BACKGROUND Atopic dermatitis(AD),or eczema,is a chronic,pruritic inflammatory skin disease affecting children and adults.Socioeconomic status(SES)plays a significant role in developing AD.However,mixed evidence from a...BACKGROUND Atopic dermatitis(AD),or eczema,is a chronic,pruritic inflammatory skin disease affecting children and adults.Socioeconomic status(SES)plays a significant role in developing AD.However,mixed evidence from a previous study by Bajwa et al makes it difficult to determine the directionality of the association.There is a lite-rature gap in understanding the causal association between AD and socioeco-nomic factors.AIM To evaluate the impact of disparities in SES on pediatric AD populations.METHODS Based on the eligibility criteria,the literature review identified eight articles since July 2021,and a descriptive analysis was conducted using an Excel spreadsheet on key components collected from the identified studies.RESULTS Eight observational studies assessed SES in pediatric AD.Five observational studies showed mixed associations between AD and SES.Sub-analysis revealed that urban areas had a higher prevalence of AD,and four studies identified a positive association between parental education and AD in the pediatric popu-lation.Socioeconomic variables,such as residential areas and household income,significantly influence disease outcomes.CONCLUSION There is mixed association between pediatric AD and SES,with AD positively associated with parental education.There is critical need to evaluate global impact of SES variables on pediatric AD.展开更多
BACKGROUND Since the advent of the 20th century,alongside the progression of medical science and technological advancements,immunotherapy has emerged as a pivotal thera-peutic approach for tumor patients subsequent to...BACKGROUND Since the advent of the 20th century,alongside the progression of medical science and technological advancements,immunotherapy has emerged as a pivotal thera-peutic approach for tumor patients subsequent to undergoing radiotherapy and chemotherapy.Arimab(camrelizumab),a flagship drug in the realm of immuno-therapy,functions as a monoclonal antibody specifically targeting the progra-mmed death protein 1(PD-1).This drug engages with the human PD-1 receptor,effectively inhibiting the PD-1/programmed death ligand 1 signaling pathway.This inhibition results in the restoration of T cell activity and the induction of an anti-tumour response.However,it is noteworthy that such interference could lead to immune-related adverse events resembling autoimmune reactions.The grow-ing availability and clinical use of immune checkpoint inhibitors have raised sig-nificant clinical concerns regarding their safety.Numerous instances of immune-related adverse reactions and the associated management strategies have been extensively reported.Timely identification and diagnosis,coupled with multidi-sciplinary consultation and the prompt administration of immunosuppressants,can effectively address severe immune-related adverse reactions.CASE SUMMARY Arimab(camrelizumab),a monoclonal antibody targeting programmed death protein 1(PD-1),disrupts the PD-1/programmed death ligand 1(PD-L1)inter-action,reactivating T cell function and triggering anti-tumor immunity.However,this disruption may trigger immune-mediated adverse events akin to autoim-mune disorders.Approximately 2.8%of such events manifest as immune-related dermatologic reactions,with 0.7%classified as grade 3,which are infrequently documented.Here,this study describes a case of grade 3 bullous dermatitis occur-ring 15 days after initiating camrelizumab therapy.The patient,a 67-year-old male with oesophageal squamous cell carcinoma,received camrelizumab plus paclitaxel alongside chemotherapy and radiotherapy in early 2022.Due to disease progression,maintenance monotherapy with camrelizumab(200 mg)commenced in June 2022.On the fourth cycle,15 days into treatment,the patient presented with an immune-checkpoint inhibitor-related rash,despite unremarkable test results.Dermatology and pharmacy consultations were conducted,leading to glucocorticoid therapy,topical interventions,and supportive care.Gastric mucosal protection,nutritional supplementation,and other adjunctive treatments were also provided.The patient's symptoms resolved within 15 days post-discharge,resulting in discontinuation of camrelizumab.Like other PD-1 inhibitors,camrelizumab is associated with immune-mediated dermatitis.Thus,optimal management of these events requires a multidisciplinary approach,vigilant monitoring,regular evalua-tions,prompt glucocorticoid administration,and specialized dermatologic care.CONCLUSION The increasing adoption of immune checkpoint inhibitors in clinical practice has prompted substantial concerns about their safety profile.A wide range of immune-related adverse events and corresponding management stra-tegies have been well-documented.Early recognition and accurate diagnosis,combined with interdisciplinary collaboration and swift initiation of immunosuppressive therapy,are essential in managing severe immune-related adverse reactions effectively.This report details the treatment trajectory and outcome of a case involving immune-related cutaneous adverse reactions,providing pertinent clinical insights for future cases.展开更多
Objective:This study aimed to investigate the association of atopic dermatitis(AD)and anxiety/depression behaviors induced by AD with the intestinal microbiota.Additionally,it sought to evaluate the therapeutic potent...Objective:This study aimed to investigate the association of atopic dermatitis(AD)and anxiety/depression behaviors induced by AD with the intestinal microbiota.Additionally,it sought to evaluate the therapeutic potential of mannan oligosaccharide(MOS)in alleviating AD symptoms through the modulation of the gut microbiota and the enhancement of short-chain fatty acids(SCFAs)production.Methods:Female Kunming mice were challenged with 2,4-dinitrofluorobenzene(DNFB)to induce AD-like symptoms.MOS was administered orally daily for 14 days.On the 6th and 11th days post-modeling,the number of scratching bouts in mice was recorded.Following dissection,epidermal thickness,mast cell infiltration,and serum levels of inflammatory cytokines were measured.Meanwhile,cerebral levels of neurotransmitters,including 5-hydroxytryptamine(5-HT)and norepinephrine(NE),were assessed.The abundance of intestinal microbiota and fecal concentrations of SCFAs were also analyzed.Results:MOS significantly reduced AD-like symptoms by reducing inflammatory cytokines,as reflected in a significant decrease in the number of scratching bouts,epidermal thickness,mast cells and inflammatory cytokine levels.MOS intervention up-regulated the expression of 5-HT and NE,and consequently alleviated anxiety and depression-like behaviors.Furthermore,compared with the AD group,MOS intervention increased the gut microbiota abundance of mice,especially beneficial bacteria such as Bifidobacterium,Lactobacillus and Klebsiella.At the same time,these beneficial bacteria significantly increased the fecal contents of SCFAs,especially propionic acid.Correlation analysis indicated that AD amelioration was positively correlated with fecal SCFAs levels and the proliferation of certain intestinal microbes.Conclusion:MOS intervention could offer a novel approach to managing AD and its psychological comorbidities.展开更多
Objectives To investigate the barriers and facilitators influencing the sustainable implementation of evidence-based practice(EBP)for Peristomal Irritant Contact Dermatitis(PICD)based on the Consolidated Framework for...Objectives To investigate the barriers and facilitators influencing the sustainable implementation of evidence-based practice(EBP)for Peristomal Irritant Contact Dermatitis(PICD)based on the Consolidated Framework for Implementation Research(CFIR).Methods The sample consisted of 17 nurses from three urology wards at a tertiary hospital in Beijing,China,who had participated in the EBP.Guided by the CFIR,we identified constructs influencing the sustainability of implementation by conducting a directed content analysis of the 17 individual in-depth interviews.By rating,the valence and magnitude of each construct were determined.Results This study identified 19 factors across the five domains of the CFIR.Among these determinants,16 were identified as barriers,while three were recognized as facilitators.Common barriers across different contexts were identified,such as delayed evidence updating,the complexity of intervention components and steps,and incompatibility between the implementation process and clinical practices.In contrast,facilitators of intervention implementation were regular communication and feedback,support and drive from principals and a positive cultural atmosphere.In addition,we identified“regular evidence updating”as an independent construct outside of the CFIR,a finding that will provide key information for updating the CFIR framework.Conclusions Regular evidence updating is crucial for the sustainability of EBP implementation.Researchers should receive consistent feedback from practitioners and adjust or modify the EBP as necessary.Additionally,researchers must consider the compatibility or adaptability of the EBP’s content with clinical practice in formulating it rather than adding additional complexity to the original workflow.展开更多
