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1.
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
2.
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
3.
Int Arch Allergy Immunol ; 180(4): 235-243, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31694044

RESUMO

Over the last decades, an increasing appearance of allergies and atopic disorders, such as asthma, dermatitis, and rhinitis, has been observed. The mechanisms of these disorders remain unclear, and therefore the development of novel therapies is limited. Current treatments are often symptomatic, nonspecific, or may have severe side effects. Further insights into the mechanisms of the underlying disease pathogenesis could reveal novel targets for treatment. In this review, we provide an update on recent basic and translational studies that offer novel insights and opportunities for the treatment of patients with atopic disorders.


Assuntos
Asma/etiologia , Dermatite Atópica/etiologia , Hipersensibilidade Alimentar/etiologia , Rinite Alérgica/etiologia , Alérgenos/imunologia , Asma/genética , Asma/terapia , Dermatite Atópica/genética , Dermatite Atópica/terapia , Hipersensibilidade Alimentar/genética , Hipersensibilidade Alimentar/terapia , Predisposição Genética para Doença/genética , Humanos , Rinite Alérgica/genética , Rinite Alérgica/terapia , Fatores de Risco
4.
J Drugs Dermatol ; 18(10): 1020-1027, 2019 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-31584781

RESUMO

Introduction: Atopic dermatitis (AD) is a chronic, relapsing skin disease starting typically in atopic-prone children between 3­6 months of age, with most children having developed AD by the age of 5 years. Intense itching leads to sleep disturbance, especially in younger children and toddlers. This review explores early intervention in infants and young children with AD by controlling skin barrier function and inflammation at the earliest time point using a moisturizer and a proactive treatment. Methods: A working group of experienced clinicians managing pediatric populations with AD convened for a meeting. The panel reviewed the literature surrounding early intervention in infants and young children with AD and developed and discussed clinical questions aimed at optimizing clinical outcomes. Results: Complex gene/immune system/environment interactions are involved in AD development. Epidermal barrier defects play a central role in the condition, with various studies showing impairment of skin barrier function at birth may precede clinical AD. Dynamic changes take place in the amounts of skin lipids during infancy. Studies confirm that daily use of a moisturizer from birth onwards may offer benefits in improving skin barrier function and possibly prevention of AD, especially in high-risk, atopic prone newborns. Plant-based moisturizers were shown to be safe and effective when applied in pediatric patients with AD and may provide a TCS-sparing effect while improving skin condition. Conclusion: Dry skin conditions during infancy may predict the subsequent development of AD. Consequently, emollient therapy from birth represents a feasible, safe, and effective approach for AD prevention. Therefore, parental education and the application of moisturizers are recommended as an integral part of AD prevention, treatment, and maintenance. J Drugs Dermatol. 2019;18(10):1020-1027.


Assuntos
Dermatite Atópica/tratamento farmacológico , Emolientes/administração & dosagem , Carga Global da Doença , Extratos Vegetais/administração & dosagem , Fatores Etários , Idade de Início , Pré-Escolar , Dermatite Atópica/epidemiologia , Dermatite Atópica/etiologia , Emolientes/efeitos adversos , Humanos , Incidência , Lactente , Recém-Nascido , Extratos Vegetais/efeitos adversos , Prevalência , Fatores de Risco
5.
Immunol Allergy Clin North Am ; 39(4): 507-519, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31563185

RESUMO

Atopic dermatitis (AD) is a chronic, relapsing disease that typically manifests in childhood and improves with age. Studies have demonstrated that the presence of AD increases the risk of developing food allergy, allergic rhinitis, and asthma later in life. Although children with AD are more likely to produce allergen-specific immunoglobulin E, there is conflicting evidence that allergen avoidance improves disease severity. Furthermore, food-elimination diets in patients with AD may increase the risk of developing immediate, life-threatening reactions to the removed food. The most effective treatments of AD aim to repair and protect the skin barrier and decrease inflammation.


