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Skin Health and Disease Jun 2024Atopic eczema is a common, chronic, inflammatory skin condition with considerable heterogeneity. South Asian people living in the UK frequently have low serum vitamin D3...
BACKGROUND
Atopic eczema is a common, chronic, inflammatory skin condition with considerable heterogeneity. South Asian people living in the UK frequently have low serum vitamin D3 (25(OH)D), and those with atopic disease can present with severe eczema. The association between vitamin D deficiency and eczema severity, and the role of vitamin D supplementation in atopic eczema is inconsistent, and under-researched in people with Asian ancestry.
OBJECTIVES
This cross-sectional study investigates the association between serum 25(OH)D and eczema severity in a cohort of South Asian children and young adults living in London.
METHODS
Eligible participants were Bangladeshi children and young adults aged 0-30 years with eczema, living in London and participating in the Tower Hamlets Eczema Assessment study. Data was collected via parent/patient self-reporting, clinical history and examination, and hospital databases. 25(OH)D levels were documented retrospectively, if available, from hospital databases. Eczema severity was classified by Eczema Area and Severity Index (EASI) score less than or greater than 10 (clear-mild vs. moderate-severe). Multivariate logistic regression was used to adjust for confounding factors.
RESULTS
681 participants were included in analyses. 25(OH)D results were available for 49.6% (338/681), 84.3% of which had deficient or insufficient lowest 25(OH)D. Lowest 25(OH)D was inversely correlated with EASI score (Spearman's rank = -0.24, < 0.001). 26.1% (178/681) had EASI >10 and a lower median lowest and nearest 25(OH)D. After adjustment for confounding EASI > 10 was significantly associated with a lowest 25(OH)D < 25 (OR 3.21, 95%CI 1.35, 8.60), use of mild-moderate potency topical steroid on the face and neck (OR 3.11, 95%CI 1.86, 5.31), calcineurin inhibitor on the face and neck (OR 2.79, 95% CI 1.26, 6.10) and potent - very potent topical steroid on the face and neck (OR2.23, 95%CI 1.02, 4.77) and body (OR 2.11, 95%CI 1.18, 3.87).
DISCUSSION
Vitamin D plays a role in modulation of proteins required for skin barrier function and regulation of the innate immune system, suggesting 25(OH)D deficiency contributes to skin inflammation. This study demonstrates a relationship between 25(OH)D deficiency and worse eczema severity in a cohort of South Asian children and young adults.
PubMed: 38846698
DOI: 10.1002/ski2.358 -
Skin Health and Disease Jun 2024Dupilumab-associated ocular surface disease is a common clinical sign appearing in patients with atopic dermatitis (AD) just few months after dupilumab treatment start,...
Dupilumab-associated ocular surface disease is a common clinical sign appearing in patients with atopic dermatitis (AD) just few months after dupilumab treatment start, developing in about 25% of patients. Atopic keratoconjunctivitis (AKC) is a well-identified clinical entity, defined as a chronic inflammatory disease of eye that affects 25%-40% of patients with AD. Most clinical signs of ocular involvement in AD patients treated with dupilumab overlaps the AKC symptoms and signs. We supposed that Dupilumab-associated ocular surface disease and AKC represent the same disease but differently called by dermatologists and ophthalmologists. AKC-like disease may develop during dupilumab therapy as a consequence of alternative cytokines pathway activation (e.g. IL33) secondary to IL-4/13 pathway block. The novel upadacitinib drug may bypass ILs pathway through Janus Kinases selective inhibition, avoiding positive or negative ILs feedback at the ocular surface level. In this case report, molecular analysis on conjunctival samples showed a lower ocular surface inflammation (lower expression of HLADR) although higher levels of IL4 and IL13 in a patient with AD and AKC during upadacitinib therapy, compared to prior dupilumab treatment. Target therapies in patients suffering from AD may prevent ocular and dermatological comorbidities improving quality of life before quality of skin and vision.
PubMed: 38846697
DOI: 10.1002/ski2.354 -
Skin Health and Disease Jun 2024In the two common inflammatory skin diseases, Atopic Dermatitis (AD) and Psoriasis (Ps), keratinocytes (KCs) respond to immune insults through activation of...
