(9R)-9-chloro-11-17-dihydroxy-17-(2-hydroxy-1-oxoethyl)-10-13-16-trimethyl-6-7-8-11-12-14-15-16-octahydrocyclopenta[a]phenanthren-3-one and Dermatitis--Atopic

A major aetiologic role for foods has been demonstrated in urticaria, atopic eczema and dermatitis herpetiformis. In some patients with urticaria, whealing occurs within minutes of the ingestion of a particular food. In most, but not necessarily all cases, this appears to be a consequence of IgE-mediated cutaneous mast cell degranulation, i.e. a classical type I hypersensitivity response. In other patients with recurrent urticaria, the whealing may be provoked by foods by a much slower and more insidious reaction. This type of reaction has been established in the case of several common food additives, notably azo dyes, but other foods may be able to cause urticaria in a similar fashion. Foods appear to play an important provocative role in many patients with atopic eczema. The reaction in such cases appears to be slow and insidious, almost always unrecognized by the patient and not detected by skin testing or tests for IgE antibodies. There can be no real doubt that dietary gluten is responsible for most, if not all dermatitis herpetiformis, though this relationship was revealed only by the finding of concurrent and usually asymptomatic jejunal villous atrophy in affected individuals. The mechanisms responsible for the slow food reactions in urticaria, atopic eczema and dermatitis herpetiformis remain largely unknown, but are likely to be different in each case.

Topics: Aging; Animals; Azo Compounds; Beclomethasone; Benzoates; Cattle; Child; Child, Preschool; Dermatitis Herpetiformis; Dermatitis, Atopic; Eggs; Food Additives; Food Hypersensitivity; Glutens; Humans; Immunoglobulin A; Immunoglobulin E; Infant; Infant, Newborn; Intestinal Diseases; Milk; Skin Diseases; Sulfones; Time Factors; Urticaria

Atopic dermatitis (AD) is an inflammatory skin disease. Although topical steroids are widely used for AD, management of severe AD is not satisfactory because of relapse or occasional aggravation of symptoms. Moreover, glucocorticoids induce in vitro IgE production. On the other hand, topical sodium cromoglycate (SCG) solution is a safe and effective treatment for AD.. We treated 43 patients with AD with SCG solution (n = 21) or with topical steroids, beclomethasone dipropionate (BD) ointment (n = 22). After 2 weeks, clinical evaluation and spontaneous immunoglobulin production by peripheral blood B cells or surface IgE+ B cells from patients in the SCG and BD groups were assessed.. Both SCG and BD treatment remarkably improved eczema. However, although SCG treatment decreased spontaneous IgE production by B cells without affecting production of IgG, IgM, or IgA, BD treatment selectively increased spontaneous IgE production. SCG treatment also decreased IgE production by surface IgE+ B cells, whereas BD treatment increased it.. Topical steroid treatment increases in vitro spontaneous IgE production by B cells. This indicated that topical steroids may decrease inflammation; however, a large-scale study on the effect of topical steroids on IgE production in vitro and in vivo may be necessary.

Topics: Administration, Topical; Adolescent; Anti-Inflammatory Agents; Beclomethasone; Child; Cromolyn Sodium; Cytokines; Dermatitis, Atopic; Double-Blind Method; Female; Glucocorticoids; Humans; Immunoglobulin E; Male; T-Lymphocytes

In a double blind, placebo controlled, crossover trial in 26 children with severe atopic eczema those receiving four weeks' treatment with combined oral plus nasal beclomethasone diproprionate improved significantly more than those receiving placebo. No adverse effects were observed, but 24 hour urinary cortisol excretion was slightly reduced. This combination may provide effective treatment in refractory atopic eczema with relatively little of the danger associated with systemic administration of prednisolone and other traditional corticosteroids.

Topics: Administration, Intranasal; Administration, Oral; Adolescent; Aerosols; Beclomethasone; Child; Child, Preschool; Clinical Trials as Topic; Dermatitis, Atopic; Double-Blind Method; Female; Humans; Male; Random Allocation

Topics: Administration, Topical; Adolescent; Adult; Aged; Beclomethasone; Betamethasone Valerate; Clinical Trials as Topic; Dermatitis, Atopic; Female; Fluocinonide; Humans; Hydrocortisone; Male; Middle Aged; Ointments; Psoriasis

