Molecular Mechanisms of Atopic Dermatitis Pathogenesis

Identification of atopic dermatitis-associated diseases based on the National health and nutrition examination survey (NHANES) 2013-2018

Atopic dermatitis (AD) is the most common chronic inflammatory skin disease. Massive cohort studies revealed that AD was associated with allergic diseases, inflammatory diseases, autoimmune diseases, cardiovascular diseases, and mental disorders. We comprehensively and systematically analyzed the correlation between AD and diseases to identify AD-associated diseases (ADADs). We involved 17,924 individuals from the National Health and Nutrition Examination Survey (NHANES) (2013-2018) dataset, and analyzed the correlation between AD and 422 diseases classified by International Classification of Diseases-10 (ICD-10) using four logistic regression models. We found that AD is significantly associated with 33 diseases: (1) allergic diseases, including urticaria, allergic rhinitis, allergy, asthma, other seasonal allergic rhinitis; (2) inflammatory diseases, including noninfective gastroenteritis and colitis, acute atopic conjunctivitis, osteoarthritis, and unspecified chronic bronchitis; (3) mental disorders with impairment (MDI), including comorbid mental disorders, schizophrenia and sleep disorder; (4) malignant tumors, including malignant neoplasm of prostate, malignant (primary) neoplasm and malignant neoplasm of breast; (5) other symptoms and diseases, other symptoms and diseases, such as wheezing, pruritus and gout. Notably, non-infective gastroenteritis and colitis showed the strongest correlation (OR: 38.39, 95% CI: 3.08-478.01) among the 33 ADADs. We identified 33 ADADs based on the NHANES (2013-2018) dataset, which provide new insights into understanding the development of these ADADs associated with AD.

Discovery and Optimization of Potent and Highly Selective PARP14 Inhibitors for the Treatment of Atopic Dermatitis

Atopic dermatitis (AD) is a chronic, recurrent, and inflammatory skin condition that remains challenging to treat effectively and safely with current therapies. Recent studies by multiple independent research groups have demonstrated that poly(ADP-ribose) polymerase 14 (PARP14) has been implicated in the progression of inflammatory diseases through its regulation of the Th2 and Th17 signaling pathways, leading to the identification of PARP14 as a promising therapeutic target. Herein, we report the discovery of a novel PARP14 inhibitor Q22 with exceptional inhibitory activity against PARP14 (IC50 = 5.52 nM), high selectivity toward PARP14, favorable pharmacokinetic properties, and a robust in vivo safety profile. Notably, compared to positive control RBN-3143, Q22 showed significant therapeutic efficacy in a dinitrochlorobenzene (DNCB)-induced AD mouse model by markedly reducing the expression of key AD-associated inflammatory cytokines, including IL-4, IL-13, and IL-17A. These findings suggest that Q22 holds considerable promise as a PARP14 inhibitor for AD treatment.

Advances in Drug Delivery Systems for Atopic Dermatitis Treatment

Atopic dermatitis (AD) is a chronic inflammatory skin disorder characterized by pruritus and impaired skin barrier function. Advances in drug delivery systems have transformed AD treatment by enhancing drug stability, bioavailability, and targeted delivery. Drug delivery systems such as liposomes, hydrogels, and microneedles enable deeper skin penetration, prolonged drug retention, and controlled release, reducing side effects and treatment frequency. Liposomes improve drug absorption and stability, while hydrogels offer high water content and responsive drug release. Microneedles facilitate painless, localized drug delivery, enhancing patient compliance. These systems address the limitations of traditional therapies like topical corticosteroids and systemic immunosuppressants, which are associated with adverse effects and poor patient adherence. Recent innovations include Janus kinase (JAK) inhibitors and biologics targeting immune pathways, demonstrating significant efficacy in reducing inflammation and symptoms. Drug delivery systems offer a safer, more efficient alternative for delivering these advanced therapies. By improving therapeutic outcomes and patient experience, drug delivery systems represent a crucial advancement in AD management.

915-3985 MHz microwave "sweep" as epidermal retention enhancer of nanoγ-tocotrienol for dermatitis treatment

Skin has complex compositions in multilayers. To promote skin permeability for drug transport to treat local skin diseases, 915-3985 MHz microwave sweep is deemed more effective than monofrequency radiation as it exhibits different wavelengths for surface and deeper skin interaction to modify skin constructs. This study examines effectiveness and mechanistic insights of 915-3985 MHz microwave sweep in topical administration of nanoemulsified γ-tocotrienol for dermatitis treatment. Physicochemical properties of γ-tocotrienol nanoemulsion and its skin permeation, retention and anti-dermatitis actions were investigated. Use of 915-3985 MHz microwave sweep promoted primarily epidermal retention of nanoemulsified γ-tocotrienol. It led to a faster recovery of dermatitis-like inflammation in vivo than microwave or nanoemulsion alone, and combination of nanoemulsion with 2450 MHz or 3985 MHz microwave. Microwave sweep fluidized the skin lipid bilayer, condensed the keratin and corneocytes, and enlarged skin aqueous pores to a greater extent than 2450/3985 MHz microwave. It relaxed epidermis more than dermis creating surface loose domains to accommodate nanoemulsified γ-tocotrienol at epidermis via microwave-skin interaction at O-H/N-H, C-H, CO/C-N skin functional groups. 915-3985 MHz microwave sweep promotes epidermal drug delivery enabling site-specific skin disease treatment and facilitating clinical translation of γ-tocotrienol.

Mendelian Randomization Combined with Single-Cell Transcriptome Analysis Reveals the Role of the Key Gene PCLAF in the Pathogenesis of Atopic Dermatitis

Background

Atopic dermatitis (AD) is a chronic inflammatory skin condition characterized by itching and rashes, influenced by genetic, environmental, and immune factors. Despite significant research, the molecular mechanisms underlying AD are not fully understood. This study aims to integrate single-cell RNA sequencing (scRNA-seq) with Mendelian Randomization (MR) to uncover genetic and metabolic pathways contributing to AD.

Materials and Methods

Data from scRNA-seq and bulk RNA sequencing datasets were analyzed to identify differentially expressed genes. The edgeR package was used for differential expression analysis, and candidate genes were explored using MR, employing eQTL data to determine causal relationships with AD. The inverse variance weighted method facilitated MR analysis, while gene set enrichment analysis (GSEA) was used to identify pathways associated with AD. Single-cell analysis was performed with the Seurat package to explore cellular heterogeneity, and pseudotime and cellular communication analyses were conducted to understand cell differentiation and interactions in AD.

Results

The study identified key genes-PCLAF, MICB, CHAD, and CA4-linked to AD, with PCLAF notably acting as a risk factor. These genes are involved in cell cycle regulation, immune evasion, cell adhesion, and metabolic processes. The MR analysis highlighted lipid, amino acid, and energy metabolism as critical pathways in AD. Single-cell analysis revealed increased cellular communication in AD, especially in Langerhans cells, keratinocytes, and T cells, signifying dysregulated immune responses and inflammatory pathways. Pseudotime analysis indicated abnormal differentiation trajectories in these cell types.

Conclusion

Our study highlights the importance of PCLAF in the pathogenesis of AD, indicating it as a potential target for future therapeutic strategies aimed at alleviating the disease by addressing genetic and metabolic disruptions.

Cure for the itch: current clinical standards and therapies in allergic eczema

Allergic Eczema (AE) is a chronic, relapsing skin condition that significantly affects the quality of life of the AE patients and their caretakers. Decades of scientific and clinical research has helped understand the highly complex underpinnings of AE presentation wherein a multitude of variables, including the conspicuous variables such as environmental allergens, immunological triggers, genetic predisposition of individuals, to more nuanced socio-economic status, play an important part. Given the complexity of the disease, it is imperative to develop biomarkers enabling early and reliable clinical identifications and help in the active management of the disease, thereby minimizing the impact and burden of the disease on the patients. In this mini review, we provide a brief overview of AE, affected demographics, variables that trigger its onset, and summarize the discovery of various clinical biomarkers such as total and specific serum IgE levels, Th2 cytokine levels, filaggrin (FLG) mutations, periostin levels in skin, etc. that have been developed over the years to further improve the state of clinical monitoring of AE presentation and progression. Lastly, we also provide an overview of the clinical interventions and therapies, such as topical agents, phototherapy, and biologics, that are available to the patients to manage AE-related complications. While we have vastly improved the standard of care and diagnosis for the AE patients, there are still many unmet needs such as developing non-invasive, effective, and reliable clinical predictors and biomarkers which can usher better personalized treatments and provide a better quality of life to affected demographics.

Monocytes Expressing IL-36G Play a Crucial Role in Atopic Dermatitis

Atopic dermatitis (ad) is a chronic inflammatory skin disease, with recent studies indicating that immune cells, such as monocytes and inflammatory cytokines, play a crucial role. By retrieving datasets from public databases and analysing immune cell infiltration in lesional skin using CIBERSORT, we found that monocytes and M2 macrophages were significantly upregulated in atopic dermatitis. Differentially expressed gene (DEG) functional enrichment analysis revealed that cytokine-cytokine receptor interaction was the most significantly enriched pathway. Further analysis of cytokines and their receptors, along with their correlation with infiltrating immune cells, identified IL36G-expressing monocytes as a key target in atopic dermatitis. We compared immune cell infiltration and cytokine-related targets in similar inflammatory skin diseases, such as psoriasis and urticaria, to evaluate similarities and differences among these three skin conditions. The analysis revealed that IL36G-expressing monocytes were also highly expressed in psoriasis but did not play a pivotal role in urticaria. Finally, we used molecular docking to predict and validate drugs targeting IL36G. Our study highlights IL36G-expressing monocytes as a common key target in atopic dermatitis and psoriasis, offering novel insights and therapeutic strategies for these related diseases.

