charité - Universitätsmedizin, Berlin, Germany
| | - M Rietzler
- Procter & Gamble Braun German Innovation Center, Frankfurter Strasse 145, 61476 Kronberg, Germany
| | - R Burghardt
- Procter & Gamble Braun German Innovation Center, Frankfurter Strasse 145, 61476 Kronberg, Germany
| | - F Siebenhaar
- Department of Dermatology and Allergy, Allergie-Centrum-Charité, Charité - Universitätsmedizin, Berlin, Germany
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Siebenhaar F, Melde A, Magerl M, Zuberbier T, Church M, Maurer M. Histamine intolerance in patients with chronic spontaneous urticaria. J Eur Acad Dermatol Venereol 2016; 30:1774-1777. [DOI: 10.1111/jdv.13778] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Accepted: 04/11/2016] [Indexed: 11/28/2022]
Affiliation(s)
- F. Siebenhaar
- Department of Dermatology and Allergy; Allergie-Centrum-Charité; Charité - Universitätsmedizin Berlin; Berlin Germany
| | - A. Melde
- Department of Dermatology and Allergy; Allergie-Centrum-Charité; Charité - Universitätsmedizin Berlin; Berlin Germany
| | - M. Magerl
- Department of Dermatology and Allergy; Allergie-Centrum-Charité; Charité - Universitätsmedizin Berlin; Berlin Germany
| | - T. Zuberbier
- Department of Dermatology and Allergy; Allergie-Centrum-Charité; Charité - Universitätsmedizin Berlin; Berlin Germany
| | - M.K. Church
- Department of Dermatology and Allergy; Allergie-Centrum-Charité; Charité - Universitätsmedizin Berlin; Berlin Germany
| | - M. Maurer
- Department of Dermatology and Allergy; Allergie-Centrum-Charité; Charité - Universitätsmedizin Berlin; Berlin Germany
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Siebenhaar F, von Tschirnhaus E, Hartmann K, Rabenhorst A, Staubach P, Peveling-Oberhag A, Wagner N, Martus P, Carter MC, Metcalfe DD, Church MK, Maurer M, Weller K. Development and validation of the mastocytosis quality of life questionnaire: MC-QoL. Allergy 2016; 71:869-77. [PMID: 26797792 DOI: 10.1111/all.12842] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/14/2016] [Indexed: 01/08/2023]
Abstract
BACKGROUND Mastocytosis is a heterogeneous disease characterized by a clonal expansion of mast cells in various organs. The vast majority of patients affected suffer from signs and symptoms caused by mediator release from mast cells. Although the disease burden is high, there is currently no specific instrument to measure health-related quality of life (HRQoL) impairment in patients with mastocytosis. OBJECTIVE The aim of this study was to develop and validate a disease-specific tool to assess HRQoL impairment in patients with cutaneous and indolent systemic mastocytosis, the Mastocytosis Quality of Life Questionnaire (MC-QoL). METHODS Sixty-two potential MC-QoL items were developed in a combined approach consisting of semi-structured patient interviews, expert input and literature research. Item selection was performed by impact analysis with 76 patients and a final review for face validity. The resulting MC-QoL was tested for validity, reliability and influence factors. In parallel, an US American-English version of the MC-QoL was developed. RESULTS A total of 158 patients (41 CM, 41 MIS and 76 ISM) took part in the MC-QoL validation study. The final 27-item questionnaire was found to have a four-domain structure ('symptoms', 'emotions', 'social life/functioning' and 'skin'), a valid total score and an excellent test-retest reliability. Multiple regression analysis revealed disease duration, but not age, gender or skin involvement to be a significant determinant of HRQoL impairment in mastocytosis. CONCLUSIONS The MC-QoL is the first disease-specific HRQoL questionnaire for adult patients with cutaneous and indolent systemic mastocytosis. This short, validated and reliable instrument will serve as a valuable tool in future clinical studies and in routine patient care.
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Affiliation(s)
- F. Siebenhaar
- Department of Dermatology and Allergy; Interdisciplinary Mastocytosis Center Charité; Charité - Universitätsmedizin Berlin; Berlin Germany
| | - E. von Tschirnhaus
- Department of Dermatology and Allergy; Interdisciplinary Mastocytosis Center Charité; Charité - Universitätsmedizin Berlin; Berlin Germany
| | - K. Hartmann
- Department of Dermatology; University of Lübeck; Lübeck Germany
| | - A. Rabenhorst
- Department of Dermatology; University of Cologne; Cologne Germany
| | - P. Staubach
- Department of Dermatology; University Medical Center Mainz; Mainz Germany
| | | | - N. Wagner
- Department of Dermatology; Clinical Center Darmstadt; Darmstadt Germany
| | - P. Martus
- Department of Medical Biostatistics; Universitätsklinikum Tübingen; Tübingen Germany
| | - M. C. Carter
- Laboratory of Allergic Diseases; National Institute of Allergy and Infectious Diseases; National Institutes of Health; Bethesda MD USA
| | - D. D. Metcalfe
- Laboratory of Allergic Diseases; National Institute of Allergy and Infectious Diseases; National Institutes of Health; Bethesda MD USA
| | - M. K. Church
- Department of Dermatology and Allergy; Interdisciplinary Mastocytosis Center Charité; Charité - Universitätsmedizin Berlin; Berlin Germany
| | - M. Maurer
