Analysis of Quality of Life and Mental Health in Patients With Atopic Dermatitis,Asthma and Allergic Rhinitis Using a Nation-wide Database,KNHANES VII

PurposeThis study investigated mental health status and quality of life in allergic disease patients compared with non-allergic controls.MethodsThis study used nationwide, population-based, cross-sectional data from the Korean National Health and Nutrition Examination Survey from 2016 to 2018. The propensity matching score was used to balance age and sex distributions between the allergic disease groups and corresponding controls. Atopic dermatitis (n = 446) and asthma (n = 483) groups were compared with controls in a 1:10 ratio, and the allergic rhinitis (n = 2,357) group was compared with controls in a 1:2 ratio. Multiple logistic regression analyses were used to evaluate the odds ratios (ORs) for mental health status and health-related quality of life (HRQoL) based on the presence of allergic diseases.ResultsThe ORs for severe psychological stress, psychological consultation and diagnosis of depression were more significantly increased in the asthma (OR, 1.41, 1.83, and 2.1, respectively) and allergic rhinitis groups (OR, 1.35, 1.48, and 1.83, respectively) compared with non-allergic controls after adjustment for confounding factors. The rate of severe problems in mobility was more significantly increased in the asthma group compared to controls.ConclusionsThe results show that efforts should be made to manage psychological problems and improve HRQoL in patients with atopic dermatitis, asthma and allergic rhinitis.     

Harmful Effect of Indoor Formaldehyde on Atopic Dermatitis in Children: A Longitudinal Study

PurposeEvidence supporting a link between indoor formaldehyde exposure and atopic dermatitis (AD) in humans is limited. The purpose of this longitudinal study was to investigate whether AD symptoms in children could be affected by indoor formaldehyde levels in ordinary households.MethodsFifty-five children with moderate-to-severe AD aged under 18 years were enrolled as a panel. They were followed up from February 2019 through February 2020. Indoor formaldehyde levels of patients'' houses and their AD symptoms were repeatedly measured on a daily basis. The generalized linear mixed model was utilized for statistical analysis. Subdivision analysis was performed by stratifying patients by sex, body mass index, presence of parental allergy, and indoor environments including mold/dampness, temperature, and relative humidity (RH).ResultsA total of 4,789 person-days of AD symptom data were collected. The average concentration of formaldehyde was 13.6 ± 16.4 ppb, with the highest value found in spring (18.1 ± 20.6 ppb). Higher levels of formaldehyde were observed when there was parental smoking, increased indoor temperature over 25.5°C, or RH over 60% (P < 0.0001). When the effect size was compared between each season after controlling for ambient particulate matter, temperature, and RH, an increase in 10 ppb of formaldehyde increased AD symptoms by 79.2% (95% confidence interval [CI], 19.6–168.4) in spring and by 39.9% (95% CI, 14.3–71.2) in summer. AD symptoms in children aged 6−18 years appeared to increase significantly, whereas there was no significant increase in children under 6 years. When indoor temperature was over 25.5°C, an increase in formaldehyde by 10 ppb increased AD symptoms by 17.8% (95% CI, 3.9–33.6).ConclusionsIndoor formaldehyde can exacerbate AD symptom in children with moderate-to-severe AD, particularly in spring and summer, even at allowable levels. Thus, minimizing exposure to indoor formaldehyde may be needed for the proper management of AD in children.     

Do Infections in Infancy Affect Sensitization to Airborne Allergens and Development of Atopic Disease?

We studied 145 children aged 7 years, who had been at day-care centers for at least 3 months during the 2 first years of their lives. The group was compared with a matched population of 145 children cared for at home. Of the 290 children, 212 participated in all phases of the study, which included a questionnaire to parents, skin prick tests with seven allergens, and a clinical examination. Day-care-center children had twice as much otitis media in infancy as "home" children ( P < 0.001), and they also tended to have more other infections. On the other hand, day-care-center children did not have more eczema in infancy, more cumulated atopic disease by the age of seven, or more positive skin tests than home children. When the groups were combined, an increased prevalence of cumulated atopic disease and positive skin tests was found in children with infections in infancy. We conclude that under the conditions of this study infections in infancy did not facilitate the development of hypersensitivity to allergens and atopic disease. The linked tendencies to develop infections and atopy could depend on some third factor.     