Assuntos
Dermatite Atópica/etiologia , Alérgenos/administração & dosagem , Alérgenos/imunologia , Animais , Dermatite Atópica/diagnóstico , Dermatite Atópica/prevenção & controle , Dermatite Atópica/terapia , Gerenciamento Clínico , Suscetibilidade a Doenças , Predisposição Genética para Doença , Humanos , Hipersensibilidade/diagnóstico , Hipersensibilidade/etiologia , Hipersensibilidade/prevenção & controle , Hipersensibilidade/terapia
6.
Iran J Allergy Asthma Immunol ; 18(4): 347-357, 2019 Aug 17.
Artigo em Inglês | MEDLINE | ID: mdl-31522443

RESUMO

Atopic dermatitis (AD) is a chronic, recurrent skin condition resulting from both genetic and environmental factors. In recent decades, the prevalence of AD has increased considerably in some countries. However, given that the role of genetics is unlikely to have changed over this short period, the increased prevalence is more likely to be explained by changes in environmental and maternal factors. The aim of this review is to comprehensively summarize the various factors impacting AD incidence in offspring and provide guidance for primary prevention. Recent research has demonstrated that environmental and climate factors, maternal history of allergies, gestational diabetes, and stress play essential roles in increasing the risk of AD in infants. Some factors have protective effects against the incidence of AD, including probiotic supplementation, fish intake, and moisturizers. This review also considers fundamental research into AD prevalence and factors that in the past were mistakenly thought to affect that prevalence, such as caesarean section and antigen avoidance. The potential influence of these factors on infant AD incidence remains inconclusive and needs further study. Furthermore, infants with a family history of atopic disease may benefit from early weaning or reduced breastfeeding duration.


Assuntos
Dermatite Atópica/epidemiologia , Dermatite Atópica/etiologia , Suscetibilidade a Doenças , Exposição Materna , Efeitos Tardios da Exposição Pré-Natal , Dieta , Meio Ambiente , Feminino , Humanos , Hipótese da Higiene , Incidência , Nutrientes , Gravidez , Probióticos , Fatores de Risco
7.
Mol Med Rep ; 20(5): 4645-4653, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31545496

RESUMO

Previous studies have demonstrated that microRNA (miR)­146a is involved in the inflammatory response of atopic dermatitis (AD). The aim of the present study was to investigate the expression of miR­146a in the serum of patients with AD and in skin lesions of AD animal models. In addition, we aimed to predict and verify the target genes of miR­146a. miR­146a expression was measured in AD patient serum via reverse transcription­quantitative PCR. T­helper (Th)1 [CD4+; interferon (IFN)­Î³+] and Th2 [CD4+; interleukin (IL)­4+] expression in peripheral blood mononuclear cells was evaluated using flow cytometry. Following the establishment of a 2,4­dinitrofluorobenzene­induced C57BL/6 mouse AD model, Th1 (CD4+IFN­Î³+) and Th2 (CD4+IL­4+) expression was analyzed in murine spleen cells via flow cytometry. Plasmids were transfected into 293T cells and at 48 h post­transfection, cells were analyzed using a luciferase assay system. The results revealed that the AD group had a significantly lower Th1/Th2 ratio and a significantly higher miR­146a expression compared with the control group (P<0.05). Furthermore, a decreased Th1/Th2 ratio and a significantly increased miR­146a expression were observed in the model group compared with the control group (P<0.01). We also conducted a dual­luciferase assay to determine whether small ubiquitin­related modifier 1 (SUMO1) if the target gene of miR­146a. We observed a ~30% decrease in the relative luciferase activity in cells containing the 3'­untranslated region of SUMO1 + miR­146a). The results of the luciferase assay indicated that may be a direct mRNA target of miR­146a; however, the quantification of band density of SUMO1 expression following western blotting did not significantly differ. The development of animal models in AD research is of vital importance. The results revealed that miR­146a may be a potential regulator involved in the pathogenesis of AD. Furthermore, the current study determined that miR­146a could be a valuable marker of AD and thus, may be applied in the development of therapeutic strategies for treating AD.


