scholarly journals Gingival Crevicular Fluid Zinc- and Aspartyl-Binding Protease Profile of Individuals with Moderate/Severe Atopic Dermatitis

Biomolecules ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. 1600
Author(s):  
Fernando Valenzuela ◽  
Javier Fernández ◽  
Marcela Aroca ◽  
Constanza Jiménez ◽  
Daniela Albers ◽  
...  
Keyword(s):  
Atopic Dermatitis ◽  
Gingival Crevicular Fluid ◽  
Clinical Manifestations ◽  
Group Versus ◽  
Antibody Array ◽  
Severe Atopic Dermatitis ◽  
Healthy Controls ◽  
Cathepsin E ◽  
Diagnostic Potential ◽  
Crevicular Fluid

Atopic dermatitis (AD) is a protease-modulated chronic disorder with heterogenous clinical manifestations which may lead to an imprecise diagnosis. To date, there are no diagnostic protease tests for AD. We explored the gingival crevicular fluid (GCF) protease profile of individuals with moderate/severe AD compared to healthy controls. An exploratory case-control study was conducted. AD patients (n = 23) and controls (n = 21) were enrolled at the International Center for Clinical Studies, Santiago, Chile. Complete dermatological and periodontal evaluations (involving the collection of GCF samples) were made. The levels of 35 proteases were analyzed using a human protease antibody array in matching AD patients (n = 6) and controls (n = 6) with healthy periodontium. The GCF levels of zinc-binding ADAM8, ADAM9, MMP8, Neprilysin/CD10, aspartyl-binding Cathepsin E, serin-binding Protein convertase9, and uPA/Urokinase proteases were lower in moderate/severe AD patients compared to controls (p < 0.05). No inter-group differences in the levels of the other 28 proteases were found. MMP8, Cathepsin E, and ADAM9 were the biomarkers with the highest sensitivity and specificity regarding the detection of AD (p < 0.05). The area under receiver operating characteristic (ROC) curve for MMP8 was 0.83 and MMP8 + ADAMP9 was 0.90, with no significant differences (p = 0.132). A combined model of MMP8, Cathepsin E, and ADAM9 was not considered since it did not converge. Then, levels of MMP8 in GCF were determined using a multiplex bead immunoassay in 23 subjects with AD and 21 healthy subjects. Lower levels of MMP8 in the GCF from the AD group versus healthy group (p = 0.029) were found. This difference remained significant after adjustment by periodontitis (p = 0.042). MMP8 revealed the diagnostic potential to identify AD patients versus healthy controls, (ROC area = 0.672, p < 0.05). In conclusion, differences in the protease profile between AD and control patients were associated with MMP8, Cathepsin E, and ADAM9. Based on the multiplex assay results, MMP8 was lower in AD patients than controls, suggesting that MMP8 may be a diagnostic biomarker candidate.

scholarly journals Gingival Crevicular Fluid Zinc- and Aspartyl-binding Protease Profile of Individuals with Moderate/Severe Atopic Dermatitis

2020 ◽  
Author(s):  
Fernando Valenzuela ◽  
Javier Fernández ◽  
Marcela Aroca ◽  
Constanza Jiménez ◽  
Daniela Albers ◽  
...  
Keyword(s):  
Atopic Dermatitis ◽  
Gingival Crevicular Fluid ◽  
Clinical Manifestations ◽  
Group Differences ◽  
Antibody Array ◽  
Severe Atopic Dermatitis ◽  
Cathepsin E ◽  
Chronic Disorder ◽  
Crevicular Fluid ◽  
And Control

Atopic dermatitis (AD) is a protease-modulated chronic disorder with heterogenous clinical manifestations which may lead to an imprecise diagnosis. So far, there are no diagnostic protease tests for AD. We explored the gingival crevicular fluid (GCF) protease profile of periodontally-healthy individuals with moderate/severe AD compared to healthy controls. An exploratory case-control study was conducted. Matching AD patients (n=6) and controls (n=6) were enrolled at the International Center for Clinical Studies, Santiago, Chile. Complete dermatological and periodontal evaluations (involving the collection of GCF samples) were made. The levels of 35 proteases were analyzed using a human protease antibody array. The GCF levels of zinc-binding ADAM8, ADAM9, MMP8 and Neprilysin/CD10, aspartyl-binding Cathepsin E, and serin-binding Protein convertase9 and uPA/Urokinase proteases were lower in moderate/severe AD patients compared to controls (p&lt;0.05). No inter-group differences in the levels of the other 28 proteases were found. MMP8, Cathepsin E and ADAM9 were the biomarkers with the highest sensitivity and specificity regarding the detection of AD (p &lt; 0.05). The area under receiver operating characteristic (ROC) curve for MMP-8+ADAMP-9 was 0.90. In conclusion, differences in the protease profile between AD and control patients associated with MMP8, Cathepsin E and ADAM9. MMP8, ADAM9 and Cathepsin E may be useful as combined diagnostic and therapeutic biomarkers of moderate/severe AD.

