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Novel Sodium Hypochlorite Cleanser Shows Clinical Response and Excellent Acceptability in the Treatment of Atopic Dermatitis

1. Caitriona Ryan M.D.^1,*, 
2. Richard E. Shaw M.A., Ph.D.², 
3. Clay J. Cockerell M.D.^1,3,4,
4. Shari Hand B.A.⁴, 
5. Fred E. Ghali M.D.^1,3,4

Article first published online: 26 APR 2013

DOI: 10.1111/pde.12150

© 2013 Wiley Periodicals, Inc.

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Pediatric Dermatology

Volume 30, Issue 3, pages 308–315, May/June 2013

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Abstract

The intermittent use of dilute sodium hypochlorite “bleach baths” has shown efficacy as adjunctive therapy for atopic dermatitis (AD). This feasibility study evaluated the clinical response and patient acceptability of treatment with a cleansing body wash containing sodium hypochlorite in children with AD. This was a 12-week open-label feasibility study of 18 children with AD conducted in a pediatric dermatology outpatient clinic between May 2011 and July 2012. Children with moderate to severe AD, defined as an Investigator Global Assessment (IGA) score of at least 3 on a 5-point scale, who were age 6 months and older and had lesional cultures positive forStaphylococcus aureus at baseline were included. Patients were instructed to wash 3 days/week for 12 weeks with the sodium hypochlorite–containing cleansing body wash. During the study period, patient's individualized topical and systemic treatment regimens were continued. Clinical response to treatment was measured using an IGA score and the percentage of body surface area (BSA) affected. Parents were also administered a retrospective questionnaire evaluating acceptability of the product. There was a statistically significant reduction in IGA score at all time points, with an overall mean reduction from baseline to final measurement using the last observation carried forward in all patients of 1.0 (p = 0.001, n = 18). Similarly the mean reduction of BSA affected was 14.8% (p = 0.005, n = 18). Parents reported that the body wash was significantly easier to use than traditional bleach baths (p < 0.001). The significant reductions in clinical disease severity scores with use of this formulation are encouraging.

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Current Opinion in Immunology takes you on a journey through key topics in immunology over the last 25 years.

25 Year Anniversary Virtual Special Issue

From danger signals, alarmins and killer cells to tolerance, signaling and infection resistance, this Virtual Special Issue ofCurrent Opinion in Immunology takes you on a journey through key topics in immunology over the last 25 years.

This Virtual Special Issue features the top cited article* from each of the journal’s 24 complete volumes.

Read the articles in this 25 year anniversary Virtual Special Issue for free until the end of 2013, and join us on a journey through immunology.

Volume 1
Mononuclear phagocytes: tissue distribution and functional heterogeneity
S. Gordon, S. Keshav, L.P. Chung
Volume 1, Issue 1, September–October 1988, Pages 26–35

Volume 2
The neutrophil
C. Haslett, J.S. Savill, L. Meagher
Volume 2, Issue 1, October 1989, Pages 10–18

Volume 3
Role of nitric oxide synthesis in macrophage antimicrobial activity
Carl F. Nathan, John B. Hibbs Jr
Volume 3, Issue 1, 1991, Pages 65–70

Volume 4
Interleukin-10
René de Waal Malefyt, Yssel Hans, Maria-Grazia Roncarolo, Hergen Spits, Jan E. de Vries
Volume 4, Issue 3, June 1992, Pages 314–320

Volume 5
The role of natural killer cells in innate resistance to infection
Gregory J. Bancroft
Volume 5, Issue 4, August 1993, Pages 503–510

Volume 6
Chemokines, leukocyte trafficking, and inflammation
Thomas J. Schall, Kevin B. Bacon
Volume 6, Issue 6, December 1994, Pages 865–873

Volume 7
Transcriptional regulation of the IL-2 gene
Jugnu Jain, Christine Loh, Anjana Rao
Volume 7, Issue 3, 1995, Pages 333–342

Volume 8
Mitogen-activated protein kinase cascades and regulation of gene expression
Bing Su, Michael Karin
Volume 8, Issue 3, June 1996, Pages 402–411

