Decreased Sudomotor Function is Involved in the Formation of Atopic Eczema in the Cubital Fossa

ORIGINAL ARTICLE doi:10.2332/allergolint.13-OA-0547 Aya Takahashi, Hiroyuki Murota, Saki Matsui, Akiko Kijima, Shun Kitaba, Jeong-Beom Lee and Ichiro Katayama [About this authors] ABSTRACT Background: Eczema in the cubital fossa, which is susceptible to sweat, is frequently observed in atopic dermatitis (AD). However, there has been no direct evidence that sweating causes eczema in the cubital fossa. Methods: To investigate this issue, axon reflex-mediated sweating volume (AXR) and skin barrier function in the cubital fossa were measured in subjects with AD and in healthy volunteers, and were applied to clinical feature of the cubital fossa. Results: AXR in the cubital fossa decreased in AD subjects; it positively correlated only with water-holding capacity in healthy subjects but not in patients with in AD. Furthermore, AD subjects with lichenoid eczema and either prurigo or papules over the cubital fossa showed extremely decreased AXR. Conclusions: These results suggest that decreased sweating is a major source of water in the stratum corneum, and decreased sudomotor function may be involved in both the cause and aggravation of representative atopic eczema in the cubital fossa. KEY WORDS: atopic dermatitis, exacerbation, homeostasis, skin barrier function, sweating Received: 15 February 2013. Accepted: 29 May 2013. Allergology International 2013; 62: 473-478 [Full Text] [Full Text PDF (393k)]

Atopic dermatitis: natural history, diagnosis, and treatment

ISRN Allergy
Volume 2014 (2014), Article ID 354250, 7 pages
http://dx.doi.org/10.1155/2014/354250

Review Article

Simon Francis Thomsen

Department of Dermatology, Bispebjerg Hospital, Bispebjerg Bakke 23, 2400 Copenhagen NV, Denmark

Received 24 February 2014; Accepted 18 March 2014; Published 2 April 2014

Academic Editors: C. Pereira and Z. Zhu

Copyright © 2014 Simon Francis Thomsen. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Atopic dermatitis is an inflammatory skin disease with early onset and with a lifetime prevalence of approximately 20%. The aetiology of atopic dermatitis is unknown, but the recent discovery of filaggrin mutations holds promise that the progression of atopic dermatitis to asthma in later childhood may be halted. Atopic dermatitis is not always easily manageable and every physician should be familiar with the fundamental aspects of treatment. This paper gives an overview of the natural history, clinical features, and treatment of atopic dermatitis.

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Regulation of the gut microbiota by the mucosal immune system in mice

1. Mizuho Hasegawa and 
2. Naohiro Inohara

+Author Affiliations

1. Department of Pathology, University of Michigan Medical School, 1150W. Medical Center Drive, Ann Arbor, MI 48109, USA

1. Correspondence to: N. Inohara; E-mail: ino@umich.edu

• Received April 7, 2014.
• Accepted April 28, 2014.

Abstract

The benefits of commensal bacteria to the health of the host have been well documented, such as providing stimulation to potentiate host immune responses, generation of useful metabolites, and direct competition with pathogens. However, the ability of the host immune system to control the microbiota remains less well understood. Recent microbiota analyses in mouse models have revealed detailed structures and diversities of microbiota at different sites of the digestive tract in mouse populations. The contradictory findings of previous studies on the role of host immune responses in overall microbiota composition are likely attributable to the high β-diversity in mouse populations as well as technical limitations of the methods to analyze microbiota. The host employs multiple systems to strictly regulate their interactions with the microbiota. A spatial segregation between the host and microbiota is achieved with the mucosal epithelium, which is further fortified with a mucus layer on the luminal side and Paneth cells that produce antimicrobial peptides. When commensal bacteria or pathogens breach the epithelial barrier and translocate to peripheral tissues, the host immune system is activated to eliminate them. Defective segregation and tissue elimination of commensals result in exaggerated inflammatory responses and possibly death of the host. In this review, we discuss the current understanding of mouse microbiota, its common features with human microbiota, the technologies utilized to analyze microbiota, and finally the challenges faced to delineate the role of host immune responses in the composition of the luminal microbiota.

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1. Int. Immunol. (2014)doi: 10.1093/intimm/dxu049First published online: May 2, 2014

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Key words

• commensal
 
• microbiota
 
• mucosal immunity

• © The Japanese Society for Immunology. 2014. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Differential serum protein markers and clinical severity of asthma

Authors Meyer N, Nuss SJ, Rothe T, Siebenhüner A, Akdis CA, Menz G

Published Date April 2014  Journal of Asthma and Allergy  Volume 2014:7 Pages 67—75

DOI http://dx.doi.org/10.2147/JAA.S53920

Received 3 September 2013, Accepted 29 October 2013, Published 25 April 2014

Norbert Meyer,^1,2 Sarah Janine Nuss,¹ Thomas Rothe,¹ Alexander Siebenhüner,¹ Cezmi A Akdis,²Günter Menz<sup>1