Substantial Effects of Carotenoids on Skin Health: A Mechanistic Perspective

There has been an upsurge in the incidences of skin disorders and their mortalities owing to various environmental, hormonal, and epigenetic risk factors. Melanoma, atopic dermatitis, psoriasis, and photoaging and associated consequences are largely observed in the population globally. The social stigma, economic burden, and adverse effects from chronic medication endured by the patients emphasize the necessity of more effective natural therapeutics. Carotenoids are economically valuable tetraterpenoid pigments synthesized by plants and microorganisms, which play a paramount role in their overall growth and development. Extensive in vitro and in vivo investigations evidenced that phytopigments like carotenoids target multiple intracellular signaling pathways involving the mitogen-activated protein kinases, Janus kinase/signal transducers, and activators of transcription, apoptotic, and autophagy proteins to ameliorate melanoma. Besides, carotenoids curbed the activation and the release of immunoregulatory molecules such as cytokines and chemokines to abrogate skin immune disorders, photoaging, and associated consequences. Here, we provide a holistic discussion on the pathophysiology of prominent skin disorders and the ameliorating effects of carotenoids as evidenced in the in vitro, in vivo, and clinical interventions. We also advocate the requisite of formulating carotenoid medications after extensive clinical interventions and validation for mitigating various skin dysfunctions.

Off-Label Treatment in Inflammatory Skin Diseases-European Point of View

Off-label treatment is the use of a drug approved for marketing, outside the registration in terms of indication, age group, dose or route of administration. Despite the constant appearance of new preparations on the market, treatment outside the SmPCs guidelines is a current clinical problem. It is believed that it is based on the needs of patients unmet by classical therapy methods. This work focuses on off-label treatment in inflammatory dermatoses such as atopic dermatitis, psoriasis, acne vulgaris and rosacea. Publications on this subject, available on PubMed, Google Scholar and the Cochrane Library, were analyzed in the form of a review, taking into account the mechanisms of action, efficacy and safety of preparations. Based on the literature analysis, it can be concluded that the use of drugs outside the SmPC indications is a common situation in dermatology. However, it is difficult to determine its exact frequency-there is a lack of data on the prevalence of off-label appliances in inflammatory dermatoses from a European perspective. Publications demonstrate varying effectiveness and safety of this form of therapy, depending on the specific preparation. Off-label treatment in dermatology remains an important and current clinical issue that should be explored in further research.

Neurotransmitter 5-HT Further Promotes LL-37-Induced Rosacea-like Inflammation Through HTR3A

Rosacea is a chronic inflammatory skin disease and is usually accompanied by extensive macrophage infiltration. There is growing evidence suggesting that neurotransmitter 5-hydroxytryptamine (5-HT) plays a crucial role in inflammatory reactions. However, the interaction between 5-HT and rosacea is still unclear. Here, we hypothesized that the inflammation of rosacea is partly caused by 5-HT, and we investigated the underlying mechanism. In this study, we employed a rosacea model induced by LL-37, which is usually applicated as a rosacea stimulator, to investigate the effects of 5-HT on rosacea in vitro and in vivo. In LL-37-(4 μM)-induced THP-1-derived macrophages, 5-HT (400 μM) further promoted the secretion of inflammatory cytokines and polarized macrophages towards M1 phenotype, which could promote an inflammatory response. Further research revealed that exposure to LL-37 and 5-HT (L5) selectively upregulated HTR3A mRNA expression but not HTR2A or HTR7 and induced colocalization of 5-HT with HTR3A. Notably, application of antagonist tropisetron (TPS) and siRNA of HTR3A suppressed L5-induced inflammation. Meanwhile, 5-HT (25 μg each injection a total of three times) deteriorated skin erythema, stimulated dermal inflammatory cell infiltration, and promoted the secretion of inflammatory cytokines in LL-37 (40 μL and 320 μM each injection a total of four times) induced rosacea-like mice, while these undesirable effects were reversed by using TPS. Our findings revealed that neurotransmitter 5-HT further promoted LL-37-induced rosacea-like inflammation through HTR3A. Our study highlights HTR3A as a promising therapeutic target, which warrants further in-depth investigation into its clinical applicability.

Selected traditional Chinese herbal medicines for the treatment of atopic dermatitis - research progress on the effect and mechanism of actions

Atopic dermatitis (AD) is a common chronic, recurrent, inflammatory skin disease characterized by pruritus, lichen-like changes and dry skin. Due to the complex pathogenesis of AD, its mechanism is primarily associated with genetic, skin barrier dysfunction, environmental, and immune factors. AD has been routinely treated with glucocorticoids, antihistamines, local immunomodulators, biological agents, and small molecules; however, the side effects are significant, and the treatment efficacy is limited. In recent years, traditional Chinese medicine (TCM) has gradually been widely used in the treatment of AD. Many studies have shown that TCM mainly regulates inflammatory cytokines, gut microbiota and the immune system. Therefore, it plays a crucial role in the treatment of AD. The treatment of atopic dermatitis using TCM is characterized by targeting multiple pathways and multiple targets, and it demonstrates significant therapeutic effects. This paper reviews the pathogenesis of AD and reports the efficacy of TCM on AD (including TCM prescription, single TCM, treatment of TCM metabolites), which provides a theoretical basis for TCM treatment of AD. TCM has certain therapeutic effects on AD. It can alleviate and treat AD in various ways. We should base our differentiation on syndrome differentiation and treatment differentiation. With the help of modern medicine, the clinical efficacy of TCM in treating AD can be improved.

Pulsatilla koreana Nakai Extract Attenuates Atopic Dermatitis-like Symptoms by Regulating Skin Barrier Factors and Inhibiting the JAK/STAT Pathway

Atopic dermatitis is caused by various factors, including complex interactions between immune responses and imbalances in T helper cells. In order to resolve the side effects of steroid-based treatment and rapidly improve atopy symptoms, the development of preventive substances for new treatments and as food supplements is essential. Pulsatilla koreana Nakai (PKN) is traditionally used as an effective herbal medicine for pain relief, anti-inflammation, and edema, and dried PKN is boiled and drunk as a tea to prevent them; however, its effect on skin manifestations such as atopy are unclear. Therefore, we investigated the in vivo and in vitro effects of PKN extract on improving symptoms of atopy as a potential treatment. By evaluating dermatitis scores and conducting histopathological analysis in mice with Dermatophagoides farina-induced atopy-like pathology, we demonstrated that PKN extract alleviated atopy symptoms. Moreover, PKN extract restored a reduction in the protein levels of skin barrier-related factors in skin tissue. Through in vitro analysis, we examined the impact of PKN on JAK/STAT signaling in IL-4/IL-13-stimulated human keratinocytes and elucidated the mechanisms that suppress the levels of skin barrier factors and inflammation. PKN extract inhibited JAK/STAT phosphorylation stimulated by IL-4/IL-13. Furthermore, docking analysis of PKN constituents indicated binding to JNK1/2 and STAT3/6 and a subsequent inhibition of signal transduction. Therefore, this suggests that PKN extract has potential not only as a treatment but also as a food supplement to improve atopic dermatitis by strengthening skin barrier factors and inhibiting key signaling molecules.

Identification and Validation of the Potential Key Biomarkers for Atopic Dermatitis Mitochondrion by Learning Algorithms

Purpose

Atopic dermatitis (AD) is a common inflammatory skin condition characterized by erythema and pruritus. Its precise pathogenesis remains unclear, though factors such as genetic predisposition, autoantigen response, allergen exposure, infections, and skin barrier dysfunction are involved. Research suggests a correlation between AD and mitochondrial dysfunction, as well as oxidative stress in skin tissues.

Methods

 Skin sample datasets related to AD (GSE36842, GSE120721, GSE16161, and GSE121212) were retrieved from the GEO database. Differential gene analysis identified differentially expressed genes (DEGs) in AD. Three potential biomarkers-COX17, ACOX2, and ADH1B-were identified using LASSO and Support Vector Machine (SVM) algorithms. These biomarkers were validated through ROC curve analysis, nomogram modeling, calibration curves, and real-time PCR. Immune infiltration analysis assessed correlations of the biomarkers. Additionally, single-cell analysis of the GSE153760 dataset identified nine cell clusters and confirmed expression patterns of the three hub genes.

Results

Differential analysis identified 150 upregulated and 367 downregulated genes. Enrichment analysis revealed significant pathways related to mitochondrial function, oxidative stress, and energy metabolism in skin samples from AD patients. Area under the curve (AUC) values for biomarkers COX17, ACOX2, and ADH1B were 1.000, 0.928, and 0.895, respectively, indicating strong predictive capacity. qPCR results showed COX17 was highly expressed in AD lesions, while ACOX2 and ADH1B were higher in normal skin, consistent with previous findings. Correlation analysis indicated ACOX2 and ADH1B were positively correlated with resting mast cells but negatively with activated T cells and NK cells, while COX17 showed a positive correlation with activated T cells and a negative correlation with resting mast cells.

