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The Immunological Association between Alopecia Areata and Respiratory Diseases: A Systematic Review.Skin Appendage Disorders Jun 2019While alopecia areata (AA) has been associated with atopy, the immunological relationship is unclear, with the association of specific atopic and systemic respiratory...
BACKGROUND
While alopecia areata (AA) has been associated with atopy, the immunological relationship is unclear, with the association of specific atopic and systemic respiratory diseases not established. The relationship between T-helper (Th)1-mediated AA and Th2-mediated atopy challenges the conventional Th1/Th2 paradigm of autoimmune disease categorization.
OBJECTIVES
To determine the association between AA and atopic respiratory diseases in adults and children, and respiratory diseases in general.
METHOD
All primary literature, excluding case reports, were identified within PubMed/MEDLINE, CINAHL, and Web of Science in May 2018 using the following search terms: "(alopecia OR hair loss) AND (respiratory OR pulmonary OR lungs OR asthma OR rhinitis OR bronchitis OR COPD OR atopy OR atopic)." Information from 32 articles meeting the inclusion and exclusion criteria was reviewed.
RESULTS
Among the 32 articles identified for inclusion, the prevalence of AA was more strongly associated with allergic rhinitis compared to asthma among pediatric and adult populations. While a significant association was identified between AA, allergic rhinitis, and a late age of onset, the association of AA and asthma remains controversial despite asthma's prevalence among AA patients. No significant difference was identified with regard to the association of AA and non-atopic respiratory diseases between adult and pediatric patients.
CONCLUSIONS
Adult and pediatric patients with AA warrant further workup for atopic respiratory diseases such as allergic rhinitis. AA may have an underlying Th2-mediated immunological component, which supports its association with atopic respiratory diseases and provides a new avenue for targeted therapies in select cases.
PubMed: 31367601
DOI: 10.1159/000496445 -
Food & Nutrition Research 2022To assess whether supplementation with long chain n-3 fatty acids during pregnancy, lactation, or infancy reduces the risk of developing asthma or atopic disease during... (Review)
Review
Supplementation with long chain n-3 fatty acids during pregnancy, lactation, or infancy in relation to risk of asthma and atopic disease during childhood: a systematic review and meta-analysis of randomized controlled clinical trials.
OBJECTIVE
To assess whether supplementation with long chain n-3 fatty acids during pregnancy, lactation, or infancy reduces the risk of developing asthma or atopic disease during childhood.
METHODS
Searches were performed in MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and Scopus up to 2021-09-20, for randomized controlled trials (RCTs) that investigated the effect of supplemental long chain n-3 fatty acids during pregnancy, lactation, or infancy for the prevention of childhood asthma or allergy. Article selection, data extraction, and risk of bias assessment (Cochrane's Risk of Bias 2.0) were independently conducted by two assessors. The evidence was synthesized qualitatively according to the criteria of the World Cancer Research Fund and meta-analyzed.
RESULTS
A total of nine RCTs met inclusion criteria; six were conducted during pregnancy, two during infancy, and one during both pregnancy and infancy. Meta-analysis showed that long chain n-3 fatty acid supplementation during pregnancy significantly reduced the risk of asthma/wheeze in the child (RR 0.62 [95% confidence interval 0.34-0.91], = 0.005, = 67.4%), but not other outcomes. Supplementation during lactation of infancy showed no effects on any outcome. The strength of evidence that long chain n-3 fatty acid supplementation during pregnancy reduces risk of asthma/wheeze in the offspring was considered . No conclusion could be made for the effects of long chain n-3 fatty acid supplementation during pregnancy for other atopic diseases, or for supplementation during lactation or infancy for any outcome.
CONCLUSION
The intake of long chain n-3 fatty acid supplements during pregnancy may reduce the risk of asthma and/or wheeze in the offspring, but the strength of evidence is low. There is inconclusive evidence for the effects of long chain n-3 fatty acid supplements during pregnancy for other outcomes, as well as for supplementation during lactation or infancy.
PubMed: 36340915
DOI: 10.29219/fnr.v66.8842 -
The Journal of Allergy and Clinical... Jan 2021Eosinophilic esophagitis (EoE) is an emerging, chronic, rare allergic disease associated with marked eosinophil accumulation in the esophagus. Previous genome-wide... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Eosinophilic esophagitis (EoE) is an emerging, chronic, rare allergic disease associated with marked eosinophil accumulation in the esophagus. Previous genome-wide association studies have provided strong evidence for 3 genome-wide susceptibility loci.
OBJECTIVE
We sought to replicate known and suggestive EoE genetic risk loci and conduct a meta-analysis of previously reported data sets.
