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Song HK, Park SH, Kim HJ, Jang S, Choo BK, Kim HK, Kim T. Inhibitory effect of Sanguisorba hakusanensis Makino ethanol extract on atopic dermatitis-like responses in NC/Nga mice and human keratinocytes. Sci Rep 2023; 13:14594. [PMID: 37670127 PMCID: PMC10480230 DOI: 10.1038/s41598-023-41676-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 08/30/2023] [Indexed: 09/07/2023] Open
Abstract
Atopic dermatitis (AD) is an allergic, inflammatory skin disease caused by immune dysregulation. In this study, we investigated anti-atopic and anti-inflammatory activities of Sanguisorba hakusanensis ethanol extract (SHE) both in vivo using NC/Nga mice and in vitro using human HaCaT keratinocytes. Oral administration of SHE suppressed several atopic symptoms associated with house dust mites (induced with Dermatophagoides farinae extract) in NC/Nga mice and decreased serum levels of inflammatory mediators such as immunoglobulin E, histamine, and inflammatory chemokines. Additionally, SHE treatment reduced the infiltration of immune cells such as mast cells and macrophages in AD skin lesions. In vitro, interferon-γ- and tumor necrosis factor-α-stimulated HaCaT cells exhibited increased expression of T helper 1 and 2 chemokines; their expression was inhibited by SHE treatment. The anti-inflammatory effects of SHE treatment involved blocking of the mitogen-activated protein kinase and signal transducer and activator of transcription 1 signaling pathways. In conclusion, SHE exerts potent anti-atopic and anti-inflammatory effects and should be considered for the clinical treatment of AD.
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Affiliation(s)
- Hyun-Kyung Song
- KM Convergence Research Division, Korea Institute of Oriental Medicine, Yuseong-daero 1672, Yuseong-gu, Daejeon, 34054, Republic of Korea
| | - Sun Haeng Park
- KM Convergence Research Division, Korea Institute of Oriental Medicine, Yuseong-daero 1672, Yuseong-gu, Daejeon, 34054, Republic of Korea
| | - Hye Jin Kim
- KM Convergence Research Division, Korea Institute of Oriental Medicine, Yuseong-daero 1672, Yuseong-gu, Daejeon, 34054, Republic of Korea
- College of Pharmacy, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, 08826, Republic of Korea
| | - Seol Jang
- KM Convergence Research Division, Korea Institute of Oriental Medicine, Yuseong-daero 1672, Yuseong-gu, Daejeon, 34054, Republic of Korea
| | - Byung-Kil Choo
- Department of Crop Science and Biotechnology, Jeonbuk National University, Jeonju, 54896, Republic of Korea
| | - Ho Kyoung Kim
- KM Convergence Research Division, Korea Institute of Oriental Medicine, Yuseong-daero 1672, Yuseong-gu, Daejeon, 34054, Republic of Korea.
| | - Taesoo Kim
- KM Convergence Research Division, Korea Institute of Oriental Medicine, Yuseong-daero 1672, Yuseong-gu, Daejeon, 34054, Republic of Korea.
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2
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Murashkin NN, Nezhvedilova RY, Fedorov DV, Epishev RV, Ivanov RA, Materikin AI, Opryatin LA, Savelova AA, Rusakova LL. Scientific and Practical Innovations in Restoring Skin Barrier Properties in Children with Atopic Dermatitis. CURRENT PEDIATRICS 2022. [DOI: 10.15690/vsp.v21i5.2457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Atopic dermatitis (AD) is a multifactorial inflammatory skin disease. Its pathogenetic basis is epidermal barrier dysfunction, immune system dysregulation, as well as skin microbiome diversity decrease that occurs due to genetic predisposition. Considering these factors, the skin of patients with AD requires constant care and use of medications with active regenerative properties. The inclusion of anti-inflammatory components in the composition of modern emollients (zinc sulfate and sucralfate) is crucial for restoring the microbiome and immune mechanisms controlling the skin. This article presents data on pathogenetic applicability and clinical efficacy of emollients with anti-inflammatory compounds in patients with AD.
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Affiliation(s)
- Nikolay N. Murashkin
- National Medical Research Center of Children’s Health; Sechenov First Moscow State Medical University; Central State Medical Academy of Department of Presidential Affairs
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3
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Asanuma Y, Ishimaru H, Sato T, Yamamoto T, Aoyama Y. Herpes simplex virus-induced murine dry skin model through sweating disturbance. J Dermatol Sci 2022; 107:151-159. [PMID: 36150981 DOI: 10.1016/j.jdermsci.2022.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 08/12/2022] [Accepted: 09/01/2022] [Indexed: 10/14/2022]
Abstract
BACKGROUND Given that ocular glands become infected secondarily to herpes simplex virus 1 (HSV-1) keratitis, resulting in the loss of tear production, sweat glands may also be susceptible to HSV-1 infection, resulting in sweating disturbance, which is observed frequently in atopic dermatitis. However, due to the lack of sweat glands on the hairy skin of mice, the role of sweating in the maintenance of skin hydration has not been elucidated. OBJECTIVE To determine the relationship between HSV-1 infection of sweat glands and sweating disturbance-induced dry skin. METHODS By using the impression mold technique, we examined the sweating response together with the detection of HSV-1 DNA in the sweat glands of footpads, the only area with sweat glands in mice, after local cutaneous HSV-1 inoculation of immunocompetent mice. RESULTS The sweating response and skin surface hydration were significantly decreased at 7-14 days post-infection. Sweating disturbance and dry skin was markedly enhanced when HSV-1 inoculation was followed by hyperthermic stress. Both resolved spontaneously and became resistant to a second HSV-1 inoculation, associated with increased anti-HSV-IgG antibodies. HSV-1 DNA was detected in sweat glands and dorsal root ganglia. The sweating response remained decreased after subcutaneous injection with pilocarpine, correlating histologically with marked dilatation of sweat gland lumens. These findings indicate that sweating disturbance is unlikely to be the outcome of nerve damage by HSV-1 infection. CONCLUSION Sweating disturbance could be due to HSV-induced dysfunction of sweat glands. We developed a sweating disturbance-induced dry skin mouse model by infection with HSV-1.
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Affiliation(s)
- Yumiko Asanuma
- Department of Dermatology, Kawasaki Medical School, Kurashiki, Okayama, Japan
| | - Hironobu Ishimaru
- Department of Pharmacology, Kawasaki Medical School, Kurashiki, Okayama, Japan
| | - Tetsuko Sato
- Department of Dermatology, Kawasaki Medical School, Kurashiki, Okayama, Japan
| | - Takenobu Yamamoto
- Department of Dermatology, Kawasaki Medical School, Kurashiki, Okayama, Japan
| | - Yumi Aoyama
- Department of Dermatology, Kawasaki Medical School, Kurashiki, Okayama, Japan.
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4
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Hawerkamp HC, Fahy CMR, Fallon PG, Schwartz C. Break on through: The role of innate immunity and barrier defence in atopic dermatitis and psoriasis. SKIN HEALTH AND DISEASE 2022; 2:e99. [PMID: 35677926 PMCID: PMC9168024 DOI: 10.1002/ski2.99] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 01/07/2022] [Accepted: 01/23/2022] [Indexed: 12/20/2022]
Abstract
The human skin can be affected by a multitude of diseases including inflammatory conditions such as atopic dermatitis and psoriasis. Here, we describe how skin barrier integrity and immunity become dysregulated during these two most common inflammatory skin conditions. We summarise recent advances made in the field of the skin innate immune system and its interaction with adaptive immunity. We review gene variants associated with atopic dermatitis and psoriasis that affect innate immune mechanisms and skin barrier integrity. Finally, we discuss how current and future therapies may affect innate immune responses and skin barrier integrity in a generalized or more targeted approach in order to ameliorate disease in patients.
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Affiliation(s)
- H C Hawerkamp
- Trinity Biomedical Sciences Institute, School of Medicine, Trinity College Dublin Dublin Ireland
| | - C M R Fahy
- Paediatric Dermatology Children's Health Ireland at Crumlin Dublin Ireland.,Royal United Hospitals NHS Foundation Trust Bath UK
| | - P G Fallon
- Trinity Biomedical Sciences Institute, School of Medicine, Trinity College Dublin Dublin Ireland.,National Children's Research Centre Our Lady's Children's Hospital Dublin Ireland.,Clinical Medicine Trinity College Dublin Dublin Ireland
| | - C Schwartz
- Trinity Biomedical Sciences Institute, School of Medicine, Trinity College Dublin Dublin Ireland.,Mikrobiologisches Institut - Klinische Mikrobiologie, Immunologie und Hygiene Universitätsklinikum Erlangen and Friedrich-Alexander Universität (FAU) Erlangen-Nürnberg Erlangen Germany.,Medical Immunology Campus Erlangen FAU Erlangen-Nürnberg Erlangen Germany
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5
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Indigo Pulverata Levis (Chung-Dae, Persicaria tinctoria) Alleviates Atopic Dermatitis-like Inflammatory Responses In Vivo and In Vitro. Int J Mol Sci 2022; 23:ijms23010553. [PMID: 35008979 PMCID: PMC8745452 DOI: 10.3390/ijms23010553] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 12/30/2021] [Accepted: 01/01/2022] [Indexed: 12/31/2022] Open
Abstract
Atopic dermatitis (AD) is a chronic inflammatory skin disease associated with a type 2 T helper cell (Th2) immune response. The IndigoPulverata Levis extract (CHD) is used in traditional Southeast Asian medicine; however, its beneficial effects on AD remain uninvestigated. Therefore, we investigated the therapeutic effects of CHD in 2,4-dinitrochlorobenzene (DNCB)-induced BALB/c mice and tumor necrosis factor (TNF)-α- and interferon gamma (IFN)-γ-stimulated HaCaT cells. We evaluated immune cell infiltration, skin thickness, and the serum IgE and TNF-α levels in DNCB-induced AD mice. Moreover, we measured the expression levels of pro-inflammatory cytokines, mitogen-activated protein kinase (MAPK), and the nuclear factor-kappa B (NF-κB) in the mice dorsal skin. We also studied the effect of CHD on the translocation of NF-κB p65 and inflammatory chemokines in HaCaT cells. Our in vivo results revealed that CHD reduced the dermis and epidermis thicknesses and inhibited immune cell infiltration. Furthermore, it suppressed the proinflammatory cytokine expression and MAPK and NF-κB phosphorylations in the skin tissue and decreased serum IgE and TNF-α levels. In vitro results indicated that CHD downregulated inflammatory chemokines and blocked NF-κB p65 translocation. Thus, we deduced that CHD is a potential drug candidate for AD treatment.
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6
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Abstract
Atopic dermatitis is a common, chronic and recurrent inflammatory skin disease, which often appears in childhood but can last into adulthood. It negatively impacts patients, their families and society in general. There is a therapeutic unmet need, with patients requiring new drugs that are safe and effective. The increasing knowledge of the pathophysiology of AD and the role of the Janus kinase (JAK) and signal transducer and activator of transcription (STAT) pathway in the development and maintenance of AD, has led to the development of agents blocking this intracellular signaling pathway, the JAK inhibitors. Baricitinib shows high selectivity for JAK1 and JAK2, making it appealing for the treatment of this condition. Phase II and phase III trials evaluated the efficacy and safety of baricitinib in the treatment of AD, and the results have been encouraging, showing a good efficacy and a favorable safety and tolerability profile. At the end of 2020, EMA approved baricitinib for the treatment of adult patients with moderate-to-severe atopic dermatitis who are candidates for systemic therapy, increasing the therapeutic option for this debilitating disease.