Assuntos
Biomarcadores , Dermatite Atópica/etiologia , Regulação da Expressão Gênica , MicroRNAs/genética , Regiões 3' não Traduzidas , Adolescente , Adulto , Animais , Estudos de Casos e Controles , Criança , Pré-Escolar , Dermatite Atópica/metabolismo , Modelos Animais de Doenças , Suscetibilidade a Doenças , Feminino , Humanos , Leucócitos Mononucleares/metabolismo , Masculino , Camundongos , Interferência de RNA , Proteína SUMO-1/genética , Proteína SUMO-1/metabolismo , Baço/imunologia , Baço/metabolismo , Linfócitos T Auxiliares-Indutores/imunologia , Linfócitos T Auxiliares-Indutores/metabolismo , Adulto Jovem
8.
Acta Med Port ; 32(9): 606-613, 2019 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-31493365

RESUMO

With an increasing prevalence during the past decades, atopic dermatitis has become a global health issue. A literature search following a targeted approach was undertaken to perform this non-systematic review, which intends to provide an overview of the epidemiology, pathophysiology, clinical features, comorbidities, and current therapies for the treatment of atopic dermatitis. In sum, this is a heterogeneous skin disorder associated with variable morphology, distribution, and disease course. Although not completely understood, its pathogenesis is complex and seems to result from a combination of genetic and environmental factors that induce skin barrier dysfunction, cutaneous and systemic immune dysregulation, skin microbiota dysbiosis, and a strong genetic influence. Diagnosis is based on specific criteria that consider patient and family history and clinical manifestations. Overall disease severity must be determined by evaluating both objective signs and subjective symptoms. Therapeutic goals require a multistep approach, focusing on reducing pruritus and establishing disease control. Patients should be advised on basic skin care and avoidance of triggers. Topical anti-inflammatory agents should be considered in disease flares or chronic/recurrent lesions. In case of inadequate response, phototherapy, systemic immunosuppressants and, more recently, dupilumab, should be added. Nevertheless, the treatment of moderate-to-severe atopic dermatitis remains challenging and novel, efficacious, safe and targeted treatments are urgently needed. In conclusion, although the last few years have seen important improvement in the understanding of the disease, future research in atopic dermatitis will continue exploring gene-environment interactions and how it affects pathophysiology, disease severity, and treatment outcomes.


Assuntos
Dermatite Atópica , Fatores Etários , Comorbidade , Dermatite Atópica/diagnóstico , Dermatite Atópica/tratamento farmacológico , Dermatite Atópica/epidemiologia , Dermatite Atópica/etiologia , Gerenciamento Clínico , Saúde da Família , Interação Gene-Ambiente , Humanos , Prevenção Primária/métodos , Qualidade de Vida , Índice de Gravidade de Doença
9.
Medicine (Baltimore) ; 98(32): e16362, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31393345

RESUMO

RATIONALE: Atopic dermatitis (AD) is a chronic recurrent dermatitis with profound itching, which could be the first manifestation of acute myeloid leukemia (AML). PATIENT CONCERNS: A 53-year-old Chinese man suffered a 6-month history of systemic symmetrical dermatitis, accompanied with profound itching. The patient was diagnosed as "eczema" in several hospitals, and the effects of antihistamine and topical steroid creams were poor. Nocturnal sleep was seriously affected by aggravating pruritus. Laboratorial examination was compatible with AML-M4. DIAGNOSES: AML-M4 with AD as first manifestation. INTERVENTIONS: IA regimen (ayninen and cytarabine) were used in induction chemotherapy. However, the patient did not achieve complete remission, and although his rash had improved, he still experienced severely general body itching. On the seventh day of chemotherapy, the patient entered the period of granulocyte deficiency with infection. OUTCOMES: The patient died due to septic shock after chemotherapy. LESSONS: The case strengthens the awareness of AML with AD as first manifestation and raises oncological vigilance in patients with AD refractory.


