Barrier dysfunction in the atopic march—how does atopic dermatitis lead to asthma in children?

Matsumoto, Kenji; Iikura, Katsuhito; Morita, Hideaki; Saito, Hirohisa

doi:10.1016/j.jaci.2020.04.014

Cited by 16 publications

(13 citation statements)

References 10 publications

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“…AD is a chronic recurrent inflammatory skin disease affecting about 30% of children and is characterized by a T H 2-cell dominated immune response, itching and impaired skin barrier ( Figure 2 A) [ 204 ]. Importantly, children with an early onset and persistent disease have a high risk of developing allergic asthma, a phenomenon known as “atopic march” [ 203 , 205 ]. AD comprises several endotypes between age groups and ethnicities, characterized by IgE levels and filaggrin mutation status, making traditional non-targeted therapies tricky [ 206 ].…”

Section: Mast Cell Contribution To Inflammatory Skin Disordersmentioning

confidence: 99%

Mast Cells in the Skin: Defenders of Integrity or Offenders in Inflammation?

Voß

Kotrba

Gaffal

et al. 2021

IJMS

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Mast cells (MCs) are best-known as key effector cells of immediate-type allergic reactions that may even culminate in life-threatening anaphylactic shock syndromes. However, strategically positioned at the host–environment interfaces and equipped with a plethora of receptors, MCs also play an important role in the first-line defense against pathogens. Their main characteristic, the huge amount of preformed proinflammatory mediators embedded in secretory granules, allows for a rapid response and initiation of further immune effector cell recruitment. The same mechanism, however, may account for detrimental overshooting responses. MCs are not only detrimental in MC-driven diseases but also responsible for disease exacerbation in other inflammatory disorders. Focusing on the skin as the largest immune organ, we herein review both beneficial and detrimental functions of skin MCs, from skin barrier integrity via host defense mechanisms to MC-driven inflammatory skin disorders. Moreover, we emphasize the importance of IgE-independent pathways of MC activation and their role in sustained chronic skin inflammation and disease exacerbation.

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Section: Mast Cell Contribution To Inflammatory Skin Disordersmentioning

confidence: 99%

Mast Cells in the Skin: Defenders of Integrity or Offenders in Inflammation?

Voß

Kotrba

Gaffal

et al. 2021

IJMS

View full text Add to dashboard Cite

show abstract

“…AD is a chronic recurrent inflammatory skin disease affecting about 30% of children and is characterized by a T H 2-cell dominated immune response, itching and impaired skin barrier (Figure 2A) [204]. Importantly, children with an early onset and persistent disease have a high risk of developing allergic asthma, a phenomenon known as "atopic march" [203,205]. AD comprises several endotypes between age groups and ethnicities, characterized by IgE levels and filaggrin mutation status, making traditional non-targeted therapies tricky [206].…”

Section: The Role Of Mast Cells In Atopic Dermatitismentioning

confidence: 99%

Mast Cells in the Skin: Defenders of Integrity or Offenders in Inflammation?

Voß

Kotrba

Gaffal

et al. 2021

Preprint

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Mast cells (MCs) are best known as key effector cells of immediate type allergic reactions that may even culminate in life-threatening anaphylactic shock syndromes. However, strategically positioned at host-environment interfaces and equipped with a plethora of receptors, MCs also play an important role in the first line defense against pathogens. Their main characteristic, the huge amount of preformed pro-inflammatory mediators embedded in secretory granules, allow for a rapid response and initiation of further immune effector cell recruitment. The same mechanism, however, may account for detrimental overshooting responses. MCs are not only detrimental in MC-driven diseases, but also responsible for disease exacerbation in other inflammatory disorders. Focusing on the skin as the largest immune organ, we herein review both beneficial and detrimental functions of skin MCs all the way from skin barrier integrity via host defense mechanisms to MC-driven inflammatory skin disorders. Moreover, we emphasize the importance of IgE-independent pathways of MC activation and their role in sustained chronic skin inflammation and disease exacerbation.

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“…AD is one of the most common chronic childhood diseases, affecting approximately 10-20% of children in Europe [4]. AD usually starts in early childhood and may represent the first step of the so-called "atopic march", which represents the natural history of allergic manifestations, characterized by a sequence of atopic diseases preceding the development of other allergic disorders later in life [5]. Typically, AD in infancy is followed by allergic rhinitis and/or asthma later in life [6].…”

Section: Introductionmentioning

confidence: 99%

The Effectiveness of Probiotic Lactobacillus rhamnosus and Lactobacillus casei Strains in Children with Atopic Dermatitis and Cow’s Milk Protein Allergy: A Multicenter, Randomized, Double Blind, Placebo Controlled Study

Cukrowská

Ceregra²,

Maciorkowska

et al. 2021

Nutrients

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Probiotics seem to have promising effects in the prevention and treatment of allergic conditions including atopic dermatitis (AD) and food allergy. The purpose of this multicenter randomized placebo-controlled trial was to evaluate the effectiveness of a probiotic preparation comprising Lactobacillus rhamnosus ŁOCK 0900, Lactobacillus rhamnosus ŁOCK 0908, and Lactobacillus casei ŁOCK 0918 in children under 2 years of age with AD and a cow’s milk protein (CMP) allergy. The study enrolled 151 children, who—apart from being treated with a CMP elimination diet—were randomized to receive the probiotic preparation at a daily dose of 109 bacteria or a placebo for three months, with a subsequent nine-month follow-up. The primary outcomes included changes in AD symptom severity assessed with the scoring AD (SCORAD) index and in the proportion of children with symptom improvement (a SCORAD score decreased by at least 30% in comparison with that at baseline). After the three-month intervention, both the probiotic and placebo groups showed a significant (p < 0.0001) decrease in SCORAD scores, which was maintained nine months later. The percentage of children who showed improvement was significantly higher in the probiotic than in the placebo group (odds ratio (OR) 2.56; 95% confidence interval (CI) 1.13–5.8; p = 0.012) after three months. Probiotics induced SCORAD improvement mainly in allergen sensitized patients (OR 6.03; 95% CI 1.85–19.67, p = 0.001), but this positive effect was not observed after nine months. The results showed that the mixture of probiotic ŁOCK strains offers benefits for children with AD and CMP allergy. Further research is necessary to assess the effect of probiotic supplementation on the development of immune tolerance. (ClinicalTrials.gov NCT04738565)

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Barrier dysfunction in the atopic march—how does atopic dermatitis lead to asthma in children?

Cited by 16 publications

References 10 publications

Mast Cells in the Skin: Defenders of Integrity or Offenders in Inflammation?

Mast Cells in the Skin: Defenders of Integrity or Offenders in Inflammation?

Mast Cells in the Skin: Defenders of Integrity or Offenders in Inflammation?

The Effectiveness of Probiotic Lactobacillus rhamnosus and Lactobacillus casei Strains in Children with Atopic Dermatitis and Cow’s Milk Protein Allergy: A Multicenter, Randomized, Double Blind, Placebo Controlled Study

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