Clinical Symptoms Of Atopic Dermatitis Research Articles

Evaluation of effectiveness of complex therapy for atopic dermatitis in children and adolescents using transcranial magnetic therapy

Today, the development and implementation of modern physiotherapeutic treatment options, including those safe for home use by patients, is promising.Purpose of the study. Studying the safety and effectiveness of transcranial magnetotherapy with mild and moderate severity of atopic dermatitis.Material and methods. The study was attended by 104 patients, aged 5 to 16 years, with a prescription of the disease from 2 months to 16 years. Patients were divided into groups: the 1st group received standard therapy, in the 2nd group they combined standard therapy and placebo in physiotherapeutic treatment, patients of the 3rd groups used transcranial therapy in monotherapy, participants of the 4th group were on combined therapy – transcranial magnetotherapy and standard.Results. According to the study, the effectiveness of transcranial magnetotherapy is based on a positive effect on the state of the central nervous system and its autonomic department, which is accompanied by the relief of clinical symptoms, itching and helps to improve psychoemotional status.Conclusions. The use of transcranial magnetotherapy in a complex with standard therapy helps to relieve clinical symptoms of atopic dermatitis and the quality of life of patients.

The effect of probiotics in the prevention of atopic dermatitis in children: a systematic review and meta-analysis.

Probiotics have anti-inflammatory effects and can alleviate clinical symptoms of atopic dermatitis (AD) in children. However, the effects of probiotics on AD in children were controversial. This study aimed to evaluate the clinical efficacy of probiotics in the prevention of AD in children by a meta-analysis method. Randomized controlled trials (RCTs) on probiotics in the prevention of AD in children performed at home and abroad were searched in the PubMed, Web of Science, China National Knowledge Infrastructure (CNKI), and Wanfang databases using a combination of subject terms and free terms. The retrieval time was from the establishment of the database to November 2022. Meta-analysis was performed by using Stata 14.0 software. The inclusion criteria were based on the Population, Intervention, Comparison, Outcomes and Study (PICOS) framework. (I) Participants: age ≤18; (II) Intervention: the intervention group received probiotics; (III) Control: the control group received placebo; (IV) Outcomes: AD; (V) the type of study: randomized control group. We collected the number of two groups and the number of AD in the included literatures. The I2 statistic was employed to evaluate heterogeneity. Thirty-seven RCTs were eventually included, including 2,986 in the experimental group and 3,145 in the control group. The meta-analysis showed that probiotics were superior to placebo in the prevention of AD [risk ratio (RR) (95% confidence interval): 0.83 (0.73, 0.94), I2=65.2%]. The sub-group meta-analysis showed that the clinical efficacy of probiotics in the prevention of AD was more significant in the following groups: mothers and infants, before and after childbirth, Lactobacillus rhamnosus or mixed probiotics, follow-up time ≤2 years, and conducted in Europe. Probiotic intervention may provide an effective means of preventing AD in children. However, due to the heterogeneity of the results of this study, the results need confirmation in follow-up studies.

WFDC12-overexpressing contributes to the development of atopic dermatitis via accelerating ALOX12/15 metabolism and PAF accumulation

Atopic dermatitis (AD) is a chronic inflammatory skin disease characterized by eczema-like skin lesions, dry skin, severe itching, and recurrent recurrence. The whey acidic protein four-disulfide core domain gene WFDC12 is highly expressed in skin tissue and up-regulated in the skin lesions of AD patients, but its role and relevant mechanism in AD pathogenesis have not been studied yet. In this study, we found that the expression of WFDC12 was closely related to clinical symptoms of AD and the severity of AD-like lesions induced by DNFB in transgenic mice. WFDC12-overexpressing in the epidermis might promote the migration of skin-presenting cells to lymph nodes and increase Th cell infiltration. Meanwhile, the number and ratio of immune cells and mRNA levels of cytokines were significantly upregulated in transgenic mice. In addition, we found that ALOX12/15 gene expression was upregulated in the arachidonic acid metabolism pathway, and the corresponding metabolite accumulation was increased. The activity of epidermal serine hydrolase decreased and the accumulation of platelet-activating factor (PAF) increased in the epidermis of transgenic mice. Collectively, our data demonstrate that WFDC12 may contribute to the exacerbation of AD-like symptoms in DNFB-induced mouse model by enhancing arachidonic acid metabolism and PAF accumulation and that WFDC12 may be a potential therapeutic target for human atopic dermatitis.

