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1.
Zhongguo Zhong Yao Za Zhi ; 46(4): 762-766, 2021 Feb.
Artigo em Chinês | MEDLINE | ID: mdl-33645108

RESUMO

Based on the clinical characteristics of atopic dermatitis( AD) in traditional Chinese medicine( TCM) and Western medicine,the existing animal models were analyzed,and the coincidence degree,advantages and disadvantages between the models and the clinical manifestations of AD were evaluated,so as to provide reference for establishing a rational animal model. After consulting relevant literatures in recent years and summarizing the existing modeling methods,it is found that spontaneous,transgenic/gene knockout models were highly consistent,but with high breeding conditions and expensive prices. The hapten-induced model was low in cost and fast in modeling. It revealed the corresponding mechanism of AD to a certain extent,but did not fully reflect the state of the entire process of AD. The modeling method was guided by Western medicine,but with a lack of pathogenic factors of traditional Chinese medicine,and so has certain limitations in TCM research. Therefore,it is necessary to combine the etiology,pathogenesis and clinical mani-festations of AD with traditional Chinese and Western medicine,so as to improve the coincidence degree between the model and the characteristics of clinical symptoms and lay the foundation for in-depth studies on AD.


Assuntos
Dermatite Atópica , Medicamentos de Ervas Chinesas , Eczema , Medicina , Animais , China , Dermatite Atópica/tratamento farmacológico , Dermatite Atópica/genética , Medicina Tradicional Chinesa
2.
Curr Allergy Asthma Rep ; 21(2): 8, 2021 02 09.
Artigo em Inglês | MEDLINE | ID: mdl-33560451

RESUMO

PURPOSE OF REVIEW: The coronavirus disease 2019 (COVID-19) has challenged healthcare system capacities and safety for health care workers, reshaping doctor-patient interaction favoring e-Health or telemedicine. The pandemic situation may make difficult to prioritize patients with allergies diseases (AD), face-to-face evaluation, and moreover concern about the possible COVID-19 diagnosis, since COVID-19 shared many symptoms in common with AD. Being COVID-19 a novel disease, everyone is susceptible; there are some advances on vaccine and specific treatment. We evaluate existing literature on allergic diseases (AD): allergic rhinitis, asthma, food allergy, drug allergy, and skin allergy, and potential underlying mechanisms for any interrelationship between AD and COVID-19. RECENT FINDINGS: There is inconclusive and controversial evidence of the association between AD and the risk of adverse clinical outcomes of COVID-19. AD patients should minimize hospital and face-to-face visits, and those who have used biologics and allergen immunotherapy should continue the treatment. It is essential to wear personal protective equipment for the protection of health care workers. Social distancing, rational use of facemasks, eye protection, and hand disinfection for health care workers and patients deserve further attention and promotion. Teleconsultation during COVID-19 times for AD patients is very encouraging and telemedicine platform can provide a reliable service in patient care.


Assuntos
Asma/terapia , Hipersensibilidade Alimentar/terapia , Controle de Infecções/métodos , Rinite Alérgica/terapia , Telemedicina , Asma/imunologia , Produtos Biológicos , Dermatite Alérgica de Contato/imunologia , Dermatite Alérgica de Contato/terapia , Dermatite Atópica/imunologia , Dermatite Atópica/terapia , Dessensibilização Imunológica , Gerenciamento Clínico , Surtos de Doenças , Hipersensibilidade a Drogas/imunologia , Hipersensibilidade a Drogas/terapia , Hipersensibilidade Alimentar/imunologia , Pessoal de Saúde , Humanos , Pandemias/prevenção & controle , Equipamento de Proteção Individual , Rinite Alérgica/imunologia
6.
Mol Genet Genomics ; 296(2): 341-353, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33438050

