Objective: to analyze the clinical efficacy of dupilumab in the treatment of moderate to severe atopic dermatitis. Methods: a total of 60 patients with moderate to severe atopic dermatitis treated in Beijing Jingcheng...Objective: to analyze the clinical efficacy of dupilumab in the treatment of moderate to severe atopic dermatitis. Methods: a total of 60 patients with moderate to severe atopic dermatitis treated in Beijing Jingcheng Skin Hospital (2021.1-2021.12) were divided into observation group (dupilumab) and control group (conventional treatment). The clinical efficacy (excellent + effective), the improvement time of clinical symptoms (eczema like skin lesions, dry skin, pruritus), EASI (total score of 6, the lower the better) and NRS (total score of 10, the lower the better) were compared after treatment. Results: there were significant differences in clinical efficacy between the observation group (dupilumab) and the control group (conventional treatment) after treatment (P 0.05). There was a significant difference in the improvement time of clinical symptoms between the observation group (dupilumab) and the control group (conventional treatment) after treatment (P 0.05). Before treatment, there were no differences in EASI and NRS scores between the observation group (dupilumab) and the control group (conventional treatment) (P > 0.05), but after treatment, there were differences in EASI and NRS scores between the observation group (dupilumab) and the control group (conventional treatment) (P 0.05). Conclusion: in the treatment of patients, the use of dupilumab can improve the treatment effect, the treatment is obvious, and the symptoms of patients are more obvious, the score of pruritus is more obvious, which is conducive to improve the quality of life of patients, and is worthy of being widely used in clinical practice.展开更多
BACKGROUND Lichenoid amyloidosis(LA)is a subtype of primary cutaneous amyloidosis characterized by persistent multiple groups of hyperkeratotic papules,usually on the lower leg,back,forearm,or thigh.LA may be associat...BACKGROUND Lichenoid amyloidosis(LA)is a subtype of primary cutaneous amyloidosis characterized by persistent multiple groups of hyperkeratotic papules,usually on the lower leg,back,forearm,or thigh.LA may be associated with several skin diseases,including atopic dermatitis(AD).The treatment of LA is considered to be difficult.However,as there is some overlap in the etiopathogenesis of LA and AD,AD treatment may also be effective for LA.CASE SUMMARY Case 1:A 70-year-old man was diagnosed with severe AD with LA based on large dark erythema and papules on the trunk and buttocks and dense hemispherical millet-shaped papules with pruritus on the extensor side of the lower limbs.He had a long history of the disease(8 years),with repeated and polymorphic skin lesions.Given the poor efficacy of traditional treatments,this patient was recommended to receive dupilumab treatment.At the initial stage,300 mg was injected subcutaneously every 2 wk.After 28 wk,the drug interval was extended to 1 mo due to the pandemic.Follow-up observations revealed that the patient reached an Eczema Area Severity Index of 90(skin lesions improved by 90%compared with the baseline)by the end of the study.Moreover,Investigator's Global Assessment score was 1,and scoring atopic dermatitis index and numeric rating scale improved by 97.7%and 87.5%compared with the baseline,respectively,with LA skin lesions having largely subsided.Case 2:A 30-year-old woman was diagnosed with severe AD with LA,due to dense and substantial papules on the dorsal hands similar to changes in cutaneous amyloidosis,and erythema and papules scattered on limbs and trunk with pruritus,present for 25 years.After 16 wk of dupilumab treatment,she stopped,and skin lesions completely subsided,without recurrence since the last follow-up.CONCLUSION Dupilumab shows rational efficacy and safety in the treatment of severe AD with LA,in addition to benefits in the quality of life of the patients.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
To the Editor:Upadacitinib,an oral janus kinase(JAK)inhibitor,exhibits a higher inhibitory potency for JAK1 compared to JAK2,JAK3,or tyrosine kinase 2,making it a promising candidate for the treatment of atopic dermat...To the Editor:Upadacitinib,an oral janus kinase(JAK)inhibitor,exhibits a higher inhibitory potency for JAK1 compared to JAK2,JAK3,or tyrosine kinase 2,making it a promising candidate for the treatment of atopic dermatitis(AD).Global trials Measure Up 1,Measure Up 2,and AD Up have demonstrated efficacy and safety data for moderate-to-severe AD,both as monotherapy and in combination with topical corticosteroids(TCS).[1,2]The updated 52-week results preliminarily reported sustained clinical benefits over 52 weeks,[3,4]but data on long-term outcomes in Chinese patients remain limited.Ethnic differences in AD pathophysiology,including variations in immune signatures,underscore the need for region-specific evidence.[5]This post hoc analysis of Measure Up 1 and AD Up trials evaluates the 140-week efficacy and safety of upadacitinib in Chinese patients.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
