scholarly journals The Effect of SARS-CoV-2 Virus Infection on the Course of Atopic Dermatitis in Patients

Medicina ◽  
2021 ◽  
Vol 57 (6) ◽  
pp. 521
Author(s):  
Martyna Miodońska ◽  
Agnieszka Bogacz ◽  
Magdalena Mróz ◽  
Szymon Mućka ◽  
Andrzej Bożek
Keyword(s):  
Atopic Dermatitis ◽  
Immunosuppressive Therapy ◽  
Systemic Treatment ◽  
Immunosuppressive Treatment ◽  
Skin Lesions ◽  
Skin Condition ◽  
Severe Form ◽  
Immune Mediated ◽  
Skin Symptoms ◽  
The Impact

Background and objectives: Atopic dermatitis (AD) is a disease with a complex pathophysiology involving immune-mediated reactions that lead to skin lesions that are typically localized and recurrent. Following the outbreak of the COVID-19 (coronavirus disease 2019) pandemic, attempting to assess the impact of SARS-CoV-2 infection on diseases caused by complex immune mechanisms has become important. The aim of this study was to assess the impact of SARS-CoV-2 infection on the course of AD, including immunosuppressive therapy, in patients with a severe form of the disease. Materials and methods: A retrospective analysis of 21 adults aged 18 to 52 years with AD diagnosed with COVID-19, including patients requiring hospitalization, was performed. Results: During SARS-CoV-2 infection, temporary exacerbation of skin lesions and/or skin pruritus was observed in nine (43%) patients but without the need for systemic treatment intervention. Patients with severe AD who received immunosuppressive therapy most often manifested mild exacerbation of skin symptoms. The skin condition improved in three patients. There was no significant effect of disease severity on the risk of severe COVID-19 (HR = 0.45; 95% CI: 0.32–0.65). Conclusions: The course of atopic dermatitis during SARS-CoV-2 infection may be different from the severity of its symptoms due to the lack of a significant influence. The immunosuppressive treatment used in patients with severe AD did not significantly affect the course of SARS-CoV-2 infection.

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

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.

scholarly journals POS1180 TREATMENT COMPLIANCE OF PATIENTS WITH RHEUMATOID ARTHRITIS DURING THE FIRST WAVE OF THE SARS-CoV-2/COVID-19 PANDEMIC IN PORTUGAL: RESULTS FROM THE COVID IN RA (COVIDRA) SURVEY

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 871.2-871
Author(s):  
F. Araujo ◽  
N. Gonçalves ◽  
A. F. Mourão
Keyword(s):  
Rheumatoid Arthritis ◽  
Inflammatory Diseases ◽  
Immunosuppressive Treatment ◽  
Treatment Compliance ◽  
Web Based ◽  
Symptoms Of Depression ◽  
Immune Mediated ◽  
Attending Physician ◽  
The Impact ◽  
E Mail

Background:The outcomes of the infection by the SARS-CoV-2 in patients with immune-mediated inflammatory diseases were largely unknown during the early days of the COVID-19 pandemic. It was hypothesized that these patients were at higher risk of morbidity and mortality due to their inherent immune dysfunction and immunosuppressive therapy. Several rheumatology societies issued recommendations urging patients not to stop their anti-rheumatic treatments.Objectives:To assess treatment compliance of patients with rheumatoid arthritis (RA) during the first wave of the SARS-CoV-2/COVID-19 pandemic in Portugal.Methods:The web-based survey COVIDRA (COVID in RA) was developed to assess the impact of the first wave mandatory confinement in patients with RA focusing on 5 domains: RA symptoms, attitudes towards medication, employment status, physical exercise and mental health. The questionnaire was sent to RA patients through e-mail and social media of the Portuguese Society of Rheumatology and two patient associations; and it was filled locally at two rheumatology centers in Lisbon. Recruitment took place during June and July 2020. Descriptive statistics were generated by the survey software and were afterwards transported and evaluated using appropriate biostatistics software.Results:We obtained 441 valid questionnaires. Most respondents were female (88.4%), caucasian (93.6%), with a mean age of 58 (+/-13) years. The majority (57.6%) had longstanding disease (>10 years) and were treated with csDMARDs (63.2%) and/or bDMARDs/tsDMARDS (23,7%). Only 14% (N=61) discontinued or reduced the dosage or frequency of their RA treatment. Most of these changes were previously planned by the attending physician (27.9%). Only 11 patients (18%) discontinued their immunosuppressive medication out of fear of becoming infected with SARS-CoV-2 (corresponding to 2.5% of total responders). Another 11 patients did so because they had no prescription, couldn’t go to the community/hospital pharmacy or couldn’t afford the medication. Although these numbers preclude any statistical analysis, when compared to patients who persisted on their treatment, those discontinuing due to fear of contagion were younger (56.4 vs 58.5 years), all female (100 vs 86.8%), with long-lasting disease (≥ 11 years) (90.9% vs 57.5%), more frequently treated with bDMARDs (36.4 vs 23.1%) and presenting more symptoms of depression (54.5 vs 49.7%).Conclusion:Most RA patients complied with their treatment during the first wave of the SARS-CoV-2 pandemic in Portugal. Only a minority changed their immunosuppressive treatment due to fear of SARS-CoV-2 infection. Very similar rates of immunosuppressive discontinuation due to fear of contagion were reported by other authors (such as Schmeiser et al, Pineda-sic et al and Fragoulis et al).Disclosure of Interests:Filipe Araujo Speakers bureau: Pfizer, Biogen, Novartis, Menarini, Consultant of: MSD, Nuno Gonçalves: None declared, Ana Filipa Mourão: None declared.