BACKGROUND
In the two common inflammatory skin diseases, Atopic Dermatitis (AD) and Psoriasis (Ps), keratinocytes (KCs) respond to immune insults through activation of proinflammatory transcription factors (TFs) and their translocation to the cell's nucleus. Therein, the TFs induce expression of genes encoding mediators of skin inflammation. The Nuclear Transport Checkpoint Inhibitors (NTCIs) were developed to regulate nuclear translocation of activated TFs, the essential step of inflammatory response. This new class of cell-penetrating peptide therapeutics controls inflammation caused by allergic, autoimmune, metabolic, and microbial insults. In preclinical model of AD, the treatment with NTCI, cSN50.1 peptide, suppressed the expression of Thymic Stromal Lymphopoietin (), the key gene in the development of allergic inflammation, among the 15 genes silenced by the NTCI. Here, we report the mechanism of anti-inflammatory action of NTCI in human skin-derived KCs.
OBJECTIVES
We aimed to determine whether the NTCI treatment can protect human KCs from harmful inflammatory insults.
METHODS
Human primary KCs were pretreated with NTCI and challenged with the mix of cytokines Tumour Necrosis Factor alpha (TNF-α) and Interleukin (IL)-17A, or with Phorbol 12-Myristate 13-Acetate (PMA), and analysed for nuclear content of TFs and the expression of genes encoding mediators of inflammation.
RESULTS
The nuclear import of TFs, Nuclear Factor ĸB (NF-ĸB) and Signal Transduction and Activator of Transcription 3 (STAT3), was inhibited in cells treated with NTCI. The expression of along with genes encoding the core mediators of inflammation (, , and ) was suppressed by NTCI. Noteworthy, NTCI silenced genes encoding Granulocyte-Macrophage Colony-Stimulating Factor (), and chemokine IL-8 (), responsible for skin infiltration by the eosinophils and other myelomonocytic cells.
CONCLUSION
The control of inflammatory response in human KCs by NTCI is attributed to the inhibition of nuclear import of proinflammatory TFs. The protection of human KCs by NTCI, adds new perspectives to the completed Phase two clinical trial of the NTCI (AMTX-100 CF) for AD (NCT04313400).
PubMed: 38846687
DOI: 10.1002/ski2.356 -
Skin Health and Disease Jun 2024A prospective controlled pilot study on the feasibility of utilization of a probiotic mixture for management of acute exacerbation of atopic dermatitis (AD). Patients...
A prospective controlled pilot study on the feasibility of utilization of a probiotic mixture for management of acute exacerbation of atopic dermatitis (AD). Patients were allocated to either standard of care (SOC) therapy with tapering dose of steroids or a probiotic mixture over 3 weeks. After the 3-week intervention, patients on steroids achieved significantly higher clinical response rates and significantly deeper response as measured by the change in SCORAD score. No gut microbiome changes could be appreciated in either group after the treatment period. We could conclude that probiotics cannot replace SOC therapy for the management of acute exacerbation of AD.
PubMed: 38846682
DOI: 10.1002/ski2.373 -
Indian Dermatology Online Journal 2024Pediatric dermatitis seborrhoica (DS) is a common inflammatory disorder of infancy and adolescence distinct from atopic dermatitis. We performed a narrative review on... (Review)
Review
Pediatric dermatitis seborrhoica (DS) is a common inflammatory disorder of infancy and adolescence distinct from atopic dermatitis. We performed a narrative review on clinical and therapeutic aspects of the disease. The prevalence varies geographically and can reach up to 10%. There is a slight male predominance. Although etiopathology is not well known, both endogenous and exogenous factors contribute. Skin microbiome and its interaction with sebaceous gland function is crucial. The inflammatory pathways include innate immune function and skin barrier disturbances. spp. and certain bacteria are increased in lesional skin. DS develops in different clinical subtypes, from localized cephalic to disseminated disease with a risk of erythroderma and eczema herpeticatum. Treatment consists of skin care and topical and rarely systemic medical therapy. Cornerstones of treatment are antifungals and mild corticosteroids. Targeted treatment is on the horizon. Pediatric DS is a common disorder important in the differential diagnosis of skin problems in infants and and children. Due to better understanding of its pathogenesis, new treatment options are developed.
PubMed: 38845676
DOI: 10.4103/idoj.idoj_593_23 -
BMC Complementary Medicine and Therapies Jun 2024Atopic dermatitis (AD) is a chronic inflammatory condition characterized by the accumulation of reactive oxygen species and the expression of inflammatory factors....
