| 1. |
- Elmelid, Andrea, 1986, et al.
(författare)
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Effects of Phototherapy on Free Vitamin D Levels in Ten Patients with Atopic Dermatitis
- 2022
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Ingår i: International Journal of Translational Medicine. - : MDPI AG. - 2673-8937. ; 2:4, s. 586-596
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Tidskriftsartikel (refereegranskat)abstract
- The role of vitamin D in atopic dermatitis (AD) is controversial. Conflicting data could be due to the use of inadequate markers for assessing vitamin D status. So far, directly measured free 25(OH)D concentrations have not been reported in AD patients. Ten adults with AD were treated with narrow band ultraviolet light B (NB-UVB) for 10–12 weeks. SCORing atopic dermatitis (SCORAD) and the visual analogue scale (VAS) were used to assess disease severity before and after NB-UVB therapy. Total and free 25(OH)D and 1,25(OH)2D serum levels were analyzed before and after treatment. Free 25(OH)D concentrations were measured with a two-step immunosorbent assay (ELISA). The majority of patients had sufficient levels of 25(OH)D before treatment (mean 76.4 nmol/L). Mean free 25(OH)D was 11.9 pmol/L and mean 1,25(OH)2D was 108.9 pmol/L. Median SCORAD decreased from 37.1 to 19.8 and VAS improved significantly after phototherapy. Total and free 25(OH)D increased in all subjects. No correlations between disease severity and vitamin D levels were found. There was no correlation between total and free 25(OH)D levels. Larger studies are needed to test the applicability of the free hormone hypothesis in AD pathogenesis.
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| 2. |
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| 3. |
- Alsterholm, Mikael, 1977, et al.
(författare)
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Antimicrobial activity of topical skin pharmaceuticals - an in vitro study
- 2010
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Ingår i: Acta Dermato-Venereologica. - : Medical Journals Sweden AB. - 0001-5555. ; 90:3, s. 239-245
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to investigate the antimicrobial activity of currently available topical skin pharmaceuticals against Candida albicans, Escherichia coli, Staphylococcus aureus, Staphylococcus epidermidis and Streptococcus pyogenes. The agar dilution assay was used to determine the minimal inhibitory concentration for cream formulations and their active substances. Corticosteroid formulations with the antiseptics clioquinol or halquinol were active against all microbes. The hydrogen peroxide formulation was primarily active against staphylococci. Clotrimazole, miconazole and econazole showed an effect against staphylococci in addition to their effect on C. albicans. In contrast, terbinafine had no antibacterial effect. Fusidic acid was active against staphylococci, with slightly weaker activity against S. pyogenes and no activity against C. albicans or E. coli. In summary, some topical skin pharmaceuticals have broad antimicrobial activity in vitro, clioquinol and halquinol being the most diverse. In limited superficial skin infection topical treatment can be an alternative to systemic antibiotics and should be considered. With the global threat of multi-resistant bacteria there is a need for new, topical, non-resistance-promoting, antimicrobial preparations for the treatment of skin infections.
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| 4. |
- Alsterholm, Mikael, 1977, et al.
(författare)
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Establishment and utility of SwedAD : a nationwide Swedish registry for patients with atopic dermatitis receiving systemic pharmacotherapy
- 2023
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Ingår i: Acta Dermato-Venereologica. - : Medical Journals Sweden AB. - 0001-5555 .- 1651-2057. ; 103
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Tidskriftsartikel (refereegranskat)abstract
- SwedAD, a Swedish nationwide registry for patients with atopic dermatitis receiving systemic pharmacotherapy, was launched on 1 September 2019. We describe here the establishment of a user-friendly registry to the benefit of patients with atopic dermatitis. By 5 November 2022, 38 clinics had recorded 931 treatment episodes in 850 patients with an approximate national coverage rate of 40%. Characteristics at enrolment included median Eczema Area and Severity Index (EASI) 10.2 (interquartile range 4.0, 19.4), Patient-Oriented Eczema Measure (POEM) 18.0 (10.0, 24.0), Dermatology Life Quality Index (DLQI) 11.0 (5.0, 19.0) and Peak Itch Numerical Rating Scale-11 (NRS-11) 6.0 (3.0, 8.0). At 3 months, median EASI was 3.2 (1.0, 7.3) and POEM, DLQI, and NRS-11 were improved. Regional coverage varied, reflecting the distribution of dermatologists, the ratio of public to private healthcare, and difficulties in recruiting certain clinics. This study highlights the importance of a nationwide registry when managing systemic pharmacotherapy of atopic dermatitis.
