Author Interviews, Brigham & Women's - Harvard, Cancer Research, Dermatology, JAMA / 14.08.2020

MedicalResearch.com Interview with: Maryam M. Asgari, MD MPH Professor Department of Dermatology, Massachusetts General Hospital Department of Population Medicine, Harvard Medical School MedicalResearch.com: What is the background for this study? What are Topical Calcineurin Inhibitors used for?  Response: Topical calcineurin inhibitors (TCIs) are FDA approved for the treatment of atopic dermatitis (though they are used off-label to treat a wide range of inflammatory conditions of the skin, including psoriasis, seborrheic dermatitis, and contact dermatitis).  There are currently two drugs available – tacrolimus and pimecrolimus – both of which carry a black box label warning users about the potential for increased skin cancer risk.  The risk associated with keratinocyte carcinoma, the most common cancer (defined as basal cell carcinoma and squamous cell carcinoma), remains poorly defined because findings from large-scale post-marketing surveillance studies are lacking.  (more…)
Author Interviews, Dermatology, FDA, Regeneron, Sanofi / 31.07.2020

MedicalResearch.com Interview with: Elizabeth Laws, PhD Vice President and Global Project Head for Dupilumab/Dupixent Sanofi Marcie Ruddy, MD, MA Strategic Program Direction, Immunology and Inflammation Regeneron  Dr. Laws and Dr. Ruddy discuss the FDA approval of a 300 mg single-dose pre-filled pen for Dupixent® (dupilumab) for all indications in patients aged 12 years and older.   MedicalResearch.com: What is the background for this announcement? What are the main indications for Dupixent? Response: Until now, Dupixent 300 mg dose was available only in pre-filled syringe for administration. The approval of the pre-filled pen provides an additional, easy-to-use option for patients to self-administer Dupixent. Dupixent is approved to treat patients aged 6 years and older with uncontrolled moderate-to-severe atopic dermatitis (AD) and can be used with or without topical treatments. Dupixent is also approved for use with other medicines for the maintenance treatment of uncontrolled moderate-to-severe eosinophilic or oral steroid dependent asthma in patients aged 12 years and older, and with other medicines for the maintenance treatment of uncontrolled chronic rhinosinusitis with nasal polyposis (CRSwNP) in adults, respectively. The pre-filled pen is approved for use in patients prescribed Dupixent who are 12 years of age and older across current indications, at the 300 mg dose. (more…)
Allergies, Author Interviews, Dermatology, Pediatrics / 25.07.2020

MedicalResearch.com Interview with: Catherine M. Ludwig is a 4th year medical student at the University of Illinois Chicago College of Medicine. Her interests in dermatology include inflammatory and genetic conditions, especially within pediatric dermatology.     Alyssa M. Thompson is currently a 2nd year medical student at the UA-COM Tucson. She graduated from the University of Arizona, Summa Cum Laude in 2018 as the athletic department's Valedictorian with a degree in Physiology and an Entrepreneurship certificate. Her passion for research and dermatology stems from her innovative and integrative mindset with specific interest in inflammatory skin disease.     MedicalResearch.com: What is the background for this study? Response: Eczema is very common in children. Prescription medications are important for managing eczema flares, but a lot of the work in treating eczema is preventative, done by consistently moisturizing the skin at home with drug store products. Allergic contact dermatitis occurs more commonly in people with eczema. A previous study was done in characterizing the allergenic potential of drug-store moisturizers and found that 88% of moisturizers contain at least one common allergen. Many moisturizers are marketed specifically to eczema, but the allergen content of these products are unknown. (more…)
Author Interviews, Dermatology, Pediatrics / 25.07.2020

