Atopic dermatitis (AD) is a chronic relapsing inflammatory skin disease with severe pruritus, and the first step of atopic march since it often precedes asthma or allergic rhinitis. Since its etiology or pathogenesis is very complex and frequently changing, physicians cannot easily understand it in entirety. New insights into the genetics and pathophysiology of AD emphasize the crucial function of the skin barrier as well as abnormal immune response. In this review, the pathogenesis of AD is explained as the combined features of impaired skin barrier and abnormal immune response rather than each independent concept. Understanding the whole pathogenesis of AD may lead to early intervention and prevention of atopic march as well as proper clinical treatment.
Asthma ; Dermatitis, Atopic* ; Early Intervention (Education) ; Genetics ; Hypersensitivity ; Pruritus ; Rhinitis ; Skin ; Skin Diseases

The prevalence and patterns of food allergy are highly variable in different parts of the world. Differences in food allergy epidemiology may be attributed to a complex interplay of genetic, epigenetic, and environmental factors, suggesting that mechanisms of food allergy may differ in various global populations. Genetic polymorphisms, migration, climate, and infant feeding practices all modulate food allergy risk, and possibly also the efficacy of interventions aimed at primary prevention of food allergy development. Approaches to diagnosis, treatment, and prevention of food allergy should thus be tailored carefully to each population's unique genetic and environmental make-up. Future research in the context of food allergy prevention should focus on elucidating factors determining differential responses between populations.
Climate ; Dermatitis, Atopic ; Diagnosis ; Epidemiology ; Epigenomics ; Food Hypersensitivity* ; Genetics ; Humans ; Infant ; Polymorphism, Genetic ; Prevalence ; Primary Prevention

Based on the clinical characteristics of atopic dermatitis( AD) in traditional Chinese medicine( TCM) and Western medicine,the existing animal models were analyzed,and the coincidence degree,advantages and disadvantages between the models and the clinical manifestations of AD were evaluated,so as to provide reference for establishing a rational animal model. After consulting relevant literatures in recent years and summarizing the existing modeling methods,it is found that spontaneous,transgenic/gene knockout models were highly consistent,but with high breeding conditions and expensive prices. The hapten-induced model was low in cost and fast in modeling. It revealed the corresponding mechanism of AD to a certain extent,but did not fully reflect the state of the entire process of AD. The modeling method was guided by Western medicine,but with a lack of pathogenic factors of traditional Chinese medicine,and so has certain limitations in TCM research. Therefore,it is necessary to combine the etiology,pathogenesis and clinical mani-festations of AD with traditional Chinese and Western medicine,so as to improve the coincidence degree between the model and the characteristics of clinical symptoms and lay the foundation for in-depth studies on AD.
Animals ; China ; Dermatitis, Atopic/genetics* ; Drugs, Chinese Herbal ; Eczema ; Medicine ; Medicine, Chinese Traditional

OBJECTIVETo investigate the role of chemokine receptor CXCR3 in patients with atopic dermatitis.

METHODSThe expression of CXCR3 mRNA was measured by fluorescent quantitative polymerase chain reaction, and the relationship between CXCR3 mRNA expression and the disease severity (graded according to SCORAD index system) was assessed by correlation analysis.

RESULTSCXCR3 mRNA expression was significantly higher in patients with atopic dermatitis than in healthy control subjects (P7lt;0.01), and showed obvious positive correlation with SCORAD index system.

CONCLUSIONThese data suggest an important role of CXCR3 in the development and progression of atopic dermatitis.

Adolescent ; Case-Control Studies ; Child ; Dermatitis, Atopic ; genetics ; Female ; Gene Expression Regulation ; Humans ; Male ; RNA, Messenger ; genetics ; metabolism ; Receptors, CXCR3 ; genetics

Adolescent ; Adult ; Asian Continental Ancestry Group ; Child ; Child, Preschool ; Dermatitis, Atopic ; genetics ; Female ; Genetic Predisposition to Disease ; Humans ; Infant ; Intermediate Filament Proteins ; genetics ; Male ; Mutation ; Young Adult

