Search This Blog

Thursday, October 2, 2014

Complexities of atopic dermatitis

Atopic dermatitis (AD) is the most common chronic inflammatory skin disease and often precedes the development of food allergy and asthma.  The defective skin barrier in AD is thought to allow the absorption of allergens through the skin.  This promotes systemic allergen sensitization, contributing to the development of food allergy and asthma, as well as skin infections such as Staphylococcus aureus and herpes simplex virus (HSV).  This month’s JACI focuses on the importance of both genetic and acquired causes of epithelial skin barrier dysfunction in driving the natural history of AD. In their review, Donald Leung and Emma Guttman-Yassky summarize current insights into AD that may lead to new treatment approaches, including several articles published in this month’s journal (J Allergy Clin Immunol 2014; 134(4): 769-779).

The causes of AD are complex and driven by a combination of genetic, environmental and immunologic factors which likely account for heterogeneity of AD onset, severity and natural history of the disease. While there is currently no cure for AD, recent studies suggest prevention of AD can be achieved by early interventions that protect the skin barrier such as emollients and topical anti-inflammatory treatments. Importantly, the control of lesional AD may improve long term outcomes not only in AD, but in allergic diseases of the gastrointestinal and respiratory tracts as well, due to the reduction of associated allergen sensitization.

Although current treatment options for AD are limited, the authors explain that in addition to Th2 antagonists (i.e. the anti IL-4R drug dupilumab), determining the key role of TSLP-receptor signaling and IL-22 that involve clinical trials with agents that target TSLP, Th22, and TH17/IL-23 will be of interest. Furthermore, the selection of therapeutics for patients with differing degrees of disease severity and /or phenotypes should be guided by defining the extent of activation in the skin and blood. For example, anti IL-23/IL-17 might provide beneficial responses particularly in intrinsic AD patients. The individual contributions of the TH22, Th17, and Th2 immune pathways to the disease phenotype will be clarified through clinical trials coupled with mechanistic studies that are currently in progress. This comprehensive review highlights the importance of translational medicine, from animal models to clinical trials, and how this approach is advancing AD research.

Questions for the authors:
Recently, both basic science and clinical research have provided novel insights into the prevention, identification, and treatment options for AD. Do you anticipate these findings to improve outcomes for not only AD but other allergic diseases as well?

Yes, because the principle underlying causation of allergic diseases likely have in common a defective epithelial barrier and abberant immune response.  This is modulated by different resident cells in each organ.

AD is most often a first step in a series of atopic diseases in the Atopic March that often leads to rhinitis, food allergy, and asthma. Could removing the first step in the Atopic March reduce the global burden of atopic disease? 

Possibly.  The studies in the current issue of JACI support the concept that skin barrier dysfunction enhances sensitization via environmental allergen exposure. A natural progression of this concept would be to correct the skin barrier defect to determine whether elimination of AD could prevent food allergy, asthma and allergic rhinitis.

5 comments:


  1. I have been suffering from HIV and Genital Herpes for the past 3 years and 8 months, and ever since then i have been taking series of treatment but there was no improvement until i came across testimonies of Dr TAKUTA on how he has been curing different people from different diseases all over the world, then i contacted him as well. After our conversation he sent me the medicine which i took according to his instructions. When i was done taking the herbal medicine i went for a medical checkup and to my greatest surprise i was cured from Herpes. My heart is so filled with joy. If you are suffering from Herpes or any other disease you can contact Dr TAKUTA today on this Email address: takutaspellalter@gmail.com or WhatsApp him on this Tell.Number +27788634102....

    Dr.TAKUTA also cures:
    1. HEPATITIS A,B,C
    2. HERPES 1/2
    3.DIABETES
    4.STROKE.
    5.STDS and STI
    6. MARRIAGE COUNSELLING
    7.LOVE SPELL CASTING
    8.JOB PROMOTION SPELLS
    9.MARITAL PROBLEM
    10.MAGIC MONEY SPELLS

    ReplyDelete

  2. I have been suffering from HIV and Genital Herpes for the past 3 years and 8 months, and ever since then i have been taking series of treatment but there was no improvement until i came across testimonies of Dr TAKUTA on how he has been curing different people from different diseases all over the world, then i contacted him as well. After our conversation he sent me the medicine which i took according to his instructions. When i was done taking the herbal medicine i went for a medical checkup and to my greatest surprise i was cured from Herpes. My heart is so filled with joy. If you are suffering from Herpes or any other disease you can contact Dr TAKUTA today on this Email address: takutaspellalter@gmail.com or WhatsApp him on this Tell.Number +27788634102....

    Dr.TAKUTA also cures:
    1. HEPATITIS A,B,C
    2. HERPES 1/2
    3.DIABETES
    4.STROKE.
    5.STDS and STI
    6. MARRIAGE COUNSELLING
    7.LOVE SPELL CASTING
    8.JOB PROMOTION SPELLS
    9.MARITAL PROBLEM
    10.MAGIC MONEY SPELLS

    ReplyDelete
  3. This man,Dr.Domic Elabe. The great and power herbalist,it's gifted and needs to be known by all those suffering from Herpes and most viral diseases. There's a cure to all sickness including HIV/AIDs,kidney stone,cancer,diabetes1,2,etc. I have Seen it with Dr.Elabe's Herbs. I saw him live on camp his not a scam. You can always contact him. I saw what makes me to trust him,his capable of curing any sickness. it's was just of recent,I understood why my aunt who he cured her 19 years old daughter from the same Herpes,called him doctor for all! Am so happy now. All my life time after I got my breakdown that I was diagnosed of Herpes,I was making use of the Acyclovir 200mg. 2 tablets every 6 hou,and of fustian cream 15grams and H5 POT Permanganate and 2x daily all couldn't work for me. All thanks to Dr. Dominic Elabe After 3 years of more researches seeking for the solution from one hospital to another but couldn't be satisfy with their result and my life was getting more closer to death. Had to listen to the voice of my aunt whom she directed me to you long ago. It was quiet unfortunate I misplaced you're contact details till when she had to call me and congratulated me in respect of her daughter's cure,that was when I remember when it says my people perish cos of lack of knowledge. You're a good and kind man. I obeyed all you medicinal rules as you instructed me after receiving from the DHL.and it all went successfully as you said...I'm so happy,cos it was a very big surprised and I think of joy to be celebrated that Stephanie it's now HSV free. More grace to you're able Dr.Dominic Elabe
    You can reach him for complaints or know more about Dr. Elabe and get cure for once for any of your heath problems ..@
    Emaile:dominicelabeherbalhome4all@gmail.com
    Phone no:+2348140918600

    ReplyDelete
  4. Couples counseling is not beneficial for all individuals. Some people enter this kind of treatment with the misguided notion that it would give them greater control or influence over their partner. But, therapy is not the place for manipulation or self-serving. Relationship counseling cincinnati therapy should provide benefits for both parties.

    ReplyDelete