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In the October 2014 issue of Journal of Allergy and Clinical Immunology, Brough et al show that early environmental peanut exposure from house dust increases the risk of peanut allergy in children with impaired skin barrier. Children were assessed for peanut allergy and had genetic studies to determine whether they could produce normal filaggrin levels. Dust samples were collected and analyzed for peanut concentration to determine in which groups of children environmental peanut exposure influenced the development of peanut allergy. In normal children environmental peanut exposure did not influence the development of peanut allergy. In contrast, in filaggrin deficient children the risk of peanut allergy increased as peanut concentration in the house dust increased. To read the full article, please click here: http://bit.ly/1qkfHeY

Atopic eczema (AE, syn. atopic dermatitis) is a major medical condition that causes substantial burden to patients, their families, and society. Various different interventions exist, many of which have been assessed in randomized controlled trials (RCTs). However, there is a lack of core outcome sets for atopic eczema (AE) which is a major obstacle for advancing evidence-based treatment.  There are several different instruments identified to assess clinical signs of AE and the global Harmonizing Outcome Measures for Eczema (HOME) initiative has already defined clinical signs, symptoms, quality of life, and long-term control of flares as core outcome domains for AE-trials. To resolve the current lack of standardization of the assessment of clinical signs of AE, the HOME initiative followed a structured process of systematic reviews and international consensus sessions to identify one core outcome measurement instrument to assess clinical signs in all future AE-trials...

Atopic dermatitis (AD) is the most common chronic inflammatory skin disease and often precedes the development of food allergy and asthma.  The defective skin barrier in AD is thought to allow the absorption of allergens through the skin.  This promotes systemic allergen sensitization, contributing to the development of food allergy and asthma, as well as skin infections such as Staphylococcus aureus and herpes simplex virus (HSV).  This month’s JACI focuses on the importance of both genetic and acquired causes of epithelial skin barrier dysfunction in driving the natural history of AD. In their review, Donald Leung and Emma Guttman-Yassky summarize current insights into AD that may lead to new treatment approaches, including several articles published in this month’s journal ( J Allergy Clin Immunol 2014; 134(4): 769-779 ). The causes of AD are complex and driven by a combination of genetic, environmental and immunologic factors which likely account for heterogeneity of ...