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
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
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 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 Atopic dermatitis is a chronic inflammatory skin disease that poses a substantial burden on patients'physical health,as well as on their psychological health and quality of life.This study specifically ...BACKGROUND Atopic dermatitis is a chronic inflammatory skin disease that poses a substantial burden on patients'physical health,as well as on their psychological health and quality of life.This study specifically examines active disease phases(excluding spontaneous remission periods)to investigate the efficacy of continuous treatments on the psychological state and life quality of patients with atopic dermatitis.AIM To evaluate the effectiveness of continuous treatment strategies,including dermatological care,psychological counseling,education,and long-term follow-up,on the psychological state and quality of life in patients with atopic dermatitis.METHODS A retrospective cohort study was conducted on 120 atopic dermatitis patients treated at our hospital between June 2023 and May 2024.A total of 120 patients were randomly assigned into control and intervention groups(60 patients each).The control group underwent routine treatment,and the intervention group was treated using continuous treatment strategies,including personalized skin care plan,psychological counseling,patient education,and long-term follow-up.Quality of life and psychological status of patients were assessed using the dermatology life quality index and Hospital Anxiety and Depression Scale.RESULTS At 12 months post-intervention,the dermatology life quality index scores in the intervention group were significantly lower than those in the control group(P<0.01),implying improved quality of life.The anxiety and depression symptoms were significantly lower in the intervention group when compared to the control group(P<0.05)as per the Hospital Anxiety and Depression Scale.In the intervention group,the rate of recurrence of skin symptoms was 15%compared to 35%in the control group,with a statistically significant difference between the two groups.CONCLUSION Continuous treatment for atopic dermatitis patients greatly improve their psychological state and quality of life,enhance disease-free survival,and offer new trains of thought for clinical treatment.Personalized integrated management over a prolonged time is important to improve quality of life in such patients.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
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
Traditional Chinese medicine(TCM)is a well-accepted therapy for atopic dermatitis(AD).However,there are currently no evidence-based guidelines integrating TCM and Western medicine for the treatment of AD,limiting the ...Traditional Chinese medicine(TCM)is a well-accepted therapy for atopic dermatitis(AD).However,there are currently no evidence-based guidelines integrating TCM and Western medicine for the treatment of AD,limiting the clinical application of such combined approaches.Therefore,the China Association of Chinese Medicine initiated the development of the current guideline,focusing on key issues related to the use of TCM in the treatment of AD.This guideline was developed in accordance with the principles of the guideline formulation manual published by the World Health Organization.A comprehensive review of the literature on the combined use of TCM and Western medicine to treat AD was conducted.The findings were extensively discussed by experts in dermatology and pharmacy with expertise in both TCM and Western medicine.This guideline comprises 23 recommendations across seven major areas,including TCM syndrome differentiation and classification of AD,principles and application scenarios of TCM combined with Western medicine for treating AD,outcome indicators for evaluating clinical efficacy of AD treatment,integration of TCM pattern classification and Western medicine across disease stages,daily management of AD,the use of internal TCM therapies and proprietary Chinese medicines,and TCM external treatments.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
