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Perkin MR, Craven J, Logan K, Strachan D, Marrs T, Radulovic S, Campbell LE, MacCallum SF, McLean WHI, Lack G, Flohr C. Association between domestic water hardness, chlorine, and atopic dermatitis risk in early life: A population-based cross-sectional study. J Allergy Clin Immunol 2016; 138:509-16. [PMID: 27241890 DOI: 10.1016/j.jaci.2016.03.031] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Revised: 03/08/2016] [Accepted: 03/16/2016] [Indexed: 12/29/2022]
Abstract
BACKGROUND Domestic water hardness and chlorine have been suggested as important risk factors for atopic dermatitis (AD). OBJECTIVE We sought to examine the link between domestic water calcium carbonate (CaCO3) and chlorine concentrations, skin barrier dysfunction (increased transepidermal water loss), and AD in infancy. METHODS We recruited 1303 three-month-old infants from the general population and gathered data on domestic water CaCO3 (in milligrams per liter) and chlorine (Cl2; in milligrams per liter) concentrations from local water suppliers. At enrollment, infants were examined for AD and screened for filaggrin (FLG) skin barrier gene mutation status. Transepidermal water loss was measured on unaffected forearm skin. RESULTS CaCO3 and chlorine levels were strongly correlated. A hybrid variable of greater than and less than median levels of CaCO3 and total chlorine was constructed: a baseline group of low CaCO3/low total chlorine (CaL/ClL), high CaCO3/low total chlorine (CaH/ClL), low CaCO3/high total chlorine (CaL/ClH) and high CaCO3/high total chlorine (CaH/ClH). Visible AD was more common in all 3 groups versus the baseline group: adjusted odds ratio (AOR) of 1.87 (95% CI, 1.25-2.80; P = .002) for the CaH/ClL group, AOR of 1.46 (95% CI, 0.97-2.21; P = .07) for the CaL/ClH, and AOR of 1.61 (95% CI, 1.09-2.38; P = .02) for the CaH/ClH group. The effect estimates were greater in children carrying FLG mutations, but formal interaction testing between water quality groups and filaggrin status was not statistically significant. CONCLUSIONS High domestic water CaCO3 levels are associated with an increased risk of AD in infancy. The influence of increased total chlorine levels remains uncertain. An intervention trial is required to see whether installation of a domestic device to decrease CaCO3 levels around the time of birth can reduce this risk.
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Affiliation(s)
- Michael R Perkin
- Population Health Research Institute, St George's, University of London, London, United Kingdom
| | - Joanna Craven
- Children's Allergies Department, Division of Asthma, Allergy and Lung Biology, King's College London, London, United Kingdom
| | - Kirsty Logan
- Children's Allergies Department, Division of Asthma, Allergy and Lung Biology, King's College London, London, United Kingdom
| | - David Strachan
- Population Health Research Institute, St George's, University of London, London, United Kingdom
| | - Tom Marrs
- Children's Allergies Department, Division of Asthma, Allergy and Lung Biology, King's College London, London, United Kingdom
| | - Suzana Radulovic
- Children's Allergies Department, Division of Asthma, Allergy and Lung Biology, King's College London, London, United Kingdom
| | - Linda E Campbell
- Centre for Dermatology and Genetic Medicine, Division of Molecular Medicine, University of Dundee, Dundee, United Kingdom
| | - Stephanie F MacCallum
- Centre for Dermatology and Genetic Medicine, Division of Molecular Medicine, University of Dundee, Dundee, United Kingdom
| | - W H Irwin McLean
- Centre for Dermatology and Genetic Medicine, Division of Molecular Medicine, University of Dundee, Dundee, United Kingdom
| | - Gideon Lack
- Children's Allergies Department, Division of Asthma, Allergy and Lung Biology, King's College London, London, United Kingdom
| | - Carsten Flohr
- Children's Allergies Department, Division of Asthma, Allergy and Lung Biology, King's College London, London, United Kingdom; St John's Institute of Dermatology, Guy's and St Thomas' Hospital NHS Foundation Trust, London, United Kingdom.