BACKGROUND
Atopic dermatitis (AD) is a chronic inflammatory condition characterized by the accumulation of reactive oxygen species and the expression of inflammatory factors. Regarding its anti-atopic activity, numerous traditional medicinal materials and secondary metabolic products play pivotal roles in modulating the associated mechanisms.
METHODS
This study aimed to utilize Salvia miltiorrhiza Bunge (SMB) as an anti-AD source. In-vitro activity assessments and qualitative and quantitative analyses using UPLC-TQ-MS/MS and HPLC-DAD were conducted in two cultivars ('Dasan' and 'Kosan'). Statistical analysis indicated that the profiles of their secondary metabolites contribute significantly to their pharmacological properties. Consequently, bio-guided fractionation was undertaken to figure out the distinct roles of the secondary metabolites present in SMB.
RESULTS
Comparative study of two cultivars indicated that 'Dasan', having higher salvianolic acid A and B, exhibited stronger antioxidant and anti-inflammatory activities. Meanwhile, 'Kosan', containing higher tanshinones, showed higher alleviating activities on anti-AD related genes in mRNA levels. Additionally, performed bio-guided fractionation re-confirmed that the hydrophilic compounds of SMB can prevent AD by inhibiting accumulation of ROS and suppressing inflammatory factors and the lipophilic components can directly inhibit AD.
CONCLUSIONS
SMB was revealed as a good source for anti-AD activity. Several bioactive compounds were identified from the UPLC-TQ-MS/MS and different compounds content was linked to biological activities. Characterization of these compounds may be helpful to understand differential role of secondary metabolites from SMB on alleviation of AD.
Topics: Salvia miltiorrhiza; Dermatitis, Atopic; Plant Extracts; Humans; Anti-Inflammatory Agents; Tandem Mass Spectrometry; Chromatography, High Pressure Liquid; Antioxidants; Reactive Oxygen Species
PubMed: 38844985
DOI: 10.1186/s12906-024-04524-z -
Journal of Medical Economics 2024
Re: Johansson E, Giovannitti M, Mezzetti M, et al. Cost-effectiveness analysis of baricitinib versus dupilumab for moderate to severe atopic dermatitis: an Italian healthcare system perspective. J Med Econ. 2023;26(1):1155-1166.
Topics: Dermatitis, Atopic; Humans; Antibodies, Monoclonal, Humanized; Purines; Cost-Benefit Analysis; Pyrazoles; Azetidines; Sulfonamides; Italy; Severity of Illness Index; Cost-Effectiveness Analysis
PubMed: 38842021
DOI: 10.1080/13696998.2024.2357978 -
Indian Journal of Dermatology,... Apr 2024
PubMed: 38841968
DOI: 10.25259/IJDVL_1018_2023 -
Indian Journal of Dermatology,... Apr 2024
PubMed: 38841959
DOI: 10.25259/IJDVL_884_2023 -
Frontiers in Pharmacology 2024Ginseng leaves are known to contain high concentrations of bioactive compounds, such as ginsenosides, and have potential as a treatment for various conditions, including...
Ginseng leaves are known to contain high concentrations of bioactive compounds, such as ginsenosides, and have potential as a treatment for various conditions, including fungal infections, cancer, obesity, oxidative stress, and age-related diseases. This study assessed the impact of ginseng leaf extract (GLE) on mast cell-mediated allergic inflammation and atopic dermatitis (AD) in DNCB-treated mice. GLE reduced skin thickness and lymph node nodules and suppressed the expression and secretion of histamine and pro-inflammatory cytokines. It also significantly lowered the production of inflammatory response mediators including ROS, leukotriene C4 (LTC4), prostaglandin E2 (PGE2), cyclooxygenase-2 (COX-2), and inducible nitric oxide synthase (iNOS). GLE inhibited the phosphorylation of MAPKs (ERK, P38, JNK) and the activation of NF-κB, which are both linked to inflammatory cytokine expression. We demonstrated that GLE's inhibitory effect on mast cell-mediated allergic inflammation is due to the blockade of the NF-κB and inflammasome pathways. Our findings suggest that GLE can be an effective therapeutic agent for mast-cell mediated and allergic inflammatory conditions.
PubMed: 38841363
DOI: 10.3389/fphar.2024.1403285