峠岡 理沙

Latex allergy is an allergic reaction to natural rubber and may occur in the perioperative period. Between 2015 and 2021, patients at Kyoto Prefectural University of Medicine were screened for latex allergy before surgery using a standardized questionnaire. Patients suspected of having latex allergy underwent skin prick tests (SPTs), wearing tests, and measurement of serum-specific IgE antibody titers. The results of the medical questionnaires, skin tests, and IgE tests were subsequently analyzed. Overall, 467 patients were suspected of having latex allergy based on the questionnaire responses. SPTs and wearing tests were positive in 105 and 10 cases, respectively. Ten patients were diagnosed with latex allergies based on the wearing tests. Questionnaire data from patients diagnosed with latex allergy revealed 8 cases of allergic symptoms after fruit and vegetable intake, 7 associated with rubber product use, 2 of anaphylactic shock of unknown cause, and 2 of involving medical staff with atopic dermatitis. Among these patients, latex-specific IgE and Hev b 6.02-specific IgE antibody titers were measured in 10 and 6 cases, respectively. Latex-specific IgE antibody titers were classified as class ≥ 2 in 3 cases, whereas Hev b 6.02-specific IgE antibody titers reached class ≥ 2 in 1. No intraoperative cases of latex allergy were observed during the study period. These findings suggest latex allergy screening using a questionnaire in combination with diagnostic testing is a useful strategy.

Naked mole-rats are extremely long-lived rodents with a lifespan of up to 40 years, during which cellular and tissue aging is rarely observed. In this study, we analyzed the extracellular matrix (ECM) of naked mole-rat skin at the molecular level to elucidate the molecules involved in anti-aging and their localization. Raman spectroscopy and Fourier transform infrared spectroscopy were applied to investigate the hierarchical structure of the ECM, showing that, whereas the epidermis of aged mice had thinned, the epidermis of naked mole-rats became thickened and hyaluronic acid (HA) was distributed under the basement membrane. Furthermore, naked mole-rat skin had a regular skin texture and flexibility, allowing the maintenance of a youthful appearance. Hyaluronic acid in naked mole-rats characteristically exists as clusters (chain HA) in skin tissue, where it is thought to permit moisture retention and maintain elasticity, contributing to the skin's youthful appearance. These results suggested that not only the density of ECM but also its spatial distribution and topographic properties are important for skin anti-aging. Our findings may contribute to the elucidation of skin disease pathology, the development of therapeutic gel scaffolds, and the control of aging.

Atopic dermatitis (AD) involves chronic eczema resulting from barrier dysfunction. Fine bubble (FB) technology generates microbubbles (< 100 μm) and ultrafine bubbles (< 1 μm) for surfactant-sparing cleansing. We assessed the short-term safety of an FB shower in AD. In this double-blind, randomized, crossover study, adults with mild AD completed two 2-week periods separated by a 2-week washout in sequence. Bathing instructions and petrolatum moisturizer use were standardized and enforced. The Eczema Area and Severity Index (EASI) was scored using whole-body photographs by a blinded team. Transepidermal water loss (TEWL) and stratum corneum hydration were measured on Days 0, 14, and 28. Because baselines were unavailable for the second 2-week period, the primary analysis compared Day 0-14 changes between groups using baseline-adjusted analysis of covariance; Day 0-28 changes were also explored. The primary outcomes were EASI changes; TEWL and hydration were the secondary outcomes. Groups used a conventional shower (control) first and then FB shower second or vice versa (once each). Twenty-three participants were analyzed (mean age 40.9 ± 8 years; 83% male). Day 0-14 EASI changes did not differ between FB and control (0.62 ± 2.21 vs. 0.05 ± 0.68; F = 0.93, p = 0.35). EASI changes to Day 28 were nonsignificant (0.02 ± 1.65 vs. -0.03 ± 1.02; p = 0.90). TEWL changes for Days 0-14 (0.31 ± 4.75 vs. 1.09 ± 6.21 g/m2/h) and to Day 28 (5.49 ± 14.43 vs. -0.27 ± 5.28 g/m2/h) showed no between-group differences. Hydration changes were similar for Days 0-14 (5.53 ± 13.23 vs. 6.14 ± 7.96 AU) and to Day 28 (18.41 ± 10.33 vs. 21.09 ± 11.07 AU). No serious adverse events or discontinuations for worsening symptoms occurred. Under standardized, low-irritant conditions, the FB shower was well-tolerated by adults with mild AD and did not worsen severity or barrier indices over 4 weeks. However, the superiority of FB to a conventional shower was not demonstrated.