Conclusion

This study suggests that the hub genes COX17, ACOX2, and ADH1B may serve as potential biomarkers in the pathogenesis of AD. These findings could provide insights for the treatment and prognosis of AD and related inflammatory skin conditions.

Chlorogenic acid alleviates DNCB-induced atopic dermatitis by inhibiting the Akt1/NF-κB signaling pathway

OBJECTIVE

Atopic dermatitis (AD) is a prevalent chronic inflammatory skin disease that significantly impacts patients' quality of life. Chlorogenic acid (CGA), a polyphenol present in various dietary sources and plants, has been shown to reduce skin inflammation. However, its efficacy and mechanisms of action in AD have not been thoroughly investigated. This study aimed to evaluate the therapeutic effect of CGA on AD in mice and explored its mechanism.

METHODS

To establish a BALB/c mouse model of AD induced by 2,4-dinitrochlorobenzene (DNCB) to evaluate the therapeutic potential of CGA. The anti-inflammatory effects of CGA were assessed by measuring IL-1β and IL-6 levels in TNF-α-stimulated HaCaT cells. The phosphorylation levels of PI3K, Akt, Akt1, NF-κB, and IκB-α were analyzed using Western blotting. Molecular docking was conducted to evaluate the binding affinity of CGA to Akt1.

RESULTS

Topical application of CGA significantly reduced dermatitis scores, spleen index, epidermal thickness, mast cell infiltration, and skin fibrosis. CGA reversed DNCB-induced increases in IgE, histamine, TNF-α, IL-1β, IL-6, and IL-8 levels. Western blot analysis showed that CGA inhibited the PI3K/Akt and NF-κB signaling pathways. In vitro, CGA exerts its anti-inflammatory effects by inhibiting the Akt1/NF-κB pathway, and the Akt activator (SC79) can counteract this effect. Molecular docking and dynamics simulations suggest that CGA may inhibit Akt1 activity by interacting with specific residues (ALA-50, GLY-37, TYR-326, ASP-323).

CONCLUSIONS

CGA improves AD by inhibiting the Akt1/NF-κB pathway, suggesting its potential as a natural treatment for AD.

Investigating the complex roles of immunocyte phenotypes in the pathogenesis of dermatitis: a causal inference Mendelian randomization analysis

The etiology of dermatitis involves complex interactions between immune cells, genetics, and environmental factors. While immunocyte phenotypes have been linked to various forms of dermatitis, their causal role remains unclear. We conducted a two-sample Mendelian randomization (MR) analysis to investigate the causal effects between 731 immunocyte phenotypes and four types of dermatitis: atopic dermatitis, contact dermatitis, infective dermatitis, and seborrhoeic dermatitis. Genetic variants were used as instrumental variables, and the inverse variance-weighted (IVW) method was employed to assess causality. Sensitivity analyses were performed to ensure robustness. The forward MR analysis identified significant associations between 22 immunocyte phenotypes and atopic dermatitis, 8 phenotypes with contact dermatitis, 5 with infective dermatitis, and 6 with seborrhoeic dermatitis. The reverse MR analysis suggested potential bidirectional interactions of atopic dermatitis and CD3 on CD28 + CD45RA- CD8br (OR = 0.924, P = 0.012). This study revealed causal relationships between specific immunocyte phenotypes and dermatitis subtypes, providing novel insights into the immunopathogenesis of dermatitis and potential therapeutic targets.

Enhanced Dermal Delivery of Nanoparticulate Formulation of Cutibacterium acnes Using Sponge Spicules for Atopic Dermatitis Treatment

Introduction

The pathogenesis of atopic dermatitis (AD) is closely linked to both genetic and environmental factors, with patients often exhibiting a range of immunological abnormalities, including a pronounced Th2-type overreaction, which is a key feature of the disease.

Purpose

Cutibacterium acnes has been shown to induce a robust Th1 immune response through intraperitoneal injections, potentially preventing the development of AD. In this study, a novel nanoparticulate formulation of Cutibacterium acnes (NFCA) was developed with the formulation optimization for the dermal delivery.

Materials and Methods

Sponge Haliclona sp. spicules (SHS) were isolated from the explants of sponge Haliclona sp. with our proprietary method. The NFCA was prepared by high-speed grinding followed by film extrusion. The skin penetration of the model drugs in NFCA with SHS were visualized using confocal microscopy. The therapeutic effects of NFCA coupled with SHSs against AD in mice were assessed by using pathohistological examination and cytokine ELISA assay.

Results

The NFCA particle size was 254.1±39.4 nm, with a PDI of 0.29±0.08 and a Zeta potential of -7.9±0.6 mV. SHS significantly enhanced total skin absorption of FD10K (39.6±6.7%, p=0.00076) as well as deposition in the viable epidermis (3.2±1.6%, p=0.08) and deep skin (dermis & receptor) (36.0±5.9%, p=1.82E-5) compared to the control. In vitro cytotoxicity tests showed that NFCA had low toxicity to HaCaT cells (IC50=63.8 mg/mL). The study confirmed that NFCA can activate immune signaling pathways, promoting the high expression of IL-6 and IL-8 in keratinocytes, enhancing TNF-α and IL-1β expression in macrophages, and inducing Th1 and Th17-type immune responses. Furthermore, we demonstrated that the dermal delivery of NFCA using SHS in vivo significantly reduced epidermal thickness, serum IgE levels, and tissue IL-4 levels, thereby accelerating skin repair and mitigating Th2 polarization.

Conclusion

SHS were employed to effectively deliver NFCA to the deeper skin layers to exert its immune functions. Moreover, the combination of SHS and NFCA can significantly cure mice with atopic dermatitis.

Blood Transcriptome Signature as Indicator and Predictor for Efficacy of Abrocitinib in Treatment of Atopic Dermatitis

Patients with atopic dermatitis (AD) exhibit significant blood transcriptome alterations, reflecting systemic inflammation. The effects of abrocitinib, a Jak1 inhibitor, on the blood transcriptome of AD remain unclear. This study aimed to investigate abrocitinib's effects on the blood transcriptome in patients with AD and identify transcriptomic predictors of treatment efficacy. Blood cell mRNA sequencing was conducted on 31 patients with AD at baseline and 4 and 12 weeks of 100 mg abrocitinib daily treatment. Differential gene expression, immune infiltration, and weighted gene coexpression network analyses were performed, along with correlation analysis of transcriptomic data and clinical traits. We observed that abrocitinib treatment significantly improved clinical signs of AD. Correspondingly, blood transcriptome normalization, including downregulation of T helper 2, T helper 1, and eosinophil and an increase in type 1 regulatory T-cell abundance, rapidly occurred by week 4, with slight rebound by week 12. Higher baseline eosinophil counts predicted greater transcript normalization. Weighted gene coexpression network analyses identified an efficacy-related gene module, leading to a 5-gene (PLIN2, CAT, CLC, RAB44, and SMPD3) efficacy-predictive model, which was validated in another independent cohort of 30 patients with AD treated with abrocitinib. In conclusion, abrocitinib treatment resulted in rapid and extensive normalization of the dysregulated blood transcripts in AD, which was associated with its clinical efficacy.

Association between organophosphate pesticide exposure and atopic dermatitis: a cross-sectional study based on NHANES 1999-2007

Background

Organophosphate pesticides (OPPs) are widely used environmental chemicals with potential health impacts, but their relationship with atopic dermatitis (AD) remains unclear.

Methods

Using data from the National Health and Nutrition Examination Survey (NHANES) 1999-2007, we investigated associations between urinary OPP metabolites and AD in 4,258 adults. Six dialkyl phosphate (DAP) metabolites were measured, and weighted quantile sum (WQS) regression was used to assess mixture effects.

Results

Both DMP (odds ratio [OR] = 1.17, 95% confidence interval [CI]: 1.05-1.31) and DMDTP (OR = 2.23, 95%CI: 1.08-4.60) showed significant positive associations with AD in fully adjusted models. WQS regression revealed significant associations between mixed OPP exposure and AD (OR = 1.25, 95%CI: 1.04-1.50), with DMP contributing most (45.8%) to the mixture effect. Stratified analyses indicated stronger associations in males, younger adults (<60 years), and smokers.

Conclusion

Our findings suggest that OPP exposure, particularly DMP, may be associated with increased AD risk in adults. These results provide new insights into environmental risk factors for AD.

Omentin-General Overview of Its Role in Obesity, Metabolic Syndrome and Other Diseases; Problem of Current Research State

Background: Omentin (omentin-1, intelectin-1, ITLN-1) is an adipokine considered to be a novel substance. Many chronic, inflammatory, or civilization diseases are linked to obesity, in which omentin plays a significant role. Methods: MEDLINE and SCOPUS databases were searched using the keywords "omentin" or "intelectin-1". Then the most recent articles providing new perspectives on the matter and the most important studies, which revealed crucial insight, were selected to summarize the current knowledge on the role of omentin in a literature review. Results and Conclusions: The valid role of this adipokine is evident in the course of metabolic syndrome. In most cases, elevated omentin expression is correlated with the better course of diseases, including: type 2 diabetes mellitus, polycystic ovary syndrome, rheumatoid arthritis, metabolic dysfunction-associated steatotic liver disease, Crohn's disease, ulcerative colitis, atherosclerosis, or ischemic stroke, for some of which it can be a better marker than the currently used ones. However, results of omentin studies are not completely one-sided. It was proven to participate in the development of asthma and atopic dermatitis and to have different concentration dynamics in various types of tumors. All of omentin's effects and properties make it an attractive subject of research, considering still unexplored inflammation mechanisms, in which it may play an important role. Omentin was proven to prevent osteoarthritis, hepatocirrhosis, and atherosclerosis in mouse models. All of the above places omentin among potential therapeutic products, and not only as a biomarker. However, the main problems with the omentin's research state are the lack of standardization, which causes many contradictions and disagreements in this field.