- Department of Dermatology and Allergy; Interdisciplinary Mastocytosis Center Charité; Charité - Universitätsmedizin Berlin; Berlin Germany
| | - K. Weller
- Department of Dermatology and Allergy; Interdisciplinary Mastocytosis Center Charité; Charité - Universitätsmedizin Berlin; Berlin Germany
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Rietzler M, Maurer M, Siebenhaar F, Angelino S, Handt J, Burghardt R, Smetana H. Innovative approaches to avoid electric shaving-induced skin irritation. Int J Cosmet Sci 2016; 38 Suppl 1:10-6. [DOI: 10.1111/ics.12329] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Accepted: 03/22/2016] [Indexed: 11/28/2022]
Affiliation(s)
- M. Rietzler
- Procter & Gamble Braun German Innovation Center; Frankfurter Strasse 145 61476 Kronberg Germany
| | - M. Maurer
- Department of Dermatology and Allergy, Allergie-Centrum-Charité; Charité - Universitätsmedizin Berlin; Berlin Germany
| | - F. Siebenhaar
- Department of Dermatology and Allergy, Allergie-Centrum-Charité; Charité - Universitätsmedizin Berlin; Berlin Germany
| | - S. Angelino
- Procter & Gamble Braun German Innovation Center; Frankfurter Strasse 145 61476 Kronberg Germany
| | - J. Handt
- Procter & Gamble Braun German Innovation Center; Frankfurter Strasse 145 61476 Kronberg Germany
| | - R. Burghardt
- Procter & Gamble Braun German Innovation Center; Frankfurter Strasse 145 61476 Kronberg Germany
| | - H. Smetana
- Procter & Gamble Braun German Innovation Center; Frankfurter Strasse 145 61476 Kronberg Germany
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Siebenhaar F, Falcone FH, Tiligada E, Hammel I, Maurer M, Sagi-Eisenberg R, Levi-Schaffer F. The search for mast cell and basophil models--are we getting closer to pathophysiological relevance? Allergy 2015; 70:1-5. [PMID: 25155287 DOI: 10.1111/all.12517] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- F. Siebenhaar
- Department of Dermatology and Allergy; Charité - Universitätsmedizin Berlin; Berlin Germany
| | - F. H. Falcone
- Division of Molecular and Cellular Science; School of Pharmacy; University of Nottingham; Nottingham UK
| | - E. Tiligada
- Department of Pharmacology; Medical School University of Athens; Athens Greece
| | - I. Hammel
- Department of Pathology; Sackler Faculty of Medicine; Tel Aviv University; Tel Aviv Israel
| | - M. Maurer
- Department of Dermatology and Allergy; Charité - Universitätsmedizin Berlin; Berlin Germany
| | - R. Sagi-Eisenberg
- Department of Cell and Developmental Biology; Sackler Faculty of Medicine; Tel Aviv University; Tel Aviv Israel
| | - F. Levi-Schaffer
- Department of Pharmacology and Experimental Therapeutics; School of Pharmacy; Institute for Drug Research; Faculty of Medicine; The Hebrew University of Jerusalem; Jerusalem Israel
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Valent P, Escribano L, Broesby-Olsen S, Hartmann K, Grattan C, Brockow K, Niedoszytko M, Nedoszytko B, Oude Elberink JNG, Kristensen T, Butterfield JH, Triggiani M, Alvarez-Twose I, Reiter A, Sperr WR, Sotlar K, Yavuz S, Kluin-Nelemans HC, Hermine O, Radia D, van Doormaal JJ, Gotlib J, Orfao A, Siebenhaar F, Schwartz LB, Castells M, Maurer M, Horny HP, Akin C, Metcalfe DD, Arock M. Proposed diagnostic algorithm for patients with suspected mastocytosis: a proposal of the European Competence Network on Mastocytosis. Allergy 2014; 69:1267-74. [PMID: 24836395 DOI: 10.1111/all.12436] [Citation(s) in RCA: 126] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/24/2014] [Indexed: 01/08/2023]
Abstract
Mastocytosis is an emerging differential diagnosis in patients with more or less specific mediator-related symptoms. In some of these patients, typical skin lesions are found and the diagnosis of mastocytosis can be established. In other cases, however, skin lesions are absent, which represents a diagnostic challenge. In the light of this unmet need, we developed a diagnostic algorithm for patients with suspected mastocytosis. In adult patients with typical lesions of mastocytosis in the skin, a bone marrow (BM) biopsy should be considered, regardless of the basal serum tryptase concentration. In adults without skin lesions who suffer from mediator-related or other typical symptoms, the basal tryptase level is an important parameter. In those with a slightly increased tryptase level, additional investigations, including a sensitive KIT mutation analysis of blood leucocytes or measurement of urinary histamine metabolites, may be helpful. In adult patients in whom (i) KIT D816V is detected and/or (ii) the basal serum tryptase level is clearly increased (>25-30 ng/ml) and/or (iii) other clinical or laboratory features suggest the presence of 'occult' mastocytosis or another haematologic neoplasm, a BM investigation is recommended. In the absence of KIT D816V and other signs or symptoms of mastocytosis or another haematopoietic disease, no BM investigation is required, but the clinical course and tryptase levels are monitored in the follow-up. In paediatric patients, a BM investigation is usually not required, even if the tryptase level is increased. Although validation is required, it can be expected that the algorithm proposed herein will facilitate the management of patients with suspected mastocytosis and help avoid unnecessary referrals and investigations.