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Forbes D, Johnston L, Gardner J, MacCallum SF, Campbell LE, Dinkova-Kostova AT, McLean WHI, Ibbotson SH, Dawe RS, Brown SJ. Filaggrin genotype does not determine the skin's threshold to UV-induced erythema. J Allergy Clin Immunol 2016; 137:1280-1282.e3. [PMID: 26830116 PMCID: PMC4819769 DOI: 10.1016/j.jaci.2015.11.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Revised: 09/28/2015] [Accepted: 11/14/2015] [Indexed: 01/01/2023]
Affiliation(s)
- Deborah Forbes
- Ninewells Hospital and Medical School, Dundee, United Kingdom
| | - Leona Johnston
- Photobiology Unit, Dermatology Department, University of Dundee, Ninewells Hospital and Medical School, Dundee, United Kingdom
| | - June Gardner
- Photobiology Unit, Dermatology Department, University of Dundee, Ninewells Hospital and Medical School, Dundee, United Kingdom
| | - Stephanie F MacCallum
- Dermatology and Genetic Medicine, Division of Molecular Medicine, College of Life Sciences and College of Medicine, Dentistry and Nursing, University of Dundee, Dundee, United Kingdom
| | - Linda E Campbell
- Dermatology and Genetic Medicine, Division of Molecular Medicine, College of Life Sciences and College of Medicine, Dentistry and Nursing, University of Dundee, Dundee, United Kingdom
| | - Albena T Dinkova-Kostova
- Division of Cancer Research, Medical Research Institute, Jacqui Wood Cancer Centre, University of Dundee, Ninewells Hospital and Medical School, Dundee, United Kingdom
| | - W H Irwin McLean
- Dermatology and Genetic Medicine, Division of Molecular Medicine, College of Life Sciences and College of Medicine, Dentistry and Nursing, University of Dundee, Dundee, United Kingdom
| | - Sally H Ibbotson
- Photobiology Unit, Dermatology Department, University of Dundee, Ninewells Hospital and Medical School, Dundee, United Kingdom
| | - Robert S Dawe
- Photobiology Unit, Dermatology Department, University of Dundee, Ninewells Hospital and Medical School, Dundee, United Kingdom
| | - Sara J Brown
- Dermatology and Genetic Medicine, Medical Research Institute, College of Medicine, Dentistry and Nursing, Ninewells Hospital and Medical School, Dundee, United Kingdom.
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Riethmuller C, McAleer MA, Koppes SA, Abdayem R, Franz J, Haftek M, Campbell LE, MacCallum SF, McLean WHI, Irvine AD, Kezic S. Filaggrin breakdown products determine corneocyte conformation in patients with atopic dermatitis. J Allergy Clin Immunol 2015; 136:1573-1580.e2. [PMID: 26071937 PMCID: PMC4669308 DOI: 10.1016/j.jaci.2015.04.042] [Citation(s) in RCA: 81] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Revised: 04/23/2015] [Accepted: 04/24/2015] [Indexed: 01/22/2023]
Abstract
Background Loss-of-function (LOF) mutations in the filaggrin gene (FLG) are a well-replicated risk factor for atopic dermatitis (AD) and are known to cause an epidermal barrier defect. The nature of this barrier defect is not fully understood. Patients with AD with FLG LOF mutations are known to have more persistent disease, more severe disease, and greater risk of food allergies and eczema herpeticum. Abnormalities in corneocyte morphology have been observed in patients with AD, including prominent villus-like projections (VP); however, these ultrastructural features have not been systematically studied in patients with AD in relation to FLG genotype and acute and convalescent status. Objective We sought to quantitatively explore the relationship between FLG genotype, filaggrin breakdown products (natural moisturizing factor [NMF]), and corneocyte morphology in patients with AD. Methods We studied 15 children at first presentation of AD and after 6 weeks of standard therapy. We applied atomic force microscopy to study corneocyte conformation in patients with AD stratified by FLG status and NMF level. By using a new quantitative methodology, the number of VPs per investigated corneocyte area was assessed and expressed as the Dermal Texture Index score. Corneocytes were also labeled with an anti-corneodesmosin antibody and visualized with scanning electron microscopy. Results We found a strong correlation between NMF levels and Dermal Texture Index scores in both acute and convalescent states (respective r = −0.80 and −0.75, P < .001 and P = .002). Most, but not all, VPs showed the presence of corneodesmosin abundantly all over the cell surface in homozygous/compound heterozygous FLG patients and, to a lesser extent, in heterozygous and wild-type patients. Conclusions NMF levels are highly correlated with corneocyte morphology in patients with AD. These corneocyte conformational changes shed further insight into the filaggrin-deficient phenotype and help explain the barrier defect in patients with AD with FLG LOF mutations.