BACKGROUND Atopic dermatitis(AD)is a chronic inflammatory skin disease characterized by visible lesions that can lead to anxiety and depression.These psychological impacts may severely affect the physical and mental h...BACKGROUND Atopic dermatitis(AD)is a chronic inflammatory skin disease characterized by visible lesions that can lead to anxiety and depression.These psychological impacts may severely affect the physical and mental health and the overall quality of life of the affected individuals.AIM To identify the risk factors for anxiety and depression among patients with AD and to assess their influence on prognosis.METHODS A cross-sectional study was conducted in 273 patients with AD who visited Shanghai Jinshan Tinglin Hospital between July 2021 and June 2023.Data were collected using standardized instruments,including the general information questionnaire,hospital anxiety and depression scale,scoring AD index,and dermatology life quality index.RESULTS Among the evaluated patients,24.5%had symptoms of anxiety,and 19.8%had symptoms of depression.Independent risk factors for anxiety included lower education level[odds ratio(OR)=0.338,95%confidence interval(CI):0.183-0.625],increased number of medical visits(OR=2.300,95%CI:1.234-4.255),sleep disorders(OR=2.013,95%CI:1.032-3.923),and allergic rhinitis(OR=2.052,95%CI:1.097-3.839).Factors for depression included more severe pruritus(OR=6.837,95%CI:1.330-35.132),higher number of medical visits(OR=2.979,95%CI:1.430-6.205),sleep disorders(OR=2.245,95%CI:1.033-5.024),and asthma(OR=2.208,95%CI:1.003-4.859).Dermatology life quality index scores correlated positively with anxiety,depression,scoring AD index,sleep disorders,number of visits,and intensity of pruritus(P<0.05).CONCLUSION In patients with AD,anxiety and depression are associated with educational level,frequency of medical visits,sleep disorders,allergic rhinitis,pruritus,and asthma,all of which exacerbate symptoms and reduce quality of life.展开更多
Background:Wenqing Yin(WQY)is a classic prescription used to treat skin diseases like atopic dermatitis(AD)in China,and the aim of this study is to investigate the therapeutic effects and molecular mechanisms of WQY o...Background:Wenqing Yin(WQY)is a classic prescription used to treat skin diseases like atopic dermatitis(AD)in China,and the aim of this study is to investigate the therapeutic effects and molecular mechanisms of WQY on AD.Methods:The DNFB-induced mouse models of AD were established to investigate the therapeutic effects of WQY on AD.The symptoms of AD in the ears and backs of the mice were assessed,while inflammatory factors in the ear were quantified using quantitative real-time-polymerase chain reaction(qRT-PCR),and the percentages of CD4^(+)and CD8^(+)cells in the spleen were analyzed through flow cytometry.The compounds in WQY were identified using ultra-performance liquid chromatography-tandem mass spectrometry(UPLC-MS/MS)analysis and the key targets and pathways of WQY to treat AD were predicted by network pharmacology.Subsequently,the key genes were tested and verified by qRT-PCR,and the potential active components and target proteins were verified by molecular docking.Results:WQY relieved the AD symptoms and histopathological injuries in the ear and back skin of mice with AD.Meanwhile,WQY significantly reduced the levels of inflammatory factors IL-6 and IL-1βin ear tissue,as well as the ratio of CD4^(+)/CD8^(+)cells in spleen.Additionally,a total of 142 compounds were identified from the water extract of WQY by UPLC-Orbitrap-MS/MS.39 key targets related to AD were screened out by network pharmacology methods.The KEGG analysis indicated that the effects of WQY were primarily mediated through pathways associated with Toll-like receptor signaling and T cell receptor signaling.Moreover,the results of qRT-PCR demonstrated that WQY significantly reduced the mRNA expressions of IL-4,IL-10,GATA3 and FOXP3,and molecular docking simulation verified that the active components of WQY had excellent binding abilities with IL-4,IL-10,GATA3 and FOXP3 proteins.Conclusion:The present study demonstrated that WQY effectively relieved AD symptoms in mice,decreased the inflammatory factors levels,regulated the balance of CD4^(+)and CD8^(+)cells,and the mechanism may be associated with the suppression of Th2 and Treg cell immune responses.展开更多
Atopic dermatitis(AD)is one of the most common chronic inflammatory skin diseases.It usually develops in childhood and may persist into adulthood.Dupilumab is a fully human monoclonal antibody directed against interle...Atopic dermatitis(AD)is one of the most common chronic inflammatory skin diseases.It usually develops in childhood and may persist into adulthood.Dupilumab is a fully human monoclonal antibody directed against interleukin-4R-alpha,the common chain of interleukin-4 and interleukin-13 receptors.Dupilumab showed clinical improvements in patients with atopic dermatitis,asthma,and chronic rhinosinusitis and is currently under development for other indications.However,there are many adverse effects reported after dupilumab therapy including local injection site reactions,conjunctivitis,headache,and nasopharyngitis.We report a new case of a 4-year-old child who experienced anaphylaxis after dupilumab injection.In addition to,we summary and disscuss the rare adverse reactions caused by dupilumab injection by searching the literature in pubmed.展开更多
Background:Atopic dermatitis(AD)is a prevalent chronic skin disorder with a complex etiology involving ge-netic,environmental,and immunological factors.The skin mycobiome has been increasingly implicated in the pathop...Background:Atopic dermatitis(AD)is a prevalent chronic skin disorder with a complex etiology involving ge-netic,environmental,and immunological factors.The skin mycobiome has been increasingly implicated in the pathophysiology of AD.Purpose:Provides a comprehensive overview of current understanding regarding the function of the skin mycobiome in AD,along with emerging research opportunities within this domain.Recent findings:In AD,the predominant fungi are Malassezia species,primarily M.restricta and M.globosa,yet their abundance is reduced,while the abundance of non-Malassezia fungi increases,leading to enhanced fungal diversity.Mycobiome may play a role in AD by eliciting immune responses or through interactions with other microorganisms.Conclusion:This review highlights the growing importance of mycobiome in AD,particularly Malassezia offers insights into disease pathogenesis and progression.展开更多
Objective:To assess the safety and topical efficacy of prim-O-glucosylcimifugin(POG)and investigate the molecular mechanisms of its therapeutic effects in atopic dermatitis(AD).Methods:The effects of POG on human kera...Objective:To assess the safety and topical efficacy of prim-O-glucosylcimifugin(POG)and investigate the molecular mechanisms of its therapeutic effects in atopic dermatitis(AD).Methods:The effects of POG on human keratinocyte cell viability and its anti-inflammatory properties were evaluated using cell counting kit-8 assay and reverse transcription-quantitative polymerase chain reaction(RT-qPCR).Subsequently,the impact of POG on the differentiation of cluster of differentiation(CD)4~+T cell subsets,including T-helper type(Th)1,Th2,Th17,and regulatory T(Treg),was examined through in vitro experiments.Network pharmacology analysis was used to elucidate POG's therapeutic mechanisms.Furthermore,the therapeutic potential of topically applied POG was further evaluated in a calcipotriol-induced mouse model of AD.The protein and transcript levels of inflammatory markers,including cytokines,lymphocyte-specific protein tyrosine kinase(Lck)mRNA,and LCK phosphorylation(p-LCK),were quantified using immunohistochemistry,RT-qPCR,and Western blot analysis.Results:POG was able to suppress cell proliferation and downregulate the transcription of interleukin 4(Il4)and Il13 mRNA.In vitro experiments indicated that POG significantly inhibited the differentiation of Th2 cells,whereas it exerted negligible influence on the differentiation of Th1,Th17 and Treg cells.Network pharmacology identified LCK as a key therapeutic target of POG.Moreover,the topical application of POG effectively alleviated skin lesions in the calcipotriol-induced AD mouse models without causing pathological changes in the liver,kidney or spleen tissues.POG significantly reduced the levels of Il4,Il5,Il13,and thymic stromal lymphopoietin(Tslp)m RNA in the AD mice.Concurrently,POG enhanced the expression of p-LCK protein and Lck mRNA.Conclusion:Our research revealed that POG inhibits Th2 cell differentiation by promoting p-LCK protein expression and hence effectively alleviates AD-related skin inflammation.展开更多