Volume 9
Origin, maturation and antigen presenting function of dendritic cells
Marina Cella, Federica Sallusto, Antonio Lanzavecchia
Volume 9, Issue 1, February 1997, Pages 10–16

Volume 10
Role of the prophenoloxidase-activating system in invertebrate immunity
Kenneth Söderhäll, Lage Cerenius
Volume 10, Issue 1, February 1998, Pages 23–28

Volume 11
The Toll-receptor family and control of innate immunity
Elizabeth B Kopp, Ruslan Medzhitov
Volume 11, Issue 1, 1 February 1999, Pages 13–18

Volume 12
Chemokines in tissue-specific and microenvironment-specific lymphocyte homing
James J Campbell, Eugene C Butcher
Volume 12, Issue 3, 1 June 2000, Pages 336–341

Volume 13
Danger signals: SOS to the immune system
Stefania Gallucci, Polly Matzinger
Volume 13, Issue 1, 1 February 2001, Pages 114–119

Volume 14
Toll-like receptors: key mediators of microbe detection
David M Underhill, Adrian Ozinsky
Volume 14, Issue 1, 1 February 2002, Pages 103–110

Volume 15
The use of dendritic cells in cancer immunotherapy
Gerold Schuler, Beatrice Schuler-Thurner, Ralph M Steinman
Volume 15, Issue 2, April 2003, Pages 138–147

Volume 16
NADPH oxidase
Bernard M Babior
Volume 16, Issue 1, 1 February 2004, Pages 42–47

Volume 17
Alarmins: chemotactic activators of immune responses
Joost J Oppenheim, De Yang
Volume 17, Issue 4, August 2005, Pages 359–365

Volume 18
How Toll-like receptors signal: what we know and what we don’t know
Luke AJ O’Neill
Volume 18, Issue 1, February 2006, Pages 3–9

Volume 19
Differentiation and function of Th17 T cells
Brigitta Stockinger, Marc Veldhoen
Volume 19, Issue 3, June 2007, Pages 281–286

Volume 20
MDA5/RIG-I and virus recognition
Osamu Takeuchi, Shizuo Akira
Volume 20, Issue 1, February 2008, Pages 17–22

Volume 21
Adoptive cell therapy for the treatment of patients with metastatic melanoma
Steven A Rosenberg, Mark E Dudley
Volume 21, Issue 2, April 2009, Pages 233–240

Volume 22
Macrophages, innate immunity and cancer: balance, tolerance, and diversity
Alberto Mantovani, Antonio Sica
Volume 22, Issue 2, April 2010, Pages 231–237

Volume 23
Innate immune DNA sensing pathways: STING, AIMII and the regulation of interferon production and inflammatory responses
Glen N Barber
Volume 23, Issue 1, February 2011, Pages 10–20

Volume 24
Autophagy as an innate immunity paradigm: expanding the scope and repertoire of pattern recognition receptors
Vojo Deretic
Volume 24, Issue 1, February 2012, Pages 21–31

*Top cited articles were selected based on data in Scopus, with citation records from 1996 to 2013

Prevalence of Asthma and Severity of Allergic Rhinitis Comparing 2 Perennial Allergens: House Dust Mites and Parietaria judaica Pollen

Original Article

Prevalence of Asthma and Severity of Allergic Rhinitis Comparing 2 Perennial Allergens: House Dust Mites and Parietaria judaica Pollen

A Sala-Cunill,1,2 J Bartra,3 G Dalmau,4 R Tella,5 E Botey,6 E Raga,7 A Valero,3 on behalf of *#

1Allergy Section, Internal Medicine Department, Hospital Universitari Vall d´Hebron, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain 2Allergy Research Unit, Allergy Department, Institut de Recerca Vall d’Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain 3Allergy Unit, Pneumology and Allergy Department, Hospital Clinic-IDIBAPS, Barcelona, Catalonia, Spain 4Allergy Unit, Hospital Universitari Joan XIII Tarragona, Catalonia, Spain 5Allergy Unit, Hospital Universitari Josep Trueta, Girona, Catalonia, Spain 6Allergy Unit, Hospital Universitari Dexeus, Barcelona, Catalonia, Spain 7Allergy Unit, Hospital Plató, Barcelona, Catalonia, Spain *Comitè d’Al.lergia Respiratòria de Catalunya, Spain. O Asensio de la Cruz, JL Eseverri Asín, E Güell Figueras, R Muñoz, A Puiggròs Casas, A Roger Reig, MM San Miguel Moncín, A Torredemer Palau #Researchers in alphabetic order: E Alcoceba, P Amat, M Baltasar, M Basagaña, V Cardona, M Cerdà, L Ferré, V Gàzquez, V Gonzalez, R Guspí, S Lara, M Lluch, Ll Marquès, N Rubira, M Rueda, R Serra, J Simón

