Current Clinical Options for the Management of Itch in Atopic Dermatitis

Lipman, Zoe M.; Labib, Angelina; Yosipovitch, Gil

doi:10.2147/ccid.s289716

Cited by 13 publications

(11 citation statements)

References 89 publications

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“…Atopic dermatitis (AD) is a chronic inflammatory skin disease, which is characterized by relapsing eczematous, oozing and weeping pruritic symptoms over dry skin with epidermal hyperplasia ( 1 ). AD affects individuals worldwide, especially children, with increased prevalence in the last few decades ( 2 , 3 ).…”

Section: Introductionmentioning

confidence: 99%

D-galactose Intake Alleviates Atopic Dermatitis in Mice by Modulating Intestinal Microbiota

et al. 2022

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Atopic dermatitis (AD) is one of the most prevalent, chronic and persistent inflammatory skin diseases closely associated with intestinal microbiota. To evaluate the effect of D-galactose intake on AD, we orally administered D-galactose to BALB/c mice whose ears and skin were treated with 2,4-dinitrochlorobenzene (DNCB). D-galactose alleviated DNCB-induced AD-like phenotypes such as redness, scaling/dryness and excoriation. Ear thickness was also decreased by D-galactose administration. Histopathological analysis revealed decreased epidermal thickening, infiltration of immune cells, especially mast cells, in the dermis. Total levels of serum IgE representing the immunological response of AD were decreased by D-galactose administration. Microbiota analysis showed that D-galactose administration restored gut microbiota profiles, which were altered in AD mice, characterized by increased abundance of Bacteroidetes and decreased abundance of Firmicutes. The increased abundance of Bacteroides and the decreased abundance of Prevotella and Ruminococcus were reversed by D-galactose treatment, following improvement of AD. Our results suggest the possible use of D-galactose as a prebiotic to alleviate AD by altering gut microbiota.

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Section: Introductionmentioning

confidence: 99%

D-galactose Intake Alleviates Atopic Dermatitis in Mice by Modulating Intestinal Microbiota

et al. 2022

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“…The management of AD with a focus on psychological stress includes autogenic training (AT) and progressive muscle relaxation (PMR) as relaxation methods; additionally, acupuncture has been reported to be effective as well [ 6 ] 7 . Studies of the musculoskeletal system have also demonstrated that high levels of psychological stress can modulate the autonomic nervous system and induce increased muscle tension, especially neck stiffness [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Release of Cervical Muscle Tension Improves Psychological Stress and Symptoms of Moderate-to-Severe Atopic Dermatitis: a Case Series with 20 Patients

Hosono

Fujita

Nimura

et al. 2022

Dermatol Ther (Heidelb)

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Introduction: Atopic dermatitis (AD) is a chronic relapsing inflammatory skin disease that is triggered by intense pruritus, impaired skin barrier function, and immune responses to allergenic substances. Break-through therapies for AD include molecular-targeted drugs and the effective management of severe symptoms of AD. However, patients with clinical improvements may continue scratching owing to the influence of psychological stress, which might lead to quick relapses of stressors and subsequent intensive scratching. New drugs may be ineffective because of such scratching behavior caused by stressors. Therefore, it may be useful to consider adjunctive treatment options that focus on external stressors as triggers of deterioration of AD. We hypothesized that improvement of psychological stress by relieving cervical muscle tension would reduce pruritus and atopic symptoms. Methods: Overall, 21 patients with moderateto-severe AD were treated to relieve cervical muscular tension using Spineliner SA201, which assists in osteopathic manipulative treatment. We assessed the subjective and objective symptoms of AD, cervical muscle tension, which was evaluated using cervical range of motion (ROM), and psychological burden. Only moisturizers were applied topically during the study period, and no topical corticosteroid therapy was used. Results: Twenty patients who completed the treatment demonstrated improvement in the symptoms of AD: changes on the visual analog scale (VAS) for pruritus were -44.2%, Eczema Area and Severity Index (EASI) was -67.9%, thymus and activation-regulated chemokine (TARC) was -56.2%, Hospital Anxiety and Depression Scale (HADS) was -27.2%, sleep disturbance was -49.7%, and Dermatology Life Quality Index (DLQI) was -46.7%. Additionally, the cervical muscle tension improved significantly: changes in cervical ROM were 14.7%. Conclusions: Release of cervical muscle tension may improve psychological stress and have an effect on moderate-to-severe AD.The manuscript was prepared according to the guidelines provided in the CONSORT guidelines.