RESUMO

Atopic dermatitis (AD) is a condition driven by T cell-mediated immune response. Targeted therapy of AD is challenging due to its complex pathogenesis. In the current study, by analyzing multiple expression and network datasets, we aimed at: (1) identifying important transcriptomic signatures/profiles for AD to seek potential therapeutic targets and (2) discovering key regulators in the pathogenesis of AD. Our differentially expressed gene (DEG) analysis revealed multiple genes involved in immune response and dermal structural integrity. Functional enrichment analyses suggested that signaling pathways involved in epidermal barrier and inflammation and immunity are overrepresented in lesional AD. Protein-protein interaction (PPI) network and causal interactions analyses highlighted the roles of regulators of epidermal integrity and immune response in the pathogenesis of AD. Prominently, a negative regulator of the B-cell receptor-mediated immune response, PKCß, has been suggested in the predicted pathogenesis model for AD, implying B cell-mediated immune response may play an equally important role as that of the T cell-mediated immune response in AD. A further search in a perturbagen database has identified small molecular drugs that may alter expression profiles of key regulators in the pathogenesis of AD. In this study, we propose a systemic multi-omics strategy incorporating multiple analyses on various datasets of transcriptomes, diseases, and pharmacology. Such integrative analyses will effectively advance our understanding on the pathogenesis and treatment of AD.


Assuntos
Biologia Computacional/métodos , Dermatite Atópica/genética , Dinitrofluorbenzeno/análogos & derivados , Perfilação da Expressão Gênica/métodos , Redes Reguladoras de Genes , Animais , Bases de Dados Genéticas , Dermatite Atópica/induzido quimicamente , Dinitrofluorbenzeno/efeitos adversos , Modelos Animais de Doenças , Regulação da Expressão Gênica , Humanos , Masculino , Camundongos , Mapas de Interação de Proteínas , Transdução de Sinais
7.
Science ; 371(6527)2021 01 22.
Artigo em Inglês | MEDLINE | ID: mdl-33479125

RESUMO

The skin confers biophysical and immunological protection through a complex cellular network established early in embryonic development. We profiled the transcriptomes of more than 500,000 single cells from developing human fetal skin, healthy adult skin, and adult skin with atopic dermatitis and psoriasis. We leveraged these datasets to compare cell states across development, homeostasis, and disease. Our analysis revealed an enrichment of innate immune cells in skin during the first trimester and clonal expansion of disease-associated lymphocytes in atopic dermatitis and psoriasis. We uncovered and validated in situ a reemergence of prenatal vascular endothelial cell and macrophage cellular programs in atopic dermatitis and psoriasis lesional skin. These data illustrate the dynamism of cutaneous immunity and provide opportunities for targeting pathological developmental programs in inflammatory skin diseases.


Assuntos
Dermatite Atópica/embriologia , Dermatite Atópica/patologia , Psoríase/embriologia , Psoríase/patologia , Pele/embriologia , Animais , Atlas como Assunto , Movimento Celular , Conjuntos de Dados como Assunto , Células Dendríticas/imunologia , Dermatite Atópica/imunologia , Fármacos Dermatológicos/farmacologia , Humanos , Imunidade Inata/genética , Metotrexato/farmacologia , Camundongos , Fagócitos/imunologia , Psoríase/imunologia , Análise de Célula Única , Pele/citologia , Pele/imunologia , Linfócitos T/imunologia , Transcriptoma
8.
Hautarzt ; 72(2): 100-105, 2021 Feb.
Artigo em Alemão | MEDLINE | ID: mdl-33475811

RESUMO

Vaccinations are among the most successful prophylactic measures in medicine. As they are applied to healthy subjects, regulatory steps before licensing of any vaccination are strictly based on clinically controlled studies as well as on registry data in the further course. The probability and relevance of adverse reactions to vaccinations have to be weighed against any harm through the respective natural infection as well as the vaccination-induced protection against infections. Intolerance reactions to vaccinations are far more suspected than proven and altogether rare. Among these, specific dermatoses like psoriasis, atopic dermatitis and lichen planus are found as well as allergic reactions and a number of more nonspecific skin symptoms. Apart from provocation or exacerbation of an underlying dermatological disease, various intolerance reactions may be encountered which are classically allergologic or anaphylactoid. People with chronic dermatoses, especially those on immunosuppressive and immunomodulatory therapy, should have all recommended standard vaccinations. Vaccinations should not be administered during acute skin manifestations and relevant comedication-especially if immunomodulatory or immunosuppressive-has be taken into account in the decision to vaccinate and to define the time point of any vaccination. Inactivated vaccines may be administered even during ongoing immunosuppressive therapy, but may result in decreased immunological reactions and protection to infection. Live vaccines should be avoided.