J Investig Allergol Clin Immunol 2013; Vol. 23(3): 145-151

Abstract Background: Allergic rhinitis (AR) is an increasingly prevalent worldwide disease that has a considerable impact on quality of life and health care costs. Asthma and AR may be part of the same disease, with AR leading to an increased risk of asthma. Objectives: To assess the prevalence of asthma in patients with AR due to house dust mites (HDMs) or Parietaria judaica and analyze the characteristics of asthma and AR in each group. Methods: Cross-sectional, multicenter study with recording of demographic and clinical characteristics. All patients had AR confirmed by symptoms and a positive skin prick test to HDMs or P judaica. They were classified according to the severity and frequency of AR following the Allergic Rhinitis and its Impact on Asthma (ARIA) and modified ARIA criteria and according to the severity of asthma following the Global Initiative for Asthma criteria. Results: We studied 395 patients (226 in the HDM group and 169 in the P judaica group) with a mean (SD) age of 43 (15.3) years. Using the modified ARIA criteria, we detected more severe and persistent AR in the P judaica group than in the HDM group (44.5% vs 24.8%, P<.001). Nevertheless, there were no statistically significant differences between the groups in terms of the severity or prevalence (50% in HDM vs 47.9% in P judaica,P=.685) of asthma. Conclusion: AR due to P judaica pollen, which behaves like a perennial allergen, is associated with the same prevalence of asthma and with more severe rhinitis than AR due to HDMs. Key words: Rhinitis. Parietaria. House dust mite. Asthma. ARIA. GINA. Allergy. Pollen. Monosensitized.   Free Full-Text (PDF)   How to use PDF documents

Treatment of Recalcitrant Chronic Urticaria With Nonsedating Antihistamines: Is There Evidence for Updosing?

Treatment of Recalcitrant Chronic Urticaria With Nonsedating Antihistamines: Is There Evidence for Updosing?

M Sánchez-Borges, F Caballero-Fonseca, A Capriles-Hulett

Allergy and Clinical Immunology Department, Centro Medico-Docente La Trinidad, Caracas, Venezuela

J Investig Allergol Clin Immunol 2013; Vol. 23(3): 141-144

Abstract Nonsedating antihistamines are the first-choice treatment for all forms of urticaria. In patients with recalcitrant urticaria who do not respond to conventional doses of antihistamines, current guidelines recommend increasing doses by up to 4 times in order to obtain better control of the disease. Although few studies have been conducted, there are convincing data from controlled trials for cetirizine, levocetirizine, and desloratadine that support the use of increased doses of such drugs in unresponsive patients. The use of higher doses of antihistamines has not been associated with increased adverse effects or somnolence. More studies with other second-generation antihistamines are required in order to improve the treatment of patients with severe, recalcitrant urticaria. Key words: Antihistamines. Cetirizine. Desloratadine. Fexofenadine. Levocetirizine. Rupatadine. Urticaria.   Free Full-Text (PDF) Continual Medical Education   How to use PDF documents

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The natural history of cow’s milk allergy in north-eastern Poland

M Kaczmarski¹ / J Wasilewska¹ / B Cudowska¹ / J Semeniuk¹ / M Klukowski¹ / E Matuszewska¹

¹Department of Pediatrics, Gastroenterology and Allergology, Medical University of Bialystok, Bialystok, Poland

Citation Information: Advances in Medical Sciences. Volume 0, Issue 0, Pages 1–9, ISSN (Online) 1898-4002, ISSN (Print) 1896-1126,DOI: 10.2478/v10039-012-0053-3, April 2013

Publication History:

Published Online:

2013-04-20

Abstract

Purpose: The rate of cow’s milk allergy diminishes with age. There is not enough information concerning geographical trends in persistent cow’s milk allergy in children. The objective of the study was to evaluate the prevalence of persistent cow’s milk allergy in children previously diagnosed with IgE-mediated cow’s milk allergy (CMA).

