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Atopic eczema

Kammi Yap Sayaseng, Peggy Vernon
Atopic dermatitis (AD), or eczema, is a chronic inflammatory skin condition characterized by relapsing pruritic and dry, scaly lesions. AD affects 10% to 20% of children in the United States and significantly affects the quality of life of patients and their families. Primary care providers (PCPs) are often the first point of contact for the management of AD symptoms. As many as 70% of patients with mild to moderate disease can be managed by a PCP, underscoring the need for these providers to understand basic AD pathophysiology and current standards of care...
March 2018: Journal of Pediatric Health Care
M Köberle, T Biedermann
Atopic dermatitis affects roughly 20% of children and 3% of adults in Germany and other industrial countries, with an increasing prevalence. Its causality has still not been conclusively clarified but a type‑2 T‑helper cell mediated immunity reaction (type 2 immunity) dominates cutaneous inflammation. In the quest for the underlying pathogenic mechanisms and the development of improved prevention and treatment options, attention is also increasingly being paid to the influence of microbial colonization...
February 16, 2018: Der Hautarzt; Zeitschrift Für Dermatologie, Venerologie, und Verwandte Gebiete
T Nijsten, D J Hijnen
Dupilumab is the first and long-awaited biological for treatment of moderate to severe atopic dermatitis. In randomised clinical trials approximately 40% of patients using dupilumab 300 mg every two weeks were clear or almost clear of their eczema after 16 and 52 weeks. We now face the challenge of patient stratification to limit the budget impact of dupilumab and hope that more targeted therapies for atopic dermatitis will follow soon.
2018: Nederlands Tijdschrift Voor Geneeskunde
Rosa M Pacheco-González, Luis García-Marcos, Eva Morales
Prenatal vitamin D status may influence offspring's respiratory and allergic outcomes; however, evidence is inconclusive. A systematic review and meta-analysis was conducted on the association between 25-hydroxyvitamin D [25(OH)D] levels in maternal blood in pregnancy or cord blood at birth with the risk of offspring's respiratory and allergic conditions. Two independent researchers conducted systematic searches for observational studies published until May 2017 using defined keywords on vitamin D and health outcomes, including respiratory tract infections (RTIs), wheeze, asthma, atopic eczema, allergic rhinitis, allergic sensitization, and lung function...
February 14, 2018: Pediatric Allergy and Immunology
Lukas Steinegger, Stephan Regenass, Lucas M Bachmann, Elsbeth Probst, Urs C Steiner
Background: Atopic allergy is a widespread disease with increasing prevalence in the second half of the twentieth century and is most often associated with clinical symptoms, like rhinoconjunctivitis, asthma or eczema. This study explored the prevalence of atopy and polysensitization in nine cohorts of Swiss medical students during the period of 2007-2015. Furthermore, the self-reported allergic symptoms, such as rhinoconjunctivitis, asthma and eczema, among students with and without atopy were assessed...
2018: Allergy, Asthma, and Clinical Immunology
S Ferreira, T Torres
Atopic dermatitis (AD) is a common, chronic, inflammatory skin disorder with high physical and emotional burden. AD usually starts in early childhood and has a heterogeneous course. Emerging evidence suggests that IL-4 and IL-13 are key cytokines in the immunopathogenesis of AD. Dupilumab is a monoclonal antibody directed against IL-4 receptor α subunit, that blocks both IL-4 and IL-13 signaling. Data from Phase I-III studies revealed that dupilumab, administered as monotherapy or with topical corticosteroids, is effective and well tolerated in the treatment of adult patients with moderate-to-severe AD...
February 5, 2018: Actas Dermo-sifiliográficas
Kristin Wickens, Christine Barthow, Edwin A Mitchell, Thorsten V Stanley, Gordon Purdie, Judy Rowden, Janice Kang, Fiona Hood, Lieke van den Elsen, Elizabeth Forbes-Blom, Isobel Franklin, Phillipa Barnes, Penny Fitzharris, Robyn M Maude, Peter Stone, Peter Abels, Rinki Murphy, Julian Crane
BACKGROUND: In a randomised placebo-controlled trial, we previously found that the probiotic Lactobacillus rhamnosus HN001 (HN001) taken by mothers from 35 weeks gestation until 6 months post-partum if breastfeeding and their child from birth to age 2 years halved the risk of eczema during the first 2 years of life. We aimed to test whether maternal supplementation alone is sufficient to reduce eczema, and compare this to our previous study when both mothers and their child were supplemented...