Atopic dermatitis (AD) is the most common chronic skin disease of young children and poses a significant global health problem. More than half of children with AD develop asthma and allergies, typically in the first few years of their life. AD is a paradigmatically complex disease with a number of contributing factors, which include genetics, the environment, infection, and skin barrier dysfunction. The diverse clinical phenotypes of AD reflect the genetic and epigenetic background affecting the innate and adaptive immune system, as well as neuro-immunological and environmental factors including microbiologic signals. The gold standard for the management of AD is efficient, ideally proactive, anti-inflammatory treatment combined with strategies aimed at restoring the epidermal barrier. This includes avoidance of trigger factors, skin barrier repair and maintenance, and the use of anti-inflammatory agents. Basic skin care is also considered an important pillar in the management of AD, with functional emollients beginning to appear on the market. In addition, a number of new candidate molecules for the treatment of AD are currently under investigation in clinical trials. Last but not least, treatment compliance remains a key factor for the successful management of AD. Due to its complex clinical phenotype, the future management of AD should be more individualized, addressing personal clinical and genetic/biologic.
Anti-Inflammatory Agents ; Asthma ; Child ; Compliance ; Dermatitis, Atopic* ; Emollients ; Epigenomics ; Genetics ; Humans ; Hypersensitivity ; Immune System ; Phenotype ; Skin ; Skin Care ; Skin Diseases

OBJECTIVETo investigate the association of filaggrin gene (FLG) polymorphism with atopic dermatitis (AD) in southern Chinese Han population.

METHODSThe frequencies of the 13 known FLG gene single nucleotide polymorphism(SNPs), including 3321delA, 441delA, 1249insG, E1795X, S3296X, R501X, 2282del4, R2447X, S2889X, 7945delA, 3702delG, Q2417X, R4307X, were detected in a cohort of 50 AD patients and 100 control individuals using polymerase chain reaction (PCR) and DNA sequencing.

RESULTSFLG 3321delA and 441delA were detected in 14 (28%) and 6 (12%) AD patients, respectively. The other 11 SNPs were not detected in the patients. None of the 13 SNPs was detected in the controls.

CONCLUSIONThe results suggested that the FLG gene might be associated with atopic dermatitis susceptibility in southern Chinese Han population.

Adolescent ; Asian Continental Ancestry Group ; genetics ; Base Sequence ; Child ; Child, Preschool ; Dermatitis, Atopic ; genetics ; Female ; Genetic Predisposition to Disease ; genetics ; Humans ; Intermediate Filament Proteins ; genetics ; Male ; Polymorphism, Single Nucleotide ; genetics

OBJECTIVETo investigate the distribution characteristics of the single nucleotide polymorphisms (SNPs) of the human CD14 gene in Chinese Han ethnic group children in Wenzhou, and their association with atopic diseases.

METHODSTotally 113 cases were recruited in atopic disease group who met the following criteria: 2 - 12 years old, clinically diagnosed as asthma or allergic rhinitis or atopic dermatitis, elevation of serum total IgE levels and serum specific IgE. Sixty-seven healthy children were enrolled in control group. The related regions of CD14 gene were sequenced to identify and characterize the SNPs, and plasma TIgE and SIgE were detected by immunoassay system and uniCAP system, respectively. The frequency of genotypes and alleles between two groups, as well as the levels of IgE in different genotypes, were compared.

RESULTSCD14/-159 SNP was present in Han ethnic group population of Wenzhou. The frequency of each genotype was 57.0% (TT), 28.0% (TC), 15.0% (CC) in normal children, and 46.9% (TT), 35.4% (TC), 17.7% (CC) in atopic children. No significant difference was found in the distribution of CD14/-159 polymorphism between atopic children and healthy control (chi(2) = 1.918, P > 0.05) according to Hardy-Weinberg principle statistics. There were no significant difference in frequency of each genotype between boys and girls. No significant difference was found in the total plasma IgE levels among groups of TT genotypes [(2520 +/- 460) IU/L], TC genotypes [(2400 +/- 460) IU/L] and CC genotype [(2500 +/- 460) IU/L] (F = 0.807, P > 0.05).

CONCLUSIONCD14/-159 SNP is present in Han ethnic group children in Wenzhou, and other SNP in CD14 gene was not found. TT genotype was the primary genotype in CD14/-159 SNP in the children studied. No relationship between CD14/-159 SNP and atopic disease or serum total IgE level was found.