Vitamin D,beyond its classical role in calcium homeostasis,has emerged as a key regulator of immune function and epithelial barrier integrity.Its deficiency during early childhood—a critical period for immune maturat...Vitamin D,beyond its classical role in calcium homeostasis,has emerged as a key regulator of immune function and epithelial barrier integrity.Its deficiency during early childhood—a critical period for immune maturation—has been increasingly implicated in the development of atopic diseases.While extensively studied in asthma,its role in non-respiratory allergic conditions such as atopic dermatitis(AD)and allergic rhinitis(AR)remains comparatively underexplored.This minireview synthesizes current mechanistic and clinical evidence on vitamin D in pediatric AD and AR.In AD,vitamin D promotes epidermal barrier function through upregulation of filaggrin and ceramide synthesis,and enhances antimicrobial defense via induction of antimicrobial peptides.Observational studies consistently report lower serum 25-hydroxyvitamin D in affected children,particularly those with allergic sensitization.Select randomized controlled trials suggest clinical improvement with supplementation,especially at doses>2000 IU/day in deficient individuals.In AR,epidemiological data indicate stronger inverse associations with seasonal(pollen-induced)disease.Proposed mechanisms include modulation of dendritic cells,regulatory T cells,T helper 2 cytokines,and mucosal barrier integrity.The shared immunopathogenesis of AD and AR underscores vitamin D’s relevance.Although promising,clinical evidence remains heterogeneous.Future research should prioritize phenotype-stratified trials to clarify optimal dosing,timing,and individual response determinants,including genetics and microbiome composition.展开更多
Objective:To evaluate the clinical effect of comfort nursing intervention in preventing incontinent-associated dermatitis(IAD)and related complications in critically ill patients.Methods:This study enrolled critically...Objective:To evaluate the clinical effect of comfort nursing intervention in preventing incontinent-associated dermatitis(IAD)and related complications in critically ill patients.Methods:This study enrolled critically ill patients from the Intensive Care Unit at Ningxiang People’s Hospital between June 2020 and June 2024.Patients were randomly assigned to a comfort nursing group(n=51)and a routine nursing group(n=53).The comfort nursing group received comprehensive comfort nursing,while the routine nursing group received standard care.The incidence,classification and area of IAD as well as the incidence of complications and patient/family satisfaction with nursing care,were assessed.Results:The incidence of IAD was significantly lower in the comfort nursing group(8 patients)compared to the routine nursing group(21 patients)(P<0.05).Additionally,the incidences of wound infection and muscle soreness were notably lower in the comfort nursing group(both P<0.05).Patient and family satisfaction in the comfort nursing group was significantly higher than in the routine nursing group(both P<0.05).Conclusion:Comfort nursing intervention is effective in preventing IAD and reducing associated complications in critically ill patients,thereby improving patient and family satisfaction with treatment.展开更多
Atopic dermatitis(AD)is a common multifactorial skin disease characterized by chronic inflammation,unbearable itching,and significant physical and mental burden on patients.In recent years,there has been extensively s...Atopic dermatitis(AD)is a common multifactorial skin disease characterized by chronic inflammation,unbearable itching,and significant physical and mental burden on patients.In recent years,there has been extensively studied on the use of natural polysaccharides in anti-inflammatory therapy,due to their low toxicity and multi-target pharmacological activity.The unique biological activities of polysaccharides from natural sources as functional food additives and cosmeceuticals present a new option for the treatment of AD.This review aims to summarize the pathogenesis of AD,the therapeutic effects,and the mechanisms of natural polysaccharides,as well as discuss the limitations and prospects of these compounds in the treatment of AD.The insights provided in this review can serve as references and inspiration for the development of applications of natural polysaccharides in the treatment of AD.展开更多
Objective:To analyze the preventive and management effects of the 4R crisis management theory on incontinence-associated dermatitis(IAD)in ICU patients with fecal incontinence.Methods:A hundred patients with fecal inc...Objective:To analyze the preventive and management effects of the 4R crisis management theory on incontinence-associated dermatitis(IAD)in ICU patients with fecal incontinence.Methods:A hundred patients with fecal incontinence who were admitted to the ICU for treatment between January 2024 and December 2024 were selected and randomly divided into two groups using a random number table.The observation group received 4R crisis management theory,while the control group received routine management.The IAD risk score,incidence of IAD,severity of IAD,and formation and healing time of IAD were compared between the two groups.Results:After management,the IAD risk score of the observation group was lower than that of the control group(P<0.05).The incidence of IAD in the observation group was lower than that in the control group,the proportion of mild IAD was higher than that in the control group,the formation time of IAD was later than that in the control group,and the healing time was shorter than that in the control group(P<0.05).Conclusion:Adopting the 4R crisis management theory for ICU patients with fecal incontinence can reduce the risk of IAD occurrence,effectively prevent IAD,reduce its severity,delay its formation time,and promote good healing.展开更多
Background:Atopic dermatitis is a chronic inflammatory skin disorder characterized by recurrent eczema-like rashes and severe itching.Taxi San is an external herbal formulation with the effects of clearing heat,drying...Background:Atopic dermatitis is a chronic inflammatory skin disorder characterized by recurrent eczema-like rashes and severe itching.Taxi San is an external herbal formulation with the effects of clearing heat,drying dampness,detoxifying,and relieving itching,making it suitable for treating acute and subacute dermatitis or eczema.Objectives:To evaluate the clinical efficacy of topical Taxi San in treating atopic dermatitis patients with dampness-heat syndrome and its inhibitory effect against Staphylococcus aureus(S.aureus)colonization.Methods:50 patients with atopic dermatitis were enrolled from the Dermatology Department of Shaanxi Provincial Hospital of Traditional Chinese Medicine,with bilateral symmetrical lesions selected as target sites.The control-side lesions were treated with boric acid solution wet compresses,while the treatment-side lesions received Taxi San solution wet compresses,both administered twice daily for 14 d.Clinical efficacy was evaluated using the Scoring Atopic Dermatitis(SCORAD),Investigator Global Assessment(IGA),Dermatology Life Quality Index/Children’s Dermatology Life Quality Index(DLQI/CDLQI),adverse events(AEs)and S.aureus colonization density,which were compared between the groups.The antibacterial efficacy of Taxi San was further investigated through in vitro antibacterial tests.Results:After 14 d of treatment with Taxi San,erythema and pimples were reduced on the treated sides.Additionally,the SCORAD,IGA,and DLQI/CDLQI scores showed significant decreases(P<0.05).S.aureus colonization on the treated sides declined markedly from 78%to 4.76%.Compared to the control sides,the reduction in S.aureus colonization following 14 d of Taxi San treatment was statistically significant(P<0.05).Furthermore,in vitro antibacterial assays demonstrated that the minimum inhibitory concentration of Taxi San against the seven tested S.aureus strains was 0.125 g/mL.Conclusions:Taxi San effectively reduces S.aureus colonization and ameliorates clinical symptoms in atopic dermatitis patients with dampness-heat syndrome,demonstrating high therapeutic potential and safety.展开更多
