Atopic Dermatitis

Atopic Dermatitis
Atopic Dermatitis

The skin that covers our bodies plays many important roles. It helps protect our muscles, ligaments, and bones from outside invaders. It helps to hold the body together. The skin is also the body’s largest organ. A wide range of conditions can affect your skin, causing redness, irritation, pain, and even scarring. Atopic dermatitis is one of the most common skin conditions that affect people in the US today, and it’s very common in children, teens, and even adults.

What Is Atopic Dermatitis?

Atopic dermatitis is a type of eczema. The National Eczema Foundation explains,

“Atopic dermatitis (also known as AD) is the most common type of eczema. In fact, more than 18 million American adults have atopic dermatitis – which often appears as a red, itchy rash normally on the cheeks, arms, and legs.”

The Mayo Clinic further explores the condition.

“Atopic dermatitis (eczema) is a condition that makes your skin red and itchy. It’s common in children, but can occur at any age. Atopic dermatitis is long lasting (chronic) and tends to flare periodically. It may be accompanied by asthma or hay fever.”

What Are the Symptoms of Atopic Dermatitis?

Atopic dermatitis shares a number of symptoms with less severe forms of eczema, but it also has some specific signs and symptoms, as well. Some of the more common include the following:

  • Redness
  • Itchy skin
  • Dry, scaly skin
  • The appearance of a rash on the arms, legs, or cheeks
  • Weeping sores during flare-ups
  • The appearance of small bumps on the arms, hands, and neck
  • Dry, flaky skin
  • Dry, cracked skin that may bleed or weep
  • Darkening of the skin around the eyes

What Are the Causes of Atopic Dermatitis?

There is no known cause of atopic dermatitis. However, there is a genetic component to the condition. Children with parents who have any form of eczema are more likely to have eczema themselves, including atopic dermatitis.

It is also commonly seen in children who have hay fever or asthma (roughly 50%). Individuals with atopic dermatitis also have a mutation in the gene that creates filaggrin, which is a protein responsible for helping maintain the outermost protective layer of the skin.

Ultimately, atopic dermatitis seems tied to the immune system, as well. When it detects a foreign invader, the body creates inflammation in an effort to halt its advance. Atopic dermatitis is a manifestation of this inflammation.

Who Is at Risk for Atopic Dermatitis?

Those who are most at risk for developing atopic dermatitis have parents and/or grandparents who suffer from eczema, hay fever, or asthma. If a single parent has one of these conditions, then there is a 50% chance that it will be passed on to their children. If both parents have one of these conditions, there is a high likelihood that their children will have them, as well.

Those who work in specific industries and who are exposed to a number of environmental factors are also at risk. Caustic agents, extreme cold, exposure to blowing sand and wind, and other conditions can cause atopic dermatitis to develop even if there is no or low genetic influence.

What Treatment Options Are Available for Atopic Dermatitis Patients?

There is no cure for atopic dermatitis. However, there are numerous ways to control and treat the condition. Perhaps the most important one for those whose condition is not caused by environmental factors is to know their triggers – specific foods, chemicals, and other things that act as allergenic causes. You should also make sure to use a medication as recommended by your doctor, and that you bathe regularly and use moisturizers appropriately. Watching for signs of flareups will also help control the condition.

The most common type of treatment for atopic dermatitis is a topical ointment applied to the skin. However, phototherapy can also be used. Immunosuppressant drugs can be used to help decrease the number and severity of flare-ups, and biologic drugs may be used to target particular components of the immune system.

How Might Stem Cell Therapy Help?

Stem cells have been studied greatly since their discovery several decades ago. These cells are the foundation on which all of the body’s various tissue types are built. They also play a central role in our ability to heal and regenerate. Their ability to reduce and eliminate inflammation makes stem cells particularly promising as a treatment for inflammatory diseases, such as atopic dermatitis.

A wide range of studies have been conducted with mesenchymal stem cells, or are being conducted currently. In 2017, a study published in the International Journal of Molecular Sciences noted that

“Mesenchymal stem cells (MSCs) possess unique immunomodulatory properties which make them a promising tool for the treatment of various inflammatory diseases”. The authors found that “6 out of 11 (55%) patients in high dose hUCB-MSCs (5 × 107 cells)-treated group exhibited a 50% reduction in the Eczema Area and Severity Index (EASI50) without any noteworthy side effects.”

Another study, this one published in the journal Stem Cells, found that in a treatment involving mice,

“The subcutaneous administration of nucleotide-binding oligomerization domain 2 (NOD2)-activated hUCBMSCs exhibited prominent protective effects against AD, and suppressed the infiltration and degranulation of mast cells (MCs). A b-hexosaminidase assay was performed to evaluate the effect of hUCB-MSCs on MC degranulation. NOD2-activated MSCs reduced the MC degranulation via NOD2-cyclooxygenase-2 signaling.


In contrast to bone marrow-derived MSCs, hUCB-MSCs exerted a cell-to-cell contact-independent suppressive effect on MC degranulation through the higher production of prostaglandin E2 (PGE2). Additionally, transforming growth factor (TGF)-b1 production from hUCB-MSCs in response to interleukin-4 contributed to the attenuation of MC degranulation by downregulating FceRI expression in MCs. In conclusion, the subcutaneous application of NOD2-activated hUCB-MSCs can efficiently ameliorate AD, and MSC-derived PGE2 and TGF-b1 are required for the inhibition of MC degranulation.”

Stem cells likely repair immune system and skin through secretion of multiple biologically active factors that help to control inflammation, assist in tissue repair and immunomodulation.

Conclusion

In the future, stem cell therapy using umbilical cord-derived, allogeneic stem cells will likely be an effective, accepted treatment for atopic dermatitis. However, additional study is required. Note that there are currently no FDA-approved stem cell therapies in the US, and any such treatments should be considered experimental.

Source:

https://www.healthline.com/health/atopic-dermatitis/what-is-atopic-dermatitis#1
https://www.mayoclinic.org/diseases-conditions/atopic-dermatitis-eczema/symptoms-causes/syc-20353273
https://www.webmd.com/skin-problems-and-treatments/eczema/eczema-basics#1
https://nationaleczema.org/eczema/types-of-eczema/atopic-dermatitis/
https://www.aad.org/public/diseases/eczema/atopic-dermatitis
https://stemcellsjournals.onlinelibrary.wiley.com/doi/pdf/10.1002/stem.1913
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5343781/

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