The effectiveness of antihistamines in the treatment of atopic dermatitis in children

Histamine is one of the key endogenous mediators involved in the regulation of essential physiological and pathological processes in the human body. Its effects are implemented through several types of specific cell surface histamine (H)-receptors. H1-receptors are the most studied ones. The main clinical effects of their stimulation are vasodilation, bronchoconstriction, pituitary gland stimulation of hormone production, increased mucus production by the nasal glands, etc. Histamine H1 receptor antagonists of two generations are pathogeneticaUy justified agents for the treatment of most allergic diseases in accordance with the current clinical guidelines. The second-generation antihistamines that are devoid of sedative effects and are clinically more effective than the first-generation drugs have been currently introduced into the allergic disease treatment practice. They are the main drugs for the treatment of allergic diseases, especially in acute symptoms of the disease. Dimetindene maleate is the drug of choice for the symptomatic treatment of skin lesions, especially in infants. The article presents the result of the analysis of 26 out-patient medical records of infants (aged from 4 to 12 months) with a verified diagnosis of “atopic dermatitis, limited form, in the exacerbation phase”. A mild course of the disease was observed in 17 children, and a moderately severe course in 9 children. The duration of treatment was 7 to 16 days. Against the background of therapy (group 1), the following results were obtained: on day 3 of treatment the SCORAD-TIS index decreased to 16.4 ± 1.6 and on day 7 to 9.1 ± 1.3 points in children with a moderate course, and to 6.7 ± 0.8 and 4.1 ± 0.9 points in children with a mild course, respectively. In the children from group 2, the decrease in SCORAD-TIS was less significant: 19.5 ± 1.5 points on day 3, 12.2 ± 1.1 points on day 7 in children with a moderate course, respectively. Similar values decreased to 9.0 ± 0.9 on day 3, and to 6.9 ± 1.2 points on day 7 in children with a mild course of atopic dermatitis. The conducted analysis demonstrates the high clinical efficacy, good tolerance and the absence of tachyphylaxis of dimetindene maleate, drops. No side effects including those associated with anticholinergic properties (dry mouth, agitation) were identified.

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The Role of Allergens in Atopic Dermatitis

Journal of Dr Behcet Uz Children s Hospital ◽

10.5222/buchd.2020.37980 ◽

2020 ◽

Author(s):

Suna Asilsoy ◽

Serdar Al

Keyword(s):

Allergic Rhinitis ◽

Atopic Dermatitis ◽

Allergic Diseases ◽

Skin Lesions ◽

Atopic Diseases ◽

Chronic Skin ◽

Genetic And Environmental Factors ◽

Inhalant Allergens ◽

Chronic Skin Disease

Atopic dermatitis (AD) is a chronic skin disease caused by genetic and environmental factors. Often it begins in early childhood. It is located at the first step of the process we refer to as atopic march. This feature is a precursor of the development of other allergic diseases such as asthma and allergic rhinitis. Especially in patients with atopy of food and inhalant allergens, the occurrence of other atopic diseases is more common. Although the role of these sensitivities in AD is controversial, it has been determined that some patients may trigger eczematous skin lesions. In this report, the role of allergens in atopic dermatitis are reviewed in the light of current literature.

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Clinical effects of 2 commercially available diets on canine atopic dermatitis

Tierärztliche Praxis Ausgabe K Kleintiere / Heimtiere ◽

10.1055/a-1543-4743 ◽

2021 ◽

Vol 49 (04) ◽

pp. 256-261

Author(s):

Teresa M. S. A. Boehm ◽

Christoph J. Klinger ◽

Laura Udraite-Vovk ◽

Christelle Navarro ◽

Ralf S. Mueller

Keyword(s):

