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1.
Medicine (Baltimore) ; 100(9): e25091, 2021 Mar 05.
Artigo em Inglês | MEDLINE | ID: mdl-33655988

RESUMO

INTRODUCTION: Several forms of allergy have been clinically presented, including, among others, atopic dermatitis (eczema), urticaria (hives), and allergic rhinitis (rhinitis). As their detailed pathogenesis continues to be researched, we aimed in the current study to compare gut microbiota differences between eczema, hives, and rhinitis patients. METHODS: We enrolled 19 eczemas, nine hives, and 11 allergic rhinitis patients in this study. Fecal samples were examined using 16S ribosomal ribonucleic acid amplicon sequencing, followed by bioinformatics and statistical analyses. We compared microbiota in dermatitis (eczema), chronic urticaria (hives), and allergic rhinitis (rhinitis). RESULTS: All clinical data were similar between the subgroups. The microbiota results indicated that Bacteroidales species were found in skin allergies, both urticaria and eczema, when compared to rhinitis. The microbiota differs substantially between those patients with atopic dermatitis (eczema), chronic urticaria (hives), and allergic rhinitis (rhinitis), thus indicating that the gut-skin and gut-nose axes exist. Gut flora colonies differ significantly between skin allergy and nose allergy. Bacteroidales species could be a clinical link between gut flora and skin allergy; of those, Bacteroids Plebeius DSM 17135 is significantly associated with the urticaria (hives) subgroup.Conclusion. Our results demonstrated high intra-group homogeneous and high inter-group heterogeneous microbiota. The clinical symptoms of eczema, hives, and rhinitis can all be linked to specific microbiota in the current study. In this pilot study, the Ruminococcaceae and Bacteroidales species are associated with allergic disease, in line with several previous published articles, and the abundance of Firmicutes Phylum is representative of intestinal dysbiosis. In the future, a larger cohort and thorough biochemical studies are needed for confirmation.


Assuntos
Dermatite Atópica/diagnóstico , Microbioma Gastrointestinal , Rinite Alérgica/diagnóstico , Pele/patologia , Urticária/diagnóstico , Adulto , Dermatite Atópica/etiologia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Estudos Prospectivos , Rinite Alérgica/etiologia , Urticária/etiologia
2.
AAPS PharmSciTech ; 22(2): 55, 2021 Jan 24.
Artigo em Inglês | MEDLINE | ID: mdl-33486609

RESUMO

Globally, the prevalence of Atopic dermatitis (AD) is significantly increasing and affecting around 20% of population including children. Complex interactions amongst abnormality in epidermal barrier function, environment, infectious agents and immunological defects are considered as key factors in the pathogenesis of AD. Although the role of oxidative stress has been studied in some skin diseases, investigation of the same in AD is intermittent. Calcineurin inhibitors and/or topical corticosteroids are currently available; however, it causes atrophy of the skin, burning sensation, and systemic side effects which leads to poor patient compliance. These limitations provoke the strong need to develop an innovative approach in managing AD. Nanomaterials for effective drug delivery to skin conditions such as AD have attracted a lot of attention owing to its ability to encapsulate, protect, and release the cargo at the diseased skin site. However, there are lots of unmet challenges especially in terms of development of non-toxic formulations and clinical translation of established nanomedicines in the form of accessible products. Numerous formulations have emerged as carrier for poorly soluble and permeable drugs, viz., lipidic, polymeric, metal, silica, liposomes, hydrocarbon gels and this field is evolving. This review is intended to provide an insight incidences associated with pathophysiology of AD and challenges with existing treatments of AD. Focus is kept on reviewing current development and emerging nanomedicines for effective treatment of AD. The review also inculcates merits of several nanomedicines in overcoming challenges of existing products and its future implications.


