-
1.
Proteomic analysis from skin swabs reveals a new set of proteins identifying skin impairment in atopic dermatitis.
Morelli, P, Gaspari, M, Gabriele, C, Dastoli, S, Bennardo, L, Pavel, AB, Patruno, C, Del Duca, E, Nisticò, SP
Experimental dermatology. 2021;(6):811-819
Abstract
Atopic Dermatitis (AD) is a common inflammatory skin disease characterized by skin and systemic inflammation, and barrier dysfunction. Herein, we investigate the proteomic profile of AD skin barrier to identify a unique signature with an easy-performed sampling approach. We enrolled 8 moderate-to-severe AD patients and 8 age- and gender-matched healthy controls. Swabs were obtained from non-lesional skin of retroauricular area and antecubital fold. Peptide mixtures obtained through protein precipitation and in-solution digestion were analysed using NanoLC-MS/MS. Label-free quantification and statistical analysis were conducted in MaxQuant and Perseus. Bioinformatics analysis was performed using Gene Ontology and STRING. We identified 908 proteins and 35 differentially expressed proteins were selected (fold change 2, FDR < 0.05). Particularly, AD skin showed downregulation of skin hydration factors, structural and epidermal proteins, abnormalities in protease-proteasome complex and lipid metabolism profile. Imbalance of antioxidant and inflammatory processes, along with TDRD15 upregulation was also observed. Our result showed partial overlap with skin biopsy/tape-strips studies, showing the reliability of our sampling approach which could be an easier method of detection of hallmark barrier proteins in AD. Furthermore, we displayed a new differentially expressed set of proteins, not yet explored in AD which can have a potential role in AD pathomechanisms.
-
2.
Efficacy of topical application of human breast milk on atopic eczema healing among infants: a randomized clinical trial.
Kasrae, H, Amiri Farahani, L, Yousefi, P
International journal of dermatology. 2015;(8):966-71
Abstract
Infant atopic eczema is an inflammatory lesion usually involving the epidermis of the skin. About 50% of infants are affected by this lesion in the first years of their lives. Studies show human breast milk (HBM) as a preventive measure and effective treatment of some sores and infections. This article evaluates the short-term efficacy of HBM versus hydrocortisone 1% ointment in infants with mild to moderate atopic dermatitis (AD). We conducted a randomized clinical trial among infants with diagnosed AD within a pediatrics unit. The majority of AD cases in both groups were considered moderate severity. There were no significant differences between these two groups at days 0, 7, 14, and 21, and the interventions of both groups were found to have the same effects. The external validity and consequently the ability to generalize the findings may be diminished as this study was conducted in a single site. Owing to HBM and the hydrocortisone 1% ointment providing the same results in the healing of AD, HBM was used because of low cost and accessibility.
-
3.
Microarray analysis reveals marked intestinal microbiota aberrancy in infants having eczema compared to healthy children in at-risk for atopic disease.
Nylund, L, Satokari, R, Nikkilä, J, Rajilić-Stojanović, M, Kalliomäki, M, Isolauri, E, Salminen, S, de Vos, WM
BMC microbiology. 2013;:12
Abstract
BACKGROUND Deviations in composition and diversity of intestinal microbiota in infancy have been associated with both the development and recurrence of atopic eczema. Thus, we decided to use a deep and global microarray-based method to characterize the diversity and temporal changes of the intestinal microbiota in infancy and to define specific bacterial signatures associated with eczema. Faecal microbiota at 6 and 18 months of age were analysed from 34 infants (15 with eczema and 19 healthy controls) selected from a prospective follow-up study based on the availability of faecal samples. The infants were originally randomized to receive either Lactobacillus rhamnosus GG or placebo. RESULTS Children with eczema harboured a more diverse total microbiota than control subjects as assessed by the Simpson's reciprocal diversity index of the microarray profiles. Composition of the microbiota did not differ between study groups at age of 6 months, but was significantly different at age of 18 months as assessed by MCPP (p=0.01). At this age healthy children harboured 3 -fold greater amount of members of the Bacteroidetes (p=0.01). Microbiota of children suffering from eczema had increased abundance of the Clostridium clusters IV and XIVa, which are typically abundant in adults. Probiotic Lactobacillus rhamnosus GG supplementation in early infancy was observed to have minor long-term effects on the microbiota composition. CONCLUSION A diverse and adult-type microbiota in early childhood is associated with eczema and it may contribute to the perpetuation of eczema.