Assuntos
Dermatite Atópica , Dermatologia , Hipersensibilidade , Humanos , Imunossupressores , Vacinação/efeitos adversos
9.
Rev Med Suisse ; 17(723): 184-187, 2021 Jan 27.
Artigo em Francês | MEDLINE | ID: mdl-33507657

RESUMO

Atopic dermatitis and psoriasis are two diseases that are thought to be distinct from each other, both clinically as well as pathogenetically. Substantial progress has been made in their treatment through the introduction of targeted therapies, blocking key steps in the respective pathogenetic pathways. Interestingly, introduction of a specific therapy for one of these diseases can occasionally trigger onset of the other. This observation helps to better understand the pathophysiology of both diseases and directly impacts their management.


Assuntos
Dermatite Atópica , Psoríase , Dermatite Atópica/epidemiologia , Dermatite Atópica/terapia , Eczema , Humanos , Psoríase/epidemiologia , Psoríase/terapia
10.
Ann Allergy Asthma Immunol ; 126(1): 40-45, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-32739313

RESUMO

BACKGROUND: The real-world persistence with dupilumab therapy for atopic dermatitis (AD) is unknown. OBJECTIVE: To characterize adults with AD who initiated dupilumab and evaluate persistence with dupilumab therapy. METHODS: This retrospective cohort study used the IBM MarketScan Commercial and Medicare database. Adults with AD who initiated dupilumab (first dispensation = index date) between March 28, 2017, and March 31, 2018, were identified and followed up until September 30, 2018, or disenrollment. Twelve months of continuous preindex enrollment were required to characterize baseline treatment history and comorbidities. Kaplan-Meier analysis was used to estimate dupilumab persistence at 6 and 12 months, assuming a 14-day injection frequency and a 30-day grace period. RESULTS: A total of 1963 adults were identified who initiated dupilumab (mean [SD] age 42.1 [15.7] years; 50.7% women; 49.8% with ≥1 atopic comorbidity). Baseline AD treatments included topical corticosteroids (81.6%), systemic corticosteroids (72.5%), and systemic immunosuppressants (22.8%). Dupilumab persistence (95% confidence interval) at 6 and 12 months was 91.9% (90.7%-93.2%) and 77.3% (75.0%-79.7%), respectively. Among 329 patients who discontinued dupilumab, the risk of reinitiation was 78.8% (95% confidence interval: 75.8%-81.7%) within an average of 4 months. CONCLUSION: Dupilumab persistence at 12 months was high, suggesting patient satisfaction with effectiveness, tolerability, and treatment regimen.


Assuntos
Anticorpos Monoclonais Humanizados/uso terapêutico , Dermatite Atópica/tratamento farmacológico , Terapia de Alvo Molecular , Adulto , Anticorpos Monoclonais Humanizados/farmacologia , Dermatite Atópica/diagnóstico , Dermatite Atópica/etiologia , Dermatite Atópica/metabolismo , Gerenciamento Clínico , Suscetibilidade a Doenças , Feminino , Humanos , Subunidade alfa de Receptor de Interleucina-4/antagonistas & inibidores , Subunidade alfa de Receptor de Interleucina-4/metabolismo , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do Tratamento
11.
Ann Allergy Asthma Immunol ; 126(1): 3-12, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-32771354