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“…Atopic dermatitis is the most common inflammatory skin disease, characterized by impaired barrier function 69 . Current pharmacological management strategies include topical agents such as corticosteroids, calcineurin inhibitors and phosphodiesterase‐4 inhibitors, and systemic agents including broad‐spectrum immunosuppressants, cyclosporine, methotrexate, mycophenolate mofetil, and azathioprine 70 . While BTK inhibition is one of a number of therapeutic strategies under investigation, 71 recent additions to the armamentarium include monoclonal antibodies (dupilumab and tralokinumab), along with Janus kinase inhibitors (baricitinib, upadacitinib and abrocitinib) 72…”

Section: Btk Pathway Inhibition In the Treatment Of Skin Diseasesmentioning

confidence: 99%

“…69 Current pharmacological management strategies include topical agents such as corticosteroids, calcineurin inhibitors and phosphodiesterase-4 inhibitors, and systemic agents including broad-spectrum immunosuppressants, cyclosporine, methotrexate, mycophenolate mofetil, and azathioprine. 70 While BTK inhibition is one of a number of therapeutic strategies under investigation, 71 recent additions to the armamentarium include monoclonal antibodies (dupilumab and tralokinumab), along with Janus kinase inhibitors (baricitinib, upadacitinib and abrocitinib). 72 The penetration of antigens through the impaired dermatological barrier leads to production of cytokines such as thymic stromal lymphopoietin, which triggers BTK-dependent signaling and this may be of therapeutic interest.…”

Section: (B) Pemphigus: Dendritic Cells Presenting Desmoglein (Dsg) A...mentioning

confidence: 99%

Bruton's tyrosine kinase inhibition—An emerging therapeutic strategy in immune‐mediated dermatological conditions

Mendes‐Bastos

Brasileiro

Kolkhir

et al. 2022

Allergy

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Bruton's tyrosine kinase (BTK), a member of the Tec kinase family, is critically involved in a range of immunological pathways. The clinical application of BTK inhibitors for B-cell malignancies has proven successful, and there is strong rationale for the potential benefits of BTK inhibitors in some autoimmune and allergic conditions, including immune-mediated dermatological diseases. However, the established risk-to-benefit profile of "first-generation" BTK inhibitors cannot be extrapolated to these emerging, non-oncological, indications. "Next-generation" BTK inhibitors such as remibrutinib and fenebrutinib entered clinical development for chronic spontaneous urticaria (CSU); rilzabrutinib and tirabrutinib are being studied as potential treatments for pemphigus. Promising data from early-phase clinical trials in CSU suggest potential for these agents to achieve strong pathway inhibition, which may translate into measurable clinical benefits, as well as other effects such as the disruption of autoantibody production. BTK inhibitors may help to overcome some of the shortcomings of monoclonal antibody treatments for immune-mediated dermatological conditions such as CSU, pemphigus, and systemic lupus erythematosus. In addition, the use of BTK inhibitors may improve understanding of the pathophysiological roles of mast cells, basophils, and B cells in such conditions.

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Current Clinical Options for the Management of Itch in Atopic Dermatitis

Cited by 13 publications

References 89 publications

D-galactose Intake Alleviates Atopic Dermatitis in Mice by Modulating Intestinal Microbiota

D-galactose Intake Alleviates Atopic Dermatitis in Mice by Modulating Intestinal Microbiota

Release of Cervical Muscle Tension Improves Psychological Stress and Symptoms of Moderate-to-Severe Atopic Dermatitis: a Case Series with 20 Patients

Bruton's tyrosine kinase inhibition—An emerging therapeutic strategy in immune‐mediated dermatological conditions

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