Formononetin: a review of its source, pharmacology, drug combination, toxicity, derivatives, and drug delivery systems

Formononetin (FMN) is a common natural metabolite that can be extracted and isolated from some common botanical drugs. In recent years, FMN has garnered increasing attention due to its beneficial biological activities. In this paper, we systematically summarize the sources of FMN and provide a comprehensive review of its pharmacological activities and molecular mechanisms, co-administration, toxicity, derivatives, and drug delivery systems in the last 5 years. The study results found that FMN has a wide range of pharmacological activities in neurological disorders, organ damage and cancer, showing great potential for clinical application and broad prospects. Researchers are exploring various types of delivery systems, including nanoparticle carriers, ligand modifications and polymer microspheres. These advanced delivery systems can enhance the stability of FMN, prolong its release time in vivo, and improve targeting, thereby optimizing its therapeutic efficacy and reducing side effects, and greatly improving its bioavailability. In conclusion, FMN is a natural metabolite with considerable research value, and its diverse biological activities make it a promising candidate for drug development and medical research.

Development and characterization of a Vaccinium vitis-idaea liposomal gel for the treatment of atopic dermatitis

OBJECTIVE

In this study, a liposomal gel with anti-inflammatory, antibacterial, and antioxidant effects and improving atopic dermatitis (AD) was prepared using Vaccinium vitis-idaea polyphenol as the main active ingredient, which is safe, effective, of stable quality and has anti-inflammatory and antimicrobial effects.

METHODS

The polyphenol extract from Vaccinium vitis-idaea was obtained through ultrasonic extraction and subsequently purified using macroporous resin. A liposome gel incorporating this extract was formulated using poloxamer 188 and poloxamer 407 as the base materials. The gel's physical characteristics, including appearance, vesicle size, and zeta potential, were systematically characterized. Furthermore, its anti-inflammatory, antioxidant, anti-aging, and anti-AD effects were assessed through both ex vivo and in vivo studies.

RESULTS

After process optimization, the yield of Vaccinium vitis-idaea polyphenol was 4.33%; the encapsulation rate of Vaccinium vitis-idaea liposome was 90.45%. The liposome gel prepared by the optimal process had a zeta potential of -33.67 mV, a particle size of 119 nm, a PDI of 0.147, and showed good stability under the conditions of 60 °C, 75% relative humidity, and light intensity of 4500 ± 500 Lux. The results of in vitro studies showed that Vaccinium vitis-idaea polyphenols have antibacterial and antioxidant effects, and the results of in vivo studies showed that the Vaccinium vitis-idaea liposome gel is safe for skin application, effectively reduces dandruff and erythema, reduces the degree of keratinization, reduces the degree of congestion and inflammatory infiltration of local tissues as well as increasing the content of collagen fibers in skin tissues, promotes the restoration of the structural integrity of the skin, and by reducing the inflammatory factors TNF-α, IL-4. By reducing the expression level of inflammatory factors TNF-α, IL-4, IL-13, and MDA, increasing the expression level of SOD, and reducing the diversity of bacterial flora in AD tissues, it can play the role of anti-inflammatory, anti-bacterial, and antioxidant effects and improve the symptoms of AD.

CONCLUSION

The present study demonstrated that the prepared Vaccinium vitis-idaea liposome gel had an ameliorating effect on AD.

Therapeutic effect of bosentan on 2, 4-dinitrochlorobenzene (DNCB)-induced atopic dermatitis mouse model

Eczematous or atopic dermatitis (AD) is a chronic autoinflammatory skin disorder distinguished by severe itching, scratching, and erosion. Bosentan is an endothelin receptor antagonist with improved immunomodulatory and anti-inflammatory actions. This study aimed to assess the efficiency of topical bosentan in alleviating a 2, 4-dinitrochlorobenzene (DNCB)-induced mouse model of AD. 50 Swiss albino mice were haphazardly grouped into 5 teams of 10 each. The first week of the experiment involved DNCB sensitization on back skin mice, preceding a four-week DNCB challenge to induce AD-like skin inflammation. The control group gets no treatment. The induction group administered DNCB only. Starting two hours after the second sensitization, the vehicle group received topical vehicle solution, the bosentan group received 5% bosentan ointment, and the tacrolimus group received 0.1% tacrolimus ointment once daily for a period of four weeks. Topical bosentan markedly mitigated DNCB-aggravated AD-like skin lesions, as displayed by decreased total dermatitis scores and lowering the upregulated counts of total leukocytes, neutrophils, lymphocytes, monocytes, and eosinophils. Additionally, bosentan dramatically alleviated interleukin (IL)-4 and IL-13 immunohistochemistry scores, as well as IL-1β, IL-6, IL-17, TNFα, and IFN-γ epidermal levels. In conclusion, Bosentan treatment also significantly diminished levels of immunoglobulin E (IgE) and oxidative biomarker malondialdehyde (MDA) and histopathology scores, notably epidermal thickness and inflammation. Bosentan mitigates the severity of DNCB-induced AD-like skin inflammation, possibly owing to its potent anti-inflammatory and immunomodulatory properties.

The Therapeutic Potential of Kiwi Extract as a Source of Cysteine Protease Inhibitors on DNCB-Induced Atopic Dermatitis in Mice and Human Keratinocyte HaCaT Cells

The discovery of effective cysteine protease inhibitors with crude protein kiwi extracts (CPKEs) has created novel challenges and prospects for pharmaceutical development. Despite extensive research on CPKEs, limited research has been conducted on treating atopic dermatitis (AD). Therefore, the objective of this work was to investigate the anti-inflammatory effects of CPKEs on TNF-α activation in a HaCaT cell model and in a DNCB (1-chloro-2, 4-dinitrochlorobenzene)-induced atopic dermatitis animal model. The molecular weight of the CPKE was determined using SDS-PAGE under non-reducing (17 kDa and 22 kDa) and reducing conditions (25 kDa, 22 kDa, and 15 kDa), whereas gelatin zymography was performed to examine the CPKE's inhibitory impact on cysteine protease (actinidin and papain) activity. Moreover, the CPKE remains stable at 60 °C, with pH levels varying from 4 to 11, as determined by the azocasein assay. CPKE treatment decreased the phosphorylation of mitogen-activated protein kinase (MAPK) and Akt, along with the activation of nuclear factor-kappa B (NF-κB)-p65 in tumor necrosis factor-α (TNF-α)-stimulated HaCaT cells. Five-week-old BALB/c mice were treated with DNCB to act as an AD-like animal model. The topical application of CPKE to DNCB-treated mice for three weeks substantially decreased clinical dermatitis severity and epidermal thickness and reduced eosinophil infiltration and mast cells into ear and skin tissues. These findings imply that CPKE derived from kiwifruit might be a promising therapy option for inflammatory skin diseases such as AD.

Genomic epidemiology and phenotypic characterization of Staphylococcus aureus isolated from atopic dermatitis patients in South China

Atopic dermatitis (AD) is a multifactorial, chronic relapsing disease. Staphylococcus aureus is the key microbial factor in AD, linked to disease activity. However, there is limited knowledge of genomic prevalence characteristics and phenotypic features of S. aureus in AD patients in China. We investigated 108 S. aureus of AD in China and globally publicly available genome sequences of 579 S. aureus of AD. Sequence type (ST) 7, ST15 and ST188 were the major lineages in China. Genes esaC, esxB, and sea were only detected in ST7, potentially contributing to its prevalence in AD. ST188 exhibited high virulence and adhesion, possibly due to the cna gene. Phylogenetic and population structure analysis revealed that 579 strains of global AD were classified into 15 sequence clusters (SCs), with SC5, SC2, and SC7 dominating. S. aureus of Chinese AD patients was mainly distributed in SC2, SC7, and SC12. Comparative genomic highlighted genes linked to AD, including enterotoxins (seh, selk, selq, entH), adhesion genes (fnbA, fnbB, sdrD, map, fib, narH). From China and global perspectives, we analyzed S. aureus's genomic epidemic traits, phylogeny, and population structure in AD skin. These findings contribute to understanding S. aureus-host interactions and genomic diversity in AD.

