Skin Response Research Articles

Dysfunction of the autonomic nervous system in gastro-esophageal reflux disease: Consequences for the cardiovascular system

ObjectiveThe pathophysiology of gastro esophageal reflux disease (GERD) implicates autonomic dysregulation of the lower esophageal sphincter tone. Our goal is to investigate whether this dysregulation of the autonomic nervous system (ANS) function observed in isolated GERD cases can affect other systems, such as cardiovascular regulation.Methods: Twenty-five participants were included in the study, 11 patients with isolated GERD and 14 controls. All patients and 7 controls responded to a COMposite Autonomic Symptoms Score 31 (COMPASS 31) questionnaire and underwent functional explorations including EMLA test, sympathetic skin response (SSR), 24-hour heart rate recording and ambulatory blood pressure measurement (ABPM). Seven additional controls underwent a 24-hour heart rate recording only. ResultsGERD patients (Age: mean 36.81±7.82; SR= 0.22) showed high clinically dysautonomic scores (COMPASS 31) (p = 0.015), increased Heart rate variability (HRV) parameters (daytime, nighttime, 24-hour SDNN (standard deviation of the RR interval (NN)), respectively p = 0.003, p < 0.001, p = 0.001; daytime and nighttime very low frequencies (VLF) respectively p = 0.03 and p = 0.007), impaired nocturnal dipping of blood pressure (3/11 patients) and high positivity of EMLA test (7/11, p = 0.037). These outcomes were strongly correlated with clinical dysautonomic assessment. No difference was observed between patients and controls regarding SSR. ConclusionOur data suggests a high parasympathetic tone amongst patients with GERD and a dysregulation of parasympathetic and sympathetic balance in the cardiovascular system with an impairment of the peripheral sympathetic fibers of cutaneous microcirculation, assessed by the EMLA test. GERD may be an inaugural symptom of autonomic neuropathy. Further functional exploration of peripheral small fibers seems to be necessary.

An Evaluation of Skin and Immunological Responses after Using a Novel Cross-Linked Porcine-Based Dermal Injectable Collagen with Lidocaine for Nasolabial Fold Correction.

Background: Hypersensitivity to the new dermal injectable porcine-based collagen with lidocaine featuring a novel cross-linking technology (test filler) for nasolabial fold correction was compared to the commercially available traditional cross-linked dermal injectable porcine-based collagen with lidocaine (control filler). Methods: Recruited participants (n = 279) received a single 0.1 mL intradermal injection of either test filler or control filler in the left forearm as a screening skin allergy test. Injection sites were assessed clinically at 24 h post-implant. Treatment was given to 252 successfully screened participants, and injection sites were monitored for 21 days. Immunological examinations were performed at screening and then at 4 and 24 weeks post-treatment. Observations for adverse events continued until the 52nd week. Results: Intradermal allergy testing results were negative for all the test recipients (0/124) and positive for two control recipients (2/132, 1.5%). Most of the participants exhibited no changes in serum immunoglobulin (IgG, IgM) and complement (C3, C4) levels. No serious adverse events related to the device were recorded. Most adverse events were common complications of dermal filler treatment and were related to the injection site. Most adverse effects were resolved or under control by 52 weeks. Conclusions: Hypersensitivity reactions with the test filler were lower than those with the control filler, validating the safe use of test filler for nasolabial fold correction without the need for pretreatment skin testing.

Screening tools for diabetic foot ulcers: a narrative review.