-
4.
Polypodium leucotomos extract in atopic dermatitis: a randomized, double-blind, placebo-controlled, multicenter trial.
Ramírez-Bosca, A, Zapater, P, Betlloch, I, Albero, F, Martínez, A, Díaz-Alperi, J, Horga, JF, ,
Actas dermo-sifiliograficas. 2012;(7):599-607
Abstract
INTRODUCTION Topical corticosteroids are used to treat inflammation and relieve itching in atopic dermatitis, but their use is limited by adverse reactions. OBJECTIVES The main aim of this study was to investigate whether daily treatment with Polypodium leucotomos extract would reduce the use of topical corticosteroids in children and adolescents with atopic dermatitis. We also analyzed oral antihistamine use and changes in disease severity. PATIENTS AND METHODS We performed a phase IV randomized, double-blind, placebo-controlled, multicenter trial involving 105 patients aged between 2 and 17 years who were receiving topical corticosteroids to treat moderate atopic dermatitis. The patients were randomized to receive, in addition to their standard treatment, Polypodium leucotomos extract or placebo (both in capsule form) for 6 months. The percentage of days on which topical corticosteroids and other atopic dermatitis treatments were used was calculated. RESULTS Use of Polypodium leucotomos extract did not significantly reduce the mean (SD) percentage of days on which topical corticosteroids were used (11% [12%] vs 12% [11%] for placebo). A significant reduction was, however, observed for oral histamine use (median percentage of days, 4.5% in the Polypodium leucotomos group and 13.6% in the placebo group [P= .038]). The percentage of patients who used oral antihistamines was also lower in the Polypodium leucotomos group. CONCLUSION Long-term treatment with Polypodium leucotomos extract has benefits for children and adolescents with atopic dermatitis who require pharmacologic treatment to reduce inflammation and relieve itching.
-
5.
Lactobacillus salivarius plus fructo-oligosaccharide is superior to fructo-oligosaccharide alone for treating children with moderate to severe atopic dermatitis: a double-blind, randomized, clinical trial of efficacy and safety.
Wu, KG, Li, TH, Peng, HJ
The British journal of dermatology. 2012;(1):129-36
Abstract
BACKGROUND Some probiotics can ameliorate childhood atopic dermatitis (AD). Prebiotics have also shown some efficacy, although when combined with probiotics as synbiotics, their efficacy may improve. OBJECTIVE We compared the effects of Lactobacillus salivarius and fructo-oligosaccharide (synbiotic) with fructo-oligosaccharide alone (prebiotic) on children with moderate to severe AD. METHODS We randomly assigned 60 children aged 2-14years with moderate to severe AD [SCORing AD (SCORAD)>25] to a treatment (synbiotic) or a control (prebiotic) group (30 per group). They received one capsule twice daily for 8weeks containing either L. salivarius plus fructo-oligosaccharide (treatment) or fructo-oligosaccharide only (control). SCORAD indices were monitored at weeks 0, 4, 8 and 10 (post-treatment). Laboratory results and AD medication use were also monitored. RESULTS Baseline demographic and clinical characteristics and SCORAD scores were similar between the two groups. At 8weeks, the treatment group SCORAD scores (27·4±12·7) were significantly lower than for the controls (36·3±14·9) (P=0·022); this difference remained at 10weeks. At 8weeks, treatment group AD intensity was significantly lower (P=0·013); more children had mild AD in the treatment group (52%; 14/27) than the control group (30%; 8/27) (P=0·024). Medication use frequency and eosinophil cationic protein levels were significantly reduced in the treatment group at 8weeks compared with 4 weeks. CONCLUSION A synbiotic combination of L. salivarius plus fructo-oligosaccharide is superior to the prebiotic alone for treating moderate to severe childhood AD. However, continued follow-up will be necessary to ascertain long-term benefits.
-
6.
Enteric-coated mycophenolate sodium versus cyclosporin A as long-term treatment in adult patients with severe atopic dermatitis: a randomized controlled trial.