Background:Atopic dermatitis(AD)affects approximately 10%of adults worldwide.CM310 is a humanized monoclonal antibody targeting interleukin-4 receptor alpha that blocks interleukin-4 and interleukin-13 signaling.This ...Background:Atopic dermatitis(AD)affects approximately 10%of adults worldwide.CM310 is a humanized monoclonal antibody targeting interleukin-4 receptor alpha that blocks interleukin-4 and interleukin-13 signaling.This trial aimed to evaluate the efficacy and safety of CM310 in Chinese adults with moderate-to-severe AD.Methods:This multicenter,randomized,double-blind,placebo-controlled,phase 2b trial was conducted in 21 medical institutions in China from February to November 2021.Totally 120 eligible patients were enrolled and randomized(1:1:1)to receive subcutaneous injections of 300 mg CM310,150 mg CM310,or placebo every 2 weeks for 16 weeks,followed by an 8-week follow-up period.The primary endpoint was the proportion of patients achieving≥75%improvement in the Eczema Area and Severity Index(EASI-75)score from baseline at week 16.Safety and pharmacodynamics were also studied.Results:At week 16,the proportion of EASI-75 responders from baseline was significantly higher in the CM310 groups(70%[28/40]for high-dose and 65%[26/40]for low-dose)than that in the placebo group(20%[8/40]).The differences in EASI-75 response rate were 50%(high vs.placebo,95%CI 31%-69%)and 45%(low vs.placebo,95%CI 26%-64%),with both P values<0.0001.CM310 at both doses also significantly improved the EASI score,Investigator’s Global Assessment score,daily peak pruritus Numerical Rating Scale,AD-affected body surface area,and Dermatology Life Quality Index compared with placebo.CM310 treatment reduced levels of thymus and activation-regulated chemokine,total immunoglobulin E,lactate dehydrogenase,and blood eosinophils.The incidence of treatment-emergent adverse events(TEAEs)was similar among all three groups,with the most common TEAEs reported being upper respiratory tract infection,atopic dermatitis,hyperlipidemia,and hyperuricemia.No severe adverse events were deemed to be attributed to CM310.Conclusion:CM310 at 150 mg and 300 mg every 2 weeks demonstrated significant efficacy and was well-tolerated in adults with moderate-to-severe AD.Trial Registration:ClinicalTrials.gov,NCT04805411.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
Atopic dermatitis(AD)is a common skin disorder difficult to be treated with medication.This study investigated the potential of ovalicin extracted from Cordyceps militaris for the treatment of AD using in vitro and in...Atopic dermatitis(AD)is a common skin disorder difficult to be treated with medication.This study investigated the potential of ovalicin extracted from Cordyceps militaris for the treatment of AD using in vitro and in vivo models.We found that,in canine macrophage cell line DH82,lipopolysaccharide(LPS)upregulated the expression of genes associated with inflammation and pruritic responses through activating calcium and interleukin-31(IL-31)signaling,and the upregulation could be suppressed by ovalicin,with an effect significantly stronger than dexamethasone.Ovalicin also reduced the expression of IL-31 downstream genes,including JAK2(Janus kinase 2),TRPV1(transient receptor potential vanilloid receptor-1),and HRH2(histamine receptor H2).Ovalicin significantly alleviated the allergic symptoms in the AD mouse model.Histologically,the number of macrophages and mast cells infiltrated in the dermis was significantly reduced by ovalicin treatment.In the skin tissue of AD mice,reduction of IL-31 receptor was observed in the ovalicin treated group compared to the group without ovalicin treatment.To our knowledge,this is the first study to elucidate the anti-atopic mechanism of ovalicin,which could be an alternative to steroidal drugs commonly used for AD treatment.展开更多
BACKGROUND Lichen amyloidosis(LA)is a chronic,severely pruritic skin disease,which is the most common form of primary cutaneous amyloidosis.The treatment of LA has been considered to be difficult.LA may be associated ...BACKGROUND Lichen amyloidosis(LA)is a chronic,severely pruritic skin disease,which is the most common form of primary cutaneous amyloidosis.The treatment of LA has been considered to be difficult.LA may be associated with atopic dermatitis(AD),and in this setting,the treatment options may be more limited.Herein,we report four cases of LA associated with AD successfully treated by dupilumab.CASE SUMMARY In this article,we describe four cases of patients who presented with recurrent skin rash accompanied by severe generalized intractable pruritus,diagnosed with refractory LA coexisting with chronic AD.Previous treatments had not produced any apparent improvement.Thus,we administered dupilumab injection subcutaneously at a dose of 600 mg for the first time and 300 mg every 2 wk thereafter.Their lesions all markedly improved.CONCLUSION Dupilumab may be a new useful treatment for LA coexisting with AD.展开更多
Atopic dermatitis(AD)and psoriasis are common chronic and relapsing inflammatory skin diseases mainly mediated by T cells.Type 2 and 17 inflammations are essential in the pathogenesis of AD and psoriasis,respectively....Atopic dermatitis(AD)and psoriasis are common chronic and relapsing inflammatory skin diseases mainly mediated by T cells.Type 2 and 17 inflammations are essential in the pathogenesis of AD and psoriasis,respectively.Clinical evidence suggests that benvitimod,a natural metabolite produced by bacterial symbionts,plays a therapeutic role in the development and progression of both AD and psoriasis.Mechanistically,the two most potent interactions with benvitimod are observed in the aryl hydrocarbon receptor(AhR)and nuclear factor-erythroid 2-related factor-2(Nrf2)pathways.However,it remains largely unknown how is the local interplay among benvitimod,AhR,and Nrf2,and how the epithelial microenvironment contributes to the complex inflammatory context that results in the treatment of AD and psoriasis.In the present study,the modulatory effects of benvitimod on treating AD and psoriasis.展开更多
