In this meta-analysis,our aim was to systematically evaluate the efficacy and safety of lotilaner ophthalmic solution in treating Demodex Blepharitis(DB),with the goal of providing evidence for clinical practice.Pub M...In this meta-analysis,our aim was to systematically evaluate the efficacy and safety of lotilaner ophthalmic solution in treating Demodex Blepharitis(DB),with the goal of providing evidence for clinical practice.Pub Med,Embase,Web of Science,The Cochrane Library,CNKI,Wanfang,and CBM were searched from inception to November 28,2023.Randomized controlled trials(RCTs)comparing lotilaner ophthalmic solution(experimental group)with placebo(control group)for the treatment of DB were included.Two researchers independently screened the literature,extracted the data,and assessed the quality of the included studies.Meta-analysis was conducted using Rev Man 5.4 software.The Grading of Recommendations,Assessment,Development,and Evaluations(GRADE)approach was used to evaluate the evidence quality of outcomes.Publication bias was assessed using a funnel plot.Four RCTs involving 947 patients were included.Meta-analysis revealed that compared to placebo,lotilaner ophthalmic solution significantly increased the rate of mite eradication(RR=3.61,95%CI(2.90,4.49),P<0.00001).Additionally,lotilaner treatment resulted in higher rates of collarette cure,erythema cure,composite erythema/collarette cure,and clinically meaningful collarette cure;the differences were statistically significant,with effect sizes(RR=5.74,95%CI(4.27,7.72),P<0.00001),(RR=3.16,95%CI(2.18,4.58),P<0.00001),(RR=6.75,95%CI(3.75,12.16),P<0.00001),and(RR=3.09,95%CI(2.65,3.60),P<0.00001),respectively.Mite density(MD=–1.42,95%CI(–2.09,–0.74),P<0.0001)and collarette grade(MD=–1.51,95%CI(–1.77,–1.25),P<0.00001)were significantly reduced.Indeed,no discernible discrepancies in the comfort levels experienced with eye drops emerged between the two groups.Although the experimental group did exhibit a slightly higher occurrence of treatment-related adverse events,ranging from instillation site discomfort to eye discharge and eyelid swelling,these variances did not attain statistical significance.Notably,upon GRADE evaluation,the study's evidence quality was deemed moderate,while scrutiny for publication bias revealed minimal indications thereof.In the realm of treatment,lotilaner ophthalmic solution shined as a beacon of efficacy,effectively combating mite infections and bolstering cure rates among patients with DB.Moreover,its administration was met with commendable compliance and upheld safety standards.展开更多
Demodex has been considered to be related with multiple skin disorders,but controversy persists.In this case-control study,a survey was conducted with 860 dermatosis patients aged 12 to 84 years in Xi'an,China to ...Demodex has been considered to be related with multiple skin disorders,but controversy persists.In this case-control study,a survey was conducted with 860 dermatosis patients aged 12 to 84 years in Xi'an,China to identify the association between facial dermatosis and Demodex.Amongst the patients,539 suffered from facial dermatosis and 321 suffered from non-facial dermatosis.Demodex mites were sampled and examined using the skin pressurization method.Multivariate regression analysis was applied to analyze the association between facial dermatosis and Demodex infestation,and to identify the risk factors of Demodex infestation.The results showed that total detection rate of Demodex was 43.0%.Patients aged above 30 years had higher odds of Demodex infestation than those under 30 years.Compared to patients with neutral skin,patients with mixed,oily,or dry skin were more likely to be infested with Demodex(odds ratios(ORs) were 2.5,2.4,and 1.6,respectively).Moreover,Demodex infestation was found to be statistically associated with rosacea(OR=8.1),steroid-induced dermatitis(OR=2.7),seborrheic dermatitis(OR=2.2),and primary irritation dermatitis(OR=2.1).In particular,ORs calculated from the severe infestation(≥5 mites/cm2) rate were significantly higher than those of the total rate.Therefore,we concluded that Demodex is associated with rosacea,steroid-induced dermatitis,seborrheic dermatitis,and primary irritation dermatitis.The rate of severe infestation is found to be more correlated with various dermatosis than the total infestation rate.The risk factors of Demodex infestation,age,and skin types were identified.Our study also suggested that good hygiene practice might reduce the chances of demodicosis and Demodex infestation.展开更多