Development of Pluronic-Based Micelles from Palm Oil Bioactive Compounds Incorporated by a Dissolvable Microarray Patch to Enhance the Efficacy of Atopic Dermatitis Therapy

The high content of vitamin E, including tocopherols and tocotrienols (TCF-TTE), in palm oil (Elaeis guineensis) has made it a promising candidate for the alternative treatment of atopic dermatitis (AD). However, the limited solubility of TCF-TTE has restricted its therapeutic efficacy. In this study, pluronic-based micelles (MCs) encapsulating palm oil-derived TCF-TTE were formulated with dissolvable microarray patch-micelles (DMP-MC) using carboxymethyl cellulose (CMC) synthesized from empty fruit bunches of palm to optimize its delivery for AD. The MC was prepared using a direct dissolution method using Pluronic F68 and F127. The results showed that MC increased the solubility of TCF-TTE, which was further confirmed by an in vitro study where 90.23 ± 2.07% TCF and 4.56 ± 1.36% TTE were released compared to the unencapsulated TCF-TTE extract. Furthermore, CMC biopolymers and MC integrated into DMP-MC with polyvinylpyrrolidone (PVP) exhibited favorable physical properties, such as mechanical strength and penetration ability. DMP-MC also exhibited a better platform with lower permeation, indicating higher retention and increased localized effects on AD skin than cream-MC. Additionally, dermatokinetic profile parameters showed significant improvement. The mean residence time (MRT) parameter indicated that TCF-TTE was retained for longer times 19.28 ± 0.02 h and 20.68 ± 0.01 h. Moreover, an in vivo study revealed that DMP-MC could relieve AD symptoms more rapidly than oral doses and cream-MC, indicating that DMP-MC proved to be more efficient. Furthermore, DMP-MC showed no tissue destruction (granulation and fibrosis) in rats treated with DMP-MC on the seventh day. Therefore, this study successfully developed the MC formula in DMP-MC formulation using synthesized CMC, which could potentially improve AD's therapeutic efficacy.

Effectiveness of Tralokinumab in Different Phenotypes of Atopic Dermatitis: A Real-World Study

INTRODUCTION

Atopic dermatitis (AD) is a chronic inflammatory skin disease characterized by pruritus and a relapsing course, affecting approximately 25% of children and 4-7% of adults. This study evaluated the efficacy, safety, and quality-of-life impact of tralokinumab, a humanized monoclonal antibody targeting interleukin-13 (IL-13), in treating moderate-to-severe AD in a real-world setting, with a focus on different AD phenotypes.

METHODS

An observational cohort of 30 adults treated with tralokinumab for ≥ 16 weeks was analyzed. Clinical and demographic data were collected, and outcomes were assessed using the Eczema Area and Severity Index (EASI), Dermatology Life Quality Index (DLQI), and numeric rating scales (NRS) for pruritus and sleep disturbances.

RESULTS

By week 16, 60% achieved a 75% improvement in EASI (EASI75) and 31% reached a 90% improvement in EASI (EASI90), reflecting substantial clinical improvements. A ≥ 4-point reduction in pruritus NRS was observed in 63% of patients by week 16, increasing to 70% by week 32. Similarly, 75% achieved significant improvements in sleep disturbance NRS by week 16, with sustained effects through week 32. Subgroup analysis revealed superior clinical responses in patients with early-onset AD and atopic comorbidities. Lower total immunoglobulin E (IgE) levels at week 16 correlated with better outcomes, suggesting total IgE as a potential biomarker. By week 32, 70% of patients had a DLQI ≤ 5, indicating minimal quality-of-life impact. Additionally, 88% reached at least one therapeutic target, and 81% met composite endpoints combining clinician-assessed and patient-reported outcomes. The safety profile was consistent with clinical trials, with mild conjunctivitis and injection site reactions as the most common adverse events.

CONCLUSION

These findings support tralokinumab as an effective and well-tolerated treatment, emphasizing the importance of phenotype-specific approaches in AD management.

Chinese Herbal Medicine and Their Active Ingredients Involved in the Treatment of Atopic Dermatitis Related Signaling Pathways

Atopic dermatitis (AD) is a common inflammatory dermatitis of the skin and poses therapeutic challenges due to the adverse reactions and high costs associated with available treatments. In Eastern Asian countries, a plethora of herbal remedies is extensively employed for the alleviation of AD. Many of these botanicals are renowned for their formidable anti-inflammatory properties, contributing to AD management. Chinese herbal medicine (CHM) and its active ingredients exhibit both prophylactic and therapeutic promise against AD by modulating inflammatory response, orchestrating immune system functions, and enhancing antioxidant activities. A comprehensive exploration of the underlying mechanisms involved in CHM treatment can enhance the comprehension of AD pathogenesis and facilitate the development of innovative drugs for AD. This study aims to elucidate the signaling pathways and potential targets implicated in CHM-based treatment of AD, providing a systematic theoretical framework for its application in therapy while serving as a valuable reference for developing more effective and safer AD therapeutic agents.

Ceramides and Skin Health: New Insights

Ceramide has transitioned from an incidental discovery to a vital element in skincare, becoming a thoroughly studied compound in the quest to treat skin conditions. Creating a moisture barrier, preserving hydration, regulating pH, controlling inflammation, and enhancing skin functions and appearance are among its established benefits. It is often used medically to repair skin barrier defects, as observed in inflammatory skin conditions like atopic dermatitis (AD) and dry skin types. Furthermore, ceramide and its metabolites are commonly used as predictors before disease manifestation and for prognostication processes, thus can be used as biomarker for clinical diagnosis as well. In the last couple of decades, momentum was also seen in the pre-clinical studies involving anti-cancer and nanotechnology field, whereby ceramide was also used as a drug, a carrier, or even adjunct formulation to increase efficacy of treatment such as chemotherapy. Approaches to increase ceramide levels include directly replenishing lost ceramides with natural extracts, synthetic pseudo-ceramides, or ceramide-like analogues, as well as using supplements that stimulate the body's natural ceramide production. Although ceramide is a well-known treatment in skincare and for common skin conditions like AD and psoriasis, its development and related pharmacology for severe skin conditions, such as skin cancer, remain in pre-clinical stages. Hence, the purpose of this research is to explore the role of ceramide in skin health and its application in common skin diseases.

Comparative study of mouse models of atopic dermatitis

Atopic dermatitis (AD) is a chronic, recurrent inflammatory disease. Animal models are important for studying disease mechanisms and identifying new therapeutic agents. However, owing to AD heterogeneity and complexity, there is currently no mouse model that can fully simulate human AD. We searched experimental articles published between 2017 and 2021 to identify the most suitable AD mouse model. We summarized and compared 614 articles, including details on mouse strains, sex, age, irritants, modeling cycles, and spontaneous mouse models. BALB/c mice (45.3 %) were the most commonly used. Generally, 4-8-week-old mice were used, and 44 irritants were identified. The most common irritant was 2,4-dinitrochlorobenzene (DNCB), followed by Dermatophagoides farinae mite antigen extract (DfE). The modeling period was generally 21-30 days. There is no perfect AD animal model, and we suggest selecting the most suitable AD model based on previous research or using two or more models to meet experimental requirements. When exploring allergies and T cell differentiation, it is recommended to use DNCB and DfE separately or in combination to stimulate BALB/c mice and NC/Nga mice for constructing AD models. If researchers want to explore the differentiation of Th17 and Th2 cells, the use of flaky tail mice is recommended. If researchers want to conduct research from the perspective of transcriptomics, it is recommended to increase the construction of IL-23 injected mice.

Evaluation of Meibography Findings and Ocular Surface Parameters in Children with Atopic Dermatitis Without Eye Complaints

BACKGROUND/OBJECTIVES

To evaluate the meibomian gland (MG) morphology and ocular surface parameters of children with atopic dermatitis (AD) without ocular symptoms.

MATERIALS AND METHOD

Forty-five eyes of 24 children with AD and 44 eyes of 27 healthy children were included in the study. Upper and lower eyelid meibography measurements were performed for all cases and the rate of MG loss and the amount of tortuosity were evaluated. A Schirmer 1 test, tear break-up time (TBUT) test, and corneal staining scoring (CSS) were applied to all cases.

RESULTS

MG loss in the upper eyelid was 15.51 ± 10.39% in the AD group, while it was 9.30 ± 5.30% in the control group (p = 0.002). MG loss in the lower eyelid was 15.79 ± 10.93% in the AD group, while it was 9.23 ± 6.90% in the control group (p = 0.002). The rate of tortuosity in 26-50% of the upper and lower eyelid MGs was significantly higher in the AD group than in the healthy control group (p = 0.002 and p = 0.007, respectively). The Schirmer 1 test values were 10.98 ± 3.89 in the AD group and 17.41 ± 3.73 in the healthy control group (p < 0.0001). The TBUT values were found to be 9.18 ± 1.99 in the AD group and 11.40 ± 1.82 in the healthy control group (p < 0.0001). The CSS result was found to be significantly higher in the AD group than in the control group (p = 0.001).

CONCLUSIONS

Significant MG loss was detected in patients with AD without eye complaints, which may cause the early deterioration of ocular surface parameters. We believe that close follow-up examinations of children with AD in terms of ocular surface complications may be necessary.

