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Serum 25-Hydroxyvitamin D Level Might Be a Useful Indicator of Disease Severity in Obese Children With atopic dermatitis: A Case-Control Study

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International Journal of Dermatology And Venereology 2024年第1期07卷 6-11页

作者： Chen Jing-Jing Fang Xiao-Kai Liu Xiu-Mei Liu Xiao-Chun Yao Xu Department of Allergy and Rheumatology Hospital for Skin Diseases (Institute of Dermatology) Chinese Academy of Medical Sciences and Peking Union Medical College Nanjing Jiangsu 210042 China

Objective: To assess the relationship between the severity of atopic dermatitis (AD) in children of varying weight categories and their serum 25-hydroxyvitamin D [25(OH)D] levels.Methods: The study population comprised 899 patients with AD and 854 age- and sex-matched controls. The Mann-WhitneyU test and Kruskal-WallisH tests were used to assess differences between groups, and Spearman correlation analysis was used to test correlation.Results: The 25(OH)D level in the AD group wasM (Q25,Q75), 24.0 (19.7, 28.4) ng/mL, which was significantly lower than the control group (26.4 [23.6, 29.9] ng/mL;Z = -3.34,P = 0.001). 25(OH)D levels in children with AD were negatively correlated with body mass index (r = -0.30,P atopic dermatitis (SCORAD;r = -0.14,P < 0.001), total immunoglobulin E (r = -0.13,P < 0.001), and eosinophil (r = -0.08,P = 0.017). There were statistically significant differences in 25(OH)D (H = 18.46,P < 0.001), total immunoglobulin E (H = 9.13,P = 0.010), eosinophil (H = 67.17,P < 0.001), and SCORAD (H = 10.49,P = 0.005) among groups with different body mass index classification. The 25(OH)D levels were 22.3 (17.5, 27.1) ng/mL in the overweight AD group and 22.3 (17.6, 25.7) ng/mL in the obese AD group, which were significantly lower than those in the normal-weight AD group (24.7 [20.4, 25.5] ng/mL;P = 0.003,P = 0.004). 25(OH)D levels were negatively correlated with SCORAD in obese AD patients (r = -0.25,P = 0.010).Conclusion: Vitamin D insufficient or deficient is obvious in children AD patients. The 25(OH)D levels in the overweight/obese AD group are significantly lower than those in the normal-weight AD group. Vitamin D level is negatively correlated with SCORAD in obese children with AD.

关键词： atopic dermatitis vitamin D disease severity index immunoglobulin E body mass index eosinophil children overweight/obese

Development and Validation of Diagnostic Criteria for Elderly atopic dermatitis

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International Journal of Dermatology And Venereology 2024年第1期07卷 1-5页

作者： Wang Shang-Shang Li Zheng Gu Chao-Ying Yin Hui-Bin Wu Yue-Meng Yao Xu Li Wei Chinese Academy of Medical Sciences and Peking Union Medical College Nanjing Jiangsu 210042 Department of Dermatology Shanghai Institute of Dermatology Huashan Hospital Fudan University Shanghai 200040 China Department of Allergy and Rheumatology Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs Hospital for Skin Diseases (Institute of Dermatology)

Objective: Elderly atopic dermatitis (AD) is a newly identified subtype of AD. Whether specific diagnostic criteria are needed for elderly AD has been debated. This study aimed to propose diagnostic criteria for elderly AD and evaluate the sensitivity.Methods: A hospital-based study was conducted. We screened the clinical features of 1,312 patients with AD of different ages in 1 cohort and proposed a set of diagnostic criteria for elderly AD. The criteria were then validated in another cohort of 223 patients clinically diagnosed with elderly AD by dermatologists specialized in AD to examine the diagnostic sensitivity compared with other criteria by chi-square test.Results: Based on the patients’ clinical features, a set of diagnostic criteria for elderly AD were proposed. The new diagnostic criteria showed significantly higher sensitivity than the classical diagnostic criteria (P < 0.001), especially for mild and moderate AD (P < 0.001). Of all 223 patients with elderly AD, 93.3% fulfilled our criteria, while only 43.5%, 65.5%, and 52.0% fulfilled the Hanifin and Rajka criteria, the Japanese Dermatology Academy criteria, and the United Kingdom Working Party criteria, respectively.Conclusion: The newly proposed criteria for elderly AD yielded high diagnostic sensitivity, particularly for mild and moderate AD.