Mass Screening for Non-Synonymous SNPs Using Custom Cancer Microarrays Directly Reveals Possible Pathogenic Predisposition Factors in AA

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 1333-1333
Author(s):  
Bartlomiej P Przychodzen ◽  
Andres Jerez ◽  
Hideki Makishima ◽  
Kathryn M Guinta ◽  
Peter Chomczynski
Keyword(s):  
Immunosuppressive Therapy ◽  
Genetic Variants ◽  
Conflicts Of Interest ◽  
Immunosuppressive Treatment ◽  
Minor Allele ◽  
Healthy Population ◽  
Whole Genome ◽  
Synonymous Snps ◽  
Low Prevalence ◽  
The Impact

Abstract Abstract 1333 While immune mechanisms are involved in the pathogenesis of idiopathic aplastic anemia (AA), identification of heritable predisposition/susceptibility traits has been difficult due to the impact of exogenous factors and the low prevalence of AA. The seemingly sporadic and likely complex and heterogeneous traits leading to AA are not easily amenable to genetic studies. With the advent of whole genome scanning (WGS) technologies such as single nucleotide polymorphism arrays (SNP-A), large scale investigations in various disorders have been conducted. A systems level understanding of a particular disease may allow for the identification of candidate genetic variants as prognostic and diagnostic biomarkers. Previous studies utilized arrays with mostly tagging SNPs and thereby the identification of causative polymorphisms was only indirectly possible through the narrowing of LD intervals. We have applied a custom cancer chip (Illumina) containing 211,155 SNP probes designed for non-synonymous SNPs, allowing for a more direct discovery of pathogenic genes with the aim of identifying low prevalence genetic variants that contribute to the development, risk and therapy responsiveness in idiopathic AA. Our study involved 116 cases used for discovery and 120 cases to be used for confirmatory studies, as well as a cohort of 1964 controls to improve the power of detection. After exclusion of SNPs with a GenTrain score of <0.65 and those in violation of Hardy Weinberg equilibrium, 202,905 SNPs (96.0% of the initial set) were passed for further investigation. Single allele 2 statistics for all autosomal markers were performed; 853 SNPs with p<1×10-7 were selected. Subsequently, all 853 SNPs were screened for functional prediction (transcription factor binding site, affecting splicing, detrimental non-synonymous variant of proteins such as cytokines or cytokine receptors). An initial group of SNPs was expanded by all the SNPs being in linkage disequilibrium (>0.8) to a total of 7445 loci. Remarkably, informative LD blocks were identified, represented by multiple markers pointing to the presence of informative polymorphisms in the corresponding regions. A total of 3 SNPs were prioritized for final investigation based on the frequency differential between patients/controls. Of great interest was rs2544773 located in MYT1L represented directly by a singular marker. The frequency of the heterozygous variant among patients was 41.9% vs. 6.5% in controls and 15.0% vs. 0.4% for the minor homozygous variant (p<1×10–17). Our results suggest that carriers of at least one copy of the G allele (GA/AA) are at a higher risk of developing AA (OR 17.6). Another interesting variant identified was a non-synonymous SNP (rs13405539) located in DPYSL5 represented directly by a singular marker. This gene was recently associated with autoimmune myelopathy and cancer. Our analysis showed that minor allele has a protective potential and was present at a frequency in patients; occurring at a homozygous (AA) frequency of 1.8% vs. 16.4% in patients and controls, respectively and a heterozygous (GA) frequency of 14.6% vs. 49.2% in patients and controls respectively (p<1×10–20). Comparison of AA patients with healthy individuals has been a primary focus of GWAS. However, we have also compared subgroups defined by clinical criteria. We subdivided patients based on responsiveness to immunosuppressive therapy. CEBPZ was represented by rs3213746 through LD with rs12469082 (p<.0001). The heterozygous (CT) frequency observed amongst refractory patients was 12.4% vs. 1.4% and 8.2% vs. 0% for the minor homozygous (TT) variant, in refractory and responder, respectively. Odds ratio: Patients carrying at least one copy of the minor allele (CT/TT) are at much higher risk being a non-responder to immunosuppressive treatment (OR=26.3). Genotypic frequencies of patients that responded to immunosuppressive treatment were similar to the frequencies observed in healthy population. CEBPZ belongs to a family of CCAAT/enhancer proteins. It has been shown to interact with TP53 and therefore may play role in modulation of apoptosis. In sum, our study represents novel, whole genome approach using custom designed, high density cancer microarray that unravels new gene targets responsible for disease susceptibility as well as response to immunosuppressive therapy. Disclosures: No relevant conflicts of interest to declare.