scholarly journals Update on Atopic Dermatitis

2019 ◽  
Vol 32 (9) ◽  
pp. 606 ◽  
Author(s):  
Tiago Torres ◽  
Eduarda Osório Ferreira ◽  
Margarida Gonçalo ◽  
Pedro Mendes-Bastos ◽  
Manuela Selores ◽  
...  
Keyword(s):  
Atopic Dermatitis ◽  
Disease Severity ◽  
Clinical Manifestations ◽  
Skin Barrier ◽  
Future Research ◽  
Severe Atopic Dermatitis ◽  
Inadequate Response ◽  
Barrier Dysfunction ◽  
Therapeutic Goals ◽  
Global Health Issue

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.

scholarly journals Salivary Levels of IL-6 and IL-17 Could Be an Indicator of Disease Severity in Patients with Calculus Associated Chronic Periodontitis

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Husniah Batool ◽  
Ahmed Nadeem ◽  
Muhammad Kashif ◽  
Faheem Shahzad ◽  
Romeeza Tahir ◽  
...  
Keyword(s):  
Chronic Periodontitis ◽  
Alveolar Bone ◽  
Gingival Crevicular Fluid ◽  
Severe Disease ◽  
Cross Sectional Study ◽  
Enzyme Linked Immunosorbent Assay ◽  
Healthy Controls ◽  
Cross Sectional ◽  
Significant Difference ◽  
Crevicular Fluid

Background/Purpose. Chronic periodontitis is an inflammatory disease of gums that causes loss of supporting structures of teeth, that is, gingiva, periodontal ligament, cementum, and alveolar bone. Levels of various cytokines in the serum, gingival tissues, and gingival crevicular fluid in patients with chronic periodontitis have been studied, but limited data are available on the level of cytokines in saliva. Therefore, a study was designed to determine levels of salivary IL-6 and IL-17 in patients with calculus associated chronic periodontitis. Materials and Methods. It was a comparative, cross-sectional study that is comprised of 41 healthy controls and 41 calculus associated chronic periodontitis patients (CP patients). According to the degree of attachment loss, CP patients were subcategorized as mild (CAL 1-2 mm), moderate (CAL 3-4 mm), and severe (CAL > 5 mm) forms of periodontitis. Salivary levels of IL-6 and IL-17 were determined using enzyme-linked immunosorbent assay (ELISA) technique. Data was analyzed using SPSS 20.0. Results. Between healthy controls and CP patients (moderate and severe disease), a statistically significant difference was observed in the concentrations of IL-6 and IL-17. In CP patients, the highest mean ± SD of salivary IL-6 and IL-17 was observed in severe CP, followed by moderate and mild CP. Regarding level of IL-6, a statistically significant difference was observed between mild and severe disease and between moderate and severe subcategories of CP patients. Similarly, statistically significant difference was observed in the level of IL-17 between mild and moderate, mild and severe disease, and moderate and severe disease. Conclusion. The levels of salivary IL-6 and IL-17 were increased significantly in calculus associated CP patients as compared to healthy controls and these levels increased with the progression of CP. Clinical Significance. Salivary levels of IL-6 and IL-17 may help in the subcategorization of CP.

scholarly journals PECULIARITIES OF CLINICAL PASSING OF ATOPIC DERMATITIS AND VITAMIN D EXCHANGE IN EARLY CHILDREN

2020 ◽  
pp. 27-35
Author(s):  
N. V. Kamut ◽  
M. M. Kiselova
Keyword(s):  
Vitamin D ◽  
Atopic Dermatitis ◽  
Young Children ◽  
Clinical Manifestations ◽  
Serum Vitamin ◽  
Scientific Data ◽  
Main Group ◽  
Severe Atopic Dermatitis ◽  
Serum Vitamin D ◽  
Vitamin D Levels