METHODS
An EoE-Custom single-nucleotide polymophism (SNP) Chip containing 956 candidate EoE risk single-nucleotide polymorphisms was used to genotype 627 cases and 365 controls. Statistical power was enhanced by adding 1959 external controls and performing meta-analyses with 2 independent EoE genome-wide association studies.
RESULTS
Meta-analysis identified replicated association and genome-wide significance at 6 loci: 2p23 (2 independent genetic effects) and 5q22, 10p14, 11q13, and 16p13. Seven additional loci were identified at suggestive significance (P < 10): 1q31, 5q23, 6q15, 6q21, 8p21, 17q12, and 22q13. From these risk loci, 13 protein-coding EoE candidate risk genes were expressed in a genotype-dependent manner. EoE risk genes were expressed in disease-relevant cell types, including esophageal epithelia, fibroblasts, and immune cells, with some expressed as a function of disease activity. The genetic risk burden of EoE-associated genetic variants was markedly larger in cases relative to controls (P < 10); individuals with the highest decile of genetic burden had greater than 12-fold risk of EoE compared with those within the lowest decile.
CONCLUSIONS
This study extends the genetic underpinnings of EoE, highlighting 13 genes whose genotype-dependent expression expands our etiologic understanding of EoE and provides a framework for a polygenic risk score to be validated in future studies.
Topics: Eosinophilic Esophagitis; Genetic Loci; Genetic Predisposition to Disease; Genome-Wide Association Study; Humans; Polymorphism, Single Nucleotide; Risk Factors
PubMed: 33446330
DOI: 10.1016/j.jaci.2020.10.018 -
Journal of Global Health Jul 2022This systematic review of randomized trials assessed the effect of emollient application compared to no emollient application in term or near-term healthy newborns. (Meta-Analysis)
Meta-Analysis
BACKGROUND
This systematic review of randomized trials assessed the effect of emollient application compared to no emollient application in term or near-term healthy newborns.
METHODS
We searched MEDLINE via PubMed, Cochrane CENTRAL, Embase, and CINAHL (updated until November 2021), clinical trials databases, and reference lists of retrieved articles. Key outcomes were neonatal mortality, systemic infections, atopic dermatitis, skin condition, and adverse events. Two authors separately evaluated the risk of bias, extracted data, and synthesized effect estimates using relative risks (RR). The GRADE approach was used to assess the certainty of evidence.
RESULTS
We screened 19 243 records and included 16 eligible trials involving 5643 participants. Five trials recruited 3352 healthy newborns (term = 728; gestation ≥35 weeks = 2624); and 11 trials included 2291 term newborns who were 'at risk' for developing atopy but were otherwise healthy. We conducted a separate analysis for these two groups of newborns. Emollient application (creams or nut, seed, and vegetable oils) started in the neonatal period and continued for four weeks to two years across studies. Meta-analysis for term healthy newborns suggests that topical emollient application may have little to no effect on atopic dermatitis (RR = 1.29, 95% CI = 0.96-1.72; two trials, 1408 newborns; low certainty evidence). Effects on food allergy (RR = 0.84; 95% CI = 0.42-1.70; one trial, 233 newborns), allergic sensitization to food allergens (RR 1.31; 95% CI 1.03 to 1.68; one trial, 234 newborns) and inhalational allergens (RR = 0.97; 95% CI = 0.44, 2.14; 1 trial, 234 newborns), skin dryness (RR = 0.74, 95% CI = 0.55-1.00; two trials, 294 newborns), and skin problems (RR = 0.92, 95% CI = 0.81-1.05; two trials, 292 newborns) were uncertain. Meta-analysis for 'at-risk' newborns suggests that intervention probably lowers the risk of atopic dermatitis (RR = 0.74, 95% CI = 0.63-0.86; 11 studies, 1988 infants; moderate certainty evidence), but may have little or no effect on food allergy and allergic sensitization to food or inhalation allergens. The effect on skin dryness and skin rash was uncertain.
CONCLUSIONS
Topical emollient application may not prevent atopic dermatitis in term healthy newborns. There is little data for other skin and allergic outcomes.
REGISTRATION
Priyadarshi M, Balachander B, Rao S, Gupta S, Sankar MJ. Use of emollients in term healthy newborns: A systematic review. PROSPERO 2020 CRD42020177437.