Restorative effects of camellia oil on the skin-barrier function in a model of DNCB-induced atopic dermatitis

This study aimed to evaluate the therapeutic efficacy of camellia oil on 2,4-dinitrochlorobenzene (DNCB)-induced atopic dermatitis (AD) in mice, as well as its effect on the expression of skin-barrier-related proteins. A mouse model of AD was created via topical application of DNCB; subsequently, the animals were randomly divided into four groups: the blank control (Control), model (Model), moisturizing cream (Moisturizer), and camellia oil (Camellia) groups. The Camellia group received camellia oil, whereas the Moisturizer group was treated with moisturizing cream, as a positive control. Skin lesions, ear and back tissue morphology, and the serum levels of IgE, IL-4, and IFN-γ were analyzed. Compared with the Control group, AD mice exhibited erythema, papules, dryness, peeling, and significantly higher serum IgE and IL-4 levels. Compared with the Model group, treatment with camellia oil and moisturizing cream considerably reduced skin inflammation, ear thickness, and scratching frequency. A histopathological analysis revealed that camellia oil reduced inflammatory-cell infiltration and edema in the AD-affected skin. Furthermore, camellia oil upregulated filaggrin (FLG), thus aiding in skin-barrier repair. These findings suggest that camellia oil significantly improves AD symptoms, enhances FLG expression, and restores the damaged skin barrier in AD mouse models.

Investigation of Clostridium butyricum on atopic dermatitis based on gut microbiota and TLR4/MyD88/ NF-κB signaling pathway

BACKGROUND

Probiotics, as common regulators of the gut microbiota, have been used in research to alleviate clinical symptoms of atopic dermatitis (AD).

OBJECTIVE

Our research team has previously identified a potential relieving effect of Clostridium butyricum on the treatment of AD, but the specific mechanism of how Clostridium butyricum alleviates AD has not yet been confirmed.

METHODS

In this study, we explored the relieving effect of Clostridium butyricum on AD through in vivo and in vitro experiments. AD mice induced by 2,4-dinitrofluorobenzene (DNFB) were orally administered with 1 × 108 CFU of Clostridium butyricum for three consecutive weeks.

RESULTS

Oral administration of Clostridium butyricum reduced ear swelling, alleviated back skin lesions, decreased mast cell and inflammatory cell infiltration, and regulated the levels of inflammation-related cytokines. Clostridium butyricum activated the intestinal immune system through the TLR4/MyD88/NF-κB signaling pathway, suppressed the expression of inflammatory factors IL-10 and IL-13, and protected the damaged intestinal mucosa.

CONCLUSION

Clostridium butyricum administration improved the diversity and abundance of the gut microbiota, enhanced the functionality of the immune system, and protected the epidermal barrier.

Area-Specific Assessment of Stratum Corneum Hydration and Transepidermal Water Loss in Pediatric Patients With Atopic Dermatitis

SCORring atopic dermatitis (SCORAD) is widely used to assess the severity of atopic eczema, but score systems based on the entire body may be limited in effective monitoring and intervention. It is crucial to monitor moisture levels in each affected body part, but empirical research is still lacking. The objective of this study was to analyze the levels of stratum corneum hydration (SCH) and transepidermal water loss (TEWL) in atopic dermatitis (AD) patients, focusing on the presence and location of atopic lesions at different body sites. The levels of TEWL and SCH were measured using the AF200 AquaFlux and the Corneometer, respectively, at 15 body sites. 98 children under the age of 10 were measured, including 83 AD patients and 15 in the control group. Patients were also assessed with SCORAD and for the presence of atopic lesions at each body site. 58.7% of AD patients had lesions in the antecubital fossa and popliteal fossa, with corresponding low SCH levels and high TEWL in the upper body. The differences in TEWL between the control group and AD patients were confirmed significant in the neck and antecubital fossa regions, while differences in SCH were identified in the face, antecubital fossa, and popliteal fossa regions. A higher TEWL was found among AD patients with atopic lesions in the face and ankle. This study suggests that continuous monitoring of SCH and TEWL levels at specific body sites can provide insights into identifying vulnerable body areas to AD and supplement the SCORAD system for more effective clinical intervention and prevention strategies.

Immunohistochemical investigation of transient receptor potential melastatin-2 and spexin immunoreactivity in atopic dermatitis and mycosis fungoides

BACKGROUND

Atopic dermatitis (AD) is a chronic, pruritic, and inflammatory dermatosis seen in individuals with an atopic predisposition. This study aimed to examine the immunoreactivity of spexin and TRPM2 in skin samples from patients with AD and MF lesions using immunohistochemical methods.

MATERIALS AND METHODS

The study utilized a total of 60 skin samples, comprising 20 from AD patients, 20 from MF patients, and 20 from control subjects. Skin samples from patients diagnosed with other dermatological diseases, malignancies, and diabetes mellitus were excluded from the study. During staining, the prevalence (0.1: <25%, 0.4: 26-50%, 0.6: 51-75%, 0.9: 76-100%) and intensity (0: none, + 0.5: very low, + 1: low, + 2: moderate, + 3: intense) of immunoreactivity were used as criteria to establish a histo-score. Calculations employed the formula histo-score = prevalence x intensity.

RESULTS

Statistically significant higher spexin histoscores were observed in both the AD and MF patient groups compared to the control group (1.30 ± 0.46, 1.04 ± 0.29, and 0.20 ± 0.07, respectively; p = 0.000). Similarly, TRPM2 histoscores were significantly higher in the AD and MF patient groups compared to the control group (1.12 ± 0.28, 1.02 ± 0.30, and 0.20 ± 0.07, respectively; p = 0.000).

CONCLUSION

It is hypothesized that the increase in the neuropeptide spexin in both AD and MF is triggered by inflammation and contributes to itching mechanisms via galanin receptors. TRPM2, an ion channel, is speculated to be a marker of Reactive Oxygen Species (ROS) in chronic inflammatory dermatoses like AD, but it may not serve as a potential biomarker for distinguishing chronic inflammatory dermatoses from MF.

Preventing NLRP3 inflammasome activation: Therapeutic atrategy and challenges in atopic dermatitis

Atopic dermatitis (AD) is a prevalent inflammatory skin disorder characterized by its chronic, persistent, and recurrent nature. The pathophysiology of this condition is complex, involving various factors including cell-mediated immune responses, compromised skin barrier function, and alterations in hypersensitivity reactions. These components synergistically contribute to the perpetuation of the bothersome "itch-scratch-itch" cycle. Recent research has highlighted the significant role of the NLRP3 inflammasome in the development of AD and other inflammatory conditions. Current research indicates that the NLRP3 inflammasome plays a pivotal role in both the acute and chronic phases of AD by modulating the Th2/Th1 immune deviation. Moreover, the pharmacological suppression of NLRP3 has shown promising results in mitigating the pathological aspects of AD. This review outlines potential drug development strategies that target the NLRP3 inflammasome as a therapeutic approach for AD and the challenges faced in this endeavor.

The primary mechanisms underlying atopic dermatitis

INTRODUCTION

Atopic dermatitis (AD) is a complex skin disease frequently linked with other atopic symptoms such allergic rhinitis and asthma. The disease's history consists of persistent relapses with extreme pruritus, which lowers quality of life. AD has become a global health concern as its incidence has increased over the last few decades. It ranks as the third most common dermatologic disorder.

AIM

There are several open questions about the mechanisms underlying atopic dermatitis (AD), This review aims to emphasize the recent advances in scientific research regarding the pathophysiologic mechanism of AD and the clinical application of these factors.

METHODS

A PubMed search was performed using the keywords "Atopic Dermatitis (AD)", "epidemiology", "clinical presentation", "diagnosis", "pathophysiology", "genetic defect", "impaired skin barrier", "immune dysregulation". The search strategy included meta-analyses, clinical trial, observational studies, and reviews.

RESULTS

Atopic dermatitis affects over 2 million children worldwide, with a lifetime incidence of up to 20%. New data suggest that its incidence is still growing, particularly in low-income nations. AD is diagnosed clinically using the patient's medical history, particular clinical symptoms, and the elimination of other non-inflammatory skin conditions. The pathogenesis of AD is extremely complicated and involves several etiologies, including genetics, the microbiome, abnormalities in the skin barrier, along with dysfunctional innate and adaptive immune systems.

CONCLUSION

Recent research has improved our understanding of disease pathophysiology in atopic dermatitis. Current and future clinical trials are expected to continue clarifying this complex and heterogeneous skin disease, and to develop medications that promise more effective therapy, particularly for individuals with limited response to conventional treatments.

Innovative approaches to eczema treatment: A review of Fevipiprant and its potential as a new therapeutic agent

Eczema is also known as atopic dermatitis, which goes on to affect the skin as a chronic inflammatory disease. It is associated with a constant feeling of scratchiness, erthyma and disruption of the natural skin barrier. Treatment provided at present may improve some of the symptoms, for instance use of corticosteroids or immunosuppressive agents, however, there is an overwhelming need for better focused and effective methods of treatment with minimal adverse effects. Fevipiprant, a DP2 receptor antagonist, has emerged as a promising agent targeting prostaglandin D2 (PGD2) pathways, which play a crucial role in eczema pathophysiology. This review examines the mechanism of action, pharmacological profile of Fevipiprant and present studies on preclinical and clinical development of Fevipiprant for treatment of eczema. Additionally, we provide a comparison of Fevipiprant with existing treatment options and evaluate its safety and tolerability. The evaluation gives a reason that targeting in the treatment of eczema by the use of Fevipiprant is able to effectively target the DP2 pathway which is associated with a good safetyl however presenting itself as a new treatment option in the management of eczema. Finally, long-term studies are essential to validate the feasibility, safety, and effectiveness of Fevipiprant compared to existing therapies for eczema. Novartis has taken advantage of this stat for comp… given the scarcity of effective therapies for paediatric atopic dermatitis in Japan. Exploring Fevipiprant from the Efficacy Perspective is also required because it will impact how it will enter clinical practice in therapy of eczema in the future.