Anti-Itching and Anti-Inflammatory Effects of Kushenol F via the Inhibition of TSLP Production.

Atopic dermatitis (AD) is a chronic inflammatory skin disease that results from eczema, itching, disrupted barrier function and aberrant cutaneous immune responses. The aim of the present study was to assess the efficacy of kushenol F as an effective treatment for AD via the suppression of thymic stromal lymphopoietin (TSLP) production. The results of the present study demonstrated that the clinical symptoms of AD were less severe and there was reduced ear thickening and scratching behavior in kushenol F-treated Dermatophagoides farinae extract (DFE)/1-chloro-2,4-dinitrochlorobenzene (DNCB)-induced AD mice. Histopathological analysis demonstrated that kushenol F decreased the DFE/DNCB-induced infiltration of eosinophil and mast cells and TSLP protein expression levels. Furthermore, kushenol F-treated mice exhibited significantly lower concentrations of serum histamine, IgE and IgG2a compared with the DFE/DNCB-induced control mice. Kushenol F also significantly decreased phosphorylated NF-κB and IKK levels and the mRNA expression levels of IL-1β and IL-6 in cytokine combination-induced human keratinocytes. The results of the present study suggested that kushenol F may be a potential therapeutic candidate for the treatment of AD via reducing TSLP levels.

Tremella fuciformis polysaccharides alleviate induced atopic dermatitis in mice by regulating immune response and gut microbiota.

Atopic dermatitis (AD), characterized by severe pruritus, immune imbalance, and skin barrier dysfunction, has a high incidence worldwide. Recent evidence has shown that the modulation of gut microbiota is crucial for alleviating clinical symptoms of AD. Tremella fuciformis polysaccharides (TFPS) have been demonstrated to have a variety of biological activities such as immunomodulatory, anti-tumor, antioxidant, anti-inflammatory, neuroprotective, hypoglycemic and hypolipidemic effects. However, their effects on AD treatment have never been investigated. In this study, we compared the therapeutic effects of topical or oral administration of TFPS on AD in dinitrofluorobenzene (DNFB)-induced AD mice. Both topical application and oral administration of TFPS led to improvement on transdermal water loss, epidermal thickening, and ear edema in AD mice, but the oral administration showed significantly better efficacy than the topical application. The TFPS treatment increased the proportion of CD4 (+) CD25 (+) Foxp3 (+) regulatory T cells in mesenteric lymph nodes. Additionally, the non-targeted metabolomics and sequencing of 16S rDNA amplicons were performed, revealing metabolite modulation in feces and changed composition of gut microbiota in mice, which were induced for AD-like disorder and treated by oral administration of TFPS. Collectively, these data suggest that the oral administration of TFPS may constitute a novel effective therapy for AD, with underlying mechanisms associated with the regulation of immune response, and improvement of both metabolism and the composition of intestinal microbiota.

Portulaca oleracea L. extracts alleviate 2,4-dinitrochlorobenzene-induced atopic dermatitis in mice.