Asian Continental Ancestry Group ; genetics ; Asthma ; genetics ; Case-Control Studies ; Child ; Child, Preschool ; Dermatitis, Atopic ; genetics ; Female ; Gene Frequency ; Genetic Predisposition to Disease ; Genotype ; Humans ; Immunoglobulin E ; blood ; Lipopolysaccharide Receptors ; genetics ; Male ; Polymorphism, Single Nucleotide ; Rhinitis, Allergic, Perennial ; genetics

BACKGROUND: The results of epidemiological studies are different from each other by genetics, social circumstances, climate, geographic localization, etc. There are few reports on prevalence of adolescent dermatoses in Korea. OBJECTIVES: We performed this study to know prevalence of dermatoses of 19-year-old conscriptees in Kangwon province, 2001 and to compare its distribution with results of other studies. METHOD: From Aug. 2001 to Dec. 2001, we have examined 12, 657 men who had visited the Chuncheon Military Manpower Administration for the purpose of physical examination for conscription in Kangwon province. We estimated the total, monthly and regional prevalence of dermatoses and the dermatoses were recorded by rank and analyzed by group of disease and disease itself. RESULTS: A total of 2, 324 patients with 2, 509 dermatological diseases were seen by a dermatologist from August 2001 to December 2001 at the Chuncheon Military Manpower Administration. The prevalence of dermatoses was 18.4%. The monthly number of patients was greatest in August, and September, October, November and December in the right order. The regional prevalence was greatest in Hwachun & Yanggu(33.9%) and the western area of Kangwon province was greater than the eastern area except Youngweol. The frequent dermatoses include acne, tattoo, melanocytic nevus, folliculitis, keratosis pilaris, dermatophytosis, contact dermatitis, bromhidrosis, atopic dermatitis, urticaria, tinea versicolor, other eczema, freckle and melasma, and keloid in the right order, respectively above 1% of total dermatoses. In the distribution of dermatoses as disease groups, diseases of skin appendages(37.6%), dermatoses due to physical agents(16.6%), melanocytic nevi(13.6%), dermatomycosis(8.7%), hereditary skin diseases(7.8%), eczema(6.6%), and pigment anomaly (2.3%) constituted 93.2% of the total. CONCLUSIONS: Prevalence surveillance of the dermatoses in Kangwon province shows that cosmetic diseases such as tattoo, melanocytic nevus and keratosis pilaris are more frequent compared with previous hospital-based study and when compared with soldiers, infectious disease and disease due to physical agent are significantly different.
Acne Vulgaris ; Adolescent ; Climate ; Communicable Diseases ; Dermatitis, Atopic ; Dermatitis, Contact ; Eczema ; Epidemiologic Studies* ; Folliculitis ; Gangwon-do* ; Genetics ; Humans ; Keloid ; Keratosis ; Korea ; Male ; Melanosis ; Military Personnel ; Nevus, Pigmented ; Physical Examination ; Prevalence ; Skin ; Skin Diseases* ; Tinea ; Tinea Versicolor ; Urticaria ; Young Adult

Research of the FLG mutation in various ethnic groups revealed non-overlapping mutation patterns. In addition, Japanese and Chinese atopic patients showed somewhat different mutations. These ethnic differences make the research on Korean patients mandatory; however, no systematic research on Korean atopic dermatitis (AD) patients has been performed. This study aims to investigate the genetic polymorphism of FLG in Korean atopic dermatitis patients. The study was made up of three groups including 9 Ichthyosis vulgaris (IV) patients, 50 AD patients and 55 normal controls: the ichthyosis group was incorporated due to the reported association between the FLG mutation and IV. In comparison to other sequencing methods, the overlapping long-range PCR was used. We revealed the genetic polymorphism of filaggrin in Koreans, and at the same time, we discovered nonsense mutations in p.Y1767X and p.K4022X in Korean AD patients. By using FLG sequencing techniques confirmed in this study, new mutations or genetic polymorphisms with ethnic characteristics would be detected and further larger studies of repeat number polymorphisms could be performed.
Adult ; Alleles ; Asian Continental Ancestry Group/*genetics ; Base Sequence ; Codon, Nonsense ; DNA/blood/chemistry/metabolism ; DNA Mutational Analysis ; Dermatitis, Atopic/*genetics ; Female ; Genotype ; Heterozygote ; Humans ; Ichthyosis Vulgaris/genetics ; Intermediate Filament Proteins/*genetics ; Male ; Polymerase Chain Reaction ; Polymorphism, Single Nucleotide