| 1. |
- Abdelhadi, Saly, et al.
(författare)
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Expression of calcitonin gene-related peptide in atopic dermatitis and correlation with distress
- 2024
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Ingår i: Immunopharmacology and immunotoxicology. - : TAYLOR & FRANCIS LTD. - 0892-3973 .- 1532-2513. ; 46:1, s. 67-72
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundAtopic dermatitis (AD) is a chronic, inflammatory, often severely itching skin disorder. It may worsen due to stress, depression, or anxiety. Calcitonin gene-related peptide (CGRP) may be involved in inflammation signaling. CGRP has also been suggested in relation to stress, depression, and anxiety. This study aimed to investigate the expression of CGRP in the skin of patients with AD.MethodsTwenty-seven adult patients with AD, characterized with clinical and psychodemographic parameters, were investigated regarding CGRP expression in skin biopsies, using an immunohistochemical technique.ResultsThe total number of CGRP-positive nerve-like fibers was found to be higher in lesional skin than in non-lesional skin. Moreover, more inflammatory cells of dendritic shape intruded into the epidermis in lesional skin compared to non-lesional skin. Keratinocytes showing expression of CGRP were also found in lesional skin. Interestingly, the number of CGRP-positive nerve-like fibers in lesional skin correlated with depressive and anxiety scores. Correlation with depressive score was also found for round CGRP-positive inflammatory cells in the epidermis.ConclusionsCGRP may have a role in both the inflammatory process and distress, in AD.
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| 2. |
- Abdelhadi, Saly Mustafa
(författare)
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Atopic dermatitis and distress
- 2023
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Atopic dermatitis (AD) is a chronic, inflammatory skin condition characterized by itching, redness, and skin lesions, affecting approximately 10–20% of children and 1–3% of adults worldwide. Distress associated with AD can negatively impact quality of life, work, and daily activities. The research aims were to explore the role of stress in AD patients and to further investigate brain activity during stress in AD patients compared with controls. Further, one possible mediator related to skin inflammation and stress, calcitonin gene-related peptide (CGRP), was studied in skin from AD patients and controls, and related to psychodemographic measurements. The initial parts of the project involved focus groups with patients and an online survey. Results from the focus group study and the survey study underlined the importance of stress as a trigger and worsening factor for patients with AD. Both studies indicated that stress, especially chronic stress, could be an important worsening factor. Decision-making and unforeseen events were often mentioned as stress triggers. In both the focus groups and the survey study, patients rated stress as of greater importance than climate factors. Itch was reported to be a result of stress and the type of stress possibly affected the nature of the pruritus experienced by patients. Furthermore, physical exercise was reported to have beneficial effects, something that was found in both the focus groups and the survey. Differences were found in possible mechanisms for stress processing in AD patients compared with controls. Reduced deactivation in the default mode network in response to stress (an arithmetic test) indicated that there is likely a cognitive functional variability in AD patients compared with healthy control subjects, manifested as lowered inhibition ability under psychological stress. This was also supported by different correlations between brain activities and various psycho-demographic data. Findings from a functional magnetic resonance imaging study indicated that psychological stress affected brain activities in the motor cortex, the somatosensory association cortex, and perception and sensory integration processing among AD patients. An immunohistochemical study showed an increase of CGRP in nerve-like fibers and inflammatory cells in inflamed skin of AD patients compared with non-lesional skin. The increase of CGRP-positive nerve-like fibers in skin correlated with depressive and anxiety scores in the patients. The results showed that psychological stress was an important trigger factor for AD and both differences in central processing of stress in AD and peripheral changes in CGRP levels in skin were observed. This emphasizes the importance of a holistic approach to treatment of AD, with the possibility for healthcare to offer more individualized treatment depending on each patient’s challenges and needs.
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| 3. |
- Jonsson, Tomas, et al.
(författare)
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Atopic dermatitis and stress: A functional magnetic resonance imaging study of female patients with atopic dermatitis using an arithmetic task
- 2024
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Ingår i: JEADV CLINICAL PRACTICE. - : WILEY. - 2768-6566. ; 3:2, s. 580-590
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundAtopic dermatitis (AD) is a chronic inflammatory skin disorder characterized by eczematous lesions, dry skin and persistent itch. AD may worsen due to psychological stress. However, little is known about the neural correlates that mediate the interaction between psychological stress and AD.ObjectivesTo identify the possible difference in brain activation during arithmetic-task induced stress in patients with AD versus healthy controls (HC) as well as the link between the brain response and clinical and psychodemographic parameters.MethodsA cohort of 29 AD female patients and 23 matched HC were recruited to investigate the potential difference in functional magnetic resonance imaging (fMRI) response to a block-designed arithmetic paradigm. Both the HC and AD subjects were evaluated regarding their psychological traits, and for the AD subjects also their clinical characteristics, including stress indicators such as heart rate and salivary cortisol. We employed both univariate and multivariate statistical methods to analyse the blood oxygen level dependent (BOLD) fMRI response of the subjects to the block-designed arithmetic paradigm.Results(1) Compared with HC subjects, the AD patients depict less deactivation in the default mode network including right angular gyrus, bilateral temporal pole and temporal lobe in response to the arithmetic task. (2) The BOLD fMRI response amplitude in the right postcentral gyrus and inferior parietal lobule is positively correlated with the stress susceptibility scores in the AD subjects, whereas the trend was the opposite of this for the HC subjects. (3) The activation in the postcentral gyrus also shows a correlation with the degree of itch in the AD patients.ConclusionsThe BOLD fMRI measurements based on an arithmetic paradigm can provide useful insight into altered brain processing and its association with psychological traits and clinical characteristics in subjects with AD. Psychological stress exacerbates brain activities for the AD subjects in the motor, somatosensory association cortex, perception and sensory integration processing. The postcentral gyrus might be of particular interest for itch and stress.
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| 4. |
- Lönndahl, Louise, et al.
(författare)
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Psychological Stress and Atopic Dermatitis : A Focus Group Study
- 2023
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Ingår i: Annals of Dermatology. - : The Korean Dermatological Association; The Korean Society for Investigative Dermatology. - 1013-9087 .- 2005-3894. ; 35:5, s. 342-347
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Atopic dermatitis (AD) is a chronic inflammatory skin disorder. It is often reported to be worsened by psychological stress.OBJECTIVE: To explore the role of psychological stress and related triggers in AD, and its connection to worsening of this disease, focusing on patients' perspectives.METHODS: In total, 28 patients with AD were included in focus groups. Topics regarding psychological stress and psychological triggers were discussed.RESULTS: The hypothesis that psychological stress may have impact on eczema and its pruritus was supported by all of the patients. Distinguishing the worsening effect of psychological stress from effects of physiological triggers, such as infection, climate and allergic factors, was claimed to be difficult by many patients. Most of the patients thought that chronic stress affected the AD more when compared to acute stress. Family problems, financial problems, work overload, school exam periods, lack of structure at work, and unforeseen events were identified as important psychological triggers. Conventional treatment/therapy with topical corticosteroids and emollients, UV light treatment, were suggested as possible treatments, as well as psychological intervention and physical exercise.CONCLUSION: Psychological stress is an important factor to consider in the management of patients with AD. In particular, chronic stress tends to worsen AD. The type of stress can possibly also affect the quality of the pruritus experienced by the patients. Unforeseen events and decision making were frequently mentioned as important triggers. Furthermore, physical exercise was reported to provide beneficial effects.
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