Circulating <scp>CD</scp>4+<scp>CD</scp>25highFoxP3+ T‐regulatory cells in patients with atopic dermatitis after narrowband‐ultraviolet B phototherapy

Samahy, May H. El; Attia, Enas A. S.; Saad, Abeer A.; Mahmoud, Eman Y.

doi:10.1111/ijd.12801

Cited by 10 publications

(7 citation statements)

References 40 publications

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“…The results suggest that this does not apply to a group of patients with AD only. In contrast to our data, a recent study from Egypt (31) showed that numbers of circulating regulatory T cells were increased significantly after 6 weeks of nbUVB phototherapy in AD patients, but the authors did not assess FLG genotype. Comparisons with our study should be made with caution, because the study from Egypt was based on patients with more severe disease, different ethnicity, and different time points of follow-up.…”

Section: Neither the Phenotype Of The Cd4 + T Cells In The Blood Nor contrasting

confidence: 99%

Increase in Vitamin D but not Regulatory T Cells following Ultraviolet B Phototherapy of Patients with Atopic Dermatitis

Simonsen

Bonefeld²,

Thyssen³

et al. 2019

Acta Derm Venerol

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SIGNIFICANCE Vitamin D synthesis is induced by ultraviolet B irradiation of the skin and may have a beneficial effect on the immune system in patients with atopic dermatitis. We measured changes in vitamin D levels and immunological markers in patients with atopic dermatitis receiving ultraviolet B photo therapy. Following ultraviolet B phototherapy, vitamin D levels were increased, as expected, but no changes were found in the immune system. Furthermore, ultraviolet B phototherapy induced equal increases in the vitamin D levels in patients with atopic dermatitis with and without a mutation that causes a defective skin barrier. This study investigated serum 25-hydroxyvitamin D (25(OH)D) concentrations and circulating regulatory T cells in patients with atopic dermatitis receiving narrow-band ultraviolet B (nbUVB) phototherapy. Thirty adult patients with atopic dermatitis were included. Blood samples were collected at baseline and at weeks 2 and 4 of nbUVB phototherapy. Skin biopsies were taken at baseline and at week 4. Serum 25(OH) D concentrations increased significantly following nbUVB phototherapy (estimate of change from baseline to week 2: 32.00 nmol/l, confidence interval (CI) 20.48-43.52, p < 0.0001, n = 25; and from baseline to week 4: 50.30 nmol/l, CI 37.28-63.33, p < 0.0001, n = 18). This increase was independent of the filaggrin gene loss-of-function mutation status. Flow cytometry showed no significant change in regulatory T cells or cytokine profiles of T cells in blood. Real-time quantitative PCR showed no change in skin cytokine levels. In conclusion, nbUVB phototherapy was associated with increased serum 25(OH)D concentrations, but not changes in circulating regulatory T cells in patients with atopic dermatitis.

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Section: Neither the Phenotype Of The Cd4 + T Cells In The Blood Nor contrasting

confidence: 99%

Increase in Vitamin D but not Regulatory T Cells following Ultraviolet B Phototherapy of Patients with Atopic Dermatitis

Simonsen

Bonefeld²,

Thyssen³

et al. 2019

Acta Derm Venerol

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“…Ultraviolet (UV) radiation has been shown to be an effective treatment modality in moderate-to-severe AD due to its proposed ability to decrease Staphylococcus aureus colonization, improve skin barrier function, reduce pruritis, and decrease tissue inflammation associated with AD 46,47. Four hundred and twenty-eight studies and 19 RCTs that enrolled over 900 subjects found medium-dose UVA1 phototherapy and narrowband (NB)-UVB phototherapy to be the safest and most effective phototherapies for moderate-to-severe AD subjects, with similar efficacy 48–51.…”

