scholarly journals The nonlesional skin surface distinguishes atopic dermatitis with food allergy as a unique endotype

2019 ◽  
Vol 11 (480) ◽  
pp. eaav2685 ◽  
Author(s):  
Donald Y. M. Leung ◽  
Agustin Calatroni ◽  
Livia S. Zaramela ◽  
Petra K. LeBeau ◽  
Nathan Dyjack ◽  
...  
Keyword(s):  
Atopic Dermatitis ◽  
Food Allergy ◽  
Sampling Method ◽  
Skin Barrier ◽  
Skin Surface ◽  
Transepidermal Water Loss ◽  
Barrier Dysfunction ◽  
Ceramide Content ◽  
Immune Pathways

Skin barrier dysfunction has been reported in both atopic dermatitis (AD) and food allergy (FA). However, only one-third of patients with AD have FA. The purpose of this study was to use a minimally invasive skin tape strip sampling method and a multiomics approach to determine whether children with AD and FA (AD FA+) have stratum corneum (SC) abnormalities that distinguish them from AD without FA (AD FA−) and nonatopic (NA) controls. Transepidermal water loss was found to be increased in AD FA+. Filaggrin and the proportion of ω-hydroxy fatty acid sphingosine ceramide content in nonlesional skin of children with AD FA+ were substantially lower than in AD FA− and NA skin. These abnormalities correlated with morphologic changes in epidermal lamellar bilayer architecture responsible for barrier homeostasis. Shotgun metagenomic studies revealed that the nonlesional skin of AD FA+ had increased abundance of Staphylococcus aureus compared to NA. Increased expression of keratins 5, 14, and 16 indicative of hyperproliferative keratinocytes was observed in the SC of AD FA+. The skin transcriptome of AD FA+ had increased gene expression for dendritic cells and type 2 immune pathways. A network analysis revealed keratins 5, 14, and 16 were positively correlated with AD FA+, whereas filaggrin breakdown products were negatively correlated with AD FA+. These data suggest that the most superficial compartment of nonlesional skin in AD FA+ has unique properties associated with an immature skin barrier and type 2 immune activation.

scholarly journals Epidermal Barrier Dysfunction in Atopic Dermatitis

2021 ◽  
Vol 79 (3) ◽  
pp. 207-216
Author(s):  
Tiago Fernandes Gomes ◽  
Rebeca Calado ◽  
Margarida Gonçalo
Keyword(s):  
Atopic Dermatitis ◽  
Current Knowledge ◽  
Skin Barrier ◽  
Initial Step ◽  
Barrier Dysfunction ◽  
Epidermal Barrier ◽  
Atopic March ◽  
T Helper 2 ◽  
Barrier Repair

Impaired skin barrier is one of the hallmarks of atopic dermatitis (AD), with abnormalities in the cornified envelope, lipid lamellae, tight junctions and cutaneous microbiome. These findings are also present in nonlesional skin of AD individuals, suggesting that epidermal barrier defects may be the initial step towards the development of AD and eventually other atopic diseases (atopic march). It is currently known that pathophysiology of AD involves an interplay between this dysfunctional skin barrier and a predominantly type 2 skewed innate and adaptive immune responses, which further disrupt the skin barrier through type 2 cytokines. In this setting, there is enhanced penetration of environmental and food allergens through a deficient barrier, leading to an increased susceptibility to sensitization. During the sensitization process, thymic stromal lymphopoietin (TSLP) polarizes skin dendritic cells to a T-helper 2 response, and TSLP seems to be a key cytokine in the sensitization of food allergy, allergic asthma and rhinitis. In this review, the authors describe the current knowledge of the pathophysiology of the epidermal barrier, its disruption in AD and how it may be involved in the development of atopic comorbidities and the role of barrier repair therapy on the prevention of the atopic march progression.  

scholarly journals EMOLLIENT MILK XEMOSE IN THERAPY OF ATOPIC DERMATITIS IN CHILDREN

2014 ◽  
Vol 11 (4) ◽  
pp. 59-63
Author(s):  
E T KINDEEVA ◽  
N G KOROTKII ◽  
A N PAMPURA
Keyword(s):  
Atopic Dermatitis ◽  
Clinical Efficacy ◽  
Combined Therapy ◽  
Allergic Inflammation ◽  
Skin Barrier ◽  
Skin Surface ◽  
Skin Lesions ◽  
Transepidermal Water Loss ◽  
Skin Barrier Function ◽  
Epidermal Barrier