文摘Objective: to analyze the clinical efficacy of dupilumab in the treatment of moderate to severe atopic dermatitis. Methods: a total of 60 patients with moderate to severe atopic dermatitis treated in Beijing Jingcheng Skin Hospital (2021.1-2021.12) were divided into observation group (dupilumab) and control group (conventional treatment). The clinical efficacy (excellent + effective), the improvement time of clinical symptoms (eczema like skin lesions, dry skin, pruritus), EASI (total score of 6, the lower the better) and NRS (total score of 10, the lower the better) were compared after treatment. Results: there were significant differences in clinical efficacy between the observation group (dupilumab) and the control group (conventional treatment) after treatment (P 0.05). There was a significant difference in the improvement time of clinical symptoms between the observation group (dupilumab) and the control group (conventional treatment) after treatment (P 0.05). Before treatment, there were no differences in EASI and NRS scores between the observation group (dupilumab) and the control group (conventional treatment) (P > 0.05), but after treatment, there were differences in EASI and NRS scores between the observation group (dupilumab) and the control group (conventional treatment) (P 0.05). Conclusion: in the treatment of patients, the use of dupilumab can improve the treatment effect, the treatment is obvious, and the symptoms of patients are more obvious, the score of pruritus is more obvious, which is conducive to improve the quality of life of patients, and is worthy of being widely used in clinical practice.
基金Supported by National Natural Science Foundation of China,No.81803160Scientific Development Program of Jilin Province,No.20200801078GH.
文摘BACKGROUND Lichenoid amyloidosis(LA)is a subtype of primary cutaneous amyloidosis characterized by persistent multiple groups of hyperkeratotic papules,usually on the lower leg,back,forearm,or thigh.LA may be associated with several skin diseases,including atopic dermatitis(AD).The treatment of LA is considered to be difficult.However,as there is some overlap in the etiopathogenesis of LA and AD,AD treatment may also be effective for LA.CASE SUMMARY Case 1:A 70-year-old man was diagnosed with severe AD with LA based on large dark erythema and papules on the trunk and buttocks and dense hemispherical millet-shaped papules with pruritus on the extensor side of the lower limbs.He had a long history of the disease(8 years),with repeated and polymorphic skin lesions.Given the poor efficacy of traditional treatments,this patient was recommended to receive dupilumab treatment.At the initial stage,300 mg was injected subcutaneously every 2 wk.After 28 wk,the drug interval was extended to 1 mo due to the pandemic.Follow-up observations revealed that the patient reached an Eczema Area Severity Index of 90(skin lesions improved by 90%compared with the baseline)by the end of the study.Moreover,Investigator's Global Assessment score was 1,and scoring atopic dermatitis index and numeric rating scale improved by 97.7%and 87.5%compared with the baseline,respectively,with LA skin lesions having largely subsided.Case 2:A 30-year-old woman was diagnosed with severe AD with LA,due to dense and substantial papules on the dorsal hands similar to changes in cutaneous amyloidosis,and erythema and papules scattered on limbs and trunk with pruritus,present for 25 years.After 16 wk of dupilumab treatment,she stopped,and skin lesions completely subsided,without recurrence since the last follow-up.CONCLUSION Dupilumab shows rational efficacy and safety in the treatment of severe AD with LA,in addition to benefits in the quality of life of the patients.
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.
文摘To the Editor:Upadacitinib,an oral janus kinase(JAK)inhibitor,exhibits a higher inhibitory potency for JAK1 compared to JAK2,JAK3,or tyrosine kinase 2,making it a promising candidate for the treatment of atopic dermatitis(AD).Global trials Measure Up 1,Measure Up 2,and AD Up have demonstrated efficacy and safety data for moderate-to-severe AD,both as monotherapy and in combination with topical corticosteroids(TCS).[1,2]The updated 52-week results preliminarily reported sustained clinical benefits over 52 weeks,[3,4]but data on long-term outcomes in Chinese patients remain limited.Ethnic differences in AD pathophysiology,including variations in immune signatures,underscore the need for region-specific evidence.[5]This post hoc analysis of Measure Up 1 and AD Up trials evaluates the 140-week efficacy and safety of upadacitinib in Chinese patients.
