Thursday, July 11 2024

How Does Eczema Develop?

Like a fence or barricade intended to stop unwanted intruders, the skin serves as a barrier protecting the body from the hundreds of allergens, irritants, pollutants and microbes people come in contact with every day. In patients with eczema, or atopic dermatitis, the most common inflammatory human skin disease, the skin barrier is leaky, allowing intruders - pollen, mold, pet dander, dust mites and others - to be sensed by the skin and subsequently wreak havoc on the immune system.

While the upper-most layer of the skin - the stratum corneum - has been pinned as the culprit in previous research, a new study published today in the Journal of Allergy and Clinical Immunology found that a second skin barrier structure, consisting of cell-to-cell connections known as tight junctions, is also faulty in eczema patients and likely plays a role in the development of the disease. Tightening both leaky barriers may be an effective treatment strategy for eczema patients, who often have limited options to temper the disease.

Disruption of the Skin Barrier

"Over the past five years, disruption of the skin barrier has become a central hypothesis to explain the development of eczema," said Lisa Beck, M.D., lead study author and associate professor in the Department of Dermatology at the University of Rochester Medical Center. "Our findings challenge the belief that the top layer of the skin or stratum corneum is the sole barrier structure: It suggests that both the stratum corneum and tight junctions need to be defective to jumpstart the disease."

Currently, there are no treatments that target skin barrier dysfunction in eczema. To treat eczema, which causes dry, red, itchy skin, physicians typically prescribe anti-inflammatory drugs, like prednisone, and a variety of topical anti-inflammatory creams and ointments. But, modest benefit, negative side effects and cost concerns associated with these therapies leave patients and doctors eagerly awaiting new alternatives.

"We want to figure out what current eczema therapies do to both barrier structures and start thinking about new treatments to close the breaks that let irritants in and water out and subsequently drive the inflammation and dryness that is characteristic of the disease," noted Beck, who treats eczema patients in addition to conducting research on the condition.

Junctions of the Skin

To better understand the role of tight junctions in eczema, Beck and her team studied skin samples from eczema patients and healthy individuals. Using resistance and permeability tests, they discovered that tight junctions, which act like a gate controlling the passage of water and particles, were strong and tight in healthy skin samples, yet loose and porous in the skin of eczema patients.

On further investigation, they found that a particular tight junction protein, claudin-1, which determines the strength and permeability of tight junctions in skin, is significantly reduced in the skin of eczema patients, but not in healthy individuals or individuals with psoriasis, another common chronic skin disease. They demonstrated that reducing claudin-1 expression in skin cells from healthy donors made the tight junctions leaky and more permeable, a finding in line with results of other research groups.

"Since claudin-1 was only reduced in eczema patients, and not the other controls, it may prove to be a new susceptibility gene in this disease," said Anna De Benedetto, M.D., postdoctoral-fellow at the Medical Center and first author of the new study. "Our hypothesis is that reduced claudin-1 may enhance the reactivity to environmental antigens and lead to greater allergen sensitization and susceptibility in people with eczema."

New Treatment for Eczema?

If the team's hypothesis stands up in future research, increasing claudin-1 to combat eczema could be a new treatment approach worth exploring. The University of Rochester has applied for patent protection for increasing claudin-1 with drug compounds to treat eczema.

Barrier problems, and in particular tight junction defects, are recognized as a common feature in many other inflammatory diseases, such as inflammatory bowel disease and asthma, where the lining of the intestine and the airways is weakened, which is why Beck and her team decided to focus on the role of this barrier structure in eczema.

Eczema affects up to 17 percent of children and about six percent of adults in the United States - close to 15 million Americans. While there are varying severities of eczema, all have an itch that can make it difficult to focus on daily activities and to sleep. People with eczema are often counseled to minimize their exposure to allergens, but that is a difficult task given the hundreds of allergens people are exposed to each day.

Saturday, June 29 2024

Drug Used to Treat Eczema May Provide Relief for Itchy Skin Diseases

A drug approved to treat eczema provided significant improvement in the symptoms of patients with severe itching diseases that currently have no targeted treatments, according to a new study published in JAMA Dermatology. The drug, abrocitinib, was found to cause minimal side effects during a small  […]

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Thursday, June 27 2024

Tips For Reducing Indoor Allergens

For people who suffer from indoor allergies, staying indoors may make them just as miserable as outdoor airborne allergens. The best way to deal with indoor allergens is to eliminate as many as possible. Allergies affect between 40 and 50 million people in the United States, according to the American Academy of Allergy, Asthma and Immunology (AAAAI). While seasonal allergies may come and go, perennial, or year-round, allergy sufferers deal with stuffy or runny noses, itchy eyes, sneezing, and wheezing 365 days a year.

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Friday, May 17 2024

Can Allergy Medicines Be Dangerous?

By Alicia Gambino People suffering from seasonal allergies turn to over-the-counter and prescription allergy products for relief of common symptoms – coughing, sneezing, runny nose, congestion and itchy eyes, nose or throat – often are not aware of the medicines' potential side effects. "All  […]

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Monday, May 13 2024

How Can I Get Rid of Dust Mites?

Completly ridding your home of dust mites may be next to impossible. They are so small they can not be seen with the naked eye. Their population is determined by the humidity of the home, the temperature of the home, and the amount of fabric or upholstery in the home. They literally can live  […]

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Thursday, April 25 2024

How Does Pollen Provoke Allergic Reactions?

How do pollen particles provoke allergic reactions? A study in The Journal of Experimental Medicine puts some of the blame on bioactive molecules that are released from pollen. These molecules bind to immune cells and cause them to launch a typical allergy-promoting immune response. Pollen from plants exposed to air pollutants produce more of these allergy-provoking compounds than do pollen from unpolluted areas, possibly explaining why allergies are more prevalent in places with high levels of car exhaust emissions.

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Wednesday, April 24 2024

Household Dust Is Full of Pollutants

You may want to think again before you dust the top of your refrigerator or vacuum under the couch. "Certain toxic chemicals, such as lead, pesticides, polychlorinated biphenyls (PCBs) and polycyclic aromatic hydrocarbons (PAHs) are routinely found in household dust," explains Andrea Ferro, professor of civil and environmental engineering at Clarkson University and an air quality researcher. "Simple activities such as dusting and vacuuming generate or resuspend the pollutants into the air that we then breathe in."

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Friday, April 5 2024

Food Allergy Prevention

Nursing mothers can help prevent or delay food allergic reactions in high-risk infants through dietary modifications, according to a report in the New England Journal of Medicine. High-risk infants are those who have someone in their family who has allergies.

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