MedicalResearch.com Interview with: Jennifer Schoch, MD Dr. Schoch is a pediatric dermatologist and Associate Professor of Dermatology at the University of Florida. Her research focuses on the infantile skin microbiome and its role in pediatric skin disease. She is a member of the Society for Pediatric Dermatology.    Reesa Monir, MD Dr. Monir is a PGY-3 dermatology resident at the University of Florida. She plans to pursue a career in pediatric dermatology.       MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Atopic dermatitis is a common pediatric skin condition that often begins during infancy. Kids and families alike suffer from the itching and demanding care required to manage this condition. While existing studies have examined the impact of race on atopic dermatitis from birth to adulthood, few studies have examined the early childhood period specifically. As this time is the peak period for diagnosis, we sought to examine the impact of race on disease prevalence during early childhood.  (more…)
Allergies, Author Interviews, Dermatology / 22.07.2020

MedicalResearch.com Interview with: Emma Guttman-Yassky, MD, PhD Professor of Dermatology and Immunology Vice Chair of the Department of Dermatology Icahn School of Medicine MedicalResearch.com: What is the background for this study? What is the importance of differentiating these two skin conditions?   Response: The background is that up to now skin biopsies were considered the gold standard for obtaining skin biomarkers of atopic dermatitis/AD and psoriasis that are linked to disease activity in skin and for obtaining the cutaneous gene and protein expression fingerprint of each individual disease. Biopsies are also used in clinical trials to obtain the skin phenotype. However biopsies are invasive, painful and scarring. Thus we need less invasive means to profile diseases and obtain biomarkers. Tape strips is a minimally invasive approach to sample and study the skin. However, prior studies using tape strips could not fully capture the phenotype of the diseases and also sampling the recovery rate was less than optimal, not allowing this approach to be widely used. Psoriasis and AD are the most common inflammatory skin diseases, but these diseases are treated very differently and in some cases are very difficult to differentiate between them clinically and even in biopsies.  (more…)
Author Interviews, Dermatology / 25.06.2020

MedicalResearch.com Interview with: Dr. Jonathan L. Silverberg MD PhD MPH Assistant Professor in Dermatology Medical Social Sciences and Preventive Medicine Northwestern, Chicago, Illinois MedicalResearch.com: What is the background for this study? Response: Topical anti-inflammatory therapy is often inadequate to achieve disease control in patients with moderate-to-severe atopic dermatitis (AD), and systemic therapy is often warranted. Tralokinumab is a fully human immunoglobulin G4 monoclonal antibody that specifically binds to the IL-13 cytokine with high affinity and inhibits downstream IL-13 pro-inflammatory signaling. Tralokinumab was previously studied as a monotherapy in moderate-severe AD in the ECZTRA1 and ECZTRA2 studies. In this Phase 3 randomized controlled study, ECZTRA3, tralokinumab was studies in combination with topical corticosteroids compared to placebo with topical corticosteroids. The use of topical anti-inflammatory therapy is more akin to the way in which systemic and biologic therapies are typically used in the real-world. (more…)
Author Interviews, Dermatology, Regeneron / 23.06.2020

MedicalResearch.com Interview with: Brad Shumel, MD Senior Director of Medical Affairs, Immunology Regeneron MedicalResearch.com: What is the background for this study? Response: Atopic dermatitis is a chronic inflammatory disease and one of the most common skin disorders in children. Severe atopic dermatitis is characterized by skin lesions that often cover a large body surface area and can include intense, persistent itch. Uncontrolled moderate-to-severe atopic dermatitis can have a physical, emotional and psychosocial impact on children, resulting in sleep deprivation, activity restriction, poor school performance, depression and anxiety that can have a greater impact on quality-of-life. The standard of care for this pediatric population has been topical corticosteroids. Children with severe atopic dermatitis who remain uncontrolled with topical therapies have limited treatment options. This Phase 3 trial was conducted to evaluate the safety and efficacy of dupilumab plus topical corticosteroids (TCS) compared with TCS alone in children with uncontrolled severe atopic dermatitis across two treatment arms – every four weeks and every two weeks (Q4W and Q2W). (more…)
Author Interviews, Dermatology, Pediatrics, Pharmaceutical Companies, Regeneron / 15.06.2020