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Affiliation(s)
- Amelia Melo
- Instituto de Ciências Biomédicas Abel Salazar, University of Porto, Porto, Portugal
| | - Jose Manuel Carrascosa
- Department of Dermatology, Germans Trias i Pujol University Hospital (HUGTP), Autonomous University of Barcelona (UAB), Badalona, Spain
| | - Tiago Torres
- Instituto de Ciências Biomédicas Abel Salazar, University of Porto, Porto, Portugal.,Department of Dermatology, Centro Hospitalar Universitário do Porto, Porto, Portugal
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7
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Fang Z, Li L, Zhang H, Zhao J, Lu W, Chen W. Gut Microbiota, Probiotics, and Their Interactions in Prevention and Treatment of Atopic Dermatitis: A Review. Front Immunol 2021; 12:720393. [PMID: 34335634 PMCID: PMC8317022 DOI: 10.3389/fimmu.2021.720393] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 06/28/2021] [Indexed: 12/15/2022] Open
Abstract
Atopic dermatitis (AD) is a public health concern and is increasing in prevalence in urban areas. Recent advances in sequencing technology have demonstrated that the development of AD not only associate with the skin microbiome but gut microbiota. Gut microbiota plays an important role in allergic diseases including AD. The hypothesis of the “gut-skin” axis has been proposed and the cross-talk mechanism between them has been gradually demonstrated in the research. Probiotics contribute to the improvement of the intestinal environment, the balance of immune responses, regulation of metabolic activity. Most studies suggest that probiotic supplements may be an alternative for the prevention and treatment of AD. This study aimed to discuss the effects of probiotics on the clinical manifestation of AD based on gut microbial alterations. Here we reviewed the gut microbial alteration in patients with AD, the association between gut microbiota, epidermal barrier, and toll-like receptors, and the interaction of probiotics and gut microbiota. The potential mechanisms of probiotics on alleviating AD via upregulation of epidermal barrier and regulation of immune signaling had been discussed, and their possible effective substances on AD had been explored. This provides the supports for targeting gut microbiota to attenuate AD.
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Affiliation(s)
- Zhifeng Fang
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, China.,School of Food Science and Technology, Jiangnan University, Wuxi, China
| | - Lingzhi Li
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, China.,School of Food Science and Technology, Jiangnan University, Wuxi, China
| | - Hao Zhang
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, China.,School of Food Science and Technology, Jiangnan University, Wuxi, China.,National Engineering Research Center for Functional Food, Jiangnan University, Wuxi, China.,(Yangzhou) Institute of Food Biotechnology, Jiangnan University, Yangzhou, China.,Wuxi Translational Medicine Research Center and Jiangsu Translational Medicine Research, Institute Wuxi Branch, Wuxi, China
| | - Jianxin Zhao
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, China.,School of Food Science and Technology, Jiangnan University, Wuxi, China.,(Yangzhou) Institute of Food Biotechnology, Jiangnan University, Yangzhou, China
| | - Wenwei Lu
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, China.,School of Food Science and Technology, Jiangnan University, Wuxi, China.,National Engineering Research Center for Functional Food, Jiangnan University, Wuxi, China
| | - Wei Chen
- State Key Laboratory of Food Science and Technology, Jiangnan University, Wuxi, China.,School of Food Science and Technology, Jiangnan University, Wuxi, China.,National Engineering Research Center for Functional Food, Jiangnan University, Wuxi, China
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8
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Wang T, Li K, Xiao S, Xia Y. A Plausible Role for Collectins in Skin Immune Homeostasis. Front Immunol 2021; 12:594858. [PMID: 33790889 PMCID: PMC8006919 DOI: 10.3389/fimmu.2021.594858] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 02/25/2021] [Indexed: 12/13/2022] Open
Abstract
The skin is a complex organ that faces the external environment and participates in the innate immune system. Skin immune homeostasis is necessary to defend against external microorganisms and to recover from stress to the skin. This homeostasis depends on interactions among a variety of cells, cytokines, and the complement system. Collectins belong to the lectin pathway of the complement system, and have various roles in innate immune responses. Mannose-binding lectin (MBL), collectin kidney 1, and liver (CL-K1, CL-L1) activate the lectin pathway, while all have multiple functions, including recognition of pathogens, opsonization of phagocytosis, and modulation of cytokine-mediated inflammatory responses. Certain collectins are localized in the skin, and their expressions change during skin diseases. In this review, we summarize important advances in our understanding of how MBL, surfactant proteins A and D, CL-L1, and CL-K1 function in skin immune homeostasis. Based on the potential roles of collectins in skin diseases, we suggest therapeutic strategies for skin diseases through the targeting of collectins and relevant regulators.
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Affiliation(s)
- Tian Wang
- Department of Dermatology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Ke Li
- Core Research Laboratory, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Shengxiang Xiao
- Department of Dermatology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yumin Xia
- Department of Dermatology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
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9
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Hispidulin alleviates 2,4-dinitrochlorobenzene and house dust mite extract-induced atopic dermatitis-like skin inflammation. Biomed Pharmacother 2021; 137:111359. [PMID: 33761595 DOI: 10.1016/j.biopha.2021.111359] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 02/01/2021] [Accepted: 02/02/2021] [Indexed: 12/13/2022] Open
Abstract
Atopic dermatitis (AD) is a chronic inflammatory skin disorder that affects 10-20% of the world's population. Therefore, the discovery of drugs for the treatment of AD is important for human health. Hispidulin (HPD; also known as scutellarein 6-methyl ether or dinatin) is a natural flavone that exerts anti-inflammatory effects. In the present study, the effectiveness of HPD on AD-like skin inflammation was investigated. We used a mouse AD model through repeated exposure of mice to 2,4-dinitrochlorobenzene and house dust mite extract (Dermatophagoides farinae extract, DFE) to the ears. In addition, tumor necrosis factor-α and interferon-γ-activated keratinocytes (HaCaT cells) were used to investigate the underlying mechanism of HPD action. Oral administration of HPD alleviated AD-like skin inflammations: it reduced ear thickness; serum immunoglobulin (Ig)E, DFE-specific IgE, and IgG2a levels; and inflammatory cell infiltration. HPD reduced the expression of pro-inflammatory cytokines and chemokines through inhibition of signal transducer and activator of transcription 1 nuclear factor-κB in HaCaT cells. Taken together, these results suggest that HPD could be a potential drug candidate for the treatment of AD.
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10
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Vijaya Chandra SH, Srinivas R, Dawson TL, Common JE. Cutaneous Malassezia: Commensal, Pathogen, or Protector? Front Cell Infect Microbiol 2021; 10:614446. [PMID: 33575223 PMCID: PMC7870721 DOI: 10.3389/fcimb.2020.614446] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 12/04/2020] [Indexed: 12/19/2022] Open
Abstract
The skin microbial community is a multifunctional ecosystem aiding prevention of infections from transient pathogens, maintenance of host immune homeostasis, and skin health. A better understanding of the complex milieu of microbe-microbe and host-microbe interactions will be required to define the ecosystem's optimal function and enable rational design of microbiome targeted interventions. Malassezia, a fungal genus currently comprising 18 species and numerous functionally distinct strains, are lipid-dependent basidiomycetous yeasts and integral components of the skin microbiome. The high proportion of Malassezia in the skin microbiome makes understanding their role in healthy and diseased skin crucial to development of functional skin health knowledge and understanding of normal, healthy skin homeostasis. Over the last decade, new tools for Malassezia culture, detection, and genetic manipulation have revealed not only the ubiquity of Malassezia on skin but new pathogenic roles in seborrheic dermatitis, psoriasis, Crohn's disease, and pancreatic ductal carcinoma. Application of these tools continues to peel back the layers of Malassezia/skin interactions, including clear examples of pathogenicity, commensalism, and potential protective or beneficial activities creating mutualism. Our increased understanding of host- and microbe-specific interactions should lead to identification of key factors that maintain skin in a state of healthy mutualism or, in turn, initiate pathogenic changes. These approaches are leading toward development of new therapeutic targets and treatment options. This review discusses recent developments that have expanded our understanding of Malassezia's role in the skin microbiome, with a focus on its multiple roles in health and disease as commensal, pathogen, and protector.
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Affiliation(s)
| | - Ramasamy Srinivas
- Skin Research Institute of Singapore, Agency for Science, Technology and Research, Singapore, Singapore
| | - Thomas L Dawson
- Skin Research Institute of Singapore, Agency for Science, Technology and Research, Singapore, Singapore
- Department of Drug Discovery, College of Pharmacy, Medical University of South Carolina, Charleston, SC, United States
| | - John E Common
- Skin Research Institute of Singapore, Agency for Science, Technology and Research, Singapore, Singapore
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11
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Alm PA. Streptococcal Infection as a Major Historical Cause of Stuttering: Data, Mechanisms, and Current Importance. Front Hum Neurosci 2020; 14:569519. [PMID: 33304252 PMCID: PMC7693426 DOI: 10.3389/fnhum.2020.569519] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 08/24/2020] [Indexed: 12/02/2022] Open
Abstract
Stuttering is one of the most well-known speech disorders, but the underlying neurological mechanisms are debated. In addition to genetic factors, there are also major non-genetic contributions. It is here proposed that infection with group A beta-hemolytic streptococcus (GAS) was a major underlying cause of stuttering until the mid-1900s when penicillin was introduced in 1943. The main mechanism proposed is an autoimmune reaction from tonsillitis, targeting specific molecules, for example within the basal ganglia. It is here also proposed that GAS infections may have continued to cause stuttering to some extent, to the present date, though more rarely. If so, early diagnosis of such cases would be of importance. Childhood cases with sudden onset of stuttering after throat infection may be particularly important to assess for possible GAS infection. The support for this hypothesis primarily comes from three lines of argument. First, medical record data from the 1930s strongly indicates that there was one type of medical event in particular that preceded the onset of childhood stuttering with unexpected frequency: diseases related to GAS throat infections. In particular, this included tonsillitis and scarlet fever, but also rheumatic fever. Rheumatic fever is a childhood autoimmune sequela of GAS infection, which was a relatively widespread medical problem until the early 1960s. Second, available reports of changes of the childhood prevalence of stuttering indicate striking parallels between stuttering and the incidence of rheumatic fever, with: (1) decline from the early 1900s; (2) marked decline from the introduction of penicillin in the mid 1940s; and (3) reaching a more stable level in the 1960s. The correlations between the data for stuttering and rheumatic fever after the introduction of penicillin are very high, at about 0.95. Third, there are established biological mechanisms linking GAS tonsillitis to immunological effects on the brain. Also, a small number of more recent case reports have provided further support for the hypothesis linking stuttering to GAS infection. Overall, it is proposed that the available data provides strong evidence for the hypothesis that GAS infection was a major cause of stuttering until the mid-1900s, interacting with genetic predisposition.