Assuntos
Dermatite Atópica/tratamento farmacológico , Nanomedicina , Animais , Ensaios Clínicos como Assunto , Dermatite Atópica/epidemiologia , Dermatite Atópica/etiologia , Composição de Medicamentos , Emulsões , Humanos , Micelas , Nanopartículas
3.
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
4.
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
5.
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
6.
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
7.
Methods Mol Biol ; 2223: 79-86, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33226588

RESUMO

Atopic dermatitis (AD) is a common skin disease characterized by chronic inflammation and itchiness. Although skin barrier dysfunction and immune abnormalities are thought to contribute to the development of AD, the precise pathogenic mechanism remains to be elucidated. We have developed a unique, diet-induced AD mouse model based on the findings that deficiencies of certain polyunsaturated fatty acids and starches cause AD-like symptoms in hairless mice. Here, we present a protocol and tips for establishing an AD mouse model using a custom diet modified from a widely used standard diet (AIN-76A Rodent Diet). We also describe methods for evaluating skin barrier dysfunction and analyzing itch-related scratching behavior. This model can be used not only to investigate the complex pathogenic mechanism of human AD but also to study the puzzling relationship between nutrition and AD development.


Assuntos
Dermatite Atópica/imunologia , Modelos Animais de Doenças , Ácidos Graxos Insaturados/química , Alimentos Formulados , Prurido/imunologia , Amido/química , Animais , Comportamento Animal , Óleo de Milho/química , Dermatite Atópica/etiologia , Dermatite Atópica/fisiopatologia , Etanol/química , Ácidos Graxos Insaturados/deficiência , Ácidos Graxos Insaturados/imunologia , Feminino , Humanos , Camundongos , Camundongos Pelados , Permeabilidade , Prurido/etiologia , Prurido/fisiopatologia , Pele/efeitos dos fármacos , Pele/imunologia , Pele/patologia , Amido/deficiência , Amido/imunologia
8.
Allergol. immunopatol ; 48(6): 694-700, nov.-dic. 2020. tab, graf
Artigo em Inglês | IBECS | ID: ibc-199260

RESUMO

INTRODUCTION: There are few atopic dermatitis (AD) incidence cohort studies in young adults, the etiology of this disease remains obscure, and AD risk factors in adults are not well understood. The objective of this study was to estimate AD ten-year incidence and prevalence in a cohort of adolescent aged 14-16 at inception in Castellon province in Valencia Region, Spain and describe related risk factors. MATERIAL AND METHODS: From 2002 to 2012, a population-based prospective cohort study was carried out. Questionnaires from the International Study of Asthma and Allergies in Childhood (ISAAC) were used with an additional questionnaire for related factors completed by participants and their parents, respectively, in 2002. In 2012 the same questionnaires were completed by the participants' through a telephone interview, and incidence and prevalence of AD were estimated. Directed acyclic graphs, Poisson regression and inverse probability weighted regression adjustment were used. RESULTS: The participation rate was 79.5% (1435/1805) with AD lifetime prevalence of 34.9% and AD incidence of 13.5 per 1000 person years. Females presented higher prevalence and incidence than males. After adjustment significant risk factors were being female, history of asthma or allergic rhinitis, family history of AD, history of respiratory infections, history of bronchitis, history of pneumonia, history of sinusitis, and birthplace outside Castellon province. The highest AD population attributable risks were female, 30.3%, and history of respiratory infections 15.3%. Differences with AD childhood risk factors were found. CONCLUSIONS: AD incidence in our cohort was high and several risks factors were related to AD


No disponible


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Dermatite Atópica/epidemiologia , Dermatite Atópica/etiologia , Estudos Prospectivos , Fatores de Risco , Incidência , Inquéritos e Questionários , Distribuição por Sexo , Distribuição de Poisson , Medição de Risco , Espanha/epidemiologia
9.
Viruses ; 13(1)2020 12 22.
Artigo em Inglês | MEDLINE | ID: mdl-33375201

RESUMO

Atopic dermatitis is accompanied by the abnormal overgrowth of Staphylococcus aureus, a common cause of skin infections and an opportunistic pathogen. Although administration of antibiotics is effective against S. aureus, the resulting reduction in healthy microbiota and the emergence of drug-resistant bacteria are of concern. We propose that phage therapy can be an effective strategy to treat atopic dermatitis without perturbing the microbiota structure. In this study, we examined whether the S. aureus phage SaGU1 could be a tool to counteract the atopic exacerbation induced by S. aureus using an atopic mouse model. Administration of SaGU1 to the back skin of mice reduced both S. aureus counts and the disease exacerbation caused by S. aureus. Furthermore, the S. aureus-mediated exacerbation of atopic dermatitis with respect to IgE plasma concentration and histopathological findings was ameliorated by the application of SaGU1. We also found that Staphylococcus epidermidis, a typical epidermal symbiont in healthy skin, significantly attenuated the emergence of SaGU1-resistant S. aureus under co-culture with S. aureus and S. epidermidis in liquid culture infection experiments. Our results suggest that phage therapy using SaGU1 could be a promising clinical treatment for atopic dermatitis.


