Background:This study aimed to assess how acupoint catgut-embedding therapy influences Th2-type immune response and the infiltration of CD4^(+)and CD8^(+)cells in DNCB-induced atopic dermatitis in BALB/c mice.It also ...Background:This study aimed to assess how acupoint catgut-embedding therapy influences Th2-type immune response and the infiltration of CD4^(+)and CD8^(+)cells in DNCB-induced atopic dermatitis in BALB/c mice.It also conducted an initial examination of the underlying molecular mechanisms.Methods:Seventy-two mice were randomly divided into four groups:normal control,DNCB-induced atopic dermatitis model(AD),AD with acupoint catgut-embedding treatment(ADA),and AD with sham-acupoint catgut-embedding treatment.After DNCB challenge to induce AD,the ADA group received acupoint catgut-embedding therapy treatment at Zusanli(ST 36)and Quchi(LI 11)acupoints every other week from day 8.Mice in the AD with sham-acupoint catgut-embedding treatment group underwent the same procedure as the ADA group but without catgut implantation.Severity was assessed using SCORAD on treatment days 1,10,and 20.On day 18,nine mice per group were euthanized,and the remaining on day 28.Histopathological changes were observed using hematoxylin-eosin and immunohistochemistry staining.TNF-α,IL-4,IL-6,and IL-13 levels were analyzed by ELISA,and GATA3 and STAT6 protein levels by western blot.Results:After 20 days of acupoint catgut-embedding therapy treatment,mice showed reduced dermatitis scores compared to DNCB-induced AD-like mice.Significant decreases occurred in serum IL-4,IL-6,IL-13,and TNF-αlevels.Skin analysis revealed marked reductions in CD4^(+)and CD8^(+)cell infiltration,as well as GATA3 and STAT6 protein levels.Conclusion:Acupoint catgut-embedding therapy may effectively alleviate atopic dermatitis by suppressing Th2 immune responses via the STAT6-GATA3 pathway and reducing CD4^(+)and CD8^(+)T cell infiltration in skin lesions.展开更多
Atopic dermatitis （AD） is a common and frequently encountered disease, which frequently appears in children. According to statistics, the percentage of AD patients between ages of 6 to 20 in dermatology clinics is 3...Atopic dermatitis （AD） is a common and frequently encountered disease, which frequently appears in children. According to statistics, the percentage of AD patients between ages of 6 to 20 in dermatology clinics is 30%^1, and the incidence in school-age children is 2%-3%^2. AD has no corresponding nomenclature in traditional Chinese medicine （TCM）. According to the initial time of attack in early childhood, it cma be classified as NaiXuan and TaiXuan; according to the location of the disease （elbow fossa and popliteal fossa）, it can be classified as SiWanFeng; according to the specific cases of different characteristics of lesions, it can be classified as ShiChuang, JinYinchuang, XueFengChuang. In TCM, the etiology of AD is complicated. It is generally considered that the pathogenesis of AD is spleen deficiency and damp-heat^3. When children suffer from pathogenic wind, pathogenic dampness, pathogenic heat, or insufficient natural endowment, damp-heat is produced and it injures patients＇ skin. Also latent damp-heat can deplete the blood and succus in the body, dry the skin and lead to AD. In short, AD can be divided into 3 syndrome types in TCM： syndrome of spleen deficiency, syndrome of damp-heat, syndrome of blood deficiency. At present, the clinical study of AD treated by TCM is increasing, but the study of children＇s treatment is still rare. This article aims to make a summary of clinical studies of children＇s AD treated with TCM in recent years.展开更多