To identify sociodemographic characteristics and risk factor of Demodex infestation,756 students aged 13-22 years in Xi'an,China were sampled for the school-based cross-sectional study.Demodex was examined using t...To identify sociodemographic characteristics and risk factor of Demodex infestation,756 students aged 13-22 years in Xi'an,China were sampled for the school-based cross-sectional study.Demodex was examined using the cellophane tape method(CTP).The results showed that the total detection rate of Demodex was 67.6%.Logistic regression analysis revealed that five variables(gender,residence,sharing sanitary ware,frequency of face-wash per day,and use of facial cleanser) were found to be uncorrelated with Demodex infestation,whereas three variables(age,skin type,and skin disease) were found to be independent correlates.Students aged over 18 years had 22.1 times higher odds of Demodex infestation compared to those under 16 years and students aged 16-18 years also had 2.1 times higher odds compared to those aged 13-15 years.Odds of having a Demodex infestation for oily or mixed skin were 2.1 times those for dry or neutral skin.Students with a facial skin disease had 3.0 times higher odds of being infested with Demodex compared to those without.The inception rate of students with facial dermatoses increased in parallel with increasing mite count.The inception rates were 21.3%,40.7%,59.2%,and 67.7% in the negative,mild,moderate,and severe infestation groups,respectively(χ2=60.6,P<0.001).Specifically,the amount of infested mites and inception rate of acne vulgaris were positively correlated(R2=0.57,moderate infestation odds ratio(OR)=7.1,severe infestation OR=10.3).It was concluded that Demodex prevalence increases with age,and Demodex presents in nearly all adult human.Sebaceous hyperplasia with oily or mixed skin seems to favour Demodex proliferation.Demodex infestation could be associated with acne vulgaris.The CTP is a good sampling method for studies of Demodex prevalence.展开更多
To observe the clinical changes of meibomian gland dysfunctipn(MGD)and ocular Demodex infestation after intense pulsed light(IPL)treatment to further examine the mechanism of IPL treating patients with MGD and ocular ...To observe the clinical changes of meibomian gland dysfunctipn(MGD)and ocular Demodex infestation after intense pulsed light(IPL)treatment to further examine the mechanism of IPL treating patients with MGD and ocular Demodex infestation.The medical records of 25 patients(49 eyes)with MGD treated with IPL,were retrospectively examined to determine outcomes.Associated ocular-surface parameters(ocular surface disease index,OSD1;lipid layer thickness,LLT;noninvasive first breakup time,NIF-BUT;noninvasive average breakup time,NIAvg?BUT;tear film breakup area,TBUA;Schirmer I Test,SIT;corneal fluorescein staining,CFS),eyelid margin abnormalities,meibum quality and expressibility,MG morphological parameters(macrostructure and microstructure),and the number of Demodex infestation were examined before and after treatment.The MG microstructure and the Demodex infestation were examined via in vivo confocal microscopy(IVCM).The results showed that there were statistically significant differences in associated ocular-surface parameters(all P<0.05)before and after IPL treatment,except SIT(P=0.065).Eyelid margin abnormalities,meibum quality and expressibility obviously improved in upper and lower eyelid after IPL treatment(all P<0.0001).MG macrostructure(MG dropouts)decreased in upper(P=0.002)and lower eyelid(P=0.001)after IPL treatment.The nine parameters of MG microstructure in upper and lower eyelid all distinctly improved after IPL treatment(all P<0.0001).The mean number of Demodex mites on the upper lid margin(6.59±7.16 to 3.12±3.81/9 eyelashes)and lower lid margin(2.55±2.11 to 1.29±1.53/9 eyelashes)significantly reduced after IPL treatment(all P<0.0001).The Demodex eradication rate was 20%(8/40)in upper lid margin and 34.15%(14/41)in lower lid margin.These findings indicate that IPL shows great therapeutic potential for patients of MGD and ocular Demodex infestation.展开更多
Until now, etiology of acne vulgaris is still uncertain. Although clinicians usually deny the association between Demodex infestation and acne vulgaris, it has been proved in some clinical practices. To confirm the as...Until now, etiology of acne vulgaris is still uncertain. Although clinicians usually deny the association between Demodex infestation and acne vulgaris, it has been proved in some clinical practices. To confirm the association between Demodex infestation and acne vulgaris, a meta-analysis was conducted. Predefined selection criteria were applied to search all published papers that analyzed the association between Demodex infestation and acne vulgaris (January 1950 to August 2011) in ISI Web of Knowledge, MEDLINE, and China National Knowledge Infrastructure (CNKI) databases. A meta-analysis was performed to calculate odds ratios (ORs) and 95% confidence intervals (CIs) based on fixed effects models or random effects models. We enrolled the 60 Chinese and 3 English papers in this meta-analysis, which covered Turkey and 25 different provinces/municipalities in China and 42 130 participants in-cluding students and residents, aged from 1 to 78 years. The pooled OR in random effects models is 2.80 (95% CI, 2.34-3.36). Stability is robust according to sensitivity analysis. The fail-safe number is 18 477, suggesting that at least 18 477 articles with negative conclusions would be needed to reverse the conclusion that acne vulgaris was related to Demodex infestation. So the effect of publication bias was insignificant and could be ignored. It was concluded that acne vulgaris is associated with Demodex infestation. This indicates that when regular treatments for acne vulgaris are ineffective, examination of Demodex mites and necessary acaricidal therapies should be considered.展开更多