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Affiliation(s)
| | - Maeve A McAleer
- Department of Dermatology, Our Lady's Children's Hospital, Crumlin, Dublin, Ireland; National Children's Research Centre, Our Lady's Children's Hospital, Crumlin, Dublin, Ireland
| | - Sjors A Koppes
- Coronel Institute of Occupational Health, Academic Medical Center, Amsterdam, The Netherlands
| | - Rawad Abdayem
- University of Lyon 1, EA4169 "Fundamental, clinical and therapeutic aspects of the skin barrier function", Lyon, France
| | | | - Marek Haftek
- University of Lyon 1, EA4169 "Fundamental, clinical and therapeutic aspects of the skin barrier function", Lyon, France
| | - Linda E Campbell
- Centre for Dermatology and Genetic Medicine, Division of Molecular Medicine, Colleges of Life Sciences and Medicine, Dentistry & Nursing, University of Dundee, Dundee, United Kingdom
| | - Stephanie F MacCallum
- Centre for Dermatology and Genetic Medicine, Division of Molecular Medicine, Colleges of Life Sciences and Medicine, Dentistry & Nursing, University of Dundee, Dundee, United Kingdom
| | - W H Irwin McLean
- Centre for Dermatology and Genetic Medicine, Division of Molecular Medicine, Colleges of Life Sciences and Medicine, Dentistry & Nursing, University of Dundee, Dundee, United Kingdom
| | - Alan D Irvine
- Department of Dermatology, Our Lady's Children's Hospital, Crumlin, Dublin, Ireland; National Children's Research Centre, Our Lady's Children's Hospital, Crumlin, Dublin, Ireland; Centre for Dermatology and Genetic Medicine, Division of Molecular Medicine, Colleges of Life Sciences and Medicine, Dentistry & Nursing, University of Dundee, Dundee, United Kingdom; Clinical Medicine, Trinity College Dublin, Dublin, Ireland.
| | - Sanja Kezic
- Coronel Institute of Occupational Health, Academic Medical Center, Amsterdam, The Netherlands.
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Flohr C, Perkin M, Logan K, Marrs T, Radulovic S, Campbell LE, MacCallum SF, McLean WHI, Lack G. Atopic dermatitis and disease severity are the main risk factors for food sensitization in exclusively breastfed infants. J Invest Dermatol 2013; 134:345-350. [PMID: 23867897 DOI: 10.1038/jid.2013.298] [Citation(s) in RCA: 129] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2013] [Revised: 05/03/2013] [Accepted: 05/21/2013] [Indexed: 11/09/2022]
Abstract
Filaggrin (FLG) loss-of-function skin barrier gene mutations are associated with atopic dermatitis (AD) and transepidermal water loss (TEWL). We investigated whether FLG mutation inheritance, skin barrier impairment, and AD also predispose to allergic sensitization to foods. Six hundred and nineteen exclusively breastfed infants were recruited at 3 months of age and examined for AD and disease severity (SCORing Atopic Dermatitis (SCORAD)), and screened for the common FLG mutations. TEWL was measured on unaffected forearm skin. In addition, skin prick testing was performed to six study foods (cow's milk, egg, cod, wheat, sesame, and peanut). Children with AD were significantly more likely to be sensitized (adjusted odds ratio (OR)=6.18, 95% confidence interval (CI): 2.94-12.98, P<0.001), but this effect was independent of FLG mutation carriage, TEWL, and AD phenotype (flexural vs. non-flexural). There was also a strong association between food sensitization and AD severity (adjusted ORSCORAD<20=3.91, 95% CI: 1.70-9.00, P=0.001 vs. adjusted ORSCORAD20=25.60, 95% CI: 9.03-72.57, P<0.001). Equally, there was a positive association between AD and sensitization with individual foods (adjusted ORegg=9.48, 95% CI: 3.77-23.83, P<0.001; adjusted ORcow's milk=9.11, 95% CI: 2.27-36.59, P=0.002; adjusted ORpeanut=4.09, 95% CI: 1.00-16.76, P=0.05). AD is the main skin-related risk factor for food sensitization in young infants. In exclusively breastfed children, this suggests that allergic sensitization to foods can be mediated by cutaneous antigen-presenting cells.