Atopic dermatitis(AD)is a chronic relapsing inflammatory skin disease.The main initiating mechanisms of AD are disruptions in the skin microbiota,dysfunction of the skin barrier,and predominantly elevated type 2 immun...Atopic dermatitis(AD)is a chronic relapsing inflammatory skin disease.The main initiating mechanisms of AD are disruptions in the skin microbiota,dysfunction of the skin barrier,and predominantly elevated type 2 immune responses.Cutibacterium acnes(C.acnes)is a commensal bacterium that is ubiquitous and predominant in healthy skin and shows intraspecific subtype diversity.The abundance of C.acnes is closely related to the sebum secreted by sebaceous glands.C.acnes has long been considered a proinflammatory skin bacterium that drives the development of acne vulgaris.Growing evidence indicates that C.acnes promotes skin microbiota homeostasis and skin barrier maintenance;however,the potential role of C.acnes in AD remains largely unexamined.This review provides the latest information on the distribution of C.acnes and its phylotypes in healthy skin and AD as well as an overview of the possible role of C.acnes in the pathophysiological pathways underlying AD.Additionally,the review focuses on new evidence regarding the protective functions of C.acnes and its metabolites in AD and discusses the potential for therapeutic applications.展开更多
背景嗜酸性粒细胞增多综合征(hypereosinophilia syndrome,HES)是一组以血液和(或)组织中嗜酸性粒细胞(eosinophil,EOS)异常增多为特征的疾病,临床表现多样,易漏诊或误诊为其他伴嗜酸性粒细胞增多的皮炎瘙痒性疾病,其中特别需与特应性皮...背景嗜酸性粒细胞增多综合征(hypereosinophilia syndrome,HES)是一组以血液和(或)组织中嗜酸性粒细胞(eosinophil,EOS)异常增多为特征的疾病,临床表现多样,易漏诊或误诊为其他伴嗜酸性粒细胞增多的皮炎瘙痒性疾病,其中特别需与特应性皮炎(atopic dermatitis,AD)进行鉴别诊断。目的评估外周血EOS计数在嗜酸性粒细胞增多综合征与特应性皮炎鉴别中的作用。方法2015年1月—2022年12月解放军总医院第一医学中心皮肤科收治的诊断明确的HES和AD患者为样本,通过受试者工作特征曲线法计算曲线下面积并评估外周血EOS的鉴别诊断效能。2023年6—12月收治的诊断明确的HES患者和外周血EOS计数>0.5×10^(9)/L的AD患者为后续研究对象,比较二者非激素系统治疗2周内外周血EOS计数变化趋势。结果HES组58例,男49例,女9例,中位年龄46(IQR:23~67)岁;AD组133例,男74例,女59例,中位年龄55(IQR:38~69)岁;HES组患者年龄更大、男性比例更高(P<0.05)。HES组中位白细胞计数[M(IQR):10.78(8.97~13.75)×10^(9)/L vs 6.61(5.44~8.55)×10^(9)/L]和中位外周血嗜酸性粒细胞计数[M(IQR):3.29(1.77~5.15)×10^(9)/L vs 0.60(0.35~1.05)×10^(9)/L]均高于AD组,差异有统计学意义(P<0.05)。HES鉴别AD诊断预测模型的ROC曲线结果提示:EOS鉴别诊断最佳阈值为1.52×10^(9)/L,敏感度为83.2%,特异度为91.8%。后续研究中10例HES患者,治疗前EOS均值(4.51±1.22)×10^(9)/L,给予2周非激素系统治疗,治疗后EOS均值(5.56±1.31)×10^(9)/L,无显著下降趋势。10例AD患者,经非激素系统治疗后第4~8天外周血EOS可降至正常水平(<0.5×10^(9)/L),下降程度平均值为(72.10%±17.12%)。结论HES和AD患者外周血EOS计数分布范围不等,且大部分AD患者给予非激素系统治疗后短期内外周血EOS计数可显著下降,可为HES与AD初步鉴别诊断提供参考,迅速启动干预治疗,对HES在不可逆的器官损伤发生之前减少EOS浸润,进而降低器官损伤的风险。展开更多
Atopic dermatitis(AD)is a common disease clinically characterized by chronic recurrent eczematous lesions,dry skin,and pruritus.AD can negatively impact patients’quality of life.The prevalence of AD in China has been...Atopic dermatitis(AD)is a common disease clinically characterized by chronic recurrent eczematous lesions,dry skin,and pruritus.AD can negatively impact patients’quality of life.The prevalence of AD in China has been increasing during the past few decades.Based on the most recent advances in the treatment of AD,we updated the 2014 version of the Guidelines for Diagnosis and Treatment of Atopic Dermatitis in China regarding the definition,epidemiology,pathogenesis,clinical classification,diagnosis,prevention,and treatment of AD.展开更多