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Affiliation(s)
- Per A. Alm
- Department of Neuroscience, Uppsala University, Uppsala, Sweden
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12
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Williamson S, Merritt J, De Benedetto A. Atopic dermatitis in the elderly: a review of clinical and pathophysiological hallmarks. Br J Dermatol 2019; 182:47-54. [PMID: 30895603 DOI: 10.1111/bjd.17896] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/15/2019] [Indexed: 12/29/2022]
Abstract
BACKGROUND Atopic dermatitis (AD) is a multifactorial and complex disease, characterized by an impaired skin barrier function and abnormal immune response. Many elderly patients present with pruritus and xerosis to dermatology, allergy and primary care clinics, and there is a lack of information available to clinicians regarding the proper diagnosis and management of these patients. Although the elderly are described as having a distinct presentation of AD and important comorbidities, most investigations and clinical care guidelines pertaining to AD do not include patients aged 60 years and older as a separate group from younger adults. OBJECTIVES To summarize current information on pathophysiology, diagnosis and management of AD in the elderly population and identify areas of insufficient information to be explored in future investigations. METHODS We carried out a systematic review of published literature, which assessed changes in the skin barrier and immune function with ageing and current information available for physicians to use in the diagnosis and treatment of AD in elderly patients. RESULTS Many age-related changes overlap with key hallmarks observed in AD, most notably a decline in skin barrier function, dysregulation of the innate immune system, and skewing of adaptive immunity to a type-2 T helper cell response, in addition to increased Staphylococcus aureus infection. CONCLUSIONS While general physiological alterations with ageing overlap with key features of AD, a research gap exists regarding specific ageing-related changes in AD disease development. More knowledge about AD in the elderly is needed to establish firm diagnostic and treatment methodologies. What's already known about this topic? Atopic dermatitis (AD) is a common inflammatory skin disease that causes significant burden worldwide. Recently, elderly patients have been considered a subgroup of patients with distinct AD manifestation. Limited studies have characterized the clinical presentation and role of IgE-mediated allergy in elderly patients with AD. What does this study add? This review offers a summary of age-related skin and immune alterations that correspond to pathogenic changes noted in patients with AD. The role of itch, environmental factors and skin microbiota in AD disease presentation in ageing patients is explored.
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Affiliation(s)
- S Williamson
- Department of Dermatology, College of Medicine, University of Florida, Gainesville, FL, U.S.A
| | - J Merritt
- Department of Dermatology, College of Medicine, University of Florida, Gainesville, FL, U.S.A
| | - A De Benedetto
- Department of Dermatology, College of Medicine, University of Florida, Gainesville, FL, U.S.A
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13
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Brandwein M, Fuks G, Israel A, Sabbah F, Hodak E, Szitenberg A, Harari M, Steinberg D, Bentwich Z, Shental N, Meshner S. Skin Microbiome Compositional Changes in Atopic Dermatitis Accompany Dead Sea Climatotherapy. Photochem Photobiol 2019; 95:1446-1453. [PMID: 31074874 DOI: 10.1111/php.13119] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 04/14/2019] [Accepted: 04/26/2019] [Indexed: 12/27/2022]
Abstract
Dead Sea climatotherapy (DSC) is a well-established therapeutic modality for the treatment of several diseases, including atopic dermatitis. Skin microbiome studies have shown that skin microbiome diversity is anticorrelated with both atopic dermatitis severity and concurrent Staphylococcus aureus overgrowth. This study aimed to determine whether DSC induces skin microbiome changes concurrent with clinical improvements in atopic dermatitis. We sampled 35 atopic dermatitis patients and ten healthy controls on both the antecubital and popliteal fossa. High-resolution microbial community profiling was attained by sequencing multiple regions of the 16S rRNA gene. Dysbiosis was observed in both lesional and nonlesional sites, which was partially attenuated following treatment. Severe AD skin underwent the most significant community shifts, and Staphylococcus epidermidis, Streptococcus mitis and Micrococcus luteus relative abundance were significantly affected by Dead Sea climatotherapy. Our study highlights the temporal shifts of the AD skin microbiome induced by Dead Sea climatotherapy and offers potential explanations for the success of climatotherapy on a variety of skin diseases, including AD.
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Affiliation(s)
- Michael Brandwein
- Biofilm Research Laboratory, Institute of Dental Sciences, Faculty of Dental Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel.,Cutaneous Microbiology Laboratory, The Skin Research Institute, The Dead Sea and Arava Science Center, Masada, Israel
| | - Garold Fuks
- Department of Physics of Complex Systems, Weizmann Institute of Science, Rehovot, Israel
| | - Avigail Israel
- Cutaneous Microbiology Laboratory, The Skin Research Institute, The Dead Sea and Arava Science Center, Masada, Israel
| | - Fareed Sabbah
- Department of Dermatology, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel
| | - Emmilia Hodak
- Department of Dermatology, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel
| | - Amir Szitenberg
- Cutaneous Microbiology Laboratory, The Skin Research Institute, The Dead Sea and Arava Science Center, Masada, Israel
| | - Marco Harari
- Cutaneous Microbiology Laboratory, The Skin Research Institute, The Dead Sea and Arava Science Center, Masada, Israel
| | - Droron Steinberg
- Biofilm Research Laboratory, Institute of Dental Sciences, Faculty of Dental Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Zvi Bentwich
- Cutaneous Microbiology Laboratory, The Skin Research Institute, The Dead Sea and Arava Science Center, Masada, Israel
| | - Noam Shental
- Department of Mathematics and Computer Science, The Open University of Israel, Raanana, Israel
| | - Shiri Meshner
- Cutaneous Microbiology Laboratory, The Skin Research Institute, The Dead Sea and Arava Science Center, Masada, Israel
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14
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Abstract
In the past forty-five years, the field of probiotics has grown from a handful of laboratory studies and clinical ideas into a legitimate research and translational entity conferring multiple benefits to humans around the world. This has been founded upon three principles: (i) the need for alterna-tives to drugs that either have sub-optimal efficacy or severe adverse effects; (ii) a growing interest in natural products and microbes, in particular cata-lyzed by studies showing the extent of microbes within humans and on our planet; and (iii) evidence on the genetics and metabolic properties of probi-otic strains, and clinical studies showing their effectiveness. While some man-ufacturers have sadly taken advantage of the market growth to sell supple-ments and foods they term probiotic, without the necessary human study evidence, there are more and more companies basing their formulations on science. Adherence to the definition of what constitutes a probiotic, conclu-sions based on tested products not generalizations of the whole field, and applications emanating from microbiome research identifying new strains that provide benefits, will make the next forty-five years significantly changed approaches to health management. Exciting applications will emerge for car-diovascular, urogenital, respiratory, brain, digestive and skin health, detoxifi-cation, as well as usage across the world's ecosystems.
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Affiliation(s)
- Scarlett Puebla-Barragan
- Departments of Microbiology & Immunology, and Surgery, Western University.,Lawson Health Research Institute
| | - Gregor Reid
- Departments of Microbiology & Immunology, and Surgery, Western University.,Lawson Health Research Institute
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Noh YH, Lee J, Seo SJ, Myung SC. Promoter DNA methylation contributes to human β-defensin-1 deficiency in atopic dermatitis. Anim Cells Syst (Seoul) 2018; 22:172-177. [PMID: 30460095 PMCID: PMC6138329 DOI: 10.1080/19768354.2018.1458652] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Revised: 03/19/2018] [Accepted: 03/21/2018] [Indexed: 01/03/2023] Open
Abstract
Atopic dermatitis (AD) is a chronic inflammatory skin disease caused by epidermal barrier dysfunction and dysregulation of innate and adaptive immunity. Epigenetic regulation of human β-defensin-1 (HBD-1) might be associated with a variety of defects in the innate immune system during AD pathogenesis. We investigated the possible mechanism of decreased HBD-1 gene expression in AD and demonstrated the restoration of HBD-1 transcription in undifferentiated normal human epidermal keratinocyte cells after treatment with a DNA methyltransferase inhibitor. We also conducted an in vitro methylated reporter assay using a reporter containing 14 CpG sites. Methylation of the 14 CpG sites within the HBD-1 5′ region resulted in an approximately 86% reduction in promoter activity and affected HBD-1 transcriptional regulation. We then compared methylation frequencies at CpG 3 and CpG 4 between non-lesional and lesional epidermis samples of patients with severe AD and between these paired tissues and healthy control epidermis from normal volunteers without AD history. Bisulfite pyrosequencing data showed significantly higher methylation frequencies at the CpG 3 and 4 sites in AD lesional samples than in non-lesional AD skin and normal skin samples (P < 0.05). These results suggest that the DNA methylation signature of HBD-1 is a novel diagnostic/prognostic marker and a promising therapeutic target for the compromised stratum corneum barrier attributed to HBD-1 deficiency.
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Affiliation(s)
- Yoo-Hun Noh
- Agricultrual Research Center, Dankook University, Yongin, Republic of Korea
| | - Jaehyouk Lee
- Bio-Integration Research Center for Nutra-Pharmaceutical Epigenetics, Department of Urology, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Seong Joon Seo
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Soon Chul Myung
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Republic of Korea
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16
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Case Studies. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2018; 1069:135-209. [DOI: 10.1007/978-3-319-89354-9_3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Sekiya A, Kono M, Akiyama M. Author's response to the comment to 'Compound heterozygotes for filaggrin gene mutations do not always show severe atopic dermatitis'. J Eur Acad Dermatol Venereol 2017; 32:e178-e179. [PMID: 29136308 DOI: 10.1111/jdv.14688] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- A Sekiya
- Department of Dermatology, Nagoya University Graduate School of Medicine, Nagoya, 466-8550, Japan
| | - M Kono
- Department of Dermatology, Nagoya University Graduate School of Medicine, Nagoya, 466-8550, Japan
| | - M Akiyama
- Department of Dermatology, Nagoya University Graduate School of Medicine, Nagoya, 466-8550, Japan
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18
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Hon KL, Ip M, Wong CK, Chan BCL, Leung PC, Leung TF. In vitro antimicrobial effects of a novel Pentaherbs concoction for atopic dermatitis. J DERMATOL TREAT 2017; 29:235-237. [PMID: 29098912 DOI: 10.1080/09546634.2017.1395804] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND In a series of bench and clinical trials, our group has determined the immunologic effects and clinical efficacy of a concoction of five herbal ingredients (PentaHerbs Formula, PHF) in treating children with atopic eczema (AE). This study investigates the antimicrobial effects that may be induced with PHF treatment. METHODS We investigated the effects of PHF on the minimal inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of Staphylococcus aureus and various bacteria that are commonly present on the skin of patients with AE. RESULTS Staphylococcus aureus ATCC 25923, Methicllin resistant Staphylococcus aureus (MRSA) ATCC BAA-43, Enterococcus faecalis ATCC 29212, Pseudomonas aeruginosa ATCC 27853, Escherichia coli ATCC 25922, Enterobacter cloacae ATCC 13047, Proteus vulgaris ATCC 6380, and Acinetobacter baumannii ATCC 19606 were tested. PHF was more effective against Staphylococcus aureus ATCC 25923 and Methicllin resistant Staphylococcus aureus (MRSA) ATCC BAA-43. MIC and MBC were 1 and 25 mg/mL, respectively. CONCLUSION PHF was more effective against Staphylococcus aureus ATCC 25923 and Methicllin resistant Staphylococcus aureus (MRSA) ATCC BAA-43t. PHF may be developed into a Staphylococcus aureus targeting topical application.