Background. Structural and functional damages of the epidermal barrier in patients with atopic dermatitis promote the entry of allergens and development of Th2-type allergic inflammation. Moisturizers containing lipids increase the physiological antiinflammatory effects of topical corticosteroids (TGKS), improve the epidermal barrier and reduce the duration of TGKS using preventing further infringement barrier. To evaluate the clinical efficacy of emollient milk Xemose in children with atopic dermatitis. Materials and methods. We examined 27 children with atopic dermatitis. Children were divided into 2 groups: patients in group 1 (n=14) used emollient milk Xemose twice a day on the skin lesions and limbs in the complex therapy, patients in the 2nd group (n=13) received combined therapy incorporating traditional dampening agents on the basis of lanolin (Unna cream) 3 times daily. All patients underwent measurement of transepidermal water loss (TEWl) (Tewameter TM 300, Multi Probe Adapter MPA 5/9, Courage + Khazaka) and the pH of the skin (Skin-pH-Meter, Multi Probe Adapter MPA 5/9, Courage + Khazaka) before and after 2 weeks of therapy. Results. Patients in groupthat used Xemose milk and children in group with Unna cream after 2 weeks showed a statistically significant decrease of TEWl (p=0,041 and p=0,04, respectively). TEWl was significantly lower in children treated for 2 weeks with milk Xemose (p=0,027) than in children treated with Unna cream. in both groups pH skin surface have not changed (р=0,22 and р=0,22 respectively). Conclusion. Clinical efficacy of milk Xemose as compound improving skin barrier function in children with atopic dermatitis was shown.

scholarly journals Modern emollients impact on the damaged skin barrier at children with atopic dermatitis

2013 ◽  
Vol 10 (4) ◽  
pp. 65-68
Author(s):  
E T Kindeeva ◽  
A N Pampura
Keyword(s):  
Atopic Dermatitis ◽  
Combined Therapy ◽  
Skin Barrier ◽  
Skin Surface ◽  
Skin Lesions ◽  
Transepidermal Water Loss ◽  
Surface Ph ◽  
Before And After ◽  
Skin Surface Ph ◽  
Group 1

Introduction. Damaged skin barrier has significant role in the pathogenesis of atopic dermatitis (AD). Use of emollients is reasonable for skin care of AD patients. Background. To compare the clinical efficacy of Kserodian plus with traditional moisturizer (cream Unna) at children with atopic dermatitis. Materials and methods. The study included 31 children with AD. Children were divided into 2 groups: patients in group 1 (n=8) used Kserodian plus 2 times daily for skin lesions and limbs in the complex therapy, patients in the 2nd group (n=13) received combined therapy incorporating traditional dampening agent on the basis of lanolin (cream Unna) 3 times daily. All patients underwent measurement of transepidermal water loss (TEWL) (Tewameter TM 300, Multi Probe Adapter MPA 5/9, Courage + Khazaka) and the pH of the skin (SkinpHMeter, Multi Probe Adapter MPA 5/9, Courage + Khazaka) before and after 2 weeks of therapy. Results. Kserodian plus decreased erythema, dryness of the skin, itching, square of leasons in all the patients. Statistically significant decrease in the values of TEWL and skin surface pH (p

scholarly journals Skin barrier status during dupilumab treatment in patients with severe atopic dermatitis

2021 ◽  
Vol 12 ◽  
pp. 204062232110583
Author(s):  
Silvia Ferrucci ◽  
Maurizio Romagnuolo ◽  
Carlo Alberto Maronese ◽  
Francesca Germiniasi ◽  
Simona Tavecchio ◽  
...  
Keyword(s):  
Atopic Dermatitis ◽  
Skin Barrier ◽  
Transepidermal Water Loss ◽  
Response To Therapy ◽  
Interleukin 4 ◽  
Severe Atopic Dermatitis ◽  
Barrier Dysfunction ◽  
Relative Variation ◽  
Good Tool ◽  
The Status

Background: Atopic dermatitis (AD) is a common chronic-relapsing inflammatory skin disease hallmarked by epidermal barrier dysfunction, increased transepidermal water loss (TEWL) and decreased skin hydration. Recent findings on the T helper 2 (Th2)-driven pathogenesis of AD have led to the development of dupilumab, a monoclonal antibody directed against interleukin-4 and interleukin-13 that has been demonstrated to be effective in the treatment of moderate-to-severe AD. The effect of dupilumab on skin barrier dysfunction, however, has not yet been adequately investigated. Objectives: The primary endpoint of this study was to assess the status of the skin barrier in nonlesional skin of patients with severe AD treated with dupilumab, by evaluating the association between the relative variation of TEWL and the achievement of a 75% reduction of EASI (EASI75) over time. Methods: TEWL was measured below the antecubital fossae by means of the Vapometer® at baseline, at week 4 (T4), at week 16 (T16) and at week 32 after dupilumab starting. EASI and NRS-itch were measured at the same time points. Results: Seventy-eight patients with severe AD treated with dupilumab were enrolled. Median TEWL relative variation respect to baseline was significantly higher in patients who achieved EASI75 as compared with those who did not achieve EASI75 at T16 and at T32, but not at T4. Conclusion: During dupilumab treatment, TEWL on nonlesional skin tends to significantly improve 4 months after treatment initiation and could be a good tool for monitoring response to therapy.