To our knowledge,few reports on Demodex studied at the molecular level are available at present.In this study our group,for the first time,cloned,sequenced and analyzed the chitin synthase(CHS) gene fragments of Demod...To our knowledge,few reports on Demodex studied at the molecular level are available at present.In this study our group,for the first time,cloned,sequenced and analyzed the chitin synthase(CHS) gene fragments of Demodex folliculorum,Demodex brevis,and Demodex canis(three isolates from each species) from Xi'an China,by designing specific primers based on the only partial sequence of the CHS gene of D.canis from Japan,retrieved from GenBank.Results show that amplification was successful only in three D.canis isolates and one D.brevis isolate out of the nine Demodex isolates.The obtained fragments were sequenced to be 339 bp for D.canis and 338 bp for D.brevis.The CHS gene sequence similarities between the three Xi'an D.canis isolates and one Japanese D.canis isolate ranged from 99.7% to 100.0%,and those between four D.canis isolates and one D.brevis isolate were 99.1%-99.4%.Phylogenetic trees based on maximum parsimony(MP) and maximum likelihood(ML) methods shared the same clusters,according with the traditional classification.Two open reading frames(ORFs) were identified in each CHS gene sequenced,and their corresponding amino acid sequences were located at the catalytic domain.The relatively conserved sequences could be deduced to be a CHS class A gene,which is associated with chitin synthesis in the integument of Demodex mites.展开更多
For a long time,classification of Demodex mites has been based mainly on their hosts and phenotypic characteristics.A new subspecies of Demodex folliculorum has been proposed,but not confirmed.Here,cox1 partial sequen...For a long time,classification of Demodex mites has been based mainly on their hosts and phenotypic characteristics.A new subspecies of Demodex folliculorum has been proposed,but not confirmed.Here,cox1 partial sequences of nine isolates of three Demodex species from two geographical sources(China and Spain) were studied to conduct molecular identification of D.folliculorum.Sequencing showed that the mitochondrial cox1 fragments of five D.folliculorum isolates from the facial skin of Chinese individuals were 429 bp long and that their sequence identity was 97.4%.The average sequence divergence was 1.24% among the five Chinese isolates,0.94% between the two geographical isolate groups(China(5) and Spain(1)),and 2.15% between the two facial tissue sources(facial skin(6) and eyelids(1)).The genetic distance and rate of third-position nucleotide transition/transversion were 0.0125,2.7(3/1) among the five Chinese isolates,0.0094,3.1(3/1) between the two geographical isolate groups,and 0.0217,4.4(3/1) between the two facial tissue sources.Phylogenetic trees showed that D.folliculorum from the two geographical isolate groups did not form sister clades,while those from different facial tissue sources did.According to the molecular characteristics,it appears that subspecies differentiation might not have occurred and that D.folliculorum isolates from the two geographical sources are of the same population.However,population differentiation might be occurring between isolates from facial skin and eyelids.展开更多
AIM： To investigate the association between ocular demodex folliculorum infestation and ocular surface manifestations in meibomian gland dysfunction（MGD）.METHODS： Eight-six patients with MGD were enrolled. All enr...AIM： To investigate the association between ocular demodex folliculorum infestation and ocular surface manifestations in meibomian gland dysfunction（MGD）.METHODS： Eight-six patients with MGD were enrolled. All enrolled subjects were tested in the following sequence： ocular surface disease index（OSDI）, slit-lamp biomicroscope examination, corneal surface regularity index（SRI） and surface asymmetry index（SAI）, tear fluid collection, fluorescein tear film break-up time（F-BUT）, corneal fluorescein staining（CFS）, Schirmer I test（SIT） and demodex folliculorum counting. Tear matrix metalloproteinase（MMP）-9 activity was assessed using MMP-9 activity assay kit.RESULTS： Among 86 MGD patients, 40 were positive for demodex. The ocular demodex-positive group showed significantly increased scores of OSDI（25.96±13.74 vs 18.07±11.55, P=0.01）, lid margin abnormality（2.38±0.87 vs 1.98±0.91, P=0.04） and CFS（1.28±2.00 vs 0.94±1.36, P=0.01） compared to the ocular demodex-free group. The tear MMP-9 activity was higher in the ocular demodex-positive group（102.9±32.4 ng/mL） than the ocular demodex-free group（46.2±19.2 ng/mL, P=0.03）. There was no significant difference in meibum quality and expressibility, SRI, SAI, F-BUT and SIT between the two groups（P〉0.05 for each）. No significant correlation was noted between the number of demodex and ocular surface parameters in demodexpositive MGD group（P〉0.05 for each）.CONCLUSION： Ocular demodex folliculorum infestation may be associated with ocular discomfort and ocular surface damage in MGD.展开更多