Haeck, IM, Knol, MJ, Ten Berge, O, van Velsen, SG, de Bruin-Weller, MS, Bruijnzeel-Koomen, CA
Journal of the American Academy of Dermatology. 2011;(6):1074-84
Abstract
BACKGROUND Cyclosporin A (CsA) is frequently used in the treatment of severe atopic dermatitis (AD). Enteric-coated mycophenolate sodium (EC-MPS) may be an alternative with equal efficacy and fewer side effects. OBJECTIVE The aim of this observer-blinded randomized controlled trial was to compare EC-MPS with CsA as long-term treatment in adult patients with severe AD. METHODS Fifty five patients with AD were treated with CsA (5 mg/kg) in a 6-week run-in period. Thereafter, patients either received CsA (3 mg/kg; n = 26) or EC-MPS (1440 mg; n = 24) during a maintenance phase of 30 weeks and there was a 12-week follow-up period. Disease activity was measured using the objective SCORAD and serum thymus and activation-regulated chemokine (TARC) levels and side effects were registered. RESULTS During the first 10 weeks the objective SCORAD and serum TARC levels in the EC-MPS study arm were higher in comparison with the CsA study arm. In addition, 7 of the 24 patients treated with EC-MPS required short oral corticosteroid courses. During maintenance phase disease activity was comparable in both study arms. Side effects in both study arms were mild and transient. After study medication withdrawal, disease activity of the patients in the CsA study arm significantly increased compared with the EC-MPS study arm. LIMITATION The nonblinding of patients and prescriber of rescue medication are limitations. CONCLUSIONS This study shows that EC-MPS is as effective as CsA as maintenance therapy in patients with AD. However, clinical improvement with EC-MPS is delayed in comparison with CsA. Clinical remission after stopping EC-MPS lasts longer compared with CsA.
-
7.
Comparative trial of moisturizer containing licochalcone A vs. hydrocortisone lotion in the treatment of childhood atopic dermatitis: a pilot study.
Udompataikul, M, Srisatwaja, W
Journal of the European Academy of Dermatology and Venereology : JEADV. 2011;(6):660-5
Abstract
BACKGROUND Although moisturizer usage has been considered a mainstay of treatment for atopic dermatitis (AD) patients, few clinical studies have been investigated. Recently, moisturizers containing non-steroidal anti-inflammatory agents, such as licochalcone A (LA) and vitamin B(12) are of emerging interest. OBJECTIVE To compare the effectiveness of moisturizer containing LA with hydrocortisone (HC) lotion in treatment of childhood AD. Methods The randomized, controlled, investigator-blinded 6-week study was conducted. Patients were administered with twice-daily application of LA lotion on one side of the body and HC lotion on the opposite side. The clinical outcome was assessed by the scoring of atopic dermatitis (SCORAD) index. The relapse rate was comparatively analysed by survival analysis. RESULTS From 30 patients enrolled, 26 patients completed the protocol. The mean age of the children was 5.8 years. The average baseline SCORAD score is about 28 on both sides. The response rates of both agents were equal to 73.33%. There is no statistical significant group difference in reduction of SCORAD score. Although we observed more rapid resolution of oedema and erythema in areas treated with HC lotion, both agents exhibited no significant difference. The relapse rate of HC group was higher than in LA group; however, there was no significant difference. No side-effect was observed from both agents. CONCLUSION The effectiveness of LA lotion is equal to that of HC lotion. It was suggested that moisturizer containing LA could be used both for treatment of acute and maintenance phase in mild-to-moderate childhood AD.
-
8.
Novel antibacterial and emollient effects of coconut and virgin olive oils in adult atopic dermatitis.