Dear Editor,Acrodermatitis continua of Hallopeau(ACH),a rare and chronic variant of pustular psoriasis,is characterized by atrophic skin changes,sterile pustules,onychodystrophy,and osteolysis of the distal phalanges ...Dear Editor,Acrodermatitis continua of Hallopeau(ACH),a rare and chronic variant of pustular psoriasis,is characterized by atrophic skin changes,sterile pustules,onychodystrophy,and osteolysis of the distal phalanges of the fingers and toes.Given the absence of international consensus guidelines and comprehensive clinical studies of high methodological rigor,the management of ACH primarily relies on antipsoriatic therapeutic approaches and empirical evidence derived from scattered case reports.With the development of biologics and small-molecule drugs,targeted therapies hold some promise for the future of its successful management[1].Here we summarize treatment outcomes of targeted therapies for ACH.展开更多
Atopic dermatitis(AD) is a chronic inflammatory skin condition. Natural products have gained traction in AD treatment due to their accessibility, low toxicity, and favorable pharmacological properties. However, their ...Atopic dermatitis(AD) is a chronic inflammatory skin condition. Natural products have gained traction in AD treatment due to their accessibility, low toxicity, and favorable pharmacological properties. However, their application is primarily constrained by poor solubility, instability, and limited permeability. The transdermal drug delivery system(TDDS) offers potential solutions for transdermal delivery, enhanced penetration, improved efficacy, and reduced toxicity of natural drugs, aligning with the requirements of modern AD treatment. This review examines the application of hydrogels, microneedles(MNs), liposomes, nanoemulsions, and other TDDS-carrying natural products in AD treatment, with a primary focus on their effects on penetration and accumulation in the skin. The aim is to provide valuable insights into the treatment of AD and other dermatological conditions.展开更多
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 child...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(P<0.05),and no significant difference was shown in the gender and age of the children(P>0.05).The proportion of family history of atopic dermatitis with asthma was higher in the experimental group(P<0.05).Conclusion:The use of antibiotics in children with atopic 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.展开更多
Atopic dermatitis,a common chronic inflammatory skin disease,has an unclear etiology and may involve multiple factors such as genetic predisposition,immune abnormalities,and impaired skin barrier function.Currently,th...Atopic dermatitis,a common chronic inflammatory skin disease,has an unclear etiology and may involve multiple factors such as genetic predisposition,immune abnormalities,and impaired skin barrier function.Currently,there is no specific medication available for the complete cure of atopic dermatitis.The current treatment approaches mainly focus on symptom relief and control rather than curative treatment.Some commonly used medications for atopic dermatitis,such as topical corticosteroids and immunosuppressants,may have certain adverse reactions and side effects.This review summarizes the research progress on natural extracts in the treatment of atopic dermatitis,aiming to provide a foundation for the development of safe and side-effectfree medications.展开更多
Objective Atopic dermatitis(AD)is a chronic inflammatory skin disease that may be linked to changes in the gut microbiome.Acupuncture has been proven to be effective in reducing AD symptoms without serious adverse eve...Objective Atopic dermatitis(AD)is a chronic inflammatory skin disease that may be linked to changes in the gut microbiome.Acupuncture has been proven to be effective in reducing AD symptoms without serious adverse events,but its underlying mechanism is not completely understood.The purpose of this study was to investigate whether the potential effect of acupuncture on AD is gut microbiota-dependent.Methods AD-like skin lesions were induced by applying MC903 topically to the cheek of the mouse.Acupuncture was done at the Gok-Ji(LI11)acupoints.AD-like symptoms were assessed by lesion scores,scratching behavior,and histopathological changes;intestinal barrier function was measured by fecal output,serum lipopolysaccharide levels,histopathological changes,and mRNA expression of markers involved in intestinal permeability and inflammation.Gut microbiota was profiled using 16S rRNA gene sequencing from fecal samples.Results Acupuncture effectively improved chronic itch as well as the AD-like skin lesions with epidermal thickening,and also significantly altered gut microbiota structure as revealed byβ-diversity indices and analysis of similarities.These beneficial effects were eliminated by antibiotic depletion of gut microbiota,but were reproduced in gut microbiota-depleted mice that received a fecal microbiota transplant from acupuncture-treated mice.Interestingly,AD mice had intestinal barrier dysfunction as indicated by increased intestinal permeability,atrophy of the mucosal structure(reduced villus height and crypt depth),decreased expression of tight junctions and mucus synthesis genes,and increased expression of inflammatory mediators in the ileum.Acupuncture attenuated these abnormalities,which was gut microbiota-dependent.Conclusion Acupuncture ameliorates AD-like phenotypes in a gut microbiota-dependent manner and some of these positive benefits are explained by modulation of the intestinal barrier,providing new perspective for non-pharmacological strategies for modulating gut microbiota to prevent and treat AD.展开更多
Objective:To investigate the influence of xylooligosaccharides on skin inflammation,behavioral characteristics,neurotransmitters,and gut flora in a mouse model of atopic dermatitis(AD)induced by 2,4-dinitrofluorobenze...Objective:To investigate the influence of xylooligosaccharides on skin inflammation,behavioral characteristics,neurotransmitters,and gut flora in a mouse model of atopic dermatitis(AD)induced by 2,4-dinitrofluorobenzene(DNFB).Methods:The AD mouse model was created by administration of DNFB for 14 consecutive days.The scoring atopic dermatitis index,enzyme-linked immunosorbent assay(ELISA),histopathology,and immunohistochemical analyses were used to assess inflammation and depression-like behaviors.Furthermore,high-throughput 16S rRNA gene sequencing was used to determine the composition of fecal microbiota.Results:Xylooligosaccharides treatment reduced the number of scratches and skin thickness,mast cell infiltration and the levels of immunoglobulin(Ig)E and T-helper cytokines compared with the AD model group.Meanwhile,xylooligosaccharides treatment reduced the immobility time of mice in the forced swimming test and increased the total movement distance and movement distance in the center area in the open-field test.Furthermore,5-hydroxytryptamine and dopamine expression in the brain was increased following xylooligosaccharides treatment.Using network pharmacology,Gene Ontology analysis showed that the targets were mainly enriched in phosphatase binding and the regulation of leukocyte differentiation,which ameliorated AD mainly through the hypoxia inducible factor-1 and phosphatidylinositide 3-kinase-protein kinase B pathways.16S rRNA gene sequencing,diversity indices,and gut microbial taxonomic composition analysis showed DNFB-induced changes in intestinal microbiota diversity in AD mice.Comparative analysis indicated that xylooligosaccharides intake improved the gut microbiome by dramatically enhancing the concentration of Lactobacillus while decreasing the concentration of Bacteroides in mice.Conclusion:Xylooligosaccharides reduce inflammatory dermatosis and related depression-like behaviors via regulating intestinal homeostasis,having medicinal value as a nutritional and functional ingredient.展开更多
文摘BACKGROUND Atopic dermatitis(AD),or eczema,is a chronic,pruritic inflammatory skin disease affecting children and adults.Socioeconomic status(SES)plays a significant role in developing AD.However,mixed evidence from a previous study by Bajwa et al makes it difficult to determine the directionality of the association.There is a lite-rature gap in understanding the causal association between AD and socioeco-nomic factors.AIM To evaluate the impact of disparities in SES on pediatric AD populations.METHODS Based on the eligibility criteria,the literature review identified eight articles since July 2021,and a descriptive analysis was conducted using an Excel spreadsheet on key components collected from the identified studies.RESULTS Eight observational studies assessed SES in pediatric AD.Five observational studies showed mixed associations between AD and SES.Sub-analysis revealed that urban areas had a higher prevalence of AD,and four studies identified a positive association between parental education and AD in the pediatric popu-lation.Socioeconomic variables,such as residential areas and household income,significantly influence disease outcomes.CONCLUSION There is mixed association between pediatric AD and SES,with AD positively associated with parental education.There is critical need to evaluate global impact of SES variables on pediatric AD.
