PubMed · 3153424
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R A Graham-Brown. 1988. Atopic dermatitis.. https://pubmed.ncbi.nlm.nih.gov/3153424/
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BACKGROUND: Atopic dermatitis (AD), a common chronic inflammatory skin disease, has been extensively studied using single-cell genomics. However, keratinocytes, as key effector cells in AD, have underlying mechanisms remain incompletely understood and require further investigation. METHODS: We integrated single-cell transcriptomic data from skin tissues of healthy controls, chronic active AD patients, spontaneously healed AD (SHAD) patients, and an ovalbumin-induced AD mouse model. The study particularly emphasized the gene expression and cellular dynamics of keratinocytes across the different groups, as well as their interactions with immune cells. RESULTS: Compared to healthy controls, we observed significant changes in the keratinocyte transcriptome, cellular state, and keratinocyte-immune cell ligand-receptor interactions in AD skin, particularly the marked activation of genes involved in antigen processing and presentation. Interestingly, such gene activation was not observed in keratinocytes from the ovalbumin-induced AD mouse model, despite its phenotype closely resembling human AD. Furthermore, in SHAD, we identified a recovery of both the ligand-receptor interaction patterns and antigen processing and presentation genes, accompanied by a notable shift in the transcriptome. This involved a significant downregulation of genes related to cytoplasmic transcription and oxidative phosphorylation. Notably, this pattern was not observed in the self-healing mouse model following the removal of ovalbumin stimulation. CONCLUSION: Our results suggest that the persistent activation of antigen processing and presentation pathways in keratinocytes may be a key driver of chronic inflammation in AD. Therefore, redirecting anti-allergic therapeutic strategies from solely targeting immune cells to targeting of keratinocyte-mediated antigen presentation may offer a more effective approach. Furthermore, we raise concerns about the use of ovalbumin-induced mouse models to recapitulate human chronic AD, as the underlying mechanisms may differ significantly.
Latex gloves are in widespread use among preclinical medical and dental students in the dissecting room. Increasing numbers of cases of severe latex sensitivity are being reported. This study was carried out to assess the size of this problem among preclinical and clinical students. First-year students (196) and fifth-year students (155) of the United Medical and Dental Schools of Guy's and St. Thomas's Hospitals (UMDS) were asked to complete a questionnaire about symptoms related to allergy to latex gloves and associated risk factors. The prevalence of all self-reported symptoms was 9.6% overall with no significant difference between first- and fifth-year students. The prevalence of rash was significantly different; 2.6% in first-year and 8.5% in fifth-year students. Of those who reported symptoms, there was a significant excess of females and of individuals with eczema, hay fever, or a family history of atopic conditions, compared with those without symptoms. There was no difference between racial groups and no demonstrable link with a history of food allergy, previous surgery, or sensitivity to household rubber products. Only 2 of the 29 individuals with symptoms reported for skin-prick testing, one of whom demonstrated Type I hypersensitivity.
Persons with atopic dermatitis run a considerable risk of developing hand eczema when exposed to occupational agents that are a burden to the skin. This also pertains to those with a history of skin atopy in childhood. This review presents estimates of the risk of developing hand eczema and examines the evidence for an effect modification by skin atopy on exposure. Skin atopy at least doubles the effects of irritant exposure and, thus, doubles the risk in occupations where hand eczema is a common problem. On the basis of this evidence, guidelines for occupational counseling can be given. Further development of a scale indicating the degree of atopic skin diathesis should facilitate the targeting of this counseling toward specific high-risk groups.