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| 5. |
- Alsterholm, Mikael, 1977, et al.
(författare)
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Frequency of bacteria, Candida and malassezia species in balanoposthitis.
- 2008
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Ingår i: Acta dermato-venereologica. - : Medical Journals Sweden AB. - 0001-5555 .- 1651-2057. ; 88:4, s. 331-6
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Tidskriftsartikel (refereegranskat)abstract
- Balanoposthitis is an inflammatory disorder of the prepuce and glans penis. Microbes involved in balanoposthitis have been investigated, but no single study has covered the growth of both bacteria, Candida and Malassezia. We report here the prevalence of these microbes in 100 patients with balanoposthitis and in 26 control patients. Among patients with balanoposthitis there was a significantly higher frequency of positive cultures than in the control group (59% and 35%, respectively, p<0.05). In the balanoposthitis group Staphylococcus aureus was found in 19%, group B streptococci in 9%, Candida albicans in 18% and Malassezia in 23% of patients. In the control group S. aureus was not found at all, whereas C. albicans was found in 7.7% and Malassezia in 23% of patients. Different microbes did not correspond with distinct clinical manifestations. In summary, we report increased frequency of microbes, specifically S. aureus, in the area of the prepuce and glans penis in balanoposthitis.
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| 6. |
- Alsterholm, Mikael, 1977, et al.
(författare)
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Fusidic acid-resistant Staphylococcus aureus in impetigo contagiosa and secondarily infected atopic dermatitis.
- 2010
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Ingår i: Acta dermato-venereologica. - : Medical Journals Sweden AB. - 0001-5555. ; 90:1, s. 52-7
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Tidskriftsartikel (refereegranskat)abstract
- Fusidic acid-resistant Staphylococcus aureus (FRSA) has been identified as a causative agent in outbreaks of impetigo and its emergence has been associated with increased use of topical fusidic acid. The frequency of FRSA in atopic dermatitis (AD) has been less extensively investigated. The aim of this study was to investigate the bacterial spectrum and frequency of FRSA in patients with impetigo or secondarily infected AD. A prospective study in our clinic in 2004 to 2008 included 38 patients with impetigo and 37 with secondarily infected AD. S. aureus was the predominant finding in all groups (bullous impetigo 92% (12/13), impetigo 76% (19/25) and secondarily infected AD 89% (33/37)). Seventy-five percent of S. aureus were fusidic acid resistant in bullous impetigo, 32% in impetigo and 6.1% in secondarily infected AD (bullous impetigo vs. AD p < 0.0001, impetigo vs. AD p < 0.05). We then performed a retrospective patient record review including all patients with impetigo or secondarily infected AD seen at the clinic during the first and last year of the prospective study. In the first year 33% (19/58) of the S. aureus isolates were fusidic acid-resistant in impetigo and 12% (5/43) in secondarily infected AD (p < 0.05). In the last year corresponding values were 24% (6/25) for impetigo and 2.2% (1/45) for AD (p < 0.01). In summary, the prospective study and the patient record review both showed higher FRSA levels in impetigo than in AD. FRSA levels were persistently low in AD. Continued restrictive use of topical fusidic acid is advised to limit an increase in FRSA levels in dermatology patients.
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| 7. |
- Alsterholm, Mikael, 1977
(författare)
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Studies on colonization and infection with Staphylococcus aureus and other microbes in skin disease
- 2012
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The skin is colonized with a wide range of microbes. Some offer vital protection from colonization and infection with pathogenic strains while others have the capacity to cause or exacerbate disease. The aim of this thesis was to investigate the role and management of microbes found on skin affected by three disorders; balanoposthitis, impetigo and atopic dermatitis (AD). Paper I investigates the frequency and distribution of bacteria, Candida and Malassezia species in balanoposthitis, a common inflammatory and/or infectious disorder of the prepuce and glans penis. Patients with balanoposthitis were colonized with microbes more often than a control group. Specifically, S. aureus was found in 19% of patients with balanoposthitis and not at all in the control group. There was no significant increase of Candida species in balanoposthitis. Different clinical manifestations did not predict the presence of specific microbes. There was no association with seborrhoeic dermatitis or psorisasis. Paper II describes the bacterial spectrum and proportion of fusidic acid-resistant S. aureus (FRSA) in cultures from lesional skin in impetigo and secondarily infected AD. S. aureus was the most frequent finding (76-93%) and fusidic acid-resistance was found in 75%, 32% and 6.1% of S. aureus isolates form patients with bullous impetigo, non-bullous impetigo and secondarily infected AD, respectively. In paper III the in vitro antimicrobial activity of topical skin pharmaceuticals was tested against S. aureus, S. epidermidis, Streptococcus pyogenes, Escherichia