RESUMO

OBJECTIVE: Atopic dermatitis (AD) is a chronic inflammatory skin disease that is complicated by an increased risk for skin and systemic infections. Preventive therapy for AD is based on skin barrier improvement and anti-inflammatory treatments, whereas overt skin and systemic infections require antibiotics or antiviral treatments. This review updates the pathophysiology, diagnosis, management, controversy of antibiotic use, and potential treatments of infectious complications of AD. DATA SOURCES: Published literature obtained through PubMed database searches and clinical pictures. STUDY SELECTIONS: Studies relevant to the mechanisms, diagnosis, management, and potential therapy of infectious complications of AD. RESULTS: Skin barrier defects, type 2 inflammation, Staphylococcusaureus colonization, and cutaneous dysbiosis are the major predisposing factors for the increased infections in AD. Although overt infections require antibiotics, the use of antibiotics in AD exacerbation remains controversial. CONCLUSION: Infectious complications are a comorbidity of AD. Although not common, systemic bacterial infections and eczema herpeticum can be life-threatening. Preventive therapy of infections in AD emphasizes skin barrier improvement and anti-inflammatory therapy. The use of antibiotics in AD exacerbation requires further studies.


Assuntos
Dermatite Atópica/complicações , Infecções/etiologia , Biomarcadores , Dermatite Atópica/etiologia , Gerenciamento Clínico , Suscetibilidade a Doenças , Desenvolvimento de Medicamentos , Disbiose , Humanos , Controle de Infecções , Infecções/diagnóstico , Infecções/terapia , Terapia de Alvo Molecular
12.
Ann Allergy Asthma Immunol ; 126(1): 21-31, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-32818591

RESUMO

OBJECTIVE: To discuss the efficacy and safety of novel and emerging topical and systemic therapeutic agents for atopic dermatitis (AD). DATA SOURCES: The review of the published literature was performed using the PubMed database, published abstracts and virtual presentations from scientific meetings, posted results on ClinicalTrials.gov, and data from industry press releases. STUDY SELECTIONS: Primary manuscripts with trial results, case reports, case series, clinical trial data from ClinicalTrials.gov, and articles highlighting expert perspectives on management of AD were selected. RESULTS: Emerging topical and systemic therapies primarily target the type 2 immune pathway. Moreover, 2 newer targeted medications are now approved by the Food and Drug Administration for both children and adults, crisaborole 2% ointment and dupilumab, with several others in the therapeutic pipeline. New directions in developing topical medications include Janus kinase inhibitors, tapinarof (an aryl hydrocarbon receptor agonist), and agents to correct microbial dysbiosis. In addition to the subcutaneously injected monoclonal antibody targeting the interleukin (IL) 4 receptor (dupilumab), other biologics targeting IL-13, IL-31, IL-33, OX40, and thymic stromal lymphopoietin are currently being tested. Oral Janus kinase inhibitors are showing outstanding efficacy and no serious safety signs, but safety concerns remain. CONCLUSION: Given the tremendous burden of AD on physical, mental, and social health, the need is high to develop new, targeted therapies. Advances in our understanding of AD pathogenesis have paved the way toward the development of new therapies that promise to revolutionize our management of AD. Future research will focus on long-term efficacy and safety and creating predictive models for choosing best management options on a personalized basis.


Assuntos
Dermatite Atópica/terapia , Biomarcadores , Terapia Combinada , Dermatite Atópica/etiologia , Dermatite Atópica/metabolismo , Gerenciamento Clínico , Suscetibilidade a Doenças , Humanos , Terapia de Alvo Molecular
13.
Ann Allergy Asthma Immunol ; 126(1): 46-53.e2, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-32896640