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Affiliation(s)
- P. Valent
- Division of Haematology; Department of Internal Medicine I; Medical University of Vienna; Vienna Austria
| | - L. Escribano
- Servicio Central de Citometria; Centro de Investigacion del Cancer (IBMCC; CSIC/USAL); IBSAL and Department of Medicine; University of Salamanca; Salamanca Spain
| | - S. Broesby-Olsen
- Department of Dermatology and Allergy Centre; Odense University Hospital; Odense Denmark
| | - K. Hartmann
- Department of Dermatology; University of Cologne; Cologne Germany
| | - C. Grattan
- Norfolk and Norwich University Hospital; Norwich UK
| | - K. Brockow
- Department of Dermatology and Allergy Biederstein; Technical University of Munich; Munich Germany
| | - M. Niedoszytko
- Department of Allergology; Medical University of Gdansk; Gdansk Poland
| | - B. Nedoszytko
- Department of Dermatology; Medical University of Gdansk; Gdansk Poland
| | - J. N. G. Oude Elberink
- Department of Allergology; University Medical Center of Groningen; University of Groningen; Groningen the Netherlands
| | - T. Kristensen
- Department of Pathology; Odense University Hospital; Odense Denmark
| | | | - M. Triggiani
- Division of Allergy and Clinical Immunology; University of Salerno; Salerno Italy
| | - I. Alvarez-Twose
- Instituto de Estudios de Mastocitosis de Castilla La Mancha (CLMast); Hospital Virgen del Valle; Toledo Spain
| | - A. Reiter
- III. Medizinische Klinik; Universitäts-Medizin Mannheim; Universität Heidelberg; Mannheim Germany
| | - W. R. Sperr
- Division of Haematology; Department of Internal Medicine I; Medical University of Vienna; Vienna Austria
| | - K. Sotlar
- Institute of Pathology; Ludwig-Maximilians-University; Munich Germany
| | - S. Yavuz
- Division of Haematology; Department of Internal Medicine; University of Istanbul; Istanbul Turkey
| | - H. C. Kluin-Nelemans
- Department of Haematology; University Medical Center Groningen; University of Groningen; Groningen the Netherlands
| | - O. Hermine
- Imagine Institute Université Paris Descartes, Sorbonne, Paris Cité; Centre national de référence des mastocytoses; Paris France
| | - D. Radia
- Department of Haematology; Guys and St Thomas' NHS Foundation Trust; Guys Hospital; London UK
| | - J. J. van Doormaal
- Department of Allergology; University Medical Center of Groningen; University of Groningen; Groningen the Netherlands
| | - J. Gotlib
- Stanford Cancer Institute; Stanford University School of Medicine; Stanford CA USA
| | - A. Orfao
- Servicio Central de Citometria; Centro de Investigacion del Cancer (IBMCC; CSIC/USAL); IBSAL and Department of Medicine; University of Salamanca; Salamanca Spain
| | - F. Siebenhaar
- Department of Dermatology & Allergy; Charité Universitätsmedizin Berlin; Berlin Germany
| | - L. B. Schwartz
- Division of Rheumatology, Allergy & Immunology; Department of Internal Medicine; Virginia Common-wealth University; Richmond VA USA
| | - M. Castells
- Division of Allergy and Immunology; Department of Medicine; Brigham and Women's Hospital; Harvard Medical School; Boston MA USA
| | - M. Maurer
- Department of Dermatology & Allergy; Charité Universitätsmedizin Berlin; Berlin Germany
| | - H.-P. Horny
- Institute of Pathology; Ludwig-Maximilians-University; Munich Germany
| | - C. Akin
- Division of Allergy and Immunology; Department of Medicine; Brigham and Women's Hospital; Harvard Medical School; Boston MA USA
| | - D. D. Metcalfe
- Laboratory of Allergic Diseases; NIAID; NIH; Bethesda MD USA
| | - M. Arock
- LBPA CNRS UMR8113; Ecole Normale Supérieure de Cachan; Cachan France
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16
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Magerl M, Abajian M, Krause K, Altrichter S, Siebenhaar F, Church MK. An improved Peltier effect-based instrument for critical temperature threshold measurement in cold- and heat-induced urticaria. J Eur Acad Dermatol Venereol 2014; 29:2043-5. [PMID: 25266078 DOI: 10.1111/jdv.12739] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Accepted: 08/05/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND Cold- and heat-induced urticaria are chronic physical urticaria conditions in which wheals, angioedema or both are evoked by skin exposure to cold and heat respectively. The diagnostic work up of both conditions should include skin provocation tests and accurate determination of critical temperature thresholds (CTT) for producing symptoms in order to be able to predict the potential risk that each individual patient faces and how this may be ameliorated by therapy. OBJECTIVE To develop and validate TempTest(®) 4, a simple and relatively inexpensive instrument for the accurate determination of CTT which may be used in clinical practice. METHODS TempTest(®) 4 has a single 2 mm wide 350 mm U-shaped Peltier element generating a temperature gradient from 4 °C to 44 °C along its length. Using a clear plastic guide placed over the skin after provocation, CTT values may be determined with an accuracy of ±1 °C. Here, TempTest(®) 4 was compared with its much more expensive predecessor, TempTest(®) 3, in inducing wheals in 30 cold urticaria patients. RESULTS Both TempTest(®) 4 and TempTest(®) 3 induced wheals in all 30 patients between 8 ° and 28 °C. There was a highly significant (P < 0.0001) correlation between the instruments in the CTT values in individual patients. CONCLUSION The TempTest(®) 4 is a simple, easy to use, licensed, commercially available and affordable instrument for the determination of CTTs in both cold- and heat-induced urticaria.
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Affiliation(s)
- M Magerl
- Department of Dermatology and Allergy, Allergie-Centrum-Charité, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - M Abajian
- Department of Dermatology and Allergy, Allergie-Centrum-Charité, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - K Krause
- Department of Dermatology and Allergy, Allergie-Centrum-Charité, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - S Altrichter
- Department of Dermatology and Allergy, Allergie-Centrum-Charité, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - F Siebenhaar
- Department of Dermatology and Allergy, Allergie-Centrum-Charité, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - M K Church
- Department of Dermatology and Allergy, Allergie-Centrum-Charité, Charité - Universitätsmedizin Berlin, Berlin, Germany
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Siebenhaar F, Förtsch A, Krause K, Weller K, Metz M, Magerl M, Martus P, Church MK, Maurer M. Rupatadine improves quality of life in mastocytosis: a randomized, double-blind, placebo-controlled trial. Allergy 2013; 68:949-52. [PMID: 23734572 DOI: 10.1111/all.12159] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2013] [Indexed: 11/27/2022]
Abstract
BACKGROUND Mastocytosis is frequently associated with mast cell-mediated symptoms which require relieving medication. While second generation antihistamines (sgAHs) are the first line therapeutic strategy to treat mast cell mediator-related symptoms, controlled clinical trials on how they improve quality of life have not been performed. METHODS This randomized, double-blind, placebo-controlled, cross-over trial assessed rupatadine 20 mg daily in the treatment of mastocytosis symptoms in 30 adult patients. Symptoms were assessed by a visual analogue scale (VAS) and symptom specific quality of life questionnaire (ItchyQoL). RESULTS The mean ItchyQoL total score and VAS symptom score were significantly improved in the rupatadine treatment phase compared with placebo. There were also significant reductions from placebo in the severity of itch, wheal and flare, flushing, tachycardia and headache but not gastrointestinal symptoms. CONCLUSIONS In this first comprehensive trial of a sgAH in mastocytosis, rupatadine 20 mg daily for 4 weeks significantly controlled symptoms and improved patients' quality of life.