coli and Candida albicans. Formulations with clioquinol, halquinol and hydrogen peroxide had a broad antimicrobial effect. The azole class of antifungal formulations had an anti-staphylococcal effect. Paper IV describes the variations in S. aureus colonization in relation to the severity of AD (assessed with SCORAD) in adult patients during a 5-month follow-up. High density of S. aureus on lesional skin, colonization of multiple body sites and persistent colonization with one strain was associated with more severe disease. Conclusion: Balanoposthitis is associated with increased colonization with potentially pathogenic microbes. The primary therapeutic target in mild to moderate cases without overt signs of infection should be to decrease inflammation and microbial load with a topical corticosteroid-antimicrobial combination. FRSA are a common cause of impetigo but have remained relatively infrequent in secondarily infected AD. Use of topical fusidic promotes the spread of resistant strains and should be avoided. Topical non-resistance-promoting anti-septic formulations could be useful in the management of superficial skin infections and help reduce the use of systemic antibiotic treatment. Detailed investigation of different aspects of S. aureus colonization in relation to AD severity can increase understanding of the complex S. aureus-AD interaction and the possible value of anti-staphylococcal interventions in clinically non-infected AD. Keywords: balanoposhtitis; microbes; Staphylococcus aureus; Candida; Malassezia; fusidic acid; fusidic acid-resistant S. aureus; impetigo; atopic dermatitis; azoles; clioquinol; halquinol; hydrogen peroxide; skin infection; SCORAD ISBN: 978-91-628-8565-6 Gothenburg 2012
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| 8. |
- Bergh Thorén, Fredrik, 1976, et al.
(författare)
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Human NK Cells induce neutrophil apoptosis via an NKp46- and Fas-dependent mechanism.
- 2012
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Ingår i: Journal of immunology (Baltimore, Md. : 1950). - : The American Association of Immunologists. - 1550-6606 .- 0022-1767. ; 188:4, s. 1668-74
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Tidskriftsartikel (refereegranskat)abstract
- Polymorphonuclear neutrophils (PMN) are potent inflammatory effector cells essential to host defense, but at the same time they may cause significant tissue damage. Thus, timely induction of neutrophil apoptosis is crucial to avoid tissue damage and induce resolution of inflammation. NK cells have been reported to influence innate and adaptive immune responses by multiple mechanisms including cytotoxicity against other immune cells. In this study, we analyzed the effect of the interaction between NK cells and neutrophils. Coculture experiments revealed that human NK cells could trigger caspase-dependent neutrophil apoptosis in vitro. This event was dependent on cell-cell contact, and experiments using blocking Abs indicated that the effect was mediated by the activating NK cell receptor NKp46 and the Fas pathway. CD56-depleted lymphocytes had minimal effects on neutrophil survival, suggesting that the ability to induce neutrophil apoptosis is specific to NK cells. Our findings provide evidence that NK cells may accelerate neutrophil apoptosis, and that this interaction may be involved in the resolution of acute inflammation.
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| 9. |
- Davidsson, Lisa, et al.
(författare)
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A simple skin blister technique for the study of in vivo transmigration of human leukocytes.
- 2013
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Ingår i: Journal of immunological methods. - : Elsevier BV. - 1872-7905 .- 0022-1759. ; 393:1-2, s. 8-17
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Tidskriftsartikel (refereegranskat)abstract
- The study of human leukocytes is almost exclusively conducted using cells isolated from peripheral blood. This is especially true for neutrophils, despite the fact that these cells are of main (pathological) importance in extravascular tissues upon e.g., infection and/or tissue damage. The journey from circulation to tissue is typically associated with a number of cellular changes, making the cells primed, or hyper-responsive, and in many aspects distinct from the cells present in circulation. Models to obtain in vivo transmigrated leukocytes from human tissue are available, but not widely used. We describe here an easy-to-use model for the study of local inflammation, stemming from limited tissue damage, which can be used to isolate viable and functional leukocytes. The model is based on the generation of aseptic skin blisters, formed by the application of negative pressure, and allows for investigations of the cellular infiltrate as well as of soluble mediators present in the exudate. We believe that this method, combined with modern analysis equipment suitable for small volumes and cell numbers, could be of great use for increasing our understanding of the nature and function of leukocytes that have left circulation and transmigrated to inflamed tissues.
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| 10. |
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| 11. |
- Lindén, D, et al.
(författare)
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PPARalpha deficiency increases secretion and serum levels of apolipoprotein B-containing lipoproteins.
