Population-based cohort study to investigate the changes in prevalence, severity profile, and treatment modalities used in Korean atopic dermatitis patients

Lee, H.J., Oh, H.J., Lee, G.N. et al. Sci Rep 14, 7979 (2024). https://doi.org/10.1038/s41598-024-57777-6

Abstract

A) Change of annual prevalence of atopic dermatitis according to age group from 2002 to 2019,
(B) distribution of atopic dermatitis patients by age group in 2002 and in 2019.

In this retrospective study spanning from 2002 to 2019, we analyzed data from 355,277 Korean patients diagnosed with atopic dermatitis (AD) through the National Health Insurance System. Our objective was to comprehensively analyze the trends in prevalence, severity profiles, and treatment approaches for AD in Korea over this 18-year period. Initially, AD prevalence stood at 3.88% in 2002 but notably rose to 5.03% by 2019. During the same period, while AD prevalence decreased in the 0–1-year-old group (from 34.52% to 24.83%), it remained relatively stable in the 1–11-year-old group. Conversely, the 12–19-year-old and 20 years or older age groups witnessed substantial increases in AD prevalence, climbing from 2.55 to 6.02% and 1.44% to 3.53%, respectively.

Filaggrin loss-of-function variants are associated with atopic dermatitis phenotypes in a diverse, early life prospective cohort

Virolainen SJ, Satish L, Biagini JM et al. JCI Insight. 2024 Apr 2:e178258. doi: 10.1172/jci.insight.178258.

Abstract

Graphical Abstract

Loss-of-Function (LoF) variants in the filaggrin (FLG) gene are the strongest known genetic risk factor for atopic dermatitis (AD), but the impact of these variants on AD outcomes is poorly understood. We comprehensively identified genetic variants through targeted region sequencing of FLG in children (n = 438) participating in the Mechanisms of Progression of Atopic Dermatitis to Asthma in Children (MPAACH) cohort. Twenty FLG LoF variants were identified, including one novel variant and nine variants not previously associated with AD. FLG LoF variants were found in 13.6% of the cohort. Among these children, the presence of one or more FLG LoF variants was associated with moderate/severe AD (odds ratio (OR) = 2.00 (95% CI, 1.23-3.68) compared to those with mild AD.

Human Leukocyte Antigens and Sulfamethoxazole/Cotrimoxazole-Induced Severe Cutaneous Adverse Reactions: A Systematic Review and Meta-Analysis

Wu PC, Chen WT, Huang IH, Chen CB, Wang CW, Tai CC, Chung WH, Chi CC. JAMA Dermatol. 2024 Apr 3. doi: 10.1001/jamadermatol.2024.0210. 

Key Points

Question  Is there an association between human leukocyte antigen (HLA) and sulfamethoxazole (SMX)/cotrimoxazole (CTX)–induced severe cutaneous adverse reactions (SCARs)?

Findings  In this systematic review and meta-analysis of 6 studies involving 322 patients with SCARs, significant associations were identified between the HLA-A*11:01, HLA-B*13:01, HLA-B*15:02, HLA-B*38:02, and HLA-C*08:01 genotypes and SMX/CTX-induced SCARs. The HLA-B*15:02 and HLA-B*38:02 genotypes were significantly associated with SMX/CTX-induced Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN), while the HLA-A*68:01 and HLA-B*39:01 genotypes were associated with SMX/CTX-induced drug reaction with eosinophilia and systemic symptoms; the HLA-B*13:01 allele showed an association with SMX/CTX-induced SJS/TEN and drug reaction with eosinophilia and systemic symptoms.

Meaning  The results of this review suggest that multiple HLA alleles were associated with SMX/CTX-induced SCARs.

Abstract

Importance  Sulfamethoxazole (SMX) and cotrimoxazole (CTX), a fixed-dose combination of SMX and trimethoprim in a 5:1 ratio, are antibacterial sulfonamides commonly used for treating various diseases.

Baseline Severity and Disease Duration Can Predict the Response to Allergen-specific Immunotherapy in Allergic Rhinitis

 Li Y, Xiao H, Zeng Y, Tang Y, Zhou L, Liu W. Iran J Allergy Asthma Immunol. 2024 Feb 11;23(1):52-58. doi: 10.18502/ijaai.v23i1.14953.

Abstract

Allergen-specific immunotherapy (AIT) has confirmed its efficacy in improving the symptoms of allergic rhinitis. However, no reliable biomarkers have been identified to predict the efficacy of AIT were found. We aimed to find clinical and immunological markers to predict efficacy in children after 2 years of sublingual immunotherapy (SLIT). A total of 285 children diagnosed with allergic rhinitis were recruited. 

