Usefulness of personal health record platform managing atopic dermatitis in Korean medicine clinical practice.
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ABSTRACT:
SUBMITTER: Nam BR
PROVIDER: S-EPMC7160562 | biostudies-literature | 2020 Jun
REPOSITORIES: biostudies-literature
Publications
Usefulness of personal health record platform managing atopic dermatitis in Korean medicine clinical practice.
Nam Bo-Ryeong BR Kim Young-Eun YE Seo Jin-Soon JS Kim An-Na AN Lee Seung-Ho SH Kim Ick-Tae IT Jang Hyun-Chul HC
Integrative medicine research 20200306 2
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Project description:Atopic dermatitis is a prevalent, inflammatory skin disease that presents with an eczematous, itchy rash. As of late, there have been many emerging monoclonal antibody inhibitor and small molecule therapies that have changed the course of eczema treatment. One of the treatments in the pipeline for atopic dermatitis is interleukin 13 monoclonal antibody inhibitor, lebrikizumab. As interleukin 13 has been identified as a pro-inflammatory cytokine in the immunological cascade of eczema, it is thought that lebrikizumab can be a great treatment choice for patients with atopic dermatitis. Lebrikizumab is currently being investigated in several studies. Thus far, lebrikizumab for the treatment of eczema has been found to be efficacious; in particular, a rapid response of pruritus improvement has been demonstrated in as early as 2 days. Additionally, it is well tolerated and has an acceptable safety profile, with reports suggesting that are decreased risks of infection when compared to dupilumab. In this review, we aim to summarize the current understanding of lebrikizumab in terms of the mechanism of action, preclinical pharmacology, pharmacokinetics and metabolism, efficacy and safety, and drug indications.
| S-EPMC9188775 | biostudies-literature
Project description:PurposeAtopic dermatitis (AD) is a chronic, relapsing eczematous inflammatory skin disease. Mutations in the filaggrin gene (FLG) are major predisposing factors for AD. Ethnic differences exist between Asian and European populations in the frequency and spectrum of FLG mutations. Moreover, a distinct set of FLG mutations has been reported in Asian populations. The aim of this study was to examine the spectrum of FLG mutations in Koreans with AD. We also investigated the association of FLG mutations and clinical features of AD and compared the Korean FLG landscape with that of other East Asian countries.Materials and methodsSeventy Korean patients with AD were enrolled in this study. Fourteen FLG mutations previously detected in Korean, Japanese, and Chinese patients were screened by genotyping.ResultsFour FLG null mutations (3321delA, K4022X, S3296X, and S2889X) were identified in eleven patients (15.7%). The most commonly detected mutations in Korean patients with AD were 3321delA (n=6, 9.1%) and K4022X (n=3, 4.5%). FLG mutations were significantly associated with elevated IgE (≥200 KIU/L and/or MAST-CLA >3+, p=0.005), palmar hyperlinearity (p<0.001), and a family history of allergic disease (p=0.021).ConclusionThis study expanded our understanding of the landscape of FLG mutations in Koreans and revealed an association between FLG mutations and AD phenotype.
| S-EPMC5290020 | biostudies-literature
Project description:BackgroundAtopic dermatitis is a chronic inflammatory skin disease that affects up to 13% of children and 10% of adults in the United States. Among patients and their families, atopic dermatitis has a considerable effect on quality of life and represents a substantial economic burden.ObjectiveTo describe the impact and challenges of atopic dermatitis and to provide nondermatologists in the healthcare community an enhanced understanding of atopic dermatitis to facilitate treatment and pharmacy benefit discussions.DiscussionAtopic dermatitis is a heterogeneous disease, and its diagnosis is hampered by a lack of objective diagnostic criteria. The current management guidelines address the distinct clinical phenotypes as a single disease and do not incorporate recent clinical advances, such as the targeting of specific inflammatory processes. The treatment guidelines for atopic dermatitis are complex and challenge healthcare providers, patients, and caregivers. Novel treatments can provide additional therapeutic options for patients with atopic dermatitis.ConclusionsTreatment options for atopic dermatitis are expanding with the development of novel anti-inflammatory therapies. An increased understanding of these advancements is necessary to optimize care for patients with atopic dermatitis.
