Cord Blood Serum Levels of IL-31 and CCL17, Cutaneous Markers, and Development of Atopic Dermatitis

D’Erme AM, Fidanzi C, Bevilacqua M, et al. JAMA Dermatol. 2024;160(10):1112–1115. doi:10.1001/jamadermatol.2024.3178

Key Points

Question  Which are the possible cutaneous and serological markers that can be used to predict the development of atopic dermatitis (AD) in infants?

Findings  In this observational study, serum biomarkers, transepidermal water loss, and hydration rate of 40 infants were evaluated. There were statistically significant higher CCL17 and IL-31 cord blood serum levels in the infants who developed AD, and anterior cubital fossa transepidermal water loss values at 1, 6, and 12 months of age were also considerably higher in infants who developed AD.

Meaning  AD is a chronic skin disease for which some identifiable cutaneous or serological markers may be capable of predicting its development.

Abstract

Importance  Atopic dermatitis (AD) is the most prevalent chronic skin condition characterized by inflammation and itching. Currently, there is no reliable method for identifying which newborns might have an increased risk of developing AD.

FDA Perspective on the Regulation of Artificial Intelligence in Health Care and Biomedicine.

Warraich HJ, Tazbaz T, Califf RM. JAMA. 2024 Oct 15. doi: 10.1001/jama.2024.21451

Abstract

Importance  Advances in artificial intelligence (AI) must be matched by efforts to better understand and evaluate how AI performs across health care and biomedicine as well as develop appropriate regulatory frameworks. This Special Communication reviews the history of the US Food and Drug Administration’s (FDA) regulation of AI; presents potential uses of AI in medical product development, clinical research, and clinical care; and presents concepts that merit consideration as the regulatory system adapts to AI’s unique challenges.

Artificial Intelligence–Enabled Medical Devices Authorized for
Marketing by the US Food and Drug Administration, by Year

Observations  The FDA has authorized almost 1000 AI-enabled medical devices and has received hundreds of regulatory submissions for drugs that used AI in their discovery and development. Health AI regulation needs to be coordinated across all regulated industries, the US government, and with international organizations. Regulators will need to advance flexible mechanisms to keep up with the pace of change in AI across biomedicine and health care. Sponsors need to be transparent about and regulators need proficiency in evaluating the use of AI in premarket development.

The role of OX40 ligand/OX40 axis signalling in atopic dermatitis

Emma Guttman-Yassky, Michael Croft, Bob Geng et al. British Journal of Dermatology, Volume 191, Issue 4, October 2024, Pages 488–496, https://doi.org/10.1093/bjd/ljae230

Abstract

Atopic dermatitis (AD) is a heterogeneous inflammatory condition involving multiple immune pathways mediated by pathogenic T cells. OX40 ligand (OX40L) and OX40 are costimulatory immune checkpoint molecules that regulate effector and memory T-cell activity and promote sustained immune responses in multiple immunological pathways, including T helper (Th)2, Th1, Th17 and Th22. As such, OX40L/OX40 signalling between antigen-presenting cells (APCs) and activated T cells postantigen recognition promotes pathogenic T-cell proliferation and survival.

Oral immunotherapy improves the quality of life of adults with food allergy

Epstein-Rigbi, N., Levy, M.B., Nachshon, L. et al. Allergy Asthma Clin Immunol 20, 53 (2024). https://doi.org/10.1186/s13223-024-00915-6

Abstract

Background

Oral immunotherapy (OIT) has become the standard of care for children with food allergy (FA) and has substantially improved their quality of life. The effect of OIT on the quality of life in adults, however, has been studied to a much lesser degree.

Methods

Patients with food allergy aged ≥ 18 years who underwent OIT at Shamir Medical Center completed the Food Allergy Quality of Life Questionnaire-Adult Form (FAQLQ-AF) before and at the end of treatment. Adults with FA not undergoing OIT who completed the FAQLQ-AF at 2 time points, served as controls.

Results

Comparison of the delta in FAQLQ-AF scores between
the study group (n = 44) and control group (n = 11). 

A total of 44 adults, median age 23.4 years, who underwent OIT for milk (n = 19), egg (n = 2), peanut (n = 9), sesame (n = 6), and tree nuts (n = 8), and 11 controls were studied. The median OIT starting dose was 23.8 mg protein. 33 patients (75%) reached full desensitization within a median of 10.3 months. The FAQLQ-AF baseline scores were comparable between the study and control groups for all items except for Food Allergy related Health (FAH) item in which the study group had a significantly better score (p = 0.02).