Atopic dermatitis (AD) is a common chronic allergic skin disease characterized clinically by severe skin lesions and pruritus. Portulaca oleracea L. (PO) is a resourceful plant with homologous properties in medicine and food. In this study, we used two different methods to extract PO, and compared the therapeutic effects of PO aqueous extract (POAE) and PO ultrasound-assisted ethanol extract (POEE) on 2,4-dinitrochlorobenzene (DNCB)-induced AD mice. The results showed that in POAE and POEE, the extraction rates of polysaccharides were 16.95% and 9.85%, while the extraction rates of total flavonoids were 3.15% and 3.25%, respectively. Compared with AD mice, clinical symptoms such as erythema, edema, dryness and ulceration in the back and left ear were alleviated, and pruritus behavior was reduced after POAE and POEE treatments. The thickness of the skin epidermis was thinned, the density of skin nerve fibers labeled with protein gene product 9.5 (PGP9.5) was decreased, and mast cell infiltration was reduced. There was a decrease in blood lymphocytes, eosinophils and basophils, a significant decrease in spleen index and a noticeable decrease in serum immunoglobulin E (Ig E). POEE significantly reduced the concentration of the skin pruritic factor interleukin (Il)-31. POAE and POEE reduced the concentration of skin histamine (His), down-regulated mRNA expression levels of interferon-γ (Ifnγ), tumor necrosis factor-α (Tnf-α), thymic stromal lymphopoietin (Tslp) and Il-4, with an increase of Filaggrin (Flg) and Loricrin (Lor) in skin lesions. These results suggested that POAE and POEE may inhibit atopic response and alleviate the clinical symptoms of AD by inhibiting the expression of immune cells, inflammatory mediators and cytokines. PO may be a potential effective drug for AD-like diseases.

Pinus koraiensis needle or cone extracts alleviate atopic dermatitis symptoms by regulating immunity and suppressing inflammation in HaCaT cells and Nc/Nga mice.

Pinus koraiensis needles (PKN) and cones (PKC) have been shown to protect against inflammation and pathogenic bacteria. We investigated the efficacies and action mechanisms of topical applications of 1,3-butylene glycol (BG) extracts and oral administration of their water extracts on atopic dermatitis (AD) symptoms. After exposing HaCaT cells and Nc/Nga mice dorsal skins to 2,4-dinitrochlorobenzene (DNCB) to induce atopic dermatitis models, they were topically applied BG (AD-control), 30% PKNX, or 30% PKCX to the skin lesions and fed water extracts (0.5%) in high-fat diets for 5weeks. Normal-control mice had no DNCB exposure. Serum immunoglobulin E (IgE), IL-4, and TNF-α levels and gene expressions of TNF-α, IL-4, IL-6, and IFN-γ in the dorsal skin and HaCaT cells were measured. The AD-control mice elevated TNF-α and IL-6 mRNA levels in HaCaT cells. Both extracts attenuated clinical AD symptoms in AD-induced Nc/Nga mice: PKNX improved hemorrhage, erythema, and lichenification of dorsal skin better than PKCX while both similarly alleviated erythema, edema, excoriation, and itching behavior. PKCX reduced IgE contents and increased filaggrin mRNA expression better than PKNX, but PKNX reduced lipid peroxides and mRNA levels of TNF-α and IL-4 in the dorsal skin. In the histological analysis of the dorsal skin, the administration of both extracts significantly decreased mast cell numbers, immune cell infiltration, gaps between the epidermis and dermis, and abnormal cell and nucleus shapes. In conclusion, both PKCX and PKNX treatment alleviated the DNCB-induced clinical symptoms of AD by alleviating immune-related symptoms and inflammation in partially different pathways. Therefore, PKNX and PKCX may be effective for AD therapy. PRACTICAL APPLICATIONS: Atopic dermatitis (AD) is related to an overly activated immune response, and it has steadily increased last 3 decades. However, no optimal sustainable treatments are available. Pinus koraiensis needles and cones extracts have been used for anti-inflammatory and antimicrobial treatment. The present study demonstrated that their intake and topical administration onto the AD lesion alleviated clinical AD symptoms associated with reduced proinflammatory cytokines, mast cell numbers, and immune cell infiltrates to maintain dermal structure with maintaining filaggrin expression in AD-induced HaCaT cells and Nc/Nga mice. These results suggested that Pinus koraiensis needles and cones extracts can be developed and applied as beneficial alternative therapies for AD.

Possible role of arginase 1 positive microglia on depressive/anxiety-like behaviors in atopic dermatitis mouse model.