Assuntos
Dermatite Atópica/etiologia , Dermatite Atópica/terapia , Infecções Estafilocócicas/microbiologia , Infecções Estafilocócicas/terapia , Fagos de Staphylococcus/fisiologia , Staphylococcus aureus/virologia , Staphylococcus epidermidis/fisiologia , Antibiose , Bacteriólise , Biópsia , Terapia Combinada , Dermatite Atópica/patologia , Resistência à Doença/genética , Interações Hospedeiro-Patógeno , Humanos , Terapia por Fagos , Infecções Estafilocócicas/patologia
10.
Medicine (Baltimore) ; 99(30): e21255, 2020 Jul 24.
Artigo em Inglês | MEDLINE | ID: mdl-32791702

RESUMO

Atopic dermatitis (AD) is a common chronic relapsing inflammatory skin disease associated with a personal or family history of atopic diseases. Determining the objective severity scoring of AD index (SCORAD) and total immunoglobulin E (IgE) to help to stage the severity (lesions extent and intensity of the lesions and then the itch and sleep disturbance they may cause) of AD in children.In this study, we adopted the SCORAD index, which consists of severity, area, and sleep disturbance, to evaluate the AD status of children up to 18 years old. We examined the blood levels of total serum IgE, white blood cell count/differential count (WBC/DC), eosinophil counts (EC), eosinophil cationic protein (ECP) and specific IgE.A total of 208 children with AD were enrolled in this study. Serum IgE values and a number of specific IgE that are positive significantly different SCORAD index through simple linear regression; however, after multiple linear regression, only IgE values (95% CI: 0.001-0.004, P < .001), total WBC count (95% CI: 0.112-1.736, P = .026), EC (95% CI: 0.045-6.706, P = .047), and specific IgE to Cheddar cheese (95% CI: 1.814-16.731, P = .015) remain different. After applying the Phi coefficient, we found that specific IgE to tuna (r = 0.632), codfish (r = 0.613), and clam (r = 0.613) each had a moderate correlation with specific IgE to Cheddar cheese. The 6 most common allergens were found to be mite (D. Farinae: 65.9%), mite (D. Pterony: 64.9%), house dust (47.6%), cockroach mix (37.0%), shrimp (30.8%), and crab (22.6%). Covariates of SCORAD index, severity, area, and sleep disturbance differed.In this study, we found that total IgE values, specific IgE values, WBC, EC, and specific IgE to Cheddar cheese have significant correlations with SCORAD index in AD of Taiwanese children.


Assuntos
Dermatite Atópica/sangue , Hipersensibilidade Alimentar/sangue , Imunoglobulina E/sangue , Alérgenos/sangue , Biomarcadores/sangue , Queijo/efeitos adversos , Criança , Pré-Escolar , Dermatite Atópica/etiologia , Hipersensibilidade Alimentar/complicações , Humanos , Lactente , Contagem de Leucócitos , Índice de Gravidade de Doença , Taiwan
11.
Environ Health Prev Med ; 25(1): 27, 2020 Jul 07.
Artigo em Inglês | MEDLINE | ID: mdl-32635895