February 7, 2018: Pediatric Allergy and Immunology
Emma Guttman-Yassky, Jonathan I Silverberg, Osamu Nemoto, Seth B Forman, August Wilke, Randy Prescilla, Amparo de la Peña, Fabio P Nunes, Jonathan Janes, Margaret Gamalo, David Donley, Jim Paik, Amy M DeLozier, Brian J Nickoloff, Eric L Simpson
BACKGROUND: Baricitinib, an oral selective inhibitor of Janus kinase (JAK)1 and JAK2, modulates pro-inflammatory cytokine signaling. OBJECTIVES: The efficacy and safety of baricitinib were evaluated in patients with moderate-to-severe atopic dermatitis (AD). METHODS: In this phase 2, randomized, double-blind, placebo-controlled study, 124 patients with moderate-to-severe AD applied topical corticosteroids (TCS) for 4 weeks before randomization to once daily placebo, baricitinib 2 mg, or baricitinib 4 mg for 16 weeks...
February 1, 2018: Journal of the American Academy of Dermatology
Helen A Brough, Inger Kull, Kerry Richards, Eva Hallner, Cilla Söderhäll, Abdel Douiri, Martin Penagos, Erik Melén, Anna Bergström, Victor Turcanu, Magnus Wickman, Gideon Lack
BACKGROUND: High household peanut consumption is associated with the development of peanut allergy, especially when peanut allergic cases are compared against atopic controls; thus environmental peanut exposure (EPE) may be a risk factor for peanut sensitization and allergy. In this study we explored the relationship between EPE and school-age peanut sensitization in a population based cohort. METHODS: Maternal bed-dust was collected postnatally and EPE was quantified using a polyclonal peanut ELISA...
February 6, 2018: Clinical and Experimental Allergy: Journal of the British Society for Allergy and Clinical Immunology
Munawar Hussain Soomro, Nour Baiz, Claire Philippat, Celine Vernet, Valerie Siroux, Cara Nichole Maesano, Shreosi Sanyal, Remy Slama, Carl-Gustaf Bornehag, Isabella Annesi-Maesano
BACKGROUND: Contradictory results exist regarding the importance of early-life exposure to phthalates for development of childhood eczema. OBJECTIVES: We evaluated the association between maternal urinary concentrations of phthalate metabolites between the 24th and 28th week of gestation and occurrence of eczema in their sons up to 5 y of age, according to allergic sensitization as assessed by total immunoglobulin E (IgE) in a subsample of individuals. METHODS: Data on health outcomes and background factors were collected using five standardized annual questionnaires completed by parents at the children's ages of 1-5 y, and their associations with phthalate metabolite urinary concentrations were assessed in 604 mother-son pairs with adjusted multiple logistic regression and Cox's survival model...
February 2, 2018: Environmental Health Perspectives
Kazuhiko Arima, Shaloo Gupta, Abhijit Gadkari, Takaaki Hiragun, Takeshi Kono, Ichiro Katayama, Sven Demiya, Laurent Eckert
Atopic dermatitis is a chronic inflammatory skin disease. The objective of this study was to characterize the burden of atopic dermatitis in Japanese adult patients relative to the general population. Japanese adults (≥18 years) with a self-reported diagnosis of atopic dermatitis and adult controls without atopic dermatitis/eczema/dermatitis were identified from the 2013 Japan National Health and Wellness Survey. Atopic dermatitis patients were propensity-score matched with non-atopic dermatitis controls (1:2 ratio) on demographic variables...
January 31, 2018: Journal of Dermatology
Claudia Gore, Robin B Gore, Sara Fontanella, Sadia Haider, Adnan Custovic
BACKGROUND: Children with severe, persistent atopic eczema (AE) have limited treatment options, often requiring systemic immunosuppression. OBJECTIVE: To evaluate the effect of the temperature-controlled laminar airflow (TLA) treatment in children/adolescents with severe AE. METHODS: We recruited 15 children aged 2-16 years with longstanding, severe AE and sensitization to ≥1 perennial inhalant allergen. Run-in period of 6-10 weeks (3 visits), was followed by 12-month treatment with overnight TLA (Airsonett® , Sweden)...
January 31, 2018: Clinical and Experimental Allergy: Journal of the British Society for Allergy and Clinical Immunology
Rekha D Jhamnani, Samara Levin, Marjohn Rasooly, Kelly D Stone, Joshua D Milner, Celeste Nelson, Tom DiMaggio, Nina Jones, Anthony L Guerrerio, Pamela A Frischmeyer-Guerrerio
Children with moderate-severe atopic dermatitis and food allergy (especially milk) exhibit reduced weight and height, while those with atopic dermatitis alone are often overweight or obese, and their body mass index correlates with eczema severity.