Histological features of immune cell infiltrate in lesional skin correlate with therapeutic response to dupilumab

Over the past decade, dupilumab, a monoclonal human antibody that inhibits interleukin (IL)-4 and IL-13 signalling, has revolutionized the therapeutic management of moderate-to-severe atopic dermatitis (AD), facilitating long-term control of its signs and symptoms. The aim of this study was to identify histological predictors of the efficacy of dupilumab after 16 weeks of treatment in a cohort of 40 adults with moderate-to-severe AD who had undergone a skin biopsy for diagnostic purposes before treatment initiation. We found that Eczema Area and Severity Index (EASI) 75 and EASI 90 responses at week 16 were significantly associated with perivascular localization [odds ratio (OR) 17.6; P = 0.04] and lichenoid distribution (OR 31.8; P = 0.03) of the immune infiltrate. Moreover, for each unit increase in the number (cells mm-2) of CD4+ cells, the likelihood of achieving an EASI 75 response decreased by 1% (OR 0.99; P = 0.04). In conclusion, our study found promising pretreatment immunohistochemical markers that could predict how well patients with AD respond to dupilumab.

The Beneficial Roles of Seaweed in Atopic Dermatitis

Atopic dermatitis (AD) is a chronic, inflammatory skin condition characterized by severe pruritus and recurrent flare-ups, significantly impacting patients' quality of life. Current treatments, such as corticosteroids and immunomodulators, often provide symptomatic relief but can lead to adverse effects with prolonged use. Seaweed, a sustainable and nutrient-dense resource, has emerged as a promising alternative due to its rich bioactive compounds-polysaccharides, phlorotannins, polyphenols, and chlorophyll-that offer anti-inflammatory, antioxidant, and immunomodulatory properties. This review explores the therapeutic potential of brown, red, and green algae in alleviating AD symptoms, highlighting the effects of specific species, including Undaria pinnatifida, Laminaria japonica, Chlorella vulgaris, and Sargassum horneri. These seaweeds modulate immune responses, reduce epidermal thickness, and restore skin barrier function, presenting a novel, safe, and effective approach to AD management. Further clinical studies are needed to confirm their efficacy and establish dosing strategies, paving the way for seaweed-derived therapies as natural alternatives in AD treatment.

The changes of intestinal flora and metabolites in atopic dermatitis mice

Introduction

Atopic dermatitis (AD) is an allergic disease caused by various factors that can affect an individual's appearance and cause psychological stress. Therefore, it is necessary to investigate the underlying mechanisms and develop effective treatment strategies. The gut microbiota and bacterial metabolism play crucial roles in human diseases. However, their specific role in AD remains unclear.

Methods

In this study, we established a mouse model of AD and found that 2,4-dinitrofluorobenzene disrupted the skin barrier in mice. The species composition of intestinal bacteria was then analyzed by fecal 16s rRNA sequencing. The metabolic level of mice was analyzed by untargeted and targeted metabolomics in stool.

Results

The levels of filaggrin and aquaporin 3 proteins in the model mice and total superoxide dismutase, catalase and malondialdehyde levels were significantly altered. Additionally, inflammatory factors such as tumor necrosis factor-alpha showed a significant increase. Using 16S rRNA gene sequencing, we identified 270 bacterial species with altered abundances of Ruminococcaceae and Bifidobacteriaceae. The untargeted metabolomic analysis detected 1,299 metabolites. Targeted analysis of free fatty acids revealed 49 metabolites with notable increases in linoleic and linolenic acid levels. Fecal bacterial transplantation experiments have demonstrated that oxidative stress, inflammation, and skin barrier damage were alleviated after transplantation.

Discussion

These findings suggested that the metabolite linoleic acid negatively correlated with Ruminococcaceae and Bifidobacteriaceae may influence AD development. Perturbations in the intestinal bacteria and flora contributed to the development of AD, and the mouse model could serve as a valuable tool for further investigation of therapeutic approaches for managing ADS.

[Monoclonal Antibodies in Allergic Diseases: Development, Pharmacology, and Clinical Applications]

The understanding of immunological processes associated with allergic diseases and advancements in antibody bioengineering has driven the development of specific biological therapies. Monoclonal antibodies, selectively targeting cytokines involved in the pathogenesis of allergic processes or their receptors, have emerged as a promising tool in treating various conditions, including asthma, allergic rhinitis, urticaria, and severe atopic dermatitis. Since the approval of the first anti-CD3 mouse monoclonal antibody in 1986, remarkable progress has been achieved, marked by the development of chimeric, 'humanized,' and 'fully human' antibodies. The 'humanization' of monoclonal antibodies has played a crucial role in reducing the risk of immunogenicity and minimizing adverse effects, thereby notably enhancing the safety and efficacy of these therapeutic interventions. The aim of this article is to address the characterization, development, pharmacokinetics, pharmacodynamics, and clinical utility of monoclonal antibodies, with a primary focus on allergic diseases.

Dendrobium officinale Kimura et Migo polysaccharide ameliorated DNFB-induced atopic dermatitis in mice associated with suppressing MAPK/NF-κB/STAT3 signaling pathways

ETHNOPHARMACOLOGICAL RELEVANCE

Dendrobium officinale Kimura et Migo as a valuable Chinese medicine has been used in China for more than 2000 years. Its main active components, polysaccharide (DOP), has been reported to have various pharmacological effects, including anti-inflammatory, antioxidant and alleviating AD effects. However, the precise mechanism underlying its therapeutic effect in AD remains largely unclear.

AIM OF THE STUDY

The present study sought to assess the efficacy of DOP and elucidate its intricate mechanisms in ameliorating DNFB-induced AD.

MATERIALS AND METHODS

Mice were sensitized with DNFB and treated with DOP application for 14 days. Treatment effects were assessed using dermatitis scores, ear thickness and scratching frequency. Epidermal thickness, mast cells and CD4+ T cells infiltration were detected by using H&E, toluidine blue staining and immunofluorescence staining respectively. Serum histamine (HIS), immunoglobulin E (IgE), thymic stromal lymphopoietin (TSLP), skin SOD, MDA, GHS, CAT, inflammatory cytokines (TNF-α, IFN-γ, IL-1β, IL-4, IL-5, IL-13) and chemokine (MIP-α, MDC, MCP-1) levels were quantify by ELISA and immunohistochemistry. Additionally, qPCR and Western blot analyses were performed to assess genes and proteins expression associated with MAPK/NF-κB/STAT3 signaling pathway.

RESULTS

The results indicated that DOP effectively mitigated AD-like skin lesions in mice through multiple pathways. It reduced epidermal thickness, ear thickness and scratching frequency in AD mice. Additionally, DOP mitigated inflammatory responses by decreasing the levels of inflammatory factors, as well as reducing serum levels of IgE, HIS, and TSLP. Moreover, DOP inhibited infiltration of mast cells and CD4+ T cells, suppressed the expression of skin chemokines such as MDC, MCP-1, and MIP-α, and enhanced filaggrin content in AD mice. Furthermore, DOP significantly boosted antioxidant capacity, as well as significantly reduced the expression of JAK1, STAT3, NF-κB p65, IκBα, ERK1/2, and p38 proteins and phosphorylated proteins such as p-JAK1, p-STAT3, p-NF-κB p65, p-IκBα, p-ERK1/2, and p-p38.

CONCLUSIONS

These findings suggested that DOP has significant anti-AD activity, primarily through reducing inflammatory responses, improving antioxidant capacity, repairing the skin barrier, and down-regulating key genes and proteins in MAPK/NF-κB/STAT3 signaling pathway, and that this study may provide valuable insights into the development of innovative therapies for the treatment of AD.

Enoximone alleviates atopic dermatitis-like skin inflammation via inhibition of type 2 T helper cell development

Atopic dermatitis (AD) is an inflammatory skin disease that affects approximately 15-20 % of the children and 1-3 % of the adults worldwide. Corticosteroids and calcineurin inhibitors are used in AD therapy; however, they cause various side effects. Current studies focus on novel therapeutic targets such as phosphodiesterases (PDEs) to mitigate AD. However, the relationship between PDE3 inhibitors and AD has not yet been reported. This study aimed to investigate the therapeutic effects and pharmaceutical mechanisms of enoximone (Enox), a PDE3 inhibitor. Mice were stimulated with 2,4-dinitrochlorobenzene (DNCB) to induce AD-like skin inflammation and were topically treated with Enox for 2 weeks. Treatment with Enox reduced the dermatitis score, skin water loss, IgE production, and expression of cytokines and chemokines that were elevated by DNCB. Histologically, Enox treatment reduced the skin thickness and the infiltration of various inflammatory cells, including macrophages, mast cells, eosinophils, and type 2 T helper (Th2) cells. HuT78, a human T cell line, was used to investigate the differentiation of T cells into Th2 cells. Enox treatment decreased the expression of Th2 cytokines and GATA3, a Th2 cell marker in HuT78, and suppressed signaling pathways that play a crucial role in Th2 cell differentiation. Collectively, the results demonstrate that Enox alleviates AD-like skin inflammation by inhibiting T-cell development. Thus, Enox may be a therapeutic candidate for the treatment of AD.