RESUMO

BACKGROUND: Adjuvants used in inactivated vaccines often upregulate type 2 immunity, which is dominant in allergic diseases. We hypothesised that cumulative adjuvant exposure in infancy may influence the development of allergies later in life by changing the balance of type 1/type 2 immunity. We examined the relationship between immunisation with different vaccine types and later allergic disease development. METHODS: We obtained information regarding vaccinations and allergic diseases through questionnaires that were used in The Japan Environment and Children's Study (JECS), which is a nationwide, multicentre, prospective birth cohort study that included 103,099 pregnant women and their children. We examined potential associations between the initial vaccination before 6 months of age and symptoms related to allergies at 12 months of age. RESULTS: Our statistical analyses included 56,277 children. Physician-diagnosed asthma was associated with receiving three (aOR 1.395, 95% CI 1.028-1.893) or four to five different inactivated vaccines (aOR 1.544, 95% CI 1.149-2.075), compared with children who received only one inactivated vaccine. Similar results were found for two questionnaire-based symptoms, i.e. wheeze (aOR 1.238, 95% CI 1.094-1.401; three vaccines vs. a single vaccine) and eczema (aOR 1.144, 95% CI 1.007-1.299; four or five vaccines vs. a single vaccine). CONCLUSIONS: Our results, which should be cautiously interpreted, suggest that the prevalence of asthma, wheeze and eczema among children at 12 months of age might be related to the amount of inactivated vaccine exposure before 6 months of age. Future work should assess if this association is due to cumulative adjuvant exposure. Despite this possible association, we strongly support the global vaccination strategy and recommend that immunisations continue. TRIAL REGISTRATION: UMIN000030786 .


Assuntos
Hipersensibilidade/epidemiologia , Vacinas Virais/efeitos adversos , Asma/epidemiologia , Asma/etiologia , Estudos de Coortes , Dermatite Atópica/epidemiologia , Dermatite Atópica/etiologia , Feminino , Hipersensibilidade Alimentar/epidemiologia , Hipersensibilidade Alimentar/etiologia , Humanos , Hipersensibilidade/etiologia , Lactente , Recém-Nascido , Japão , Masculino , Vacinas de Produtos Inativados/efeitos adversos
12.
Artigo em Inglês | MEDLINE | ID: mdl-32397578

RESUMO

Background: The territorial expansion and increased population size of haematophagous arthropods (i.e., the castor bean tick Ixodes ricinus (Ixodida: Ixodidae) and the deer ked Lipoptena cervi (Diptera: Hippoboscidae)) has enhanced the risk of human infestations in Europe. The aim of our study was to present skin lesions induced by tick and deer ked bites in patients from recreational forest regions in southeastern Poland and pay attention to features of skin changes that may be useful in differential diagnosis. Methods: We compare the skin lesions after I. ricinus and L. cervi bite and draw attention to the biological and ecological traits of both ectoparasites, which may be diagnostically relevant for determination of the cause of skin symptoms reported by patients. Results: I. ricinus bites lead to development of erythematous-infiltrative poorly demarcated lesions with a centrally located bite mark, which usually disappears within one to several days. In turn, L. cervi bites leave irregularly shaped scattered erythematous papules. The papules may persist for up to one year and are accompanied by itching. Conclusions: Correct assessment of the clinical picture and its association with an arthropod bite (e.g., tick or deer ked) is highly important for further diagnostic procedures (i.e., differentiation of skin lesions developing in tick-borne diseases and, consequently, correct choice of pharmacological therapy). I. ricinus and L. cervi differ in their developmental cycles and rhythms of activity, which indicates that both species should be considered potential causative agents in the differential diagnosis of skin lesions when the patient has been bitten by an arthropod in autumn and winter months.


Assuntos
Cervos/parasitologia , Dermatite Atópica/etiologia , Dípteros , Mordeduras e Picadas de Insetos/patologia , Ixodes , Doenças Parasitárias em Animais/epidemiologia , Animais , Dermatite Atópica/imunologia , Dermatite Atópica/patologia , Europa (Continente)/epidemiologia , Humanos , Mordeduras e Picadas de Insetos/imunologia , Polônia/epidemiologia
13.
PLoS One ; 15(5): e0225675, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32469869