MedicalResearch.com Interview with: Amy S Paller, MD Chair, Department of Dermatology Director, Skin Biology and Diseases Resource-Based Center Walter J. Hamlin Professor of Dermatology Professor of Dermatology and Pediatrics (Dermatology) Feinberg School of Medicine Northwestern University  Dr. Paller discusses the FDA approval of Dupixent® (dupilumab) for children aged 6 to 11 years with moderate-to-severe atopic dermatitis (eczema), whose disease is not adequately controlled with topical prescription therapies or when those therapies are not advisable.  MedicalResearch.com: What is the background for this announcement? Would you briefly discuss what is meant by atopic dermatitis and how it affects children? Response: “Atopic dermatitis, the most common form of eczema, is a chronic inflammatory disease that often appears as a rash on the skin. Moderate-to-severe atopic dermatitis is characterized by rashes that can potentially cover much of the body and can include intense, persistent itching, skin lesions and skin dryness, cracking, redness or darkness, crusting and oozing. Itch is one of the most burdensome symptoms for patients and can be debilitating. This recent FDA approval expands the use of Dupilumab in the U.S. to include children aged 6 to 11 years with uncontrolled moderate-to-severe atopic dermatitis, making it the only biologic medicine approved for this use in this population. Dupilumab is also approved in the U.S. to treat patients aged 12 years and older with moderate-to-severe atopic dermatitis. Moderate-to-severe atopic dermatitis can place a particularly substantial burden on young children aged 6 to 11 years and their families. Limited treatment options leave many of these children to cope with intense, unrelenting itch and skin lesions. Families of these children can spend countless hours helping them to manage their disease.” (more…)
Author Interviews, Dermatology / 12.06.2020

MedicalResearch.com Interview with: David Granville PhD, FAHA Professor, Pathology and Laboratory Medicine, UBC Associate Director, Vancouver Coastal Health Research Institute, VGH-UBC Associate Director, BC Professional Firefighters Burn & Wound Healing Group, Department of Surgery, UBC Principal Investigator, iCORD and UBC Centre for Heart Lung Innovation MedicalResearch.com: What is the background for this study? Response: Atopic dermatitis (aka. eczema) is a chronic inflammatory skin condition characterized by patches of dry, red, itchy skin. These patches can come and go - a process often referred to as 'flare ups'. Often when these flare ups occur, people avoid going out, or to work, resulting in lost productivity and reduced quality of life. While the cause of these flare-ups is not completely understood, a loss of the skin's protective barrier function is believed to be a triggering event. This is because the outer layer of skin (epidermis) acts as a barrier to allergens and other foreign entities from getting into the skin. When this outer barrier is lost, allergens are able to cross and penetrate the deeper layers of skin. This triggers an inflammatory response. The inflammatory response, in turn, can release factors that cause further disruption of the barrier thereby exacerbating the flare up. The outer skin barrier can be thought of in terms of a brick wall in which the 'bricks', or skin cells in this case, are held together by a molecular 'grout' known as adhesion proteins. If these adhesion proteins, which tightly anchor the skin cells together, are lost, the skin becomes more permeable to the outer environment, allowing foreign antigens to enter in, and conversely, moisture to escape out resulting in skin dryness and shedding (more…)
Author Interviews, Dermatology / 13.05.2020

MedicalResearch.com Interview with: Brian S. Kim, MD, MTR, FAAD Associate Professor of Medicine (Dermatology) Co-Director, Center for the Study of Itch and Sensory Disorders Division of Dermatology, Department of Medicine Washington University School of Medicine St. Louis, MO  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Itch is the central and most debilitating symptom of atopic dermatitis. However, surprisingly, measuring itch or quality of life in clinical trials is not often a primary endpoint. Therefore, this study focuses in very detailed fashion on how ruxolitinib cream improves pruritus in a clinically meaningful way and its ultimate impact on quality of life. What patients want to know at the end of the day is how much will this drug change my life?  Not, whether it statistically beat out a placebo group. Indeed, what this study shows is that ruxolitinib cream has a major impact on itch in a meaningful way that is also tied to improvements in quality of life. (more…)
Author Interviews, Dermatology, Neurology / 28.04.2020