文摘BACKGROUND Since the advent of the 20th century,alongside the progression of medical science and technological advancements,immunotherapy has emerged as a pivotal thera-peutic approach for tumor patients subsequent to undergoing radiotherapy and chemotherapy.Arimab(camrelizumab),a flagship drug in the realm of immuno-therapy,functions as a monoclonal antibody specifically targeting the progra-mmed death protein 1(PD-1).This drug engages with the human PD-1 receptor,effectively inhibiting the PD-1/programmed death ligand 1 signaling pathway.This inhibition results in the restoration of T cell activity and the induction of an anti-tumour response.However,it is noteworthy that such interference could lead to immune-related adverse events resembling autoimmune reactions.The grow-ing availability and clinical use of immune checkpoint inhibitors have raised sig-nificant clinical concerns regarding their safety.Numerous instances of immune-related adverse reactions and the associated management strategies have been extensively reported.Timely identification and diagnosis,coupled with multidi-sciplinary consultation and the prompt administration of immunosuppressants,can effectively address severe immune-related adverse reactions.CASE SUMMARY Arimab(camrelizumab),a monoclonal antibody targeting programmed death protein 1(PD-1),disrupts the PD-1/programmed death ligand 1(PD-L1)inter-action,reactivating T cell function and triggering anti-tumor immunity.However,this disruption may trigger immune-mediated adverse events akin to autoim-mune disorders.Approximately 2.8%of such events manifest as immune-related dermatologic reactions,with 0.7%classified as grade 3,which are infrequently documented.Here,this study describes a case of grade 3 bullous dermatitis occur-ring 15 days after initiating camrelizumab therapy.The patient,a 67-year-old male with oesophageal squamous cell carcinoma,received camrelizumab plus paclitaxel alongside chemotherapy and radiotherapy in early 2022.Due to disease progression,maintenance monotherapy with camrelizumab(200 mg)commenced in June 2022.On the fourth cycle,15 days into treatment,the patient presented with an immune-checkpoint inhibitor-related rash,despite unremarkable test results.Dermatology and pharmacy consultations were conducted,leading to glucocorticoid therapy,topical interventions,and supportive care.Gastric mucosal protection,nutritional supplementation,and other adjunctive treatments were also provided.The patient's symptoms resolved within 15 days post-discharge,resulting in discontinuation of camrelizumab.Like other PD-1 inhibitors,camrelizumab is associated with immune-mediated dermatitis.Thus,optimal management of these events requires a multidisciplinary approach,vigilant monitoring,regular evalua-tions,prompt glucocorticoid administration,and specialized dermatologic care.CONCLUSION The increasing adoption of immune checkpoint inhibitors in clinical practice has prompted substantial concerns about their safety profile.A wide range of immune-related adverse events and corresponding management stra-tegies have been well-documented.Early recognition and accurate diagnosis,combined with interdisciplinary collaboration and swift initiation of immunosuppressive therapy,are essential in managing severe immune-related adverse reactions effectively.This report details the treatment trajectory and outcome of a case involving immune-related cutaneous adverse reactions,providing pertinent clinical insights for future cases.
文摘Objective:This study aimed to investigate the association of atopic dermatitis(AD)and anxiety/depression behaviors induced by AD with the intestinal microbiota.Additionally,it sought to evaluate the therapeutic potential of mannan oligosaccharide(MOS)in alleviating AD symptoms through the modulation of the gut microbiota and the enhancement of short-chain fatty acids(SCFAs)production.Methods:Female Kunming mice were challenged with 2,4-dinitrofluorobenzene(DNFB)to induce AD-like symptoms.MOS was administered orally daily for 14 days.On the 6th and 11th days post-modeling,the number of scratching bouts in mice was recorded.Following dissection,epidermal thickness,mast cell infiltration,and serum levels of inflammatory cytokines were measured.Meanwhile,cerebral levels of neurotransmitters,including 5-hydroxytryptamine(5-HT)and norepinephrine(NE),were assessed.The abundance of intestinal microbiota and fecal concentrations of SCFAs were also analyzed.Results:MOS significantly reduced AD-like symptoms by reducing inflammatory cytokines,as reflected in a significant decrease in the number of scratching bouts,epidermal thickness,mast cells and inflammatory cytokine levels.MOS intervention up-regulated the expression of 5-HT and NE,and consequently alleviated anxiety and depression-like behaviors.Furthermore,compared with the AD group,MOS intervention increased the gut microbiota abundance of mice,especially beneficial bacteria such as Bifidobacterium,Lactobacillus and Klebsiella.At the same time,these beneficial bacteria significantly increased the fecal contents of SCFAs,especially propionic acid.Correlation analysis indicated that AD amelioration was positively correlated with fecal SCFAs levels and the proliferation of certain intestinal microbes.Conclusion:MOS intervention could offer a novel approach to managing AD and its psychological comorbidities.
基金supported by the Peking University Nursing Discipline Research Development Fund(No.TYZH2023001)。
文摘Objectives To investigate the barriers and facilitators influencing the sustainable implementation of evidence-based practice(EBP)for Peristomal Irritant Contact Dermatitis(PICD)based on the Consolidated Framework for Implementation Research(CFIR).Methods The sample consisted of 17 nurses from three urology wards at a tertiary hospital in Beijing,China,who had participated in the EBP.Guided by the CFIR,we identified constructs influencing the sustainability of implementation by conducting a directed content analysis of the 17 individual in-depth interviews.By rating,the valence and magnitude of each construct were determined.Results This study identified 19 factors across the five domains of the CFIR.Among these determinants,16 were identified as barriers,while three were recognized as facilitators.Common barriers across different contexts were identified,such as delayed evidence updating,the complexity of intervention components and steps,and incompatibility between the implementation process and clinical practices.In contrast,facilitators of intervention implementation were regular communication and feedback,support and drive from principals and a positive cultural atmosphere.In addition,we identified“regular evidence updating”as an independent construct outside of the CFIR,a finding that will provide key information for updating the CFIR framework.Conclusions Regular evidence updating is crucial for the sustainability of EBP implementation.Researchers should receive consistent feedback from practitioners and adjust or modify the EBP as necessary.Additionally,researchers must consider the compatibility or adaptability of the EBP’s content with clinical practice in formulating it rather than adding additional complexity to the original workflow.