RESUMO

A cross-sectional hypothesis generating study was performed to investigate modifiable exposures such as whether feeding pattern (a non-processed meat based diet, NPMD, or an ultra-processed carbohydrate based diet, UPCD), certain environmental factors and their timing of exposure might be associated with the development of canine atopic dermatitis (CAD). Also, genetic and demographic factors were tested for associations with CAD. The data was collected from the validated internet-based DogRisk food frequency questionnaire in Finland. A total of 2236 dogs were eligible for the study (the owners reported 406 cases and 1830 controls). Our main interest was to analyze modifiable early risk factors of CAD, focusing on nutritional and environmental factors. We tested four early life periods; prenatal, neonatal, early postnatal and late postnatal periods. Twenty-two variables were tested for associations with CAD using logistic regression analysis. From the final models we identified novel dietary associations with CAD: the NPMD during the prenatal and early postnatal periods had a significant negative association with the incidence of CAD in adult dogs (age above 1 year). Oppositely, UPCD was associated with a significantly higher risk for CAD incidence. Other variables that were associated with a significantly lower risk for CAD were maternal deworming during pregnancy, sunlight exposure during early postnatal period, normal body condition score during the early postnatal period, the puppy being born within the same family that it would stay in, and spending time on a dirt or grass surface from 2 to 6 months. Also, the genetic factors regarding maternal history of CAD, allergy-prone breeds and more than 50% white-colored coat all showed a significant positive association with CAD incidence in agreement with previous findings. Although no causality can be established, feeding NPMD early in life seemed to be protective against CAD, while UPCD could be considered a risk factor. Prospective intervention studies are needed to establish the causal effects of the protective role of NPMD on prevalence of CAD during the fetal and early postnatal life.


Assuntos
Dermatite Atópica/diagnóstico , Dieta/efeitos adversos , Doenças do Cão/diagnóstico , Exposição Ambiental/efeitos adversos , Animais , Dermatite Atópica/etiologia , Dermatite Atópica/patologia , Doenças do Cão/etiologia , Doenças do Cão/patologia , Cães , Comportamento Alimentar/fisiologia , Humanos , Internet , Fatores de Risco , Inquéritos e Questionários
14.
PLoS One ; 15(4): e0232189, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32343720

RESUMO

Insect bite hypersensitivity (IBH) is a Th-2, IgE-mediated dermatitis of horses caused by bites of insects of the genus Culicoides that has common features with human atopic dermatitis. Together with Th-2 cells, the epithelial barrier plays an important role in development of type I hypersensitivities. In order to elucidate the role of the epithelial barrier and of the skin immune response in IBH we studied the transcriptome of lesional whole skin of IBH-horses (IBH-LE; n = 9) in comparison to non-lesional skin (IBH-NL; n = 8) as well as to skin of healthy control horses (H; n = 9). To study the "baseline state" of the epithelial barrier, we investigated the transcriptome of non-lesional epidermis in IBH-horses (EPI-IBH-NL; n = 10) in comparison with healthy epidermis from controls (EPI-H; n = 9). IBH-LE skin displayed substantial transcriptomic difference compared to H. IBH-LE was characterized by a downregulation of genes involved in tight junction formation, alterations in keratins and substantial immune signature of both Th-1 and Th-2 types with particular upregulation of IL13, as well as involvement of the hypoxic pathway. IBH-NL shared a number of differentially expressed genes (DEGs) with IBH-LE, but was overall more similar to H skin. In the epidermis, genes involved in metabolism of epidermal lipids, pruritus development, as well as IL25, were significantly differentially expressed between EPI-IBH-NL and EPI-H. Taken together, our data suggests an impairment of the epithelial barrier in IBH-affected horses that may act as a predisposing factor for IBH development. Moreover, these new mechanisms could potentially be used as future therapeutic targets. Importantly, many transcriptional features of equine IBH skin are shared with human atopic dermatitis, confirming equine IBH as a natural model of skin allergy.