A Prospective Study to Compare Clinical Outcomes of Allergic Rhinitis Between Older and Younger Adults: A Potential Effect of Depression in Older Patients

Although younger patients with allergic rhinitis (AR) have been successfully treated with pharmacotherapy, there are no definitive data on treatment outcomes in older patients with AR. We performed a prospective study of 51 older adults with AR (aged over 65 years) and 101 younger AR patients (aged from 19 to 40 years) to compare clinical outcomes between the 2 groups and to evaluate the impact of depressed mood on treatment outcomes in older AR patients. Changes in total symptom scores (TSS), rhinitis-specific quality of life questionnaire (RQLQ) results, rhinitis control assessment test (RCAT) results and visual analog scale (VAS) scores were evaluated after 4-week treatment according to the Allergic Rhinitis and its Impact on Asthma (ARIA) guideline, and the severity of depressed mood was assessed by using the geriatric depression scale. After 4-week treatment, younger AR patients had greater improvements in clinical scores compared with older adults; differences in least squares mean changes from baseline in older patients vs. younger patients were 1.71 (P = 0.004) for TSS, 10.84 (P < 0.001) for RQLQ, 0.80 (P = 0.275) for RCAT, and 8.60 for VAS score (P = 0.061). Multiple logistic regression analysis showed that the severity of depressed mood was independently associated with severe chronic upper airway disease (adjusted odds ratio, 1.385; P = 0.004). Our results suggest that older AR patients are less responsive to standard treatment compared with younger AR patients and that depressed mood is strongly associated with the increased risk of uncontrolled AR in older AR patients.     

Atopic Disorders and Their Risks of Migraine: A Nationwide Population-Based Cohort Study

PurposeMigraine is a relatively common neurologic disorder. A possible link between atopic disorders and migraine has been suggested. This study investigated atopic disorders and their risks of migraine in the Korean population.MethodsFrom the Korean National Health Insurance Service database, patients aged ≥ 20 years who underwent health screening between January and December of 2009 were enrolled. To evaluate the risk of migraine, Cox proportional hazards regression analyses were performed.ResultsIn multivariable analysis, the atopic dermatitis group (adjusted hazard ratio [aHR], 1.28; 95% confidence interval [CI], 1.23–1.33), asthma group (aHR, 1.32; 95% CI, 1.30–1.34) and allergic rhinitis group (aHR, 1.45; 95% CI, 1.44–1.46) had significantly increased risks of migraine compared to their respective control groups (P < 0.001). The patients with 1 (aHR, 1.43; 95% CI, 1.42–1.44), 2 (aHR, 1.50; 95% CI, 1.47–1.53), and 3 (aHR, 1.64; 95% CI, 1.43–1.88) atopic disorders had significantly increased risks of migraine compared to the control group (P < 0.001).ConclusionsOur results demonstrate that patients with atopic disorders may have increased risk of migraine and that the larger the number of concomitant atopic disorders, the higher the risk of migraine.     

Effect of the Hand Antiseptic Agents Benzalkonium Chloride,Povidone-Iodine,Ethanol, and Chlorhexidine Gluconate on Atopic Dermatitis in NC/Nga Mice

Antiseptic agents can cause skin irritation and lead to severe problems, especially for individuals with atopic diatheses. We investigated the effect of 4 different antiseptic agents using an atopic dermatitis (AD) model mouse. NC/Nga mice were subcutaneously injected with mite allergen (Dp) to induce AD-like skin lesions (ADSLs), and an application of 0.2% (w/v) benzalkonium chloride (BZK), 10% (w/v) povidone-iodine (PVP-I), 80% (v/v) ethanol (Et-OH), or 0.5% (v/v) chlorhexidine gluconate (CHG) was applied to the ear envelope. BZK induced a significant increase in the severity of the clinical score, infiltration of inflammatory cells, local expression of inflammatory cytokines in subcutaneous tissue, and total serum immunoglobulin (Ig) E. PVP-I increased the clinical score, number of mast cells, and production of inflammatory cytokines, and total serum IgE. Et-OH increased the clinical score and number of inflammatory cells, but showed no effect on serum IgE levels. No differences in any parameters were observed between CHG and the vehicle. Collectively, the results suggest the severity of the ADSL was related in part to the strength of the immunoreaction. These findings suggest that CHG could offer the lowest risk of inducing ADSL in individuals with atopic dermatitis and that medical staff and food handlers with AD could benefit from its use.     