AIM:To evaluate the correlation between Demodex infestation and keratitis,and to assess demodicosis using a simple approach.METHODS:A modified slit lamp illumination(at 40×magnification)was used to observe Demode...AIM:To evaluate the correlation between Demodex infestation and keratitis,and to assess demodicosis using a simple approach.METHODS:A modified slit lamp illumination(at 40×magnification)was used to observe Demodex tails in 40patients with refractory keratitis and 80 healthy controls.Bacterial smear and culture of the conjunctival sac and corneal lesion were performed to identify the pathogen.Tea tree oil ointment(TTOO)was added as a Demodex killing agent for lid scrubs to the treatment when Demodex infestation was confirmed.RESULTS:Demodex tails were found in all patients compared to 42/80 of the controls(P<0.01).Seventeen patients presented blepharitis,while 23 were free of scales and inflammation at the lid margin.The demodicosis was mild,moderate,and severe in 8,19,and 13 patients,respectively,compared to mild in 42 controls(P<0.01).The keratitis was mild,moderate,and severe in 13,19,and 8patients,respectively.The severity of Demodex infestation was not correlated to the severity of keratitis(P=0.126).The growth of Staphylococcus was revealed in nine patients who did not react to antibiotic eye drops prior to the TTOO treatment.Patients’signs and symptoms got resolved after the lid scrub with TTOO.CONCLUSION:Ocular Demodex needs to be checked and treated in refractory keratitis patients with or without blepharitis.A slit-lamp illumination under high magnification favors the judgment of the severity of Demodex infestation.展开更多
Objective:To explore the clinical effect of Chinese medicine aerosol fumigation on demodex infection related meibomian gland dysfunction.Methods:In this prospective study,60 patients(120 eyes)were selected and randoml...Objective:To explore the clinical effect of Chinese medicine aerosol fumigation on demodex infection related meibomian gland dysfunction.Methods:In this prospective study,60 patients(120 eyes)were selected and randomly divided into 2 groups:the treatment group(30 cases,60 eyes)was treated with Chinese medicine aerosol fumigation and meibomian gland massage,the control group(30 cases,60 eyes)was treated with meibomian gland massage.Observation of Demodex count,symptom scores,break-up time(BUT),Schirmer I test(SIT),meibomian gland secretion function scores and eyelid fat traits scores were used to compare the difference between before and after treatment.Results:There was no significant difference in Demodex count,symptom scores,BUT,SIT,meibomian gland secretion function scores and eyelid fat traits scores between the 2 groups before treatment(P>0.05).After treatment,symptom scores,meibomian gland secretion function scores and eyelid fat traits and Demodex count of the treatment group were significantly reduced(P<0.01).Conclusion:Chinese medicine aerosol fumigation can relieve symptoms of of demodex infection related meibomian gland dysfunctionand reduce the number of ocular Demodex.展开更多
Purpose: Demodex folliculorum is a transparent mite, 0.3 - 0.4 mm long, which asymptomatically parasitizes the human pilosebaceous follicles. D. folliculorum is observed in normal skin with a prevalence of 100% and a ...Purpose: Demodex folliculorum is a transparent mite, 0.3 - 0.4 mm long, which asymptomatically parasitizes the human pilosebaceous follicles. D. folliculorum is observed in normal skin with a prevalence of 100% and a density of ≤ 5 D/cm2 in the adult population. Materials and Methods: This study evaluated the differences in pH on the five facial sites between the two populations with and without D. folliculorum. The relationship between pH and skin surface oil was analyzed in populations with and without Demodex mites. Mongolian 750 subjects (370 males and 380 females) aged 16 - 84 years, who lived in Ulaanbaatar city, were enrolled in this study. The eligibility criteria included a minimum age of 16 and no physical and dermatologic illness, no cosmetic. Results: Skin surface oil among the five facial areas differed significantly in both subjects with and without Demodex folliculorum (P < 0.001). When the skin surface oil on the T-zone, U-zone was compared, those on the T-zone were significantly higher than those of the U-zone (P < 0.001) in both populations (P< 0.01). The pH levels on the five facial sites, and U-zone, T-zone and MFpH differed significantly in among both subjects with and without Demodex folliculorum (P < 0.001). In both groups, the pH levels of the U-zone were significantly lower than the pH of the T-zone (P Conclusions: Among the five facial sites in subjects with Demodex folliculorum, there were significant negative correlations between skin surface oil and pH on the forehead (p < 0.001, r = 652), cheek (P < 0.001, r = 0.656), nose (P < 0.001, r = 0.754), chin (P < 0.001, r = 0.679), and T-zone (P < 0.001, r = 0.698), MFSE-MFpH (P < 0.001, r = 0.483). In contrast, among the five sites in subjects without Demodex folliculorum, a significant negative correlation between skin surface oil and pH was observed on the forehead (p < 0.001, r = 766), cheek (P < 0.001, r = 0.798), nose (P < 0.001, r = 0.706), chin (P < 0.001, r = 0.823), and T-zone (P < 0.001, r = 0.602), U-zone (P < 0.001, r = -0.550)展开更多
