Topical Anti‐Inflammatory Treatments for Eczema: A Cochrane Systematic Review and Network Meta‐Analysis
Clinical & Experimental Allergy,
Journal Year:
2024,
Volume and Issue:
54(12), P. 960 - 972
Published: Sept. 2, 2024
Eczema
is
the
most
burdensome
skin
condition
worldwide
and
topical
anti-inflammatory
treatments
are
commonly
used
to
control
symptoms.
The
relative
effectiveness
safety
of
different
uncertain.
Language: Английский
Changes and clinical significance of serum vitamin A, 25-(OH)D3, TG2, IL-4 and IL-13 levels in children with eczema
Archives of Dermatological Research,
Journal Year:
2025,
Volume and Issue:
317(1)
Published: Feb. 8, 2025
Language: Английский
DIFENSE Study Protocol: Early Intervention With Difamilast Ointment in Infantile Early‐Onset Atopic Dermatitis for Prevention of Transcutaneous Sensitisation
Kiwako Yamamoto‐Hanada,
No information about this author
Kazuyoshi Okamoto,
No information about this author
Nobuharu Kishimoto
No information about this author
et al.
Clinical & Experimental Allergy,
Journal Year:
2025,
Volume and Issue:
unknown
Published: March 26, 2025
Atopic
dermatitis
(AD)
is
acknowledged
as
the
first
phase
in
allergic
march,
with
heightened
IgE
levels
[1]
linked
to
a
greater
likelihood
of
experiencing
food
allergy
symptoms
[2].
Importantly,
occurrence
early-onset
AD
during
infancy
has
been
found
significantly
increase
odds
ratio
for
development
allergies
[3].
Additionally,
suitable
transdermal
and
oral
interventions
may
impact
trajectory
which
includes
prevention
allergies.
The
'dual
allergen
exposure
hypothesis'
suggested
mechanistic
framework
allergies,
since
randomised
controlled
trials
(RCTs)
have
validated
effectiveness
both
treatments,
this
hypothesis
effectively
evolved
into
an
established
theory.
Numerous
RCTs
explored
potential
moisturisers
preventing
part
skincare
strategies.
Nevertheless,
variations
study
populations,
types
moisturisers,
frequencies
application
skin
cleansing
protocols
led
inconsistent
results.
Large-scale
carried
out
Northern
Europe
United
Kingdom
not
substantiated
preventative
effects
on
A
Cochrane
Review
by
Kelleher
et
al.
[4]
determined
that
interventions,
include
use
do
aid
children.
distinguished
dysfunctional
barrier,
chronic
inflammation
pruritus.
Interventions
focus
exclusively
restoration
barrier
through
demonstrated
be
insufficient
mitigating
onset
In
addition,
RCT
performed
utilisation
mild
nonsteroidal
topical
agent
(pimecrolimus)
solely
affected
eczema
lesions
did
inhibit
[5].
This
outcome
indicates
minimal
anti-inflammatory
treatments
targeting
only
visibly
regions
fall
short
reducing
risk
even
appears
normal
shows
compromised
function
inflammatory
markers,
reflecting
existence
subclinical
at
molecular
level
[6].
As
result,
successfully
percutaneous
sensitisation
demands
well-rounded
strategy
integrates
improvement
reaching
beyond
visible
cover
nonlesional
skin.
Infants
who
manifest
1–2
months
life
exhibit
greatest
developing
particularly
those
exhibiting
before
introduction
solid
foods,
exacerbates
their
further
infants
are
demographic
most
urgently
needs
preventive
actions.
retrospective
analysis
conducted
our
institution
indicated
prompt
intervention
following
manifestation
AD,
encompassing
proactive
treatment
administered
regions,
was
associated
reduced
probability
[7].
After
achieving
remission,
maintaining
strict
control
becomes
essential
lower
IgE-mediated
Conventional
strategies
concentrate
entirely
might
sufficient
attaining
complete
PACI
Study
[8],
multicentre
trial
2023,
early
protocol
implemented,
included
applying
corticosteroids
(TCS)
eczematous
but
also
areas.
produced
25%
decline
prevalence
egg
age
28
weeks
relative
standard
treatment.
However,
group
statistically
lowered
body
weight
height
compared
conventional
group,
although
definitive
link
between
TCS
dosage
these
outcomes
(weight
height)
found.
These
results
suggest
importance
individualised
plans
rather
than
generalised
approach
all
infants.
Recently,
difamilast
ointment
[9],
new
medication,
come
light
adjunctive
alongside
TCS.
Difamilast
supports
implementation
treatment,
allowing
persistent
while
alleviating
adverse
effects,
period
remission
maintenance.