Assuntos
Doenças dos Cavalos/imunologia , Hipersensibilidade/veterinária , Mordeduras e Picadas de Insetos/veterinária , Animais , Ceratopogonidae/patogenicidade , Citocinas/genética , Dermatite Atópica/etiologia , Dermatite Atópica/imunologia , Dermatite Atópica/veterinária , Epitélio/imunologia , Perfilação da Expressão Gênica , Doenças dos Cavalos/etiologia , Doenças dos Cavalos/genética , Cavalos , Humanos , Hipersensibilidade/etiologia , Hipersensibilidade/imunologia , Mordeduras e Picadas de Insetos/genética , Mordeduras e Picadas de Insetos/imunologia , Modelos Imunológicos , Prurido/genética , Prurido/imunologia , Prurido/veterinária , Transdução de Sinais/genética , Transdução de Sinais/imunologia , Pele/imunologia , Especificidade da Espécie , Células Th2/imunologia
15.
Pediatr Ann ; 49(3): e140-e146, 2020 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-32155280

RESUMO

Atopic dermatitis (AD) is the most common inflammatory skin condition in pediatric patients. AD has long been associated with comorbidities including food allergies, asthma, and allergic rhinitis, but recent literature has expanded this list to include attention-deficit/hyperactivity disorder and depression. AD has tremendous impact on quality of life for both affected children and their families. Improved understanding of AD pathogenesis, particularly regarding skin barrier dysfunction, the role of the cutaneous microbiome, and immune dysregulation, has spawned exciting new therapeutic directions. Although good skin care and appropriate use of topical corticosteroids remain first-line treatment, more precisely targeted treatments hold great promise. A recently approved topical phosphodiesterase inhibitor, crisaborole, and a subcutaneously administered interleukin-4/interleukin-13 blocker, dupilumab, are the first of what will likely be many new treatment options for patients with AD. [Pediatr Ann. 2020;49(3):e140-e146.].


Assuntos
Dermatite Atópica , Inibidores de Fosfodiesterase , Anticorpos Monoclonais Humanizados/uso terapêutico , Asma/complicações , Criança , Comorbidade , Dermatite Atópica/tratamento farmacológico , Dermatite Atópica/etiologia , Hipersensibilidade Alimentar/complicações , Humanos , Inibidores de Fosfodiesterase/uso terapêutico , Qualidade de Vida , Rinite Alérgica/tratamento farmacológico
16.
Int Arch Allergy Immunol ; 181(5): 365-374, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32097952

RESUMO

OBJECTIVE: Precise diagnosis of allergy requires knowledge of the population's food allergy (FA) spectrum and predictors. METHODS: Medical charts of Turkish children aged 0-2 years with FA and/or atopic dermatitis (AD) were reviewed. RESULTS: A total of 1,389 patients, 912 with FA and 1,140 with AD, were included. In the FA group, the most frequently diagnosed FAs were egg white (75.9%), cow's milk (55.7%), tree nuts (31.5%) and sesame (20.6%). The detection of FA in 99% of children with any kind of FA necessitate testing with egg white, cow's milk, hazelnut, sesame, walnut, cashew, and pistachio. In the FA group, 72.7 and 56.8% had AD and multiple FA respectively. Multiple FA (56.8 vs. 49.8%) and hen's egg allergy (85.5 vs. 50.2%, p < 0.005) were more common and cow's milk allergy (51.4 vs. 67.1%, p < 0.005) less common in the AD subgroup of the FA group than in the non-AD subgroup. Multiple FA likelihood increases parallel to the severity of AD (p < 0.05). In the AD group, 58.2% had an immunoglobulin E-mediated FA. The risk of concomitant FA increased as the age at symptom onset of AD decreased (OR 0.800 [95% CI 0.731-0.875]; p < 0.001) and the severity of AD increased (OR 2.350 [95% CI 1.898-2.911]; p < 0.001). CONCLUSION: Although severe and early-onset AD is a predictor of the presence and magnitude of FA in infancy, the spectrum of FA is a reflection of cultural characteristics. The clinical presentations of both AD and FA may in fact be an expression of the extent of the immune dysregulation underlying atopy and allergy.