I have read with great interest the recent article ＂A meta-analysis of association between acne vulgaris and Demodex infestation＂ by Zhao et al. （2012）, published in Journal of Zhejiang University SCIENCE B （Biom...I have read with great interest the recent article ＂A meta-analysis of association between acne vulgaris and Demodex infestation＂ by Zhao et al. （2012）, published in Journal of Zhejiang University SCIENCE B （Biomedicine ＆ Biotechnology） （another two articles by Zhao et al. （2011a; 2011b） are also related to Demodex infestation）. The article is highly thought provoking. Interestingly, Demodex infestation may be associated with a number of other facial dermatological lesions besides ache vulgaris.展开更多
基金National Key R&D Program of China(Grant No.2020YFC2008304)Health Commission of Henan Province(Grant No.LHGJ20220426)。
文摘In this meta-analysis,our aim was to systematically evaluate the efficacy and safety of lotilaner ophthalmic solution in treating Demodex Blepharitis(DB),with the goal of providing evidence for clinical practice.Pub Med,Embase,Web of Science,The Cochrane Library,CNKI,Wanfang,and CBM were searched from inception to November 28,2023.Randomized controlled trials(RCTs)comparing lotilaner ophthalmic solution(experimental group)with placebo(control group)for the treatment of DB were included.Two researchers independently screened the literature,extracted the data,and assessed the quality of the included studies.Meta-analysis was conducted using Rev Man 5.4 software.The Grading of Recommendations,Assessment,Development,and Evaluations(GRADE)approach was used to evaluate the evidence quality of outcomes.Publication bias was assessed using a funnel plot.Four RCTs involving 947 patients were included.Meta-analysis revealed that compared to placebo,lotilaner ophthalmic solution significantly increased the rate of mite eradication(RR=3.61,95%CI(2.90,4.49),P<0.00001).Additionally,lotilaner treatment resulted in higher rates of collarette cure,erythema cure,composite erythema/collarette cure,and clinically meaningful collarette cure;the differences were statistically significant,with effect sizes(RR=5.74,95%CI(4.27,7.72),P<0.00001),(RR=3.16,95%CI(2.18,4.58),P<0.00001),(RR=6.75,95%CI(3.75,12.16),P<0.00001),and(RR=3.09,95%CI(2.65,3.60),P<0.00001),respectively.Mite density(MD=–1.42,95%CI(–2.09,–0.74),P<0.0001)and collarette grade(MD=–1.51,95%CI(–1.77,–1.25),P<0.00001)were significantly reduced.Indeed,no discernible discrepancies in the comfort levels experienced with eye drops emerged between the two groups.Although the experimental group did exhibit a slightly higher occurrence of treatment-related adverse events,ranging from instillation site discomfort to eye discharge and eyelid swelling,these variances did not attain statistical significance.Notably,upon GRADE evaluation,the study's evidence quality was deemed moderate,while scrutiny for publication bias revealed minimal indications thereof.In the realm of treatment,lotilaner ophthalmic solution shined as a beacon of efficacy,effectively combating mite infections and bolstering cure rates among patients with DB.Moreover,its administration was met with commendable compliance and upheld safety standards.
基金Project supported by the National Natural Science Foundation of China (No. 30872199)the Natural Science Foundation of Shaanxi Province (No. 2006C247),China
文摘Demodex has been considered to be related with multiple skin disorders,but controversy persists.In this case-control study,a survey was conducted with 860 dermatosis patients aged 12 to 84 years in Xi'an,China to identify the association between facial dermatosis and Demodex.Amongst the patients,539 suffered from facial dermatosis and 321 suffered from non-facial dermatosis.Demodex mites were sampled and examined using the skin pressurization method.Multivariate regression analysis was applied to analyze the association between facial dermatosis and Demodex infestation,and to identify the risk factors of Demodex infestation.The results showed that total detection rate of Demodex was 43.0%.Patients aged above 30 years had higher odds of Demodex infestation than those under 30 years.Compared to patients with neutral skin,patients with mixed,oily,or dry skin were more likely to be infested with Demodex(odds ratios(ORs) were 2.5,2.4,and 1.6,respectively).Moreover,Demodex infestation was found to be statistically associated with rosacea(OR=8.1),steroid-induced dermatitis(OR=2.7),seborrheic dermatitis(OR=2.2),and primary irritation dermatitis(OR=2.1).In particular,ORs calculated from the severe infestation(≥5 mites/cm2) rate were significantly higher than those of the total rate.Therefore,we concluded that Demodex is associated with rosacea,steroid-induced dermatitis,seborrheic dermatitis,and primary irritation dermatitis.The rate of severe infestation is found to be more correlated with various dermatosis than the total infestation rate.The risk factors of Demodex infestation,age,and skin types were identified.Our study also suggested that good hygiene practice might reduce the chances of demodicosis and Demodex infestation.