The prevalence of diabetic foot ulcers (DFUs) is 4 to 10% among people with diabetes mellitus. DFUs are associated with increased morbidity and mortality as well as reduced quality of life and have a significant impact on overall healthcare expenditure. The main predisposing factors for DFU are diabetic neuropathy, peripheral arterial disease, and trauma. The fact that a range of tests can be used to identify patients at risk for DFU often causes confusion among practitioners regarding which screening tests should be implemented in clinical practice. Herein we sought to determine whether tests of somatic nerve function, such as pinprick sensation, thermal (cold/hot) test, ankle reflexes, vibration perception, 10-g monofilament, Ipswich touch test, neuropathy disability score, and nerve conduction studies, predict the development of DFUs. In addition, we examined whether sudomotor function screening tests, such as Neuropad, sympathetic skin response, and other tests, such as elevated plantar pressure or temperature measurements, can be used for DFU screening. If not treated properly, DFUs can have serious consequences, including amputation, early detection and treatment are vital for patient outcomes.

52260 Downtitration of Baricitinib Following Clear or Almost Clear Skin Response: Evaluation from the BREEZE-AD3 Substudy

52260 Downtitration of Baricitinib Following Clear or Almost Clear Skin Response: Evaluation from the BREEZE-AD3 Substudy

52792 Lebrikizumab provides stable skin response with no or minimal fluctuations for up to two years in patients with atopic dermatitis

52792 Lebrikizumab provides stable skin response with no or minimal fluctuations for up to two years in patients with atopic dermatitis

Identifying physiological indicators of the cognitive, thermal, and combined (cognitive-thermal) stress conditions.

Physiologically based stress detection systems have proven to be effective in identifying different stress conditions in the body to determine the source of stress and be able to counteract it. However, some stress conditions have not been widely studied, including thermal stress, cognitive stress, and combined (thermal-cognitive) stress conditions, which are frequently encountered in work or school environments. In order to develop systems to detect and differentiate these conditions, it is necessary to identify the physiological indicators that characterize each of them. The present research aims to identify which physiological indicators (heart rate, respiratory rate, galvanic skin response, and local temperature) could differentiate different stress conditions (no-stress, cognitive stress, thermal stress, and combined (thermal-cognitive) stress conditions). Thirty participants were exposed to cognitive, thermal, and combined stress sources while recording their physiological signals. The findings indicate that both mean heart rate and mean galvanic skin response identify moderate thermal and cognitive stress conditions as distinct from a no-stress condition, yet they do not differentiate between the two stress conditions. Additionally, heart rate uniquely identifies the cognitive-thermal stress condition, effectively distinguishing this combined stress condition from the singular stress conditions and the no-stress condition. Mean local temperature specifically signals thermal stress conditions, whereas mean respiratory rate accurately identifies cognitive stress conditions, with both indicators effectively separating these conditions from each other and from the no-stress condition. This is the first basis for differentiating thermal and cognitive stress conditions through physiological indicators.

Panax ginseng extract prevents UVB-induced skin photodamage by modulating VMP1-mediated ER stress

BackgroundThe endoplasmic reticulum (ER) stress is a crucial toxic signaling event triggered by chronic exposure to Ultraviolet B radiation (UVB), which significantly exacerbate photodamage responses in the irradiated skin. Therefore, the identification of agents capable of inhibiting ER stress could serve as a promising therapeutic strategy for addressing the unmet clinical needs in the treatment of UVB-induced photodamage. MethodsA UVB-irradiated mouse model was used and topical administration of Panax ginseng extract was carried out for a duration of 9 weeks. Vitamin E was used as a positive control. After 9 weeks of administration, the skin appearance, epidermal hyperplasia, infiltration of inflammatory cells, apoptosis, and collagen content were measured. The keratinocytes were irradiated with 6 mJ/cm2 UVB to establish an in vitro model. The levels of ER stress and apoptosis were investigated both in vivo and in vitro using qRT-PCR, immunoblotting, and immunofluorescence. ResultsAmong the 14 extracts derived from 13 distinct plant species that were screened, Panax ginseng, Prunus mume, and Camellia japonica showed inhibitory effect on UVB-induced ER stress. Notably, Panax ginseng effectively inhibits collagen degradation and apoptosis in both irradiated keratinocytes and Balb/C mice skin. Furthermore, the silencing of VMP1 significantly impeded the cellular protective effect of Panax ginseng extract on UVB-irradiated keratinocytes, indicating that Panax ginseng exerts its protective effects through targeted promotion of VMP1. ConclusionOur data suggest that Panax ginseng extract possess a therapeutical effect on UVB radiation-induced photodamage by promoting VMP1-mediated inhibition of ER stress.