To
delve
deeper
atopic
(AD),
we
embarked
DIFENSE
(jRCTs031240529)
(Figure
1).
(Early
Intervention
Ointment
Infantile
Early-Onset
Dermatitis
Prevention
Transcutaneous
Sensitization)
multicentre,
randomised,
comparative
exploratory
will
last
16
weeks.
recruit
150
infants,
100
allocated
50
group.
primary
endpoint
assess
percentage
sensitised
serum
white,
ovomucoid,
milk,
wheat,
omega-5
gliadin,
walnut,
Jug
r
1,
peanut
Ara
h
2
enrolment.
Eligible
participants
aged
42
90
days
diagnosed
based
UKWP
criteria
within
initial
symptoms.
article's
Online
Repository
https://zenodo.org/records/14942018.
We
anticipate
provide
pioneering
evidence
support
advanced
designed
prevent
subsequent
K.Y.-H.,
K.O.,
N.K.,
T.K.
Y.O.
conceived
idea
study.
All
authors
contributed
establishing
protocol.
supervised
conduct
reviewed
manuscript
draft
revised
it
critically
intellectual
content.
approved
publication
final
version
manuscript.
supported
grant
from
AMED
(Grant
number,
JP
23gn0110078s020,
JP24hk010299j0001,
JP24ek0410104h0002)
Otsuka
Pharmaceutical
Co.
Ltd.
English
editing
Grammarly.
National
Center
Child
Health
Development
signed
joint
research
agreement.
K.O.
N.K.
employees
Currently,
individual
participant
data
sharing
unavailable
because
IRB
permission
yet
obtained.
Individual
available
after
granted.
Any
queries
can
emailed
Primary
Investigator
Kiwako
Yamamoto-Hanada
[email
protected].
Language: Английский
Skin and oral intervention for food allergy prevention based on the dual allergen exposure hypothesis
Clinical and Experimental Pediatrics,
Journal Year:
2023,
Volume and Issue:
67(10), P. 477 - 485
Published: June 19, 2023
Early-onset
atopic
dermatitis
increases
an
individual’s
risk
of
food
allergies,
suggesting
that
transcutaneous
sensitization
may
occur
through
inflamed
skin.
Regarding
allergy
causation,
the
dual
allergen
exposure
hypothesis
proposes
oral
leads
to
immune
tolerance,
whereas
via
skin
causes
allergies.
This
suggests
it
is
important
induce
tolerance
and
prevent
allergic
review
focuses
on
breakthrough
evidence
based
involves
both
interventions
for
prevention.
Language: Английский
KITY Study Protocol: A Randomised Controlled Trial for Eczema Prevention by Ingestion of Kestose in High‐Risk Neonates
Clinical & Experimental Allergy,
Journal Year:
2024,
Volume and Issue:
unknown
Published: Dec. 18, 2024
Atopic
eczema
represents
one
of
the
prevalent
dermatological
conditions
encountered
in
routine
clinical
settings,
with
cohort
investigations
revealing
that
approximately
30%
infants
exhibit
symptoms
during
early
stages
life.
This
condition
serves
as
a
critical
precursor
to
series
allergic
manifestations
termed
'atopic
march',
thereby
underscoring
significance
implementing
preventive
measures
at
an
stage
[1].
Eczema
is
characterised
multifactorial
disorder,
indicating
integrative
approach
addressing
various
interconnected
elements
imperative.
Investigations
centered
around
'skin-gut
axis'
have
been
progressing,
microbiome
instrumental
pathophysiology
dermal
conditions.
The
operates
regulator
immune
system,
facilitating
bidirectional
communication
diverse
tissues
and
organs
sustain
homeostasis.
Dysbiosis,
defined
imbalance
within
microbiome,
both
skin
gastrointestinal
tract,
significantly
correlated
aberrant
responses
recognised
contributing
factor
onset
eczema.
In
recent
years,
it
has
posited
enteral
strategies
aimed
modulating
microbiomes
could
serve
promising
avenue
for
management
prophylaxis
diseases.
Our
studies
(T-CHILD
JECS)
indicated
relationship
between
antibiotic
exposure
disrupting
gut
incidence
conditions,
including
[2]
FPIES
[3]
general
populations,
suggesting
enhancing
microbiota
equilibrium
such
prebiotics
may
play
role
prevention.
However,
specific
advocated
by
existing
guidelines
currently
lack
robust
empirical
support.
Notwithstanding,
from
scientific
viewpoint,
promotion
balanced
highly
plausible
exert
effects
against
development
Prebiotics
are
compounds
remain
unaltered
unabsorbed
proximal
functioning
substrates
intestinal
preservation
health.