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Affiliation(s)
- Kam Lun Hon
- a Department of Paediatrics , The Chinese University of Hong Kong, Prince of Wales Hospital , Shatin , Hong Kong.,d Institute of Chinese Medicine , The Chinese University of Hong Kong , Hong Kong
| | - Margaret Ip
- b Department of Microbiology , The Chinese University of Hong Kong, Prince of Wales Hospital , Shatin , Hong Kong
| | - Chun Kwok Wong
- c Department of Chemical Pathology , The Chinese University of Hong Kong, Prince of Wales Hospital , Shatin , Hong Kong.,d Institute of Chinese Medicine , The Chinese University of Hong Kong , Hong Kong.,e Partner State Key Laboratory of Phytochemistry and Plant Resources in West China , The Chinese University of Hong Kong , Hong Kong
| | - Ben Chung Lap Chan
- d Institute of Chinese Medicine , The Chinese University of Hong Kong , Hong Kong.,e Partner State Key Laboratory of Phytochemistry and Plant Resources in West China , The Chinese University of Hong Kong , Hong Kong
| | - Ping Chung Leung
- d Institute of Chinese Medicine , The Chinese University of Hong Kong , Hong Kong.,e Partner State Key Laboratory of Phytochemistry and Plant Resources in West China , The Chinese University of Hong Kong , Hong Kong
| | - Ting Fan Leung
- a Department of Paediatrics , The Chinese University of Hong Kong, Prince of Wales Hospital , Shatin , Hong Kong
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Choi YA, Choi JK, Jang YH, Lee S, Lee SR, Choi JH, Park JH, Shin TY, Kim SH. Anti‑inflammatory effect of Amomum xanthioides in a mouse atopic dermatitis model. Mol Med Rep 2017; 16:8964-8972. [PMID: 28990098 DOI: 10.3892/mmr.2017.7695] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Accepted: 08/31/2017] [Indexed: 11/06/2022] Open
Abstract
Atopic dermatitis (AD) is a chronic relapsing inflammatory skin disorder. The present study investigated the effects of Amomum xanthioides extract (AXE) on AD‑like skin inflammation using a Dermatophagoides farinae extract (DFE) and 2,4‑dinitrochlorobenzene (DNCB)‑induced mouse AD model. Hematoxylin and eosin staining results demonstrated that repeated DFE/DNCB exposure markedly increased the thickening of the dermis and epidermis, in addition to the infiltration of eosinophils and mast cells. However, oral administration of AXE reduced these histopathological alterations in a dose‑dependent manner. Elevated serum histamine, total and DFE‑specific immunoglobulin E (IgE), and IgG2a were also decreased by treatment with AXE. In addition, reverse transcription‑quantitative polymerase chain reaction (RT‑qPCR) results demonstrated that the mRNA expression of tumor necrosis factor (TNF)‑α, interferon (IFN)‑γ, interleukin (IL)‑4, IL‑13, IL‑31 and IL‑17A was reduced in ear skin following AXE administration in AD mice. Fluorescence‑activated cell sorting demonstrated that the population of CD4+/IL‑4+, CD4+/IFN‑γ+ and CD4+/IL‑17A+ cells in draining lymph nodes was also significantly decreased in AXE‑treated mice compared with AD mice without AXE treatment. Furthermore, keratinocytes that were stimulated with TNF‑α and IFN‑γ exhibited increased gene expression of pro‑inflammatory cytokines and chemokines, including TNF‑α, IL‑1β, IL‑6, IL‑8, C‑C motif chemokine ligand (CCL)17 and CCL22, as determined by RT‑qPCR. However, upregulation of these genes was reduced by AXE pretreatment. Based on these results, we hypothesize that AXE may be useful in the treatment of allergic skin inflammation, particularly AD.
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Affiliation(s)
- Young-Ae Choi
- Department of Pharmacology, Cell and Matrix Research Institute, School of Medicine, Kyungpook National University, Daegu 41944, Republic of Korea
| | - Jin Kyeong Choi
- Department of Pharmacology, Cell and Matrix Research Institute, School of Medicine, Kyungpook National University, Daegu 41944, Republic of Korea
| | - Yong Hyun Jang
- Department of Dermatology, School of Medicine, Kyungpook National University, Daegu 41944, Republic of Korea
| | - Soyoung Lee
- Immunoregulatory Materials Research Center, Korea Research Institute of Bioscience and Biotechnology, Jeongeup, Jeollabuk‑do 56212, Republic of Korea
| | - Sang-Rae Lee
- National Primate Research Center, Korea Research Institute of Bioscience and Biotechnology, Cheongju, Chungcheongbuk‑do 28116, Republic of Korea
| | - Jung Ho Choi
- R&D Center Pharmaceutical Laboratory, Korean Drug Co., Ltd., Seoul 06300, Republic of Korea
| | - Jee Hun Park
- R&D Center Pharmaceutical Laboratory, Korean Drug Co., Ltd., Seoul 06300, Republic of Korea
| | - Tae-Yong Shin
- Department of Pharmacy, College of Pharmacy, Woosuk University, Samrye, Jeollabuk‑do 55338, Republic of Korea
| | - Sang-Hyun Kim
- Department of Pharmacology, Cell and Matrix Research Institute, School of Medicine, Kyungpook National University, Daegu 41944, Republic of Korea
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Knaysi G, Smith AR, Wilson JM, Wisniewski JA. The Skin as a Route of Allergen Exposure: Part II. Allergens and Role of the Microbiome and Environmental Exposures. Curr Allergy Asthma Rep 2017; 17:7. [PMID: 28210979 DOI: 10.1007/s11882-017-0675-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
PURPOSE OF REVIEW This second part of the article aims to highlight recent contributions in the literature that enhance our understanding of the cutaneous immune response to allergen. RECENT FINDINGS Several properties of allergens facilitate barrier disruption and cutaneous sensitization. There is a strong epidemiologic relationship between the microbiome, both the gut and skin, and atopic dermatitis (AD). The mechanisms connecting these two entities remain enigmatic; however, recent murine models show that commensal skin bacteria play an active role in supporting skin barrier homeostasis and defense against microbial penetration. Likewise, the association between the lack of colonization with Staph species and AD development suggests a potentially functional role for these organisms in regulating the skin barrier and response to environmental allergens. In undisrupted skin, evidence suggests that the cutaneous route may promote allergen tolerance. Properties of environmental allergens and commensal bacteria add to the complex landscape of skin immunity. Further investigation is needed to elucidate how these properties regulate the cutaneous immune response to allergen.
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Affiliation(s)
- George Knaysi
- Department of Public Health Sciences, University of Virginia School of Medicine, Charlottesville, VA, 22908, USA
- Geisel School of Medicine, Dartmouth College, 1 Rope Ferry Road, Hanover, NH, 03755, USA
| | - Anna R Smith
- Department of Medicine, University of Virginia School of Medicine, Charlottesville, VA, 22908, USA
| | - Jeffrey M Wilson
- Department of Medicine, University of Virginia School of Medicine, Charlottesville, VA, 22908, USA
| | - Julia A Wisniewski
- Department of Medicine, University of Virginia School of Medicine, Charlottesville, VA, 22908, USA.
- Department of Pediatrics, University of Virginia School of Medicine, Charlottesville, VA, 22908, USA.
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Hepburn L, Hijnen D, Sellman B, Mustelin T, Sleeman M, May R, Strickland I. The complex biology and contribution of Staphylococcus aureus
in atopic dermatitis, current and future therapies. Br J Dermatol 2017; 177:63-71. [DOI: 10.1111/bjd.15139] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/15/2016] [Indexed: 12/22/2022]
Affiliation(s)
- L. Hepburn
- MedImmune; Milstein Building; Granta Park; Cambridge CB21 6GH U.K
| | - D.J. Hijnen
- University Medical Center Utrecht; Department of Dermatology; Utrecht the Netherlands
| | | | | | - M.A. Sleeman
- MedImmune; Milstein Building; Granta Park; Cambridge CB21 6GH U.K
| | - R.D. May
- MedImmune; Milstein Building; Granta Park; Cambridge CB21 6GH U.K
| | - I. Strickland
- MedImmune; Milstein Building; Granta Park; Cambridge CB21 6GH U.K
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Domínguez-Hüttinger E, Christodoulides P, Miyauchi K, Irvine AD, Okada-Hatakeyama M, Kubo M, Tanaka RJ. Mathematical modeling of atopic dermatitis reveals “double-switch” mechanisms underlying 4 common disease phenotypes. J Allergy Clin Immunol 2017; 139:1861-1872.e7. [DOI: 10.1016/j.jaci.2016.10.026] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 10/07/2016] [Accepted: 10/26/2016] [Indexed: 12/22/2022]
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23
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Can C, Yazıcıoğlu M, Gürkan H, Tozkır H, Görgülü A, Süt NH. Lack of Association Between Toll-like Receptor 2 Polymorphisms (R753Q and A-16934T) and Atopic Dermatitis in Children from Thrace Region of Turkey. Balkan Med J 2017; 34:232-238. [PMID: 28443596 PMCID: PMC5450863 DOI: 10.4274/balkanmedj.2015.1253] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Accepted: 12/31/2016] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Atopic dermatitis is the most common chronic inflammatory skin disease. A complex interaction of both genetic and environmental factors is thought to contribute to the disease. AIMS To evaluate whether single nucleotide polymorphisms in the TLR2 gene c.2258C>T (R753Q) (rs5743708) and TLR2 c.-148+1614T>A (A-16934T) (rs4696480) (NM_0032643) are associated with atopic dermatitis in Turkish children. STUDY DESIGN Case-control study. METHODS The study was conducted on 70 Turkish children with atopic dermatitis aged 0.5-18 years. The clinical severity of atopic dermatitis was evaluated by the severity scoring of atopic dermatitis index. Serum total IgE levels, specific IgE antibodies to inhalant and food allergens were measured in both atopic dermatitis patients and controls, skin prick tests were done on 70 children with atopic dermatitis. Genotyping for TLR2 (R753Q and A-16934T) single nucleotide polymorphisms was performed in both atopic dermatitis patients and controls. RESULTS Cytosine-cytosine and cytosin-thymine genotype frequencies of the TLR2 R753Q single nucleotide polymorphism in the atopic dermatitis group were determined as being 98.6% and 1.4%, cytosine allele frequency for TLR2 R753Q single nucleotide polymorphism was determined as 99.29% and the thymine allele frequency was 0.71%, thymine-thymine, thymine-adenine, and adenine-adenine genotype frequencies of the TLR2 A-16934T single nucleotide polymorphism were 24.3%, 44.3%, and 31.4%. The thymine allele frequency for the TLR2 A-16934T single nucleotide polymorphism in the atopic dermatitis group was 46.43%, and the adenine allele frequency was 53.57%, respectively. There was not statistically significant difference between the groups for all investigated polymorphisms (p>0.05). For all single nucleotide polymorphisms studied, allelic distribution was analogous among atopic dermatitis patients and controls, and no significant statistical difference was observed. No homozygous carriers of the TLR2 R753Q single nucleotide polymorphism were found in the atopic dermatitis and control groups. CONCLUSION The TLR2 (R753Q and A-16934T) single nucleotide polymorphisms are not associated with atopic dermatitis in a group of Turkish patients.