January 25, 2018: Journal of Allergy and Clinical Immunology
Lianghua Bin, Xiaozhao Li, Brittany Richers, Joanne E Streib, Jack W Hu, Patricia Taylor, Donald Y M Leung
BACKGROUND: Atopic dermatitis (AD) is a common inflammatory skin disease. A subset of AD is susceptible to disseminated herpes simplex virus (HSV) infection, a complication termed as eczema herpeticum(ADEH+). The immune mechanisms causing ADEH+ remain elusive. Using RNA-sequencing, we recently found that ankyrin repeat domain 1 (ANKRD1) was significantly induced in human peripheral blood mononuclear cells (PBMCs) upon HSV-1 stimulation; and its induction in ADEH+ was significantly reduced as compared to AD patients without a history of EH (ADEH-)...
January 22, 2018: Journal of Allergy and Clinical Immunology
Maria José Rosa, Alison G Lee, Rosalind J Wright
PURPOSE OF REVIEW: The objective of this review is to provide an update on our evolving understanding of the effects of stress in pregnancy and during early development on the onset of asthma-related phenotypes across childhood, adolescence, and into early adulthood. RECENT FINDINGS: Accumulating evidence over the past 2 decades has established that prenatal and early-life psychological stress and stress correlates (e.g., maternal anxiety or depression) increase the risk for childhood respiratory disorders...
January 23, 2018: Current Opinion in Allergy and Clinical Immunology
Işın Sinem Bağci, Thomas Ruzicka
IL-31 is a novel cytokine expressed in many human tissues and involved mainly in TH2-weighted inflammation. IL-31 signals through a receptor complex consisting of IL-31 receptor α and oncostatin M receptor β. The available data show that IL-31 is strongly linked with chronic pruritic skin disorders, such as atopic eczema, and represents a novel target for directed drug therapy. Regulation of immune responses and cellular differentiation and proliferation are recently elucidated effects of IL-31, suggesting a more complex and diverse area of effect for this novel cytokine...
January 20, 2018: Journal of Allergy and Clinical Immunology
L Howells, S Ratib, J R Chalmers, L Bradshaw, K S Thomas
BACKGROUND: The Patient Oriented Eczema Measure (POEM), scored 0-28, is the core outcome instrument recommended for measuring patient-reported atopic eczema symptoms in clinical trials. To date, two published studies have broadly concurred that the MIC of the POEM is 3 points. Further assessment of the minimally important change (MIC) of POEM in different populations, and using a variety of methods, will improve interpretability of the POEM in research and clinical practice. OBJECTIVES: To calculate the smallest detectable change in the POEM and estimate the MIC of the POEM using a variety of methods in a trial dataset of children with moderate to severe atopic eczema...
January 21, 2018: British Journal of Dermatology
Eric L Simpson, Carsten Flohr, Lawrence F Eichenfield, Thomas Bieber, Howard Sofen, Alain Taïeb, Ryan Owen, Wendy Putnam, Marcela Castro, Kendra DeBusk, Chin-Yu Lin, Athina Voulgari, Karl Yen, Theodore A Omachi
BACKGROUND: Interleukin (IL)-13 plays a key role in type 2 inflammation and is an emerging pathogenic mediator in atopic dermatitis. OBJECTIVE: We investigated the efficacy and safety of lebrikizumab, an anti-IL-13 monoclonal antibody, as add-on to topical corticosteroid (TCS). METHODS: A randomized, placebo-controlled, double-blind, phase II study. Adults with moderate-to-severe AD were required to use twice-daily TCS, and randomized (1:1:1:1) to lebrikizumab 125 mg single dose (SD), 250 mg SD, 125 mg once every 4 weeks (Q4W), or placebo Q4W for 12 weeks, after 2-week TCS run-in...
January 15, 2018: Journal of the American Academy of Dermatology
Maja-Lisa Clausen, Tove Agner, Berit Lilje, Sofie M Edslev, Thor Bech Johannesen, Paal Skytt Andersen
Importance: Skin microbiome correlates with disease severity for lesional and nonlesional skin, indicating a global influence of atopic dermatitis (AD). A relation between skin microbiome and filaggrin gene (FLG) mutations proposes a possible association between skin microbiome and host genetics. Objectives: To assess skin and nasal microbiome diversity and composition in patients with AD and compare with healthy controls, and to investigate the microbiome in relation to disease severity and FLG mutations in patients with AD...
January 17, 2018: JAMA Dermatology
Roberto Paganelli, Claudia Petrarca, Mario Di Gioacchino
The 2017 Nobel Prize for Physiology or Medicine, awarded for the discoveries made in the past 15 years on the genetic and molecular mechanisms regulating many physiological functions, has renewed the attention to the importance of circadian rhythms. These originate from a central pacemaker in the suprachiasmatic nucleus in the brain, photoentrained via direct connection with melanopsin containing, intrinsically light-sensitive retinal ganglion cells, and it projects to periphery, thus creating an inner circadian rhythm...
2018: Clinical and Molecular Allergy: CMA
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