Atopic dermatitis: Therapeutic concepts evolving from new pathophysiologic insights

Jung, Thomas; Stingl, Georg

doi:10.1016/j.jaci.2008.09.042

Cited by 71 publications

(53 citation statements)

References 103 publications

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“…To date, therapy for atopic dermatitis (AD), a frequent chronic inflammatory skin disease, is limited to symptomatic anti-inflammatory, antipruritic, or immunomodulatory treatment approaches [1]. However, rationale-based treatment conducted to counteract disease-aggravating pathways induced by trigger factors for AD would be much more effective in reducing the number of flare-ups and the severity of AD, thereby improving the quality of life of these patients.…”

Section: Introductionmentioning

confidence: 99%

Subcutaneous Immunotherapy with a Depigmented Polymerized Birch Pollen Extract – A New Therapeutic Option for Patients with Atopic Dermatitis

Novak

Thaçi

Hoffmann

et al. 2011

Int Arch Allergy Immunol

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Background: Birch pollen is an important outdoor allergen able to aggravate symptoms in atopic dermatitis (AD). Specific immunotherapy (SIT), an established procedure for allergic airway diseases, might also represent an attractive therapeutic option for the causal treatment of allergen-triggered cutaneous symptoms in these patients. Studies with house dust mite SIT have already shown beneficial effects in AD patients, whereas the safety and efficacy of SIT with birch pollen extract in AD patients have not been studied so far. The aim of this study was to evaluate for the first time the safety and efficacy of SIT with a depigmented polymerized birch pollen extract in AD patients. Methods: Fifty-five adult patients with moderate-to-severe AD and clinically relevant sensitization to birch pollen received SIT for 12 weeks. SIT was continued during birch pollen season. The assessment of safety, the total SCORAD value, and the Dermatology Life Quality Index (DLQI) were evaluated. Results: The median total SCORAD value was reduced by 34% (p < 0.001) during the course of treatment and the mean DLQI improved by 49% (p < 0.001) despite strong simultaneous birch pollen exposure. Eight patients (14.5%) developed systemic reactions and 19 patients (34.5%) developed local reactions which were of mild intensity in most cases. No patient discontinued the study prematurely due to adverse drug reactions. Coseasonal treatment was well tolerated. Conclusion: SIT with a depigmented polymerized birch pollen extract leads to significant improvement of the SCORAD value and the DLQI in patients suffering from moderate-to-severe AD sensitized to birch pollen.

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Section: Introductionmentioning

confidence: 99%

Subcutaneous Immunotherapy with a Depigmented Polymerized Birch Pollen Extract – A New Therapeutic Option for Patients with Atopic Dermatitis

Novak

Thaçi

Hoffmann

et al. 2011

Int Arch Allergy Immunol

View full text Add to dashboard Cite

show abstract

“…Atopic dermatitis (AD) is a genetically determined, chronically relapsing, inflammatory skin disease that has a complex immunopathogenesis [1]. Dysregulation of Th2-mediated and innate immunity is involved in the development of asthma and allergic diseases, including AD [2].…”

Section: Introductionmentioning

confidence: 99%

Plasma fibrin clot properties in atopic dermatitis: links between thrombosis and atopy

Nastałek

Wojas‐Pelc

Undas

2010

J Thromb Thrombolysis

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Myocardial infarction and ischemic stroke are associated with formation of dense fibrin clots resistant to lysis. Although pro- and antithrombotic alterations have been reported in atopy, fibrin clot function has not been studied in atopic patients. The aim of the current study was to investigate fibrin clot properties in patients with atopic dermatitis (AD). Plasma fibrin clot permeability, turbidity and clot lysis were assessed in 130 consecutive AD patients, aged 29.7 +/- 11 [+/-SD] years (mean SCORAD index, 32.4 +/- 14.9), free of thrombotic events. A control group comprised 130 healthy controls matched for demographics. Patients with AD had lower clot permeability (7.12 +/- 1.87 vs. 9.32 +/- 0.86 x 10(-9) cm(2); P < 0.0001), increased fiber thickness (maximum clot absorbancy at 405 nm, 4.03 +/- 0.54 vs. 3.47 +/- 0.25), faster clot formation (the lag phase, 39.16 +/- 4.61 vs. 43.05 +/- 4.56 s), higher maximum D-dimer levels released from clots, reflecting increased clot mass (4.05 +/- 0.57 vs. 3.47 +/- 0.25 mg/l; P < 0.0001), lower rate of D-dimer release (0.073 +/- 0.01 vs. 0.078 +/- 0.01 mg/l/min; P < 0.0001), and prolonged fibrinolysis time (9.26 +/- 1.47 vs. 7.81 +/- 1.17 min; P < 0.0001) compared with controls. Concomitant asthma (n = 36; 27.7%) was related to a higher rate of D-dimer release from clots than the remainder (0.075 +/- 0.01 vs. 0.072 +/- 0.01 mg/l/min, respectively; P = 0.03). Altered plasma fibrin clot properties associated with reduced efficiency of fibrinolysis can be detected in AD patients, which might represent a novel mechanism that modulates a hemostatic balance in atopy.

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“…The key factors in the management of atopic dermatitis are not only related to the use of effective topical antiinflammatory agents but also in providing skin hydration and barrier repair (Jung & Stingl, 2008), thus the ingredients selected to such vehicles are of extremely importance. Emollients are often used in the treatment of atopic dermatitis and other inflammatory dermatitis with the aim of improving skin hydration and mitigating xerosis.…”

Section: Introductionmentioning

confidence: 99%

Mometasone furoate-loaded cold processed oil-in-water emulsions:in vitroandin vivostudies

et al. 2014

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Over the years, research has focused on strategies to increase benefit/risk ratio of corticoids. However, vehicles intended for topical glucocorticoids delivery with an improved benefit/risk ratio are still on demand. The aim of this work was the in vitro and in vivo characterization of cold processed oil-in-water (o/w) emulsions intended for mometasone furoate (MF) delivery to induce drug targeting to upper skin strata, decreasing adverse effects. Two o/w emulsions, containing 0.1% of MF, were developed differing in the glycol used (2-methyl-2,4-pentanediol -PT and ethoxydiglycol -TC emulsions). In vitro permeation studies revealed that these emulsions are suitable vehicles for the delivery of MF containing ingredients which are responsible for a drastically increased on the permeability coefficients of MF from a theoretical value of 1.18 Â 10 À4 cm/h to 5.20 Â 10 À4 AE 2.05 Â 10 À4 cm/h and 6.30 Â 10 À4 AE 2.94 Â 10 À4 cm/h, for PT and TC, respectively. The tape stripping results showed that the amount of drug that reached the viable skin layers was very low (1.99 %) and the amount that remained in the stratum corneum (SC) was 10.61%. The in vivo studies showed that the developed formulations decreased the edema and erythema in mice skin in more that 90%, assuring, at least, the same anti-inflammatory effect compared with the commercial cream. PT placebo demonstrated to contribute to restore the skin barrier by increasing the amount of lipids within the human skin.

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Atopic dermatitis: Therapeutic concepts evolving from new pathophysiologic insights

Cited by 71 publications

References 103 publications

Subcutaneous Immunotherapy with a Depigmented Polymerized Birch Pollen Extract – A New Therapeutic Option for Patients with Atopic Dermatitis

Subcutaneous Immunotherapy with a Depigmented Polymerized Birch Pollen Extract – A New Therapeutic Option for Patients with Atopic Dermatitis

Plasma fibrin clot properties in atopic dermatitis: links between thrombosis and atopy

Mometasone furoate-loaded cold processed oil-in-water emulsions:in vitroandin vivostudies

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