Atopic Dermatitis ◽

Essential Fatty Acids ◽

Control Diet ◽

Clinical Signs ◽

Skin Lesions ◽

Clinical Effects ◽

Entire Study ◽

Canine Atopic Dermatitis ◽

Beneficial Effects ◽

Double Blinded

Abstract Objective Canine atopic dermatitis (CAD) is a common skin disease in dogs. Prior studies were able to determine beneficial effects of essential fatty acids (EFA) on the clinical signs of CAD. The aim of this study was set to evaluate the effects of a newly designed, EFA-enriched diet on the clinical signs of CAD compared to another EFA-enriched diet. Materials and methods In this prospective, randomized, double-blinded study, 31 privately owned dogs with atopic dermatitis received either the control diet (diet A, Hill’s Prescription Diet™ d/d™ Salmon & Rice, n = 17) or the test diet (diet B, Veterinary HPM™ Dermatology Support D1, Virbac, n = 14) for 12 weeks. At the beginning of the study as well as after 4, 8 and 12 weeks, skin lesions and pruritus were evaluated via validated scores and the administered medication was documented. At the same time, the dogs’ coat quality was evaluated via a distinct scoring system. In both groups, a total of 7 dogs each completed the entire study. Results After 12 weeks, there was a mild improvement in lesion scores, pruritus and coat quality with both diets. Clinical relevance In this study, both diets improved the patients’ skin lesions pruritus and coat quality.

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Traditional Herbal Medicines, Newer Herbs and Other Novel Approaches Integrated in Herbal Medicine for Atopic Dermatitis-A Narrative Review

Current Drug Therapy ◽

10.2174/1574885514666191018165209 ◽

2020 ◽

Vol 15 (3) ◽

pp. 194-208

Author(s):

Pravin Kumar ◽

Dinesh Kumar Sharma ◽

Mahendra Singh Ashawat

Keyword(s):

Atopic Dermatitis ◽

Herbal Medicines ◽

Developed Countries ◽

Skin Lesions ◽

Scientific Data ◽

Herbal Drugs ◽

Biological Drugs ◽

Alternative Treatment Option

Atopic Dermatitis (AD) is a prolonged reverting skin ailment with characteristically distributed skin lesions. In the previous decades, researchers had shown a marked interest in AD due to its increased prevalence in developed countries. Although different strategies including biological and immune modulators are available for the treatment of AD, each has certain limitations. The researchers had shown considerable interest in the management of AD with herbal medicines. The establishment of herbal drugs for AD might eliminate local as well as systemic adverse effects associated with long term use of corticosteroids and also higher cost of therapy with biological drugs. The present review discusses the traditional East Asian herbal medicines and scientific data related to newer herbal extracts or compositions for the treatment of AD. In vivo animal models and in vitro cell cultures, investigated with herbal medicines to establish a possible role in AD treatment, have also been discussed in the paper. The paper also highlights the role of certain new approaches, i.e. pharmacopuncture, a combination of allopathic and herbal medicines; and novel carriers (liposomes, cubosomes) for herbal drugs on atopic skin. In conclusion, herbal medicines can be a better and safe, complementary and alternative treatment option for AD.

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Impressic Acid Ameliorates Atopic Dermatitis-Like Skin Lesions by Inhibiting ERK1/2-Mediated Phosphorylation of NF-κB and STAT1

International Journal of Molecular Sciences ◽

10.3390/ijms22052334 ◽

2021 ◽

Vol 22 (5) ◽

pp. 2334

Author(s):

Jae Ho Choi ◽

Gi Ho Lee ◽

Sun Woo Jin ◽

Ji Yeon Kim ◽

Yong Pil Hwang ◽

...

Keyword(s):

