Eczema Patients More Sensitive To Irritating Effects Of Hard Water

MedicalResearch.com Interview with:

Dr. Danby

Dr. Danby

Dr. Simon G. Danby, PhD
Independent Research Fellow
Sheffield Dermatology Research,
Department of Infection & Immunity & Cardiovascular Disease,
Faculty of Medicine, Dentistry & Healthy,
University of Sheffield
UK 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Living in a hard water area has been widely associated with a higher risk of developing atopic eczema, a chronic skin condition characterized by an intensely itchy red rash, however the reasons for this association were unclear. We therefore conducted a study to determine how hard water contributes to the development of this condition.

We found that exposing the skin to hard water damages the skin barrier – which is our defense against outside threats such as bacteria or sun burn – and increases the sensitivity of the skin to potentially irritant surfactants found in everyday wash products. This is because hard water contains high levels of calcium and magnesium ions that bind to surfactants, such as sodium lauryl sulfate (SLS) and sodium lauryl ether sulfate (SLES), making them insoluble so that they precipitate onto the skin.

Hard water also has a high alkalinity, meaning that it can help raise skin surface pH, so that it becomes more alkaline. Skin pH is normally acidic, and a shift towards alkaline pH disturbs the skins natural function as a physical barrier and leaves it prone to colonization by potentially pathogenic bacteria. By damaging the skin barrier, washing with hard water may contribute to the development of atopic eczema.

Importantly, patients with eczema were much more sensitive to the effects of hard water than people with healthy skin. This increase in sensitivity was associated with a genetic predisposition to a skin barrier defect brought about by mutations in the gene encoding filaggrin (FLG loss-of-function mutations). Filaggrin is a structural protein important for the formation of our skin’s barrier to the outside environment. Up to half of people with eczema carry a filaggrin gene. This new study illustrates the mechanism by which calcium and magnesium ions in hard water, surfactants and filaggrin interact to damage the skin barrier.

We report that removing the calcium and magnesium ions using an ion-exchange water softener could mitigate the negative effects of hard water on the skin. The implication is that using a water softener could help reduce the incidence of eczema by reducing the harmful effects of covert irritants in everyday wash products.

MedicalResearch.com: What should clinicians and patients take away from your report?

Response: That the way we care for our skin, including the products and the water we use, has a significant impact on the health of our skin. Further research is needed to identify the best approach to caring for our skin from birth.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Response: We are now embarking on a pilot trial to investigate whether installation of a domestic water softener around the time of birth can prevent skin barrier breakdown and eczema in those living in hard water areas.

The Softened Water for Eczema Prevention (SOFTER) trial will be undertaken by Dr Flohr and his team from King’s College London and the National Institute for Health Research (NIHR) Biomedical Research Centre at Guy’s & St Thomas’ NHS Foundation Trust in collaboration with the University of Sheffield team and colleagues from the University of Dundee, the Centre of Evidence-Based Dermatology at Nottingham University, Imperial College London, the National Institute for Health (Bethesda, USA), and Amsterdam Medical Centre. 

MedicalResearch.com: Is there anything else you would like to add?

Response: The study was funded by Harvey Water Softeners

The paper, The Effect of Water Hardness on Surfactant Deposition Following Washing and Subsequent Skin Irritation in Atopic Dermatitis Patients and Healthy Controls, is published in the Journal of Investigative Dermatology. DOI: 10.10.16/j.jid2017.08.037

To keep up to date with news from the Sheffield Dermatology Research group follow us on twitter @Shef_Derm

MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.

Citation:

The Effect of Water Hardness on Surfactant Deposition Following Washing and Subsequent Skin Irritation in Atopic Dermatitis Patients and Healthy Controls
Danby SG1, Brown K2, Wigley AM3, Chittock J4, Pyae PK5, Flohr C6, Cork MJ7.
J Invest Dermatol. 2017 Sep 12. pii: S0022-202X(17)32938-X. doi: 10.1016/j.jid.2017.08.037. [Epub ahead of print]

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions. 

 

 

 

 

 

Treating Iron Deficiency In Infants Has Beneficial Brain and Behavioral Effects In Children

MedicalResearch.com Interview with:

Staffan Berglund MD PhD Umeå University Sweden

Dr. Berglund

Staffan Berglund MD PhD
Umeå University
Sweden 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Iron deficiency has been associated with impaired neurodevelopment and iron supplementation is recommended to those at risk. While it is well known that very low birth weight infants are at risk of iron deficiency, less has been known regarding the large subgroup of children born with only marginally low birth weight (2000-2500g). In the present study, we previously showed that this relatively common group of otherwise healthy children is at risk of iron deficiency during infancy (Berglund Pediatrics 2010;126).

In the study published this week, we now also found that supplementation during the first six months of life had long term positive effects on their behavioral profile, with significant reduction of externalizing behavioral problems.