| S-EPMC6485648 | biostudies-literature
Project description:The microbiome, comprising various bacteria, assumes a significant role in the immune system's maturation and maintaining bodily homeostasis. Alterations in the microbial composition can contribute to the initiation and progression of inflammation. Recent studies reveal that changes in microbial composition and function, known as dysbiosis in the skin and gut, have been associated with altered immunological responses and skin barrier disruption. These changes are implicated in the development of several skin diseases, such as atopic dermatitis (AD). This review examines research demonstrating the potential of microbiome repair as a therapeutic approach to reduce the effect of inflammatory processes in the skin during atopic dermatitis. This way, corticosteroids in atopic dermatitis therapy can be reduced or even replaced with treatments focusing on controlling the skin microbiome. This study used scientific literature from recognized platforms, including PubMed, Scopus, Google Scholar, and ScienceDirect, covering publications from 2013 to 2023. The primary aim of this study was to assess the efficacy of skin microbiome management in treating atopic dermatitis. This study concludes that physicians must comprehensively understand the microbiome's involvement in atopic dermatitis, including its pathophysiological implications and its relevance to therapeutic interventions.
| S-EPMC10645580 | biostudies-literature
Project description:The last decades have brought an interest in ultrasound applications in dermatology. Especially in the case of atopic dermatitis, where the formation of a subepidermal low echogenic band (SLEB) may serve as an independent indicator of the effects of treatment, the use of ultrasound is of particular interest. This study proposes and evaluates the computer-aided diagnosis method for assessing atopic dermatitis (AD). The fully automated image processing framework combines advanced machine learning techniques for fast, reliable, and repeatable HFUS image analysis, supporting clinical decisions. The proposed methodology comprises accurate SLEB segmentation followed by a classification step. The data set includes 20 MHz images of 80 patients diagnosed with AD according to Hanifin and Rajka criteria, which were evaluated before and after treatment. The ground true labels- clinical evaluation based on Investigator Global Assessment index (IGA score) together with ultrasound skin examination was performed. For reliable analysis, in further experiments, two experts annotated the HFUS images twice in two-week intervals. The analysis aimed to verify whether the fully automated method can classify the HFUS images at the expert level. The Dice coefficient values for segmentation reached 0.908 for SLEB and 0.936 for the entry echo layer. The accuracy of SLEB presence detection results (IGA0) is equal to 98% and slightly outperforms the experts' assessment, which reaches 96%. The overall accuracy of the AD assessment was equal to 69% (Cohen's kappa 0.78) and was comparable with the experts' assessment, ranging between 64% and 70% (Cohen's kappa 0.73-0.79). The results indicate that the automated method can be applied to AD assessment, and its combination with standard diagnosis may benefit repeatable analysis and a better understanding of the processes that take place within the skin and aid treatment monitoring.
| S-EPMC11697316 | biostudies-literature
Project description:BackgroundAtopic dermatitis (AD) is a heterogeneous chronic inflammatory skin disease. Most AD during infancy resolves during childhood, but moderate-to-severe AD with allergic sensitization is more likely to persist into adulthood and more often occurs with other allergic diseases.ObjectiveWe sought to find susceptibility loci by performing the first genome-wide association study (GWAS) of AD in Korean children with recalcitrant AD, which was defined as moderate-to-severe AD with allergic sensitization.MethodsOur study included 246 children with recalcitrant AD and 551 adult control subjects with a negative history of both allergic disease and allergic sensitization. DNA from these subjects was genotyped; sets of common single nucleotide polymorphisms (SNPs) were imputed and used in the GWAS after quality control checks.ResultsSNPs at a region on 13q21.31 were associated with recalcitrant AD at a genome-wide threshold of significance (P < 2.0 × 10(-8)). These associated SNPs are more than 1 Mb from the closest gene, protocadherin (PCDH)9. SNPs at 4 additional loci had P values of less than 1 × 10(-6), including SNPs at or near the neuroblastoma amplified sequence (NBAS; 2p24.3), thymus-expressed molecule involved in selection (THEMIS; 6q22.33), GATA3 (10p14), and S-phase cyclin A-associated protein in the ER (SCAPER; 15q24.3) genes. Further analysis of total serum IgE levels suggested 13q21.31 might be primarily an IgE locus, and analyses of published data demonstrated that SNPs at the 15q24.3 region are expression quantitative trait loci for 2 nearby genes, ISL2 and proline-serine-threonine phosphatase interacting protein 1 (PSTPIP1), in immune cells.ConclusionOur GWAS of recalcitrant AD identified new susceptibility regions containing genes involved in epithelial cell function and immune dysregulation, 2 key features of AD, and potentially extend our understanding of their role in pathogenesis.