- 2001
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Ingår i: Journal of lipid research. - 0022-2275. ; 42:11, s. 1831-40
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Tidskriftsartikel (refereegranskat)abstract
- This study investigates the importance of peroxisome proliferator activated receptor alpha (PPARalpha) for serum apolipoprotein B (apoB) levels and hepatic secretion of apoB-containing lipoproteins. Total serum apoB and VLDL-apoB levels were higher in female PPARalpha-null mice compared with female wild-type mice, but no difference was seen in male mice. Furthermore, hepatic triglyceride secretion rate, determined in vivo after Triton WR1339 injection, was 2.4-fold higher in female PPARalpha-null mice compared with female wild-type mice, but no difference was observed in male mice. However, when fed a high fat diet, male PPARalpha-null mice displayed 2-fold higher serum levels of apoB and LDL cholesterol compared with male wild-type mice, but triglyceride levels were not affected. Hepatic LDL receptor protein levels were not influenced by PPARalpha deficiency, gender, or the fat diet. Hepatocyte cultures from female PPARalpha-null mice (cultured for 4 days in serum free medium) showed 2-fold higher total apoB secretion and increased secretion of apoB-48 VLDL, as well as 2.7-fold larger accumulation of VLDL-triglycerides in the medium compared with wild-type cultures. In conclusion, PPARalpha-deficient female mice, but not males, display high serum apoB associated with VLDL and increased hepatic triglyceride secretion. Moreover, male PPARalpha-null mice show increased susceptibility to high fat diet in terms of serum apoB levels.
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| 12. |
- Polesie, Sam, et al.
(författare)
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A systematic review investigating the proportion of clinical images shared in prospective randomized controlled trials involving patients with atopic dermatitis and systemic pharmacotherapy
- 2024
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Ingår i: Journal of dermatological treatment. - 0954-6634 .- 1471-1753. ; 35
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: For individuals with atopic dermatitis (AD), interpreting scientific papers that present clinical outcomes including the Eczema Area and Severity Index (EASI) and Investigators Global Assessment may be difficult. When compared to tabulated data and graphs, images from before and after treatment are often far more meaningful to these patients that ultimately will be candidates for the treatment. This systematic review focused on determining the frequency of clinical image sharing in AD research. Materials and methods: Conducted in accordance with PRISMA guidelines, the review concentrated on randomized controlled trials that investigated predefined and available systemic treatments for AD. The search was performed in the MEDLINE database for studies published from the inception until 21 December 2023. Results: The review included 60 studies, encompassing 17,799 randomized patients. Across these studies, 16 images representing 6 patients were shared in the manuscripts, leading to a sharing rate of 0.3‰. Conclusions: The almost missing inclusion of patient images in clinical trial publications hinders patient understanding. Adding images to scientific manuscripts could significantly improve patients’ comprehension of potential treatment outcomes. This review highlights the need for authors, the pharmaceutical industry, study sponsors, and publishers to enhance and promote patient information through increased use of visual data.
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| 13. |
- Sigurdardottir, Gunnthorunn, et al.
(författare)
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Cross-Cultural Validation of the RECAP of Atopic Eczema Question-naire in a Swedish Population
- 2024
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Ingår i: Acta Dermato-Venereologica. - : Medical Journals Sweden. - 0001-5555 .- 1651-2057. ; 104
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Tidskriftsartikel (refereegranskat)abstract
- A Swedish translation of the patient-reported outcome measure for assessing long-term control of atopic dermatitis, Recap of atopic eczema (RECAP), has not been validated. Cross-cultural translation and multi-centre validation of the translated RECAP questionnaire were therefore performed. Disease severity was assessed using the validated Investigator Global Assessment Scale for atopic dermatitis (vIGA-ADTM). The Swedish RECAP was completed by 208 individuals aged 16 years or older with a median age of 36 years (interquartile range [IQR] 27-48). The participants considered the questionnaire suitable for assessing eczema control. The median RECAP score (range 0-28) was 12 (IQR 5-19). The mean and median vIGA-ADTM scores (range 0-4) were 2 (standard deviation [SD] 2) and 3 (IQR 2-4), respectively. A correlation between RECAP and the vIGA-ADTM was observed (p < 0.001). There was no significant change in scores for participants who answered the questionnaire twice within 14 days. Over time, improved or worsened eczema, as evaluat-ed by vIGA-ADTM, affected RECAP scores significantly (p < 0.001). The study suggests that RECAP can assess AD control in a Swedish clinical setting and shows -acceptable reliability.
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