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ATOPIC DERMATITIS –
DISEASE ETIOLOGY AND
CLINICAL MANAGEMENT
Edited by Jorge Esparza-Gordillo
and Itaru Dekio
Atopic Dermatitis – Disease Etiology and Clinical Management
Edited by Jorge Esparza-Gordillo and Itaru Dekio
Published by InTech
Janeza Trdine 9, 51000 Rijeka, Croatia
Copyright © 2012 InTech
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Notice
Statements and opinions expressed in the chapters are these of the individual contributors
and not necessarily those of the editors or publisher. No responsibility is accepted for the
accuracy of information contained in the published chapters. The publisher assumes no
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materials, instructions, methods or ideas contained in the book.
Publishing Process Manager Dejan Grgur
Technical Editor Teodora Smiljanic
Cover Designer InTech Design Team
First published February, 2012
Printed in Croatia
A free online edition of this book is available at www.intechopen.com
Additional hard copies can be obtained from orders@intechweb.org
Atopic Dermatitis – Disease Etiology and Clinical Management,
Edited by Jorge Esparza-Gordillo and Itaru Dekio
p. cm.
ISBN 978-953-51-0110-9
Contents
Preface IX
Part 1 Disease Etiology 1
Chapter 1 Flaky Tail Mouse as a Novel Animal
Model of Atopic Dermatitis: Possible Roles
of Filaggrin in the Development of Atopic Dermatitis 3
Catharina Sagita Moniaga and Kenji Kabashima
Chapter 2 Mouse Models for Atopic Dermatitis Developed in Japan 21
Hiromichi Yonekawa, Toyoyuki Takada,
Hiroshi Shitara, Choji Taya, Yoshibumi Matsushima,
Kunie Matsuoka and Yoshiaki Kikkawa
Chapter 3 The Roles of Th2-Type Cytokines in the
Pathogenesis of Atopic Dermatitis 39
Kenji Izuhara, Hiroshi Shiraishi, Shoichiro Ohta,
Kazuhiko Arima and Shoichi Suzuki
Chapter 4 Epidermal Serine Proteases and Their
Inhibitors in Atopic Dermatitis 51
Ulf Meyer-Hoffert
Chapter 5 The Role of Prostanoids in Atopic Dermatitis 65
Tetsuya Honda and Kenji Kabashima
Chapter 6 Expression and Function of CCL17 in Atopic Dermatitis 81
Susanne Stutte, Nancy Gerbitzki,
Natalija Novak and Irmgard Förster
Part 2 Microrganisms in Atopic Dermatits 105
Chapter 7 Microorganisms and Atopic Dermatitis 107
Itaru Dekio
VI Contents
Chapter 8 Atopic Dermatitis and Skin Fungal Microorganisms 123
Takashi Sugita, Enshi Zhang, Takafumi Tanaka, Mami Tajima,
Ryoji Tsuboi, Yoshio Ishibashi, Akemi Nishikawa
Chapter 9 Fungus as an Exacerbating Factor of Atopic Dermatitis,
and Control of Fungi for the Remission of the Disease 141
Takuji Nakashima and Yoshimi Niwano
Part 3 Diagnosis and Clinical Management 159
Chapter 10 Atopic Dermatitis:
From Pathophysiology to Diagnostic Approach 161
Nicola Fuiano and Cristoforo Incorvaia
Chapter 11 Advances in Assessing the Severity
of Atopic Dermatitis 169
Zheng-Hong Di, Li Zhang, Ya-Ni Lv, Li-Ping Zhao,
Hong-Duo Chen and Xing-Hua Gao
Chapter 12 Physical and Chemical Factors that Improve
Epidermal Permeability Barrier Homeostasis 197
Mitsuhiro Denda