BACKGROUND: The Prevention of Allergy via Cutaneous Intervention (PACI) randomized controlled trial (RCT) demonstrated that early enhanced topical corticosteroid (TCS) therapy modestly reduced food allergy (FA) at 28 weeks of age. The present prospective follow-up study (PACI-ON) evaluated whether these effects persisted to age 3 years. METHODS: Participants were randomized in infancy to early enhanced (proactive) or early conventional (reactive) TCS treatment (1:1) for atopic dermatitis (AD) until 28 weeks. A total of 590 (91%) children who completed the PACI RCT were followed to age 3 years. During follow-up, no protocolized interventions were given; all participants received usual care. Main outcomes included physician-diagnosed FA, AD severity (EASI, POEM), sensitization profiles, allergic comorbidities, and growth parameters as safety outcomes. RESULTS: At age 3 years, the prevalence of any FA remained lower in the early enhanced group than in the conventional group (47.4% vs. 58.8%, p = 0.006), mainly driven by a reduced prevalence of raw egg allergy (30.4% vs. 40.5%, p = 0.013). No between-group differences were observed for wheeze, asthma, or rhinitis. Japanese cedar sensitization at age 2 was lower in the enhanced group (6.1% vs. 12.2%, p = 0.02 6) but not at age 3. AD control and quality of life were well maintained and similar across groups, with > 90% achieving mild or less disease. Early growth suppression at 1 year resolved by age 3. CONCLUSION: Early enhanced AD intervention was associated with a sustained modest reduction in its planned primary follow-up outcome of FA and safety (growth) up to age 3. Although most differences were small and may reflect early diagnosis and good overall management in both groups, the findings support early AD treatment as a potential strategy to modify allergic disease trajectories.

BACKGROUND AND OBJECTIVE: The increasing prevalence of atopic dermatitis (AD) has raised concerns about whether individuals with AD require specific cardiovascular disease (CVD) prevention strategies. This study investigated the association between AD and CVD among middle-aged adults. METHODS: We conducted a nested case-control study using data from the Kyoto Claim Database (April 2013-March 2023) among individuals aged 40-59 years who were followed for ≥ 3 years. Cases were patients with first-onset CVD (hospitalization for ischemic heart disease or stroke), whereas controls had no history of CVD. AD was defined by an ICD-10 code (L20) plus a topical corticosteroid (TCS) prescription. For each case, 10 controls were matched on age, sex, index month, hypertension, diabetes, dyslipidemia, hyperuricemia, and use of anticoagulant or antiplatelet agents. Logistic regression was used to assess associations between CVD and AD prevalence or severity. RESULTS: We identified 2,757 CVD cases, including 1,247 with ischemic heart disease and 1,563 with stroke (median age 53 years [interquartile range, 49-56]; 2,031 [73.7%] male). Comorbidities included hypertension in 1,430 (51.9%), diabetes in 583 (21.1%), dyslipidemia in 1,018 (36.9%), hyperuricemia in 307 (11.1%), and anticoagulant or antiplatelet prescriptions in 377 (13.7%). The median follow-up period was 60 months. After matching, 2,672 cases and 26,720 controls were compared. AD was diagnosed in 66 cases (2.5%) and 728 controls (2.7%), with no significant association between AD and CVD (odds ratio [OR], 0.90; 95% confidence interval, 0.69-1.16). Regarding AD severity, 3 cases (0.1%) and 76 controls (0.3%) were in the top 10% of average monthly TCS dose (≥37.8 g/month); 28 cases (1.0%) and 352 controls (1.3%) received class 1 TCS; and 14 cases (0.5%) and 144 controls (0.5%) received systemic treatment (immunosuppressants or biologics). AD severity was not associated with CVD risk (ORs: 0.39 [0.10-1.05], 0.79 [0.53-1.15], and 0.97 [0.53-1.62], respectively). A limitation of this study was potential misclassification of AD status due to the nature of claims data. CONCLUSION: Among adults aged 40-59 years, AD was not significantly associated with an increased risk of CVD onset, even in severe cases. Targeted CVD screening for patients with AD may not be necessary; however, comprehensive management of standard CVD risk factors remains essential, as in the general population.