Atopic dermatitis (AD) and mood disorder comorbidities are typical, but the exact mechanism underlying their interplay has not been clarified. In this study, we aimed to identify the possible mechanisms of anxiety/depressive-like behaviors observed in AD, focusing on microglia. AD was induced by Dermatophagoides farinae body extract (Dfb) in NC/Nga mice and anxiety/depressive-like behaviors were analyzed by behavioral assessments such as open field test (OFT), tail suspension test (TST), sucrose preference test (SPT), and social interaction. As clinical symptoms of AD induced, anxiety/depressive-like behaviors were increased in the OFT and TST and serum glucocorticoid was elevated. AD mice showed an increased mRNA expression of interleukin-4 (IL-4) in lymph nodes but decreased arginase 1 (Arg1) mRNA expression without a change of IL-4 in the hippocampus. In addition, AD mice showed microglia with a shortened branch of de-ramified form and astrocytes with longer processes and decreased branching in the hippocampus, especially in the dentate gyrus (DG). The immunofluorescence study of the DG confirmed that Arg1 reduction was associated with microglia, but not astrocytes. Furthermore, glucocorticoid receptor reduction, increased 5-HT1AR, reduced phosphorylated cAMP response element-binding protein (pCREB), and brain-derived neurotrophic factor (BDNF) expression were identified in the hippocampus of AD mice. Notably, an immunofluorescence study confirmed that pCREB was decreased in the DG of AD mice. Collectively, our data suggest that the reduced Arg1 positive microglia might contribute to anxiety/depressive-like behaviors via pCREB/BDNF reduction in AD.

Use of Bleach Baths for Atopic Dermatitis: An Indian Perspective.

Atopic dermatitis (AD) is a chronic, relapsing inflammatory skin disorder affecting 15-20% of children and 1-10% of adults. Staphylococcus aureus (S. aureus) infection is the most frequent complication of AD and is involved in the worsening of the disease. Systemic and topical antibiotics are used in the treatment for AD but there are concerns over increasing resistance. Bleach (sodium hypochlorite, NaOCl) baths are an inexpensive, widely accessible, alternative antibiotic treatment that may not worsen antibiotic resistance. Bleach baths are used as adjunctive treatment in AD patients to treat superinfections, although their mechanism of action is not well understood. Balancing safety concerns with efficacious treatment should be important especially for AD where the majority of patients are in pediatrics age groups. Studies available in PubMed databases were included in this review. Most suggested bleach bath improves clinical symptoms of AD and restores surface microbiome by eradicating bacteria, most notably S. aureus. Some studies have noted that this antimicrobial effect has reduced the need for topical corticosteroids. In addition, bleach seems to have strong anti-inflammatory and antipruritic effects. Overall, bleach baths seem to be safe on human skin, without disrupting the epidermal barrier function. The review concluded, although there are some advantages of use of bleach baths, more studies to investigate long-term efficacy and safety of bleach baths are required before fixing its role in the treatment of AD especially in the context of the Indian scenario.

26284 The effect of vitamin D supplementation in atopic dermatitis: A systematic review and meta-analysis of randomized controlled clinical trials

Background: With immunomodulatory properties, vitamin D (vitD) supplementation can improve clinical symptoms of atopic dermatitis (AD). Previous investigations had limited number of studies, so we sought to provide an up-to-date review including only randomized controlled trials (RCTs).

Chrysin Inhibits TNFα-Induced TSLP Expression through Downregulation of EGR1 Expression in Keratinocytes.

Thymic stromal lymphopoietin (TSLP) is an epithelial cell-derived cytokine that acts as a critical mediator in the pathogenesis of atopic dermatitis (AD). Various therapeutic agents that prevent TSLP function can efficiently relieve the clinical symptoms of AD. However, the downregulation of TSLP expression by therapeutic agents remains poorly understood. In this study, we investigated the mode of action of chrysin in TSLP suppression in an AD-like inflammatory environment. We observed that the transcription factor early growth response (EGR1) contributed to the tumor necrosis factor alpha (TNFα)-induced transcription of TSLP. Chrysin attenuated TNFα-induced TSLP expression by downregulating EGR1 expression in HaCaT keratinocytes. We also showed that the oral administration of chrysin improved AD-like skin lesions in the ear and neck of BALB/c mice challenged with 2,4-dinitrochlorobenzene. We also showed that chrysin suppressed the expression of EGR1 and TSLP by inhibiting the extracellular signal-regulated kinase (ERK) 1/2 and c-Jun N-terminal kinase (JNK) 1/2 mitogen-activated protein kinase pathways. Collectively, the findings of this study suggest that chrysin improves AD-like skin lesions, at least in part, through the downregulation of the ERK1/2 or JNK1/2-EGR1-TSLP signaling axis in keratinocytes.