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Affiliation(s)
- Ceren Can
- Department of Pediatric Allergy and Immunology, Trakya University School of Medicine, Edirne, Turkey
| | - Mehtap Yazıcıoğlu
- Department of Pediatric Allergy and Immunology, Trakya University School of Medicine, Edirne, Turkey
| | - Hakan Gürkan
- Department of Genetics, Trakya University School of Medicine, Edirne, Turkey
| | - Hilmi Tozkır
- Department of Genetics, Trakya University School of Medicine, Edirne, Turkey
| | - Adnan Görgülü
- Department of Dermatology, Trakya University School of Medicine, Edirne, Turkey
| | - Necdet Hilmi Süt
- Department of Biostatistics, Trakya University School of Medicine, Edirne, Turkey
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Jain C, Das S, Ramachandran VG, Saha R, Bhattacharya SN, Dar S. Malassezia Yeast and Cytokine Gene Polymorphism in Atopic Dermatitis. J Clin Diagn Res 2017; 11:DC01-DC05. [PMID: 28511379 DOI: 10.7860/jcdr/2017/23948.9474] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Accepted: 12/28/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Atopic Dermatitis (AD) is a recurrent chronic condition associated with microorganism and their interaction with the susceptible host. Malassezia yeast is a known commensal which is thought to provoke the recurrent episodes of symptoms in atopic dermatitis patients. Malassezia immunomodulatory properties along with defective skin barrier in such host, results in disease manifestation. Here, we studied Single Nucleotide Polymorphism (SNP) in IL10 and IFN γ genes of the host and its relation with susceptibility to Malassezia infection. AIM To isolate Malassezia yeast from AD patients and compare the genetic susceptibility of the host by correlating the cytokine gene polymorphism with the control subjects. MATERIALS AND METHODS Study was conducted from January 2012 to January 2013. It was a prospective observational study done in Department of Microbiology and Department of Dermatology and Venereology in University College of Medical Sciences and GTB Hospital, Delhi. Sample size comprised of 38 cases each of AD. Skin scrapings were used for fungal culture on Sabouraud Dextrose Agar (SDA) and Modified Dixon Agar (MDA) and isolated were identified as per conventional phenotypic methods. Genomic DNA was extracted from blood samples collected from all study subjects. Cytokine genotyping was carried out by Amplification Refractory Mutations System- Polymerase Chain Reaction (ARMS-PCR) with sequence specific primers. Three SNPs (IL10-1082A/G; IL10-819/592C/T; IFN-γ+874A/T) in two cytokine genes were assessed in all the patients and healthy controls. STATISTICAL ANALYSIS Chi-Square Test or Fisher's-Exact Test and Bonferroni's correction. RESULTS In AD group, Malassezia yeasts were cultured in 24 out of 38 samples and thus the identification rate was 63.1 percent as compared to healthy group, 52.6 percent (20/38). Significant difference in allele, or genotype distribution were observed in IL10-819/592C/T and IFN-γ+874A/T gene polymorphism in AD group. CONCLUSION Higher isolation rate in cases as compared to control group highlights the implication of Malassezia in AD. Association between specific cytokine gene polymorphism and clinical outcome was found to be significant in study group. The result of cytokine gene polymorphism in the present study demonstrated susceptibility of host to Malassezia infection.
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Affiliation(s)
- Charu Jain
- Senior Resident, Department of Microbiology, UCMS and GTB Hospital, Delhi, India
| | - Shukla Das
- Professor, Department of Microbiology, UCMS and GTB Hospital, Delhi, India
| | - V G Ramachandran
- Professor, Department of Microbiology, UCMS and GTB Hospital, Delhi, India
| | - Rumpa Saha
- Assistant Professor, Department of Microbiology, UCMS and GTB Hospital, Delhi, India
| | - S N Bhattacharya
- Professor and Head, Department of Dermatology and Venerology, UCMS and GTB Hospital, Delhi, India
| | - Sajad Dar
- PhD Student, Department of Microbiology, UCMS and GTB Hospital, Delhi, India
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Bin L, Leung DYM. Genetic and epigenetic studies of atopic dermatitis. ALLERGY, ASTHMA, AND CLINICAL IMMUNOLOGY : OFFICIAL JOURNAL OF THE CANADIAN SOCIETY OF ALLERGY AND CLINICAL IMMUNOLOGY 2016; 12:52. [PMID: 27777593 PMCID: PMC5069938 DOI: 10.1186/s13223-016-0158-5] [Citation(s) in RCA: 155] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Accepted: 10/04/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND Atopic dermatitis (AD) is a chronic inflammatory disease caused by the complex interaction of genetic, immune and environmental factors. There have many recent discoveries involving the genetic and epigenetic studies of AD. METHODS A retrospective PubMed search was carried out from June 2009 to June 2016 using the terms "atopic dermatitis", "association", "eczema", "gene", "polymorphism", "mutation", "variant", "genome wide association study", "microarray" "gene profiling", "RNA sequencing", "epigenetics" and "microRNA". A total of 132 publications in English were identified. RESULTS To elucidate the genetic factors for AD pathogenesis, candidate gene association studies, genome-wide association studies (GWAS) and transcriptomic profiling assays have been performed in this period. Epigenetic mechanisms for AD development, including genomic DNA modification and microRNA posttranscriptional regulation, have been explored. To date, candidate gene association studies indicate that filaggrin (FLG) null gene mutations are the most significant known risk factor for AD, and genes in the type 2 T helper lymphocyte (Th2) signaling pathways are the second replicated genetic risk factor for AD. GWAS studies identified 34 risk loci for AD, these loci also suggest that genes in immune responses and epidermal skin barrier functions are associated with AD. Additionally, gene profiling assays demonstrated AD is associated with decreased gene expression of epidermal differentiation complex genes and elevated Th2 and Th17 genes. Hypomethylation of TSLP and FCER1G in AD were reported; and miR-155, which target the immune suppressor CTLA-4, was found to be significantly over-expressed in infiltrating T cells in AD skin lesions. CONCLUSIONS The results suggest that two major biologic pathways are responsible for AD etiology: skin epithelial function and innate/adaptive immune responses. The dysfunctional epidermal barrier and immune responses reciprocally affect each other, and thereby drive development of AD.
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Affiliation(s)
- Lianghua Bin
- The Department of Dermatology, the First Affiliated Hospital, Jinan University, Guangzhou, China
- Biomedical Translational Research Institute, Jinan University, Guangzhou, China
- Department of Pediatrics, National Jewish Health, 1400 Jackson Street, Room K926i, Denver, CO 80206 USA
| | - Donald Y. M. Leung
- Department of Pediatrics, National Jewish Health, 1400 Jackson Street, Room K926i, Denver, CO 80206 USA
- Guangdong Provincial Key Laboratory of Allergy & Clinical Immunology, The State Key Clinical Specialty in Allergy, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
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López-Álvarez MR, Jiang W, Jones DC, Jayaraman J, Johnson C, Cookson WO, Moffatt MF, Trowsdale J, Traherne JA. LILRA6 copy number variation correlates with susceptibility to atopic dermatitis. Immunogenetics 2016; 68:743-7. [PMID: 27333811 PMCID: PMC5026711 DOI: 10.1007/s00251-016-0924-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Accepted: 06/10/2016] [Indexed: 02/06/2023]
Abstract
Leukocyte immunoglobulin-like receptors (LILR) are expressed mostly on myelomonocytic cells where they are mediators of immunological tolerance. Two LILR genes, LILRA3 and LILRA6, exhibit marked copy number variation. We assessed the contribution of these genes to atopic dermatitis (AD) by analysing transmission in 378 AD families. The data indicated that copies of LILRA6 were over-transmitted to affected patients. They are consistent with a contribution of LILR genes to AD. They could affect the equilibrium between activating and inhibitory signals in the immune response.
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Affiliation(s)
- M R López-Álvarez
- Immunology Division, Department of Pathology, University of Cambridge, Tennis Court Road, Cambridge, CB2 1QP, UK
| | - W Jiang
- Cambridge Institute for Medical Research, University of Cambridge, Cambridge Biomedical Campus, Wellcome Trust/MRC Building, Hills Road, Cambridge, CB2 0XY, UK
| | - D C Jones
- Immunology Division, Department of Pathology, University of Cambridge, Tennis Court Road, Cambridge, CB2 1QP, UK
| | - J Jayaraman
- Cambridge Institute for Medical Research, University of Cambridge, Cambridge Biomedical Campus, Wellcome Trust/MRC Building, Hills Road, Cambridge, CB2 0XY, UK
| | - C Johnson
- Immunology Division, Department of Pathology, University of Cambridge, Tennis Court Road, Cambridge, CB2 1QP, UK.,Cambridge Institute for Medical Research, University of Cambridge, Cambridge Biomedical Campus, Wellcome Trust/MRC Building, Hills Road, Cambridge, CB2 0XY, UK.,Molecular Genetics and Genomics Section, National Heart and Lung Institute, Imperial College London, Dovehouse Street, London, SW3 6LY, UK
| | - W O Cookson
- Molecular Genetics and Genomics Section, National Heart and Lung Institute, Imperial College London, Dovehouse Street, London, SW3 6LY, UK
| | - M F Moffatt
- Molecular Genetics and Genomics Section, National Heart and Lung Institute, Imperial College London, Dovehouse Street, London, SW3 6LY, UK
| | - J Trowsdale
- Immunology Division, Department of Pathology, University of Cambridge, Tennis Court Road, Cambridge, CB2 1QP, UK.,Cambridge Institute for Medical Research, University of Cambridge, Cambridge Biomedical Campus, Wellcome Trust/MRC Building, Hills Road, Cambridge, CB2 0XY, UK
| | - J A Traherne
- Immunology Division, Department of Pathology, University of Cambridge, Tennis Court Road, Cambridge, CB2 1QP, UK. .,Cambridge Institute for Medical Research, University of Cambridge, Cambridge Biomedical Campus, Wellcome Trust/MRC Building, Hills Road, Cambridge, CB2 0XY, UK.
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Yu Y, Zhang Y, Zhang J, Dou X, Yang H, Shao Y, Wang K, Yu B, Zhang W, Lau HYA. Impaired Toll-like receptor 2-mediated Th1 and Th17/22 cytokines secretion in human peripheral blood mononuclear cells from patients with atopic dermatitis. J Transl Med 2015; 13:384. [PMID: 26682905 PMCID: PMC4683963 DOI: 10.1186/s12967-015-0744-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Accepted: 11/30/2015] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Impaired Toll-like receptor 2 (TLR2) function has been associated with the pathogenesis of atopic dermatitis (AD). However, there are only few studies reporting on the TLR2-induced immunological responses of circulating leucocytes of AD patients. We thus investigated the expression and secretion of Th1, Th2 and Th17/22 cytokines triggered by TLR2 ligands in human peripheral blood mononuclear cells (PBMCs) from AD patients. Expression of TLR2, 1, 6 and high-affinity receptor for IgE (FcεRI) were further investigated to evaluate the outcome of immune response in AD. METHODS Expression of TLR2, 1, 6 and FcεRI in PBMCs from AD patients and healthy individuals were measured by qPCR. Subsequent to stimulation with TLR2 ligands PGN and Pam3CSK4, expression and secretion of Th1, Th2 and Th17/22 cytokines were investigated by qPCR and ELISA. RESULTS The levels of TLR2, 1, 6 mRNA were not altered in both groups of subjects while that of FcεRI was increased in AD patients. Subsequent to the activation by TLR2 ligands, PBMCs from AD patients significantly released less IFN-γ, IL-17F and IL-22 than those from healthy controls while no detectable level of release was observed with the other cytokines. In contrast, significantly higher levels of mRNA expression for TNF-α, IL5, IL-17A and IL-22 were observed in TLR2 activated PBMCs of AD patients than those of healthy control. CONCLUSIONS PBMCs from AD patients are defective in the secretion of Th1 and Th17/22 cytokines in response to TLR2 ligands. The inconsistent increased expression of the mRNA for the corresponding Th1 cytokines and the Th2 cytokines IL-5 suggested that there may be alterations of downstream signaling events in the cytokine release mechanisms of PBMCs that are associated with the development of AD.