Assuntos
Hipersensibilidade Alimentar/epidemiologia , Hipersensibilidade Alimentar/etiologia , Pré-Escolar , Dermatite Atópica/epidemiologia , Dermatite Atópica/etiologia , Dermatite Atópica/imunologia , Feminino , Hipersensibilidade Alimentar/imunologia , Humanos , Imunoglobulina E , Lactente , Recém-Nascido , Masculino , Prevalência , Estudos Retrospectivos , Turquia/epidemiologia
17.
Scand J Immunol ; 91(3): e12856, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31794090

RESUMO

Atopic dermatitis (AD) is a chronic inflammatory skin disease. A hallmark of AD is dry itchy skin that results from defects in the epidermal barrier function. Aloe vera is used widely to promote general health and is administered topically to treat skin conditions such as eczema, burns and wounds. However, effects of A vera on AD were not fully elucidated. In this study, we investigated the oral administration of processed A vera gel (PAG) containing low molecular weight Aloe polysaccharides to treat ovalbumin (OVA)-induced AD in mice. Oral administration of PAG suppressed total and OVA-specific IgE production in sera and decreased the epidermal thickness of skin. Numbers of Ki-67-positive cells were reduced by PAG treatment. Expression levels of tight junction genes, including those that encode ZO-1, Claudin-1 and Claudin-8, were decreased in AD skin lesions, whereas oral administration of PAG partially restored the expression levels of tight junction genes. In addition, IL-4 and IL-17A mRNA transcript levels were reduced in skin lesions after PAG treatment. Taken together, our findings suggest that oral administration of PAG ameliorated AD, normalized tight junction gene expression and suppressed inflammatory cytokines in AD skin.


Assuntos
Aloe/química , Antialérgicos/farmacologia , Dermatite Atópica/etiologia , Exsudatos de Plantas/farmacologia , Polissacarídeos/farmacologia , Junções Íntimas/efeitos dos fármacos , Junções Íntimas/imunologia , Animais , Antialérgicos/química , Biomarcadores , Citocinas/metabolismo , Dermatite Atópica/tratamento farmacológico , Dermatite Atópica/patologia , Modelos Animais de Doenças , Progressão da Doença , Feminino , Mediadores da Inflamação/metabolismo , Queratinócitos/efeitos dos fármacos , Queratinócitos/imunologia , Queratinócitos/metabolismo , Camundongos , Ovalbumina/efeitos adversos , Exsudatos de Plantas/química , Polissacarídeos/química , Pele/efeitos dos fármacos , Pele/imunologia , Pele/metabolismo , Pele/patologia
18.
Vet Dermatol ; 31(2): 116-127, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31749195

RESUMO

BACKGROUND: It is suspected that many canine cutaneous adverse food reactions (CAFR) are true immunological hypersensitivities; however, few specific dietary allergens have been identified. OBJECTIVE: To compare serum immunoglobulin (Ig)E and IgG reactivity to specific food antigens in privately owned dogs with and without CAFR. ANIMALS: Eighteen adult dogs with nonseasonal pruritus recruited from a hospital population. METHODS AND MATERIALS: Dogs were fed an extensively hydrolysed poultry-based diet exclusively for 12 weeks. Serum was collected at the beginning of the trial. Canine atopic dermatitis extent and severity index and pruritus Visual Analog Scale scoring were performed at the beginning and end of the trial. Immunoblotting was performed to identify IgE and/or IgG binding to specific proteins in beef, egg, milk, chicken, pork, soy and wheat extracts. RESULTS: A CAFR (defined as an unequivocal relapse of pruritus after dietary challenge) was diagnosed in 10 dogs, with 60% relapsing when fed chicken-based diets. Binding of subjects' IgG to almost all proteins in all extracts was seen regardless of reported dietary history. Few proteins were exclusively or predominantly bound by IgE in CAFR dogs. Exceptions included a 42 kDa band (chicken), a 52 kDa band (beef), a 46 kDa band (beef and milk) and a poorly defined high molecular weight protein or proteins (beef and milk). CONCLUSION: This study demonstrated three protein bands and a poorly defined band predominantly recognized by sera from dogs with CAFR relative to non-CAFR dog sera. Almost all proteins were bound by IgG in all dogs, suggesting prior exposure to unreported foods.