MedicalResearch.com Interview with: Santosh K. Mishra M.Tech., PhD Assistant Professor of Neuroscience Department of Molecular Biomedical Sciences NC State Veterinary Medicine Raleigh, NC 2760 MedicalResearch.com: What is the background for this study? Would you briefly explain what is meant by atopic dermatitis? Response: Chronic allergic itch is a worldwide problem that leads to substantial health expenses,but what causes this universal urge to scratch remains elusive in chronic allergic itch. Atopic dermatitis is a common allergic skin disease that often associated with extremely itchy and inflamed skin. In our study, we showed, for the first time, a molecular pathway that is involved in chronic allergic itch as we identified an endogenous mediator (periostin) and a new role for its sensory neuron receptor, the integrin αVβ3, which drives the excitability and transmission of itch signal to the spinal cord.  (more…)
Allergies, Asthma, Author Interviews, Dermatology, Pediatrics / 10.03.2020

MedicalResearch.com Interview with: Marcella Aquino, M.D. Hasbro Children's Hospital Department of Pediatrics Division of Allergy & Immunology Associate Professor of Pediatrics   Daphne Koinis-Mitchell PhD Professor (Research) in the Departments of Psychiatry and Human Behavior and Pediatrics Warren Alpert Medical School of Brown University Providence, Rhode Island 02903   MedicalResearch.com: What is the background for this study? Response: Urban minority children with asthma are at increased risk for sleep loss and poorer sleep quality secondary to socio-contextual stressors (poverty, stressors of urban living) and the underlying challenges related to following possibly complex asthma treatment regimens. Atopic dermatitis (AD) is very frequently seen in children with asthma and increases the risk for poor quality sleep, for example difficulty falling asleep, awakenings during the night, difficulty awakening in the morning, and/or daytime sleepiness.  (more…)
Author Interviews, Dermatology, Immunotherapy, Science / 27.02.2020

MedicalResearch.com Interview with: Brian S. Kim, MD, MTR, FAAD Associate Professor of Medicine (Dermatology) Co-Director, Center for the Study of Itch and Sensory Disorders Division of Dermatology, Department of Medicine Washington University School of Medicine St. Louis, MO 63110 MedicalResearch.com: What is the background for this study? Response: It has been known well for decades that a specific part of your immune system called the “type 2 immune response” is overactive in atopic disease. Indeed, that is what new drugs like dupilumab block so effectively and thus revolutionized the treatment of atopic disorders just in the last few years. In fact, our lab focuses predominantly on this part of the immune system. However, increasingly it is becoming recognized that the immune system is not just about whether it is “on or off” but rather a balance like yin and yang. Along these lines, we noticed that a cell that could theoretically counterbalance atopic inflammation was significantly deficient in many patients with eczema. This cell is the natural killer (NK) cell. (more…)
Author Interviews, Dermatology / 20.12.2019

MedicalResearch.com Interview with: Dr Kim Kjoeller MD Executive Vice President, Global Research & Development LEO Pharm Discusses the recent announcement from  LEO Pharma A/S that tralokinumab  met all primary and secondary endpoints in its three Phase 3 studies (ECZTRA 1-3) for the treatment of moderate-to-severe atopic dermatitis in adults. MedicalResearch.com: What is the background for this study? Would you briefly explain what is meant by Atopic Dermatitis? Response: Atopic Dermatitis (AD) – also known as ‘atopic eczema’ – is a chronic, inflammatory, heterogeneous skin disease characterized by intense itch and eczematous lesions is the most common inflammatory skin disease in the world, with limited effective treatment options, especially for moderate-to-severe patients. The primary objective of these studies was to evaluate the efficacy of tralokinumab compared with placebo in treating moderate-to-severe atopic dermatitis.
  • ECZTRA 1 and 2 evaluated the use of tralokinumab as monotherapy
  • ECZTRA 3 evaluated the use of tralokinumab in combination with a topical corticosteroid (TCS).
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Author Interviews, Cancer Research, Dermatology, JAMA / 11.12.2019