关键词： atopic dermatitis elderly diagnostic criteria sensitivity clinical features atypical

Acupoint catgut-embedding therapy ameliorates DNCB-induced atopic dermatitis in BALB/c mice by regulating Th2 type immune response and reducing infiltration of CD4^(+)and CD8^(+)cells

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Traditional Medicine Research 2024年第9期9卷 14-20页

作者： Cheng Qin Xiang-Yi Kong Fang Wang Jin Xu Zhuo Zhang Xue-Song Yang Jian-Zhou Ye College of First Clinical Medicine Yunnan University of Traditional Chinese MedicineKunming 650500China Yunnan Key Laboratory of Dai and Yi Medicines Yunnan University of Chinese MedicineKunming 650500China Yunnan Provincial Key Laboratory of Molecular Biology for Sinomedicine Yunnan University of Chinese MedicineKunming 650500China Department of Dermatology The First Affiliated Hospital of Yunnan University of Traditional Chinese MedicineKunming 650021China

Background:This study aimed to assess how acupoint catgut-embedding therapy influences Th2-type immune response and the infiltration of CD4^(+)and CD8^(+)cells in DNCB-induced atopic dermatitis in BALB/c mice.It also conducted an initial examination of the underlying molecular mechanisms.Methods:Seventy-two mice were randomly divided into four groups:normal control,DNCB-induced atopic dermatitis model(AD),AD with acupoint catgut-embedding treatment(ADA),and AD with sham-acupoint catgut-embedding treatment.After DNCB challenge to induce AD,the ADA group received acupoint catgut-embedding therapy treatment at Zusanli(ST 36)and Quchi(LI 11)acupoints every other week from day 8.Mice in the AD with sham-acupoint catgut-embedding treatment group underwent the same procedure as the ADA group but without catgut implantation.Severity was assessed using SCORAD on treatment days 1,10,and 20.On day 18,nine mice per group were euthanized,and the remaining on day 28.Histopathological changes were observed using hematoxylin-eosin and immunohistochemistry staining.TNF-α,IL-4,IL-6,and IL-13 levels were analyzed by ELISA,and GATA3 and STAT6 protein levels by western blot.Results:After 20 days of acupoint catgut-embedding therapy treatment,mice showed reduced dermatitis scores compared to DNCB-induced AD-like mice.Significant decreases occurred in serum IL-4,IL-6,IL-13,and TNF-αlevels.Skin analysis revealed marked reductions in CD4^(+)and CD8^(+)cell infiltration,as well as GATA3 and STAT6 protein levels.Conclusion:Acupoint catgut-embedding therapy may effectively alleviate atopic dermatitis by suppressing Th2 immune responses via the STAT6-GATA3 pathway and reducing CD4^(+)and CD8^(+)T cell infiltration in skin lesions.

关键词： atopic dermatitis acupoint catgut-embedding therapy Th2 type immune response

Correlation Analysis Between Children with atopic dermatitis and Asthma and Factors Affecting Intestinal Flora

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Journal of Clinical and Nursing Research 2024年第5期8卷 233-243页

作者： Wei Chen Hanyue Dong Hongmin Li Department of Dermatology Affiliated Hospital of Nanjing University of Chinese Medicine155 Hanzhong RoadNanjing 210029Jiangsu ProvinceChina

Objective:In order to reveal the potential association between intestinal flora and atopic dermatitis with asthma,the study compares the changes in intestinal flora before and after treatment with antibiotics in children and explores the risk factors for the disease development in children.The differences between asthma-controlled children and healthy children were also analyzed to investigate whether there was a correlation between the level of control and intestinal flora in asthmatic children.Methods:367 children with atopic dermatitis and asthma were selected,and the control group was healthy children who did not have other skin diseases.Fecal samples were collected from healthy children and children with asthma,and the intestinal flora was tested at Beijing Nebula Medical Testing Laboratory Co.At the same time,50 children were selected according to the inclusion and exclusion criteria to take amide antibiotics during hospitalization,and stool samples were collected before and after taking antibiotics.Results:The proportion of Gram-positive cocci increased and the proportion of Gram-positive bacilli decreased after the administration of antibiotics in children with atopic dermatitis and asthma(P0.05).The proportion of family history of atopic dermatitis with asthma was higher in the experimental group(Patopic dermatitis with asthma showed a positive correlation with changes in intestinal flora.The use of antibiotics may lead to changes in intestinal flora and increase the risk of atopic dermatitis with asthma.Antibiotic use in infancy and childhood is also recognized as a risk factor for atopic dermatitis with asthma.Therefore,the use of antibiotics should be minimized in preventing and treating atopic dermatitis with asthma.