目的观察岭南火针配合氯雷他定片治疗成人特应性皮炎(atopic dermatitis,AD)的临床疗效。方法将114例AD成年患者随机分为治疗组和对照组,每组57例。治疗组采用岭南火针配合口服氯雷他定片治疗,对照组采用单纯口服氯雷他定片治疗。观察...目的观察岭南火针配合氯雷他定片治疗成人特应性皮炎(atopic dermatitis,AD)的临床疗效。方法将114例AD成年患者随机分为治疗组和对照组,每组57例。治疗组采用岭南火针配合口服氯雷他定片治疗,对照组采用单纯口服氯雷他定片治疗。观察两组治疗前后血清白细胞介素-4(interleukin-4,IL-4)、免疫球蛋白E(immunoglobulin E,IgE)和干扰素-γ(interferon-γ,IFN-γ)的水平以及AD评分(scoring atopic dermatitis,SCORAD)、湿疹面积及严重度指数(eczema area and severity index,EASI)和皮肤病生活质量指数(dermatology life quality index,DLQI)的评分变化,并比较两组临床疗效及不良反应发生率。结果两组治疗后血清IL-4和IgE水平均较同组治疗前显著下降(P<0.05),IFN-γ水平均显著上升(P<0.05),SCORAD、EASI及DLQI评分显著降低(P<0.05)。治疗组治疗后血清IL-4、IgE和IFN-γ的水平以及SCORAD、EASI和DLQI的评分与对照组比较,差异均具有统计学意义(P<0.05)。治疗组总有效率为96.5%,明显高于对照组的84.2%(P<0.05)。两组治疗期间不良反应发生率比较,差异无统计学意义(P>0.05)。结论岭南火针配合氯雷他定片治疗成人期AD疗效确切,能改善患者血清炎症反应,降低疾病严重程度,提高患者免疫力和生活质量,且安全性较高。展开更多
基金supported by grants from the National Natural Science Foundation of China(Grant No.82260940)the Yunnan Provincial(Traditional Chinese Medicine)Clinical Dermatology Center,12th Five-year Key Construction Discipline of State Administration of Traditional Chinese Medicine“Dai Pharmacy”+1 种基金Open Project of Yunnan Key Laboratory of Dai and Yi Medicines(No.30971101100)Key Laboratory of Chemistry in Ethnic Medicinal Resources,State Ethnic Affairs Commission&Ministry of Education,Yunnan Minzu University.
文摘Background:This study aimed to assess how acupoint catgut-embedding therapy influences Th2-type immune response and the infiltration of CD4^(+)and CD8^(+)cells in DNCB-induced atopic dermatitis in BALB/c mice.It also conducted an initial examination of the underlying molecular mechanisms.Methods:Seventy-two mice were randomly divided into four groups:normal control,DNCB-induced atopic dermatitis model(AD),AD with acupoint catgut-embedding treatment(ADA),and AD with sham-acupoint catgut-embedding treatment.After DNCB challenge to induce AD,the ADA group received acupoint catgut-embedding therapy treatment at Zusanli(ST 36)and Quchi(LI 11)acupoints every other week from day 8.Mice in the AD with sham-acupoint catgut-embedding treatment group underwent the same procedure as the ADA group but without catgut implantation.Severity was assessed using SCORAD on treatment days 1,10,and 20.On day 18,nine mice per group were euthanized,and the remaining on day 28.Histopathological changes were observed using hematoxylin-eosin and immunohistochemistry staining.TNF-α,IL-4,IL-6,and IL-13 levels were analyzed by ELISA,and GATA3 and STAT6 protein levels by western blot.Results:After 20 days of acupoint catgut-embedding therapy treatment,mice showed reduced dermatitis scores compared to DNCB-induced AD-like mice.Significant decreases occurred in serum IL-4,IL-6,IL-13,and TNF-αlevels.Skin analysis revealed marked reductions in CD4^(+)and CD8^(+)cell infiltration,as well as GATA3 and STAT6 protein levels.Conclusion:Acupoint catgut-embedding therapy may effectively alleviate atopic dermatitis by suppressing Th2 immune responses via the STAT6-GATA3 pathway and reducing CD4^(+)and CD8^(+)T cell infiltration in skin lesions.