MedicalResearch.com Interview with: Lily Wang Student at University of Toronto Toronto, Ontario, Canada  MedicalResearch.com: What is the background for this study? Response:  Impaired skin barrier and aberrant immune function in atopic dermatitis (AD) may impact immune response to malignancy. Conflicting data exist on the risk of cancer in patients with AD. The purpose of our study was to determine the risk of non-cutaneous and cutaneous cancers in patients with atopic dermatitis compared to the general population (i.e. without AD).  (more…)
Author Interviews, Dermatology / 25.10.2019

MedicalResearch.com Interview with: Dr. Stephan Weidinger, MD, MaHM Professor of Dermatology Christian-Albrechts-Universit Kiel  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Relatively little is known about the epidemiology and burden of Atopic Dermatitis (AD) in children, adolescents and adults, however, there is increasing evidence that the disease is highly prevalent also in these age groups. Further, very little is known about the disease severity strata. Severity, however, largely defines treatment needs. The EPI-CARE (EPIdemiology of Children with Atopic dermatitis Reporting on their Experience) study was a cross-sectional web-based study of the prevalence and burden of AD in both children and adolescents. It was performed globally across Europe, North America (US, Canada), Latin America (Argentina, Brazil, Colombia, Mexico), Asia (Japan, Taiwan), the Middle East (Israel, Kingdom of Saudi Arabia, Turkey, the United Arab Emirates) and Russia, and used very stringent definitions of AD and the same methodology across age groups. We first analyzed the adolescent data, and it turned out that the prevalence of active Atopic Dermatitis is higher than expected, ranging from 9.29% in the US and 14.7% in Europe. Of note, almost 50% of the adolescents with current AD reported an overall moderate to severe disease activity, and the majority reported a multidimensional burden that includes not only the skin symptoms associated with AD, but also sleep disturbances, symptoms of anxiety/depression, and reductions in quality‐of‐life and productivity. Adolescents also reported a high burden of coexisting atopic diseases that increased with AD severity – 68.6% of those with moderate AD and 81% of those with severe AD reported at least one coexisting atopic disease. atopic dermatitis substantially affects the life of patients and their families, and this burden is higher with greater AD severity. (more…)
Author Interviews, Dermatology, Nature, Stanford / 18.10.2019

MedicalResearch.com Interview with: Stephen J. Galli, MD Mary Hewitt Loveless, MD Professor Professor of Pathology and of Microbiology and Immunology Department of Pathology Stanford University School of Medicine Center for Clinical Sciences Research Stanford, CA and Nicolas Gaudenzio PhD Unité de Différenciation Epithéliale et Autoimmunité Rhumatoïde INSERM, Université de Toulouse Toulouse, France MedicalResearch.com: What is the background for this study? What are the main findings? Response: We took a lead from existing clinical data showing that patients with moderate to severe atopic dermatitis, an increasingly common disorder producing skin pathology, also have elevated levels of neuropeptides in their blood, particularly one neuropeptide, named “substance P”, whose level is correlated with disease severity. These patients also have high levels of mast cell-specific proteases in the blood, indicating that mast cells, which are innate immune cells present in the skin, and which can be activated when exposed to substance P, might play an essential role in modulating inflammatory and allergic processes. Based on these observations, our teams (Galli Lab at Stanford University, USA and Gaudenzio Lab at Inserm Toulouse, France) decided to focus on the possible interactions between sensory neurons, which are a source of substance P, and mast cells. The results of this work have now been published in the journal Nature Immunology. (more…)
Author Interviews, Dermatology, Pediatrics / 25.09.2019

