The Role of Diet Modification in Atopic Dermatitis: Navigating the Complexity

Rustad, Andrea M; Nickles, Melissa A; Bilimoria, Sara; Lio, Peter A.

doi:10.1007/s40257-021-00647-y

Cited by 15 publications

(10 citation statements)

References 71 publications

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“… 215 , 217 Notably, avoidance of food is not indicated in management of most AD. 237 It is not uncommon that patients or providers incorrectly suspect diet as the cause of AD and inaccurately assign food allergies; this not only results in inappropriate testing and dietary changes but may also result in neglect of established AD treatments and possibly even development of IgE-mediated food allergy. 237 , 238 However, it is important for clinicians to be aware that the prevalence of food allergy is significantly higher in children with AD, as compared to healthy children.…”

Section: Environmental Contributionsmentioning

confidence: 99%

Genetic/Environmental Contributions and Immune Dysregulation in Children with Atopic Dermatitis

Chong¹,

Visitsunthorn²,

Ong³

2022

JAA

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Atopic dermatitis (AD) is one of the most common skin conditions in humans. AD affects up to 20% of children worldwide and results in morbidity for both patients and their caregivers. The basis of AD is an interplay between genetics and the environment characterized by immune dysregulation. A myriad of mutations that compromise the skin barrier and/or immune function have been linked to AD. Of these, filaggrin gene ( FLG ) mutations are the most evidenced. Many other mutations have been implicated in isolated studies that are often unreplicated, creating an archive of genes with potential but unconfirmed relevance to AD. Harnessing big data, polygenic risk scores (PRSs) and genome-wide association studies (GWAS) may provide a more practical strategy for identifying the genetic signatures of AD. Epigenetics may also play a role. Staphylococcus aureus is the most evidenced microbial contributor to AD. Cutaneous dysbiosis may result in over-colonization by pathogenic strains and aberrant skin immunity and inflammation. Aeroallergens, air pollution, and climate are other key environmental contributors to AD. The right climate and/or commensals may improve AD for some patients.

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Section: Environmental Contributionsmentioning

confidence: 99%

Genetic/Environmental Contributions and Immune Dysregulation in Children with Atopic Dermatitis

Chong¹,

Visitsunthorn²,

Ong³

2022

JAA

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“…Atopic dermatitis (AD) is a prevalent and disabling condition affecting until 7% of general adult population ( Eckert et al , 2019 ). Different factors contribute to the severity of this condition including genetic predisposition ( Nedoszytko et al , 2020 ), T-cell-driven over-inflammation ( Langan et al , 2020 ) and environmental factors such as air pollution ( Lopez et al , 2021 ) or type of diet ( Rustad et al , 2022 ). The course of this condition can be complicated by different medical comorbidities including asthma or allergic rhinitis ( Langan et al , 2020 ).…”

Section: Introductionmentioning

confidence: 99%

Mental health in patients affected by atopic dermatitis: which effects of treatment with dupilumab?

Ferrucci,

Tavecchio,

Nicolini

et al. 2023

International Clinical Psychopharmacology

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Atopic dermatitis (AD) is an inflammatory skin disease. Patients with AD are prone to develop anxiety and mood disorders. Aim of this study is to investigate if treatment with dupilumab may improve mental health status of patients affected by AD. A total of 66 patients with severe AD were included: 24 subjects were candidate or have just started (one month) treatment with dupilumab, and 42 have been in treatment for one year. 25.8%, 30.3%, and 45.5% of the total sample showed, respectively, clinically significant anxiety, depression, and symptoms of Internet addiction. Patients with anxiety symptoms resulted to have more severe AD, more sleep problems (P = 0.028), less quality of life (P = 0.001), more severe depressive symptoms (P < 0.001), to be more frequently women (P = 0.016), to be less frequently treated with dupilumab for one year (P = 0.025). Similarly, patients with clinically significant depressive symptoms resulted to have more severe AD, more sleep problems (P = 0.003), less quality of life (P < 0.001), more severe anxiety symptoms (P < 0.001), to be less frequently treated with dupilumab for one year (P = 0.008). Patients with AD treated for one year with dupilumab showed a better mental health profile in terms of less severe anxiety and depression with respect to their counterparts.

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“…Kelleher et al found that increased TEWL at two days after birth was associated with increased risk of development of AD at one year of age [ 35 ]. A constantly growing body of evidence supports that food allergy follows atopic dermatitis diagnosis and leads to the reasonable conclusion that AD is involved in the causal pathway towards food allergy [ 21 , 23 , 37 ]. Although less commonly, food allergy might precede AD onset in a small number of children [ 38 ].…”

Section: Association Between Food Sensitization and Food Allergy With...mentioning

confidence: 99%

Atopic Dermatitis and Food Allergy: A Complex Interplay What We Know and What We Would Like to Learn

Papapostolou

Xepapadaki

Gregoriou

et al. 2022

JCM

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Atopic dermatitis (AD) is a chronic inflammatory skin disorder characterized by intense pruritus, eczematous lesions, and relapsing course. It presents with great clinical heterogeneity, while underlying pathogenetic mechanisms involve a complex interplay between a dysfunctional skin barrier, immune dysregulation, microbiome dysbiosis, genetic and environmental factors. All these interactions are shaping the landscape of AD endotypes and phenotypes. In the “era of allergy epidemic”, the role of food allergy (FA) in the prevention and management of AD is a recently explored “era”. Increasing evidence supports that AD predisposes to FA and not vice versa, while food allergens are presumed as one of the triggers of AD exacerbations. AD management should focus on skin care combined with topical and/or systemic treatments; however, in the presence of suspected food allergy, a thorough allergy evaluation should be performed. Food-elimination diets in food-allergic cases may have a beneficial effect on AD morbidity; however, prolonged, unnecessary diets are highly discouraged since they can lead to loss of tolerance and potentially increase the risk of IgE-mediated food allergy. Preventive AD strategies with the use of topical emollients and anti-inflammatory agents as well as early introduction of food allergens in high-risk infants seem promising in managing and preventing food allergy in AD patients. The current review aims to overview data on the complex AD/FA relationship and provide the most recent developments on whether food allergy interventions change the AD course and vice versa.

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The Role of Diet Modification in Atopic Dermatitis: Navigating the Complexity

Cited by 15 publications

References 71 publications

Genetic/Environmental Contributions and Immune Dysregulation in Children with Atopic Dermatitis

Genetic/Environmental Contributions and Immune Dysregulation in Children with Atopic Dermatitis

Mental health in patients affected by atopic dermatitis: which effects of treatment with dupilumab?

Atopic Dermatitis and Food Allergy: A Complex Interplay What We Know and What We Would Like to Learn

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