Assuntos
Dermatite Atópica/etiologia , Leucemia Mieloide Aguda/complicações , Leucemia Mieloide Aguda/diagnóstico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Dermatite Atópica/tratamento farmacológico , Humanos , Leucemia Mieloide Aguda/tratamento farmacológico , Leucemia Mieloide Aguda/fisiopatologia , Masculino , Pessoa de Meia-Idade
10.
Nutrients ; 11(8)2019 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-31374861

RESUMO

Maternal diet during pregnancy plays a likely role in infant immune development through both direct nutrient specific immunomodulatory effects and by modulating the composition and metabolic activity of the maternal gut microbiome. Dietary fibers, as major substrates for microbial fermentation, are of interest in this context. This is the first study to examine maternal intakes of different fiber sub-types and subsequent infant allergic disease. In an observational study of 639 mother-infant pairs (all infants had a family history of allergic disease) we examined maternal intakes of total fiber, soluble fiber, insoluble fiber, resistant starch, and prebiotic fiber, by a semi-quantitative food frequency questionnaire at 36-40 weeks' gestation. Infants attended an allergy clinical assessment at 12 months of age, including skin prick testing to common allergens. Higher maternal dietary intakes of resistant starch were associated with reduced doctor diagnosed infant wheeze, adjusted odds ratio (aOR) 0.68 (95% CI 0.49, 0.95, p = 0.02). However, in contrast, higher maternal intakes of resistant starch were associated with higher risk of parent reported eczema aOR 1.27 (95% CI 1.09, 1.49, p < 0.01) and doctor diagnosed eczema aOR 1.19 (95% CI 1.01, 1.41, p = 0.04). In conclusion, maternal resistant starch consumption was differentially associated with infant phenotypes, with reduced risk of infant wheeze, but increased risk of eczema.


Assuntos
Dermatite Atópica/etiologia , Fibras na Dieta/administração & dosagem , Fibras na Dieta/efeitos adversos , Fenômenos Fisiológicos da Nutrição Materna , Estado Nutricional , Efeitos Tardios da Exposição Pré-Natal , Recomendações Nutricionais , Hipersensibilidade Respiratória/prevenção & controle , Adulto , Dermatite Atópica/diagnóstico , Feminino , Humanos , Lactente , Masculino , Gravidez , Fatores de Proteção , Hipersensibilidade Respiratória/diagnóstico , Hipersensibilidade Respiratória/etiologia , Sons Respiratórios , Medição de Risco , Fatores de Risco
11.
Vet Dermatol ; 30(5): 396-e119, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31407839

RESUMO

BACKGROUND: Canine atopic dermatitis (cAD) is one the most common and distressing skin disorders seen in dogs. It is characterized by dysfunction in the skin barrier, with a complex pathogenesis combining both genetic and environmental factors. OBJECTIVES: To evaluate associations between environmental factors and case-control status in two closely related, at-risk breeds, the Labrador retriever and golden retriever. ANIMALS: Two thousand four hundred and forty-five pet dogs, of which 793 were classed as cases (575 Labrador and 218 golden retrievers) and 1,652 as controls (1,120 Labrador and 532 golden retrievers). METHODS AND MATERIALS: Case-control status was assigned based upon owner response to a standardized validated questionnaire. Retrospective data on rearing environment were collected via additional questions. Univariate and multivariate logistic regressions were utilized to evaluate associations between environmental factors and case-control status. RESULTS: Risk factors included being reared in an urban environment (not living currently in an urban environment), being male, being neutered, receiving flea control and being allowed on upholstered furniture. Protective factors included living with other dogs (not cats) and walking in woodlands, fields or beaches. Additionally, amongst Labrador retrievers, chocolate-coloured dogs were at greater risk of having cAD than black- or yellow-coated dogs. CONCLUSIONS AND CLINICAL IMPORTANCE: This study is the largest of its kind to date to investigate the role of the environment in cAD. Although precise triggers are unclear, this study complements earlier studies in highlighting the protective role of a rural environment and some novel associations with disease development.