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Affiliation(s)
- Carsten Flohr
- St John's Institute of Dermatology, Guy's and St Thomas' Hospital NHS Foundation Trust, London, UK.,Children's Allergies Department, Division of Asthma, Allergy and Lung Biology, King's College London
| | - Michael Perkin
- Children's Allergies Department, Division of Asthma, Allergy and Lung Biology, King's College London
| | - Kirsty Logan
- Children's Allergies Department, Division of Asthma, Allergy and Lung Biology, King's College London
| | - Tom Marrs
- Children's Allergies Department, Division of Asthma, Allergy and Lung Biology, King's College London
| | - Suzana Radulovic
- Children's Allergies Department, Division of Asthma, Allergy and Lung Biology, King's College London
| | - Linda E Campbell
- Centre for Dermatology and Genetic Medicine, Division of Molecular Medicine, University of Dundee, Dundee, UK
| | - Stephanie F MacCallum
- Centre for Dermatology and Genetic Medicine, Division of Molecular Medicine, University of Dundee, Dundee, UK
| | - W H Irwin McLean
- Centre for Dermatology and Genetic Medicine, Division of Molecular Medicine, University of Dundee, Dundee, UK
| | - Gideon Lack
- Children's Allergies Department, Division of Asthma, Allergy and Lung Biology, King's College London
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MacCallum SF, Groves MJ, James J, Murray K, Appleyard V, Prescott AR, Drbal AA, Nicolaou A, Cunningham J, Haydock S, Ganley IG, Westwood NJ, Coates PJ, Lain S, Tauro S. Dysregulation of autophagy in chronic lymphocytic leukemia with the small-molecule Sirtuin inhibitor Tenovin-6. Sci Rep 2013; 3:1275. [PMID: 23429453 PMCID: PMC3572444 DOI: 10.1038/srep01275] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2012] [Accepted: 01/23/2013] [Indexed: 12/11/2022] Open
Abstract
Tenovin-6 (Tnv-6) is a bioactive small molecule with anti-neoplastic activity. Inhibition of the Sirtuin class of protein deacetylases with activation of p53 function is associated with the pro-apoptotic effects of Tnv-6 in many tumors. Here, we demonstrate that in chronic lymphocytic leukemia (CLL) cells, Tnv-6 causes non-genotoxic cytotoxicity, without adversely affecting human clonogenic hematopoietic progenitors in vitro, or murine hematopoiesis. Mechanistically, exposure of CLL cells to Tnv-6 did not induce cellular apoptosis or p53-pathway activity. Transcriptomic profiling identified a gene program influenced by Tnv-6 that included autophagy-lysosomal pathway genes. The dysregulation of autophagy was confirmed by changes in cellular ultrastructure and increases in the autophagy-regulatory proteins LC3 (LC3-II) and p62/Sequestosome. Adding bafilomycin-A1, an autophagy inhibitor to Tnv-6 containing cultures did not cause synergistic accumulation of LC3-II, suggesting inhibition of late-stage autophagy by Tnv-6. Thus, in CLL, the cytotoxic effects of Tnv-6 result from dysregulation of protective autophagy pathways.