基金Project supported by the National Natural Science Foundation of China (No. 30872199)the Natural Science Foundation of Shaanxi Province (No. 2006C247),China
文摘To identify sociodemographic characteristics and risk factor of Demodex infestation,756 students aged 13-22 years in Xi'an,China were sampled for the school-based cross-sectional study.Demodex was examined using the cellophane tape method(CTP).The results showed that the total detection rate of Demodex was 67.6%.Logistic regression analysis revealed that five variables(gender,residence,sharing sanitary ware,frequency of face-wash per day,and use of facial cleanser) were found to be uncorrelated with Demodex infestation,whereas three variables(age,skin type,and skin disease) were found to be independent correlates.Students aged over 18 years had 22.1 times higher odds of Demodex infestation compared to those under 16 years and students aged 16-18 years also had 2.1 times higher odds compared to those aged 13-15 years.Odds of having a Demodex infestation for oily or mixed skin were 2.1 times those for dry or neutral skin.Students with a facial skin disease had 3.0 times higher odds of being infested with Demodex compared to those without.The inception rate of students with facial dermatoses increased in parallel with increasing mite count.The inception rates were 21.3%,40.7%,59.2%,and 67.7% in the negative,mild,moderate,and severe infestation groups,respectively(χ2=60.6,P<0.001).Specifically,the amount of infested mites and inception rate of acne vulgaris were positively correlated(R2=0.57,moderate infestation odds ratio(OR)=7.1,severe infestation OR=10.3).It was concluded that Demodex prevalence increases with age,and Demodex presents in nearly all adult human.Sebaceous hyperplasia with oily or mixed skin seems to favour Demodex proliferation.Demodex infestation could be associated with acne vulgaris.The CTP is a good sampling method for studies of Demodex prevalence.
基金This study was supported by the National Natural Science Foundation of China(No.81670824)the Natural Science Foundation of Hubei Province of China(No.2016CFB421).
文摘To observe the clinical changes of meibomian gland dysfunctipn(MGD)and ocular Demodex infestation after intense pulsed light(IPL)treatment to further examine the mechanism of IPL treating patients with MGD and ocular Demodex infestation.The medical records of 25 patients(49 eyes)with MGD treated with IPL,were retrospectively examined to determine outcomes.Associated ocular-surface parameters(ocular surface disease index,OSD1;lipid layer thickness,LLT;noninvasive first breakup time,NIF-BUT;noninvasive average breakup time,NIAvg?BUT;tear film breakup area,TBUA;Schirmer I Test,SIT;corneal fluorescein staining,CFS),eyelid margin abnormalities,meibum quality and expressibility,MG morphological parameters(macrostructure and microstructure),and the number of Demodex infestation were examined before and after treatment.The MG microstructure and the Demodex infestation were examined via in vivo confocal microscopy(IVCM).The results showed that there were statistically significant differences in associated ocular-surface parameters(all P<0.05)before and after IPL treatment,except SIT(P=0.065).Eyelid margin abnormalities,meibum quality and expressibility obviously improved in upper and lower eyelid after IPL treatment(all P<0.0001).MG macrostructure(MG dropouts)decreased in upper(P=0.002)and lower eyelid(P=0.001)after IPL treatment.The nine parameters of MG microstructure in upper and lower eyelid all distinctly improved after IPL treatment(all P<0.0001).The mean number of Demodex mites on the upper lid margin(6.59±7.16 to 3.12±3.81/9 eyelashes)and lower lid margin(2.55±2.11 to 1.29±1.53/9 eyelashes)significantly reduced after IPL treatment(all P<0.0001).The Demodex eradication rate was 20%(8/40)in upper lid margin and 34.15%(14/41)in lower lid margin.These findings indicate that IPL shows great therapeutic potential for patients of MGD and ocular Demodex infestation.
基金supported by the National Natural Science Foundation of China (No. 30872199)the Natural Science Foundation of Shaanxi Province (No. 2006C247), China
文摘Until now, etiology of acne vulgaris is still uncertain. Although clinicians usually deny the association between Demodex infestation and acne vulgaris, it has been proved in some clinical practices. To confirm the association between Demodex infestation and acne vulgaris, a meta-analysis was conducted. Predefined selection criteria were applied to search all published papers that analyzed the association between Demodex infestation and acne vulgaris (January 1950 to August 2011) in ISI Web of Knowledge, MEDLINE, and China National Knowledge Infrastructure (CNKI) databases. A meta-analysis was performed to calculate odds ratios (ORs) and 95% confidence intervals (CIs) based on fixed effects models or random effects models. We enrolled the 60 Chinese and 3 English papers in this meta-analysis, which covered Turkey and 25 different provinces/municipalities in China and 42 130 participants in-cluding students and residents, aged from 1 to 78 years. The pooled OR in random effects models is 2.80 (95% CI, 2.34-3.36). Stability is robust according to sensitivity analysis. The fail-safe number is 18 477, suggesting that at least 18 477 articles with negative conclusions would be needed to reverse the conclusion that acne vulgaris was related to Demodex infestation. So the effect of publication bias was insignificant and could be ignored. It was concluded that acne vulgaris is associated with Demodex infestation. This indicates that when regular treatments for acne vulgaris are ineffective, examination of Demodex mites and necessary acaricidal therapies should be considered.