Atopic Dermatitis ◽

Skin Lesions ◽

Histopathological Analysis ◽

Mrna Levels ◽

Chemokine Production ◽

Dermal Thickness ◽

Skin Symptoms ◽

Tnf Α ◽

Ifn Γ ◽

In Cells

Impressic acid (IPA), a lupane-type triterpenoid from Acanthopanax koreanum, has many pharmacological activities, including the attenuation of vascular endothelium dysfunction, cartilage destruction, and inflammatory diseases, but its influence on atopic dermatitis (AD)-like skin lesions is unknown. Therefore, we investigated the suppressive effect of IPA on 2,4-dinitrochlorobenzene (DNCB)-induced AD-like skin symptoms in mice and the underlying mechanisms in cells. IPA attenuated the DNCB-induced increase in the serum concentrations of IgE and thymic stromal lymphopoietin (TSLP), and in the mRNA levels of thymus and activation regulated chemokine(TARC), macrophage derived chemokine (MDC), interleukin-4 (IL-4), interleukin-5 (IL-5), interleukin-13 (IL-13), tumor necrosis factor-alpha (TNF-α) and interferon-gamma (IFN-γ) in mice. Histopathological analysis showed that IPA reduced the epidermal/dermal thickness and inflammatory and mast cell infiltration of ear tissue. In addition, IPA attenuated the phosphorylation of NF-κB and IκBα, and the degradation of IκBα in ear lesions. Furthermore, IPA treatment suppressed TNF-α/IFN-γ-induced TARC expression by inhibiting the NF-κB activation in cells. Phosphorylation of extracellular signalregulated protein kinase (ERK1/2) and the signal transducer and activator of transcription 1 (STAT1), the upstream signaling proteins, was reduced by IPA treatment in HaCaT cells. In conclusion, IPA ameliorated AD-like skin symptoms by regulating cytokine and chemokine production and so has therapeutic potential for AD-like skin lesions.

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Effects of mineral complex material treatment on 2,4- dinitrochlorobenzene-induced atopic dermatitis like-skin lesions in mice model

BMC Complementary Medicine and Therapies ◽

10.1186/s12906-021-03259-5 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Johny Bajgai ◽

Jing Xingyu ◽

Ailyn Fadriquela ◽

Rahima Begum ◽

Dong Heui Kim ◽

...

Keyword(s):

Atopic Dermatitis ◽

Water Loss ◽

Immunoglobulin E ◽

Skin Barrier ◽

Skin Lesions ◽

Total Serum ◽

Skin Barrier Function ◽

Barrier Dysfunction ◽

Complex Material ◽

Mineral Complex

Abstract Background Atopic dermatitis (AD) is a chronic allergic inflammatory skin disease characterized by complex pathogenesis including skin barrier dysfunction, immune-redox disturbances, and pruritus. Prolonged topical treatment with medications such as corticosteroids, calcineurin inhibitors, and T-cell inhibitors may have some potential side-effects. To this end, many researchers have explored numerous alternative therapies using natural products and mineral compounds with antioxidant or immunomodulatory effects to minimize toxicity and adverse-effects. In the current study, we investigated the effects of mineral complex material (MCM) treatment on 2, 4-dinitrochlorobenzene (DNCB)-induced AD-like skin lesions in SKH-1 hairless mice. Methods Animals were divided into four groups; normal control (NC), negative control treated with DNCB only (DNCB only), positive control treated with DNCB and tacrolimus ointment (PC) and experimental group treated with DNCB and MCM patch (MCM). Skin inflammation and lesion severity were investigated through analyses of skin parameters (barrier score and strength, moisture and trans-epidermal water loss level), histopathology, immunoglobulin E, and cytokines. In addition, reactive oxygen species (ROS), nitric oxide (NO), glutathione peroxidase (GPx), and catalase (CAT) levels were measured in both serum and skin lysate. Results Our results demonstrates that MCM patch improved the progression of AD-like skin lesions by significantly increasing skin barrier strength and decreasing trans-epidermal water loss. Additionally, dermal administration of MCM patch significantly reduced epidermal thickness, ROS, and NO levels in skin lysate. Furthermore, we found that MCM suppressed the levels of AD-involved (Th1 and Th2) cytokines such as IL-2, IFN-γ, and IL-4 in blood. In addition, the levels of other Th1, and Th2 and inflammatory cytokines such as IL-1β, TNF-α, IL-6, IL-12(p70) and IL-10 were found lowest in the MCM group than in the DNCB only and PC groups. Moreover, we found total serum IgE level significantly increased after DNCB treatment, but decreased in the PC and MCM groups. Conclusion Taken together, our findings suggest that MCM application may have beneficial effects either systemic or regional on DNCB-induced AD lesional skin via regulation of the skin barrier function and immune-redox response.