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 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(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.
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.
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.
基金Supported by the Hebei Provincial Medical Science Research Project Plan Project,No.20242386.
文摘BACKGROUND Atopic dermatitis is a chronic inflammatory skin disease that poses a substantial burden on patients'physical health,as well as on their psychological health and quality of life.This study specifically examines active disease phases(excluding spontaneous remission periods)to investigate the efficacy of continuous treatments on the psychological state and life quality of patients with atopic dermatitis.AIM To evaluate the effectiveness of continuous treatment strategies,including dermatological care,psychological counseling,education,and long-term follow-up,on the psychological state and quality of life in patients with atopic dermatitis.METHODS A retrospective cohort study was conducted on 120 atopic dermatitis patients treated at our hospital between June 2023 and May 2024.A total of 120 patients were randomly assigned into control and intervention groups(60 patients each).The control group underwent routine treatment,and the intervention group was treated using continuous treatment strategies,including personalized skin care plan,psychological counseling,patient education,and long-term follow-up.Quality of life and psychological status of patients were assessed using the dermatology life quality index and Hospital Anxiety and Depression Scale.RESULTS At 12 months post-intervention,the dermatology life quality index scores in the intervention group were significantly lower than those in the control group(P<0.01),implying improved quality of life.The anxiety and depression symptoms were significantly lower in the intervention group when compared to the control group(P<0.05)as per the Hospital Anxiety and Depression Scale.In the intervention group,the rate of recurrence of skin symptoms was 15%compared to 35%in the control group,with a statistically significant difference between the two groups.CONCLUSION Continuous treatment for atopic dermatitis patients greatly improve their psychological state and quality of life,enhance disease-free survival,and offer new trains of thought for clinical treatment.Personalized integrated management over a prolonged time is important to improve quality of life in such patients.
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.
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Guidelines for the Diagnosis and Treatment of Atopic Dermatitis in Adults with Integrated Traditional Chinese and Western Medicine(No.ZYZB-2023-580)under the High-level Chinese Medicine Key Discipline Construction Project(Integrative Chinese and Western Medicine Clinic)of the National Administration of Traditional Chinese Medicine(No.zyyzdxk-2023065)Support for the Clinical Evidence-Based Capacity Building of High-Level Key Disciplines of Traditional Chinese Medicine in Shanghai in 2024 from the Shanghai Municipal Commission of Science and Technology(No.23Y31920300)the Young Qi Huang Scholar of the National Administration of Traditional Chinese Medicine。
文摘Traditional Chinese medicine(TCM)is a well-accepted therapy for atopic dermatitis(AD).However,there are currently no evidence-based guidelines integrating TCM and Western medicine for the treatment of AD,limiting the clinical application of such combined approaches.Therefore,the China Association of Chinese Medicine initiated the development of the current guideline,focusing on key issues related to the use of TCM in the treatment of AD.This guideline was developed in accordance with the principles of the guideline formulation manual published by the World Health Organization.A comprehensive review of the literature on the combined use of TCM and Western medicine to treat AD was conducted.The findings were extensively discussed by experts in dermatology and pharmacy with expertise in both TCM and Western medicine.This guideline comprises 23 recommendations across seven major areas,including TCM syndrome differentiation and classification of AD,principles and application scenarios of TCM combined with Western medicine for treating AD,outcome indicators for evaluating clinical efficacy of AD treatment,integration of TCM pattern classification and Western medicine across disease stages,daily management of AD,the use of internal TCM therapies and proprietary Chinese medicines,and TCM external treatments.
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.