基金Project supported by the National Natural Science Foundation of China (No. 81271856)the National College of Innovative Experimental Projects of China (No. 101069819)
文摘To our knowledge,few reports on Demodex studied at the molecular level are available at present.In this study our group,for the first time,cloned,sequenced and analyzed the chitin synthase(CHS) gene fragments of Demodex folliculorum,Demodex brevis,and Demodex canis(three isolates from each species) from Xi'an China,by designing specific primers based on the only partial sequence of the CHS gene of D.canis from Japan,retrieved from GenBank.Results show that amplification was successful only in three D.canis isolates and one D.brevis isolate out of the nine Demodex isolates.The obtained fragments were sequenced to be 339 bp for D.canis and 338 bp for D.brevis.The CHS gene sequence similarities between the three Xi'an D.canis isolates and one Japanese D.canis isolate ranged from 99.7% to 100.0%,and those between four D.canis isolates and one D.brevis isolate were 99.1%-99.4%.Phylogenetic trees based on maximum parsimony(MP) and maximum likelihood(ML) methods shared the same clusters,according with the traditional classification.Two open reading frames(ORFs) were identified in each CHS gene sequenced,and their corresponding amino acid sequences were located at the catalytic domain.The relatively conserved sequences could be deduced to be a CHS class A gene,which is associated with chitin synthesis in the integument of Demodex mites.
基金Project(No. 81271856)supported by the National Natural Science Foundation of China
文摘For a long time,classification of Demodex mites has been based mainly on their hosts and phenotypic characteristics.A new subspecies of Demodex folliculorum has been proposed,but not confirmed.Here,cox1 partial sequences of nine isolates of three Demodex species from two geographical sources(China and Spain) were studied to conduct molecular identification of D.folliculorum.Sequencing showed that the mitochondrial cox1 fragments of five D.folliculorum isolates from the facial skin of Chinese individuals were 429 bp long and that their sequence identity was 97.4%.The average sequence divergence was 1.24% among the five Chinese isolates,0.94% between the two geographical isolate groups(China(5) and Spain(1)),and 2.15% between the two facial tissue sources(facial skin(6) and eyelids(1)).The genetic distance and rate of third-position nucleotide transition/transversion were 0.0125,2.7(3/1) among the five Chinese isolates,0.0094,3.1(3/1) between the two geographical isolate groups,and 0.0217,4.4(3/1) between the two facial tissue sources.Phylogenetic trees showed that D.folliculorum from the two geographical isolate groups did not form sister clades,while those from different facial tissue sources did.According to the molecular characteristics,it appears that subspecies differentiation might not have occurred and that D.folliculorum isolates from the two geographical sources are of the same population.However,population differentiation might be occurring between isolates from facial skin and eyelids.
基金Supported by the National Natural Science Foundation of China(No.81500693)
文摘AIM： To investigate the association between ocular demodex folliculorum infestation and ocular surface manifestations in meibomian gland dysfunction（MGD）.METHODS： Eight-six patients with MGD were enrolled. All enrolled subjects were tested in the following sequence： ocular surface disease index（OSDI）, slit-lamp biomicroscope examination, corneal surface regularity index（SRI） and surface asymmetry index（SAI）, tear fluid collection, fluorescein tear film break-up time（F-BUT）, corneal fluorescein staining（CFS）, Schirmer I test（SIT） and demodex folliculorum counting. Tear matrix metalloproteinase（MMP）-9 activity was assessed using MMP-9 activity assay kit.RESULTS： Among 86 MGD patients, 40 were positive for demodex. The ocular demodex-positive group showed significantly increased scores of OSDI（25.96±13.74 vs 18.07±11.55, P=0.01）, lid margin abnormality（2.38±0.87 vs 1.98±0.91, P=0.04） and CFS（1.28±2.00 vs 0.94±1.36, P=0.01） compared to the ocular demodex-free group. The tear MMP-9 activity was higher in the ocular demodex-positive group（102.9±32.4 ng/mL） than the ocular demodex-free group（46.2±19.2 ng/mL, P=0.03）. There was no significant difference in meibum quality and expressibility, SRI, SAI, F-BUT and SIT between the two groups（P〉0.05 for each）. No significant correlation was noted between the number of demodex and ocular surface parameters in demodexpositive MGD group（P〉0.05 for each）.CONCLUSION： Ocular demodex folliculorum infestation may be associated with ocular discomfort and ocular surface damage in MGD.