A genetic algorithm-based method to modulate the difficulty of serious games along consecutive robot-assisted therapy sessions

Background and Objective:One of the biggest challenges during neurorehabilitation therapies is finding an appropriate level of therapy intensity for each patient to ensure the recovery of movement of the affected limbs while maintaining motivation. Different studies have proposed adapting the difficulty of exercises based on psychophysiological state, based on success rate, or by modeling the user’s skills. However, all studies propose solutions for a single session, requiring a calibration process before using it in each session. We propose a dynamic adaptation method that can be used during different rehabilitation sessions, without the need for recalibration between sessions. Methods:The adaptation architecture is based on a genetic algorithm that aims to maintain a certain score level and to motivate the user to move. The method has been evaluated with two serious games for five sessions using a rehabilitation robot. A common initial evaluation was made for all the users involved in the study, and the game parameters that best suited each user from the previous session were introduced as the starting point of the next session. In addition, the desired score rate was lowered between sessions to increase the difficulty level. The psychophysiological state of the users was measured based on the Self-Assessment Manikin test, as well as different cardiorespiratory and galvanic skin response signals were analyzed. Results:The adaptation architecture proposed can find those game parameters that maximize the user movement for both games. In one of the games, the score rate set for each session is followed with high fidelity. The degree of personalization in the games increases between sessions as the dispersion of the game parameters grows. The Self-Assessment Manikin test and the physiological signals results would indicate that the psychophysiological state remains equal between sessions despite an increase in game difficulty. Conclusions:The genetic algorithm-based game adaptation has proven efficacy in maximizing the therapy performance through the sessions without needing recalibration. It also can be concluded that the design of the game influences the adaptation performance. Additionally, adaptive game design facilitated by our method does not significantly impact players’ emotional or physiological states.

Determining the Optimal Window Duration to Enhance Emotion Recognition Based on Galvanic Skin Response and Photoplethysmography Signals

Automatic emotion recognition using portable sensors is gaining attention due to its potential use in real-life scenarios. Existing studies have not explored Galvanic Skin Response and Photoplethysmography sensors exclusively for emotion recognition using nonlinear features with machine learning (ML) classifiers such as Random Forest, Support Vector Machine, Gradient Boosting Machine, K-Nearest Neighbor, and Decision Tree. In this study, we proposed a genuine window sensitivity analysis on a continuous annotation dataset to determine the window duration and percentage of overlap that optimize the classification performance using ML algorithms and nonlinear features, namely, Lyapunov Exponent, Approximate Entropy, and Poincaré indices. We found an optimum window duration of 3 s with 50% overlap and achieved accuracies of 0.75 and 0.74 for both arousal and valence, respectively. In addition, we proposed a Strong Labeling Scheme that kept only the extreme values of the labels, which raised the accuracy score to 0.94 for arousal. Under certain conditions mentioned, traditional ML models offer a good compromise between performance and low computational cost. Our results suggest that well-known ML algorithms can still contribute to the field of emotion recognition, provided that window duration, overlap percentage, and nonlinear features are carefully selected.

Machine Learning, Deep Learning, and Data Preprocessing Techniques for Detecting, Predicting, and Monitoring Stress and Stress-Related Mental Disorders: Scoping Review.