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Affiliation(s)
- F. Siebenhaar
- Department of Dermatology and Allergy; Interdisciplinary Mastocytosis Center Charité; Charité - Universitätsmedizin Berlin; Berlin; Germany
| | - A. Förtsch
- Department of Dermatology and Allergy; Interdisciplinary Mastocytosis Center Charité; Charité - Universitätsmedizin Berlin; Berlin; Germany
| | - K. Krause
- Department of Dermatology and Allergy; Interdisciplinary Mastocytosis Center Charité; Charité - Universitätsmedizin Berlin; Berlin; Germany
| | - K. Weller
- Department of Dermatology and Allergy; Interdisciplinary Mastocytosis Center Charité; Charité - Universitätsmedizin Berlin; Berlin; Germany
| | - M. Metz
- Department of Dermatology and Allergy; Interdisciplinary Mastocytosis Center Charité; Charité - Universitätsmedizin Berlin; Berlin; Germany
| | - M. Magerl
- Department of Dermatology and Allergy; Interdisciplinary Mastocytosis Center Charité; Charité - Universitätsmedizin Berlin; Berlin; Germany
| | - P. Martus
- Department of Medical Biostatistics; Universitätsklinikum Tübingen; Tübingen; Germany
| | - M. K. Church
- Department of Dermatology and Allergy; Interdisciplinary Mastocytosis Center Charité; Charité - Universitätsmedizin Berlin; Berlin; Germany
| | - M. Maurer
- Department of Dermatology and Allergy; Interdisciplinary Mastocytosis Center Charité; Charité - Universitätsmedizin Berlin; Berlin; Germany
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Maurer M, Magerl M, Metz M, Siebenhaar F, Weller K, Krause K. Practical algorithm for diagnosing patients with recurrent wheals or angioedema. Allergy 2013; 68:816-9. [PMID: 23646863 DOI: 10.1111/all.12153] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/19/2013] [Indexed: 11/28/2022]
Abstract
BACKGROUND Chronic urticaria is a common disorder characterized by recurrent wheals, angioedema, or both. Several differential diagnoses need to be considered in patients presenting with wheals and/or angioedema. These include rare diseases such as autoinflammatory syndromes and urticarial vasculitis in patients with recurrent wheals and bradykinin-mediated angioedema in patients with recurrent swellings. AIM AND RESULT: In order to not miss these conditions, we have developed a symptom-based diagnostic algorithm for the management of patients with wheals and/or angioedema. DISCUSSION AND CONCLUSION By asking the right questions and performing a limited diagnostic workup as suggested here, this algorithm may help to establish the right diagnosis and treat patients early and more effectively.
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Affiliation(s)
- M. Maurer
- Department of Dermatology and Allergy; Allergie-Centrum-Charité; Charité - Universitätsmedizin Berlin; Berlin; Germany
| | - M. Magerl
- Department of Dermatology and Allergy; Allergie-Centrum-Charité; Charité - Universitätsmedizin Berlin; Berlin; Germany
| | - M. Metz
- Department of Dermatology and Allergy; Allergie-Centrum-Charité; Charité - Universitätsmedizin Berlin; Berlin; Germany
| | - F. Siebenhaar
- Department of Dermatology and Allergy; Allergie-Centrum-Charité; Charité - Universitätsmedizin Berlin; Berlin; Germany
| | - K. Weller
- Department of Dermatology and Allergy; Allergie-Centrum-Charité; Charité - Universitätsmedizin Berlin; Berlin; Germany
| | - K. Krause
- Department of Dermatology and Allergy; Allergie-Centrum-Charité; Charité - Universitätsmedizin Berlin; Berlin; Germany
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19
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Magerl M, Rother M, Bieber T, Biedermann T, Brasch J, Dominicus R, Hunzelmann N, Jakob T, Mahler V, Popp G, Schäkel K, Schlingensiepen R, Schmitt J, Siebenhaar F, Simon JC, Staubach P, Wedi B, Weidner C, Maurer M. Randomized, double-blind, placebo-controlled study of safety and efficacy of miltefosine in antihistamine-resistant chronic spontaneous urticaria. J Eur Acad Dermatol Venereol 2012; 27:e363-9. [PMID: 22928719 DOI: 10.1111/j.1468-3083.2012.04689.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Chronic spontaneous urticaria (CSU), a mast cell-driven condition, is debilitating, common, and hard to treat. Miltefosine, a lipid raft modulator, can inhibit mast cell responses in vivo. OBJECTIVE To study the safety and efficacy of systemic miltefosine treatment in CSU patients resistant to standard-dosed antihistamines. METHODS In this investigator-initiated multicentre, randomized, double-blind, placebo-controlled study, CSU patients were treated for 4 weeks with daily doses of up to 150-mg miltefosine (n = 47) or placebo (n = 26). Disease activity was assessed using the urticaria activity score. Safety and tolerability of miltefosine were also assessed. RESULTS After 4 weeks of treatment, Urticaria Activity Score (UAS7) levels were substantially more reduced in miltefosine-treated patients (-6.3 vs. -3.5 in placebo-treated patients; P = 0.05). Also, the number of weals, but not the intensity of pruritus, was significantly reduced in miltefosine-treated patients vs. placebo-treated patients (P = 0.02). In general, adverse events were frequent in both groups (miltefosine: 88%, placebo: 65% of patients) but mostly mild to moderate in severity. We did not observe any serious adverse events. CONCLUSIONS The results of this study indicate that miltefosine is an effective and safe treatment option for CSU patients who do not respond to standard-dosed antihistamines.