RESUMO

BACKGROUND: Monitoring the effects of biologic therapies in skin diseases will benefit from alternative noninvasive skin sampling techniques to evaluate immune pathways in diseased tissue early and longitudinally. OBJECTIVE: To establish a minimally invasive profiling of skin cytokines for diagnosis, therapeutic response monitoring, and clinical research in atopic dermatitis (AD) and other skin diseases, particularly in pediatric cohorts. METHODS: We developed a novel method for cytokine profiling in the epidermis using skin tape strips (STSs) in a setting designed to maximize the efficiency of protein extraction from STSs. This method was applied to analyze STS protein extracts from the lesional skin of children having AD (n = 41) and normal, healthy controls (n = 22). A total of 20 cytokines were probed with the ultrasensitive Mesoscale multiplex cytokine assay. RESULTS: A significant increase in interleukin (IL)-1b (P < .01), IL-18 (P < .001), and IL-8 (P < .001) with a decrease in IL-1a (P < .001) in the stratum corneum of AD lesional skin was found. Concurrently, an increase in markers associated with type 2 inflammatory response was readily detectable in AD lesional skin, including C-C motif chemokine ligand (CCL) 22, CCL 17, and thymic stromal lymphopoietin (TSLP). The levels of IL-1b, IL-18, and TSLP exhibited positive correlations with the AD severity index (Scoring AD index) and skin transepidermal water loss (TEWL), whereas an inverse correlation between IL-1a and Scoring AD index and IL-1a and TEWL was found. The levels of CCL17, CCL22, TSLP, IL-22, and IL-17a correlated with skin TEWL measurements. CONCLUSION: Using minimally invasive STS analysis, we identified cytokine profiles easily sampled in AD lesional skin. The expression of these markers correlated with disease severity and reflected changes in TEWL in lesional skin. These markers suggest new response assessment targets for AD skin. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03168113.


Assuntos
Biomarcadores , Citocinas/metabolismo , Dermatite Atópica/etiologia , Dermatite Atópica/metabolismo , Mediadores da Inflamação/metabolismo , Fitas Reagentes , Dermatite Atópica/diagnóstico , Humanos , Índice de Gravidade de Doença , Avaliação de Sintomas
14.
J Dermatolog Treat ; 32(1): 114-116, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31132923

RESUMO

Background: Dupilumab is used for treatment of atopic dermatitis through blockade of IL-4 and IL-13 signaling of the Th2 pathway. Recent case reports have described alopecia, psoriasis, persistent facial dermatitis, and recall dermatitis at patch test sites after the initiation of dupilumab therapy.Case report: We describe the case of a 67-year-old female with atopic dermatitis who developed recurrent episodic flares of rosacea temporally associated with dupilumab injections that resolved after dupilumab discontinuation.Conclusion: The cause of rosacea-like reaction associated with dupilumab treatment is unknown. Th2 pathway inhibition by dupilumab may promote Demodex proliferation and increased IL-17-mediated inflammation implicated in the pathophysiology of rosacea.Abbreviations: atopic dermatitis: AD; interleukin: IL; persistent facial dermatitis: PFD; T-helper cell type 1: Th1; T-helper cell type 2: Th2; T-helper cell type 17: Th17; tumor necrosis factor-∝: TNF-∝.


Assuntos
Anticorpos Monoclonais Humanizados/uso terapêutico , Dermatite Atópica/tratamento farmacológico , Rosácea/diagnóstico , Idoso , Anticorpos Monoclonais Humanizados/efeitos adversos , Eritema/etiologia , Feminino , Humanos , Subunidade alfa de Receptor de Interleucina-4/antagonistas & inibidores , Subunidade alfa de Receptor de Interleucina-4/metabolismo , Recidiva , Rosácea/etiologia
15.
J Dermatolog Treat ; 32(1): 45-48, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29460656

RESUMO

AIM: Symptomatology and severity of atopic dermatitis (AD) can be objectively measured with equipment. This study aimed to compare skin measurements and investigate their correlations with various clinical severity scores. METHODS: Skin hydration (SH), transepidermal water loss (TEWL), pH, erythema, pigmentation, and ITA (individual typology angle) were measured (using Delfin, Courage + Khazaka, and Mettler Toledo equipment), and correlated with Patient-Oriented Eczema Measure (POEM, a short-term subjective-symptom score), Scoring Atopic Dermatitis (SCORAD, a short-term subjective-symptom and objective-sign score), Nottingham Eczema Severity Score (NESS, a long-term subjective-symptom score), Children Dermatology Life Quality Index (CDLQI, a short-term subjective-symptom score) with Spearman's rho coefficient. RESULTS: 80 sets of clinical scores from eczema patients (mean age: 10.8 ± 4.9 years; 44.6% male) were evaluated. The POEM, objective SCORAD, CDLQI correlated well with each other. Skin pH ranged from 4.3 to 7.0 (mean 5.7 ± 0.61). Skin pH was correlated with Objective SCORAD components, including area (rho = 0.269, p = .036), erythema (rho = 0.302, p = .018), and lichenification (rho = 0.365, p = .026) and with the usage frequency of topical antibiotics. Skin pH was also correlated with other skin measurements, including SH (Delfin equipment: rho = -0.38, p < .001). SH and TEWL as measured by Delfin equipment correlated better with a number of symptoms and signs than Courage + Khazaka equipment. Other clinical measurements including erythema, melanin, and skin color did not demonstrate strong correlations with clinical symptom scores. CONCLUSION: Skin pH (using Mettler Toledo), SH, and TEWL (using Delfin equipment) correlated well with various clinical symptomatology scores. Less acidic pH appears to be associated with worse clinical scores of symptomatology, and increase usage of topical antibiotics, These findings not only support the supplementary usage of equipment in aiding objective documentation of clinical symptomatology in eczema therapeutic research but also the advocacy of maintaining more acidic skin and avoiding alkaline soap and emollient products.