Patient Satisfaction with Psoriasis Therapies: An Update and Introduction to Biologic Therapy

2004 ◽  
Vol 8 (5) ◽  
pp. 310-320 ◽  
Author(s):  
Andrew Y. Finlay ◽  
Jean-Paul Ortonne
Keyword(s):  
Quality Of Life ◽  
Patient Satisfaction ◽  
Biologic Therapy ◽  
Skin Condition ◽  
Biologic Agents ◽  
Immune Mediated ◽  
Related Quality ◽  
Health Related ◽  
The Impact

Background: Psoriasis is a chronic, immune-mediated skin condition that often requires lifelong treatment. Many patients report dissatisfaction with traditional nonbiologic therapies because they are ineffective for their psoriasis, are associated with side effects, or impact negatively on quality of life. Objectives: The aim of this article is to review the effect on patient quality of life of traditional nonbiologic psoriasis therapies and to discuss the impact of biologic psoriasis therapies on patient satisfaction. Methods: A review of the literature is presented. Results: Traditional nonbiologic psoriasis therapies can negatively impact quality of life due to a variety of factors including inconvenience and toxicity. Biologic agents have been developed that target the immunopathogenesis of psoriasis. Based on favorable efficacy and safety results in clinical trials, some of these agents are now approved for clinical use. Evidence suggests that patients receiving biologic therapies experience significant improvements in health-related quality of life. Conclusion: Biologic agents offer new hope for patients with psoriasis that their chronic condition can be controlled in a manner that improves their quality of life and may lead to high levels of satisfaction with their treatment.

Topical treatment of chronic dermatoses with kertoplastic agents

2016 ◽  
Vol 19 (3) ◽  
pp. 170-172
Author(s):  
O. V Grabovskaya ◽  
E. Yu Vertieva ◽  
L. A Shestakova ◽  
Ekaterina V. Grekova
Keyword(s):  
Atopic Dermatitis ◽  
Topical Treatment ◽  
Psoriasis Vulgaris ◽  
Skin Diseases ◽  
Systemic Treatment ◽  
Skin Condition ◽  
Results Of Treatment ◽  
Severity Of The Disease

Atopic dermatitis and psoriasis are common chronic dermatosis characterized by prolonged recurrent course. Depending on the severity of the disease topical and systemic treatment are applied. Keratoplastic agents play an important role in treatment of skin diseases. These agents include Naftalan Cream 30%, which significantly improves the skin condition. The results of treatment of 10 patients with atopic dermatitis and 10 patients with psoriasis vulgaris Naftalan cream 30% are presented.

scholarly journals Acute Brucellosis Presenting with Bleeding Tendency due to Isolated Severe Thrombocytopenia

2018 ◽  
Vol 2018 ◽  
pp. 1-3
Author(s):  
M. Aon ◽  
T. Al-Enezi
Keyword(s):  
Platelet Count ◽  
Skin Lesions ◽  
Severe Form ◽  
Severe Thrombocytopenia ◽  
Bleeding Tendency ◽  
Rapid Rise ◽  
Mild Anemia ◽  
Short Course ◽  
Immune Mediated ◽  
Serologic Reaction