关键词： atopic dermatitis Asthma Intestinal flora Antibiotics Influencing factors

Blue Cap Is Effective and Safe for the Treatment of atopic dermatitis in Children

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Open Journal of Pediatrics 2024年第3期14卷 609-622页

作者： Mirjana Gajić-Veljić Biljana Marenović Margita Mijušković Vesna Reljić Danica Tiodorović Danijela Popović Sanja Zorić-Blagojević Milica Vučinić David Marquez-Soriano Jovan Lalošević University of Belgrade Faculty of Medicine Department of Dermatology and Venereology University Clinical Center of Serbia Beograd Serbia University of Niš Faculty of Medicine Department of Dermatology and Venereology University Clinical Center of Ni&#353 Ni&#353 Serbia City Institute for Skin and Venereal Diseases Beograd Serbia Scientific Department Catalysis S.L. Madrid Spain

Background: atopic dermatitis (AD) is the most common inflammatory skin disease in children. Treatment of AD is based on skin barrier repair and reduction of inflammation. We analyzed the efficacy and safety of activated piroctone olamine (APO)—Blue Cap—in children with AD. Materials and Methods: An open-label interventional clinical study was carried out at three clinical centers in Serbia. A total of 58 patients with AD, aged between 3 and 18 years were included and treated with Blue Cap Foam (100 ml;CATALYSIS S.L. Madrid)—Activated Piroctone Olamine—applied twice a day in the affected areas with eczema for 30 days and final assessment at 45 days from baseline. Photographic documentation, clinical evaluation, therapy effectiveness and safety questionnaires were assessed at baseline, 15, 30 and 45 days. Results: Our results demonstrated a significant reduction in signs (erythema, scaling, infiltration, excoriations, xerosis) and symptoms (pruritus) at weeks 2 and 4 of the study. At the end of the study, most patients had moderate (28.6%) to great (62.5%) disappearance of manifestations and moderate (25%) to great (71.4%) skin quality improvement. The effect and tolerability of the therapy were evaluated as very good in 66.1 % and 67.9% and good in about 14.3% and 17.9%, assessed by the investigator and patient, respectively. Three patients experienced a burning sensation at the beginning of the study, the side-effects were resolved as the patients continued applying the foam. After two weeks of cessation of the investigated foam, a significant percentage of patients experienced worsening in the final assessment done by the investigator as well as the participant. In the final assessment, a significantly high percentage (57.1%) of patients had a total reduction of manifestation, and a significant number of participants considered the applied product as treatment success, assessed by the investigator (62.5%) as well as the participants (66.4%). Conclusions: Blue Cap is effective and safe in children with AD, altho

关键词： Pediatric Dermatology atopic dermatitis Piroctone Olamine Skin Care

Living symbiotic bacteria-involved skin dressing to combat indigenous pathogens for microbiome-based biotherapy toward atopic dermatitis

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Bioactive Materials 2023年第3期21卷 253-266页

作者： Xinhua Liu Youteng Qin Liyun Dong Ziyi Han Tianning Liu Ying Tang Yun Yu Jingjie Ye Juan Tao Xuan Zeng Jun Feng Xian-Zheng Zhang Key Laboratory of Biomedical Polymers of Ministry of Education&Department of Chemistry Wuhan UniversityWuhan430072PR China Department of Dermatology Union HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan430074PR China State Key Laboratory Breeding Base of Basic Science of Stomatology(Hubei-MOST)&Key Laboratory of Oral Biomedicine of Ministry of Education(KLOBM) School and Hospital of StomatologyWuhan UniversityWuhan430079PR China