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Gomisin M2 Ameliorates Atopic Dermatitis-like Skin Lesions via Inhibition of STAT1 and NF-κB Activation in 2,4-Dinitrochlorobenzene/Dermatophagoides farinae Extract-Induced BALB/c Mice

Molecules ◽

10.3390/molecules26154409 ◽

2021 ◽

Vol 26 (15) ◽

pp. 4409

Author(s):

Jinjoo Kang ◽

Soyoung Lee ◽

Namkyung Kim ◽

Hima Dhakal ◽

Taeg-Kyu Kwon ◽

...

Keyword(s):

Atopic Dermatitis ◽

Oral Administration ◽

Skin Diseases ◽

Nuclear Translocation ◽

Skin Lesions ◽

Biologically Active ◽

Therapeutic Effects ◽

Dermatophagoides Farinae ◽

Tnf Α ◽

Ifn Γ

The extracts of Schisandra chinensis (Turcz.) Baill. (Schisandraceae) have various therapeutic effects, including inflammation and allergy. In this study, gomisin M2 (GM2) was isolated from S. chinensis and its beneficial effects were assessed against atopic dermatitis (AD). We evaluated the therapeutic effects of GM2 on 2,4-dinitrochlorobenzene (DNCB) and Dermatophagoides farinae extract (DFE)-induced AD-like skin lesions with BALB/c mice ears and within the tumor necrosis factor (TNF)-α and interferon (IFN)-γ-stimulated keratinocytes. The oral administration of GM2 resulted in reduced epidermal and dermal thickness, infiltration of tissue eosinophils, mast cells, and helper T cells in AD-like lesions. GM2 suppressed the expression of IL-1β, IL-4, IL-5, IL-6, IL-12a, and TSLP in ear tissue and the expression of IFN-γ, IL-4, and IL-17A in auricular lymph nodes. GM2 also inhibited STAT1 and NF-κB phosphorylation in DNCB/DFE-induced AD-like lesions. The oral administration of GM2 reduced levels of IgE (DFE-specific and total) and IgG2a in the mice sera, as well as protein levels of IL-4, IL-6, and TSLP in ear tissues. In TNF-α/IFN-γ-stimulated keratinocytes, GM2 significantly inhibited IL-1β, IL-6, CXCL8, and CCL22 through the suppression of STAT1 phosphorylation and the nuclear translocation of NF-κB. Taken together, these results indicate that GM2 is a biologically active compound that exhibits inhibitory effects on skin inflammation and suggests that GM2 might serve as a remedy in inflammatory skin diseases, specifically on AD.

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Topical Spilanthol Inhibits MAPK Signaling and Ameliorates Allergic Inflammation in DNCB-Induced Atopic Dermatitis in Mice

International Journal of Molecular Sciences ◽

10.3390/ijms20102490 ◽

2019 ◽

Vol 20 (10) ◽

pp. 2490 ◽

Cited By ~ 4

Author(s):

Wen-Chung Huang ◽

Chun-Hsun Huang ◽

Sindy Hu ◽

Hui-Ling Peng ◽

Shu-Ju Wu

Keyword(s):

Atopic Dermatitis ◽

Mast Cells ◽

Protein Kinase ◽

Allergic Inflammation ◽

Skin Lesions ◽

Mapk Signaling ◽

Mitogen Activated Protein Kinase ◽

Mapk Pathways ◽

Mitogen Activated Protein ◽

Cox 2

Atopic dermatitis (AD) is a recurrent allergic skin disease caused by genetic and environmental factors. Patients with AD may experience immune imbalance, increased levels of mast cells, immunoglobulin (Ig) E and pro-inflammatory factors (Cyclooxygenase, COX-2 and inducible NO synthase, iNOS). While spilanthol (SP) has anti-inflammatory and analgesic activities, its effect on AD remains to be explored. To develop a new means of SP, inflammation-related symptoms of AD were alleviated, and 2,4-dinitrochlorobenzene (DNCB) was used to induce AD-like skin lesions in BALB/c mice. Histopathological analysis was used to examine mast cells and eosinophils infiltration in AD-like skin lesions. The levels of IgE, IgG1 and IgG2a were measured by enzyme-linked immunosorbent assay (ELISA) kits. Western blot was used for analysis of the mitogen-activated protein kinase (MAPK) pathways and COX-2 and iNOS protein expression. Topical SP treatment reduced serum IgE and IgG2a levels and suppressed COX-2 and iNOS expression via blocked mitogen-activated protein kinase (MAPK) pathways in DNCB-induced AD-like lesions. Histopathological examination revealed that SP reduced epidermal thickness and collagen accumulation and inhibited mast cells and eosinophils infiltration into the AD-like lesions skin. These results indicate that SP may protect against AD skin lesions through inhibited MAPK signaling pathways and may diminish the infiltration of inflammatory cells to block allergic inflammation.