MedicalResearch.com Interview with: Hal Flowers MD Assistant Professor of Dermatology University of Virginia Dr. Flowers specializes in autoimmune connective tissue disease (rheumatologic dermatology), phototherapy and blistering skin diseases  MedicalResearch.com: What is the background for this study? Response: Unfortunately, there really is not much literature at all addressing the treatment of atopic dermatitis with apple cider vinegar (ACV), even though we know that this is something our patients are doing. ACV is appealing as a “natural therapy” for treatment of skin disease. Since it’s an acid, it can theoretically correct the loss of acidity that occurs in the skin of our eczema patients. Plus, we know that high enough concentrations will kill certain bacteria that promote eczema, particularly Staphylococcus aureus. There are plenty of blogs and anecdotes as well as physicians who recommend this treatment, but as of yet, we don’t know the best concentration, safety or the benefit of ACV.  (more…)
Author Interviews, Dermatology, Infections, Pediatrics / 16.09.2019

MedicalResearch.com Interview with: Carrie C. Coughlin, MD Member of the Society for Pediatric Dermatology Assistant Professor, Dermatology Departments of Medicine and Pediatrics Washington University School of Medicine / St. Louis Children's Hospital   Cristopher C. Briscoe, MD Dermatology Resident, PGY-2 Washington University School of Medicine in St. Louis    MedicalResearch.com: What is the background for this study? What are the main findings? Dr. Briscoe: Superinfection of atopic dermatitis (AD) in pediatric patients is a common complication. Our study sought to determine the best empiric antibiotic choice for these patients while a bacterial culture is pending. We retrospectively analyzed 182 skin cultures from pediatric atopic dermatitis patients seen in the outpatient setting over five years and found that 170 (93.4%) grew Staphylococcus aureus. Of these, 130 (76.5%) grew methicillin-sensitive S. aureus (MSSA), 37 (21.8%) grew methicillin-resistant S. aureus (MRSA), and 3 (1.8%) grew both MSSA and MRSA. There was no statistically significant relationship between age, sex, race, or dilute bleach bath usage and MRSA infection. Interestingly, as compared to a separate group of pediatric atopic dermatitis patients seen in the emergency room, our patients had lower rates of MSSA susceptibility to doxycycline and MRSA susceptibility to TMP-SMX. (more…)
Author Interviews, Dermatology, JAMA, Pediatrics, Sleep Disorders, UCSF / 26.03.2019

MedicalResearch.com Interview with: Dr. Katrina Abuabara, MD, MA, MSCE Department of Dermatology Program for Clinical Research, University of California, San Francisco MedicalResearch.com: What is the background for this study? Response: The wellbeing and development of children is strongly influenced by parents’ physical and psychosocial health. Parents of children with chronic illness, in particular, are susceptible to poor sleep, and previous studies have found major sleep impairments among parents of children with ventilator dependency and cystic fibrosis, but few studies have examined sleep patterns among parents of children with more common chronic illnesses like atopic dermatitis (also known as eczema). (more…)
Author Interviews, Depression, Dermatology / 24.03.2019

MedicalResearch.com Interview with: Dr. Jonathan L. Silverberg MD PhD MPH Assistant Professor in Dermatology Medical Social Sciences and Preventive Medicine Northwestern, Chicago, Illinois MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Atopic Dermatitis is characterized by chronic and often severe and debilitating itch, skin pain, sleep disturbances, skin lesions and multiple comorbid health conditions. The signs, symptoms and comorbidities of atopic dermatitis can lead to significant psychosocial distress and mental health burden We performed a cross-sectional, population-based study of 2893 US adults. We found that adults with atopic dermatitis had more severe symptoms scores for anxiety and depression (Hospital Anxiety and Depression anxiety). Adults with atopic dermatitis also had higher prevalences of anxiety and depression. Mean symptom scores and prevalences of anxiety and depression were even higher in adults with moderate and severe atopic dermatitis compared to those with mild atopic dermatitis. All respondents with severe PO-SCORAD, POEM and PO-SCORAD-itch scores had elevated anxiety and depression scores. Many adults with atopic dermatitis that had elevated anxiety and depression scores reported no diagnosis of anxiety or depression.  (more…)
Author Interviews, Dermatology, Eli Lilly / 16.02.2019