文摘BACKGROUND Atopic dermatitis(AD)is a chronic inflammatory skin disease characterized by visible lesions that can lead to anxiety and depression.These psychological impacts may severely affect the physical and mental health and the overall quality of life of the affected individuals.AIM To identify the risk factors for anxiety and depression among patients with AD and to assess their influence on prognosis.METHODS A cross-sectional study was conducted in 273 patients with AD who visited Shanghai Jinshan Tinglin Hospital between July 2021 and June 2023.Data were collected using standardized instruments,including the general information questionnaire,hospital anxiety and depression scale,scoring AD index,and dermatology life quality index.RESULTS Among the evaluated patients,24.5%had symptoms of anxiety,and 19.8%had symptoms of depression.Independent risk factors for anxiety included lower education level[odds ratio(OR)=0.338,95%confidence interval(CI):0.183-0.625],increased number of medical visits(OR=2.300,95%CI:1.234-4.255),sleep disorders(OR=2.013,95%CI:1.032-3.923),and allergic rhinitis(OR=2.052,95%CI:1.097-3.839).Factors for depression included more severe pruritus(OR=6.837,95%CI:1.330-35.132),higher number of medical visits(OR=2.979,95%CI:1.430-6.205),sleep disorders(OR=2.245,95%CI:1.033-5.024),and asthma(OR=2.208,95%CI:1.003-4.859).Dermatology life quality index scores correlated positively with anxiety,depression,scoring AD index,sleep disorders,number of visits,and intensity of pruritus(P<0.05).CONCLUSION In patients with AD,anxiety and depression are associated with educational level,frequency of medical visits,sleep disorders,allergic rhinitis,pruritus,and asthma,all of which exacerbate symptoms and reduce quality of life.
基金supported by grants from the National Natural Science Foundation of China(82004252)the Project of Administration of Traditional Chinese Medicine of Guangdong Province(202405112017596500)the Basic and Applied Basic Research Foundation of Guangzhou Municipal Science and Technology Bureau(202102020533).
文摘Background:Wenqing Yin(WQY)is a classic prescription used to treat skin diseases like atopic dermatitis(AD)in China,and the aim of this study is to investigate the therapeutic effects and molecular mechanisms of WQY on AD.Methods:The DNFB-induced mouse models of AD were established to investigate the therapeutic effects of WQY on AD.The symptoms of AD in the ears and backs of the mice were assessed,while inflammatory factors in the ear were quantified using quantitative real-time-polymerase chain reaction(qRT-PCR),and the percentages of CD4^(+)and CD8^(+)cells in the spleen were analyzed through flow cytometry.The compounds in WQY were identified using ultra-performance liquid chromatography-tandem mass spectrometry(UPLC-MS/MS)analysis and the key targets and pathways of WQY to treat AD were predicted by network pharmacology.Subsequently,the key genes were tested and verified by qRT-PCR,and the potential active components and target proteins were verified by molecular docking.Results:WQY relieved the AD symptoms and histopathological injuries in the ear and back skin of mice with AD.Meanwhile,WQY significantly reduced the levels of inflammatory factors IL-6 and IL-1βin ear tissue,as well as the ratio of CD4^(+)/CD8^(+)cells in spleen.Additionally,a total of 142 compounds were identified from the water extract of WQY by UPLC-Orbitrap-MS/MS.39 key targets related to AD were screened out by network pharmacology methods.The KEGG analysis indicated that the effects of WQY were primarily mediated through pathways associated with Toll-like receptor signaling and T cell receptor signaling.Moreover,the results of qRT-PCR demonstrated that WQY significantly reduced the mRNA expressions of IL-4,IL-10,GATA3 and FOXP3,and molecular docking simulation verified that the active components of WQY had excellent binding abilities with IL-4,IL-10,GATA3 and FOXP3 proteins.Conclusion:The present study demonstrated that WQY effectively relieved AD symptoms in mice,decreased the inflammatory factors levels,regulated the balance of CD4^(+)and CD8^(+)cells,and the mechanism may be associated with the suppression of Th2 and Treg cell immune responses.
基金supported by Clinical Research Operating Fund of Central High Level Hospitals(2022-PUMCH-B-088).
文摘Atopic dermatitis(AD)is one of the most common chronic inflammatory skin diseases.It usually develops in childhood and may persist into adulthood.Dupilumab is a fully human monoclonal antibody directed against interleukin-4R-alpha,the common chain of interleukin-4 and interleukin-13 receptors.Dupilumab showed clinical improvements in patients with atopic dermatitis,asthma,and chronic rhinosinusitis and is currently under development for other indications.However,there are many adverse effects reported after dupilumab therapy including local injection site reactions,conjunctivitis,headache,and nasopharyngitis.We report a new case of a 4-year-old child who experienced anaphylaxis after dupilumab injection.In addition to,we summary and disscuss the rare adverse reactions caused by dupilumab injection by searching the literature in pubmed.
基金supported by CAMS Innovation Fund for Medical Sciences(CIFMS,No.2022-I2M-C&T-B-096)National Natural Science Foundation of China(82373489,82273542,82304023).
文摘Background:Atopic dermatitis(AD)is a prevalent chronic skin disorder with a complex etiology involving ge-netic,environmental,and immunological factors.The skin mycobiome has been increasingly implicated in the pathophysiology of AD.Purpose:Provides a comprehensive overview of current understanding regarding the function of the skin mycobiome in AD,along with emerging research opportunities within this domain.Recent findings:In AD,the predominant fungi are Malassezia species,primarily M.restricta and M.globosa,yet their abundance is reduced,while the abundance of non-Malassezia fungi increases,leading to enhanced fungal diversity.Mycobiome may play a role in AD by eliciting immune responses or through interactions with other microorganisms.Conclusion:This review highlights the growing importance of mycobiome in AD,particularly Malassezia offers insights into disease pathogenesis and progression.