Assuntos
Dermatite Atópica/veterinária , Doenças do Cão/etiologia , Meio Ambiente , Animais , Dermatite Atópica/etiologia , Dermatite Atópica/genética , Doenças do Cão/genética , Cães , Feminino , Predisposição Genética para Doença , Masculino , Análise Multivariada , Razão de Chances , Estudos Retrospectivos , Fatores de Risco
12.
Medicine (Baltimore) ; 98(35): e16540, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31464891

RESUMO

Antibiotics during infancy, delivery, and breastfeeding affect the intestinal microbiota in early life and is associated with allergic disease. Gastroenteritis (GE) during infancy also affects intestinal microbiota in early life, however, its relationship to allergic disease has not been investigated.Data of 45,499 males and 49,430 females, from birth to 5 years of age, were collected from a national database in Taiwan. Subjects were categorized into early GE (GE within 0-6 months) and non-early GE group (no GE within 0-6 months). The rates of asthma (AS), allergic rhinitis (AR), and atopic dermatitis (AD) over 5 years were evaluated and compared between the groups. In patients with AS, AR, and AD, the number of clinical visits and drug prescriptions for the allergic disease was also evaluated to assess the effect of early GE on allergic disease.After adjusting for the effect of GE in later life and other factors, the rates of AS [OR (odds ratio) 1.54, 95% confidence interval (CI) 1.48-1.60], AR [OR 1.49, 95% CI 1.45-1.54], and AD [OR 1.40, 95% CI 1.33-1.47] were higher in the early GE group than in the non-early GE group. The magnitude of the increase was higher in females than in males. In those with AS, AR, and AD, the number of clinical visits and drug prescriptions was not different between the early GE and non-early GE groups. In children with early GE, good control of GE in the following years lowered the rate of allergic disease.Early-life GE was associated with increased rates of AS, AR, and AD in later life and this was trend more prominent in females.


Assuntos
Asma/epidemiologia , Dermatite Atópica/epidemiologia , Gastroenterite/complicações , Rinite Alérgica/epidemiologia , Asma/etiologia , Estudos de Casos e Controles , Pré-Escolar , Dermatite Atópica/etiologia , Feminino , Gastroenterite/epidemiologia , Humanos , Lactente , Recém-Nascido , Masculino , Rinite Alérgica/etiologia , Caracteres Sexuais , Taiwan/epidemiologia
13.
Immunol Med ; 42(2): 84-93, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31318324

RESUMO

Atopic dermatitis (AD) is the most common inflammatory skin disease driven by both terminal keratinocyte differentiation defects and type 2 immune responses, and this condition causes psychological and social morbidity. Although patients with severe AD require systemic immunotherapy, conventional agents including ciclosporin could not be used for several years due to side effects such as nephrotoxicity, hypertension and long-term risks of malignancy. It is well known that dupilumab, which blocks receptor binding of both IL-4 and IL-13, is remarkably efficacious in the treatment of AD. We have entered a new era when many novel topical and systemic agents that may have great potential in AD treatment are emerging through clinical trials. The purpose of this article is to summarize the efficacy and safety of the current topical and systemic therapies in AD by reviewing recently published papers regarding phase II/III clinical trials. It is revealed that topical phosphodiesterase 4 inhibitors and Janus kinase (JAK) inhibitors are promising treatments for AD. Moreover, systemic therapies such as biologics targeting IL-13 and oral JAK inhibitors show strong efficacy in AD.


Assuntos
Dermatite Atópica/tratamento farmacológico , Inibidores de Janus Quinases/administração & dosagem , Inibidores da Fosfodiesterase 4/administração & dosagem , Acrilamidas/administração & dosagem , Administração Tópica , Anticorpos Monoclonais Humanizados/administração & dosagem , Produtos Biológicos/administração & dosagem , Compostos de Boro/administração & dosagem , Compostos Bicíclicos Heterocíclicos com Pontes/administração & dosagem , Dermatite Atópica/etiologia , Dermatite Atópica/imunologia , Humanos , Imunoterapia , Interleucina-13 , Terapia de Alvo Molecular , Piperidinas/administração & dosagem , Piridinas/administração & dosagem , Pirimidinas/administração & dosagem , Pirróis/administração & dosagem , Resorcinóis/administração & dosagem , Estilbenos/administração & dosagem , Canais de Cátion TRPV/antagonistas & inibidores
15.
Immunol Med ; 42(1): 10-15, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31204894

RESUMO

Atopic dermatitis (AD) is caused by complex interactions between a variety of genetic and environmental factors that contribute to the maintenance of the chronic inflammatory skin condition. Most conventional treatments have been designed for the so-called 'average patient'. In recent years however, many previously unknown details pertaining to the mechanisms of the pathogenesis of AD have been elucidated, and novel treatments based on these pathological mechanisms or on subgroup classifications have been developed. Herein, how future treatment strategies for AD can be developed is described.