Assuntos
Eczema/patologia , Pele/química , Administração Tópica , Adolescente , Antibacterianos/administração & dosagem , Criança , Pré-Escolar , Dermatite Atópica/patologia , Eczema/psicologia , Feminino , Humanos , Concentração de Íons de Hidrogênio , Lactente , Masculino , Índice de Gravidade de Doença , Pele/metabolismo
16.
J Dermatolog Treat ; 32(1): 19-28, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31693426

RESUMO

Importance: While dupilumab has emerged as an effective treatment for moderate-to-severe atopic dermatitis (AD) since its approval in 2017, interleukin-4 and 13 blockade has also demonstrated efficacy in off-label chronic dermatologic conditions.Objective: To identify chronic dermatologic conditions in which dupilumab has demonstrated efficacy.Findings: Thirty-three reports of dupilumab use in non-AD dermatologic conditions were identified through systematic literature review. Effective use of dupilumab has been reported in case reports and case series in the treatment of chronic pruritus, prurigo nodularis, eczematous eruption of aging, allergic contact dermatitis, chronic hand eczema, alopecia areata, urticaria, eosinophilic annular erythema, bullous pemphigoid and papuloerythroderma of Ofuji. Clinical trials are underway evaluating the efficacy of dupilumab in allergic contact dermatitis, chronic hand eczema, alopecia areata, chronic spontaneous urticaria and cholinergic urticaria.Conclusions and relevance: Overlap in immune signaling pathways between AD and chronic pruritus, eczematous eruption of aging, allergic contact dermatitis, chronic hand eczema, alopecia areata, urticaria, eosinophilic annular erythema, bullous pemphigoid and papuloerythroderma of Ofuji make these conditions candidates for dupilumab therapy when standard treatments have failed or are contraindicated. While promising as a therapeutic option, off-label prescribing of dupilumab requires consideration of challenges in insurance authorization and out-of-pocket cost to the patient.


Assuntos
Anticorpos Monoclonais Humanizados/uso terapêutico , Dermatite Atópica/tratamento farmacológico , Alopecia em Áreas/tratamento farmacológico , Anticorpos Monoclonais/uso terapêutico , Eczema/tratamento farmacológico , Humanos , Urticária/tratamento farmacológico
17.
Life Sci ; 266: 118906, 2021 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-33338502

RESUMO

AIMS: The aim of this study was to investigate the role of TRPA1 in the pathogenesis of AD. MAIN METHODS: The experimental atopic dermatitis (AD)-like skin lesions were established using 2,4-dinitrochlorobenzene (DNCB). Mice were divided into three groups: TRPA1-/- and WT groups were treated with DNCB dissolved in a 3:1 mixture of acetone and olive oil; the negative control group was treated with 3:1 mixture of acetone and olive oil without DNCB. The treatment lasted for 21 days, after which the animals were sacrificed and their blood, ears and dorsal skin tissue samples were collected for analysis. KEY FINDINGS: Lower dermatitis score, ear thickness, pruritus score, and epidermal hyperplasia were observed in mice in TRPA1-/- mice compared to the WT group. Besides, lower dermal mast cell infiltration, proinflammatory cytokines, Th2 cytokines and the infiltration of macrophages were observed in the TRPA1-/- mice compared to the WT group. Furthermore, we demonstrated that TRPA1 antagonist HC-030031 could alleviate AD-like symptoms and reduce the degree of epidermal hyperplasia in mice. SIGNIFICANCE: TRPA1 has a crucial role during the AD pathogenesis in mice, thus may be used as a potential new target for treating patients with chronic skin inflammatory disease.