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Affiliation(s)
- Yangyang Yu
- School of Medicine, Shenzhen University, Shenzhen, Guangdong, China.
- Shenzhen Key Laboratory for Translational Medicine of Dermatology, Biomedical Research Institute, Shenzhen Peking University-The Hong Kong University of Science and Technology Medical Center, No. 1120, Lianhua Road, Futian District, Shenzhen, 518036, Guangdong, China.
| | - Yarui Zhang
- Shenzhen Key Laboratory for Translational Medicine of Dermatology, Biomedical Research Institute, Shenzhen Peking University-The Hong Kong University of Science and Technology Medical Center, No. 1120, Lianhua Road, Futian District, Shenzhen, 518036, Guangdong, China.
| | - Jie Zhang
- Department of Dermatology, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China.
| | - Xia Dou
- Department of Dermatology, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China.
| | - Hong Yang
- Department of Clinical Laboratory, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China.
| | - Yong Shao
- Shenzhen Key Laboratory for Translational Medicine of Dermatology, Biomedical Research Institute, Shenzhen Peking University-The Hong Kong University of Science and Technology Medical Center, No. 1120, Lianhua Road, Futian District, Shenzhen, 518036, Guangdong, China.
- Department of Dermatology, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China.
| | - Kepeng Wang
- Shenzhen Key Laboratory for Translational Medicine of Dermatology, Biomedical Research Institute, Shenzhen Peking University-The Hong Kong University of Science and Technology Medical Center, No. 1120, Lianhua Road, Futian District, Shenzhen, 518036, Guangdong, China.
| | - Bo Yu
- Shenzhen Key Laboratory for Translational Medicine of Dermatology, Biomedical Research Institute, Shenzhen Peking University-The Hong Kong University of Science and Technology Medical Center, No. 1120, Lianhua Road, Futian District, Shenzhen, 518036, Guangdong, China.
- Department of Dermatology, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China.
| | - Wei Zhang
- Shenzhen Key Laboratory for Translational Medicine of Dermatology, Biomedical Research Institute, Shenzhen Peking University-The Hong Kong University of Science and Technology Medical Center, No. 1120, Lianhua Road, Futian District, Shenzhen, 518036, Guangdong, China.
| | - Hang Yung Alaster Lau
- School of Biomedical Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR, China.
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Billeci L, Tonacci A, Tartarisco G, Ruta L, Pioggia G, Gangemi S. Association Between Atopic Dermatitis and Autism Spectrum Disorders: A Systematic Review. Am J Clin Dermatol 2015; 16:371-88. [PMID: 26254000 DOI: 10.1007/s40257-015-0145-5] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Atopic dermatitis (AD) is an allergic disorder caused by both immunological dysregulation and epidermal barrier defect. Several studies have investigated the association between AD and mental health disorders. Autism spectrum disorders (ASD) are a heterogeneous group of neurodevelopmental conditions characterized by impairments in social communication and restricted, stereotyped interests and behaviors. The concurrent increased prevalence of AD and ASD in the last decades has led many scientists to investigate the relationship between the two diseases. OBJECTIVE The aim of this systematic review was to examine the association between AD and ASD. METHODS A systematic review was performed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. PubMed and ScienceDirect were searched up to March 2015 for all reports examining the association between ASD and AD. Descriptive statistics of the studies are reported. RESULTS The review included 18 studies assessing the association between ASD and AD. Of these studies, two focused on ASD in relation to AD alone, 14 discussed ASD in relation to both AD and other atopic disorders, and two evaluated AD in parents of children with ASD. Most of these studies found a positive association between the two disorders, although there were some studies going in the opposite direction. The entity of the association is somewhat inconsistent among the different studies given that the frequencies of AD in ASD compared with a control group ranged from 7 to 64.2%. In addition, odds ratios (ORs) or hazard ratios (HRs) gave different results as three studies found a weak association with an OR below 2 and a nonsignificant p value, and three other studies found a moderate or strong association with an OR ranging from 1.52 to 7.17 and a significant p value. When all atopic disorders were considered when evaluating the risk of ASD, the association was strong with an HR of 3.4 or an OR of 1.24 and p < 0.001. CONCLUSIONS Overall, the results of this systematic review seem to reveal an association between ASD and AD, suggesting that subjects with ASD have an increased risk of presenting with AD compared with typically developing controls, and vice versa. This association is supported by clinical/epidemiological aspects, shared genetic background and common immunological and autoimmune processes. However, the variability in study population and design, and the presence of other risk factors acting as confounding factors, sometimes contribute to inconsistent results. Further studies are needed to clarify the underlying pathophysiologic mechanism explaining the association between ASD and AD and to explore the causal association between the two conditions.
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Affiliation(s)
- Lucia Billeci
- National Research Council of Italy, Institute of Clinical Physiology, IFC-CNR, Pisa Unit, Pisa, Italy
| | - Alessandro Tonacci
- National Research Council of Italy, Institute of Clinical Physiology, IFC-CNR, Pisa Unit, Pisa, Italy
| | - Gennaro Tartarisco
- National Research Council of Italy, Institute of Clinical Physiology, IFC-CNR, Messina Unit, Via C. Valeria, SNC, 98125, Messina, Italy
| | - Liliana Ruta
- National Research Council of Italy, Institute of Clinical Physiology, IFC-CNR, Messina Unit, Via C. Valeria, SNC, 98125, Messina, Italy
- Department of Developmental Neuroscience, Stella Maris Scientific Institute, Calambrone, Pisa, Italy
| | - Giovanni Pioggia
- National Research Council of Italy, Institute of Clinical Physiology, IFC-CNR, Messina Unit, Via C. Valeria, SNC, 98125, Messina, Italy.
| | - Sebastiano Gangemi
- School and Division of Allergy and Clinical Immunology, Department of Clinical and Experimental Medicine, University Hospital "G. Martino", Messina, Italy
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Glatz M, Bosshard PP, Hoetzenecker W, Schmid-Grendelmeier P. The Role of Malassezia spp. in Atopic Dermatitis. J Clin Med 2015; 4:1217-28. [PMID: 26239555 PMCID: PMC4484996 DOI: 10.3390/jcm4061217] [Citation(s) in RCA: 86] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Revised: 05/19/2015] [Accepted: 05/22/2015] [Indexed: 12/20/2022] Open
Abstract
Malassezia spp. is a genus of lipophilic yeasts and comprises the most common fungi on healthy human skin. Despite its role as a commensal on healthy human skin, Malassezia spp. is attributed a pathogenic role in atopic dermatitis. The mechanisms by which Malassezia spp. may contribute to the pathogenesis of atopic dermatitis are not fully understood. Here, we review the latest findings on the pathogenetic role of Malassezia spp. in atopic dermatitis (AD). For example, Malassezia spp. produces a variety of immunogenic proteins that elicit the production of specific IgE antibodies and may induce the release of pro-inflammatory cytokines. In addition, Malassezia spp. induces auto-reactive T cells that cross-react between fungal proteins and their human counterparts. These mechanisms contribute to skin inflammation in atopic dermatitis and therefore influence the course of this disorder. Finally, we discuss the possible benefit of an anti-Malassezia spp. treatment in patients with atopic dermatitis.
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Affiliation(s)
- Martin Glatz
- Allergy Unit, Department of Dermatology, University Hospital of Zurich, Gloriastrasse 31, 8091 Zurich, Switzerland.
| | - Philipp P Bosshard
- Allergy Unit, Department of Dermatology, University Hospital of Zurich, Gloriastrasse 31, 8091 Zurich, Switzerland.
| | - Wolfram Hoetzenecker
- Allergy Unit, Department of Dermatology, University Hospital of Zurich, Gloriastrasse 31, 8091 Zurich, Switzerland.
| | - Peter Schmid-Grendelmeier
- Allergy Unit, Department of Dermatology, University Hospital of Zurich, Gloriastrasse 31, 8091 Zurich, Switzerland.
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Nutten S. Atopic dermatitis: global epidemiology and risk factors. ANNALS OF NUTRITION AND METABOLISM 2015; 66 Suppl 1:8-16. [PMID: 25925336 DOI: 10.1159/000370220] [Citation(s) in RCA: 643] [Impact Index Per Article: 71.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Atopic dermatitis (AD) is a chronic inflammatory skin disease posing a significant burden on health-care resources and patients' quality of life. It is a complex disease with a wide spectrum of clinical presentations and combinations of symptoms. AD affects up to 20% of children and up to 3% of adults; recent data show that its prevalence is still increasing, especially in low-income countries. First manifestations of AD usually appear early in life and often precede other allergic diseases such as asthma or allergic rhinitis. Individuals affected by AD usually have genetically determined risk factors affecting the skin barrier function or the immune system. However, genetic mutations alone might not be enough to cause clinical manifestations of AD, and it is merely the interaction of a dysfunctional epidermal barrier in genetically predisposed individuals with harmful effects of environmental agents which leads to the development of the disease. AD has been described as an allergic skin disease, but today, the contribution of allergic reactions to the initiation of AD is challenged, and it is proposed that allergy is rather a consequence of AD in subjects with a concomitant underlying atopic constitution. Treatment at best achieves symptom control rather than cure; there is thus a strong need to identify alternatives for disease prevention.
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Affiliation(s)
- Sophie Nutten
- Nutrition and Health Department, Nestlé Research Center, Lausanne, Switzerland
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Hong CH, Chang KL, Wang HJ, Yu HS, Lee CH. IL-9 induces IL-8 production via STIM1 activation and ERK phosphorylation in epidermal keratinocytes: A plausible mechanism of IL-9R in atopic dermatitis. J Dermatol Sci 2015; 78:206-14. [PMID: 25840641 DOI: 10.1016/j.jdermsci.2015.03.004] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Revised: 03/02/2015] [Accepted: 03/03/2015] [Indexed: 02/01/2023]
Abstract
BACKGROUND IL-9 and its receptor play important roles in the pathogenesis of asthma. Its role in atopic dermatitis (AD) was examined in just a few studies, including nucleotide polymorphisms, increased transcriptional levels of IL-9 and IL-9R in diseased skin, and an association of blood IL-9 levels with clinical severity. OBJECTIVE Little was known about the pathophysiological regulation of IL-9/IL-9R in AD skin. We asked whether IL-9R was expressed in epidermal keratinocytes; if so, what the functional outcome, cytokine production, and signaling pathway of IL-9/IL-9R in keratinocytes are. METHODS We measured and compared the expression of IL-9R in skin from AD patients and controls by immunofluorescence. We also performed in vitro studies on the IL-9-treated primary keratinocytes, including flow cytometry for IL-9R expressions, Western blotting for mTOR, S6K, ERK, p38, and STAT3 activations, ELISA for cytokine levels, and immunofluorescence for STIM1. RESULTS We found that IL-9R was indeed expressed in keratinocytes but not in fibroblasts. Its expression in keratinocytes was enhanced by IL-4 but not by TGF-beta1. IL-9 induced a moderate production of IL-8 but not CXCL16, CCL22, TSLP, nor IL-33. IL-9 induced formation of STIM1-puncta. IL-9 induced ERK phosphorylation both dose- and time-dependently, but not mTOR, S6K, p38, or STAT3. Pretreatment with U0126 (ERK inhibitor) but not rapamycin (mTOR inhibitor) abrogated the IL-9-mediated IL-8 production. Blockage of STIM1 with BTP2 or SKF96265 abrogated ERK phosphorylation and IL-8 production induced by IL-9. CONCLUSION This study represents the first to show the regulation of the IL-9-STIM1-ERK-IL-8 axis in keratinocyte, and how the axis might play an important role in the pathophysiology of AD.