Assuntos
Dermatite Atópica/tratamento farmacológico , Dermatite Atópica/etiologia , Terapia de Alvo Molecular/tendências , Animais , Anticorpos , Anticorpos Monoclonais/uso terapêutico , Dermatite Atópica/genética , Dermatite Atópica/imunologia , Humanos , Imunoglobulina E/imunologia , Subunidade alfa de Receptor de Interleucina-4/imunologia , Proteínas de Filamentos Intermediários/genética , Camundongos , Mutação , Ácidos Nucleicos/uso terapêutico , Oligodesoxirribonucleotídeos/uso terapêutico , Fator de Transcrição STAT6 , beta-Defensinas
16.
Biomed Res Int ; 2019: 2450605, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31119157

RESUMO

Atopic dermatitis (AD) prevalence is rising worldwide. Literature data suggest the incidence of AD in developing countries is gradually getting close to that of developed ones, in which AD affects 20% of the paediatric population. Such an increment, associated with significant variations in prevalence among the various countries, underlines the importance of environmental factors in the disease onset. Among these, great importance is given to hygiene, intestinal microbiota, exposure to bacterial endotoxins, outdoor living with contact to animals, atmospheric pollution, weather, and diet. Genetic (alteration of the skin barrier function) as well as immunologic factors concur with the environmental ones. Only the systematical study of all these elements can best elucidate AD epidemiology.


Assuntos
Alérgenos/efeitos adversos , Dermatite Atópica/epidemiologia , Dermatite Atópica/etiologia , Animais , Dermatite Atópica/patologia , Dieta/efeitos adversos , Endotoxinas/efeitos adversos , Poluição Ambiental/efeitos adversos , Microbioma Gastrointestinal , Humanos , Higiene , Pediatria/tendências , Fatores de Risco , Tempo (Meteorologia)
17.
APMIS ; 127(5): 386-424, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31124204

RESUMO

The current state, tools, and applications of personalized medicine with special emphasis on inflammatory skin diseases like psoriasis and atopic dermatitis are discussed. Inflammatory pathways are outlined as well as potential targets for monoclonal antibodies and small-molecule inhibitors.


Assuntos
Dermatite Atópica/tratamento farmacológico , Medicina de Precisão , Psoríase/tratamento farmacológico , Câmaras de Exposição Atmosférica , Biomarcadores , Dermatite Atópica/etiologia , Dermatite Atópica/genética , Epigenômica , Humanos , Testes Farmacogenômicos , Medicina de Precisão/métodos , Proteômica , Transcriptoma , Sequenciamento Completo do Genoma
18.
Medicina (Kaunas) ; 55(5)2019 May 12.
Artigo em Inglês | MEDLINE | ID: mdl-31083640

RESUMO

Background and Objectives: The growing burden and deleterious health consequences of allergic diseases, especially of allergic rhinitis (AR) and atopic dermatitis (AD), in developed countries remains an important public health issue. The current study aimed to assess the prevalence and to identify the risk factors of atopic dermatitis and allergic rhinitis among residents of Pohang-Si and Yeongdeok-Gun, two municipal areas in South Korea. Materials and Methods: A cross-sectional study was conducted in both municipal areas between 12 November and 13 December 2017. A total of 302 subjects were recruited from 100 households (25 apartments and 25 houses in each municipality), by system extraction according to district code numbers. Data were collected using International Study of Asthma and Allergies in Childhood (ISAAC) Standard Questionnaires for children and a health questionnaire for adults. Risk factors were identified by multivariate logistic regression analysis. Results: Of the 302 study participants, 12.9% and 25.5% had AD and AR, respectively. The significant factors associated with AD by multivariate logistic regression analysis were age ≥19 years (aOR (adjusted odds ratio) 6.9; 95% CI (confidence interval) (2.9-16.37)), residence in Pohang-Si (aOR 2.5; 95% CI (1.18-5.53)), and family history of allergic disease (aOR 2.3; 95% CI (1.09-4.9)). Similarly, the significant factors associated with AR were male gender (aOR 2.3; 95% CI (1.24-4.42)), age ≥19 years (aOR 4.4; 95% CI (2.28-8.48)), residence in Pohang-Si (aOR 2.8; 95% CI (1.51-5.37)), and family history of allergic disease (aOR 6.7; 95% CI (3.50-12.82)). Conclusion: The present study shows that age ≥19 years, residence in Pohang-Si, and family history of allergic disease are risk factors for AD and AR, and that, additionally, male gender is a risk factor of AR. Understanding the risk factors of allergic diseases can aid the design and implementation of evidence-specific strategies to reduce the long-standing problems associated with allergic disease.


