PMID- 27075216
OWN - NLM
STAT- MEDLINE
DCOM- 20170522
LR  - 20220408
IS  - 1346-8138 (Electronic)
IS  - 0385-2407 (Linking)
VI  - 43
IP  - 11
DP  - 2016 Nov
TI  - Potential preventive effects of proactive therapy on sensitization in moderate to 
      severe childhood atopic dermatitis: A randomized, investigator-blinded, 
      controlled study.
PG  - 1283-1292
LID - 10.1111/1346-8138.13408 [doi]
AB  - Proactive therapy for atopic dermatitis (AD) effectively prevents exacerbation. 
      However, its role in preventing subsequent sensitization to allergens has not 
      been prospectively studied. We investigated whether proactive therapy for AD can 
      effectively impact immunological parameters in a randomized, 
      investigator-blinded, parallel group study. Thirty patients aged 3 months to 7 
      years with moderate to severe AD who had undergone an AD educational program were 
      allocated to a proactive treatment group or a reactive treatment group. During 
      the disease control period, patients in the proactive group performed 
      intermittent preventive application of topical corticosteroid for 1 year. Changes 
      in the severity scoring, quality of life measures and immunological parameters 
      (serum thymus and activation regulated chemokine [TARC], total immunoglobulin E 
      [IgE] and house dust mite-specific IgE levels) were evaluated and compared 
      between the proactive and reactive treatment groups. Although the average topical 
      corticosteroid ointment use per day in both groups was not significantly 
      different, the severity and quality of life scores were significantly lower in 
      the proactive group than in the reactive group at the final visit. In addition, 
      compared with baseline levels, serum TARC levels remained significantly lower 
      during proactive therapy, while house dust mite-specific IgE levels were 
      significantly increased only in the reactive group. The results suggest that in 
      addition to controlling the severity of AD, intermittent preventive 
      administration of topical corticosteroids may prevent an increase in 
      aeroallergen-specific IgE levels in patients with childhood AD. The use of TARC 
      levels as a biomarker for AD remission is also supported.
CI  - (c) 2016 Japanese Dermatological Association.
FAU - Fukuie, Tatsuki
AU  - Fukuie T
AD  - Department of Pediatrics, Hamamatsu University School of Medicine, Shizuoka, 
      Japan. fukuie-t@hama-med.ac.jp.
AD  - Division of Allergy, Department of Medical Subspecialties, National Center for 
      Child Health and Development, Tokyo, Japan. fukuie-t@hama-med.ac.jp.
FAU - Hirakawa, Satoshi
AU  - Hirakawa S
AD  - Department of Dermatology, Hamamatsu University School of Medicine, Shizuoka, 
      Japan.
FAU - Narita, Masami
AU  - Narita M
AD  - Division of Allergy, Department of Medical Subspecialties, National Center for 
      Child Health and Development, Tokyo, Japan.
FAU - Nomura, Ichiro
AU  - Nomura I
AD  - Division of Allergy, Department of Medical Subspecialties, National Center for 
      Child Health and Development, Tokyo, Japan.
FAU - Matsumoto, Kenji
AU  - Matsumoto K
AD  - Department of Allergy and Immunology, National Research Institute for Child 
      Health and Development, Tokyo, Japan.
FAU - Tokura, Yoshiki
AU  - Tokura Y
AD  - Department of Dermatology, Hamamatsu University School of Medicine, Shizuoka, 
      Japan.
FAU - Ohya, Yukihiro
AU  - Ohya Y
AD  - Division of Allergy, Department of Medical Subspecialties, National Center for 
      Child Health and Development, Tokyo, Japan.
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20160414
PL  - England
TA  - J Dermatol
JT  - The Journal of dermatology
JID - 7600545
RN  - 0 (Adrenal Cortex Hormones)
RN  - 0 (Biomarkers)
RN  - 0 (CCL17 protein, human)
RN  - 0 (Chemokine CCL17)
RN  - 0 (Ointments)
RN  - 37341-29-0 (Immunoglobulin E)
SB  - IM
MH  - Adrenal Cortex Hormones/*therapeutic use
MH  - Biomarkers/blood
MH  - Chemokine CCL17/*blood
MH  - Child
MH  - Child, Preschool
MH  - Dermatitis, Atopic/blood/complications/*prevention & control
MH  - Female
MH  - Humans
MH  - Immunization
MH  - Immunoglobulin E/blood
MH  - Infant
MH  - Male
MH  - Ointments
MH  - Staphylococcal Infections/microbiology
MH  - Staphylococcus aureus/isolation & purification
MH  - Treatment Outcome
OTO - NOTNLM
OT  - atopic dermatitis
OT  - atopic march
OT  - immunoglobulin E
OT  - proactive therapy
OT  - randomized controlled trial
EDAT- 2016/10/28 06:00
MHDA- 2017/05/23 06:00
CRDT- 2016/04/15 06:00
PHST- 2016/01/14 00:00 [received]
PHST- 2016/03/08 00:00 [accepted]
PHST- 2016/10/28 06:00 [pubmed]
PHST- 2017/05/23 06:00 [medline]
PHST- 2016/04/15 06:00 [entrez]
AID - 10.1111/1346-8138.13408 [doi]
PST - ppublish
SO  - J Dermatol. 2016 Nov;43(11):1283-1292. doi: 10.1111/1346-8138.13408. Epub 2016 
      Apr 14.