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Affiliation(s)
- M Magerl
- Department of Dermatology and Allergy; Allergie-Centrum-Charité; Charité- Universitätsmedizin Berlin, Berlin, Germany Department Clinical Operations, X-pert Med GmbH, Gräfelfing, Germany Department of Dermatology and Allergy, University of Bonn, Bonn, Germany Department of Dermatology, Eberhard Karls University Tübingen, Tübingen, Germany Department of Dermatology and Allergy, UK-SH, Campus Kiel, Kiel, Germany Praxisklinik und Gemeinschaftspraxis, Dülmen, Germany Department of Dermatology and Allergy, Universitätsklinikum Köln, Cologne, Germany Department of Dermatology and Allergy, Universitäts-Hautklinik Freiburg, Freiburg, Germany Department of Dermatology, University Hospital Erlangen, Erlangen, Germany Licca Clinical Research Institute, Augsburg, Germany Department of Dermatology, Universitätsklinikum Heidelberg, Heidelberg, Germany Jado Technologies GmbH, Dresden, Germany Department of Occupational and Social Medicine, Medizinische Fakultät Carl Gustav Carus, TU Dresden, Germany Department of Dermatology, Venerology and Allergy, Universitätklinikum Leipzig, Leipzig, Germany Department of Dermatology and Allergy, Universitätsmedizin Mainz, Mainz, Germany Department of Dermatology and Allergy, Medizinische Hochschule Hannover, Hannover, Germany X-pert Med GmbH, Jena, Germany
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Abstract
Mastocytoses are a group of rare diseases characterized, in most cases, by a benign proliferation and accumulation of mast cells in different tissues. In children, mastocytosis affects usually exclusively the skin and differs in many aspects from adult-onset mastocytosis. Except for diffuse cutaneous mastocytosis, which is an uncommon subtype of childhood-onset mastocytosis, involvement of the bone marrow or additional extracutaneous organs is rarely seen in children. The prognosis of childhood-onset mastocytosis is usually very good. Compared to adult patients who most commonly experience chronic-stable or slowly progressive disease, mastocytosis in children is mostly transient and self-limiting. In this review, we present and discuss the subtypes of childhood-onset mastocytosis, recent advances in the understanding of their pathogenesis as well as similarities and differences between adult- and childhood-onset mastocytosis.
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Affiliation(s)
- F Siebenhaar
- Interdisciplinary Mastocytosis Center Charité, Klinik für Dermatologie, Venerologie und Allergologie, Charité – Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin.
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21
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Krause K, Weller K, Stefaniak R, Wittkowski H, Altrichter S, Siebenhaar F, Zuberbier T, Maurer M. Efficacy and safety of the interleukin-1 antagonist rilonacept in Schnitzler syndrome: an open-label study. Allergy 2012; 67:943-50. [PMID: 22583335 DOI: 10.1111/j.1398-9995.2012.02843.x] [Citation(s) in RCA: 83] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/05/2012] [Indexed: 11/30/2022]
Abstract
BACKGROUND Schnitzler syndrome (SchS) is a rare disease with suspected autoinflammatory background that shares several clinical symptoms, including urticarial rash, fever episodes, arthralgia, and bone and muscle pain with cryopyrin-associated periodic syndromes (CAPS). Cryopyrin-associated periodic syndromes respond to treatment with interleukin-1 antagonists, and single case reports of Schnitzler syndrome have shown improvement following treatment with the interleukin-1 blocker anakinra. This study evaluated the effects of the interleukin-1 antagonist rilonacept on the clinical signs and symptoms of SchS. METHODS Eight patients with SchS were included in this prospective, single-center, open-label study. After a 3-week baseline, patients received a subcutaneous loading dose of rilonacept 320 mg followed by weekly subcutaneous doses of 160 mg for up to 1 year. Efficacy was determined by patient-based daily health assessment forms, physician's global assessment (PGA), and measurement of inflammatory markers including C-reactive protein (CRP), serum amyloid A (SAA), and S100 calcium-binding protein A12 (S100A12). RESULTS Treatment with rilonacept resulted in a rapid clinical response as demonstrated by significant reductions in daily health assessment scores and PGA scores compared with baseline levels (P < 0.05). These effects, which were accompanied by reductions in CRP and SAA, continued over the treatment duration. Rilonacept treatment was well tolerated. There were no treatment-related severe adverse events and no clinically significant changes in laboratory safety parameters. CONCLUSION Rilonacept was effective and well tolerated in patients with SchS and may represent a promising potential therapeutic option.