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Molecular pathogenesis and clinical implications of eczema herpeticum

Expert Reviews in Molecular Medicine ◽

10.1017/s1462399408000756 ◽

2008 ◽

Vol 10 ◽

Cited By ~ 27

Author(s):

Caroline Bussmann ◽

Wen-Ming Peng ◽

Thomas Bieber ◽

Natalija Novak

Keyword(s):

Atopic Dermatitis ◽

Age Of Onset ◽

Current Knowledge ◽

Allergen Challenge ◽

Skin Lesions ◽

Molecular Pathogenesis ◽

Type I Interferons ◽

Total Serum ◽

Type I ◽

Eczema Herpeticum

A subgroup of patients with atopic dermatitis develops one or more episodes of a severe viral skin infection caused by herpes simplex virus superimposed on eczematous skin lesions. This condition is named atopic dermatitis complicated by eczema herpeticum. Characteristic features of patients developing eczema herpeticum include an early age of onset of atopic dermatitis with a persistent and severe course into adulthood, predilection for eczematous skin lesions in the head and neck area, elevated total serum IgE levels and increased allergen sensitisation. Deficiencies at the level of both the innate and the adaptive immune system, which have been identified in atopic dermatitis, are much more pronounced in this subgroup. Predisposing cellular factors include a reduced number of plasmacytoid dendritic cells in the epidermis and a modified capacity of these cells to produce type I interferons after allergen challenge. In addition, lower levels of antimicrobial peptides in the skin of atopic dermatitis patients, resulting in part from a Th2-prone micromilieu, contribute to the lack of an effective defence against viral attack. In this review, we summarise the current knowledge of the molecular pathogenesis of eczema herpeticum.

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Localization and site-specific cell–cell interactions of group 2 innate lymphoid cells

International Immunology ◽

10.1093/intimm/dxab001 ◽

2021 ◽

Author(s):

Kiniwa Tsuyoshi ◽

Kazuyo Moro

Keyword(s):

Lipid Production ◽

Allergic Diseases ◽

Innate Lymphoid Cells ◽

The Body ◽

Cell Interactions ◽

Lymphoid Cells ◽

Specific Cell ◽

Inflammatory Conditions ◽

Group 2 ◽

Cell Cell

Abstract Group 2 innate lymphoid cells (ILC2s) are novel lymphocytes discovered in 2010. Unlike T or B cells, ILC2s are activated nonspecifically by environmental factors and produce various cytokines, thus playing a role in tissue homeostasis, diseases including allergic diseases, and parasite elimination. ILC2s were first reported as cells abundantly present in fat-associated lymphoid clusters in adipose tissue. However, subsequent studies revealed their presence in various tissues throughout the body, acting as key players in tissue-specific diseases. Recent histologic analyses revealed that ILC2s are concentrated in specific regions in tissues, such as the lamina propria and perivascular regions, with their function being controlled by the surrounding cells, such as epithelial cells and other immune cells, via cytokine and lipid production or by cell–cell interactions through surface molecules. Especially, some stromal cells are identified as the niche cells for ILC2s, both in the steady state and under inflammatory conditions, through the production of IL-33 or extracellular-matrix factors. Additionally, peripheral neurons reportedly co-localize with ILC2s and alter their function directly through neurotransmitters. These findings suggest that the different localizations or different cell–cell interactions might affect the function of ILC2s. Furthermore, generally, ILC2s are thought to be tissue-resident cells; however, they occasionally migrate to other tissues and perform a new role; this supports the importance of the microenvironment for their function. We summarize here the current understanding of how the microenvironment controls ILC2 localization and function with the aim of promoting the development of novel diagnostic and therapeutic methods.

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