The article is devoted to the study of features of clinical course of atopic dermatitis and vitamin D exchange in young children conducted by us by estimation of severity of atopic dermatitis depending on the value of SCORAD index, determination of 25(OH)D concentration in serum of children by immunochemical method with chemocentric analysis according to the classification approved by experts of the international endocrinological society. In the examination of 188 young children, two groups were formed on the basis of the Lviv City Children's Clinical Hospital. Children from 1 month to 1 year of age with manifestations of atopic dermatitis (n = 120), who were born full-term and had no birth defects, metabolic disorders, severe perinatal CNS lesions formed the main group. The comparison group consisted of 68 healthy young children without chronic diseases. All children had atopic dermatitis in the main group and were classified by severity (depending on the SCORAD index): children with mild severity – 31 (26 %), moderate 47 (39 %), and severe 42 (35 %). As a result of the study, we found a association between the severity of clinical manifestations of atopic dermatitis and the level of vitamin D in the serum. Comparative analysis of the severity of atopic dermatitis, depending on the level of vitamin D in the serum, showed that with severe atopic dermatitis in children of the main group, the level of 25(OH)D was significantly lower compared to its indicators in children with moderate to severe (P < 0.05). Serum vitamin D levels are significantly lower in all forms of atopic dermatitis severity and correlate significantly with the overall SCORAD severity score, erythema intensity, excoriation, itching, and sleep disturbances. The scientific data on the presence of feedback correlation (r = –0,48; P < 0,05) between the development of atopic dermatitis in children and their level of 25(OH)D in serum were added. Our findings suggest that there is a need for a differentiated approach to treating early-stage atopic dermatitis of varying severity, a personalized therapeutic approach to choosing a vitamin D supplementation, given the level of 25(OH)D in the serum.

Diagnostic Potential of Host Response Mediators

1993 ◽  
Vol 7 (2) ◽  
pp. 175-181 ◽  
Author(s):  
S. Offenbacher ◽  
J.G. Collins ◽  
P.A. Heasman
Keyword(s):  
Disease Activity ◽  
Host Response ◽  
Gingival Crevicular Fluid ◽  
Diagnostic Tools ◽  
Predictive Values ◽  
Diagnostic Measures ◽  
Diagnostic Potential ◽  
Crevicular Fluid ◽  
Sensitivity Specificity ◽  
Considerable Body

This review summarizes the data which relate the validation and application of host response markers as diagnostic tests forperiodontal diseases. Practical considerations regarding the general application and evaluation of a diagnostic test for periodontal disease are presented. Experiments which have documented the performance of host response markers as diagnostic measures of disease activity in terms of sensitivity, specificity, and predictive values are summarized. Particular emphasis is placed on the diagnostic potential of gingival crevicular fluid (GCF) components. The considerable body of evidence supporting the potential application of GCF-PGE2 levels for predicting episodes of disease progression and reflecting disease activity is summarized and placed into perspective for the development of future diagnostic tools.

Marfan syndrome in combination with severe atopic dermatitis: importance of early diagnosis and treatment of patients with allergic dermatitis in childhood

2021 ◽  
Vol 16 (2) ◽  
pp. 68-73
Author(s):  
P.G. Svist ◽  
◽  
E.V. Orlova ◽  
L.M. Smirnova ◽  
S.S. Parshintseva ◽  
...  
Keyword(s):  
Early Childhood ◽  
Atopic Dermatitis ◽  
Side Effects ◽  
Marfan Syndrome ◽  
Clinical Manifestations ◽  
Treatment Strategies ◽  
Hereditary Diseases ◽  
Severe Atopic Dermatitis ◽  
Key Words Atopic Dermatitis ◽  
Effective Treatment Regimen

We report a case of a rare combination of Marfan syndrome and severe atopic dermatitis (AD) in a 32-year-old male patient. He developed AD in early childhood and then had a relapse at the age of 18 years caused by stress. After this, AD became severe due to stress associated with aortic aneurysmectomy. The patient also had side effects caused by steroids, including multiple pustular eruptions, Kaposi's varicelliform eruption, edema and hyperemia of the periorbital area, pain and swelling of the small joints of the hands. These side effects, as well as specific cardiovascular symptoms typical of Marfan syndrome necessitated the search for alternative treatment strategies for severe AD. Eventually, we managed to find an effective treatment regimen that caused no side effects or adverse events, while the symptoms subsided. This case demonstrates the importance of early AD diagnosis in childhood in order to prevent its transition into severe chronic form that can hardly be managed in adulthood. Key words: atopic dermatitis, children, diagnostic criteria, clinical manifestations, hereditary diseases, Marfan syndrome

scholarly journals Arginine and glutamate levels in the gingival crevicular fluid from patients with chronic periodontitis