Section: Treatmentsmentioning

confidence: 99%

Treatment resistant atopic dermatitis: challenges and solutions

Johnson¹,

Franco²,

Beck³

et al. 2019

CCID

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Atopic dermatitis (AD) is a common, chronic, relapsing-remitting inflammatory disease that can be challenging to treat. Patients with mild disease are usually managed well with good skin care practices including moisturization and appropriate bathing along with intermittent use of topical therapies such as topical corticosteroids and/or topical calcineurin inhibitors during flares. Patients with frequent flares may benefit from proactive application of topical therapies twice a week to the most troublesome areas. Patients with severe disease often present significant treatment challenges. Systemic therapies are usually required for severe AD but have varying degrees of success and can be associated with side-effect profiles that require counseling and close monitoring. Phototherapy has been shown to have success in treating moderate-to-severe AD, but several factors can limit its utility and efficacy including cost and access. New therapies are in development targeting specific pathways relevant for AD. Dupilumab was the first biologic treatment approved in North America, Europe, and Japan for adults with moderate-to-severe AD. Although this treatment can lead to rapid improvement in the majority of patients, there are inadequate responders. In this review, we discuss the clinical challenges and treatment options for moderate-to-severe refractory AD.

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“…By reducing the number of epidermal nerve fibers and the expression of axon guidance molecules, it is also considered a good therapeutic approach for AD-associated itch, relieving patients from this oppressive symptom [26, 27]. Moreover, UV irradiation is also able to modulate the immune response of AD patients via upregulation of FoxP3-positive regulatory T cells, whose number is directly correlated with the degree of AD severity score improvements [28]. Different artificial light sources are available against AD: broadband UVB (290–320 nm), narrow-band (NB) UVB (311–313 nm), excimer laser (308 nm), UVA-1 (340–400 nm), psoralens and UVA (PUVA), and combined UVA/UVB (280–400 nm).…”

Section: Methodsmentioning

confidence: 99%

Systemic Treatment of Adult Atopic Dermatitis: A Review

Megna

Napolitano

Patruno

et al. 2016

Dermatol Ther (Heidelb)

133

109

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Atopic dermatitis (AD) is a common chronic inflammatory skin disease that predominantly affects children. However, it can persist in adulthood and/or start at older ages. Due to its chronic nature and frequently occurring relapses, AD has a substantial effect on patients' quality of life, often requiring long-term systemic treatment, especially in adult patients, who are more frequently refractory to adequate topical treatment with mid- to high-potent corticosteroids and/or calcineurin inhibitors. Therefore, treatment with systemic therapies is often needed to take control of the disease, prevent exacerbations and improve quality of life. However, data regarding systemic treatment effectiveness and long-term safety in adult patients with AD are insufficient. Indeed, standardized international guidelines are lacking, and the treatment approach widely differs among diverse countries. This review focuses on the use of systemic treatments in adult AD patients analyzing published literature.

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Circulating CD4⁺CD25^highFoxP3⁺ T‐regulatory cells in patients with atopic dermatitis after narrowband‐ultraviolet B phototherapy

Abstract: Significant reduction in AD disease severity is correlated with the change in Tregs% and Tregs/Teffs.

Cited by 10 publications

References 40 publications

Increase in Vitamin D but not Regulatory T Cells following Ultraviolet B Phototherapy of Patients with Atopic Dermatitis

Increase in Vitamin D but not Regulatory T Cells following Ultraviolet B Phototherapy of Patients with Atopic Dermatitis

<p>Treatment resistant atopic dermatitis: challenges and solutions</p>

Systemic Treatment of Adult Atopic Dermatitis: A Review

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Circulating CD4+CD25highFoxP3+ T‐regulatory cells in patients with atopic dermatitis after narrowband‐ultraviolet B phototherapy

Abstract: Significant reduction in AD disease severity is correlated with the change in Tregs% and Tregs/Teffs.

Cited by 10 publications

References 40 publications

Increase in Vitamin D but not Regulatory T Cells following Ultraviolet B Phototherapy of Patients with Atopic Dermatitis

Increase in Vitamin D but not Regulatory T Cells following Ultraviolet B Phototherapy of Patients with Atopic Dermatitis

<p>Treatment resistant atopic dermatitis: challenges and solutions</p>

Systemic Treatment of Adult Atopic Dermatitis: A Review

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Circulating CD4⁺CD25^highFoxP3⁺ T‐regulatory cells in patients with atopic dermatitis after narrowband‐ultraviolet B phototherapy