Verallo-Rowell, VM, Dillague, KM, Syah-Tjundawan, BS
Dermatitis : contact, atopic, occupational, drug. 2008;(6):308-15
Abstract
BACKGROUND Atopic dermatitis (AD) skin is dry and readily colonized by Staphylococcus aureus (SA). Coconut and olive oils are traditionally used to moisturize and treat skin infections. OBJECTIVE To compare virgin coconut oil (VCO) and virgin olive oil (VOO) in moisturizing dryness and removing SA from colonized AD skin. METHODS This was a double-blind controlled trial in two outpatient dermatology clinics with adult AD patients who were diagnosed by history, pattern, evolution, and skin lesions and who were randomized to apply VCO or VOO twice daily at two noninfected sites. SA cultures, photography, and objective-SCORAD severity index (O-SSI) scoring were done at baseline and after 4 weeks. RESULTS Twenty-six subjects each received VCO or VOO. Of those on VCO, 20 were positive for SA colonies at baseline versus 12 on VOO. Post intervention, only 1 (5%) VCO subject remained positive versus 6 (50%) of those on VOO. Relative risk for VCO was 0.10, significantly superior to that for VOO (10:1, p = .0028; 95% CI, 0.01-0.73); thus, the number needed to treat was 2.2. For the O-SSI, the difference was not significant at baseline (p = .15) but was significantly different post treatment (p = .004); this was reduced for both oils (p < .005) but was greater with VCO. CONCLUSION VCO and monolaurin's O-SSI reduction and in vitro broad-spectrum activity against SA (given clinical validity here), fungi, and viruses may be useful in the proactive treatment of AD colonization.
-
9.
Environmental risk factors for early infantile atopic dermatitis.
Wang, IJ, Guo, YL, Weng, HJ, Hsieh, WS, Chuang, YL, Lin, SJ, Chen, PC
Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology. 2007;(5):441-7
Abstract
Previous studies of predictors of atopic dermatitis (AD) in Asia have had limited sample size and small numbers of variables focused primarily on family history or dietary exposures. The purpose of this study was to evaluate the influence of various environmental risk factors for early infantile AD. We used multistage, stratified systematic sampling to recruit 2048 mother-child pairs from the Taiwan national birth registration in 2003. Information on environmental risk factors for infant AD gathered by questionnaire were available from 1760 infants at 6 months of age. Multiple logistic regression was used to estimate adjusted odds ratios (aORs) and their 95% confidence intervals (CIs) for risk factors for AD after adjusting for potential confounders. AD was noted in 118 of 1760 (6.7%) of the infants. After adjusting for maternal age and education, family history of atopy, infant gender, and gestational age, fungi on walls of the house [aOR 2.14 (95% CI 1.41-3.22)] and frequent use of microwave oven at home [aOR 1.71 (95% CI 1.13-2.58)] increased the risk of early infantile AD. This study suggests that environmental factors do play a role in early infantile AD. Fungi, a kind of aeroallergen, are especially important in humid climate as in Taiwan and their impacts might be felt at the early infant stage. The hazards of microwave use should be paid more attention.
-
10.
Comparative effect of tacrolimus and betamethasone valerate on the passive sustainable hydration of the stratum corneum in atopic dermatitis.
Xhauflaire-Uhoda, E, Thirion, L, Piérard-Franchimont, C, Piérard, GE
Dermatology (Basel, Switzerland). 2007;(4):328-32
Abstract
BACKGROUND There is ample evidence that the skin barrier function is altered in atopic dermatitis. Little information is available about the effect of topical corticosteroids and calcineurin inhibitors on this function. PURPOSE To assess the water content and its rate of accumulation in the stratum corneum of atopic patients using an indirect electrometric method while on tacrolimus or betamethasone valerate treatment. METHOD Twenty-one patients with moderate atopic dermatitis affecting both forearms completed this double-blind randomized study. One forearm was treated twice daily for 3 weeks with 0.1% tacrolimus ointment. The other forearm was similarly treated with 0.12% betamethasone valerate ointment. Electrometric measurements were made under continuous occlusion secured by a Nova Dermal Phase Meter sensor probe. Assessments were performed at inclusion, after the 3-week treatment and after a further 3-week follow-up out of treatment. RESULTS During treatment, both compounds yielded a similar improvement in skin barrier function. Indeed, under probe occlusion, the rate of water accumulation was significantly decreased. This improvement was sustained after stopping the tacrolimus treatment. By contrast, the benefit was in part lost at the site that had been treated by betamethasone valerate. CONCLUSION The difference in the effect of the 2 compounds may be due to the negative influence of betamethasone valerate on the epidermal metabolism leading to progressive atrophy of the tissue. The better preservation of the skin barrier function after stopping tacrolimus treatment may help retarding relapses of atopic dermatitis.