The severity of atopic dermatitis and the relation to the level of total IgE,onset of atopic dermatitis and family history about atopy

The aim of this study is the evaluation, if the level of total IgE, onset of atopic dermatitis (AD) and the family history are in the significant dependence to the severity of AD. The statistical evaluation of the dependence between the severity of AD and the the level of total IgE, family history and onset of AD was performed. 296 patients were examined. The level of total IgE above 200 IU/ml is recorded in 93 % of patients suffering from severe form and the positive data about atopy in family history are recorded in 66 % of patients with severe form of AD. The significant dependence was recorded between the severity of AD and parameters such as the level of total IgE, and family history about atopy. No dependence was recorded between the severity of AD and the onset of AD.     

度普利尤单抗治疗中度至重度特应性皮炎的有效性和 安全性的 Meta 分析

目的 系统评价度普利尤单抗治疗中度至重度特应性皮炎的有效性与安全性。方法 利用计算机检索知网、万 方、维普、PubMed 、Embase 、Cochrane Library 和 Web of Science 等数据库及 ClinicalTrials.gov 网站,收集有关度普利尤单 抗治疗中度至重度特应性皮炎的随机对照试验。检索时间均为自建库之日起到 2022 年 6 月。对所获得的文献进行筛选、数 据提取及质量评价后,采用 RevMan 5.4 统计软件进行定量分析。结果 共纳入 13 项研究,4270 例患者。Meta 分析结果显 示,治疗组的 IGA 反应率为［RR=3.64 ,95%CI（3.18,4.17 ）,P<0.00001 ］,EASI-50 反应率为［RR=2.49 ,95%CI（2.30, 2.70 ）,P<0.00001 ］,EASI 评分为［MD =-28.51 ,95% CI（-31.86 ,-25.16 ）,P<0.00001 ］,NRS 评分为［MD =-4.92 , 95% CI （-5.49 ,-4.36 ）,P<0.00001 ］,SCORAD 评分为［MD= -30.81 ,95%CI（-31.01 ,-30.61 ）,P<0.00001 ］,均优 于对照组,差异具有统计学意义。在安全性方面, 两组总体不良事件发生率没有明显差别［RR=0.98,95%CI（0.94 ,1.02 ）, P=0.38 ］; 治疗组严重不良事件发生率较对照组更低［RR=0.47,95%CI（0.33,0.67 ）,P<0.0001 ］,差异具有统计学意义。 结论 当前证据表明度普利尤单抗治疗中度至重度特应性皮炎疗效确切,能明显改善患者皮损面积、严重程度、瘙痒及睡眠情况, 安全性较高。     

Pollen counts in relation to the prevalence of allergic rhinoconjunctivitis, asthma and atopic eczema in the International Study of Asthma and Allergies in Childhood (ISAAC)

BACKGROUND: Although pollens are major allergens associated with allergic rhinoconjunctivitis and asthma, there is little information about the relative prevalence of these conditions in populations with different pollen exposures. OBJECTIVE: The purpose of this study was to investigate the relationship between pollen exposure and allergic symptoms among children in different countries. METHODS: An ecological analysis was conducted to see whether pollen exposure (pollen counts, and duration and severity of pollen seasons) is associated with symptoms of allergic rhinoconjunctivitis, asthma and atopic eczema in 28 centres within 11 countries (nine being in Europe). Data on the prevalence of symptoms in 13-14-year olds were based on the responses to the written questionnaires from the International Study of Asthma and Allergies in Childhood (ISAAC). The analysis was adjusted for gross national product and mean annual relative humidity. RESULTS: There was little relationship between pollen exposure and symptom prevalence, except for a significant inverse association between grass pollen counts and lifetime prevalence of the symptoms of allergic rhinitis (P=0.03). Almost all the regression coefficients were negative. The associations were even weaker and all non-significant when the analyses were conducted within countries, using a random intercept fixed slope model, but there was still no evidence of a positive association between pollen exposure and symptoms. CONCLUSION: There is a weak but consistent tendency for the prevalence of allergic symptoms to be inversely associated with pollen exposure. This finding accords with evidence from several countries, suggesting that the prevalence of hayfever and asthma tends to be lower in rural than in urban areas, and lowest among people living on farms. Exposure to allergenic pollen in early life does not appear to increase the risk of acquiring symptoms of respiratory allergy, and may even give some protection against them.     