Grüber
et
al.
[4]
demonstrated
formulation
incorporating
oligosaccharides
time
birth
mitigate
Nonetheless,
2017,
Cuello-Garcia
[5]
published
comprehensive
systematic
review
assessing
prophylactic
impact
on
eczema,
which
revealed
no
statistically
significant
variations.
showed
overall
effect
was
reduction
risk
when
compared
control
group,
although
confidence
interval
did
not
exclude
null
(RR,
0.68;
95%
CI,
0.40–1.15;
2030
participants;
six
trials).
Among
array
prebiotics,
our
investigation
concentrated
specifically
kestose.
Kestose
classified
trisaccharides,
comprising
combination
sucrose
fructose
via
β-1,1-glycosidic
linkage.
resistant
digestion.
ingested
orally,
kestose
transported
lower
tract
without
being
digested
[6].
It
selectively
utilised
microbiota.
shown
enhance
proliferation
butyrate-producing
bacterial
strains
(Faecalibacterium
prausnitzii)
[7],
elevating
butyrate
concentrations.
Butyrate
anticipated
facilitate
differentiation
regulatory
T
cells
(Tregs)
manifestations.
Shibata
[8]
reported
findings
regarding
therapeutic
efficacy
context
involving
30
children
below
age
three
diagnosed
intervention
group
daily
over
12-week
period,
whereas
consumed
maltose.
Post-intervention,
SCORAD
score
registered
19.5
37.5
maltose
signifying
amelioration
(p
<
0.001).
As
milk
allergy
children,
enhanced
relative
abundance
Faecalibacterium
species
modestly
increased
dose
cow's
tolerated
[9].
there
exists
dearth
prior
examining
preventative
We
undertaking
double-blind,
randomised,
two-group
parallel
comparison
study
kestose,
prebiotic,
high-risk
contrasting
intake
(Kestose
Intake
prevention
atopic
dermatitis
Tokyo;
KITY
Study)
registration
Japan
Registry
Clinical
Trials
(jRCT):
ID:
jRCTs031220020
(https://jrct.niph.go.jp/en-latest-detail/jRCTs031220020).
does
administer
pregnant
women
(Figure
1).
protocol
this
article's
Online
Repository
10.5281/zenodo.13905238.
K.Y.-H.,
M.S.-A.,
Y.I.
Y.O.
conceived
idea
study.
All
authors
contributed
fix
protocol.
K.P.
contributes
statistics.
T.K.
advised
procedure.
M.S.-A.
drafted
original
manuscript.
K.T.,
H.O.
D.H.
recruited
followed
participants.
Y.H.,
H.M.
K.M.
handled
blood
samples.
T.F.,
K.Y.-H.
supervised
conduct
reviewed
manuscript
draft
revised
critically
intellectual
content.
approved
publication
final
version
Ms.
Miwako
Seike
Mariko
Noda
developed
data
plan
Dr.
Mayumi
Sako,
Nozomi
Fukui
Tomoko
Matsushita
monitoring
Kozue
Miyake,
Yuki
Saito,
Junko
Ikeda,
Saki
Ueno,
Saya
Kitami,
Yukie
Miyata,
Mr.
Sora
Nazuka,
Sayuri
Tateai,
Kazuko
Hayase,
Takako
Kimura,
Nishimura,
Kumiko
Watabe
Emiko
Matsuzaka
supported
research
based
Japanese
Act
(Act
No.
16
14
April
2017)
described
website
(https://www.mhlw.go.jp/file/06-Seisakujouhou-10800000-Iseikyoku/0000213334.pdf).
Certified
Review
Board
National
Center
Child
Health
Development
February
24,
2022
(Reference
number:
CRB3200005).
trial
(https://jrct.niph.go.jp/en-latest-detail/jRCTs031220020)
13,
2022.
parents
provided
their
written
consent
participation
before
we
enrolled
trial.
conducted
collaborative
project
funded
Natural
Science
Co.
Ltd.
involved
certain
aspects
(such
provision
delivery
test
sugar,
sugar
cosmetics
participants)
preparing
presentation
materials
assisting
writing
conference
presentations).
they
analysis
results.
There
conflict
interest
planning,
implementation,
interpretation
or
results
would
affect
rights
interests
principal
investigator
manages
following
Conflict
Interest
Management
Guidance
under
submitted
standard
Research
approval.
Each
researcher
appropriately
any
conflicts
related
standards
plans
discloses
them
required
academic
conferences
medical
journals
presented.
support
available
request
corresponding
author.
publicly
due
privacy
ethical
restrictions.
Language: Английский