Many skin diseases,such as atopic dermatitis(AD),are featured with the dysbiosis of skin microbiota.The clinically recommended options for AD treatments suffer from poor outcomes and high side-effects,leading to severe quality-of-life impairment.To deal with this long-term challenge,we develop a living bacterial formu-lation(Hy@Rm)that integrates skin symbiotic bacteria of Roseomonas mucosa with poly(vinyl pyrrolidone),poly(vinyl alcohol)and sodium alginate into a skin dressing by virtue of the Ca^(2+)-mediated cross-linking and the freezing-thawing(F-T)cycle method.Hy@Rm dressing creates a favorable condition to not only serve as extrinsic culture harbors but also as nutrient suppliers to support R.mucosa survival in the harsh microenvi-ronment of AD sites to defeat S.aureus,which predominantly colonizes AD skins as an indigenous pathogen,mainly through the secretion of sphingolipids metabolites by R.mucosa like a therapeutics bio-factory.Mean-while,this elaborately designed skin dressing could accelerate wound healing,normalize aberrant skin char-acters,recover skin barrier functions,alleviate AD-associated immune/inflammation responses,functioning like a combinational therapy.This study offers a promising means for the topical bacteria transplant to realize effective microbe biotherapy toward the skin diseases feature with microbe milieu disorders,including but not limited to AD disease.

关键词： atopic dermatitis Skin symbiotic bacteria Skin dressing Indigenous pathogens Microbiome-based biotherapy

The translational revolution in atopic dermatitis:the paradigm shift from pathogenesis to treatment

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Cellular & Molecular Immunology 2023年第5期20卷 448-474页

作者： Paola Facheris Jane Jeffery Ester Del Duca Emma Guttman-Yassky Laboratory of Inflammatory Skin Diseases Department of DermatologyIcahn School of Medicine at Mount SinaiNew YorkNYUSA Humanitas Clinical and Research Center Department of DermatologyRozzanoMilanoItaly Duke University School of Medicine DurhamNCUSA Department of Dermatology Icahn School of Medicine at Mount SinaiNew YorkNYUSA.

atopic dermatitis(AD)is the most common inflammatory skin disease,and it is considered a complex and heterogeneous condition.Different phenotypes of AD,defined according to the patient age at onset,race,and ethnic background;disease duration;and other disease characteristics,have been recently described,underlying the need for a personalized treatment approach.Recent advancements in understanding AD pathogenesis resulted in a real translational revolution and led to the exponential expansion of the therapeutic pipeline.The study of biomarkers in clinical studies of emerging treatments is helping clarify the role of each cytokine and immune pathway in AD and will allow addressing the unique immune fingerprints of each AD subset.Personalized medicine will be the ultimate goal of this targeted translational research.In this review,we discuss the changes in the concepts of both the pathogenesis of and treatment approach to AD,highlight the scientific rationale behind each targeted treatment and report the most recent clinical efficacy data.

关键词： atopic dermatitis translational revolution biomarkers eczema

Acupoint Autohemotherapy Attenuates atopic dermatitis Lesions by Regulating Th1/Th2 Balance in DNCB-Induced BALB/c Mice

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Chinese Journal of Integrative Medicine 2022年第7期28卷 612-619页

作者： ZENG Zhi-wen HUANG Jin-quan CHEN Yong YU Xiao ZHU Wei ZHANG Dong-shu School of Traditional Chinese Medicine Southern Medical UniversityGuangzhou 510515China Department of Traditional Chinese Medicine Affiliated Dongguan People's HospitalSouthern Medical UniversityDongguanGuangdong Province 523058China Department of Rheumatology and Immunology Shenzhen People's HospitalThe Second Clinical Medical College of Jinan UniversityShenzhenGuangdong Province 518020China School of Basic Medical Sciences Southern Medical UniversityGuangzhou 510515China Guangzhou Center for Disease Control and Prevention Guangzhou 510515China