基金supported by the National Natural Science Foundation of China(No.82004359)Youth Talent Promotion Project of China Association of Traditional Chinese Medicine(2024–2026)Category B(No.2024-QNRC2-B04)+9 种基金Youth Medical Talents-Specialist Program of Shanghai“Rising Stars of Medical Talents”Youth Development ProgramHealth Young Talents of Shanghai Municipal Health Commission(No.2022YQ026)Shanghai Dermatology Research Center(No.2023ZZ02017)Shanghai Skin Disease Hospital demonstration research ward project(No.SHDC2023CRW009)Shanghai Key Discipline Construction Project of Traditional Chinese Medicine(No.shzyyzdxk-2024104)Shanghai Municipal Health Commission Health Industry Clinical Research Special Project(No.20224Y0373No.20234Y0075)Clinical Incubation Program(No.lcfy2023-08)Evidence-based dermatology base sponsored by State Administration of Traditional Chinese MedicineHigh-level Chinese Medicine Key Discipline Construction Project(Integrative Chinese and Western Medicine Clinic)of National Administration of TCM(No.zyyzdxk-2023065)。
文摘Objective:To assess the safety and topical efficacy of prim-O-glucosylcimifugin(POG)and investigate the molecular mechanisms of its therapeutic effects in atopic dermatitis(AD).Methods:The effects of POG on human keratinocyte cell viability and its anti-inflammatory properties were evaluated using cell counting kit-8 assay and reverse transcription-quantitative polymerase chain reaction(RT-qPCR).Subsequently,the impact of POG on the differentiation of cluster of differentiation(CD)4~+T cell subsets,including T-helper type(Th)1,Th2,Th17,and regulatory T(Treg),was examined through in vitro experiments.Network pharmacology analysis was used to elucidate POG's therapeutic mechanisms.Furthermore,the therapeutic potential of topically applied POG was further evaluated in a calcipotriol-induced mouse model of AD.The protein and transcript levels of inflammatory markers,including cytokines,lymphocyte-specific protein tyrosine kinase(Lck)mRNA,and LCK phosphorylation(p-LCK),were quantified using immunohistochemistry,RT-qPCR,and Western blot analysis.Results:POG was able to suppress cell proliferation and downregulate the transcription of interleukin 4(Il4)and Il13 mRNA.In vitro experiments indicated that POG significantly inhibited the differentiation of Th2 cells,whereas it exerted negligible influence on the differentiation of Th1,Th17 and Treg cells.Network pharmacology identified LCK as a key therapeutic target of POG.Moreover,the topical application of POG effectively alleviated skin lesions in the calcipotriol-induced AD mouse models without causing pathological changes in the liver,kidney or spleen tissues.POG significantly reduced the levels of Il4,Il5,Il13,and thymic stromal lymphopoietin(Tslp)m RNA in the AD mice.Concurrently,POG enhanced the expression of p-LCK protein and Lck mRNA.Conclusion:Our research revealed that POG inhibits Th2 cell differentiation by promoting p-LCK protein expression and hence effectively alleviates AD-related skin inflammation.
文摘Vitamin D,beyond its classical role in calcium homeostasis,has emerged as a key regulator of immune function and epithelial barrier integrity.Its deficiency during early childhood—a critical period for immune maturation—has been increasingly implicated in the development of atopic diseases.While extensively studied in asthma,its role in non-respiratory allergic conditions such as atopic dermatitis(AD)and allergic rhinitis(AR)remains comparatively underexplored.This minireview synthesizes current mechanistic and clinical evidence on vitamin D in pediatric AD and AR.In AD,vitamin D promotes epidermal barrier function through upregulation of filaggrin and ceramide synthesis,and enhances antimicrobial defense via induction of antimicrobial peptides.Observational studies consistently report lower serum 25-hydroxyvitamin D in affected children,particularly those with allergic sensitization.Select randomized controlled trials suggest clinical improvement with supplementation,especially at doses>2000 IU/day in deficient individuals.In AR,epidemiological data indicate stronger inverse associations with seasonal(pollen-induced)disease.Proposed mechanisms include modulation of dendritic cells,regulatory T cells,T helper 2 cytokines,and mucosal barrier integrity.The shared immunopathogenesis of AD and AR underscores vitamin D’s relevance.Although promising,clinical evidence remains heterogeneous.Future research should prioritize phenotype-stratified trials to clarify optimal dosing,timing,and individual response determinants,including genetics and microbiome composition.
文摘Objective:To evaluate the clinical effect of comfort nursing intervention in preventing incontinent-associated dermatitis(IAD)and related complications in critically ill patients.Methods:This study enrolled critically ill patients from the Intensive Care Unit at Ningxiang People’s Hospital between June 2020 and June 2024.Patients were randomly assigned to a comfort nursing group(n=51)and a routine nursing group(n=53).The comfort nursing group received comprehensive comfort nursing,while the routine nursing group received standard care.The incidence,classification and area of IAD as well as the incidence of complications and patient/family satisfaction with nursing care,were assessed.Results:The incidence of IAD was significantly lower in the comfort nursing group(8 patients)compared to the routine nursing group(21 patients)(P<0.05).Additionally,the incidences of wound infection and muscle soreness were notably lower in the comfort nursing group(both P<0.05).Patient and family satisfaction in the comfort nursing group was significantly higher than in the routine nursing group(both P<0.05).Conclusion:Comfort nursing intervention is effective in preventing IAD and reducing associated complications in critically ill patients,thereby improving patient and family satisfaction with treatment.
基金supported by the National Natural Science Foundation of China(22078162)Priority Academic Program Development of Jiangsu Higher Education Institutions(PAPD)Jiangsu Province Graduate Research Innovation Program Project(KYCX22-1065)。
文摘Atopic dermatitis(AD)is a common multifactorial skin disease characterized by chronic inflammation,unbearable itching,and significant physical and mental burden on patients.In recent years,there has been extensively studied on the use of natural polysaccharides in anti-inflammatory therapy,due to their low toxicity and multi-target pharmacological activity.The unique biological activities of polysaccharides from natural sources as functional food additives and cosmeceuticals present a new option for the treatment of AD.This review aims to summarize the pathogenesis of AD,the therapeutic effects,and the mechanisms of natural polysaccharides,as well as discuss the limitations and prospects of these compounds in the treatment of AD.The insights provided in this review can serve as references and inspiration for the development of applications of natural polysaccharides in the treatment of AD.
基金Exploration of the Preventive Effect of Skin Management Program Based on 4R Crisis Management Theory on Incontinence-Associated Dermatitis in ICU Patients with Fecal Incontinence(Project No.:YK202335)。
文摘Objective:To analyze the preventive and management effects of the 4R crisis management theory on incontinence-associated dermatitis(IAD)in ICU patients with fecal incontinence.Methods:A hundred patients with fecal incontinence who were admitted to the ICU for treatment between January 2024 and December 2024 were selected and randomly divided into two groups using a random number table.The observation group received 4R crisis management theory,while the control group received routine management.The IAD risk score,incidence of IAD,severity of IAD,and formation and healing time of IAD were compared between the two groups.Results:After management,the IAD risk score of the observation group was lower than that of the control group(P<0.05).The incidence of IAD in the observation group was lower than that in the control group,the proportion of mild IAD was higher than that in the control group,the formation time of IAD was later than that in the control group,and the healing time was shorter than that in the control group(P<0.05).Conclusion:Adopting the 4R crisis management theory for ICU patients with fecal incontinence can reduce the risk of IAD occurrence,effectively prevent IAD,reduce its severity,delay its formation time,and promote good healing.
基金supported by the Shaanxi Provincial Research and Innovation Team for Atopic Dermatitis of Traditional Chinese Medicine(No.TZKN-CXTD-02)the Key Industry Innovation Chain Project of Shaanxi Province(No.2021ZDLSF04-12).