Apolipoprotein E polymorphism and lipid levels differ by gender and family history of diabetes: the Rancho Bernardo Study

Association between apolipoprotein E (apoE) gene polymorphism and lipid levels was studied in 164 nondiabetic first-degree relatives of persons with diabetes and 962 nondiabetic persons with no family history of diabetes. Sex-specific genotypic distribution of apoE polymorphism did not differ between persons with and without a family history of diabetes. In first-degree relatives, lipid levels did not differ among persons with apoE2 (E2/2, E2/3), apoE3/3, and apoE4 (E4/4, E3/4) after adjusting for age, waist circumference, smoking, and alcohol and estrogen use. In persons without a family history of diabetes, both men (p<0.01) and women (p<0.001) with apoE2 showed lower levels of total and low density lipoprotein cholesterol compared with persons with apoE3/3 and apoE4. In women with a family history of diabetes, persons with apoE4 had larger waist circumference (p<0.05). ApoE2 allele is associated with more favorable levels of total and low density lipoprotein cholesterol in men and women without a family history of diabetes. ApoE4 allele is associated with obesity independent of dyslipidemia in women but not men with a family history of diabetes. ApoE polymorphism is not associated with lipids in men or women with a family history of diabetes.     

Age Trajectories of Genetic Variance in Physical Functioning: A Longitudinal Study of Danish Twins Aged 70 Years and Older

Genetic-evolutionary theories of aging predict that the genetic variance for fitness traits increases with age, while epidemiological-gerontological theories predict an increase in the environmental variance for most traits. In this study we examine the age trajectories of the genetic and environmental variance in physical functioning in a sample of 4731 Danish twins aged 70+ who are being followed longitudinally every second year with up to four assessments completed. A biometric growth model (Neale and McArdle, 2000) was applied to a validated physical ability score. The model included an overall level effect, a rate of linear change effect, and residual effects. The best-fitting model was a sex-specific model including additive genetic and nonshared environmental factors affecting level and rate of change and only nonshared environmental factors affecting the wave-specific levels. For both sexes there is an approximate doubling of both the total variance and the genetic variance in the physical ability score over the four waves and, hence, a rather stable heritability. However, the heritability is approximately .10 for males and .30 for females in all four waves. The heritability of level and slope showed a similar pattern: .11–14 in males and .35–.39 in females. The increase in both additive genetic variance and environmental variance is in agreement with genetic-evolutionary and epidemiological-gerontological theories of aging, respectively. The present study suggests that overall level of strength may be a better phenotype for future molecular genetic studies on physical functioning in the elderly than rate of change, because rate of change is vulnerable to sample attrition due to mortality and dropout and because four waves were needed to be able to detect a heritability for rate of change of the same magnitude as the heritability for level of physical functioning.     

A Model of Disease-Specific Worry in Heritable Disease: The Influence of Family History, Perceived Risk and Worry About Other Illnesses

Disease-related worry is associated with family history and perceived risk of that disease; however, the influences of general risk perceptions and tendencies to worry about diseases have been neglected in the literature. This study investigates a model of disease-specific worry which includes family history, disease-specific perceived risk, and perceived risk for and worry about other diseases. Participants completed a survey assessing these variables in relation to several heritable diseases. Structural equation modeling found that family history predicted disease-specific perceived risk but not perceived risk for other diseases. Disease-specific perceived risk predicted disease-specific worry and worry about other diseases. Perceived risk for other diseases predicted worry about other diseases and disease-specific perceived risk but not disease-specific worry. Disease-specific worry predicted worry about other diseases. This model was supported across several diseases and indicates that disease-specific and general considerations of risk influence worry about a disease and should be considered in interventions.     

A Portrait of the Bcl-2 Protein Family: Life,Death, and the Whole Picture

The Bcl-2 family of proteins are important regulators of cell death. They are comprised of two opposing factions, the proapoptotic versus the antiapoptotic members. Both are required for normal development and cellular homeostasis of the immune system and other tissues. However, in certain circumstances they may participate in the development of disease.