Objective: To evaluate the therapeutic effects of acupoint autohemotherapy(A-AHT) on 1-chloro-2,4-dinitrobenzene(DNCB)-induced atopic dermatitis(AD) in mice focusing on regulating T helper 1/T helper 2(Th1/Th2) immune responses. Methods: Thirty BALB/c mice were divided into 5 groups by a random number table, including normal control(NC), AD model(AD), A-AHT, sham A-AHT(sA-AHT), and acupoint injection of normal saline(A-NS) groups, 6 mice per group. Mice were challenged by DNCB for the establishment of experimental AD model. On the 8th day, except for the NC and AD groups, the mice in the other groups received management once every other day for a total of 28 days. For the A-AHT and sA-AHT groups, 0.05 mL of autologous whole blood(AWB) was injected into bilateral Zusanli(ST 36) and Quchi(LI 11) and sham-acupoints(5 mm lateral to ST 36 and LI 11), respectively. The A-NS group was administrated with 0.05 m L of normal saline by acupoint injection into ST 36 and LI 11. dermatitis severity for dorsal skin of mice was determined using the Severity Scoring of atopic dermatitis(SCORAD) every week. The total immunoglobulin E(IgE), interleukin-4(IL-4), and interferon-gamma(IFN-γ) cytokine levels in serum were examined by enzyme-linked immunosorbent assay(ELISA). Spleen Th1/Th2 expression were analyzed via flow cytometry and immunohistochemical assay was used to detect T-box expressed in T cell(T-bet) and GATA-binding protein 3(GATA3) expressions in skin lesions of mice. Results: Compared with the AD group, both A-AHT and sA-AHT reduced the SCORAD index and serum IgE level(P<0.05 or P<0.01);A-AHT, sA-AHT and A-NS down-regulated serum IL-4 level and upregulated IFN-γ/IL-4 ratio(P<0.05 or P<0.01);A-AHT regulated the Th1/Th2 shift specifically and increased the related transcription factors such as T-bet expression and T-bet/GATA3 ratio(P<0.05). Conclusion: A-AHT showed significant effectiveness on the AD model mice, through regulating Th1/Th2 immune responses.

关键词： acupoint autohemotherapy atopic dermatitis Th1/Th2 immunoglobulin E

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Ocular manifestations of children with atopic dermatitis in Saudi Arabia

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International Journal of Ophthalmology(English edition) 2023年第5期16卷 787-793页

作者： Lina Hassan Raffa Tala Musa Roblah Nasser Talal Balbaid Bader Sameer Zimmo Mahmood Jameel Showail Department of Ophthalmology King Abdulaziz University HospitalJeddahSaudi Arabia Faculty of Medicine King Abdulaziz UniversityJeddahSaudi Arabia Department of Dermatology King Abdulaziz University HospitalJeddahSaudi Arabia

AIM:To examine the incidence of ocular abnormalities in children with atopic dermatitis(AD)in Saudi Arabia and its association with the severity of AD.METHODS:This is a cross-sectional study on 50 children with AD who were between 5 and 16 years of age.The severity of AD was evaluated using the SCORing atopic dermatitis(SCORAD)index.All the children underwent slit lamp exams,visual acuity assessment,intraocular pressure measurement,and corneal topography.The children were considered to have an ophthalmic abnormality if one or more of the following signs were present:glaucoma,keratoconus suspicion,in addition to lid,conjunctival,corneal,lenticular,or retinal abnormalities.RESULTS:Based on the SCORAD severity index,14%of children had mild AD(7/50),38%had moderate AD(19/50),and nearly half had severe AD.More than half the children exhibited facial involvement,and half had peri-orbital signs.The mean SCORAD index was 35.75.The mean age was 10.48±3.6y,and the cohort showed a slight male predominance(54%males).Both eyes of the 50 children in the cohort were studied.Based on the ocular examinations,92%of the patients showed ocular abnormalities:lid abnormalities(27/50)followed by keratitis(22/50).Four patients had moderate risk for keratoconus in one eye and eight patients were suspected to have keratoconus.However,SCORAD severity index was not associated with age,sex,or the number or presence of ophthalmic abnormalities.CONCLUSION:This is the first study in Saudi Arabia to evaluate the prevalence of ocular manifestations in children with AD.The results indicate that the majority of children with AD have ocular abnormalities that mainly include lid abnormalities.Based on these findings,larger scale studies are needed to affirm whether regular screening for ophthalmic abnormalities would be beneficial for children with AD in terms of early intervention and prevention of sight-threatening complications.

关键词： atopic dermatitis children eczema keratoconus ocular disease ophthalmic abnormalities prevalence SCORAD