scholarly journals Early intervention of atopic dermatitis as a preventive strategy for progression of food allergy

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Alyssa Sweeney ◽  
Vanitha Sampath ◽  
Kari C. Nadeau
Keyword(s):  
Atopic Dermatitis ◽  
Food Allergy ◽  
Allergic Sensitization ◽  
Skin Barrier ◽  
Atopic Disease ◽  
Underlying Mechanism ◽  
Population Characteristics ◽  
Preventive Strategy ◽  
Atopic Diseases ◽  
Barrier Dysfunction

Abstract Background Atopic diseases, such as atopic dermatitis (AD) and food allergy (FA), have increased in prevalence in industrialized countries during the past few decades and pose a significant health burden. They appear to have a common underlying mechanism and a natural disease progression. AD is generally the first atopic disease to manifest followed by other atopic diseases, such as FA, allergic rhinitis, or allergic asthma suggesting that they are likely different manifestations of the same disease. Body Evidence suggests that allergic sensitization occurs through an impaired skin barrier, while consumption of these foods at an early age may actually result in tolerance. This has been termed the Dual-Allergen-Exposure hypothesis. Loss of barrier integrity has been hypothesized to enable penetration of allergens, pollutants, and microbes and initiation of an inflammatory immune cascade of events leading to sensitization. The immune dysfunction is thought to further exacerbate the impaired skin barrier to form a vicious cycle. There is much interest in preventing or protecting the skin barrier from developing a proinflammatory atopic state, which may potentially lead to the development of AD and subsequently, FA. Conclusion Research on preventing or treating skin barrier dysfunction is ongoing. A number of studies have evaluated the efficacy of emollients in preventing AD and FA with mixed results. Studies have differed in the study design, population characteristics, emollients type, and frequency, duration, and area of application. Emollient type has varied widely from oils, creams, petrolatum-based lotions, and trilipid creams. Current research is directed towards the use of trilipid emollients that are similar to the skin’s natural lipid composition with a 3:1:1 ratio of ceramides, cholesterol and free fatty acids and a pH that is similar to that of skin to determine their effectiveness for skin barrier repair and prevention of AD and FA.

scholarly journals Echinochrome A Treatment Alleviates Atopic Dermatitis-like Skin Lesions in NC/Nga Mice via IL-4 and IL-13 Suppression

Marine Drugs ◽  
2021 ◽  
Vol 19 (11) ◽  
pp. 622
Author(s):  
Hyeong Rok Yun ◽  
Sang Woo Ahn ◽  
Bomin Seol ◽  
Elena A. Vasileva ◽  
Natalia P. Mishchenko ◽  
...  
Keyword(s):  
Atopic Dermatitis ◽  
Clinical Symptoms ◽  
Sea Urchins ◽  
Skin Barrier ◽  
Skin Lesions ◽  
Transepidermal Water Loss ◽  
Interleukin 4 ◽  
Barrier Dysfunction ◽  
Echinochrome A ◽  
Anti Inflammatory

Atopic dermatitis (AD) is a chronic inflammatory skin disease in which skin barrier dysfunction leads to dryness, pruritus, and erythematous lesions. AD is triggered by immune imbalance and oxidative stress. Echinochrome A (Ech A), a natural pigment isolated from sea urchins, exerts antioxidant and beneficial effects in various inflammatory disease models. In the present study, we tested whether Ech A treatment alleviated AD-like skin lesions. We examined the anti-inflammatory effect of Ech A on 2,4-dinitrochlorobenzene (DNCB)-induced AD-like lesions in an NC/Nga mouse model. AD-like skin symptoms were induced by treatment with 1% DNCB for 1 week and 0.4% DNCB for 5 weeks in NC/Nga mice. The results showed that Ech A alleviated AD clinical symptoms, such as edema, erythema, and dryness. Treatment with Ech A induced the recovery of epidermis skin lesions as observed histologically. Tewameter® and Corneometer® measurements indicated that Ech A treatment reduced transepidermal water loss and improved stratum corneum hydration, respectively. Ech A treatment also inhibited inflammatory-response-induced mast cell infiltration in AD-like skin lesions and suppressed the expression of proinflammatory cytokines, such as interferon-γ, interleukin-4, and interleukin-13. Collectively, these results suggest that Ech A may be beneficial for treating AD owing to its anti-inflammatory effects.