Topics: Dermatitis, Atopic; Emollients; Humans; Infant; Infant Mortality; Infant, Newborn; Randomized Controlled Trials as Topic
PubMed: 35871408
DOI: 10.7189/jogh.12.12002 -
International Journal of Molecular... Jan 2024We aim to summarize the current evidence of Vascular endothelial growth factors (VEGF)s in external eye diseases and determine whether serum and plasma VEGF levels are... (Review)
Review
We aim to summarize the current evidence of Vascular endothelial growth factors (VEGF)s in external eye diseases and determine whether serum and plasma VEGF levels are associated with tear and ocular surface tissues. A systematic search of PUBMED and EMBASE was conducted using PRISMA guidelines between October 2022 and November 2023, with no restriction on language or publication date. Search terms included relevant MESH terms. These studies were evaluated for quality, and an assessment of the risk of bias was also carried out. Extracted data were then visually represented through relevant tables or figures. The initial literature search yielded 777 studies from PUBMED, 944 studies from EMBASE, and 10 studies from manual searches. Fourteen eligible studies were identified from 289 articles published from 2000 to 2023 in the English language or with English translations, including rabbit models, murine models, and human-derived samples. Most studies were retrospective in nature and case-control studies. Various common external eye diseases, such as dry eye disease (DED) and allergic eye disease were investigated. Despite limitations and small sample sizes, researchers have found elevated tissue levels of the VEGF in the vascularized cornea, especially in animal models, but there is no evidence of clear changes in the tear concentrations of VEGF in DED and allergic eye disease. Tear VEGF is associated with corneal vascularization. Anti-VEGF therapies may have the potential to manage such conditions.
Topics: Humans; Animals; Mice; Rabbits; Vascular Endothelial Growth Factor A; Retrospective Studies; Tears; Vascular Endothelial Growth Factors; Dry Eye Syndromes
PubMed: 38338647
DOI: 10.3390/ijms25031369 -
Life (Basel, Switzerland) Apr 2022The associations of fetal fatty acids status to immune-related health parameters later in life are unclear. Our aim is to collect all available information on the... (Review)
Review
The associations of fetal fatty acids status to immune-related health parameters later in life are unclear. Our aim is to collect all available information on the relationship between fatty acid status at birth and allergy in childhood. Systematic literature search was performed on Ovid MEDLINE, Cochrane Library, and Embase. The search retrieved 897 articles without duplicates; 14 articles remained after excluding those that did not fit into our inclusion criteria. When the dichotomous parameter of suffering or not from allergic condition in childhood was analyzed, cord blood eicosapentaenoic acid (EPA) values proved to be significantly lower in allergic than non-allergic children in four comparisons from three studies. When the linear parameters of odds ratios and relative risks for allergy were taken into consideration, high cord blood EPA, but also high docosahexaenoic acid (DHA) and high total n-3 long-chain polyunsaturated fatty acid values were associated to clinically relevant reduction (at least 38%) in eight comparisons from five studies. Within the cord blood samples, higher EPA, docosapentaenoic acid, and DHA values were significantly and negatively associated in eight correlation analyses from three studies with laboratory parameters considered to reflect allergic trait. The data reported here may provide information for defining optimal fatty acid intakes for pregnant women.
PubMed: 35455017
DOI: 10.3390/life12040526 -
Respiratory Medicine Sep 2021Childhood atopy is a complex condition with both a genetic and an environmental component. This systematic review will explore the current understanding of the...
BACKGROUND AND OBJECTIVES
Childhood atopy is a complex condition with both a genetic and an environmental component. This systematic review will explore the current understanding of the importance of early life exposures to a farm in the development of atopy measured by objective markers of skin prick testing, and specific IgE measurements in school age children.
METHODS
A systematic review was performed.
RESULTS
Among 7285 references identified, 14 studies met the inclusion criteria (13 cross-sectional studies and 1 case-control study). The results were fairly consistent in that early farm-related exposures can protect children from becoming atopic at school age. In general, there was heterogeneity in the assessment of outcomes and exposures.
CONCLUSIONS
Early-life farm exposures are associated with a protective effect on childhood atopy as assessed by objective markers. Future work should focus on understanding specific farm exposures that may important in these associations between atopy and farm exposures in children.
Topics: Age Factors; Biomarkers; Case-Control Studies; Child; Cross-Sectional Studies; Environmental Exposure; Farms; Humans; Hypersensitivity, Immediate; Immunoglobulin E; Risk; Skin Tests
PubMed: 34252858
DOI: 10.1016/j.rmed.2021.106378 -
Asian Pacific Journal of Allergy and... Aug 2023The effect of probiotics in the treatment of atopic dermatitis (AD) is inconclusive, partially due to the heterogeneities of AD.
BACKGROUND
The effect of probiotics in the treatment of atopic dermatitis (AD) is inconclusive, partially due to the heterogeneities of AD.
