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Stem cells become a new strategy for the treatment of atopic dermatitis
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Stem cells become a new strategy for the treatment of atopic dermatitis. Stem cells have achieved many results in the treatment of autoimmune diseases, providing a new treatment method for atopic dermatitis, and has good application prospects.
In daily life, many people are deeply troubled by atopic dermatitis and are forced to enter the vicious circle of itching-scratching-inflammation.
Atopic dermatitis sounds like just a type of skin disease, and there is no danger of life. However, the severe itching symptoms and recurrence characteristics brought about by it will cause serious sleep disturbance and mental burden on the sufferer. Even accompanied by cardiovascular disease. Therefore, some people call it “an undead cancer”, which shows the great harm of atopic dermatitis.
According to the 2015 “Clin Dermatol” literature report, the prevalence of AD in children is as high as 20%, and the prevalence of adults is 3%-10%. Atopic dermatitis has seriously affected the life and work status of patients.
Therefore, it is very necessary to seek new and safe and effective clinical methods for atopic dermatitis.
Atopic dermatitis (AD) is a common chronic, recurrent, and inflammatory skin disease. The most basic features are dry skin, chronic eczema-like dermatitis and severe itching, often accompanied by allergic rhinitis or asthma. About 40%-80% of patients have a family history of allergies.
Doctors like to use three words to describe it-chronic, recurrent, and itchy. The pathogenesis of AD is complex and is the result of the interaction of multiple factors such as heredity, immunity, infection, and environment.
From newborn babies to the elderly, people of every age will experience atopic dermatitis.
1. Infancy (birth-2 years old)
Mainly manifested as acute eczema, such as facial erythema, papules, and exudation. These little babies are often irritable, crying, and sleepless because of itching, and most of them can gradually get better and heal within 2 years of age. But there are also uncured cases, which may develop into childhood atopic dermatitis.
2. Childhood (>2-12 years old)
Most evolved from infancy, but can also occur without infancy. The disease has been ill for a long time, and the skin lesions have also changed. Most of them are dry and thick, with obvious lichenoid changes. The skin lesions are also slightly limited, and are common in the elbow fossa, popliteal fossa, neck flexion, and face. The most troublesome is the severe itching, so it is often accompanied by scratches.
3. Adolescence and adulthood (>12-60 years old)
It can develop from infancy, childhood, or directly occur in adolescence or adulthood. The appearance of the skin lesions is similar to that of childhood, and it is still mostly dry and hypertrophic dermatitis damage, and a few patients have prurigo-like skin lesions. The difference is that the skin lesions are often more extensive, except for the elbow fossa, popliteal fossa, and the front of the neck, but can also occur on the trunk, face, limbs, and hands.
4. Old age (>60 years old)
It is a special type that has gradually been paid attention to in recent years. There are more men than women. The rash is usually severe and widespread, involving the trunk, limbs, scalp, and even the face and neck. In severe cases, it can develop into erythroderma.
In addition, atopic dermatitis can also have many other characteristics, including dry skin, ichthyosis, keratosis pilaris, pityriasis white, palm pattern, hand and foot dermatitis, eczema, nipple eczema, eyelid eczema, cheilitis, Excessive insect bite reaction, white scratches, etc.
The same mosquito bites, AD patients often have more obvious reactions
The mechanism of action of stem cells to treat AD
The traditional treatment of atopic dermatitis focuses on daily care and hormone medication. But even so, many patients are still poorly controlled and their symptoms recur repeatedly. Oral or topical glucocorticoids are a “double-edged sword”, and long-term medication may bring side effects.
Stem cells are mostly used in clinical applications in the field of tissue engineering and trauma. Research has confirmed that stem cells have unique immune regulation and tissue repair capabilities, and have important clinical significance for immune diseases and allergic diseases.
Previous studies have found that skin defects and abnormal immune responses are key factors in the occurrence and development of atopic dermatitis. Therefore, the unique repair ability and immune regulation of stem cells are essential for effective treatment of atopic dermatitis.
The mechanism of action of stem cells to treat atopic dermatitis:
Inhibit skin inflammation
Stem cells can reduce the symptoms of atopic dermatitis in the body by reducing systemic inflammation. Mesenchymal stem cells (MSCs) regulate Th1/Th2 immune balance and upregulate Treg cells. The atopic dermatitis skin lesions infused with MSCs were significantly improved, the number of inflammatory cell infiltration in the skin lesions was significantly reduced, and the ear draining lymph nodes CD4+CD25+ fork-head spiral transcription factor (Foxp) 3+ regulatory T cells (Treg) The number has increased significantly, and the ratio of IFN-γ/IL-4 has increased.
Repair damaged skin barrier
Another scholar injected fat-derived MSCs exosomes into atopic dermatitis mice, and atopic dermatitis mice that received dexamethasone served as a control group. A total of 12 transplants were performed. The result was determined: MSCs exosomes Induces the production of epidermal ceramide and dihydroceramide, significantly reduces epidermal dehydration, and enhances stratum corneum (SC) hydration. After stem cell treatment, deep RNA sequencing analysis of skin lesions in model mice showed that MSCs exosomes restored the expression of genes related to skin barrier, lipid metabolism, cell cycle, and inflammation.
Stem cells can promote the de novo synthesis of ceramide through paracrine, effectively restore the epidermal barrier function in atopic dermatitis, and repair skin damage caused by chronic inflammation or autoimmune diseases.
Stem cell therapy clinical case
“J Transl Med” reported that the researchers gave 4 patients with atopic dermatitis intravenous infusion of MSC (2×108/week, 3 to 5 times), and used the atopic dermatitis score (SCO-RAD) for evaluation. Results After a follow-up of 2 to 5 months, it was found that the skin lesion area of AD patients was reduced, the severity of the skin lesion, the degree of itching and insomnia were significantly improved, the total SCO-RAD score was significantly reduced, and no side effects occurred.
A double-blind, randomized and controlled phase II clinical trial further proved its efficacy. Kim et al. enrolled 34 moderate and severe AD patients (20-60 years old) into subcutaneous injection of MSCs low-dose (2.5×107) group and High-dose (5.0×107) group, observed for 12 weeks, evaluated using SCO-RAD, Eczema Area and Severity Index (EASI), Investigator’s Overall Evaluation (IGA) score, adverse reaction evaluation and serum biomarkers .
The results showed that the patients treated with stem cells showed a dose-dependent manner. In the high-dose group, 55% of patients had a 50% reduction in EASI score, a 50% reduction in SCO-RAD score and a 33% reduction in IGA score, and both IgE and peripheral blood eosinophils Decline to varying degrees.
Chinese scholar Zhao et al. pointed out in the “Journal of Clinical Dermatology” that stem cells have proven to be a promising alternative therapy to overcome intractable skin diseases. It can alleviate the process of AD and improve symptoms. Stem cell treatment of AD has potential Research and clinical value.
Stem cells have achieved many results in the treatment of autoimmune diseases, providing a new treatment method for atopic dermatitis, and has good application prospects.
Stem cells become a new strategy for the treatment of atopic dermatitis
(sourceinternet, reference only)