Chapter 13 Trigger Factors, Allergens
and Allergy Testing in Atopic Dermatitis 213
Evmorfia Ladoyanni
Chapter 14 Food Allergy in Atopic Dermatitis 229
Geunwoong Noh and Jae Ho Lee
Chapter 15 Clinical Management of Atopic Dermatitis 251
Soheyla Mahdavian, Patty Ghazvini, Luis Pagan,
Angela Singh and Todd Woodard
Part 4 New Treatments 267
Chapter 16 Occlusive Therapy in Atopic Dermatitis 269
Misha M. Heller, Eric S. Lee,Faranak Kamangar,
Wilson Liao and John Y. M. Koo
Chapter 17 Suplatast Tosilate for Prophylaxis of Pediatric Atopy 289
S. Yoshihara, M. Ono, Y. Yamada, H. Fukuda,
T. Abe and O. Arisaka
Chapter 18 Thinking Atopic Dermatitis Treatment Differently:
Specific Immunotherapy as an Option 299
Massimo Milani
Contents VII
Chapter 19 Improvement of Atopic Dermatitis
by Human Sebaceous Fatty Acids and Related Lipids 309
Hiroyuki Araki, Yoshiya Sugai and Hirofumi Takigawa
Chapter 20 Probiotics and Atopic Dermatitis 325
Feriel Hacini-Rachinel, Ivana Jankovic,
Anurag Singh and Annick Mercenier
Chapter 21 The Role of Probiotics in Atopic
Dermatitis Prevention and Therapy 353
Öner Özdemir
Chapter 22 Food Compounds Inhibit Staphylococcus Aureus Bacteria
and the Toxicity of Staphylococcus Enterotoxin A (SEA)
Associated with Atopic Dermatitis 387
Reuven Rasooly and Mendel Friedman
Preface
Atopic Dermatitis is a common disease characterized by inflamed, itching and dry
skin. This relapsing allergic disorder has complex etiology and shows a remarkably
high clinical heterogeneity which complicates the diagnosis and clinical management.
This book is divided into 4 sections. The first section (Disease Etiology) describes some of
the physiological mechanisms underlying Atopic Dermatitis, including alterations in the
immune system and the skin-barrier function. The important role of host-microorganism
interactions on the pathophysiology of Atopic Dermatitis is discussed in the second
section (Microorganisms in Atopic Dermatitis). An overview of the clinical diagnostic
criteria and the disease management protocols commonly used is given in the third
section (Diagnosis and Clinical Management). The last section (New Treatments)
describes new therapeutic approaches that are not widely used but are currently being
studied due to preliminary evidence showing a clinical benefit for Atopic Dermatitis.
As a co-editor, it was my greatest pleasure to work with Dr Jorge Esparza-Gordillo on
this book, which handles cutting-edge ideas on atopic dermatitis, provided by
ambitious specialists. Every chapter is a real pearl of the subject, and as a clinician-
scientist, I was delighted to read the manuscript one by one. I believe clinicians and
researchers worldwide will benefit from this book as a unique free online publication.
Thanks to Ms. Bojana Zelenika and Mr. Dejan Grgur of InTech - Open Access
Publisher, this book is published with a very quick publication process, and will thus
reach the reader with the latest information. Last but not least, I thank my wife Shoko
for her enormous support during this project.