OBJECTIVE
The aim of the present study was to investigate the efficacy of probiotics in the treatment of AD with a subgroup analysis according to country, severity of AD, duration of supplementation, and probiotic strain.
METHODS
Original articles reporting the therapeutic efficacy of probiotics for AD were identified by searching PubMed, Cochrane Library databases, and Embase from inception to September 30, 2022.
RESULTS
This meta-analysis included 1,382 patients with AD from 25 randomized controlled trials. Probiotic supplementation was effective for the treatment of AD, reflected in a significant decrease in the SCORing Atopic Dermatitis (SCORAD) index (SMD, -4.0; 95%CI, -7.3 to -0.7). The subgroup analysis showed a significant therapeutic effect for AD among patients with mild or moderate AD (SMD, -1.4; 95%CIs -2.2 to -0.7), in those supplemented for more than three months (SMD, -5.1; 95%CIs -9.7 to -0.4), and in those supplemented with a probiotic that contained Lactobacillus spp. strains combined with or without other strains (SMD, -4.4; 95%CIs -8.0 to -0.8). In addition, the therapeutic effects of probiotics showed differences according to country and geographic region.
CONCLUSIONS
Probiotics can be beneficial for the treatment of AD, and their therapeutic effect may be individually tailored to improve it based on the severity of AD, strain of probiotics, duration of supplementation, and geographic region.
PubMed: 37578483
DOI: 10.12932/AP-280323-1576 -
Italian Journal of Pediatrics Apr 2024Evidence about feeding practices' consequences in small for gestational age newborns is not well established because they are less likely to initiate and continue... (Review)
Review
Evidence about feeding practices' consequences in small for gestational age newborns is not well established because they are less likely to initiate and continue breastfeeding than other newborns. Our aim was to study current knowledge about the benefits of exclusive human milk diet after 2 years of age in small for gestational age newborns. A systematic review of the literature was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline criteria. Pubmed and Scopus were searched for studies published from databases inception until June 2, 2023. Included articles were analysed and synthesised. Risk of bias and level of evidence assessments were performed. They were enrolled small for gestational age newborns fed by breastfeeding, breast milk or donor milk. The systematic review included 9 articles which were related to 4 health domains: neurodevelopment, cardiovascular, somatic growth and bone mineralization and atopy. Extracted data support a beneficial effect of breastfeeding on these outcomes. Better quality of evidence and longer follow-up are needed.
Topics: Humans; Milk, Human; Infant, Newborn; Breast Feeding; Infant, Small for Gestational Age
PubMed: 38679716
DOI: 10.1186/s13052-024-01648-3 -
Medical Principles and Practice :... 2018To study the available data on the prevalence of atopic diseases and food allergy in children living on the Arabian Peninsula.
OBJECTIVES
To study the available data on the prevalence of atopic diseases and food allergy in children living on the Arabian Peninsula.
METHODS
A PubMed search for relevant published articles was conducted using the following search terms singly or in combination: "atopy," "atopic disease," "atopic disorder," "International Study of Asthma and Allergies in Childhood," "ISAAC," "asthma," "allergic rhinitis," "eczema," and "food allergy" in combination with the names of countries of the Arabian Peninsula (Kuwait, United Arab Emirates, Bahrain, Qatar, Oman, Kingdom of Saudi Arabia, and Yemen). The search captured studies published up to December 2017.
RESULTS
A total of 8 publications reporting prevalence rates of any type of atopic disease in children in 7 countries of the Arabian Peninsula were retrieved. The prevalence of all atopic disorders was comparable between countries of the Arabian Peninsula. The overall prevalence of asthma ranged from 8 to 23%, while the reported prevalence of eczema ranged from 7.5 to 22.5%. There was great variation in the prevalence rates of rhinoconjunctivitis, which ranged from 6.3 to 30.5%. The prevalence of food allergy (8.1%) was reported for 1 country only, the United Arab Emirates.
CONCLUSIONS
The reported overall rates of atopic disease in countries of the Arabian Peninsula are comparable to those reported in other industrialized countries. This is probably related to the good economic status in the region, which is reflected in the living standards and lifestyle. Further, genetic factors, such as factors related to gene polymorphism, and the high rate of consanguinity in the region may contribute to the higher prevalence of atopic diseases.
Topics: Asthma; Eczema; Food Hypersensitivity; Genetic Predisposition to Disease; Humans; Hypersensitivity; Middle East; Prevalence; Rhinitis, Allergic; Risk Factors; Surveys and Questionnaires
PubMed: 30149382
DOI: 10.1159/000493267