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Baby Teeth Can Expose Toxic Levels of Minerals Associated With Autism

MedicalResearch.com Interview with:

Manish Arora, PhD Associate Professor Environmental Medicine & Public Health Icahn School of Medicine at Mount Sinai

Dr. Arora

Manish Arora, PhD
Associate Professor
Environmental Medicine & Public Health
Icahn School of Medicine at Mount Sinai

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Autism has both genetic and environmental risk factors. Our aim was to study if exposure to toxic metals, such as lead, or disruptions in the uptake of essential nutrient elements such as manganese or zinc would be related to autism risk. Furthermore, we were interested in not only understanding how much exposure had taken place but also which developmental periods were associated with increased susceptibility to autism risk.

Researchers suspect that the risk factors for autism start early in life, even prenatally, but measuring in utero exposures is technically very challenging. We used a newly developed technique that uses lasers to map growth rings in baby teeth (like growth rings in trees) to reconstruct the history of toxic metal and essential nutrient uptake. We applied this technology in samples collected from twins, including twins who were discordant for autism. This allowed us to have some control over genetic factors.

We found that twins with autism had higher levels of lead in their teeth compared to their unaffected twin siblings. They also had lower levels of zinc and manganese. The lower uptake of zinc was restricted to approximately 10 weeks before birth to a few weeks after birth, indicating that as a critical developmental period.

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Food Costs Can Lead To Less Protein and Phosphorous in Indigent Kidney Transplant Patients

MedicalResearch.com Interview with:

Ms. Shifra Mincer Medical Student in the class of 2019 SUNY Downstate Medical School

Shifra Mincer

Ms. Shifra Mincer
Medical Student in the class of 2019
SUNY Downstate Medical School

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Hypophosphatemia is commonly encountered in the post-transplant setting. Early post-transplant hypophosphatemia has been ascribed to excess FGF23 and hyperphosphaturia.

Many patients remain hypohosphatemic months or even years after their transplant and the mechanism was assumed to be the same, however, our group recently reported that patients with late post-transplant hypophosphatemia had very little phosphorous in their urine (Wu S, Brar A, Markell, MS. Am J Kidney Dis. 2016,67(5): A18). We hypothesized that they were not eating enough phosphorous to compensate for the acute phosphorous losses they experienced immediately post-transplant.

In this study, using both 3-day diet journals and 24-hour diet recall questionnaires, we found that mean intake of phosphorous and protein was barely at the Recommended Daily Allowance, and that despite 70% of the patients using EBT, 30% of those patients still reported concerns regarding food security. Patients who reported that the cost of food influenced their dietary choices ate 43% less protein (average 48,5 gms vs. 85.8 gms) and 29% less phosphorous (average 887 mg vs 1257 mg). When ability to rise from a chair over a 30 second period was evaluated, only patients who expressed food cost concerns were unable to complete the test.

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Low Magnesium May Be Linked To Increased Risk of Hip Fractures

MedicalResearch.com Interview with:

Dr Setor Kunutsor Ba(Legon), MBChB(Legon), MA(Cantab), PhD(Cantab) Research Fellow Musculoskeletal Research Unit University of Bristol

Dr. Kunutsor

Dr Setor Kunutsor Ba(Legon), MBChB(Legon), MA(Cantab), PhD(Cantab)
Research Fellow
Musculoskeletal Research Unit
University of Bristol

MedicalResearch.com: What is the background for this study?

Response: Bone fractures are one of the leading causes of disability and ill health especially among the ageing population and are a burden to health care systems. There is established evidence that calcium and vitamin D play an important role in bone health.

Magnesium is an essential trace element, being the second most abundant intracellular cation after potassium and the fourth most abundant cation in the body. It serves several important functions in the body, which include protein synthesis, nucleic acid synthesis, enzymatic reactions, and has also been shown to be cardio-protective. It is also an important component of bone, with majority (67 percent) of total body magnesium known to be found in the bone tissue. There have been suggestions from both human and animal experiments that magnesium may have a beneficial effect on bone health; however, its relationship with fractures is not very certain.

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Compared To Other Blood Pressure Medications Diuretics Have Bone Protective Effect

MedicalResearch.com Interview with:

Joshua I. Barzilay, MD Kaiser Permanente of Georgia Duluth, GA 30096

Dr. Joshua I. Barzilay

Joshua I. Barzilay, MD
Kaiser Permanente of Georgia
Duluth, GA 30096

MedicalResearch.com: What is the background for this study?

Response: Hypertension (HTN) and osteoporosis (OP) are age-related disorders. Both increase rapidly in prevalence after age 65 years. Prior retrospective, post hoc studies have suggested that thiazide diuretics may decrease the risk of osteoporosis. These studies, by their nature, are open to bias. Moreover, these studies have not examined the effects of other anti HTN medications on osteoporosis.