Consensus Update for Systemic Treatment of Atopic Dermatitis

BackgroundIn 2015, the Korean Atopic Dermatitis Association (KADA) working group published consensus guidelines for treating atopic dermatitis (AD).ObjectiveWe aimed to provide updated consensus recommendations for systemic treatment of AD in South Korea based on recent evidence and experience.MethodsWe compiled a database of references from relevant systematic reviews and guidelines on the systemic management of AD. Evidence for each statement was graded and classified based on thestrength of the recommendation. Forty-two council members from the KADA participated in three rounds of voting to establish a consensus on expert recommendations.ResultsWe do not recommend long-term treatment with systemic steroids forpatients with moderate-to-severe AD due to the risk of adverse effects. We recommend treatment with cyclosporine or dupilumab and selective treatment with methotrexate or azathioprine for patients with moderate-to-severe AD. We suggest treatment with antihistamines as an option for alleviating clinical symptoms of AD. We recommend selective treatment with narrowband ultraviolet B for patients with chronic moderate-to-severe AD. We do not recommend treatment with oral antibiotics for patients with moderate-to-severe AD but who have no signs of infection. We did not reach a consensus on recommendations for treatment with allergen-specific immunotherapy, probiotics, evening primrose oil, orvitamin D for patients with moderate-to-severe AD. We also recommend educational interventions and counselling for patients with AD and caregivers to improve the treatment success rate.ConclusionWe look forward to implementing a new and updated consensus of systemic therapy in controlling patients with moderate-to-severe AD.

Schizonepeta Tenuifolia with Alpinia Oxyphylla Alleviates Atopic Dermatitis and Improves the Gut Microbiome in Nc/Nga Mice.

Atopic dermatitis (AD) is a chronic inflammatory skin disease that may be related to gut microbes. Schizonepeta Tenuifolia Briquet (STB) and Alpinia Oxyphylla Miquel (AOM) has traditionally been used for anti-inflammatory activity. We evaluated the effects of STB, AOM and STB+AOM extracts on 2,4-dinitro-1-chlorobenzene (DNCB)-induced AD skin lesions in Nc/Nga mice and action mechanism was explored. AD lesions were induced in the dorsal skin of Nc/Nga mice by topical application of 1% followed by 0.2% DNCB. After DNCB was applied, the mice had topical applications of either 30% water, 0.01% dexamethasone, 30% STB, 30% AOM, 15% STB + 15% AOM extracts in butylene glycol (BG). Each group was also fed corresponding high-fat diets with 1% dextrin (AD-Con and AD-Positive), 1% STB (AD-STB), 1% AOM (AD-AOM) and 0.5% STB + 0.5% (AD-MIX). Normal-control mice had no DNCB application. The study evaluated the skin AD severity, scratching behavior and weight changes of AD mice for 5 weeks. Compared with AD-Con, AD-STB, AD-AOM and AD-MIX alleviated the clinical AD symptoms (erythema, pruritus, edema, erosion and lichenification and scratching behaviors), normalized immune chemistry (serum IgE concentration, mast cells and eosinophil infiltration), improved skin hyperplasia and enhanced the gut microbiome. AD-STB, AD-AOM, AD-MIX and AD-positive treatments inhibited cutaneous mRNA expression of TNF-α, IL-4 and IL-13 and serum IgE concentrations. AD-MIX most effectively reduced clinical AD symptoms and proinflammatory cytokines. AD-Positive also reduced them but serum GOT and GPT concentrations were abnormally high. AD-STB and AD-MIX increased the alpha-diversity of fecal bacteria and reduced the serum acetate concentration, compared to the AD-Con. In conclusion, the mixture of STB and AOM is effective for treating AD symptoms locally and systemically without adverse effects and are potential interventions for atopic dermatitis.

Bleach for Atopic Dermatitis.