Mental stress and its consequent mental health disorders (MDs) constitute a significant public health issue. With the advent of machine learning (ML), there is potential to harness computational techniques for better understanding and addressing mental stress and MDs. This comprehensive review seeks to elucidate the current ML methodologies used in this domain to pave the way for enhanced detection, prediction, and analysis of mental stress and its subsequent MDs. This review aims to investigate the scope of ML methodologies used in the detection, prediction, and analysis of mental stress and its consequent MDs. Using a rigorous scoping review process with PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines, this investigation delves into the latest ML algorithms, preprocessing techniques, and data types used in the context of stress and stress-related MDs. A total of 98 peer-reviewed publications were examined for this review. The findings highlight that support vector machine, neural network, and random forest models consistently exhibited superior accuracy and robustness among all ML algorithms examined. Physiological parameters such as heart rate measurements and skin response are prevalently used as stress predictors due to their rich explanatory information concerning stress and stress-related MDs, as well as the relative ease of data acquisition. The application of dimensionality reduction techniques, including mappings, feature selection, filtering, and noise reduction, is frequently observed as a crucial step preceding the training of ML algorithms. The synthesis of this review identified significant research gaps and outlines future directions for the field. These encompass areas such as model interpretability, model personalization, the incorporation of naturalistic settings, and real-time processing capabilities for the detection and prediction of stress and stress-related MDs.

Distinct melanocyte subpopulations defined by stochastic expression of proliferation or maturation programs enable a rapid and sustainable pigmentation response.

The ultraviolet (UV) radiation triggers a pigmentation response in human skin, wherein, melanocytes rapidly activate divergent maturation and proliferation programs. Using single-cell sequencing, we demonstrate that these 2 programs are segregated in distinct subpopulations in melanocytes of human and zebrafish skin. The coexistence of these 2 cell states in cultured melanocytes suggests possible cell autonomy. Luria-Delbrück fluctuation test reveals that the initial establishment of these states is stochastic. Tracking of pigmenting cells ascertains that the stochastically acquired state is faithfully propagated in the progeny. A systemic approach combining single-cell multi-omics (RNA+ATAC) coupled to enhancer mapping with H3K27 acetylation successfully identified state-specific transcriptional networks. This comprehensive analysis led to the construction of a gene regulatory network (GRN) that under the influence of noise, establishes a bistable system of pigmentation and proliferation at the population level. This GRN recapitulates melanocyte behaviour in response to external cues that reinforce either of the states. Our work highlights that inherent stochasticity within melanocytes establishes dedicated states, and the mature state is sustained by selective enhancers mark through histone acetylation. While the initial cue triggers a proliferation response, the continued signal activates and maintains the pigmenting subpopulation via epigenetic imprinting. Thereby our study provides the basis of coexistence of distinct populations which ensures effective pigmentation response while preserving the self-renewal capacity.

One-Channel Wearable Mental Stress State Monitoring System.

Assessments of stress can be performed using physiological signals, such as electroencephalograms (EEGs) and galvanic skin response (GSR). Commercialized systems that are used to detect stress with EEGs require a controlled environment with many channels, which prohibits their daily use. Fortunately, there is a rise in the utilization of wearable devices for stress monitoring, offering more flexibility. In this paper, we developed a wearable monitoring system that integrates both EEGs and GSR. The novelty of our proposed device is that it only requires one channel to acquire both physiological signals. Through sensor fusion, we achieved an improved accuracy, lower cost, and improved ease of use. We tested the proposed system experimentally on twenty human subjects. We estimated the power spectrum of the EEG signals and utilized five machine learning classifiers to differentiate between two levels of mental stress. Furthermore, we investigated the optimum electrode location on the scalp when using only one channel. Our results demonstrate the system's capability to classify two levels of mental stress with a maximum accuracy of 70.3% when using EEGs alone and 84.6% when using fused EEG and GSR data. This paper shows that stress detection is reliable using only one channel on the prefrontal and ventrolateral prefrontal regions of the brain.

User-Centered Evaluation of the Wearable Walker Lower Limb Exoskeleton; Preliminary Assessment Based on the Experience Protocol.