Genetic contributions to epigenetic-defined endotypes of allergic phenotypes in children

Emma E. Thompson, Xiaoyuan Zhong, Peter Carbonetto et al. doi: https://doi.org/10.1101/2024.10.03.24314618 

Abstract

Background

Asthma is the most common chronic respiratory disease in children, but little is known about genetic contributions to its underlying endotypes. To address this gap, we studied the methylome, transcriptome, and genome from children with extensive phenotyping from birth.

Methods We performed DNA methylation (DNAm) studies using the Asthma&Allergy array and RNA-sequencing in nasal mucosal cells from 284 children (age 11 years) in the Urban Environment and Childhood Asthma (URECA) birth cohort with genotypes from whole-genome sequencing. Using empirical Bayes matrix factorization on all CpGs on the array, we derived 16 DNAm signatures and tested for associations between phenotypes and gene expression. We then replicated results in two additional cohorts and estimated the heritability of phenotype-associated signatures using single-nucleotide polymorphisms (SNPs) associated with an allergic disease, and with CpGs and genes associated with the signatures.

Overlap and number of CpGs and genes associated with DNAm signatures 5, 8, and 16.

Mild atopic dermatitis is characterized by increase in non-staphylococcus pathobionts and loss of specific species

Delanghe, L., De Boeck, I., Van Malderen, J. et al.  Sci Rep 14, 23659 (2024). https://doi.org/10.1038/s41598-024-74513-2

Abstract

Associations between atopic dermatitis

and skin microbiome diversity

Atopic dermatitis is the most common inflammatory skin condition with a severe negative impact on patients’ quality of life. The etiology of AD is complex and depends on age, genetics, the immune system, environmental factors, and the skin microbiome, with a key role for pathogenic Staphylococcus aureus in the development of severe AD. However, the composition of the skin microbiome in mild AD is understudied. Here, using metagenomic shallow shotgun sequencing, we showed that mild AD lesions did not show a significant difference in the diversity of the skin microbiome compared to samples from non-AD patients and that the relative abundance of S. aureus did not differ in these mild AD lesions.

Blood eosinophil count correlates with alveolar damage in emphysema-predominant COPD

Nakamura, S., Wakahara, K., Majima, S. et al. BMC Pulm Med 24, 510 (2024). https://doi.org/10.1186/s12890-024-03320-2

Abstract

Background

Although blood eosinophil count is recognized as a useful biomarker for the management of chronic obstructive pulmonary disease (COPD), the impact of eosinophils in COPD has not been fully elucidated. Here we aimed to investigate the relationships between the blood eosinophil count and various clinical parameters including lung structural changes.

Methods

Ninety-three COPD patients without concomitant asthma were prospectively enrolled in this study. Blood eosinophil count, serum IgE level, serum periostin level, and chest computed tomography (CT) scans were evaluated. Eosinophilic COPD was defined as COPD with a blood eosinophil count ≧ 300/µL. We examined the correlation between the blood eosinophil count and structural changes graded by chest CT, focusing specifically on thin airway wall (WT thin) and thick airway wall (WT thick) groups.

Bilastine Reimagined: A Comprehensive Exploration of Pruritus Management With a Novel Antihistamine

Mahajan B, Banodkar P, Bhardwaj G, et al. (October 10, 2024)  Cureus 16(10): e71232. doi:10.7759/cureus.71232

Abstract

Managing pruritic conditions is essential due to their significant impact on patients' quality of life. Chronic urticaria (CU), characterized by persistent itching and hives, severely affects daily activities and sleep. CU includes chronic inducible urticaria and chronic spontaneous urticaria, with the latter lacking identifiable triggers, making treatment especially challenging. CU is a condition that occurs across all age groups, with a higher prevalence among young adults and middle-aged women.

Clinical profile differences between various
second-generation H1 antihistamines

Current antihistamine treatments include first-generation antihistamines, which are associated with sedation, and second-generation antihistamines such as cetirizine and fexofenadine, which cause less sedation but have varying efficacy and safety profiles. Bilastine, a novel second-generation H1-antihistamine, offers advantages due to its potent antihistaminic activity, rapid onset of action, and minimal sedation.