基金Supported by the National Natural Science Foundation of China(No.82271052,No.82271058,No.U20A20386)the Taishan Scholar Program(No.tspd20150215,No.tsqn201909188)。
文摘AIM:To evaluate the correlation between Demodex infestation and keratitis,and to assess demodicosis using a simple approach.METHODS:A modified slit lamp illumination(at 40×magnification)was used to observe Demodex tails in 40patients with refractory keratitis and 80 healthy controls.Bacterial smear and culture of the conjunctival sac and corneal lesion were performed to identify the pathogen.Tea tree oil ointment(TTOO)was added as a Demodex killing agent for lid scrubs to the treatment when Demodex infestation was confirmed.RESULTS:Demodex tails were found in all patients compared to 42/80 of the controls(P<0.01).Seventeen patients presented blepharitis,while 23 were free of scales and inflammation at the lid margin.The demodicosis was mild,moderate,and severe in 8,19,and 13 patients,respectively,compared to mild in 42 controls(P<0.01).The keratitis was mild,moderate,and severe in 13,19,and 8patients,respectively.The severity of Demodex infestation was not correlated to the severity of keratitis(P=0.126).The growth of Staphylococcus was revealed in nine patients who did not react to antibiotic eye drops prior to the TTOO treatment.Patients’signs and symptoms got resolved after the lid scrub with TTOO.CONCLUSION:Ocular Demodex needs to be checked and treated in refractory keratitis patients with or without blepharitis.A slit-lamp illumination under high magnification favors the judgment of the severity of Demodex infestation.
基金National Natural Science Foundation of China(No.81574029)Jinming National Famous and Old Traditional Chinese Medicine Expert Inheritance Studio,and"Hundreds of Millions"Talent Project(No.Qihuang Project)for Qihuang Scholar of Inheritance and Innovation of Traditional Chinese Medicine.
文摘Objective:To explore the clinical effect of Chinese medicine aerosol fumigation on demodex infection related meibomian gland dysfunction.Methods:In this prospective study,60 patients(120 eyes)were selected and randomly divided into 2 groups:the treatment group(30 cases,60 eyes)was treated with Chinese medicine aerosol fumigation and meibomian gland massage,the control group(30 cases,60 eyes)was treated with meibomian gland massage.Observation of Demodex count,symptom scores,break-up time(BUT),Schirmer I test(SIT),meibomian gland secretion function scores and eyelid fat traits scores were used to compare the difference between before and after treatment.Results:There was no significant difference in Demodex count,symptom scores,BUT,SIT,meibomian gland secretion function scores and eyelid fat traits scores between the 2 groups before treatment(P>0.05).After treatment,symptom scores,meibomian gland secretion function scores and eyelid fat traits and Demodex count of the treatment group were significantly reduced(P<0.01).Conclusion:Chinese medicine aerosol fumigation can relieve symptoms of of demodex infection related meibomian gland dysfunctionand reduce the number of ocular Demodex.
文摘Purpose: Demodex folliculorum is a transparent mite, 0.3 - 0.4 mm long, which asymptomatically parasitizes the human pilosebaceous follicles. D. folliculorum is observed in normal skin with a prevalence of 100% and a density of ≤ 5 D/cm2 in the adult population. Materials and Methods: This study evaluated the differences in pH on the five facial sites between the two populations with and without D. folliculorum. The relationship between pH and skin surface oil was analyzed in populations with and without Demodex mites. Mongolian 750 subjects (370 males and 380 females) aged 16 - 84 years, who lived in Ulaanbaatar city, were enrolled in this study. The eligibility criteria included a minimum age of 16 and no physical and dermatologic illness, no cosmetic. Results: Skin surface oil among the five facial areas differed significantly in both subjects with and without Demodex folliculorum (P < 0.001). When the skin surface oil on the T-zone, U-zone was compared, those on the T-zone were significantly higher than those of the U-zone (P < 0.001) in both populations (P< 0.01). The pH levels on the five facial sites, and U-zone, T-zone and MFpH differed significantly in among both subjects with and without Demodex folliculorum (P < 0.001). In both groups, the pH levels of the U-zone were significantly lower than the pH of the T-zone (P Conclusions: Among the five facial sites in subjects with Demodex folliculorum, there were significant negative correlations between skin surface oil and pH on the forehead (p < 0.001, r = 652), cheek (P < 0.001, r = 0.656), nose (P < 0.001, r = 0.754), chin (P < 0.001, r = 0.679), and T-zone (P < 0.001, r = 0.698), MFSE-MFpH (P < 0.001, r = 0.483). In contrast, among the five sites in subjects without Demodex folliculorum, a significant negative correlation between skin surface oil and pH was observed on the forehead (p < 0.001, r = 766), cheek (P < 0.001, r = 0.798), nose (P < 0.001, r = 0.706), chin (P < 0.001, r = 0.823), and T-zone (P < 0.001, r = 0.602), U-zone (P < 0.001, r = -0.550)
文摘I have read with great interest the recent article ＂A meta-analysis of association between acne vulgaris and Demodex infestation＂ by Zhao et al. （2012）, published in Journal of Zhejiang University SCIENCE B （Biomedicine ＆ Biotechnology） （another two articles by Zhao et al. （2011a; 2011b） are also related to Demodex infestation）. The article is highly thought provoking. Interestingly, Demodex infestation may be associated with a number of other facial dermatological lesions besides ache vulgaris.