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Affiliation(s)
- Stephanie F. MacCallum
- Dundee Cancer Centre, Ninewells Hospital, University of Dundee, Dundee, Scotland, United Kingdom DD1 9SY
- These authors contributed equally to this work
| | - Michael J. Groves
- Dundee Cancer Centre, Ninewells Hospital, University of Dundee, Dundee, Scotland, United Kingdom DD1 9SY
- These authors contributed equally to this work
| | - John James
- Cell Signalling and Immunology, College of Life Sciences, University of Dundee, Scotland, United Kingdom DD1 5EH
| | - Karen Murray
- Dundee Cancer Centre, Ninewells Hospital, University of Dundee, Dundee, Scotland, United Kingdom DD1 9SY
| | - Virginia Appleyard
- Dundee Cancer Centre, Ninewells Hospital, University of Dundee, Dundee, Scotland, United Kingdom DD1 9SY
| | - Alan R. Prescott
- Cell Signalling and Immunology, College of Life Sciences, University of Dundee, Scotland, United Kingdom DD1 5EH
| | - Abed A. Drbal
- School of Pharmacy and Centre for Skin Sciences, School of Life Sciences, University of Bradford, Bradford BD7 1DP, UK
| | - Anna Nicolaou
- School of Pharmacy and Centre for Skin Sciences, School of Life Sciences, University of Bradford, Bradford BD7 1DP, UK
| | - Joan Cunningham
- Department of Cytogenetics, Ninewells Hospital and Medical School, Dundee, Scotland, United Kingdom DD1 9SY
| | - Sally Haydock
- Department of Cytogenetics, Ninewells Hospital and Medical School, Dundee, Scotland, United Kingdom DD1 9SY
| | - Ian G. Ganley
- MRC Protein Phosphorylation Unit, College of Life Sciences, University of Dundee, Scotland, United Kingdom DD1 5EH
| | - Nicholas J. Westwood
- School of Chemistry and Biomedical Sciences Research Complex, University of St Andrews and EaStCHEM, St Andrews, Fife, UK, KY16
| | - Philip J. Coates
- Dundee Cancer Centre, Ninewells Hospital, University of Dundee, Dundee, Scotland, United Kingdom DD1 9SY
- Tayside Tissue Bank, Ninewells Hospital, University of Dundee, Dundee, Scotland, United Kingdom DD1 9SY
| | - Sonia Lain
- Dundee Cancer Centre, Ninewells Hospital, University of Dundee, Dundee, Scotland, United Kingdom DD1 9SY
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Nobels väg 16, 171 11 Stockholm, Sweden
| | - Sudhir Tauro
- Dundee Cancer Centre, Ninewells Hospital, University of Dundee, Dundee, Scotland, United Kingdom DD1 9SY
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Gu X, Coates PJ, MacCallum SF, Boldrup L, Sjöström B, Nylander K. TRAF4 is potently induced by TAp63 isoforms and localised according to differentiation in SCCHN. Cancer Biol Ther 2007; 6:1986-90. [PMID: 18087216 DOI: 10.4161/cbt.6.12.5002] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
p63, a member of the p53 family, is overexpressed in squamous cell carcinoma of the head and neck (SCCHN) and some other tumors of epithelial origin. As a transcription factor, p63 can bind to p53-type response elements and there is some overlap between p53 family transcriptional targets. Tumor necrosis factor receptor associated factor 4 (TRAF4) is a p53 regulated gene which is overexpressed in many human carcinomas. We investigated the involvement of p63 in regulation of TRAF4 and the expression of the TRAF4 protein in SCCHN. Disrupting endogenous p63 expression resulted in downregulation of TRAF4 mRNA and protein in an SCCHN cell line. Endogenous p63 bound to the TRAF4 promoter in vivo and reporter assays showed that p63, p73 and p53 can all transactivate TRAF4, with TAp63 isoforms being the most potent activators. The level of TRAF4 activation by TAp63 was two-fold higher than by p53, and TRAF4 was ten-fold more responsive to TAp63 than another p63-target, IGFBP3. Nuclear expression of TRAF4 was seen in normal oral epithelium and highly/moderately differentiated SCCHN, whereas cytoplasmic expression of TRAF4 was seen in poorly differentiated SCCHN. These results indicate that TRAF4 is a common target of p53 family members and that localization of TRAF4 is associated with differentiation of SCCHN cells.
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Affiliation(s)
- Xiaolian Gu
- Department of Medical Biosciences/Pathology, Umeå University, Umeå, Sweden
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