The clinical efficacy was evaluated by comparing endpoint and baseline symptom and medication scores (SMS). Baseline clinical and immunological markers (serum total and specific immunoglobulin [Ig]E) and their correlation with clinical efficacy were analyzed.

Cytokines in Allergic Conjunctivitis: Unraveling Their Pathophysiological Roles

Chigbu, D.I.; Karbach, N.J.; Abu, S.L.; Hehar, N.K. Life 2024, 14, 350. https://doi.org/10.3390/life14030350

Abstract

Allergic conjunctivitis is one of the common immune hypersensitivity disorders that affect the ocular system. The clinical manifestations of this condition exhibit variability contingent upon environmental factors, seasonal dynamics, and genetic predisposition. While our comprehension of the pathophysiological engagement of immune and nonimmune cells in the conjunctiva has progressed, the same cannot be asserted for the cytokines mediating this inflammatory cascade. In this review, we proffer a comprehensive description of interleukins 4 (IL-4), IL-5, IL-6, IL-9, IL-13, IL-25, IL-31, and IL-33, as well as thymic stromal lymphopoietin (TSLP), elucidating their pathophysiological roles in mediating the allergic immune responses on the ocular surface.

Full-dose challenge of moderate, severe, and unknown beta-lactam allergies in the emergency department

Anderson AM, Coallier S, Mitchell RE et al. Acad Emerg Med. 2024 Mar 21. doi: 10.1111/acem.14893.

Abstract

Objective

This study aims to assess the outcome of challenging documented moderate, severe, or unknown beta-lactam allergies with full dose administration of a beta-lactam antibiotic in emergency department (ED) patients admitted for acute bacterial infection.

Methods

A single-center, retrospective, descriptive study of adult patients challenged with a full dose of beta-lactam in the ED from January 2021 to December 2022 was conducted. Included patients had at least one documented moderate, severe, or unknown beta-lactam allergy in the electronic medical record (EMR) without documentation of prior tolerance. Patient demographics, prior beta-lactam antibiotic reaction, beta-lactam administered in the ED, inpatient beta-lactam continuation, adverse drug reactions, and updates to allergy profiles were collected. Descriptive statistics for data analysis were performed using SPSS Version 22.

Dupilumab-associated head and neck dermatitis shows a pronounced type 22 immune signature mediated by oligoclonally expanded T cells

 Bangert, C., Alkon, N., Chennareddy, S. et al.  Nat Commun 15, 2839 (2024). https://doi.org/10.1038/s41467-024-46540-0

Abstract

Dupilumab, an IL4R-blocking antibody, has shown clinical efficacy for atopic dermatitis (AD) treatment. In addition to conjunctivitis/blepharitis, the de novo appearance of head/neck dermatitis is now recognized as a distinct side effect, occurring in up to 10% of patients. Histopathological features distinct from AD suggest a drug effect, but exact underlying mechanisms remain unknown. We profiled punch biopsies from dupilumab-associated head and neck dermatitis (DAHND) by using single-cell RNA sequencing and compared data with untreated AD and healthy control skin.

Hereditary or acquired? Comprehensive genetic testing assists in stratifying angioedema patients

Rozevska M, Kanepa A, Purina S, Gailite L, Nartisa I, Farkas H, Rots D, Kurjane N. Allergy Asthma Clin Immunol. 2024 Mar 30;20(1):28. doi: 10.1186/s13223-024-00889-5.

Abstract

Retention of the last SERPING1 intron present due to the NM_000062.2:c.1249 + 
4 A > G r.spl variant found in patient no. 9 using transcriptome sequencing.

Hereditary angioedema (HAE) poses diagnostic challenges due to its episodic, non-specific symptoms and overlapping conditions. This study focuses on the genetic basis of HAE, particularly focusing on unresolved cases and those with normal C1-inhibitor levels (nC1-INH HAE). This study reveals that conventional testing identified pathogenic variants in only 10 patients (n = 32), emphasizing the necessity for an integrative approach using genome, exome, and transcriptome sequencing. Despite extensive genetic analyses, the diagnostic yield for nC1-INH HAE remains low in our study, the pathogenic variant for nC1-INH HAE was identified in only 1 patient (n = 21). Investigation into candidate genes yielded no pathogenic variants, prompting a re-evaluation of patients’ diagnoses.