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Affiliation(s)
- Chien-Hui Hong
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Dermatology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; Department of Dermatology, National Yang-Ming University College of Medicine, Taipei, Taiwan
| | - Kee-Lung Chang
- Department of Biochemistry, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Hung-Jen Wang
- Department of Urology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Hsin-Su Yu
- Department of Dermatology, Kaohsiung Medical University, Kaohsiung, Taiwan; National Environmental Health Research Center, National Health Research Institute, Miao-Li, Taiwan.
| | - Chih-Hung Lee
- Department of Dermatology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan; Department of Dermatology, Chang Gung University College of Medicine, Taoyuan, Taiwan.
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Red face revisited: Endogenous dermatitis in the form of atopic dermatitis and seborrheic dermatitis. Clin Dermatol 2014; 32:109-15. [PMID: 24314384 DOI: 10.1016/j.clindermatol.2013.05.032] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Atopic dermatitis and seborrheic dermatitis are multifactorial dermatitides that are known collectively as endogenous dermatitis. Both conditions can affect the face, but they have clinical, epidemiological, and physiopathological peculiarities that distinguish them from each other. These two diseases are very common all around the world. Atopic dermatitis is associated with xerosis and increased susceptibility to irritants and proteins; patients with this condition have a tendency to develop asthma, allergic rhinitis, and systemic manifestations that are mediated by immunoglobulin E. Seborrheic dermatitis is a moderate chronic dermatitis that is restricted to regions with a high production of sebum and areas that have cutaneous folds. There are many studies about pathophysiology related to the immunology and genetics of atopic dermatitis, but little is known about the genetic and immunological markers of seborrheic dermatitis.
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ZHANG ZHONGKUI, YANG YONG, BAI SHURONG, ZHANG GUIZHEN, LIU TAIHUA, ZHOU ZHOU, WANG CHUNMEI, TANG LIJUN, WANG JUN, HE SIXIAN. Screening for key genes associated with atopic dermatitis with DNA microarrays. Mol Med Rep 2014; 9:1049-55. [DOI: 10.3892/mmr.2014.1908] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2013] [Accepted: 12/16/2013] [Indexed: 11/05/2022] Open
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Taïeb A. Molecular genetics of the epidermal differentiation complex: perspectives for dermatology and medicine or the ‘purloined letter syndrome’. ACTA ACUST UNITED AC 2014. [DOI: 10.1586/17469872.2.2.105] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Toda M, Nakamura T, Ohbayashi M, Ikeda Y, Dawson M, Aye CC, Miyazaki D, Ono SJ. Mechanisms of leukocyte trafficking in allergic diseases: insights into new therapies targeting chemokines and chemokine receptors. Expert Rev Clin Immunol 2014; 3:351-64. [DOI: 10.1586/1744666x.3.3.351] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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Sollid J, Furberg A, Hanssen A, Johannessen M. Staphylococcus aureus: Determinants of human carriage. INFECTION GENETICS AND EVOLUTION 2014; 21:531-41. [DOI: 10.1016/j.meegid.2013.03.020] [Citation(s) in RCA: 125] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2013] [Revised: 03/15/2013] [Accepted: 03/16/2013] [Indexed: 02/02/2023]
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Salimi M, Barlow JL, Saunders SP, Xue L, Gutowska-Owsiak D, Wang X, Huang LC, Johnson D, Scanlon ST, McKenzie ANJ, Fallon PG, Ogg GS. A role for IL-25 and IL-33-driven type-2 innate lymphoid cells in atopic dermatitis. ACTA ACUST UNITED AC 2013; 210:2939-50. [PMID: 24323357 PMCID: PMC3865470 DOI: 10.1084/jem.20130351] [Citation(s) in RCA: 720] [Impact Index Per Article: 65.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Type 2 innate lymphoid cells promote skin inflammation in mice and men, in part by producing IL-5 and IL-13 in response to IL-33 Type 2 innate lymphoid cells (ILC2s, nuocytes, NHC) require RORA and GATA3 for their development. We show that human ILC2s express skin homing receptors and infiltrate the skin after allergen challenge, where they produce the type 2 cytokines IL-5 and IL-13. Skin-derived ILC2s express the IL-33 receptor ST2, which is up-regulated during activation, and are enriched in lesional skin biopsies from atopic patients. Signaling via IL-33 induces type 2 cytokine and amphiregulin expression, and increases ILC2 migration. Furthermore, we demonstrate that E-cadherin ligation on human ILC2 dramatically inhibits IL-5 and IL-13 production. Interestingly, down-regulation of E-cadherin is characteristic of filaggrin insufficiency, a cardinal feature of atopic dermatitis (AD). ILC2 may contribute to increases in type 2 cytokine production in the absence of the suppressive E-cadherin ligation through this novel mechanism of barrier sensing. Using Rag1−/− and RORα-deficient mice, we confirm that ILC2s are present in mouse skin and promote AD-like inflammation. IL-25 and IL-33 are the predominant ILC2-inducing cytokines in this model. The presence of ILC2s in skin, and their production of type 2 cytokines in response to IL-33, identifies a role for ILC2s in the pathogenesis of cutaneous atopic disease.
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Affiliation(s)
- Maryam Salimi
- Medical Research Council (MRC) Human Immunology Unit, National Institute for Health Research Biomedical Research Centre, Radcliffe Department of Medicine, University of Oxford, Oxford OX3 9DS, England, UK
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Domínguez-Hüttinger E, Ono M, Barahona M, Tanaka RJ. Risk factor-dependent dynamics of atopic dermatitis: modelling multi-scale regulation of epithelium homeostasis. Interface Focus 2013; 3:20120090. [PMID: 23853706 PMCID: PMC3638487 DOI: 10.1098/rsfs.2012.0090] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Epithelial tissue provides the body with its first layer of protection against harmful environmental stimuli by enacting the regulatory interplay between a physical barrier preventing the influx of external stimuli and an inflammatory response to the infiltrating stimuli. Importantly, this interdependent regulation occurs on different time scales: the tissue-level barrier permeability is regulated over the course of hours, whereas the cellular-level enzymatic reactions leading to inflammation take place within minutes. This multi-scale regulation is key to the epithelium's function and its dysfunction leads to various diseases. This paper presents a mathematical model of regulatory mechanisms in the epidermal epithelium that includes processes on two different time scales at the cellular and tissue levels. We use this model to investigate the essential regulatory interactions between epidermal barrier integrity and skin inflammation and how their dysfunction leads to atopic dermatitis (AD). Our model exhibits a structure of dual (positive and negative) control at both cellular and tissue levels. We also determined how the variation induced by well-known risk factors for AD can break the balance of the dual control. Our model analysis based on time-scale separation suggests that each risk factor leads to qualitatively different dynamic behaviours of different severity for AD, and that the coincidence of multiple risk factors dramatically increases the fragility of the epithelium's function. The proposed mathematical framework should also be applicable to other inflammatory diseases that have similar time-scale separation and control architectures.
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The effect of slurry on skin permeability to methylene blue dye in dairy cows with and without a history of digital dermatitis. Animal 2013; 7:1731-7. [PMID: 23822976 DOI: 10.1017/s1751731113001274] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
This study aimed to determine whether there was a difference in skin permeability to methylene blue dye or skin morphology between dairy cows that differed in their susceptibility to digital dermatitis (DD) and to assess the effect of contact with slurry on skin permeability. Twenty nine dairy cows were monitored for DD during the winter housing period and classed as DD+ (previous DD infection, n = 17), or DD- (no recorded infection, n = 12). The animals were culled and a skin sample was taken from above the heel of each hind foot and frozen. Samples were later defrosted and one sample from each cow was tested for permeability, whereas the other was treated with slurry for 24 h before permeability testing. To test permeability, methylene blue dye was applied to the skin surface in a Franz diffusion cell. After 48 h, the amount of dye that had passed through the skin was estimated. The stratum corneum thickness and the density of hair follicles were determined from additional heel skin samples. Skin permeability to methylene blue dye was significantly greater for samples that had been treated with slurry but did not differ between DD+ and DD- animals. No difference was found in the stratum corneum thickness or density of hair follicles between DD+ and DD- animals. These findings imply that individual differences in general skin permeability are not a major factor in determining DD susceptibility and suggest that contact with slurry could contribute to DD infection by increasing the permeability of the skin, which may facilitate pathogen entry. Further work is required to clarify the role played by slurry in the pathogenesis of DD.
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Mullin J, Carter S, Williams N, McEwan N, Nuttall T. Transcription of canine toll-like receptor 2, β-defensin 1 and β-defensin 103 in infected atopic skin, non-infected atopic skin, healthy skin and the CPEK cell line. Vet Microbiol 2013; 162:700-706. [DOI: 10.1016/j.vetmic.2012.09.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2012] [Revised: 09/06/2012] [Accepted: 09/20/2012] [Indexed: 11/15/2022]
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Abstract
Despite the acknowledged contributions of a defective epidermal permeability barrier, dryness of the skin, and the propensity to develop secondary infections to the etiology and pathophysiology of atopic dermatitis (AD), these epidermal changes have, until recently, been assumed to reflect downstream consequences that are secondary phenomena of the primary immunologic abnormality--the historical "inside-outside" view that AD is basically an intrinsic inflammatory disease. In this review, we focused on the role of the epidermal barrier function in the pathophysiology of AD. Specifically, we presented data in support of a barrier-initiated pathogenesis of AD, ie, the "outside-inside" concept. First, we reviewed the evidence on the existence of inherited barrier abnormalities in AD. Reported studies on the possible association of mutations in the filaggrin gene (FLG) and data on human tissue kallikreins (KLKs) and AD have been addressed. We then dealt with the question of the causal link between impaired epidermal barrier and inflammation. Finally, the association between innate immune defense system and the increased avidity of Staphylococcus aureus for atopic skin was examined. Despite very convincing evidence to support the barrier-initiated pathogenesis of AD, the view that AD reflects the downstream consequences of a primary immunologic abnormality cannot be dismissed out of hand. Almost every line of evidence in support of the role of the epidermal barrier as the "driver" of the disease activity can be challenged and at least partially contradicted by opposing evidence. Until more data are available and until all the dust settles around this issue, we should take advantage of what we already know and use our knowledge for practical purposes. Deployment of specific strategies to restore the barrier function in AD means the use of moisturizers as first-line therapy.
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Affiliation(s)
- Ronni Wolf
- Dermatology Unit, Kaplan Medical Center, Rehovot 76100, Israel.