文摘Atopic dermatitis （AD） is a common and frequently encountered disease, which frequently appears in children. According to statistics, the percentage of AD patients between ages of 6 to 20 in dermatology clinics is 30%^1, and the incidence in school-age children is 2%-3%^2. AD has no corresponding nomenclature in traditional Chinese medicine （TCM）. According to the initial time of attack in early childhood, it cma be classified as NaiXuan and TaiXuan; according to the location of the disease （elbow fossa and popliteal fossa）, it can be classified as SiWanFeng; according to the specific cases of different characteristics of lesions, it can be classified as ShiChuang, JinYinchuang, XueFengChuang. In TCM, the etiology of AD is complicated. It is generally considered that the pathogenesis of AD is spleen deficiency and damp-heat^3. When children suffer from pathogenic wind, pathogenic dampness, pathogenic heat, or insufficient natural endowment, damp-heat is produced and it injures patients＇ skin. Also latent damp-heat can deplete the blood and succus in the body, dry the skin and lead to AD. In short, AD can be divided into 3 syndrome types in TCM： syndrome of spleen deficiency, syndrome of damp-heat, syndrome of blood deficiency. At present, the clinical study of AD treated by TCM is increasing, but the study of children＇s treatment is still rare. This article aims to make a summary of clinical studies of children＇s AD treated with TCM in recent years.
文摘Atopic dermatitis(AD)is a chronic relapsing inflammatory skin disease.The main initiating mechanisms of AD are disruptions in the skin microbiota,dysfunction of the skin barrier,and predominantly elevated type 2 immune responses.Cutibacterium acnes(C.acnes)is a commensal bacterium that is ubiquitous and predominant in healthy skin and shows intraspecific subtype diversity.The abundance of C.acnes is closely related to the sebum secreted by sebaceous glands.C.acnes has long been considered a proinflammatory skin bacterium that drives the development of acne vulgaris.Growing evidence indicates that C.acnes promotes skin microbiota homeostasis and skin barrier maintenance;however,the potential role of C.acnes in AD remains largely unexamined.This review provides the latest information on the distribution of C.acnes and its phylotypes in healthy skin and AD as well as an overview of the possible role of C.acnes in the pathophysiological pathways underlying AD.Additionally,the review focuses on new evidence regarding the protective functions of C.acnes and its metabolites in AD and discusses the potential for therapeutic applications.
