scholarly journals The link between atopic dermatitis and asthma- immunological imbalance and beyond

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Martina Yaneva ◽  
Razvigor Darlenski
Keyword(s):  
Atopic Dermatitis ◽  
Targeted Therapy ◽  
Economic Burden ◽  
Predictive Value ◽  
Medical Literature ◽  
Clinical Phenotype ◽  
Industrialized Countries ◽  
Atopic Diseases ◽  
Atopic March ◽  
Pathogenetic Mechanisms

AbstractAtopic diseases are multifactorial chronic disturbances which may evolve one into another and have overlapping pathogenetic mechanisms. Atopic dermatitis is in most cases the first step towards the development of the atopic march and represents a major socio-economic burden in the industrialized countries. The treatment of atopic diseases is often long-lasting and in some cases with lower effectiveness than expected.In order to prevent the development of the atopic march, the links between the atopic diseases have to be understood. The aim of this review is to present some major points outlining the link between atopic dermatitis and asthma, through a research in the medical literature from recent years.Stratifying patient populations according to the clinical phenotype of their disease and according to specific measurable values (biomarkers) can help to establish the main etiopathogenetic mechanisms of the disease in these populations. This will add predictive value for the evolution of the disease, and will allow the use and research of more targeted therapy in order to stop this evolution and comorbidities.

scholarly journals Current understanding of allergic march and the role of eczema in its development

2018 ◽  
Vol 72 ◽  
pp. 43-51
Author(s):  
Karolina Gwoździewicz ◽  
Ewa Cichocka-Jarosz
Keyword(s):  
Atopic Dermatitis ◽  
Subsequent Development ◽  
Childhood And Adolescence ◽  
Skin Microbiome ◽  
Atopic Diseases ◽  
Barrier Dysfunction ◽  
Atopic March ◽  
Leading Role ◽  
Typical Sequence

An increasing morbidity of atopic diseases (atopic dermatitis, food allergy, asthma and allergic rhinitis) documented in large cohort epidemiological studies is at least partially determined by high hygienic standards of living. Over the last 40 years, the accepted concept of pathogenesis of atopic diseases, the so-called atopic march, was proposed by Fouchard in 1973. It referred to the natural history of atopy manifestation, with a typical sequence of symptoms presented as atopic dermatitis in early childhood for subsequent development of allergic respiratory symptoms in late childhood and adolescence. New data suggests that the leading role of atopic dermatitis in atopic march might be less pronounced than previously expected, indicating coexistence rather than succession of atopic symptoms. The objective of this paper is to present the currently discussed concepts of atopic dermatitis – its pathogenesis, etiology, course and role in the development of other allergic diseases. More widely, we will present: 1. The genetic factors involved in skin barrier disruption with the leading role of loss-of-function gene for filaggrin mutation, 2. Genetic defects and epigenetic regulation of the immune system 3. Epidermal changes with physical barrier dysfunction as well as 4. Skin microbiome disturbances with Staphylococcus aureus colonization leading to abnormalities of the epidermal protective barrier.

Atopic dermatitis: new horizons of therapy

2019 ◽  
Vol 1 (7) ◽  
pp. 29-32 ◽  
Author(s):  
L. S. Kruglova ◽  
E. M. Gensler
Keyword(s):  
Blood Pressure ◽  
Immune Response ◽  
Allergic Rhinitis ◽  
Atopic Dermatitis ◽  
Targeted Therapy ◽  
Inflammatory Response ◽  
Bronchial Asthma ◽  
New Horizons ◽  
The Past

Over the past decades, the first breakthrough milestone in the treatment of severe forms of atopic dermatitis (AD) has been targeted therapy aimed at inhibiting IL-4 and IL-13. This was made possible thanks to advances in the understanding of the pathogenesis of AD, the driver of which is the Th2-type immune response, which also underlies such manifestations of atopy as bronchial asthma, allergic rhinitis, and polynosis. In the case of the Th2-type immune response, cytokines IL-4 and IL-13 are secreted, which are the main promoters of the inflammatory response in AD. Inhibition of IL-4 and IL-13 leads to the prevention of inflammation and is an effective approach to therapy. The use of therapy aimed at inhibition of cytokines allows you to effectively cope with the manifestations of severe and moderately severe blood pressure.

scholarly journals Foundational Statistical Principles in Medical Research: Sensitivity, Specificity, Positive Predictive Value, and Negative Predictive Value

Medicina ◽  
2021 ◽  
Vol 57 (5) ◽  
pp. 503
Author(s):  
Thomas F. Monaghan ◽  
Syed N. Rahman ◽  
Christina W. Agudelo ◽  
Alan J. Wein ◽  
Jason M. Lazar ◽  
...  
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Medical Literature ◽  
Disease Prevalence ◽  
Positive Test Result ◽  
Predictive Values ◽  
Sensitivity Specificity ◽  
Test Result ◽  
Test Probability

Sensitivity, which denotes the proportion of subjects correctly given a positive assignment out of all subjects who are actually positive for the outcome, indicates how well a test can classify subjects who truly have the outcome of interest. Specificity, which denotes the proportion of subjects correctly given a negative assignment out of all subjects who are actually negative for the outcome, indicates how well a test can classify subjects who truly do not have the outcome of interest. Positive predictive value reflects the proportion of subjects with a positive test result who truly have the outcome of interest. Negative predictive value reflects the proportion of subjects with a negative test result who truly do not have the outcome of interest. Sensitivity and specificity are inversely related, wherein one increases as the other decreases, but are generally considered stable for a given test, whereas positive and negative predictive values do inherently vary with pre-test probability (e.g., changes in population disease prevalence). This article will further detail the concepts of sensitivity, specificity, and predictive values using a recent real-world example from the medical literature.