文摘Background:Atopic dermatitis is a chronic inflammatory skin disorder characterized by recurrent eczema-like rashes and severe itching.Taxi San is an external herbal formulation with the effects of clearing heat,drying dampness,detoxifying,and relieving itching,making it suitable for treating acute and subacute dermatitis or eczema.Objectives:To evaluate the clinical efficacy of topical Taxi San in treating atopic dermatitis patients with dampness-heat syndrome and its inhibitory effect against Staphylococcus aureus(S.aureus)colonization.Methods:50 patients with atopic dermatitis were enrolled from the Dermatology Department of Shaanxi Provincial Hospital of Traditional Chinese Medicine,with bilateral symmetrical lesions selected as target sites.The control-side lesions were treated with boric acid solution wet compresses,while the treatment-side lesions received Taxi San solution wet compresses,both administered twice daily for 14 d.Clinical efficacy was evaluated using the Scoring Atopic Dermatitis(SCORAD),Investigator Global Assessment(IGA),Dermatology Life Quality Index/Children’s Dermatology Life Quality Index(DLQI/CDLQI),adverse events(AEs)and S.aureus colonization density,which were compared between the groups.The antibacterial efficacy of Taxi San was further investigated through in vitro antibacterial tests.Results:After 14 d of treatment with Taxi San,erythema and pimples were reduced on the treated sides.Additionally,the SCORAD,IGA,and DLQI/CDLQI scores showed significant decreases(P<0.05).S.aureus colonization on the treated sides declined markedly from 78%to 4.76%.Compared to the control sides,the reduction in S.aureus colonization following 14 d of Taxi San treatment was statistically significant(P<0.05).Furthermore,in vitro antibacterial assays demonstrated that the minimum inhibitory concentration of Taxi San against the seven tested S.aureus strains was 0.125 g/mL.Conclusions:Taxi San effectively reduces S.aureus colonization and ameliorates clinical symptoms in atopic dermatitis patients with dampness-heat syndrome,demonstrating high therapeutic potential and safety.
基金supported by the National Natural Science Foundation of China(Grant Nos.82073439 and 82373475).
文摘Dear Editor,Acrodermatitis continua of Hallopeau(ACH),a rare and chronic variant of pustular psoriasis,is characterized by atrophic skin changes,sterile pustules,onychodystrophy,and osteolysis of the distal phalanges of the fingers and toes.Given the absence of international consensus guidelines and comprehensive clinical studies of high methodological rigor,the management of ACH primarily relies on antipsoriatic therapeutic approaches and empirical evidence derived from scattered case reports.With the development of biologics and small-molecule drugs,targeted therapies hold some promise for the future of its successful management[1].Here we summarize treatment outcomes of targeted therapies for ACH.
基金supported by the NINGBO Medical & Health Leading Academic Discipline Project (No. 2022-ZF02)Ningbo Major Research and Development Plan Project (No.2023Z207)。
文摘Atopic dermatitis(AD) is a chronic inflammatory skin condition. Natural products have gained traction in AD treatment due to their accessibility, low toxicity, and favorable pharmacological properties. However, their application is primarily constrained by poor solubility, instability, and limited permeability. The transdermal drug delivery system(TDDS) offers potential solutions for transdermal delivery, enhanced penetration, improved efficacy, and reduced toxicity of natural drugs, aligning with the requirements of modern AD treatment. This review examines the application of hydrogels, microneedles(MNs), liposomes, nanoemulsions, and other TDDS-carrying natural products in AD treatment, with a primary focus on their effects on penetration and accumulation in the skin. The aim is to provide valuable insights into the treatment of AD and other dermatological conditions.
文摘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(P<0.05),and no significant difference was shown in the gender and age of the children(P>0.05).The proportion of family history of atopic dermatitis with asthma was higher in the experimental group(P<0.05).Conclusion:The use of antibiotics in children with atopic 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.
文摘Atopic dermatitis,a common chronic inflammatory skin disease,has an unclear etiology and may involve multiple factors such as genetic predisposition,immune abnormalities,and impaired skin barrier function.Currently,there is no specific medication available for the complete cure of atopic dermatitis.The current treatment approaches mainly focus on symptom relief and control rather than curative treatment.Some commonly used medications for atopic dermatitis,such as topical corticosteroids and immunosuppressants,may have certain adverse reactions and side effects.This review summarizes the research progress on natural extracts in the treatment of atopic dermatitis,aiming to provide a foundation for the development of safe and side-effectfree medications.
基金supported by grants from the National Research Foundation of Korea funded by the Korean government(No.2020R1A4A1018598,NRF-2021R1A2C2006818,2022M3A9B6017813 and NRF-2023R1A2C1006836).
文摘Objective Atopic dermatitis(AD)is a chronic inflammatory skin disease that may be linked to changes in the gut microbiome.Acupuncture has been proven to be effective in reducing AD symptoms without serious adverse events,but its underlying mechanism is not completely understood.The purpose of this study was to investigate whether the potential effect of acupuncture on AD is gut microbiota-dependent.Methods AD-like skin lesions were induced by applying MC903 topically to the cheek of the mouse.Acupuncture was done at the Gok-Ji(LI11)acupoints.AD-like symptoms were assessed by lesion scores,scratching behavior,and histopathological changes;intestinal barrier function was measured by fecal output,serum lipopolysaccharide levels,histopathological changes,and mRNA expression of markers involved in intestinal permeability and inflammation.Gut microbiota was profiled using 16S rRNA gene sequencing from fecal samples.Results Acupuncture effectively improved chronic itch as well as the AD-like skin lesions with epidermal thickening,and also significantly altered gut microbiota structure as revealed byβ-diversity indices and analysis of similarities.These beneficial effects were eliminated by antibiotic depletion of gut microbiota,but were reproduced in gut microbiota-depleted mice that received a fecal microbiota transplant from acupuncture-treated mice.Interestingly,AD mice had intestinal barrier dysfunction as indicated by increased intestinal permeability,atrophy of the mucosal structure(reduced villus height and crypt depth),decreased expression of tight junctions and mucus synthesis genes,and increased expression of inflammatory mediators in the ileum.Acupuncture attenuated these abnormalities,which was gut microbiota-dependent.Conclusion Acupuncture ameliorates AD-like phenotypes in a gut microbiota-dependent manner and some of these positive benefits are explained by modulation of the intestinal barrier,providing new perspective for non-pharmacological strategies for modulating gut microbiota to prevent and treat AD.
文摘Objective:To investigate the influence of xylooligosaccharides on skin inflammation,behavioral characteristics,neurotransmitters,and gut flora in a mouse model of atopic dermatitis(AD)induced by 2,4-dinitrofluorobenzene(DNFB).Methods:The AD mouse model was created by administration of DNFB for 14 consecutive days.The scoring atopic dermatitis index,enzyme-linked immunosorbent assay(ELISA),histopathology,and immunohistochemical analyses were used to assess inflammation and depression-like behaviors.Furthermore,high-throughput 16S rRNA gene sequencing was used to determine the composition of fecal microbiota.Results:Xylooligosaccharides treatment reduced the number of scratches and skin thickness,mast cell infiltration and the levels of immunoglobulin(Ig)E and T-helper cytokines compared with the AD model group.Meanwhile,xylooligosaccharides treatment reduced the immobility time of mice in the forced swimming test and increased the total movement distance and movement distance in the center area in the open-field test.Furthermore,5-hydroxytryptamine and dopamine expression in the brain was increased following xylooligosaccharides treatment.Using network pharmacology,Gene Ontology analysis showed that the targets were mainly enriched in phosphatase binding and the regulation of leukocyte differentiation,which ameliorated AD mainly through the hypoxia inducible factor-1 and phosphatidylinositide 3-kinase-protein kinase B pathways.16S rRNA gene sequencing,diversity indices,and gut microbial taxonomic composition analysis showed DNFB-induced changes in intestinal microbiota diversity in AD mice.Comparative analysis indicated that xylooligosaccharides intake improved the gut microbiome by dramatically enhancing the concentration of Lactobacillus while decreasing the concentration of Bacteroides in mice.Conclusion:Xylooligosaccharides reduce inflammatory dermatosis and related depression-like behaviors via regulating intestinal homeostasis,having medicinal value as a nutritional and functional ingredient.
