The Skin as a Route of Allergen Exposure: Part II. Allergens and Role of the Microbiome and Environmental Exposures

Knaysi, George; Smith, Anderson D.; Wilson, Jeffrey M.; Wisniewski, Julia

doi:10.1007/s11882-017-0675-4

Cited by 22 publications

(18 citation statements)

References 86 publications

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“…Additionally, other surfactants, such as present in wool alcohols, may also increase penetration of other compounds 41. Also, the influence of emollients on the skin microbiome42, 43 could change the tolerance against several allergens44 making frequent emollient applicators more prone to ACD. For this subject, however, more detailed research is warranted.…”

Section: Discussionmentioning

confidence: 99%

Both children and adult patients with difficult‐to‐treat atopic dermatitis have high prevalences of concomitant allergic contact dermatitis and are frequently polysensitized

Boonstra

Rustemeyer

Middelkamp-Hup

2018

Acad Dermatol Venereol

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BackgroundConcomitant allergic contact dermatitis (ACD) has been described as a possible cause of atopic dermatitis (AD) becoming difficult‐to‐treat. However, contact sensitization in this patient group has barely been studied.ObjectiveTo study the occurrence of ACD in a population of difficult‐to‐treat AD children and adults.MethodsClinical and patch test information of 48 patients with difficult‐to‐treat AD unresponsive to conventional outpatient treatments was gathered retrospectively. We studied prevalence and relevance of common allergens, performed dynamic patch test analysis and assessed occurrence of polysensitization.ResultsIn 48 patients with difficult‐to‐treat AD, 75% (n = 36/48) had a concomitant contact allergy, and 39% (n = 14/36) of these patients were polysensitized. ACD and polysensitization prevalences were equal amongst children and adults. The most frequent and relevant reactions were seen against wool alcohols, surfactants cocamidopropyl betaine and dimethylaminopropylamine, bichromate and fragrance mix I. Dynamic pattern analysis showed these reactions to be mostly allergic and not irritative of nature.ConclusionDifficult‐to‐treat AD patients frequently suffer from concomitant (multiple) contact allergies, and this may be a reason why the AD turns into a difficult‐to‐treat disease. Awareness of this phenomenon is necessary, as pragmatic implementation of allergen avoidance strategies may be helpful in getting disease control in this population.

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Section: Discussionmentioning

confidence: 99%

Both children and adult patients with difficult‐to‐treat atopic dermatitis have high prevalences of concomitant allergic contact dermatitis and are frequently polysensitized

Boonstra

Rustemeyer

Middelkamp-Hup

2018

Acad Dermatol Venereol

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“…As a consequence, early exposure to aeroallergens through the skin may be a risk factor for allergic sensitization. However, the mechanisms of cutaneous penetration of allergens, sensitization, and the development of allergic disease are likely much more complex than previously assumed (Knaysi, Smith, Wilson, & Wisniewski, 2017).…”

Section: Aeroallergensmentioning

confidence: 96%

How to prevent skin damage from air pollution. Part 1: Exposure assessment

Damevska

Boev

Mirakovski

et al. 2019

Dermatologic Therapy

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Both epidemiological and experimental studies have demonstrated the crucial connection between air pollution exposure and skin disorders. The exact mechanisms by which air pollutants mediate skin damage remain largely unknown. Therefore, it is very necessary to investigate the mechanism of air pollution-induced skin damage and explore some potential protective and therapeutic methods. In this review, we focus on the qualitative and quantitative skin exposure assessment methodologies-a relatively new field of interdisciplinary research. K E Y W O R D Sair pollution, exposure assessment, skin

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“…Allergens Historically, the relationship between exposure to allergens, specifically inhaled allergens (horse dander, ragweed pollen, timothy grass) and AD was demonstrated in 1918 (40). Currently, it is known that in some phenotypes of AD there is an immune response to allergens, mediated by IgE and T cells (41). The skin barrier function and innate immunity are involved in this pathology due to the properties of some allergens (41) that facilitate barrier disruption and cutaneous sensitization.…”

Section: Environmental Factorsmentioning

confidence: 99%

Atopic Dermatitis Host and Environment Model: Revisiting Therapeutic Options

Lopes

Соколова

Abreu

et al. 2020

Eur Ann Allergy Clin Immunol

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Atopic Dermatitis affects both children and adults and is a serious health concern in many countries. AD is a complex disease with host and environmental factors underlying its pathology. Its treatment is multidimensional reflecting the diverse nature of its triggers and includes emollients, topical steroids and calcineurin inhibitors among others. Immunological dysfunction can be addressed broadly with systemic immunosupressors and specifically with monoclonal antibodies. Dupilumab, which targets IL-4 and IL-13 was granted approval for treatment of moderate-to-severe AD. Biologics targeting IgE/Th2 pathways may have its role in patients with overlapping AD and asthma. Psychological distress can exacerbate symptoms and is associated with increased severity of AD. Environmental triggers, such as, allergens can be addressed in selected cases with allergic immunotherapy. In this paper, we discuss AD treatment and propose a new step-by-step approach aiming at maintaining disease control and improving quality of life. ty is associated with various inflammatory conditions, including asthma and allergic diseases. As such, a fundamental role for microorganisms in human health, whether indigenous or environmental, is becoming increasingly evident. Besides the importance of the environment in the development of allergic diseases, an increased familiar predisposition for the development of these conditions may exist. This observation led researchers to hypothesize that host genetic factors could be involved in the pathogenesis of AD. The description, back in 2006, that loss-of-function mutations in the filaggrin (FLG) gene were a strong genetic risk factor for AD, became a significant breakthrough regarding prognosis and treatment. FLG monomers aggregate keratin filaments into tight bundles, resulting in the collapse and flattening of corneocytes that maintain both skin barrier integrity and normal stratum corneum (SC) lipids. Therefore, mutations in the FLG gene may increase skin permeability, predisposing individuals to skin allergen penetration and subsequent infection. These mutations have also

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The Skin as a Route of Allergen Exposure: Part II. Allergens and Role of the Microbiome and Environmental Exposures

Cited by 22 publications

References 86 publications

Both children and adult patients with difficult‐to‐treat atopic dermatitis have high prevalences of concomitant allergic contact dermatitis and are frequently polysensitized

Both children and adult patients with difficult‐to‐treat atopic dermatitis have high prevalences of concomitant allergic contact dermatitis and are frequently polysensitized

How to prevent skin damage from air pollution. Part 1: Exposure assessment

Atopic Dermatitis Host and Environment Model: Revisiting Therapeutic Options

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