scholarly journals Economic Burden of Adult Patients with Moderate to Severe Atopic Dermatitis Indicated for Systemic Treatment

2019 ◽  
Vol 99 (9) ◽  
pp. 762-768 ◽  
Author(s):  
L Ariëns ◽  
K Nimwegen ◽  
M Shams ◽  
D Bruin ◽  
J Schaft ◽  
...  
Keyword(s):  
Atopic Dermatitis ◽  
Economic Burden ◽  
Systemic Treatment ◽  
Adult Patients ◽  
Severe Atopic Dermatitis

Economic burden of renal cell carcinoma among older adults in the targeted therapy era

2019 ◽  
Vol 37 (6) ◽  
pp. 356.e19-356.e28 ◽  
Author(s):  
Hrishikesh P. Kale ◽  
D'Arcy P. Mays ◽  
Pramit A. Nadpara ◽  
Patricia W. Slattum ◽  
Asit K. Paul ◽  
...  
Keyword(s):  
Older Adults ◽  
Renal Cell Carcinoma ◽  
Targeted Therapy ◽  
Cell Carcinoma ◽  
Economic Burden ◽  
Renal Cell

scholarly journals Evaluation of Omics-Based Strategies for the Management of Advanced Lung Cancer

2020 ◽  
pp. OP.20.00117
Author(s):  
Ravi Salgia ◽  
Isa Mambetsariev ◽  
Rebecca Pharaon ◽  
Jeremy Fricke ◽  
Angel Ray Baroz ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Decision Making ◽  
Targeted Therapy ◽  
Predictive Value ◽  
Advanced Nsclc ◽  
Therapeutic Options ◽  
Advanced Lung Cancer ◽  
Molecular Testing ◽  
Cox Regression Analysis ◽  
The Impact

PURPOSE: Omic-informed therapy is being used more frequently for patients with non–small-cell lung cancer (NSCLC) being treated on the basis of evidence-based decision-making. However, there is a lack of a standardized framework to evaluate those decisions and understand the association between omics-based management strategies and survival among patients. Therefore, we compared outcomes between patients with lung adenocarcinoma who received omics-driven targeted therapy versus patients who received standard therapeutic options. PATIENTS AND METHODS: This was a retrospective study of patients with advanced NSCLC adenocarcinoma (N = 798) at City of Hope who received genomic sequencing at the behest of their treating oncologists. A thoracic oncology registry was used as a clinicogenomic database to track patient outcomes. RESULTS: Of 798 individuals with advanced NSCLC (median age, 65 years [range, 22-99 years]; 60% white; 50% with a history of smoking), 662 patients (83%) had molecular testing and 439 (55%) received targeted therapy on the basis of the omic-data. A fast-and-frugal decision tree (FFT) model was developed to evaluate the impact of omics-based strategy on decision-making, progression-free survival (PFS), and overall survival (OS). We calculated that the overall positive predictive value of the entire FFT strategy for predicting decisions regarding the use of tyrosine kinase inhibitor–based targeted therapy was 88% and the negative predictive value was 96%. In an adjusted Cox regression analysis, there was a significant correlation with survival benefit with the FFT omics-driven therapeutic strategy for both PFS (hazard ratio [HR], 0.56; 95% CI, 0.42 to 0.74; P < .001) and OS (HR, 0.51; 95% CI, 0.36 to 0.71; P < .001) as compared with standard therapeutic options. CONCLUSION: Among patients with advanced NSCLC who received care in the academic oncology setting, omics-driven therapy decisions directly informed treatment in patients and was correlated with better OS and PFS.

scholarly journals Skin Barrier Abnormalities and Immune Dysfunction in Atopic Dermatitis

2020 ◽  
Vol 21 (8) ◽  
pp. 2867 ◽  
Author(s):  
Gabsik Yang ◽  
Jin Kyung Seok ◽  
Han Chang Kang ◽  
Yong-Yeon Cho ◽  
Hye Suk Lee ◽  
...  
Keyword(s):  
Atopic Dermatitis ◽  
Systemic Disease ◽  
Skin Barrier ◽  
Immune Dysregulation ◽  
Food Allergies ◽  
Atopic Diseases ◽  
Barrier Dysfunction ◽  
Underlying Mechanisms ◽  
Chronic Pruritus ◽  
And Function

Atopic dermatitis (AD) is a common and relapsing skin disease that is characterized by skin barrier dysfunction, inflammation, and chronic pruritus. While AD was previously thought to occur primarily in children, increasing evidence suggests that AD is more common in adults than previously assumed. Accumulating evidence from experimental, genetic, and clinical studies indicates that AD expression is a precondition for the later development of other atopic diseases, such as asthma, food allergies, and allergic rhinitis. Although the exact mechanisms of the disease pathogenesis remain unclear, it is evident that both cutaneous barrier dysfunction and immune dysregulation are critical etiologies of AD pathology. This review explores recent findings on AD and the possible underlying mechanisms involved in its pathogenesis, which is characterized by dysregulation of immunological and skin barrier integrity and function, supporting the idea that AD is a systemic disease. These findings provide further insights for therapeutic developments aiming to repair the skin barrier and decrease inflammation.

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