2008 ◽  
Vol 19 (4) ◽  
pp. 318-322 ◽  
Author(s):  
Narda Téllez ◽  
Natalia Aguilera ◽  
Belkis Quiñónez ◽  
Elizabeth Silva ◽  
Luis Enrique González ◽  
...  
Keyword(s):  
Chronic Periodontitis ◽  
Gingival Crevicular Fluid ◽  
Healthy Controls ◽  
Clinical Attachment Loss ◽  
Measure Concentration ◽  
Periodontal Tissues ◽  
Glutamate Concentration ◽  
Probing Depth ◽  
Crevicular Fluid ◽  
Post Hoc

The objectives of this study were to determine arginine and glutamate levels in the gingival crevicular fluid (GCF) of adult chronic periodontitis patients versus periodontally healthy controls, and to compare two kinds of microdialysis probes: normal and U-shaped probes. The analysis of GCF components was developed to improve the diagnosis of periodontal disease (PD). Proteolysis in the periodontal tissues increases the concentration of amino acids (aa) in the GCF and the levels of these aa may reveal PD features and stages. GCF samples were collected by microdialysis in situ from 5 periodontally affected sites (probing depth >5 mm, clinical attachment loss >3 mm) in 14 adult chronic periodontitis patients and from 14 adult periodontally healthy controls. Capillary zone electrophoresis coupled to laser induced fluorescence detection was used to measure concentration of arginine and glutamate in the GCF. Data were analyzed statistically by ANOVA and Tukey's post-hoc tests (?=0.05). Arginine concentration was increased (p<0.001) and glutamate concentration was decreased (p<0.001) in chronic periodontitis patients as compared to controls. There were no significant differences (p=0.069) between the normal and U-shaped probes. In conclusion, the increase of arginine and decrease of glutamate concentration in GCF were associated to the presence of periodontitis, and might be used as markers to recognize periodontally susceptible subjects as well as to evaluate the treatment course.

scholarly journals Increased Frequency of CTLA-4 and PD-1 Expressing Regulatory T Cells and Basophils With an Activating Profile in Infants With Moderate-to-Severe Atopic Dermatitis Hypersensitized to Food Allergens

2021 ◽  
Vol 9 ◽  
Author(s):  
Agurtzane Bilbao ◽  
Raquel Pérez-Garay ◽  
Idoia Rius ◽  
Alex Irurzun ◽  
Iñigo Terrén ◽  
...  
Keyword(s):  
Atopic Dermatitis ◽  
Specific Ige ◽  
Treg Cells ◽  
Severe Atopic Dermatitis ◽  
Healthy Controls ◽  
Food Allergens ◽  
Phenotypic Analysis ◽  
Healthy Donors ◽  
Food Antigens ◽  
Complementary Diet

Background: Infants with severe atopic dermatitis (AD) may be sensitized to foods that have not been introduced into their diet, posing a risk for developing an immediate hypersensitivity reaction on the first exposure to the food to which they are sensitized. The aim of this work was to perform an analysis of the sensitization profile in infants with moderate-to-severe AD and to identify cellular and molecular markers for food allergy (FA).Methods: Blood samples from healthy donors and children with moderate-to-severe AD were studied. Specific IgE to several allergens were determined using ImmunoCAP FEIA system and ISAC technology. Furthermore, using flow cytometry-based studies, basophils and regulatory T (Treg) cells were phenotypically characterized.Results: 90% of children with AD were sensitized to food antigens before introducing them into the diet, and 100% developed FA. Phenotypic analysis showed a significantly higher percentage of CTLA-4 and PD-1 expressing Treg cells in AD patients than in healthy controls. Basophils from patients exhibited a marked reduction in the expression of CD300a, higher expression of FcεRI and CXCR4, and to some extent higher expression of CD63 and CD300c.Conclusions: Infants with moderate-to-severe AD are at high risk of being sensitized to food allergens. Therefore, to avoid allergic reactions, broad-spectrum sensitization studies are necessary before introducing complementary diet. Increased expression of CTLA-4 and PD-1 suggests greater suppressive potential of Treg cells in infants with AD than healthy controls. Furthermore, our results suggest a role for CD300 molecules on circulating basophils as possible biomarkers for FA susceptibility.

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