Assuntos
Alérgenos/imunologia , Ração Animal/efeitos adversos , Dermatite Atópica/veterinária , Hipersensibilidade Alimentar/veterinária , Imunoglobulina E/sangue , Imunoglobulina G/sangue , Prurido/veterinária , Alérgenos/sangue , Animais , Dermatite Atópica/etiologia , Dermatite Atópica/imunologia , Doenças do Cão/etiologia , Doenças do Cão/imunologia , Cães , Feminino , Hipersensibilidade Alimentar/sangue , Hipersensibilidade Alimentar/imunologia , Masculino , Prurido/etiologia , Prurido/imunologia , Índice de Gravidade de Doença , Pele/imunologia , Pele/patologia
19.
Contact Dermatitis ; 82(4): 211-217, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31625171

RESUMO

INTRODUCTION: Allergic contact dermatitis (ACD) of the feet accounts for approximately 10% of all patch tested patients. OBJECTIVE: To study the clinical profile of patients with feet dermatitis and relevant contact allergens in Spain over a 10-year period. METHODS: Retrospective observational study of patients with suspected ACD from the GEIDAC (Spanish Research Group on Contact Dermatitis and Cutaneous Allergy) baseline series from eight hospitals in Spain between 2004 and 2014. The clinical data collected from each patient were age, sex, occupation, history of atopic dermatitis, and eczema location. RESULTS: A total of 450 cases clinically presented dermatitis affecting the feet; of these, 41% of were males and 5.6% were suspected to be of occupational origin. As much as 47% were diagnosed with ACD, 20% with atopic dermatitis/dyshidrotic eczema, and 5% with psoriasis. The "feet group" included statistically significantly more females in the age range of 21 to 60 years. The most frequent relevant contact allergens were potassium dichromate, cobalt(II) chloride, p-tert-butylphenol formaldehyde resin, mercapto mix, and mercaptobenzothiazole. CONCLUSIONS: ACD is the most frequent clinical diagnosis of feet dermatitis in our series. The most frequent allergens are similar to those published in other series of foot ACD in Europe and the trend has not changed in the studied decade.


Assuntos
Dermatite Alérgica de Contato/epidemiologia , Dermatoses do Pé/epidemiologia , Adulto , Cobalto/efeitos adversos , Dermatite Alérgica de Contato/etiologia , Dermatite Atópica/epidemiologia , Dermatite Atópica/etiologia , Dermatite Irritante/epidemiologia , Dermatite Irritante/etiologia , Dermatite Ocupacional/epidemiologia , Dermatite Ocupacional/etiologia , Eczema Disidrótico/epidemiologia , Feminino , Dermatoses do Pé/induzido quimicamente , Humanos , Masculino , Dicromato de Potássio/efeitos adversos , Psoríase/induzido quimicamente , Psoríase/epidemiologia , Resinas Sintéticas/efeitos adversos , Estudos Retrospectivos , Espanha/epidemiologia , Compostos de Sulfidrila/efeitos adversos
20.
Arch Environ Occup Health ; 75(1): 18-26, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-30595111

RESUMO

The association between early daycare attendance and risk of allergic diseases remains inconclusive. Therefore, we examined the association among Japanese children on a long-term basis using a nationwide longitudinal survey data. We estimated the association between daycare attendance at age 6 or 18 months and allergy development using information on outpatient visits for atopic dermatitis (AD), food allergy (FA), and asthma and admission for asthma up to 12 years of age as a proxy for developing these diseases, with multilevel logistic regression. Early daycare attendance was associated with increased odds of AD at ages 2.5-3.5 years: the adjusted odds ratio (OR) was 1.34 [95% CI: 1.21, 1.47]. The association with FA was equivocal. The odds of asthma was increased before age 3.5 years and afterwards decreased: the adjusted ORs were 1.60 [1.44, 1.77] for ages 1.5-2.5 years and 0.77 [0.69, 0.87] for ages 5.5-7 years. The effect of early daycare attendance depends on the type of allergies.


Assuntos
Asma/epidemiologia , Creches/estatística & dados numéricos , Dermatite Atópica/epidemiologia , Hipersensibilidade Alimentar/epidemiologia , Hospitalização/estatística & dados numéricos , Saúde do Lactente/estatística & dados numéricos , Asma/etiologia , Dermatite Atópica/etiologia , Hipersensibilidade Alimentar/etiologia , Humanos , Hipersensibilidade , Incidência , Lactente , Japão/epidemiologia , Estudos Longitudinais
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