Assuntos
Dermatite Atópica/complicações , Inflamação/prevenção & controle , Macrófagos/imunologia , Mastócitos/imunologia , Prurido/prevenção & controle , Canal de Cátion TRPA1/fisiologia , Acetanilidas/farmacologia , Animais , Dermatite Atópica/induzido quimicamente , Dermatite Atópica/patologia , Dinitroclorobenzeno/toxicidade , Inflamação/etiologia , Inflamação/patologia , Macrófagos/efeitos dos fármacos , Mastócitos/efeitos dos fármacos , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout , Prurido/etiologia , Prurido/patologia , Purinas/farmacologia , Canal de Cátion TRPA1/antagonistas & inibidores
18.
J Formos Med Assoc ; 120(1 Pt 2): 429-442, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32564976

RESUMO

BACKGROUND/PURPOSE: Atopic dermatitis (AD) is a chronic inflammatory disease commonly seen in children and increasingly recognized in adults. With recent advances in the therapeutic development for AD, the Taiwanese Dermatological Association (TDA) established a committee to update the consensus for AD management in Taiwan. This report describes the 2020 updated consensus for the management of AD. METHODS: A panel of 11 core members was convened to review and discuss aspects of AD management and draft recommendation during the first two meetings. The 2015 TDA consensus and the 2017 European guideline, along with recent peer-reviewed articles, serve as the foundation for the update. In the third meeting, AD expert dermatologists selected on a national scale were invited to vote on the final statements. A total of 27 dermatologists attended the final meeting. The consensus was achieved when ratings of 7-9 (out of a total score of 9) accounted for ≥ 75% of the total votes. RESULTS: Consensus was achieved on the therapeutic options for AD by lines of treatment. A treatment algorithm was presented to illustrate the place of each modality in terms of basic care, acute disease control, and maintenance therapy. Special considerations for the pediatric population, as well as for women during pregnancy and lactation, are discussed. CONCLUSION: Topical corticosteroids with long-term emollient-based therapies remain the cornerstone of AD treatment. Systemic treatments are indicated when topical therapies and phototherapy fail to control the disease. The recent approval of dupilumab and emerging targeted therapies are expected to bring significant clinical benefit for patients whose disease is inadequately managed by existing options.


Assuntos
Dermatite Atópica , Grupo com Ancestrais do Continente Asiático , Consenso , Dermatite Atópica/tratamento farmacológico , Feminino , Humanos , Gravidez , Taiwan
19.
J Ethnopharmacol ; 266: 113397, 2021 Feb 10.
Artigo em Inglês | MEDLINE | ID: mdl-32971159