文摘背景嗜酸性粒细胞增多综合征(hypereosinophilia syndrome,HES)是一组以血液和(或)组织中嗜酸性粒细胞(eosinophil,EOS)异常增多为特征的疾病,临床表现多样,易漏诊或误诊为其他伴嗜酸性粒细胞增多的皮炎瘙痒性疾病,其中特别需与特应性皮炎(atopic dermatitis,AD)进行鉴别诊断。目的评估外周血EOS计数在嗜酸性粒细胞增多综合征与特应性皮炎鉴别中的作用。方法2015年1月—2022年12月解放军总医院第一医学中心皮肤科收治的诊断明确的HES和AD患者为样本,通过受试者工作特征曲线法计算曲线下面积并评估外周血EOS的鉴别诊断效能。2023年6—12月收治的诊断明确的HES患者和外周血EOS计数>0.5×10^(9)/L的AD患者为后续研究对象,比较二者非激素系统治疗2周内外周血EOS计数变化趋势。结果HES组58例,男49例,女9例,中位年龄46(IQR:23~67)岁;AD组133例,男74例,女59例,中位年龄55(IQR:38~69)岁;HES组患者年龄更大、男性比例更高(P<0.05)。HES组中位白细胞计数[M(IQR):10.78(8.97~13.75)×10^(9)/L vs 6.61(5.44~8.55)×10^(9)/L]和中位外周血嗜酸性粒细胞计数[M(IQR):3.29(1.77~5.15)×10^(9)/L vs 0.60(0.35~1.05)×10^(9)/L]均高于AD组,差异有统计学意义(P<0.05)。HES鉴别AD诊断预测模型的ROC曲线结果提示:EOS鉴别诊断最佳阈值为1.52×10^(9)/L,敏感度为83.2%,特异度为91.8%。后续研究中10例HES患者,治疗前EOS均值(4.51±1.22)×10^(9)/L,给予2周非激素系统治疗,治疗后EOS均值(5.56±1.31)×10^(9)/L,无显著下降趋势。10例AD患者,经非激素系统治疗后第4~8天外周血EOS可降至正常水平(<0.5×10^(9)/L),下降程度平均值为(72.10%±17.12%)。结论HES和AD患者外周血EOS计数分布范围不等,且大部分AD患者给予非激素系统治疗后短期内外周血EOS计数可显著下降,可为HES与AD初步鉴别诊断提供参考,迅速启动干预治疗,对HES在不可逆的器官损伤发生之前减少EOS浸润,进而降低器官损伤的风险。
文摘Atopic dermatitis(AD)is a common disease clinically characterized by chronic recurrent eczematous lesions,dry skin,and pruritus.AD can negatively impact patients’quality of life.The prevalence of AD in China has been increasing during the past few decades.Based on the most recent advances in the treatment of AD,we updated the 2014 version of the Guidelines for Diagnosis and Treatment of Atopic Dermatitis in China regarding the definition,epidemiology,pathogenesis,clinical classification,diagnosis,prevention,and treatment of AD.
文摘目的观察岭南火针配合氯雷他定片治疗成人特应性皮炎(atopic dermatitis,AD)的临床疗效。方法将114例AD成年患者随机分为治疗组和对照组,每组57例。治疗组采用岭南火针配合口服氯雷他定片治疗,对照组采用单纯口服氯雷他定片治疗。观察两组治疗前后血清白细胞介素-4(interleukin-4,IL-4)、免疫球蛋白E(immunoglobulin E,IgE)和干扰素-γ(interferon-γ,IFN-γ)的水平以及AD评分(scoring atopic dermatitis,SCORAD)、湿疹面积及严重度指数(eczema area and severity index,EASI)和皮肤病生活质量指数(dermatology life quality index,DLQI)的评分变化,并比较两组临床疗效及不良反应发生率。结果两组治疗后血清IL-4和IgE水平均较同组治疗前显著下降(P<0.05),IFN-γ水平均显著上升(P<0.05),SCORAD、EASI及DLQI评分显著降低(P<0.05)。治疗组治疗后血清IL-4、IgE和IFN-γ的水平以及SCORAD、EASI和DLQI的评分与对照组比较,差异均具有统计学意义(P<0.05)。治疗组总有效率为96.5%,明显高于对照组的84.2%(P<0.05)。两组治疗期间不良反应发生率比较,差异无统计学意义(P>0.05)。结论岭南火针配合氯雷他定片治疗成人期AD疗效确切,能改善患者血清炎症反应,降低疾病严重程度,提高患者免疫力和生活质量,且安全性较高。