Individuals with atopic dermatitis (AD) have used bleach baths to treat superinfections, although their mechanism of action is not well understood. The ClinicalTrials.gov, National Eczema Association, and PubMed databases were searched for studies that investigate the role bleach plays in modulating AD. Fifteen studies were included in this review. Bleach bath improves clinical symptoms of AD and restores surface microbiome by eradicating bacteria, most notably Staphylococcus aureus. Many studies have noted that this antimicrobial effect has reduced the need for topical corticosteroids or topical antibiotics. In addition, bleach seems to have strong anti-inflammatory and antipruritogenic effects. Lastly, bleach baths seem to be safe on human skin, without disrupting epidermal barrier function. Although the effects of bleach are promising, studies that investigate the long-term use of bleach alone, without concomitant AD treatment modalities, are needed. The emergence of new bleach-containing products warrants future investigations to examine their effects on cutaneous microbiome, epidermal barrier function, and immunity.

Structure and function of the epidermal barrier in patients with atopic dermatitis - treatment options. Part one.

Atopic dermatitis is a chronic, recurrent inflammatory skin disease, which is frequently familial. The main cause of the disease seems to be a defect of the epidermal barrier resulting from a genetic predisposition concerning the epidermis, functioning of the immune system as well as environmental factors (which are not related to the immune system). Genes responsible for encoding protein S100, filaggrin, proteases and their inhibitors are the main genes related to the problem of epidermal barrier dysfunction. There is a close connection between structural and immunological processes. Increased expression of cytokine Th2 profile belongs to the latter category. The objective of the present paper is to describe the influence of aforementioned factors on epidermis structure and dysfunction which leads to clinical symptoms of atopic dermatitis.

Roles of histamine H4 receptor in the pathogenesis of atopic dermatitis

Histamine is an important mediator in inflammatory responses, and histamine H4 receptor is a newly discovered histamine receptor mainly expressed on immune organs and cells. Recent researches have indicated that histamine H4 receptor participates in immunoregulation, pruritus and epidermal proliferation in the pathogenesis of atopic dermatitis. Specific antagonists of histamine H4 receptor can affect the development and attenuate clinical symptoms of atopic dermatitis, such as eczematoid dermatitis and intractable itch, by exerting antiinflammatory, immunoregulatory and antipruritic effects via T-lymphocytes, antigen-presenting cells and keratinocytes. Hence, histamine H4 receptor antagonists are expected to be a novel and effective approach to the treatment of atopic dermatitis. Key words: Dermatitis, atopic; Histamine; Receptors, histamine H4; Hypersensitivity; Pruritus

Sublingual immunotherapy in the treatment of atopic dermatitis: a systematic review using the GRADE system.

Controversy exists regarding the role of allergen immunotherapy as a therapeutic intervention for patients with atopic dermatitis and aeroallergen sensitivity. Our aim was to critically appraise the evidence supporting the use of sublingual immunotherapy for patients with atopic dermatitis and aeroallergen sensitivity. We performed a literature search using the terms "sublingual immunotherapy" and "atopic dermatitis" and "sublingual immunotherapy" and "eczema." We used the same terms to search PubMed, Ovid, and Scopus. Our limits were "Humans" and "English." We excluded articles that were not in English. These articles were analyzed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Many studies reported improvement in clinical symptoms of atopic dermatitis. Serious methodological shortcomings were noted including but not limited to lack of control group, lack of randomization, incomplete descriptions of randomization and/or allocation concealment, many enrolled subjects not completing participation, and/or data analysis not by intention to treat.