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Affiliation(s)
- K. Krause
- Department of Dermatology and Allergy, Allergie-Centrum-Charité; Charité - Universitätsmedizin Berlin; Berlin; Germany
| | - K. Weller
- Department of Dermatology and Allergy, Allergie-Centrum-Charité; Charité - Universitätsmedizin Berlin; Berlin; Germany
| | - R. Stefaniak
- Department of Dermatology and Allergy, Allergie-Centrum-Charité; Charité - Universitätsmedizin Berlin; Berlin; Germany
| | - H. Wittkowski
- Department of Pediatrics; Universitätsklinikum Münster; Münster; Germany
| | - S. Altrichter
- Department of Dermatology and Allergy, Allergie-Centrum-Charité; Charité - Universitätsmedizin Berlin; Berlin; Germany
| | - F. Siebenhaar
- Department of Dermatology and Allergy, Allergie-Centrum-Charité; Charité - Universitätsmedizin Berlin; Berlin; Germany
| | - T. Zuberbier
- Department of Dermatology and Allergy, Allergie-Centrum-Charité; Charité - Universitätsmedizin Berlin; Berlin; Germany
| | - M. Maurer
- Department of Dermatology and Allergy, Allergie-Centrum-Charité; Charité - Universitätsmedizin Berlin; Berlin; Germany
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22
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Weller K, Viehmann K, Bräutigam M, Krause K, Siebenhaar F, Zuberbier T, Maurer M. Management of chronic spontaneous urticaria in real life--in accordance with the guidelines? A cross-sectional physician-based survey study. J Eur Acad Dermatol Venereol 2011; 27:43-50. [PMID: 22150693 DOI: 10.1111/j.1468-3083.2011.04370.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Recently, the updated EAACI/GA(2) LEN/EDF/WAO guidelines for urticaria have been published. OBJECTIVE To examine how chronic spontaneous urticaria (csU) patients in Germany are diagnosed and treated, and to compare the outcome to the guideline recommendations. METHODS During this cross-sectional survey study, most dermatologists, paediatricians and 5149 general practitioners in private practice in Germany were asked to participate. All physicians who agreed were requested to complete a standardized questionnaire about their diagnostic and therapeutic management of csU. RESULTS A total of 776 questionnaires were available for analysis. Most physicians (82%) were attempting to identify underlying causes in their csU patients, but with only limited success. More than 70% reported to check for total serum IgE and to do skin prick testing (not suggested in first line by guideline). In contrast, only 10% applied the autologous serum skin test. The most common first-line treatments were non-sedating antihistamines in standard or higher doses (as recommended). However, many physicians reported still using first generation sedating antihistamines (23%) (not recommended) or systemic steroids (18%). Experience with alternative options was low. Less than one-third of the participants reported to be familiar with the guidelines. Those who did, were found to be more likely to check for underlying causes, to be more experienced with antihistamine updosing and to be more reluctant to use sedating antihistamines or systemic steroids. CONCLUSION The diagnostic and therapeutic management of csU by private practice physicians does not sufficiently comply with the guidelines. Awareness of the guidelines can lead to improved care.
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Affiliation(s)
- K Weller
- Department of Dermatology and Allergy, Allergy-Centrum-Charité, Charité-Universitätsmedizin, Berlin, Germany
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Maurer M, Altrichter S, Ardelean E, Krause K, Magerl M, Metz M, Siebenhaar F, Weller K, Zuberbier T. [Therapeutic alternatives for antihistamine-refractory urticaria]. Hautarzt 2011; 61:765-9. [PMID: 20711555 DOI: 10.1007/s00105-010-1934-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Patients with chronic spontaneous urticaria, the most frequent non-acute form of urticaria, generally exhibit a clinical picture of persistent disease, a high degree of disease activity, considerable impairment of quality of life, and poor response to treatment. More than half of the patients continue to develop symptoms despite standard therapy with non-sedating antihistamines. In these cases, the antihistamine dose should be increased (up to four times the daily dose). If this approach also does not result in symptom control, the high-dose antihistamine should be combined with a leukotriene antagonist and if necessary an H2 blocker. If the patient does not respond to this combination therapy, cyclosporin A, dapsone, or omalizumab should be administered.
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Affiliation(s)
- M Maurer
- Klinik für Dermatologie, Venerologie und Allergologie, Allergie-Centrum-Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin.
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24
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Weller K, Altrichter S, Ardelean E, Krause K, Magerl M, Metz M, Siebenhaar F, Maurer M. [Chronic urticaria. Prevalence, course, prognostic factors and impact]. Hautarzt 2011; 61:750-7. [PMID: 20694454 DOI: 10.1007/s00105-010-1933-8] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Chronic urticaria (CU) is one of the most frequent diseases in the field of dermatology. Recent studies have shown a point prevalence between 0.5 and 1% in the total population with a predominance of females. In general, all age groups and all classes of the population can be affected. An incidence peak has been found in the third and fourth decades. According to the current guidelines, CU is characterized by the spontaneous occurrence of wheals and/or angioedema for more than 6 weeks. However, epidemiological studies have revealed that the majority of patients suffer for several months, or frequently years. Disease duration is likely to be longer in case of angioedema, a combination with physical urticaria, positivity in the autologous serum skin test (autoreactivity) and a high disease severity. Studies on the impairment of quality of life have been shown that many CU patients suffer as strong from their disease as patients with coronary artery disease. Apart from pure physical symptoms, patients experience restrictions in daily life activities and social life. In addition, sleep disturbances are common and CU patients frequently exhibit psychiatric comorbidities. To avoid frustration in care, it is important to perceive all different dimensions of CU that impact the patient's life and to take the patients and their disease seriously. The aim of therapy should be to obtain total symptom control.
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Affiliation(s)
- K Weller
- Klinik für Dermatologie, Venerologie und Allergologie, Allergie-Centrum-Charité, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin.