1</sup>Hochgebirgsklinik Davos, Davos-Wolfgang, Switzerland; ²Swiss Institute of Allergy and Asthma Research (SIAF), Davos Platz, Switzerland

Background: Asthma is a heterogeneous disease characterized by different clinical phenotypes and the involvement of multiple inflammatory pathways. During airway inflammation, many cytokines and chemokines are released and some are detectable in the sera.
Objective: Serum chemokines and cytokines, involved in airway inflammation in asthma patients, were investigated.
Methods: A total of 191 asthma patients were classified by hierarchical cluster analysis, including the following parameters: forced expiratory volume in 1 second (FEV₁), eosinophil cationic protein (ECP) serum levels, blood eosinophils, Junipers asthma symptom score, and the change in FEV₁, ECP serum levels, and blood eosinophils after 3 weeks of asthma therapy. Serum proteins were measured by multiplex analysis. Receiver operating characteristic (ROC) curves were used to evaluate the validity of serum proteins for discriminating between asthma clusters.
Results: Classification of asthma patients identified one cluster with high ECP serum levels, increased blood eosinophils, low FEV₁ values, and good FEV₁ improvement in response to asthma therapy (n=60) and one cluster with low ECP serum levels, low numbers of blood eosinophils, higher FEV₁ values, and no FEV₁ improvement in response to asthma therapy (n=131). Serum interleukin (IL)-8, eotaxin, vascular endothelial growth factor (VEGF), cutaneous T-cell-attracting chemokine (CTACK), growth-related oncogene (GRO)-α, and hepatocyte growth factor (HGF) were significantly different between the two clusters of asthma patients. ROC analysis for serum proteins calculated a sensitivity of 55.9% and specificity of 75.8% for discriminating between them.
Conclusion: Serum cytokine and chemokine levels might be predictors for the severity of asthmatic inflammation, asthma control, and response to therapy, and therefore might be useful for treatment optimization.

Keywords: asthma, cluster, phenotype, serum cytokines

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Clinical effectiveness and safety of montelukast in asthma. What are the conclusions from clinical trials and meta-analyses?

Authors Hon KLE, Leung TF, Leung AKC

Published Date  Drug Design, Development and Therapy » Volume 2014:8 Pages 839—850

DOI http://dx.doi.org/10.2147/DDDT.S39100

Received 30 January 2014, Accepted 26 March 2014, Published 26 June 2014

Kam Lun Ellis Hon,¹ Ting Fan Leung,¹ Alexander KC Leung^2
1Department of Paediatrics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong; ²Department of Pediatrics, The University of Calgary, Calgary, AB, Canada

Abstract: Asthma is a common childhood atopic disease associated with chronicity and impaired quality of life. As there is no cure for this disease, treatment relies on avoidance of triggers such as food and aeroallergens, the use of inhaled bronchodilators/corticosteroids and antiallergic or immunomodulating therapies. Inhaled corticosteroids (ICSs) and bronchodilators have been the mainstay. However, in Asia, myths and fallacies regarding Western medicine and corticosteroids are prevalent and lead to nonadherence to treatment. Also, use of traditional and proprietary herbal medicines is popular. In the past decades, a novel class of nonsteroidal immunomodulating montelukasts has become available. This article reviews the evidence for the effectiveness and clinical efficacy of these medications. A number of randomized and controlled trials have been performed over the years. The majority of studies confirm the usefulness of montelukast as monotherapy and add-on therapy to ICS in mild to moderate childhood asthma across all age groups. ICSs are generally superior to montelukasts for asthma management. However, montelukast has a place in the treatment of young children with viral-triggered wheezing diseases, exercise-induced asthma, and in children whose parents are steroid-phobic and find ICS unacceptable.

Keywords: cysteinyl leukotriene receptor antagonist, inhaled corticosteroid, randomized control trial, meta analysis

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Interleukin-17 Producing T Cells could be a Marker for Patients with Allergic Rhinitis

ORIGINAL ARTICLES

Vanya Tsvetkova-Vicheva PhD, Emiliana Konova PhD, Tcvetan Lukanov PhD, Svetla Gecheva MD, Angelika Velkova PhD Dsc and Regina Komsa-Penkova PhD

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IMAJ 2014: 16: June: 358-362

ABSTRACT

 Background: Interleukin-17A (IL-17A)-producing CD4+T helper cells have been implicated in allergic inflammation; however, the role of IL-17A in allergic rhinitis (AR) patients with different degrees of atopy and airway reactivity to methacholine (Mch) has not been examined.

Objectives: To explore IL-17A-producing CD3+CD4+T cells in peripheral blood of patients with persistent AR and assess the degree of atopy, eosinophil count (Eo count), and bronchial hyper-responsiveness (BHR) to methacholine.