RESUMO

ETHNOPHARMACOLOGICAL RELEVANCE: Atopic dermatitis (AD) is a complex skin disease with highly heterogeneous inflammation, which ranks among the largest component of the nonfatal diseases worldwide. The medications currently used to treat AD primarily include antihistamines, vitamin D and anti-inflammatory drugs, etc. But, the usage of these drugs is usually accompanied by various side-effects. Formononetin (FMN), a natural active ingredient of Astragalus membranaceus (Fisch.) Bunge, decreases the AD relapse rate, reduces recurring severity incidence and resists the inflammation in the initial stage of AD. However, the underlying mechanism of FMN on repressing the development of AD is still unknown. AIM OF THE STUDY: To investigate the potential mechanism of FMN on relieving the initial responses of AD and elucidate its possible therapeutic targets in vivo and in vitro. MATERIALS AND METHODS: A fluorescein isothiocyanate (FITC)-induced mouse model of the initial stage of AD was established in vivo. Human keratinocytes (HaCaT) cells were co-stimulated with tumor necrosis factor alpha (TNF-α) and polyinosinic-polycytidylic acid (Poly(I:C)) in vitro. The production of thymic stromal lymphopoietin (TSLP) and immunoglobulin E (IgE) were detected by enzyme-linked immunosorbnent assay (ELISA). The protein expression was measured through immunohistochemistry and western blotting. The mRNA expression was examined by real-time quantitative polymerase chain reaction (RT-qPCR). The impact of TNF-α-induced protein 3 (TNFAIP3/A20) was reflected using its small interfering RNA (siRNA). The role of G protein-coupled estrogen receptor (GPER) was explored using its agonist (G1), antagonist (G15) or siRNA (siGPER) in vitro. RESULTS: We found that FMN upregulated the expression of A20 protein and mRNA in the initial stage of AD model, especially in the epithelial region of ear tissue, and inhibited the production of TSLP simultaneously. Consistently, FMN significantly upregulated A20 protein and its mRNA expression while reduced TSLP protein and its mRNA expression in vitro, and this effect could be antagonized by A20 siRNA (siA20). Moreover, compared with PPT (ERα agonist) and DPN (ERß agonist), G1 could significantly increase the expression of A20. In addition, compared with MPP (ERα antagonist) and PHTPP (ERß antagonist), G15 could markedly reduce the expression of A20. Furthermore, the effects of FMN on A20 were interfered by siGPER and G15 in vitro and in vivo. CONCLUSIONS: These results demonstrated that FMN attenuated AD by upregulating A20 expression via activation of GPER. This new strategy might have effective therapeutic potential for AD and other inflammatory disorders.


Assuntos
Dermatite Atópica/tratamento farmacológico , Inflamação/tratamento farmacológico , Isoflavonas/farmacologia , Proteína 3 Induzida por Fator de Necrose Tumoral alfa/genética , Animais , Citocinas/metabolismo , Dermatite Atópica/patologia , Modelos Animais de Doenças , Humanos , Inflamação/patologia , Queratinócitos/efeitos dos fármacos , Queratinócitos/patologia , Masculino , Camundongos , Camundongos Endogâmicos BALB C , Receptores Estrogênicos/metabolismo , Receptores Acoplados a Proteínas-G/metabolismo , Regulação para Cima/efeitos dos fármacos
20.
Wiad Lek ; 73(10): 2255-2260, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33310959

RESUMO

OBJECTIVE: The aim of the research was to investigate the spectrum of food sensitization, followed by the determination of the main clinical criteria and immunological markers of food allergy in children with gastroduodenal pathology and atopic dermatitis. PATIENTS AND METHODS: Materials and methods: We conducted a comprehensive clinical and immunological examination of 120 children aged from 6 to 15 years with gastroduodenal pathology (group 1; n = 64) and atopic dermatitis (group 2; n = 56), who had a history of adverse allergic reactions to food. The control group consisted of 22 apparently healthy children. RESULTS: Results: In the group of children with gastroduodenal pathology, the spectrum of the most common significant food allergens was represented by legumes, the reaction to which was observed in 25 (39.1%) subjects, eggs (25.0%) and fish (23.4%), which were found in every fourth child. Among patients with atopic dermatitis, the leading positions were occupied by fruits, which were registered in 20 (35.7%) children, nuts - in 15 (26.8%), honey and vegetables - in 11 (19.6%) children, respectively. The study of immunological status in comparison with the control group revealed reliable increases in pro-inflammatory T-helper-2 cytokines - interleukin-4 and chemokine TARC/CCL-17 and a simultaneous decrease in anti-inflammatory interleukin-10 in children of the 1st and 2nd groups who had gastrointestinal and skin manifestations of allergic reactions when eating food products. CONCLUSION: Conclusions: The study of peculiarities of adverse reactions to food in the examined children allowed us to identify specific clinical criteria and immunological markers of food allergy, which had certain features depending on the skin or gastrointestinal manifestations.


Assuntos
Dermatite Atópica , Hipersensibilidade a Ovo , Hipersensibilidade Alimentar , Adolescente , Alérgenos , Animais , Criança , Humanos , Imunoglobulina E
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