Dataset Information

A pilot study of emollient therapy for the primary prevention of atopic dermatitis.

ABSTRACT:

Background

Prevention strategies in atopic dermatitis (AD) using allergen avoidance have not been consistently effective. New research reveals the importance of the skin barrier in the development of AD and possibly food allergy and asthma. Correcting skin barrier defects from birth may prevent AD onset or moderate disease severity.

Objective

We sought to determine the feasibility of skin barrier protection as a novel AD prevention strategy.

Methods

We enrolled 22 neonates at high risk for developing AD in a feasibility pilot study using emollient therapy from birth.

Results

No intervention-related adverse events occurred in our cohort followed up for a mean time of 547 days. Of the 20 subjects who remained in the study, 3 (15.0%) developed AD, suggesting a protective effect when compared with historical controls. Skin barrier measurements remained within ranges seen in normal-appearing skin.

Limitations

No conclusions regarding efficacy can be made without a control group.

Conclusions

Skin barrier repair from birth represents a novel and feasible approach to AD prevention. Further studies are warranted to determine the efficacy of this approach.

SUBMITTER: Simpson EL

PROVIDER: S-EPMC3156679 | biostudies-literature | 2010 Oct

REPOSITORIES: biostudies-literature

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Publications

A pilot study of emollient therapy for the primary prevention of atopic dermatitis.

Simpson Eric L EL Berry Trista M TM Brown Peter A PA Hanifin Jon M JM

Journal of the American Academy of Dermatology 20100807 4

<h4>Background</h4>Prevention strategies in atopic dermatitis (AD) using allergen avoidance have not been consistently effective. New research reveals the importance of the skin barrier in the development of AD and possibly food allergy and asthma. Correcting skin barrier defects from birth may prevent AD onset or moderate disease severity.<h4>Objective</h4>We sought to determine the feasibility of skin barrier protection as a novel AD prevention strategy.<h4>Methods</h4>We enrolled 22 neonates ...[more]

PMID: 20692725

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Project description:RationaleIn mouse models for atopic dermatitis (AD) hypothalamus pituitary adrenal axis (HPA) dysfunction and neuropeptide-dependent neurogenic inflammation explain stress-aggravated flares to some extent. Lately, cholinergic signaling has emerged as a link between innate and adaptive immunity as well as stress responses in chronic inflammatory diseases. Here we aim to determine in humans the impact of acute stress on neuro-immune interaction as well as on the non-neuronal cholinergic system (NNCS).MethodsSkin biopsies were obtained from 22 individuals (AD patients and matched healthy control subjects) before and after the Trier social stress test (TSST). To assess neuro-immune interaction, nerve fiber (NF)-density, NF-mast cell contacts and mast cell activation were determined by immunohistomorphometry. To evaluate NNCS effects, expression of secreted mammal Ly-6/urokinase-type plasminogen activator receptor-related protein (SLURP) 1 and 2 (endogenous nicotinic acetylcholine receptor ligands) and their main corresponding receptors were assessed by quantitative RT-PCR.ResultsWith respect to neuro-immune interaction we found higher numbers of NGF+ dermal NF in lesional compared to non-lesional AD but lower numbers of Gap43+ growing NF at baseline. Mast cell-NF contacts correlated with SCORAD and itch in lesional skin. With respect to the NNCS, nicotinic acetylcholine receptor ?7 (?7nAChR) mRNA was significantly lower in lesional AD skin at baseline. After TSST, PGP 9.5+ NF numbers dropped in lesional AD as did their contacts with mast cells. NGF+ NF now correlated with SCORAD and mast cell-NF contacts with itch in non-lesional skin. At the same time, SLURP-2 levels increased in lesional AD skin.ConclusionsIn humans chronic inflammatory and highly acute psycho-emotional stress interact to modulate cutaneous neuro-immune communication and NNCS marker expression. These findings may have consequences for understanding and treatment of chronic inflammatory diseases in the future.

Dataset Information

A pilot study of emollient therapy for the primary prevention of atopic dermatitis.

Background

Objective

Methods

Results

Limitations

Conclusions

Publications

A pilot study of emollient therapy for the primary prevention of atopic dermatitis.

Similar Datasets

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