| S-EPMC4562879 | biostudies-literature
Project description:PURPOSE:Variations in barrier- or immune response-related genes are closely related to the development of atopic dermatitis (AD). This study was designed to identify genetic variations and clinical features to predict 'recalcitrant AD.' METHODS:AD patients were classified as treatable and recalcitrant. Treatable AD patients showed satisfactory clinical improvement with basic and topical treatments. Recalcitrant AD patients used systemic immune-suppressants for over 4 weeks as they had not shown clinical improvement with basic and topical treatments. The frequency of gene variations in barrier- (FLG 3321delA, FLG K4022X, KLK7, SPINK 1156, SPINK 1188, SPINK 2475) and immune response- (DEFB1, KDR, IL-5RA, IL-9, and IL-12RB1a, b) related genes were compared between each AD group and the controls. RESULTS:Of all, 249 treatable AD and 32 recalcitrant AD were identified. Heterozygous mutations (Hetero) in KLK7 was more frequent in recalcitrant AD patients than treatable AD, without statistical significance. Hetero in DEFB1 was more frequent in treatable AD patients. However, no other significant genetic differences between treatable and recalcitrant AD was observed. Instead, higher initial Eczema Area Severity Index (EASI) score, serum immunoglobulin E (IgE) level, allergen specific IgE for house dust mites, and family history of atopic diseases were associated with recalcitrant AD with statistical significance. CONCLUSIONS:According to our study, no genetic variation to predict recalcitrant AD was identified, suggesting that clinical manifestation, rather than genetic variations of AD patients is more likely to be an important factor in predicting the prognosis of AD. Further large-scale studies on the correlation between genetic variation and recalcitrant AD are needed.
| S-EPMC5911443 | biostudies-literature
Project description:Research of the FLG mutation in various ethnic groups revealed non-overlapping mutation patterns. In addition, Japanese and Chinese atopic patients showed somewhat different mutations. These ethnic differences make the research on Korean patients mandatory; however, no systematic research on Korean atopic dermatitis (AD) patients has been performed. This study aims to investigate the genetic polymorphism of FLG in Korean atopic dermatitis patients. The study was made up of three groups including 9 Ichthyosis vulgaris (IV) patients, 50 AD patients and 55 normal controls: the ichthyosis group was incorporated due to the reported association between the FLG mutation and IV. In comparison to other sequencing methods, the overlapping long-range PCR was used. We revealed the genetic polymorphism of filaggrin in Koreans, and at the same time, we discovered nonsense mutations in p.Y1767X and p.K4022X in Korean AD patients. By using FLG sequencing techniques confirmed in this study, new mutations or genetic polymorphisms with ethnic characteristics would be detected and further larger studies of repeat number polymorphisms could be performed.
| S-EPMC4901008 | biostudies-literature
Project description:ObjectiveThis expert-led consensus aims to provide primary care providers (PCPs) with recommendations for the care of atopic dermatitis (AD) in patients aged <18 years. The first point of contact for diagnosis and management of AD is often a PCP, and appropriate, coordinated care between PCPs and AD specialists is essential to optimizing care.Study designA systematic literature review was conducted followed by expert-led development of 25 consensus management recommendations relevant to 4 key themes in AD management: defining control, current and emerging treatments, referral care pathways, and patient-caregiver experience. Consensus was achieved using a modified Delphi process. For each statement, consensus for inclusion was considered achieved if ≥75% of the experts voted within the 7-9 range on a 9-point scale.ResultsConsensus was reached on 24 of 25 statements. Nine statements reached the score of 7-9 by 100% of the experts. Of these, 4 were pertinent to topical therapy for the management of childhood and adolescent AD in primary care: the need for anti-inflammatory medication to achieve clear or almost clear skin; the need to tailor decisions about therapy to the individual patient or family; the importance of coordinated management between PCPs and specialists as part of effective treatment approaches; and the importance of patient and/or caregiver engagement in shared decision-making.ConclusionsIt is hoped that these recommendations will guide the management of pediatric AD in primary care settings, facilitate coordinated care between PCPs and AD specialists, and improve outcomes for patients and their families.
| S-EPMC11824657 | biostudies-literature
Project description:BackgroundThe urinary levels of volatile organic compound (VOC) metabolites provide individual exposure levels compared to data obtained by measuring these compounds in ambient air. We aimed to investigate the association between personal urinary concentrations of VOC metabolites and symptoms of atopic dermatitis in schoolchildren.MethodsNine urinary VOC metabolites were analyzed from urine samples of 149 children. Diagnosis of atopic dermatitis was determined using standardized questionnaires. Pediatricians visited the schools and rated the severity of symptoms using the SCORing Atopic Dermatitis (SCORAD) in all children.ResultsForty-five children (30.2%) had atopic dermatitis based on the International Study of Asthma and Allergies in Childhood (ISAAC) results and 35 children (23.8%) had symptoms of atopic dermatitis with positive SCORAD index values (defined as SCORAD ≥ 5). Children with benzylmercapturic acid detected in personal urines were associated with presence of atopic dermatitis and positive SCORAD index values. Children in the highest quartile of mandelic acid concentration were associated with presence of atopic dermatitis and positive SCORAD results.ConclusionPersonal exposure to VOCs, as indicated by urinary levels of VOC metabolites, was associated with presence of atopic dermatitis and the SCORAD index value.
| S-EPMC8885456 | biostudies-literature