Using lower limb exoskeletons provides potential advantages in terms of productivity and safety associated with reduced stress. However, complex issues in human-robot interactions are still open, such as the physiological effects of exoskeletons and the impact on the user's subjective experience. In this work, an innovative exoskeleton, the Wearable Walker, is assessed using the EXPERIENCE benchmarking protocol from the EUROBENCH project. The Wearable Walker is a lower-limb exoskeleton that enhances human abilities, such as carrying loads. The device uses a unique control approach called Blend Control that provides smooth assistance torques. It operates two models simultaneously, one in the case in which the left foot is grounded and another for the grounded right foot. These models generate assistive torques combined to provide continuous and smooth overall assistance, preventing any abrupt changes in torque due to model switching. The EXPERIENCE protocol consists of walking on flat ground while gathering physiological signals, such as heart rate, its variability, respiration rate, and galvanic skin response, and completing a questionnaire. The test was performed with five healthy subjects. The scope of the present study is twofold: to evaluate the specific exoskeleton and its current control system to gain insight into possible improvements and to present a case study for a formal and replicable benchmarking of wearable robots.

New Insights Concerning Phytophotodermatitis Induced by Phototoxic Plants.

The present review explores the underlying mechanisms of phytophotodermatitis, a non-immunologic skin reaction triggered by certain plants followed by exposure to ultraviolet radiation emitted by sunlight. Recent research has advanced our understanding of the pathophysiology of phytophotodermatitis, highlighting the interaction between plant-derived photosensitizing compounds (e.g., furanocoumarins and psoralens) and ultraviolet light leading to skin damage (e.g., erythema, fluid blisters, edema, and hyperpigmentation), identifying these compounds as key contributors to the phototoxic reactions causing phytophotodermatitis. Progress in understanding the molecular pathways involved in the skin's response to these compounds has opened avenues for identifying potential therapeutic targets suitable for the management and prevention of this condition. The review emphasizes the importance of identifying the most common phototoxic plant families (e.g., Apiaceae, Rutaceae, and Moraceae) and plant species (e.g., Heracleum mantegazzianum, Ruta graveolens, Ficus carica, and Pastinaca sativa), as well as the specific phytochemical compounds responsible for inducing phytophototoxicity (e.g., limes containing furocoumarin have been linked to lime-induced photodermatitis), underscoring the significance of recognizing the dangerous plant sources. Moreover, the most used approaches and tests for accurate diagnosis such as patch testing, Wood's lamp examination, or skin biopsy are presented. Additionally, preventive measures such as adequate clothing (e.g., long-sleeved garments and gloves) and treatment strategies based on the current knowledge of phytophotodermatitis including topical and systemic therapies are discussed. Overall, the review consolidates recent findings in the field, covering a diverse array of phototoxic compounds in plants, the mechanisms by which they trigger skin reactions, and the implications for clinical management. By synthesizing these insights, we provide a comprehensive understanding of phytophotodermatitis, providing valuable information for both healthcare professionals and researchers working to address this condition.

A Multicenter Phase II Trial of Ruxolitinib for Treatment of Corticosteroid Refractory Sclerotic Chronic Graft-Versus-Host Disease.