Mild anemia and leukopenia are the most common hematologic findings in the course of acute brucellosis. Severe form of thrombocytopenia is less frequently reported. We describe a case of acute brucellosis in a 20-year-old man, who presented with fever, purpuric skin lesions, epistaxis, and hematuria. The absolute platelet count was 2 × 109/L. The patient was diagnosed as suffering from brucellosis on the basis of a strongly positive serologic reaction and was treated with antibiotics and a short course of corticosteroids, with a rapid rise in platelet count. Brucella infection can cause immune-mediated thrombocytopenia that is reversible after appropriate antimicrobial therapy and steroid treatment.

scholarly journals The Role of Staphylococcus aureus in Secondary Infections in Patients with Atopic Dermatitis (AD)

2016 ◽  
Vol 65 (3) ◽  
pp. 253-259 ◽  
Author(s):  
Jacek Międzobrodzki
Keyword(s):  
Staphylococcus Aureus ◽  
Atopic Dermatitis ◽  
Skin Barrier ◽  
Skin Lesions ◽  
Skin Condition ◽  
Staphylococcal Infection ◽  
Secondary Infections ◽  
Allergic Skin ◽  
Atopic Skin ◽  
Favorable Conditions

Staphylococcus aureus colonizes the mucous membrane of the nasal vestibule of a significant number of healthy people. These microorganisms are opportunistic pathogens, that in favorable conditions, may cause infections of various course, location or manifestation. Secondary infections emerge in cases when other risk factors contribute to such a change. One of the diseases during which S. aureus changes its saprophytic character to a pathogenic one is atopic dermatitis (AD), an allergic skin condition of a chronic and recurrent nature. Patients with AD are highly predisposed to secondary staphylococcal infections due to active S. aureus colonization of the stratum corneum, damage of the skin barrier or a defective immune response. Microorganisms present in skin lesions destroy the tissue by secreting enzymes and toxins, and additionally stimulate secondary allergic reactions. The toxins secreted by strains of S. aureus also act as superantigens and penetrate the skin barrier contributing to a chronic inflammation of the atopic skin lesions. The S. aureus species also releases proinflammatory proteins, including enzymes that cause tissue damage. When initiating treatment it is particularly important to properly assess that the onset of the secondary bacterial infection is caused by S. aureus and thus justifying the inclusion of antibiotic therapy. Depending on the severity and extent of the staphylococcal infection, topical antibiotics are used, usually mupirocin or fusidic acid, or general antibiotic treatment is introduced. Another therapeutic strategy without antibiotics has given a positive effect in patients.

scholarly journals Quality of life in atopic dermatitis in Asian countries: a systematic review

2021 ◽  
Author(s):  
Jinghui Huang ◽  
Yue Jia Choo ◽  
Helen Elizabeth Smith ◽  
Christian Apfelbacher
Keyword(s):  
Quality Of Life ◽  
Atopic Dermatitis ◽  
English Language ◽  
Skin Condition ◽  
Asian Countries ◽  
Factors Affecting ◽  
Asian Populations ◽  
Wide Range ◽  
The Impact

AbstractAtopic dermatitis (AD) is a common chronic inflammatory skin condition which impacts psychological wellbeing and social relationships. There have been studies of AD’s impact on quality of life (QoL) in Western countries, but these findings cannot be directly extrapolated to Asian populations with genetic, environmental and cultural differences. Therefore, we aimed to systematically review the literature pertaining to QoL impairment in AD in East and Southeast Asia to characterize the impact of AD on patients and their families, and to identify the factors affecting the degree of QoL impairment. A search of English language papers was conducted on MEDLINE, EMBASE, PSYCInfo, Global Health and Web of Science. Observational studies measuring QoL using single or multi-item instruments in people with self-reported or physician diagnosed atopic dermatitis were included. 27 studies from 29 articles were included and synthesized. There is data documenting QoL impairment in AD sufferers and their families, across a wide range of Asian countries, healthcare settings and ages. Aspects of QoL impacted to a greater extent included symptoms of itch, feelings of embarrassment, and sleep disturbance. Severity of disease affects the degree of impairment of QoL, but there is no apparent link between QoL impairment and patient demographic factors, or other medical factors such as age at diagnosis or duration of illness. Our findings also highlighted the need for clinicians to actively explore the impact of patient’s symptoms, especially in an Asian context where healthcare communications are traditionally doctor-centric.

scholarly journals Effect of Topically Applied Wikstroemia dolichantha Diels on the Development of Atopic Dermatitis-Like Skin Symptoms in Mice