Assuntos
Dermatite Atópica/etiologia , Rinite Alérgica/etiologia , Adulto , Asma/complicações , Asma/epidemiologia , Estudos Transversais , Dermatite Atópica/epidemiologia , Feminino , Humanos , Modelos Logísticos , Masculino , Razão de Chances , República da Coreia/epidemiologia , Rinite Alérgica/epidemiologia , Fatores de Risco , Inquéritos e Questionários
19.
S Afr Med J ; 109(5): 323-327, 2019 Apr 29.
Artigo em Inglês | MEDLINE | ID: mdl-31131799

RESUMO

BACKGROUND: There are no previous data on tolerance development in children with atopic dermatitis (AD) and concomitant food allergy in low- and middle-income settings. OBJECTIVES: To determine the rate of tolerance acquisition to egg and peanut 5 years after diagnosing food allergies in South African (SA) children with AD, and to explore factors influencing tolerance acquisition. METHODS: Five years after first diagnosing food allergy in 37 SA children with egg and/or peanut allergy, they were reassessed for their allergies by questionnaire, skin-prick tests (SPTs) and ImmunoCAP-specific IgE (sIgE) tests (Thermo Fisher Scientific/Phadia, Sweden) to egg white, ovomucoid, peanut and Arachis hypogaea allergen 2 (Ara h 2), and incremental food challenges. RESULTS: Eighteen of 25 originally egg-allergic patients and 19 of 24 originally peanut-allergic children were followed up at a median age of 8 years and 3 months and 9 years and 6 months, respectively. A high percentage of children (72.2%) outgrew their egg allergy, and 15.8% outgrew their peanut allergy. Allergic comorbidity remained high, with asthma increasing over time, and AD remaining moderate in severity in the cohort overall. At diagnosis, sIgE egg white ≤9.0 kU/L and sIgE ovomucoid ≤2.0 kU/L were associated with tolerance development to egg 5 years later. At follow-up, sIgE egg white ≤0.70 kU/L, sIgE ovomucoid ≤0.16 kU/L, SPT egg-white extract ≤1 mm and SPT fresh egg ≤5 mm were associated with tolerance. At diagnosis, sIgE Ara h 2 ≤1.7 kU/L and SPT peanut ≤10 mm were associated with tolerance development to peanut 5 years later. At follow-up, sIgE peanut ≤0.22 kU/L, sIgE Ara h 2 ≤0.18 kU/L and SPT peanut ≤5.5 mm were associated with tolerance. CONCLUSIONS: Egg allergy was outgrown in 72.2% and peanut allergy in 15.8% of SA children 5 years after diagnosis of AD. This is in keeping with findings derived from studies in higher socioeconomic settings, and can help to guide the counselling of patients with allergies to these foods of high nutritional value.


Assuntos
Dermatite Atópica/epidemiologia , Hipersensibilidade a Ovo/complicações , Tolerância Imunológica , Hipersensibilidade a Amendoim/complicações , Criança , Pré-Escolar , Dermatite Atópica/diagnóstico , Dermatite Atópica/etiologia , Hipersensibilidade a Ovo/epidemiologia , Hipersensibilidade a Ovo/imunologia , Feminino , Seguimentos , Humanos , Incidência , Lactente , Masculino , Hipersensibilidade a Amendoim/epidemiologia , Hipersensibilidade a Amendoim/imunologia , Estudos Retrospectivos , Testes Cutâneos , África do Sul/epidemiologia , Fatores de Tempo
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