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Krause K, Ardelean E, Kessler B, Magerl M, Metz M, Siebenhaar F, Weller K, Worm M, Zuberbier T, Maurer M. Antihistamine-resistant urticaria factitia successfully treated with anti-immunoglobulin E therapy. Allergy 2010; 65:1494-5. [PMID: 20560911 DOI: 10.1111/j.1398-9995.2010.02409.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- K Krause
- Department of Dermatology and Allergy, Allergie-Centrum-Charité, Charité – Universitätsmedizin Berlin, Charitéplatz 1, D-10117 Berlin, Germany
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Krause K, Degener F, Altrichter S, Ardelean E, Kalogeromitros D, Magerl M, Metz M, Siebenhaar F, Weller K, Maurer M. Kälteinduzierte Quaddeln und Angioödeme. Hautarzt 2010; 61:743-9. [DOI: 10.1007/s00105-010-1932-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Młynek A, Magerl M, Siebenhaar F, Weller K, Vieira dos Santos R, Zuberbier T, Zalewska-Janowska A, Maurer M. Results and relevance of critical temperature threshold testing in patients with acquired cold urticaria. Br J Dermatol 2009; 162:198-200. [DOI: 10.1111/j.1365-2133.2009.09441.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Hartmann K, Siebenhaar F, Belloni B, Brockow K, Eben R, Hartmann B, Ruëff F, Schoepke N, Staubach P, Weber A, Maurer M. Effects of topical treatment with the raft modulator miltefosine and clobetasol in cutaneous mastocytosis: a randomized, double-blind, placebo-controlled trial. Br J Dermatol 2009; 162:185-90. [DOI: 10.1111/j.1365-2133.2009.09434.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Magerl M, Schmolke J, Metz M, Zuberbier T, Siebenhaar F, Maurer M. Prevention of signs and symptoms of dermographic urticaria by single-dose ebastine 20 mg. Clin Exp Dermatol 2009; 34:e137-40. [DOI: 10.1111/j.1365-2230.2008.03097.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Abstract
BACKGROUND Acquired cold urticaria (ACU) is a skin condition, in which exposure to cold results in wheals and itching and sometimes general systemic complications. It has a profound impact on patient quality of life. Second-generation antihistamines are recommended as the first-line treatment, but to date only a few have been scientifically tested for this condition. AIM To assess the safety and efficacy of ebastine in preventing ACU symptoms. METHODS Twenty-two adult ACU patients participated in a double-blind crossover trial of 20 mg ebastine. The safety of ebastine was sensitively assessed with a psychometric battery testing cognitive performance and mood. After cold challenge, wheal and erythema were assessed by the investigator and the intensities of pruritus and burning were rated by the subject. RESULTS Ebastine had no negative impact on any of the parameters of cognitive performance or mood. It dramatically reduced the number of patients who experienced wheals, pruritus, and burning after challenge. CONCLUSION Ebastine is safe and effective in preventing the symptoms of ACU.
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Affiliation(s)
- M Magerl
- Allergie-Centrum-Charité, Department of Dermatology and Allergy, Charité- Universitätsmedizin Berlin, Berlin, Germany
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Siebenhaar F, Weller K, Mlynek A, Magerl M, Altrichter S, Vieira Dos Santos R, Maurer M, Zuberbier T. Acquired cold urticaria: clinical picture and update on diagnosis and treatment. Clin Exp Dermatol 2007; 32:241-5. [PMID: 17355280 DOI: 10.1111/j.1365-2230.2007.02376.x] [Citation(s) in RCA: 79] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Acquired cold urticaria (ACU) is a frequent subtype of physical urticaria that is caused by the release of proinflammatory mast cell mediators after cold exposure. Although the underlying causes of ACU still remain to be clarified in detail, a wide range of diseases has been reported to be associated with ACU. This review gives an overview of the clinical picture, the differential diagnoses, diagnostic tests and the aetiology of ACU, and summarizes current and novel therapeutic options based on the current literature.
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Affiliation(s)
- F Siebenhaar
- Department of Dermatology and Allergy, Charité-Universitätsmedizin Berlin, Berlin, Germany
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Bayer P, Blümchen K, Michael T, Cremer R, Fricke C, Henne T, Peters H, Hofmann U, Niggemann B, Lafargue B, Schweikardt T, Decker H, Lippert U, Zachmann K, Ferrari D, Neumann C, Soruri A, Gerstenberg M, Dahten A, Koch C, Fokuhl V, Luger E, Worm M, Windhorst V, Eben R, Przybilla B, Bußmann C, Hagemann T, Hanfland J, Haidl G, Bieber T, Novak N, Mlynek A, Weller K, Magerl M, Siebenhaar F, Altrichter S, Vieira dos Santos R, Boodstein N, Zalewska-Janowska A, Maurer M, Berking C, Siebenhaar G, Krieger A, Krieg T, Hartmann K, Hunzelmann N, Eberlein B, Gulyas A, Schultz K, Lecheler J, Gass S, Kroiss M, Huss-Marp J, Behrendt H, Ring J. Poster. Allergo J 2007. [DOI: 10.1007/bf03370562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Staubach P, Onnen K, Vonend A, Metz M, Siebenhaar F, Tschentscher I, Opper B, Magerl M, Lüdtke R, Kromminga A, Maurer M. Autologous whole blood injections to patients with chronic urticaria and a positive autologous serum skin test: a placebo-controlled trial. Dermatology 2006; 212:150-9. [PMID: 16484822 DOI: 10.1159/000090656] [Citation(s) in RCA: 96] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2005] [Accepted: 08/14/2005] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Patients with chronic urticaria (CU) frequently exhibit positive skin test reactions to autologous serum (ASST). Therapies aimed at inducing tolerance to circulating histamine-releasing factors in ASST+ CU patients, e.g. by treatment with autologous whole blood (AWB), have not yet been tested. OBJECTIVE To test whether ASST+ CU patients can benefit from repeated low-dose intramuscular injections of AWB. METHODS We characterized CU severity and duration, anti-Fc(epsilon)RI and anti-IgE expression, use of antihistamines, and quality of life in 56 CU patients (ASST+: 35, ASST-: 21) and assessed the therapeutic effects of 8 weekly AWB injections in a randomized, placebo-controlled, single-blind, parallel-group trial. RESULTS Numbers, size, intensity, and/or duration of CU symptoms, quality of life, as well as expression of anti-Fc(epsilon)RI or anti-IgE were similar in ASST+ and ASST- CU patients. However, CU in ASST+ patients was of longer duration and required markedly more antihistaminic medication. Interestingly, ASST+ patients, but not ASST- patients, showed significantly (1) reduced CU activity, (2) decreased use of antihistamines, and (3) improved quality of life after AWB treatment. Placebo treatment was ineffective in both groups, but differences of AWB and placebo treatment responses did not achieve statistical significance in either group, most likely due to the limited number of patients treated. CONCLUSION Our findings suggest that ASST+ CU is clinically different from other CU subforms and that ASST+ CU patients can benefit from AWB therapy.