Here we used a prospective blood pressure study of ~5 years duration to examine the effects of a thiazide diuretic, a calcium channel blocker and an ACE inhibitor on hip and pelvic fractures. We chose these fractures since they are almost always associated with hospitalization and thus their occurrence can be verified.

After the conclusion of the study we added another several years of follow up by querying medicare data sets for hip and pelvic fractures in those participants with medicare coverage after the study conclusion.

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Children using stimulant medications may be at risk for lower bone density

MedicalResearch.com Interview with:
Alexis Jamie Feuer MD
Assistant Professor of Clinical Pediatrics
Weill Cornell Medical College

MedicalResearch.com: What is the background for this study?

Response: Osteoporosis is a debilitating disorder characterized by low bone density and increased risk of fractures. Adolescence and young adulthood are critically important times for accruing peak bone density and failure to obtain adequate bone mass by early adulthood may result in future osteoporosis. In children, the use of certain medications can lead to a decrement in the acquisition of bone mass. Past studies have shown that stimulant medications, such as those used to treat Attention Deficit Hyperactivity Disorder (ADHD), may slow the rate of linear growth in children. To date, little research has been done to see what effects stimulant use may have on bone density and bone accrual in children. Stimulants exert their effects via activation of the sympathetic nervous system, and as there is mounting evidence that indicates the sympathetic nervous system plays a critical role in the acquisition of bone density, we sought to determine if there is any association between stimulant medication use and bone mass in the pediatric population.

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Urinary Citrate Excretion May Be Indirect Biomarker of Bone Health

MedicalResearch.com Interview with:
Jonas Esche

Dipl.-Mol. Biomed
University of Bonn
Institute of Nutritional and Food Sciences
DONALD Study

MedicalResearch.com: What is the background for this study?

Response: Modern western diets increase diet-dependent acid load and net acid excretion which are suggested to have adverse long-term effects on bone. Urinary potential renal acid load (uPRAL) is an established parameter to assess nutritional acid load. Urinary citrate, on the other hand, integrates nutritional and also systemic influences on acid-base homeostasis with high citrate indicating prevailing alkalization.
Against this background urinary citrate excretion was used as a new index of acid-base status and its relationship with bone strength and long-term fracture risk was examined.

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Calcium Supplements May Raise Risk of Dementia in Elderly Women with Cerebrovascular Disease

MedicalResearch.com Interview with:

Silke Kern, MD, PhD Neuropsychiatric Epidemiology Unit and Clinical Neurochemistry Laboratory Department of Psychiatry and Neurochemistry Institute of Neuroscience and Physiology Sahlgrenska Academy University of Gothenburg Gothenburg, Sweden

Dr. Silke Kern

Silke Kern, MD, PhD
Neuropsychiatric Epidemiology Unit and Clinical Neurochemistry Laboratory
Department of Psychiatry and Neurochemistry
Institute of Neuroscience and Physiology
Sahlgrenska Academy
University of Gothenburg
Gothenburg, Sweden

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Calcium has an important role in ischemic neuronal cell death and atherosclerosis. Several studies suggest that increased serum calcium increases the risk for vascular events and worsens the outcome after stroke. Widespread ischemic neuronal cell death and atherosclerosis might lead to dementia. We therefore examined if Calcium supplementation is associated with development of dementia. Our study is the first to show a relationship between Calcium supplementation and increased risk for dementia in older women. This risk is mainly confined to women with cerebrovascular disease (history of stroke or presence of white matter lesions).

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Some Populations Are Genetically Immune to Osteoporosis

MedicalResearch.com Interview with:
Dr. Constance Hilliard
Department of History
University of North Texas
Denton, TX

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: As an evolutionary historian, I have devoted the last several years to researching the health implications of genetic diversity. I was particularly concerned with the tendency of medical researchers to unwittingly use the biology of people with Northern European ancestry as a universal standard for everyone. For instance, lactose intolerance may be a disorder in that community, which suffers high rates of osteoporosis. But since 65% of the world’s population are lactose intolerant and have low rates of osteoporosis, a one-size-fits-all approach to bone health can prove dangerous for those whose ethnic-specific biological needs are overlooked.

This study shows that osteoporosis is not a global problem. It has a strong and devastating impact in dairy-farming societies and is virtually non-existent in the tsetse zone of West Africa, where cattle rearing and dairying are not possible. Previous studies have tried to correlate the degenerative bone disease with socio-economic income. However, this study compares two regions of Africa with similar socio-economic conditions. In dairy-farming East Africa, the incidence of osteoporosis is 245 per 100,000. However in the tsetse belt of West Africa, where people do not consume dairy products, it is 3 per 100,000. When regression analyses are performed on 40 countries around the world, the association between dairy consumption and osteoporosis is high (0.851). It only correlates with national Gross National Product at a regression rate of 0.447.

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