Specific immunotherapy in the treatment of atopic dermatitis: a systematic review using the GRADE system

BackgroundControversy exists regarding the potential role of specific immunotherapy (SIT) as a therapeutic intervention for patients with atopic dermatitis (AD) and aeroallergen sensitivity. ObjectiveTo critically appraise the evidence supporting the use of SIT for patients with AD and aeroallergen sensitivity. MethodsA literature search was performed using the terms immunotherapy plus atopic dermatitis and immunotherapy plus eczema. The same terms were used to search PubMed, Ovid, and Scopus. The limits were humans, English, and randomized controlled trial. Articles that were not in English or were observational in nature were excluded. These double-blinded randomized controlled trials were analyzed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. ResultsSeven articles fulfilled the inclusion characteristics; 1 involved sublingual SIT. All studies reported improvement in clinical symptoms of AD; however, studies differed in which type of patient (ie, with mild vs severe AD) benefited most from immunotherapy. Serious methodologic shortcomings were noted, including, but not limited to, many enrolled patients not completing participation; small study; and incomplete descriptions of randomization, blinding, allocation concealment, and/or data analysis not by intention to treat. ConclusionIn a systematic review using the GRADE system, the strength of recommendation is weak for use of SIT in patients with AD. High-quality evidence from methodologically sound double-blinded randomized controlled trials is needed to support administration of SIT for patients with AD.

Dose-Dependent Effects of Evening Primrose Oil in Children and Adolescents with Atopic Dermatitis

BackgroundPrevious clinical trials with evening primrose oil in atopic dermatitis (AD) treatment have shown different results. In addition, the optimal dose and duration of treatment with evening primrose oil have not yet been determined.ObjectiveThe aim of this study is to investigate the dose-response treatment effects of evening primrose oil on clinical symptoms of AD and serum concentrations of polyunsaturated fatty acids.MethodsForty AD patients were enrolled for the study and randomly divided into 2 groups: those who received evening primrose oil 160 mg daily for 8 weeks and those who received 320 mg of evening primrose oil twice daily for 8 weeks. We evaluated the Eczema Area Severity Index (EASI) scores of all AD patients at weeks 0, 2, 4 and 8. In addition, we measured the levels of serum fatty acids, including C16 : 0 (palmitic), C18 : 2n (linoleic), C18 : 3n (linolenic) and C20 : 4 (arachidonic acid) using gas chromatography.ResultsThe serum fatty acid levels C18 : 3n and C20 : 4 were higher in the 320 mg group than in the 160 mg group, with statistical significance. After evening primrose oil treatment, EASI scores were reduced in the 2 groups. The improvement in EASI scores was greater in the 320 mg group than in the 160 mg group. There were no side effects seen in either group during the study in the 2 groups.ConclusionThe results of this study suggest that the 320 mg and 160 mg groups may be equally effective in treating AD patients and show dose-dependent effects on serum fatty acid levels and EASI scores.

Recombinant human interferon gamma (Gamma Immunex) in treatment of atopic dermatitis

Atopic dermatitis (AD) is a chronic, inflammatory skin disease which is characterized by severe pruritus and affects patients' quality of life. In recent years gamma interferon (IFN-gamma) has been accepted as a novel treatment for severe AD, however, its mechanism of action is not clearly identified. Present study evaluated the effect of recombinant human interferon gamma (rIFN-gamma: Gamma Immunex, Exir Pharmaceutical Company, Iran) on severity of AD (SCORAD), dermatology life quality index (DLQI) as well as serum levels of IL-4, IgE and IL-6 in AD patients. Twenty AD patients were entered in to a study in Baqiyatallah outpatient clinics and received rIFN-gamma (50 μg/m(2) body area, 3 times per week, subcutaneously) for 1 month. SCORAD and DLQI were assessed at beginning and end of the treatment period. IL-4, IL-6 and IgE were measured in blood samples before and after 1 month treatment with rIFN-gamma. DLQI mean value before treatment was 20.80 ± 3.95, which decreased to 8.20 ± 2.14 after treatment (P < 0.001). SCORAD-A (percentile of the body surface involved in AD), SCORAD-B (the severity of clinical features) and SCORAD-C (patients' scaling of itching and somnolence) significantly decreased after treatment (P < 0.001, P < 0.001 and P < 0.01). Total SCORAD at the end of treatment period was less than basal value (27.83 ± 8.48 vs. 70.04 ± 8.48; P < 0.001). Treatment with rIFN-gamma decreased serum levels of IL-4 and IL-6 (P < 0.05), but IgE remained unchanged. Results suggested the controlling effect of rIFN-gamma treatment on clinical symptoms of AD, which involves suppression of IL-4 but not IgE production.