Atopic dermatitis future or investigational therapies: Difference between revisions
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== Overview == | == Overview == | ||
== | ==Investigational therapies== | ||
A more novel form of treatment involves exposure to broad or narrow-band ultraviolet light. UV radiation exposure has been found to have a localized immunomodulatory effect on affected tissues, and may be used to decrease the severity and frequency of flares <ref>Beattie PE, Finlan LE, Kernohan NM, Thomson G, Hupp TR, Ibbotson SH. The effect of ultraviolet (UV)A1, UVB and solar-simulated radiation on p53 activation and p21. The British Journal of Dermatology. 2005 May;152(5):1001-8</ref>. In particular, Meduri et al. have suggested that the usage of UVA1 is more effective in treating acute flares, whereas narrow-band UVB is more effective in long-term management scenarios <ref>Meduri NB, Vandergriff T, Rasmussen H, Jacobe H. Phototherapy in the management of atopic dermatitis: a systematic review. Photodermatology, Photoimmunology and Photomedicine. 2007 Aug;23(4):106-12</ref>. However, UV radiation has also been implicated in various types of skin cancer <ref>Jans J, Garinis GA, Schul W, van Oudenaren A, Moorhouse M, Smid M, Sert YG, van der Velde A, Rijksen Y, de Gruijl FR, van der Spek PJ, Yasui A, Hoeijmakers JH, Leenen PJ, van der Horst GT. Differential role of basal keratinocytes in UV-induced immunosuppression and skin cancer. Molecular and Cellular Biology. 2006 Nov; 26(22) pp. 8515-26</ref>, and thus UV treatment is not without risk. | A more novel form of treatment involves exposure to broad or narrow-band ultraviolet light. UV radiation exposure has been found to have a localized immunomodulatory effect on affected tissues, and may be used to decrease the severity and frequency of flares <ref>Beattie PE, Finlan LE, Kernohan NM, Thomson G, Hupp TR, Ibbotson SH. The effect of ultraviolet (UV)A1, UVB and solar-simulated radiation on p53 activation and p21. The British Journal of Dermatology. 2005 May;152(5):1001-8</ref>. In particular, Meduri et al. have suggested that the usage of UVA1 is more effective in treating acute flares, whereas narrow-band UVB is more effective in long-term management scenarios <ref>Meduri NB, Vandergriff T, Rasmussen H, Jacobe H. Phototherapy in the management of atopic dermatitis: a systematic review. Photodermatology, Photoimmunology and Photomedicine. 2007 Aug;23(4):106-12</ref>. However, UV radiation has also been implicated in various types of skin cancer <ref>Jans J, Garinis GA, Schul W, van Oudenaren A, Moorhouse M, Smid M, Sert YG, van der Velde A, Rijksen Y, de Gruijl FR, van der Spek PJ, Yasui A, Hoeijmakers JH, Leenen PJ, van der Horst GT. Differential role of basal keratinocytes in UV-induced immunosuppression and skin cancer. Molecular and Cellular Biology. 2006 Nov; 26(22) pp. 8515-26</ref>, and thus UV treatment is not without risk. | ||
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Many of the same types of treatment are used in domestic dogs with atopic dermatitis. In addition, domestic dogs may be successfully managed with allergen-specific immunotherapy; many are treated with low-dose cyclosporine lipid emulsion. | Many of the same types of treatment are used in domestic dogs with atopic dermatitis. In addition, domestic dogs may be successfully managed with allergen-specific immunotherapy; many are treated with low-dose cyclosporine lipid emulsion. | ||
==Future research== | |||
It was less than ten years ago that the researchers discovered the first mouse model to spontaneously developed AE-like lesions, the inbred NC/Nga mouse.<ref>Gutermuth, J. et al. Mouse models of atopic eczema critically evaluated. Intl Arch Allergy Immunol 135 (2004), pp. 262-276.</ref> These models have been used for tests that would have been impossible in humans, like the administration of Mycobacterium vaccae for the possible prevention of AE-like lesions.<ref>Arkwright, P.D. et al. Mycobacterium vaccae reduces scratching behavior but not the rash in NC mice with eczema: a randomized, blinded, placebo-controlled trial. J Invest Dermatol 124 (2005), pp. 140-143. </ref> | |||
==References== | ==References== | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Investigational therapies
A more novel form of treatment involves exposure to broad or narrow-band ultraviolet light. UV radiation exposure has been found to have a localized immunomodulatory effect on affected tissues, and may be used to decrease the severity and frequency of flares [1]. In particular, Meduri et al. have suggested that the usage of UVA1 is more effective in treating acute flares, whereas narrow-band UVB is more effective in long-term management scenarios [2]. However, UV radiation has also been implicated in various types of skin cancer [3], and thus UV treatment is not without risk.
If ultraviolet light therapy is employed, initial exposure should be no longer than 5-10 minutes, depending on skin type. UV therapy should only be moderate, and care special should be taken to avoid sunburn (sunburn will only aggravate the eczema). It does not necessarily have to be administered in a hospital, it can be done at a tanning salon or in natural sunlight, so as long as it's done under the direction and supervision of a dermatologist.
Many of the same types of treatment are used in domestic dogs with atopic dermatitis. In addition, domestic dogs may be successfully managed with allergen-specific immunotherapy; many are treated with low-dose cyclosporine lipid emulsion.
Future research
It was less than ten years ago that the researchers discovered the first mouse model to spontaneously developed AE-like lesions, the inbred NC/Nga mouse.[4] These models have been used for tests that would have been impossible in humans, like the administration of Mycobacterium vaccae for the possible prevention of AE-like lesions.[5]
References
- ↑ Beattie PE, Finlan LE, Kernohan NM, Thomson G, Hupp TR, Ibbotson SH. The effect of ultraviolet (UV)A1, UVB and solar-simulated radiation on p53 activation and p21. The British Journal of Dermatology. 2005 May;152(5):1001-8
- ↑ Meduri NB, Vandergriff T, Rasmussen H, Jacobe H. Phototherapy in the management of atopic dermatitis: a systematic review. Photodermatology, Photoimmunology and Photomedicine. 2007 Aug;23(4):106-12
- ↑ Jans J, Garinis GA, Schul W, van Oudenaren A, Moorhouse M, Smid M, Sert YG, van der Velde A, Rijksen Y, de Gruijl FR, van der Spek PJ, Yasui A, Hoeijmakers JH, Leenen PJ, van der Horst GT. Differential role of basal keratinocytes in UV-induced immunosuppression and skin cancer. Molecular and Cellular Biology. 2006 Nov; 26(22) pp. 8515-26
- ↑ Gutermuth, J. et al. Mouse models of atopic eczema critically evaluated. Intl Arch Allergy Immunol 135 (2004), pp. 262-276.
- ↑ Arkwright, P.D. et al. Mycobacterium vaccae reduces scratching behavior but not the rash in NC mice with eczema: a randomized, blinded, placebo-controlled trial. J Invest Dermatol 124 (2005), pp. 140-143.