MedicalResearch.com Interview with: Lotus Mallbris, MD PhD Dermatologist and Vice President, Head of Global Immunology Drug Development Platform Team Leader at Lilly MedicalResearch.com: What is the background for this study? Would you briefly explain what is meant by atopic dermatitis? How common is this condition?  Response:The BREEZE-AD1 and BREEZE-AD2 clinical trials are multicenter, randomized, double-blind, placebo-controlled, Phase 3 studies to evaluate the efficacy and safety of baricitinib monotherapy in adult patients with moderate to severe atopic dermatitis. These are two of five studies that will be part of the placebo-controlled data program intended to support global registrations. Atopic dermatitis, a serious form of eczema, is a chronic, relapsing skin disease characterized by intense itching, dry skin and inflammation that can be present on any part of the body. It affects approximately 1-3 percent of adults worldwide. (more…)
Author Interviews, Dermatology, Eli Lilly / 25.09.2018

MedicalResearch.com Interview with: Lotus Mallbris, M.D., Ph.D., Vice president, Immunology Development Lilly Bio-Medicines  MedicalResearch.com: What is the background for this study? What are the main findings? Response: By exploring creative clinical approaches and patient-centric pathways to more thoroughly address the key aspects of treating these complex conditions, Lilly is bringing innovation forward in hopes of reducing the burden of dermatologic disease for people around the world. The results of the IXORA-S study suggest that Taltz may provide significantly greater clearance of nail psoriasis than ustekinumab. This is significant because nail lesions are a common feature of psoriasis. It’s often associated with discomfort, which can lead to functional impairment and distress, further supporting the importance of complete clearance.   (more…)
Author Interviews, Bone Density, Dermatology, Osteoporosis / 21.06.2018

MedicalResearch.com Interview with: Dr. Jonathan L. Silverberg MD PhD MPH Assistant Professor in Dermatology Medical Social Sciences and Preventive Medicine Northwestern University, Chicago, Illinois MedicalResearch.com: What is the background for this study? Response: Persons with atopic dermatitis have a number of risk factors for osteopenia and osteoporosis, including systemic atopy and inflammation, being less physically active and using a lot of topical and/or systemic corticosteroids. We aimed to determine whether adults with atopic dermatitis in fact have higher rates of physician-diagnosed osteopenia and osteoporosis. (more…)
Allergies, Author Interviews, Dermatology, Inflammation, Pediatrics / 07.03.2018

MedicalResearch.com Interview with: elstarNidhi Malhotra PhD Boston Children's Hospital Division of Allergy and Immunology Senior Scientist at Elstar Therapeutics Inc. MedicalResearch.com: What is the background for this study? What are the main findings? Response: Allergies such as Atopic Dermatitis (AD) are rampant in the industrialized nations. Why are we more predisposed to developing hypersensitive reactions to innocuous proteins (allergens) is not well understood. To gain better understanding and to develop better therapies, we need to first delve deeper into how our immune system regulates homeostasis in tissues such as skin. The main cell types that thwart inflammatory reactions are known as regulatory T cells. These cells are generated in thymus and reside in secondary lymphoid tissues but they are also prominent at tissue sites such as in dermal layer of skin. In this study, I focused on understanding how Tregs resident in skin are distinct from the Tregs in secondary lymphoid organs such as lymph nodes (LNs). I uncovered that functioning of Tregs in skin is underpinned by a distinct set of genes. One main gene that I found to be highly expressed in skin Tregs but not in LN Tregs is Rora, which encodes for the transcription factor ROR alpha (RORa). This observation was intriguing as previous studies had elucidated the requirement of RORa in the development of inflammatory type-2 innate lymphoid cells (ILC2s) and it has been considered the antagonizing RORa functioning would curb allergic responses. However, I observed that Tregs require RORa to suppress allergic responses. In particular, RORa regulates the expression of a TNF receptor family member DR3, which binds to the cytokine TL1A. TL1A has a role in enhancing suppressive activity of Tregs while also enhancing type-2 cytokine production from ILC2s. Hence, in the absence of DR3 in Tregs, we believe more TL1A is available to ILC2s resulting in unrestrained allergic responses.  (more…)
Author Interviews, Dermatology, JAMA, Microbiome / 19.01.2018