Sclerotic chronic graft-versus-host disease (cGVHD) represents a highly morbid and refractory form of cGVHD, and novel therapies for sclerotic cGVHD are critically needed. This study aimed to determine the efficacy of ruxolitinib in patients with corticosteroid refractory sclerotic cGVHD. In a single-arm multicenter phase II trial (N = 47), adults with sclerotic cGVHD refractory to corticosteroids and ≥one additional line of systemic therapy for cGVHD received ruxolitinib for ≥six months (ClinicalTrials.gov identifier: NCT03616184). The primary end point was complete or partial response (PR) in skin and/or joint defined according to the 2014 National Institute of Health cGVHD Consensus Criteria. Following the use of ruxolitinib for a median of 11 months, PR in skin and/or joints was noted in 49% (95% CI, 34 to 64) at 6 months, with 45% having joint and fascia response and 19% having skin response. The duration of skin/joint response was 77% (95% CI, 48 to 91) at 12 months. Overall cGVHD PR was noted in 47% (95% CI, 32 to 61). Improvement in Lee Symptom Scale summary and skin subscale scores was noted in 38% of patients. With a cumulative incidence of treatment failure of 20.8% (95% CI, 10.0 to 34.1), nonrelapse mortality (NRM) of 2.2% (95% CI, 0.17 to 10.3), and no recurrent malignancy, failure-free survival (FFS) was 77.1% (95% CI, 61.3 to 87.0) at 12 months. Ruxolitinib was overall well tolerated with no new safety signals. The use of ruxolitinib was associated with relatively high rates of skin/joint responses and overall cGVHD responses, improvement in patient-reported outcomes, low NRM, and high FFS in patients with refractory sclerotic cGVHD. Ruxolitinib offers an effective treatment option for refractory sclerotic cGVHD.

Treponema pallidum Periplasmic and Membrane Proteins Are Recognized by Circulating and Skin CD4+ T Cells.

Histologic and serologic studies suggest the induction of local and systemic Treponema pallidum-specific CD4+ T-cell responses to T. pallidum infection. We hypothesized that T. pallidum-specific CD4+ T cells are detectable in blood and in the skin rash of secondary syphilis and persist in both compartments after treatment. Peripheral blood mononuclear cells collected from 67 participants were screened by interferon-γ (IFN-γ) ELISPOT response to T. pallidum sonicate. T. pallidum-reactive T-cell lines from blood and skin were probed for responses to 89 recombinant T. pallidum antigens. Peptide epitopes and HLA class II restriction were defined for selected antigens. We detected CD4+ T-cell responses to T. pallidum sonicate ex vivo. Using T. pallidum-reactive T-cell lines we observed recognition of 14 discrete proteins, 13 of which localize to bacterial membranes or the periplasmic space. After therapy, T. pallidum-specific T cells persisted for at least 6 months in skin and 10 years in blood. T. pallidum infection elicits an antigen-specific CD4+ T-cell response in blood and skin. T. pallidum-specific CD4+ T cells persist as memory in both compartments long after curative therapy. The T. pallidum antigenic targets we identified may be high-priority vaccine candidates.

Mitigation of ultraviolet-induced erythema and inflammation by para-hydroxycinnamic acid in human skin.

To evaluate whether p-hydroxycinnamic acid (pHCA) alone and in combination with niacinamide (Nam) can mitigate UV-induced erythema, barrier disruption, and inflammation. Three independent placebo-controlled double-blinded studies were conducted on female panellists who were pretreated on sites on their backs for 2 weeks with skin care formulations which contained 0.3% or 1% pHCA with 5% Nam, 1% pHCA alone, 1.8% octinoxate, or control formula. Treated sites were then exposed to 1.5 minimal erythemal dose (MED) solar simulated radiation (SSR) and had chromameter and expert grading measures for erythema, barrier integrity via TEWL, and the skin surface IL-1RA/IL-1α inflammatory biomarkers isolated from D-Squame tapes. Across the three independent studies, pHCA alone or in combination with Nam showed a significant mitigation of UV-induced erythema, barrier disruption, and levels of the surface inflammatory biomarkers IL-1RA/IL-1α. The cinnamate analogue Octinoxate did not replicate the effects of pHCA. The study results show that pHCA alone or in combination with Nam can mitigate UV-induced damage to skin. These include mitigation of UV-induced erythema as measured by instrument and expert grade visualization. Additionally, pHCA with Nam protected damage to the barrier and reduced the induction of the SASP-related surface inflammatory biomarker IL-1RA/IL-1α. The inability of Octinoxate to have any protective effect and the detection of low levels of pHCA on skin surface after 24 h of application supports that these effects are based on a biological response to pHCA. These findings add to the body of evidence that pHCA alone or in combination with Nam can enhance the skin's biological response to UV-induced damage. This supports pHCA can potentially impact aging and senescence, thereby maintain skin's functionality and appearance.