scholarly journals Skin barrier dysfunction measured by transepidermal water loss at 2 days and 2 months predates and predicts atopic dermatitis at 1 year

2015 ◽  
Vol 135 (4) ◽  
pp. 930-935.e1 ◽  
Author(s):  
Maeve Kelleher ◽  
Audrey Dunn-Galvin ◽  
Jonathan O'B. Hourihane ◽  
Deirdre Murray ◽  
Linda E. Campbell ◽  
...  
Keyword(s):  
Atopic Dermatitis ◽  
Water Loss ◽  
Skin Barrier ◽  
Transepidermal Water Loss ◽  
Barrier Dysfunction

scholarly journals ‘Barrier dysfunction in Atopic newBorns studY’ (BABY): protocol of a Danish prospective birth cohort study

BMJ Open ◽  
2020 ◽  
Vol 10 (7) ◽  
pp. e033801
Author(s):  
Trine Gerner ◽  
Anne-Sofie Halling ◽  
Maria Rasmussen Rinnov ◽  
Nina Haarup Ravn ◽  
Mette Hjorslev Knudgaard ◽  
...  
Keyword(s):  
Atopic Dermatitis ◽  
Cohort Study ◽  
Birth Cohort ◽  
Skin Barrier ◽  
Transepidermal Water Loss ◽  
Birth Cohort Study ◽  
Tape Stripping ◽  
Barrier Dysfunction ◽  
Prospective Birth Cohort ◽  
Prospective Birth Cohort Study

IntroductionSkin barrier development and dysfunction in premature and mature newborns is important for the risk of atopic dermatitis (AD).Methods and analysisThe Barrier dysfunction in Atopic newBorns studY (BABY) Cohort is a prospective birth cohort study of 150 preterm children (gestational age (GA) below 37+0) and 300 term children (GA 37+0 to 41+6). Skin barrier is assessed through transepidermal water loss, tape stripping, Raman-spectroscopy and microbiome sampling. Clinical examinations are done and DNA from buccal swabs is collected for genetic analyses. Thymus size is assessed by ultrasound examination. Information on pregnancy, delivery, parental exposures and diseases are collected, and structured telephone interviews are conducted at 18 and 24 months to assess exogenous exposures in the child and onset of AD. Hanifin and Rajka criteria as well as The UK Working Party's Diagnostic Criteria for Atopic Dermatitis are used to diagnose AD. Severity of AD is assessed using the Eczema Area and Severity Index (EASI) and Patient Oriented Eczema Measure (POEM).Ethics and disseminationThe study is approved by the scientific Ethical Committee of the Capital Region (H-16042289 and H-16042294).Outcomes will be presented at national and international conferences and in peer-reviewed publications.

scholarly journals Role of skin microbiome in epidermal barrier dysfunction and development of atopic dermatitis in high risk infants

2019 ◽  
Vol 16 (1) ◽  
pp. 59-64
Author(s):  
N B Migacheva
Keyword(s):  
At Risk ◽  
Atopic Dermatitis ◽  
Skin Barrier ◽  
Transepidermal Water Loss ◽  
Skin Microbiome ◽  
Children At Risk ◽  
Barrier Dysfunction ◽  
Epidermal Barrier ◽  
Microbiome Composition

Background. Colonization of skin with S. aureus in atopic dermatitis (AD) patients is a widespread phenomenon and a factor complicating the course of the disease. At present, it is not quite clear the role of S. aureus in the development of AD in children at risk. The aim of our study was to discribe the skin microbiome composition in young children at risk, as well as to investigate the role of S. aureus in skin barrier dysfunction and the development of AD. Material and methods. 12months follow-up study of 37 infants at risk has been performed. It included a general clinical examination, a microbiological investigation of skin microbiome (at 1 and 6 months), and investigation of epidermal barrier function by determining the transepidermal water loss (TEWL) at 1, 3, 6 and 12 months. Realization of AD during the observation period was considered as main outcome. Results. The prevalence of S. aureus colonization of infants aged 1 month was 45.9%, at the age of 6 months - 29.7%. Correlation analysis revealed an association between the skin colonization with S. aureus and a decrease of TEWL (p = 0.004), as well as the cumulative incidence of AD (p

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