Material/Methods: Diagnosis of cow’s milk allergy was established by a medical history of symptoms associated with exposure to cow’s milk, positive skin prick tests with cow’s milk, the presence of milk-specific IgE, and by a positive double- or single-blind placebo-controlled food challenge with milk confirmed by a positive open-controlled milk challenge. A second oral challenge was performed after at least one year of a milk-free diet and children with a positive oral milk rechallenge were diagnosed as having a persistent CMA.

Results: Two hundred ninety-one children, 2-14 years of age (mean 5.30±3.16 years, 95% CI, 5.02-5.62 years) completed the study. Persistent CMA was diagnosed in 79 patients (27.1%). Two hundred twelve children (72.9%) outgrew their allergy to cow’s milk at a mean age of 5 years after an average time of 16.4±0.8 months on an elimination diet. Eighty percent of children below 3 years of age became milk tolerant. Milk-specific IgE (p=0.018) and history of paternal bronchial asthma and/or rhinitis (p=0.020) were associated with persistence of cow’s milk allergy in regression analysis.

Conclusions: An age above 3 years, as well as features of atopy, individual and familial, may be associated with a risk of delayed tolerance to milk in children.

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Anti-Inflammatory Dimethylfumarate: A Potential New Therapy for Asthma?

Mediators of Inflammation
Volume 2013 (2013), Article ID 875403, 10 pages
http://dx.doi.org/10.1155/2013/875403

Review Article

Anti-Inflammatory Dimethylfumarate: A Potential New Therapy for Asthma?

Petra Seidel¹ and Michael Roth^1,2

¹Pulmonary Cell Research, Department of Biomedicine, University of Basel, Hebelstraße 20, 4031 Basel, Switzerland
²Pneumology, Department of Internal Medicine, University Hospital Basel, Petersgraben 4, 4031 Basel, Switzerland

Received 11 December 2012; Revised 7 February 2013; Accepted 7 February 2013

Academic Editor: Gustavo Duarte Pimentel

Copyright © 2013 Petra Seidel and Michael Roth. This is an open access article distributed under theCreative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Asthma is a chronic inflammatory disease of the airways, which results from the deregulated interaction of inflammatory cells and tissue forming cells. Beside the derangement of the epithelial cell layer, the most prominent tissue pathology of the asthmatic lung is the hypertrophy and hyperplasia of the airway smooth muscle cell (ASMC) bundles, which actively contributes to airway inflammation and remodeling. ASMCs of asthma patients secrete proinflammatory chemokines CXCL10, CCL11, and RANTES which attract immune cells into the airways and may thereby initiate inflammation. None of the available asthma drugs cures the disease—only symptoms are controlled. Dimethylfumarate (DMF) is used as an anti-inflammatory drug in psoriasis and showed promising results in phase III clinical studies in multiple sclerosis patients. In regard to asthma therapy, DMF has been anecdotally reported to reduce asthma symptoms in patients with psoriasis and asthma. Here we discuss the potential use of DMF as a novel therapy in asthma on the basis of in vitro studies of its inhibitory effect on ASMC proliferation and cytokine secretion in ASMCs.

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Epigenetic changes associated with disease progression in a model of childhood allergic asthma

• Research Article

First posted online April 23, 2013, doi: 10.1242/dmm.011247Dis. Model. Mech. April 23, 2013, doi: 10.1242/dmm.011247

Epigenetic changes associated with disease 

progression in a model of childhood allergic asthma

1. Adam Collison1, 
2. Jessica S. Siegle2, 
3. Nicole G. Hansbro1,
4. Chau-To Kwok2, 
5. Cristan Herbert2, 
6. Joerg Mattes1, 
7. Megan Hitchins2,
8. Paul S. Foster1 and 
9. Rakesh K. Kumar2,*