MedicalResearch.com Interview with: Maja-Lisa Clausen MD, Ph.D.-fellow Department of Dermatology Copenhagen University Hospital Bispebjerg  MedicalResearch.com: What is the background for this study? Response: ​The human microbiome seems to play an important role in health and disease, by influencing host cells and contributing to host immunity. A balanced interplay between host cells and resident bacteria is important, and dysbiosis is linked to several diseases, including skin diseases like atopic dermatitis. Patients with atopic dermatitis suffer from ​frequent skin infections, and their skin microbiome is dominated by S. aureus. Frequent skin infections lead to frequent use of antibiotics, and with worldwide increase in resistant bacteria, a better understanding of the interplay between host and bacteria is paramount in order to develop new treatment strategies. (more…)
Abuse and Neglect, Dermatology, Pharmacology / 11.12.2017

MedicalResearch.com Interview with: Dr. Jonathan L. Silverberg MD PhD MPH Assistant Professor in Dermatology Medical Social Sciences and Preventive Medicine Northwestern University, Chicago, Illinois MedicalResearch.com: What is the background for this study? What are the main findings? Response: Systemic corticosteroids are commonly used as systemic treatments for atopic dermatitis. However, few studies assessed the efficacy and safety of systemic corticosteroids in atopic dermatitis. This systematic review sought to summarize the available evidence for their use in atopic dermatitis. Overall, 52 reviews and 12 studies were included in this systematic review. Most studies suffered from small sample size, low quality. In one of the only randomized-controlled trials performed, systemic corticosteroids were less effective than cyclosporine and led to more rebound flares. There were numerous safety and tolerability concerns with both short and long-term treatment with systemic corticosteroids. One study found that even short-term use of systemic corticosteroids was associated with increased sepsis, venous thromboembolism and fractures. (more…)
Author Interviews, Dermatology / 20.11.2017

MedicalResearch.com Interview with: Dr. Jonathan L. Silverberg MD PhD MPH Assistant Professor in Dermatology Medical Social Sciences and Preventive Medicine Northwestern University, Chicago, Illinois MedicalResearch.com: What is the background for this study? What are the main findings? Response: Bleach baths have become widely used in clinical practice for the treatment of atopic dermatitis (AD). However, there have been conflicting results about the efficacy of bleach baths across different studies. We performed a systematic review and meta-analysis to determine whether bleach baths are consistently effective in decreasing the severity of atopic dermatitis. Bleach baths were shown to be effective at reducing AD severity in all 4 of the included studies. However, when comparing bleach baths vs. regular water baths, only 2 found significantly greater decreases in atopic dermatitis severity with bleach baths, 1 found greater decreases with water baths, and 1 found no significant differences. There were 15 different severity assessment evaluations across studies at 4 weeks: only 3 assessments demonstrated that bleach baths were more effective than water baths, 11 reported no difference, and 1 reported regular water baths to be more effective. In pooled meta-analyses, there were no significant differences observed between bleach vs water baths at 4 weeks vs baseline for the Eczema Area and Severity Index or body surface area. Finally, there were no differences of Staphylococcus aureus density, other bacteriological assessments or skin infection rates between bleach vs. water baths. (more…)