Methods: The study involved 61 patients and 30 controls. The percentage of CD3+CD4+IL-17A+T cells in peripheral blood was measured by flow cytometry, bronchial challenges with Mch were performed, as was skin prick tests with standard inhalant allergens, and Eo count was measured. Atopic status was determined by the number of positive SPT results and wheal mean diameter.

Results: A statistically significant difference in Th17 cell percentage was found in the AR and control groups (2.59 ± 1.32% and 1.24 ± 0.22% respectively, P = 0.001). Forty-one patients (67.2%) were polysensitized to indoor and outdoor allergens, while 20 (32.8%) had positive skin prick tests to indoor allergens. CD4+T cellswere significantly higher in the patient group compared to the control group (2.91 ± 1.5% versus 1.91 ± 0.62%,P = 0.005), as was Eo count (4.48 ± 2.13 vs. 2.32 ± 1.83) (P = 0.0001). Forty-one in the AR group (67%) and 7 (23%) in the control group were Mch-positive (P = 0.001). The percentage of IL-17A-producing CD4+T cells was significantly higher in males compared to females (3.15 ± 1.8% versus 2.31 ± 0.9%, P = 0.02)

Conclusions: Polysensitized AR patients exhibited higher IL-17A-producing CD4+T cell levels and eosinophil counts. Male patients displayed a higher frequency of IL-17A-producing T cells. 

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Helicobacter pylori infection and skin disorders

Hong Kong Med J 2014;20:Epub 18 July 2014

DOI: 10.12809/hkmj134174

REVIEW ARTICLE

Zekayi Kutlubay, MD¹; Tuba Zara, MD¹; Burhan Engin, MD¹; Server Serdaroğlu, MD¹; Yalçın Tüzün, MD¹; Erkan Yilmaz, MD²; Bülent Eren, MD³

¹ Dermatology Department, Cerrahpasa Faculty of Medicine, Istanbul University, Cerrahpaşa, 34099 Istanbul, Turkey

² Blood Bank, Tissue Typing Laboratory, Cerrahpasa Faculty of Medicine, Istanbul University, Cerrahpaşa, 34099 Istanbul, Turkey

³ Council of Forensic Medicine of Turkey, Bursa Morgue Department, 16010, Bursa, Turkey

 

Corresponding author: Dr Bülent Eren (drbulenteren@gmail.com)

Abstract

Helicobacter pylori is a Gram-negative bacterium that has been linked to peptic ulcer disease, gastric lymphoma, and gastric carcinoma. Apart from its well-demonstrated role in gastroduodenal diseases, some authors have suggested a potential role of Helicobacter pylori infection in several extra-intestinal pathologies including haematological, cardiovascular, neurological, metabolic, autoimmune, and dermatological diseases. Some studies suggest an association betweenHelicobacter pylori infection and skin diseases such as chronic idiopathic urticaria and rosacea. There have also been few case reports documenting association between Helicobacter pylori and psoriasis vulgaris, Behçet’s disease, alopecia areata, Henoch-Schönlein purpura, and Sweet’s syndrome. However, more systematic studies are required to clarify the proposed association between Helicobacter pylori and skin diseases; most of the studies do not show relevant relationships of these diseases with Helicobacter pylori infections. This review discusses skin diseases that are believed to be associated with Helicobacter pylori.

 

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Immunomodulation by Gut Microbiota: Role of Toll-Like Receptor Expressed by T Cells

Journal of Immunology Research
Volume 2014 (2014), Article ID 586939, 8 pages
http://dx.doi.org/10.1155/2014/586939

Mariagrazia Valentini,¹ Alessia Piermattei,¹ Gabriele Di Sante,¹ Giuseppe Migliara,¹ Giovanni Delogu,² and Francesco Ria¹

¹Institute of General Pathology, Università Cattolica del Sacro Cuore, Largo F. Vito 1, 00168 Rome, Italy
²Institute of Microbiology, Università Cattolica del Sacro Cuore, Largo F. Vito 1, 00168 Rome, Italy

Received 30 April 2014; Revised 1 July 2014; Accepted 2 July 2014; Published 24 July 2014

Academic Editor: Rossella Cianci

Copyright © 2014 Mariagrazia Valentini et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

A close relationship exists between gut microbiota and immune responses. An imbalance of this relationship can determine local and systemic immune diseases. In fact the immune system plays an essential role in maintaining the homeostasis with the microbiota that normally resides in the gut, while, at the same time, the gut microbiota influences the immune system, modulating number and function of effector and regulatory T cells. To achieve this aim, mutual regulation between immune system and microbiota is achieved through several mechanisms, including the engagement of toll-like receptors (TLRs), pathogen-specific receptors expressed on numerous cell types. TLRs are able to recognize ligands from commensal or pathogen microbiota to maintain the tolerance or trigger the immune response. In this review, we summarize the latest evidences about the role of TLRs expressed in adaptive T cells, to understand how the immune system promotes intestinal homeostasis, fights invasion by pathogens, and is modulated by the intestinal microbiota.

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