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Mackool BT, Goverman J, Nazarian RM. Case records of the Massachusetts General Hospital. Case 14-2012. A 43-year-old woman with fever and a generalized rash. N Engl J Med 2012; 366:1825-34. [PMID: 22571205 DOI: 10.1056/nejmcpc1111572] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Bonnie T Mackool
- Department of Dermatology, Massachusetts General Hospital, Boston, USA
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Edwards LA, O'Neill C, Furman MA, Hicks S, Torrente F, Pérez-Machado M, Wellington EM, Phillips AD, Murch SH. Enterotoxin-producing staphylococci cause intestinal inflammation by a combination of direct epithelial cytopathy and superantigen-mediated T-cell activation. Inflamm Bowel Dis 2012; 18:624-40. [PMID: 21887731 DOI: 10.1002/ibd.21852] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2011] [Accepted: 07/13/2011] [Indexed: 12/31/2022]
Abstract
BACKGROUND Enterotoxin-producing Staphylococcus aureus may cause severe inflammatory intestinal disease, particularly in infants or immunodeficient or elderly patients. They are also recognized to be associated with sudden infant death syndrome. Little is known, however, about mucosal responses to staphylococci. METHODS The mucosal lesion in three infants with staphylococcal enterocolitis was assessed by immunohistochemistry and electron microscopy. The organisms underwent extensive molecular analysis. Their toxins were assessed for capacity to induce T-cell activation and host mucosal responses examined by in vitro organ culture. Epithelial responses were studied by coculture with HEp-2 and Caco-2 cells. RESULTS Intestinal biopsies from the patients showed marked epithelial damage with mucosal inflammation. The three staphylococci, representing two distinct clones, were methicillin-sensitive, producing SEG/I enterotoxins and Rho-inactivating EDIN toxins. Their enterotoxins potently activated T cells, but only whole organisms could induce in vitro enteropathy, characterized by remarkable epithelial desquamation uninhibited by tacrolimus. EDIN-producing staphylococci, but not their supernatants, induced striking cytopathy in HEp-2 epithelial cells but not in Caco-2 cells. Although HEp-2 and Caco-2 cells produced similar IL-8, CCL20, and cathelicidin LL37 responses upon bacterial exposure, only Caco-2 cells expressed mRNA for the β-defensins HBD2 and HBD3, while HEp-2 cells were unable to do so. CONCLUSIONS Staphylococci induce enterocolitis by a combination of direct enterocyte cytopathy mediated by EDIN toxins, disrupting the epithelial barrier, and enterotoxin superantigen-induced mucosal T-cell activation. Gut epithelial production of β-defensins may contribute to host defense against invasive staphylococcal disease.
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Affiliation(s)
- Lindsey A Edwards
- Centre for Paediatric Gastroenterology Royal Free and University College Medical School, London, UK
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Nada HA, Gomaa NI, Elakhras A, Wasfy R, Baker RA. Skin colonization by superantigen-producing Staphylococcus aureus in Egyptian patients with atopic dermatitis and its relation to disease severity and serum interleukin-4 level. Int J Infect Dis 2012; 16:e29-33. [DOI: 10.1016/j.ijid.2011.09.014] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2011] [Revised: 07/24/2011] [Accepted: 09/15/2011] [Indexed: 11/25/2022] Open
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Howell MD, Gao P, Kim BE, Lesley LJ, Streib JE, Taylor PA, Zaccaro DJ, Boguniewicz M, Beck LA, Hanifin JM, Schneider LC, Hata TR, Gallo RL, Kaplan MH, Barnes KC, Leung DYM. The signal transducer and activator of transcription 6 gene (STAT6) increases the propensity of patients with atopic dermatitis toward disseminated viral skin infections. J Allergy Clin Immunol 2011; 128:1006-14. [PMID: 21762972 DOI: 10.1016/j.jaci.2011.06.003] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2010] [Revised: 06/01/2011] [Accepted: 06/02/2011] [Indexed: 01/10/2023]
Abstract
BACKGROUND Atopic dermatitis (AD) is a chronic inflammatory skin disease associated with increased susceptibility to recurrent skin infections. OBJECTIVE We sought to determine why a subset of patients with AD have an increased risk of disseminated viral skin infections. METHODS Human subjects with AD with a history of eczema herpeticum (EH) and various control groups were enrolled. Vaccinia virus (VV) expression was measured by means of PCR and immunofluorescent staining in skin biopsy specimens from each study group after incubation with VV. Transgenic mice with a constitutively active signal transducer and activator of transcription 6 gene (STAT6) were characterized for response to VV skin inoculation. Genotyping for 10 STAT6 single nucleotide polymorphisms (SNPs) was performed in a white patient sample (n = 444). RESULTS VV gene and protein expression were significantly increased in the skin of patients with EH compared with other subject groups after incubation with VV in vitro. Antibody neutralization of IL-4 and IL-13 resulted in lower VV replication in patients with a history of EH. Mice that expressed a constitutively active STAT6 gene compared with wild-type mice had increased mortality and satellite lesion formation after VV skin inoculation. Significant associations were observed between STAT6 SNPs and EH (rs3024975, rs841718, rs167769, and rs703817) and IFN-γ production. The strongest association was observed for a 2-SNP haplotype (patients with AD with a history of EH vs patients with AD without a history of EH, 24.9% vs 9.2%; P = 5.17 × 10(-6)). CONCLUSION The STAT6 gene increases viral replication in the skin of patients with AD with a history of EH. Further genetic association studies and functional investigations are warranted.
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Affiliation(s)
- Michael D Howell
- Department of Pediatrics, National Jewish Health, Denver, Colo 80206, USA
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Clark DW, Wenaas A, Citardi MJ, Luong A, Fakhri S. Chronic rhinosinusitis with nasal polyps: elevated serum immunoglobulin E is associated with Staphylococcus aureus on culture. Int Forum Allergy Rhinol 2011; 1:445-50. [PMID: 22144053 DOI: 10.1002/alr.20079] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2010] [Revised: 04/05/2011] [Accepted: 05/24/2011] [Indexed: 02/04/2023]
Abstract
BACKGROUND Recent data has implicated Staphylococcus aureus (SA) superantigen as a potential disease modifier in patients with chronic rhinosinusitis (CRS) with nasal polyps (CRSwNP). The objective of this work was to compare total serum immunoglobulin E (IgE) and serum eosinophils in patients with CRSwNP and CRS without nasal polyps (CRSsNP) based on culture results of the 3 most commonly isolated bacteria. METHODS Retrospective review at a tertiary rhinology referral center of patients with CRS over a 4-year period. RESULTS Bacterial cultures and immunologic data were obtained from 62 patients with CRSwNP and 34 patients with CRSsNP. SA was the most prevalent bacteria in the CRSwNP group, isolated in 19 patients (31%). Patients with elevated total serum IgE (>114 IU/mL) were more likely to have SA on culture (p = 0.04) in this population. The percent serum eosinophil levels in the SA+ group compared with the SA- group was not significant (6.0 vs 5.1, p = 0.17). Lund-Mackay computed tomography (CT) scores, but not Sino-Nasal Outcome Test 20 (SNOT-20) scores were significantly higher in the SA+ vs SA- group (p = 0.03) in patients with CRSwNP. The CRSsNP group demonstrated no difference in IgE or serum eosinophils between different bacterial groups. CONCLUSION Our findings suggest that there is an association between SA sinonasal presence and elevated total serum IgE in patients with CRSwNP. In addition, SA+ patients had higher Lund-Mackay CT scores, indicating a higher objective burden of disease in this group of patients.
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Affiliation(s)
- David W Clark
- University of Texas Medical School at Houston, Department of Otorhinolaryngology-Head and Neck Surgery and Texas Sinus Institute, Houston, TX 77030, USA
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Matiz C, Tom WL, Eichenfield LF, Pong A, Friedlander SF. Children with atopic dermatitis appear less likely to be infected with community acquired methicillin-resistant Staphylococcus aureus: the San Diego experience. Pediatr Dermatol 2011; 28:6-11. [PMID: 21070347 DOI: 10.1111/j.1525-1470.2010.01293.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Given the increasing rate of community-acquired methicillin resistant Staphylococcus aureus skin infections in the population, such infections might be concurrently increasing in patients with atopic dermatitis. This study assessed current and prior rates of community-acquired methicillin resistant Staphylococcus aureus and methicillin-susceptible Staphylococcus aureus skin and soft tissue infections in children with atopic dermatitis compared to the general pediatric population. Other antibiotic sensitivity and resistance patterns, including clindamycin-inducible resistance, were also identified. Retrospective study of all skin and soft tissue isolates were positive for Staphylococcus aureus during two distinct 1-year periods, obtained by the outpatient services and the emergency department at Rady Children's Hospital, the major regional pediatric health center in San Diego, California. Of the Staphylococcus aureus isolates obtained from January to December 2000, none from atopic dermatitis patients were methicillin resistant Staphylococcus aureus, while 4.2% of those obtained from the general outpatient pediatric population showed methicillin resistance. In the period from June 2007 to May 2008, 11 of 78 isolates (14.1%) from children with atopic dermatitis were methicillin resistant Staphylococcus aureus. This was significantly lower than the rate of increase noted in the general pediatric population (658 of 1482, or 44.4%, in 2007/2008, p < 0.05). Clindamycin-inducible resistance was noted in 1.9% of the isolates in the general population; all six tested isolates from atopic patients lacked clindamycin-inducible resistance. In this study, children with atopic dermatitis had a much lower rate of community-acquired methicillin resistant Staphylococcus aureus infection compared to the general outpatient pediatric population. Clindamycin-inducible resistance was very low in both groups.
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Affiliation(s)
- Catalina Matiz
- Division of Pediatric Dermatology, University of California, San Diego and Rady Children's Hospital, San Diego, California 92123, USA
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Biagini Myers JM, Khurana Hershey GK. Eczema in early life: genetics, the skin barrier, and lessons learned from birth cohort studies. J Pediatr 2010; 157:704-14. [PMID: 20739029 PMCID: PMC2957505 DOI: 10.1016/j.jpeds.2010.07.009] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2009] [Revised: 04/22/2010] [Accepted: 07/06/2010] [Indexed: 12/17/2022]
Abstract
Eczema is a chronic inflammatory disorder of the skin that affects up to 30% of children. It often afflicts infants in the first few months of life and can be the first indicator of the atopic march. Recent results from birth cohort studies have uncovered novel information regarding genetic and environmental factors that promote the development of eczema. Birth cohort studies provide an optimal study design to elucidate these associations and prospectively track longitudinal data including exposure assessment and health outcomes from birth into early life and childhood. This is especially relevant for eczema given the age specific emergence of this disease. In this review, we will provide a general overview of pediatric eczema and discuss the important findings in the literature with respect to genetics and environmental exposures, highlighting those derived from birth cohort studies. Additionally, we will review how these relate to the atopic march, the hygiene hypothesis and the integrity of the skin barrier.
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Affiliation(s)
| | - Gurjit K. Khurana Hershey
- Division of Asthma Research, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA, Division of Allergy and Immunology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
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Kobaly K, Somani AK, McCormick T, Nedorost ST. Effects of Occlusion on the Skin of Atopic Dermatitis Patients. Dermatitis 2010. [DOI: 10.2310/6620.2010.10013] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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