Toward Adaptive Virtual Reality Systems: Understanding Emotional and Physiological Responses in VR Game

Virtual reality (VR) affective computing is expanding to include systems that can identify and respond to human emotions. This study explores emotional responses in VR using the game Pong to monitor these reactions under different gameplay conditions. It investigates how game pace and opponent behavior affect emotions, assessed through physiological metrics like electrocardiogram, galvanic skin response, electromyogram, and player behaviors. Results from three game variations—slow-paced, fast-paced, and lag-induced—showed distinct emotional and physiological responses. Significant differences were found in arousal and valence levels, with varying heart rate and skin conductance among the game conditions. These findings suggest that VR game design can significantly influence emotional states, providing insights that could help develop more engaging and responsive VR systems. Thus, this study demonstrates the potential of VR to evoke and measure specific emotional responses, contributing to the fields of human-computer interaction, and affective computing.

Impact of Skin Exposure to Benzo[a]pyrene in Rat Model: Insights into Epidermal Cell Function and Draining Lymph Node Cell Response.

The skin is a direct target of the air pollutant benzo[a]pyrene (BaP). While its carcinogenic qualities are well-studied, the immunotoxicity of BaP after dermal exposure is less understood. This study examines the immunomodulatory effects of a 10-day epicutaneous BaP application, in environmentally/occupationally relevant doses, by analyzing ex vivo skin immune response (skin explant, epidermal cells and draining lymph node/DLN cell activity), alongside the skin's reaction to sensitization with experimental hapten dinitrochlorobenzene (DNCB). The results show that BaP application disrupts the structure of the epidermal layer and promotes immune cell infiltration in the dermis. BaP exposure led to oxidative stress in epidermal cells, characterized by decreased reduced glutathione and increased AHR and Cyp1A1 expression. Production and gene expression of proinflammatory cytokines (TNF, IL-1β) by epidermal cells decreased, while IL-10 response increased. Decreased spontaneous production of IFN-γ and IL-17, along with unchanged IL-10, was observed in DLC cells, whereas ConA-stimulated production of these cytokines was elevated. Local immunosuppression caused by BaP application seems to reduce the skin's response to an additional stimulus, evidenced by decreased effector activity of DLN cells three days after sensitization with DNCB. These findings provide new insight into the immunomodulatory effects and health risks associated with skin exposure to BaP.

Unravelling the Complexities and Recent Advances in the Management of Atopic Dermatitis

Abstract: Atopic dermatitis (AD) is a non-fatal, non-communicable, chronic skin inflammatory condition marked by itching, lesions, and skin barrier dysfunction. As per the International Eczema Council, as of 2022, more than 200 million people were suffering from AD, with the disease burden reported highest in children. Environmental factors, genetic predisposition, and lifestyle have been found to be essential factors in triggering the adverse skin response. In this review, we provide a detailed overview of the pathophysiology of AD, how the skin barrier gets altered from normal condition to AD, and the role of genetic defects in Filaggrin protein, affecting the skin barrier function by altering the skin pH and hydration. Also, we highlight the role of toll-like receptors (TLRs) and the altered skin and gut microbiota in inducing chronic inflammatory responses and playing a significant role in the pathogenesis of the disease. Further, we discuss the role of several chemokines and cytokines, which could serve as important prognosis markers for early detection, monitoring the disease progression, and assessing the response to the treatment. We also report the current treatment regime of multimodal therapeutics ranging from topical emollients to topical, oral, and injectable immune modulatory agents. Besides, we discuss the importance of the gut-skin microbiome axis and the increasingly important role of prebiotics in AD treatment.