基金funded by the National 13th Five-Year Plan for Major New Drug Development of China(No.2017ZX09302010)
文摘Background:Atopic dermatitis(AD)affects approximately 10%of adults worldwide.CM310 is a humanized monoclonal antibody targeting interleukin-4 receptor alpha that blocks interleukin-4 and interleukin-13 signaling.This trial aimed to evaluate the efficacy and safety of CM310 in Chinese adults with moderate-to-severe AD.Methods:This multicenter,randomized,double-blind,placebo-controlled,phase 2b trial was conducted in 21 medical institutions in China from February to November 2021.Totally 120 eligible patients were enrolled and randomized(1:1:1)to receive subcutaneous injections of 300 mg CM310,150 mg CM310,or placebo every 2 weeks for 16 weeks,followed by an 8-week follow-up period.The primary endpoint was the proportion of patients achieving≥75%improvement in the Eczema Area and Severity Index(EASI-75)score from baseline at week 16.Safety and pharmacodynamics were also studied.Results:At week 16,the proportion of EASI-75 responders from baseline was significantly higher in the CM310 groups(70%[28/40]for high-dose and 65%[26/40]for low-dose)than that in the placebo group(20%[8/40]).The differences in EASI-75 response rate were 50%(high vs.placebo,95%CI 31%-69%)and 45%(low vs.placebo,95%CI 26%-64%),with both P values<0.0001.CM310 at both doses also significantly improved the EASI score,Investigator’s Global Assessment score,daily peak pruritus Numerical Rating Scale,AD-affected body surface area,and Dermatology Life Quality Index compared with placebo.CM310 treatment reduced levels of thymus and activation-regulated chemokine,total immunoglobulin E,lactate dehydrogenase,and blood eosinophils.The incidence of treatment-emergent adverse events(TEAEs)was similar among all three groups,with the most common TEAEs reported being upper respiratory tract infection,atopic dermatitis,hyperlipidemia,and hyperuricemia.No severe adverse events were deemed to be attributed to CM310.Conclusion:CM310 at 150 mg and 300 mg every 2 weeks demonstrated significant efficacy and was well-tolerated in adults with moderate-to-severe AD.Trial Registration:ClinicalTrials.gov,NCT04805411.
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.
基金supported by the Basic Science Research Program through the National Research Foundation of Korea funded by the Ministry of Education,Science and Technology(Grant No.2020R1A2C1010215)the Brain Korea 21 Future Veterinary Medicine Leading Education and Research Center,College of Veterinary Medicine,Seoul National University.
文摘Atopic dermatitis(AD)is a common skin disorder difficult to be treated with medication.This study investigated the potential of ovalicin extracted from Cordyceps militaris for the treatment of AD using in vitro and in vivo models.We found that,in canine macrophage cell line DH82,lipopolysaccharide(LPS)upregulated the expression of genes associated with inflammation and pruritic responses through activating calcium and interleukin-31(IL-31)signaling,and the upregulation could be suppressed by ovalicin,with an effect significantly stronger than dexamethasone.Ovalicin also reduced the expression of IL-31 downstream genes,including JAK2(Janus kinase 2),TRPV1(transient receptor potential vanilloid receptor-1),and HRH2(histamine receptor H2).Ovalicin significantly alleviated the allergic symptoms in the AD mouse model.Histologically,the number of macrophages and mast cells infiltrated in the dermis was significantly reduced by ovalicin treatment.In the skin tissue of AD mice,reduction of IL-31 receptor was observed in the ovalicin treated group compared to the group without ovalicin treatment.To our knowledge,this is the first study to elucidate the anti-atopic mechanism of ovalicin,which could be an alternative to steroidal drugs commonly used for AD treatment.
文摘BACKGROUND Lichen amyloidosis(LA)is a chronic,severely pruritic skin disease,which is the most common form of primary cutaneous amyloidosis.The treatment of LA has been considered to be difficult.LA may be associated with atopic dermatitis(AD),and in this setting,the treatment options may be more limited.Herein,we report four cases of LA associated with AD successfully treated by dupilumab.CASE SUMMARY In this article,we describe four cases of patients who presented with recurrent skin rash accompanied by severe generalized intractable pruritus,diagnosed with refractory LA coexisting with chronic AD.Previous treatments had not produced any apparent improvement.Thus,we administered dupilumab injection subcutaneously at a dose of 600 mg for the first time and 300 mg every 2 wk thereafter.Their lesions all markedly improved.CONCLUSION Dupilumab may be a new useful treatment for LA coexisting with AD.
文摘Atopic dermatitis(AD)and psoriasis are common chronic and relapsing inflammatory skin diseases mainly mediated by T cells.Type 2 and 17 inflammations are essential in the pathogenesis of AD and psoriasis,respectively.Clinical evidence suggests that benvitimod,a natural metabolite produced by bacterial symbionts,plays a therapeutic role in the development and progression of both AD and psoriasis.Mechanistically,the two most potent interactions with benvitimod are observed in the aryl hydrocarbon receptor(AhR)and nuclear factor-erythroid 2-related factor-2(Nrf2)pathways.However,it remains largely unknown how is the local interplay among benvitimod,AhR,and Nrf2,and how the epithelial microenvironment contributes to the complex inflammatory context that results in the treatment of AD and psoriasis.In the present study,the modulatory effects of benvitimod on treating AD and psoriasis.