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Affiliation(s)
- P Staubach
- Department of Dermatology, University of Mainz, Mainz, Germany
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Biró T, Ko MC, Bromm B, Wei ET, Bigliardi P, Siebenhaar F, Hashizume H, Misery L, Bergasa NV, Kamei C, Schouenborg J, Roostermann D, Szabó T, Maurer M, Bigliardi-Qi M, Meingassner JG, Hossen MA, Schmelz M, Steinhoff M. How best to fight that nasty itch - from new insights into the neuroimmunological, neuroendocrine, and neurophysiological bases of pruritus to novel therapeutic approaches. Exp Dermatol 2005; 14:225-40. [PMID: 15740597 DOI: 10.1111/j.0906-6705.2005.0321a.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
While the enormous clinical and psychosocial importance of pruritus in many areas of medicine and the detrimental effects of chronic 'itch' on the quality of life of an affected individual are widely appreciated, the complexity of this sensation is still often grossly underestimated. The current Controversies feature highlights this complexity by portraying pruritus as a truly interdisciplinary problem at the crossroads of neurophysiology, neuroimmunology, neuropharmacology, protease research, internal medicine, and dermatology, which is combated most successfully if one keeps the multilayered nature of 'itch' in mind and adopts a holistic treatment approach - beyond the customary, frequently frustrane monotherapy with histamine receptor antagonists. In view of the often unsatisfactory, unidimensional, and altogether rather crude standard instruments for pruritus management that we still tend to use in clinical practice today, an interdisciplinary team of pruritus experts here critically examines recent progress in pruritus research that future itch management must take into consideration. Focusing on new insights into the neuroimmunological, neuroendocrine, and neurophysiological bases of pruritus, and discussing available neuropharmacological tools, specific research avenues are highlighted, whose pursuit promises to lead to novel, and hopefully more effective, forms of pruritus management.
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Affiliation(s)
- T Biró
- Department of Physiology, University of Debrecen, Medical and Health Sciences Center, H-4012 Debrecen, PO Box 22, Hungary.
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Abstract
Symptoms in patients with autoreactive urticaria (ArU), a sub-form of chronic urticaria (CU), are caused by circulating histamine-releasing signals. ArU patients are readily identified by the autologous serum skin test, in which they exhibit inflammatory reactions to their serum after intracutaneous injection. CU patients who also exhibit functional autoantibodies against IgE and/or its high affinity receptor Fc(epsilon)RI are thought to suffer from autoimmune urticaria (Aiu). ArU and AiU are pathogenetically and clinically different from other sub-forms of CU.
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Affiliation(s)
- M Maurer
- Zentrum für Immundermatologie, Universitäts-Hautklink Mainz, Langenbeckstrasse 1, 55131 Mainz.
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Botchkarev VA, Komarova EA, Siebenhaar F, Botchkareva NV, Sharov AA, Komarov PG, Maurer M, Gudkov AV, Gilchrest BA. p53 Involvement in the control of murine hair follicle regression. Am J Pathol 2001; 158:1913-9. [PMID: 11395365 PMCID: PMC1891974 DOI: 10.1016/s0002-9440(10)64659-7] [Citation(s) in RCA: 64] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
p53 is a transcription factor mediating a variety of biological responses including apoptotic cell death. p53 was recently shown to control apoptosis in the hair follicle induced by ionizing radiation and chemotherapy, but its role in the apoptosis-driven physiological hair follicle regression (catagen) remains to be elucidated. Here, we show that p53 protein is strongly expressed and co-localized with apoptotic markers in the regressing hair follicle compartments during catagen. In contrast to wild-type mice, p53 knockout mice show significant retardation of catagen accompanied by significant decrease in the number of apoptotic cells in the hair matrix. Furthermore, p53 null hair follicles are characterized by alterations in the expression of markers that are encoded by p53 target genes and are implicated in the control of catagen (Bax, Bcl-2, insulin-like growth factor binding protein-3). These data suggest that p53 is involved in the control of apoptosis in the hair follicle during physiological regression and imply that p53 antagonists may be useful for the management of hair growth disorders characterized by premature entry into catagen, such as androgenetic alopecia, alopecia areata, and telogen effluvium.
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Affiliation(s)
- V A Botchkarev
- Department of Dermatology, Boston University School of Medicine, Boston, Massachusetts 02118, USA.
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Botchkarev VA, Komarova EA, Siebenhaar F, Botchkareva NV, Komarov PG, Maurer M, Gilchrest BA, Gudkov AV. p53 is essential for chemotherapy-induced hair loss. Cancer Res 2000; 60:5002-6. [PMID: 11016618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
Anticancer drugs stimulate apoptosis in the hair follicles (HF) and cause hair loss, the most common side effect of chemotherapy. In a mouse model for chemotherapy-induced hair loss, we demonstrate that p53 is essential for this process: in contrast to wild-type mice, p53-deficient mice show neither hair loss nor apoptosis in the HF keratinocytes that maintained active proliferation after cyclophosphamide treatment. HF in p53 mutants are characterized by down-regulation of Fas and insulin-like growth factor-binding protein 3 and by increased expression of Bcl-2. These observations indicate that local pharmacological inhibition of p53 may be useful to prevent chemotherapy-associated hair loss.
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Affiliation(s)
- V A Botchkarev
- Department of Dermatology, Boston University School of Medicine, Massachusetts 02118, USA.
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