+Author Affiliations

1. ¹ University of Newcastle and Hunter Medical Research Institute, Newcastle, Australia;
2. ² University of New South Wales, Sydney, Australia

1. ↵*Author for correspondence (r.kumar@unsw.edu.au)

Summary

Development of asthma in childhood is linked to viral infections of the lower respiratory tract in early life, with subsequent chronic exposure to allergens. Progression to persistent asthma is associated with a Th2-biased immunological response and structural remodelling of the airways. The underlying mechanisms are unclear, but may involve epigenetic changes. To investigate this, we employed a novel mouse model in which self-limited neonatal infection with a pneumovirus, followed by sensitisation to ovalbumin via the respiratory tract and low-level chronic challenge with aerosolised antigen, leads to development of an asthmatic phenotype. We assessed expression of microRNA by cells in the proximal airways, comparing changes over the period of disease progression, and used target prediction databases to identify genes likely to be up- or down-regulated as a consequence of altered regulation of microRNA. In parallel, we assessed DNA methylation in pulmonary CD4+ T cells. We found that a limited number of microRNA exhibited marked up- or down-regulation following early-life infection and sensitisation, for many of which the levels of expression were further changed following chronic challenge with the sensitizing antigen. Targets of these microRNA included genes involved in immune/inflammatory responses (e.g. Gata3, Kitl) and in tissue remodelling (e.g. Igf1, Tgfbr1), as well as genes for various transcription factors and signalling proteins. In pulmonary CD4+ T cells, there was significant demethylation at promoter sites for interleukin-4 and interferon-γ, the latter increasing following chronic challenge. We conclude that in this model, progression to an asthmatic phenotype is linked to epigenetic regulation of genes associated with inflammation and structural remodelling, and with T cell commitment to a Th2 immunological response. Epigenetic changes associated with this pattern of gene activation may play a role in the development of childhood asthma.

Research Article:

• Adam Collison, 
• Jessica S. Siegle, 
• Nicole G. Hansbro, 
• Chau-To Kwok,
• Cristan Herbert, 
• Joerg Mattes, 
• Megan Hitchins, 
• Paul S. Foster,
• and Rakesh K. Kumar

Epigenetic changes associated with disease progression in a model of childhood allergic asthmaDis. Model. Mech. 2013 dmm.011247; First posted online April 23, 2013,doi:10.1242/dmm.011247

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• Received November 2, 2012.
• Accepted April 16, 2013.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial Share Alike License (http://creativecommons.org/licenses/by-nc-sa/3.0), which permits unrestricted non-commercial use, distribution and reproduction in any medium provided that the original work is properly cited and all further distributions of the work or adaptation are subject to the same Creative Commons License terms.

Interleukin 13 and the evolution of asthma therapy

Am J Clin Exp Immunol 2012;1(1):20-27.Review ArticleInterleukin 13 and the evolution of asthma therapyGabriele Grünig, David B. Corry, Joan Reibman, Marsha Wills-Karp

Departments of Environmental Medicine and Medicine, NYU Langone Medical Center, Tuxedo, NY 10987, USA; Departments of Medicine and Pathology and Immunology, the Michael E. DeBakey VA Medical Center, and the Biology of Inflammation Center, Baylor College of Medicine, Houston, TX 77030, USA; Department of Medicine, NYU Langone Medical Center, New York, NY 10016, USA; Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Medicine, Baltimore, MD 21218, USA.

Received January 23, 2012; accepted March 5, 2012; Epub April 23, 2012; Published June 30, 2012

Abstract: This is a concise review on Interleukin (IL)-13 and the evolution of asthma therapy, from discovery of the molecule, the identification of its pathogenic role in animal models of asthma, to the development of clinically successful neutralizing agents.   The translational path from basic research to clinical application was not sequential as expected but random with respect to the tools (molecular; cell biology, animal models, human studies) used and to the application of academic versus industry research.   The experiences with the development of neutralizing anti-IL-13 reagents emphasize the need for inclusion of a biomarker assay in the clinical trials that both identifies individuals that actually have aberrant expression of the pathway of interest and allows determining whether the target of interest is neutralized. (AJCEI1201001).

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