Drug repurposing or repositioning (DR) refers to finding new therapeutic applications for existing drugs. Current computational DR methods face data representation and negative data sampling challenges. Although retrospective studies attempt to operate various representations, it is a crucial step for an accurate prediction to aggregate these features and bring the associations between drugs and diseases into a unified latent space. In addition, the number of unknown associations between drugs and diseases, which is considered negative data, is much higher than the number of known associations, or positive data, leading to an imbalanced dataset. In this regard, we propose the DrugRep-KG method, which applies a knowledge graph embedding approach for representing drugs and diseases, to address these challenges. Despite the typical DR methods that consider all unknown drug-disease associations as negative data, we select a subset of unknown associations, provided the disease occurs because of an adverse reaction to a drug. DrugRep-KG has been evaluated based on different settings and achieves an AUC-ROC (area under the receiver operating characteristic curve) of 90.83% and an AUC-PR (area under the precision-recall curve) of 90.10%, which are higher than in previous works. Besides, we checked the performance of our framework in finding potential drugs for coronavirus infection and skin-related diseases: contact dermatitis and atopic eczema. DrugRep-KG predicted beclomethasone for contact dermatitis, and fluorometholone, clocortolone, fluocinonide, and beclomethasone for atopic eczema, all of which have previously been proven to be effective in other studies. Fluorometholone for contact dermatitis is a novel suggestion by DrugRep-KG that should be validated experimentally. DrugRep-KG also predicted the associations between COVID-19 and potential treatments suggested by DrugBank, in addition to new drug candidates provided with experimental evidence. The data and code underlying this article are available at https://github.com/CBRC-lab/DrugRep-KG.

Topics: Algorithms; Beclomethasone; COVID-19; Dermatitis, Atopic; Dermatitis, Contact; Drug Repositioning; Fluorometholone; Humans; Pattern Recognition, Automated; Retrospective Studies

Beclomethasone dipropionate (BDP) is a synthetic glucocorticoid with great topical potency. It has previously been demonstrated to be an effective treatment for childhood atopic dermatitis (AD) when given orally. We have monitored linear growth and adrenal function in a group of children treated with oral BDP for severe AD. Stable control of disease was achieved in 10/14 patients (mean dose: 1000 micrograms/day, range 800-1800). At this maintenance dose, there was evidence of deceleration of linear growth in 7/10 patients. There was no significant difference between pre-treatment 8 a.m. plasma cortisol levels and those on the maintenance dose. However, there was a reduction in 24-hour urinary cortisol excretion during maintenance treatment, although this did not reach statistical significance. We regard oral BDP as a useful treatment in widespread childhood atopic AD that has not responded adequately to topical therapy. However, it is mandatory that growth be monitored carefully during its use.

Topics: Beclomethasone; Child; Child, Preschool; Dermatitis, Atopic; Female; Humans; Infant; Male

The biological role of T cell receptor (TCR) gamma delta bearing cells is currently not fully understood. Recently, a monoclonal antibody (TCR delta 1) reacting against the whole molecule became available which facilitates the direct analysis of TCR-gamma delta+ cells. We studied 11 children with atopic dermatitis, 20 children with atopic asthma, 18 adults with atopic dermatitis and 38 healthy age matched controls aged 4-51 years. Lymphocytes were isolated from heparinized peripheral blood and the proportion of TCR-gamma delta+ lymphocytes was determined by FACS analysis. Patients with atopic diseases yielded a significantly (P less than 0.01) lower proportion of TCR-gamma delta+ cells compared with normal controls (median 4.8% versus 7.1%). The percentage of TCR-gamma delta+ cells showed an age-dependent decline in both the patient group (r = -0.49, P less than 0.01) and the control group (r = -0.40, P less than 0.01). In addition, the proportion of cells which expressed CD8, TCR-gamma delta or CD4, TCR-gamma delta simultaneously was determined by double labelling immunofluorescence. Whereas CD4+, TCR-gamma delta+ cells could be identified in only a few individuals, CD8+, TCR-gamma delta+ cells were found in nearly all controls (median 2.4%, range 0.0-10.8%); atopic patients displayed significantly (P less than 0.01) lower proportions of CD8+, TCR-gamma delta+ cells.

Topics: Adolescent; Adult; Albuterol; Antibodies, Monoclonal; Asthma; Beclomethasone; CD8 Antigens; Child; Child, Preschool; Cromolyn Sodium; Dermatitis, Atopic; Flow Cytometry; Humans; Hypersensitivity, Immediate; Receptors, Antigen, T-Cell, gamma-delta; Theophylline

Topics: Administration, Oral; Adult; Aspirin; Beclomethasone; Child; Cromolyn Sodium; Dermatitis, Atopic; Food Hypersensitivity; Histamine H1 Antagonists; Humans; Ibuprofen; Indomethacin; Infant; Ketotifen; Nifedipine

Topics: Adolescent; Asthma; Beclomethasone; Child; Chronic Disease; Dermatitis, Atopic; Eye Diseases; Female; Humans; Male