Nutrients ◽  
2019 ◽  
Vol 11 (4) ◽  
pp. 914 ◽  
Author(s):  
Jonghwan Jegal ◽  
No-June Park ◽  
Tae-Young Kim ◽  
Sangho Choi ◽  
Sang Woo Lee ◽  
...  
Keyword(s):  
Atopic Dermatitis ◽  
Barrier Function ◽  
Immunoglobulin E ◽  
Skin Barrier ◽  
Skin Lesions ◽  
Transepidermal Water Loss ◽  
Skin Hydration ◽  
Interleukin 4 ◽  
Skin Barrier Function ◽  
Skin Symptoms

Plants of the genus Wikstroemia are traditionally used to treat inflammatory diseases like bronchitis and rheumatoid arthritis. In the present study, the anti-atopic effects of an EtOH extract of Wikstroemia dolichantha (WDE) on oxazolone- and DNCB (2,4-dinitrochlorobenzene)-induced dermatitis in mice were investigated. Both ears of BALB/c mice were exposed to oxazolone, and dorsal skins of SKH-1 hairless mice were sensitized with DNCB to induce acute eczematous atopic skin lesions. 1% WDE was applied daily to oxazolone- and DNCB-induced AD mice for two or three weeks, respectively. Total IL-4 and IgE concentrations in serum, transepidermal water loss (TEWL) and skin hydration were assessed. High-performance liquid chromatography/mass spectrometry (HPLC/MS) was used to determine the composition of WDE. Dermal application of 1% WDE grossly and histopathologically improved oxazolone- and DNCB-induced AD skin symptoms. Epidermal thickness and mast cell infiltration were significantly lower in animals treated with WDE than in vehicle controls. Furthermore, in addition to reducing DNCB-induced increases in serum IL-4 (interleukin 4) and IgE (immunoglobulin E) levels, WDE also decreased TEWL and increased skin hydration (indicative of improved skin barrier function). The four flavonoids taxifolin, aromadendrin, padmatin and chamaejasmine were tentatively identified in WDE by HPLC-DAD/QTOF-MS. The above results show WDE protected against oxazolone- and DNCB-induced AD in mice by down-regulating the TH2-associated cytokine IL-4 and improving skin barrier function and suggest WDE might be useful for the management of atopic dermatitis.

Cheek Microbial Communities Vary in Young Children with Atopic Dermatitis in China

Dermatology ◽  
2019 ◽  
Vol 236 (2) ◽  
pp. 160-169
Author(s):  
Liya Song ◽  
Qian Wang ◽  
Yumei Zheng ◽  
Laiji Ma ◽  
Yuanyuan Chen ◽  
...  
Keyword(s):  
Atopic Dermatitis ◽  
Biofilm Formation ◽  
Klebsiella Oxytoca ◽  
Skin Lesions ◽  
Skin Condition ◽  
Skin Microbiome ◽  
Hacat Cells ◽  
Bacterial Fermentation ◽  
Complex Interactions

Background: Atopic dermatitis (AD) is a chronic, recurrent skin condition with recently increased incidence in younger children. AD development has been correlated with the skin microbiome, and Staphylococcus aureus enrichment causes significant increases in skin lesions. Objective: Our objectives were to compare the microbial diversity of the cheek skin of children with or without AD aged 0–1 years in China, and to determine whether 4 types of skin-isolated bacteria could inhibit S. aureus in vitro. Methods: The skin microbial samples of cheek skin of children were sequenced by 16S rRNA V1-V2 region. Four skin isolated bacterial fermentation supernatants were tested for effects on S. aureus growth, membrane formation, and induction of cytokine secretion from HaCaT cells. Results: Bacterial diversity decreased significantly in skin with severe AD compared to healthy skin (p < 0.01). Seven phyla had content >1%, 4 of which differed in AD (p < 0.05). 38 genera had content >1%, 15 differed (p < 0.05). Differences in 8 species were observed (p < 0.05). In vitro antibacterial and cellular experiments showed that S. aureus growth, biofilm formation, and induction of interleukin (IL)-1α and IL-6 secretion from HaCaT cells were significantly inhibited by Klebsiella oxytoca, Kocuria rhizophila, and Staphylococcus epidermidis culture supernatants (p < 0.05). Conclusion: Skin microbiome changes in children varied with age and with AD. There were complex interactions between skin isolated bacteria and S. aureus which could inhibit S. aureus growth and biofilm formation in vitro, suggesting that these microorganisms could be used in AD treatment.

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