Itaru Dekio, MD, PhD
Department of Dermatology, Faculty of Medicine,
Shimane University, Izumo,
Japan
[...]... Moniaga, et al., 2010, Presland, et al., 2000) (Fig.1) 8 Atopic Dermatitis – Disease Etiology and Clinical Management Fig 1 Flgft mouse has a truncated and smaller profilaggin and a lack of filaggrin protein 3.2 Flaky tail mouse and ichtyosis vulgaris Ichthyosis vulgaris (IV) is a heterogeneous autosomal skin disease characterized by dry and scaly skin, mild hyperkeratosis, and a decreased or absent... photographs in both wild type NC/Nga (upper low) and NCN24 mice (lower low) 26 Atopic Dermatitis – Disease Etiology and Clinical Management Imune cells Table 1 The number of immune cells in wild-type (wt) and NCN24 mice were not occurring in the first hair cycles, with congestion and scaly symptoms, and advanced dermatitis was seen in both wild type and NCN24 starting from the early anagen phase The... been noted as a disease of immunological etiology (Leung &Bieber, 2003) Elias et al proposed the outside-to-inside pathogenic mechanisms in AD for the following reasons: (1) the extent of the permeability barrier abnormality parallels the severity of the 4 Atopic Dermatitis – Disease Etiology and Clinical Management disease phenotype in AD; (2) both the clinically uninvolved skin sites and the skin cleared... Oyoshi, et al., 2009) with more total cells, 10 Atopic Dermatitis – Disease Etiology and Clinical Management lymphocytes, eosinophils, and mononuclear cells in Flgft mice compared to control mice These data support the diagnosis of AD-like dermatitis in Flgft mice in the steady state under SPF conditions Fig 4 Hematoxyllin and eosin (H&E)-stained sections in 8- and 18-week old mice Scale bar, 100µm Therefore,... 2011) Filaggrins proteolytically degraded into a pool of free amino acids including histidine and glutamine which are further converted to, respectively, urocanic acid (UCA) and 2- 6 Atopic Dermatitis – Disease Etiology and Clinical Management pyrrolidone-5-carboxylic acid (PCA) The concentrations of UCA and PCA in SC in the carriers of FLG mutations were significantly lower than those in healthy donors... These findings demonstrate that Flgft mice tend to generate allergen-specific IgE and cytokine following cutaneous allergen challenge to the skin even without additional barrier disruption 12 Atopic Dermatitis – Disease Etiology and Clinical Management Fig 6 Amount of FITC in the skin of B6 and Flgft mice (left panel) and fluorescence intensities of FITC of the skin (right panel) after topical application... tail and varitint-waddler-J J Hered, 63, 3, (May-Jun), 135-140 Lee, K H., et al (2011) Filaggrin knockdown and Toll-like receptor 3 (TLR3) stimulation enhanced the production of thymic stromal lymphopoietin (TSLP) from epidermal layers Exp Dermatol, 20, 2, (Feb), 149-151 Leung, D Y &Bieber, T (2003) Atopic dermatitis Lancet, 361, 9352, (Jan 11), 151-160 18 Atopic Dermatitis – Disease Etiology and Clinical. .. the disease might be due to: 1) the disease is polygenic and many different genetic factors may be affected with the diseases, 2) the disease is clinically heterogeneous and different subphenotypes are influenced by different risk loci, which is not always followed by one-to-one correspondence, 3) different populations have a different genetic pool and may have different genetic factors for the disease, ... proper processes Fig 2 The severity and histological features of the atopic dermatitis- like skin lesions in wild type (upper row) and NCN24 (lower row) mice during the progression of AD The atopic dermatitis- like skin lesions were observed in the pinnae and scapula of the dorsal area along with congestion and scaly symptoms, and advanced dermatitis was seen in the middle- and right-side photographs in both...Part 1 Disease Etiology 1 Flaky Tail Mouse as a Novel Animal Model of Atopic Dermatitis: Possible Roles of Filaggrin in the Development of Atopic Dermatitis Catharina Sagita Moniaga and Kenji Kabashima Department of Dermatology, Kyoto University Graduate School of Medicine Japan 1 Introduction Understanding of human diseases has been enormously expanded by the use of animal models, . ATOPIC DERMATITIS –
DISEASE ETIOLOGY AND
CLINICAL MANAGEMENT
Edited by Jorge Esparza-Gordillo
and Itaru Dekio
Atopic Dermatitis. orders@intechweb.org
Atopic Dermatitis – Disease Etiology and Clinical Management,
Edited by Jorge Esparza-Gordillo and Itaru Dekio
p. cm.
ISBN 978-953-51-0110-9
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