Novel candidate plasma proteins for the pathogenesis and treatment of atopic dermatitis revealed by proteome-wide association study

Atopic dermatitis (AD) is an immune-related skin disease with a genetic background. Numerous loci have been identified associated with AD to better comprehend its complicated genetic mechanisms by genome‑wide association studies (GWASs). However, current studies reveal the underlying mechanisms of these loci in the pathogenesis of AD inadequately. Therefore, we integrated the GWAS statistics of AD with plasma proteins to explore candidate proteins correlated with the pathogenesis of AD based on protein-centered omics studies. Herein, we adopted the updated AD GWAS statistics (N = 864,982) and the dataset of plasma protein quantitative trait loci (pQTLs), comprising 1,348 proteins from individuals of European descent. We first conducted the AD-related proteome-wide association studies (PWASs) (N = 7,213) by integrating pQTLs with the AD GWAS statistics and identified twenty-six significant plasma proteins by PWAS (FDR < 0.05). Then, the potential causal proteins of AD were identified via Mendelian randomization (MR), and seventeen causal proteins of AD were discovered afterward. Following this, Bayesian colocalization analysis was then utilized to explore proteins sharing the same causal variants. Five causal proteins strongly associated with the pathogenesis of AD were eventually pinpointed. Finally, we discovered drugs that could be repurposed for AD with the plasma proteins that might contribute to the pathogenesis of AD in the Drug Gene Interaction Database.

Injection site reactions after dupilumab or tralokinumab for atopic dermatitis

Background: Injection site reaction (ISR) is a local phenomenon defined as a constellation of symptoms, including swelling, erythema, pruritus, and pain around the site of injection.Objective: ISR is reported as a frequent adverse event after subcutaneous injection (SCI) of several biologics.Methods: We performed an observational real-life study to compare dupilumab and tralokinumab as regards ISR, analysing frequency, duration and intensity of symptoms related to SCI. From January 2023 to June 2023, we enrolled adult patients affected by moderate to severe AD and being on dupilumab or tralokinumab treatment. A 12 items questionnaire was administered to all enrolled patients.Results and conclusions: Three hundred and ninety-two patients were included. ISR was a frequent occurrence in both the treatment groups, with tralokinumab causing ISR more frequently than dupilumab. However, the reactions were generally mild and no patient stopped therapy.

Transdermal delivery of natural products against atopic dermatitis

Atopic dermatitis (AD) is a chronic inflammatory skin condition. Natural products have gained traction in AD treatment due to their accessibility, low toxicity, and favorable pharmacological properties. However, their application is primarily constrained by poor solubility, instability, and limited permeability. The transdermal drug delivery system (TDDS) offers potential solutions for transdermal delivery, enhanced penetration, improved efficacy, and reduced toxicity of natural drugs, aligning with the requirements of modern AD treatment. This review examines the application of hydrogels, microneedles (MNs), liposomes, nanoemulsions, and other TDDS-carrying natural products in AD treatment, with a primary focus on their effects on penetration and accumulation in the skin. The aim is to provide valuable insights into the treatment of AD and other dermatological conditions.

The role of NLRP3 inflammasome in type 2 inflammation related diseases

Type 2 inflammation related diseases, such as atopic dermatitis, asthma, and allergic rhinitis, are diverse and affect multiple systems in the human body. It is common for individuals to have multiple co-existing type 2 inflammation related diseases, which can impose a significant financial and living burden on patients. However, the exact pathogenesis of these diseases is still unclear. The NLRP3 inflammasome is a protein complex composed of the NLRP3 protein, ASC, and Caspase-1, and is activated through various mechanisms, including the NF-κB pathway, ion channels, and lysosomal damage. The NLRP3 inflammasome plays a role in the immune response to pathogens and cellular damage. Recent studies have indicated a strong correlation between the abnormal activation of NLRP3 inflammasome and the onset of type 2 inflammation. Additionally, it has been demonstrated that suppressing NLRP3 expression effectively diminishes the inflammatory response, highlighting its promising therapeutic applications. Therefore, this article reviews the role of NLRP3 inflammasome in the development and therapy of multiple type 2 inflammation related diseases.

Atopic Dermatitis: A Review of Diagnosis and Treatment

Atopic dermatitis, more commonly known as atopic eczema, is a chronic, relapsing inflammatory skin disorder characterized by dry skin, localized erythematous rash, and intense pruritus. The clinical manifestations are variable and age dependent. As one of the most common skin disorders globally, atopic dermatitis poses a significant clinical and economic burden on affected patients. Individual treatment strategies are imperative in improving patient outcomes and reducing these burdens. Recent advances in understanding the genetic, immunologic, and environmental factors influencing atopic dermatitis have opened avenues for novel treatment modalities. This article highlights the clinical presentation, pathophysiology, diagnosis criteria, as well as current recommendations on treatment of atopic dermatitis.

Effects of Huang-Lian-Jie-Du decoction on improving skin barrier function and modulating T helper cell differentiation in 1-chloro-2,4-dinitrobenzene-induced atopic dermatitis mice

Background: Atopic dermatitis (AD) is among the most frequently encountered skin diseases, bothering a considerable number of patients. Today, corticosteroids and antihistamines are among the numerous drugs applied for the therapy of AD. However, lengthy use of them contributes to side effects, such as physiological changes in skin. As an alternative and supplementary therapy, traditional Chinese medicine has become a trend for AD treatment. Huang-Lian-Jie-Du decoction (HLJDD), a renowned herbal formula has been employed to treat inflammatory diseases such as AD. However, its role in regulating immunity in AD remains unclear. The object of this study was to elucidate the efficacy of HLJDD and reveal the implicit mechanism from an immunological perspective in AD-like mice. Methods: In brief, 1-chloro-2,4-dinitrobenzene (DNCB) for the sensitization phase (1% DNCB) and stimulation phase (1.5% DNCB) were applied for BALB/c mice. HLJDD and dexamethasone (DXMS) were administered orally to the mice. Mice skin and spleens were collected to evaluate the efficacy of HLJDD. 16S rRNA sequencing was applied to evaluate the commensal microbiota changes in skin and fecal. In vitro, spleen CD4+ T cells and bone marrow-derived mast cells (BMMCs) were co-cultured to explore the modulation of HLJDD in T helper (Th) cells phenotyping. Results: HLJDD showcased a substantial amelioration in skin through the upregulation of FLG, LOR, AQP3, and reducing scratching behaviors in AD-like mice, Also, the quantity of infiltrated mast cells (MCs), pruritus-related mRNA were decreased. In addition, the expression of OX40/OX40L was decreased by HLJDD, which was critical in Th-cell phenotyping. With the treatment of HLJDD, Th1/Th2 and Th17/Treg ratios in AD-like mice became balanced. The structure of commensal microbiota in AD-like mice was affected by HLJDD. HLJDD could also improve the imbalance of Th17/Treg in vitro. Conclusion: HLJDD could improve the symptoms of AD-like mice by alleviating the scratching behaviors via decreased Th2 and pruritus-related mRNA expression. HLJDD also enhanced the relative diversity of skin microbiota and changed the structure of intestinal microbiota. An in-depth study found that HLJDD could balance the ratio of Th1/Th2, Th17/Treg in AD-like mice, and Th17/Treg in vitro by regulating the OX40/OX40L signaling pathway.

Efficacy and safety of lebrikizumab for the treatment of moderate-to-severe atopic dermatitis: a systematic review and meta-analysis

Background

Lebrikizumab, an IL-13 immunomodulator, has shown recommendable effectiveness and safety in clinical studies for the treatment of moderate-to-severe atopic dermatitis (AD) in adolescents and adults.

Objective

To evaluate the efficacy and safety of lebrikizumab in the treatment of moderate-to-severe AD through a meta-analysis.

Methods

PubMed, Embase, Web of Science, Medline, and ClinicalTrials.gov databases were searched up to 8 August 2023. Randomized clinical trials of lebrikizumab treatment for moderate-to-severe AD were included by screening titles, abstracts, and papers.

Results

Five studies involving 1,551 patients with AD were identified. Pooled analysis revealed significant improvements in the Eczema Area and Severity Index (EASI) score (SMD = -0.527; 95% CI = [-0.617, -0.436]), Investigator's Global Assessment (IGA) score (RR = 2.122; 95% CI = [1.803, 2.496]), Body Surface Area (BSA) score (SMD = -0.608; 95% CI = [-1.099, -0.118]), SCORing Atopic Dermatitis (SCORAD) score (SMD = -0.441; 95% CI = [-0.633, -0.250]). Moreover, Pruritus Numeric Rating Scale (P-NRS) score, Patient-oriented Eczema Measure (POEM) scores, Sleep-loss score and Dermatology Life Quality Index (DLQI) scores showed similar results. Adverse events (AEs) (RR = 0.984; 95% CI = [0.907, 1.068]) for lebrikizumab showed no statistically significant difference compared to placebo, with similar results for serious adverse events (SAEs) (RR = 0.748; 95% CI = [0.410, 1.364]).

Conclusion

This meta-analysis reveals that lebrikizumab has higher efficacy and safety in the treatment of moderate-to-severe AD, with the 250 mg Q2W dosage regimen appearing to be more advantageous.