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Article ; Online: Interleukin antagonists for atopic dermatitis: a new era of therapy.

Tsiogka, Aikaterini / Paschou, Eleni / Koumaki, Dimitra / Vakirlis, Efstratios / Gregoriou, Stamatios

2024

Abstract: Introduction: Over the last decade, increasing understanding of the immunopathogenesis of atopic dermatitis (AD) enabled the recognition of multiple therapeutic targets and subsequently the development of novel, highly effective systemic treatments, ... ...

Abstract	Introduction: Over the last decade, increasing understanding of the immunopathogenesis of atopic dermatitis (AD) enabled the recognition of multiple therapeutic targets and subsequently the development of novel, highly effective systemic treatments, including interleukin (IL)-antagonists. To date, the IL-4Ra-inhibitor dupilumab, and the IL-13 inhibitor tralokinumab, have gained regulatory approval in Europe for the treatment of moderate-to-severe AD, while more than 70 new therapeutics are currently in development. Areas covered: In this review, we address the role of ILs in the pathogenesis of AD and provide an overview of the novel and investigational IL-antagonists, as regards their efficacy and safety on moderate-to-severe AD. Expert opinion: Current data have established IL-4 and IL-13 inhibitors as effective and safe for the treatment of moderate-to-severe AD, as regards the rapid control of flares as well as the long-term remission of the disease. Data regarding the efficacy and safety of other IL-inhibitors, including those targeting IL-31, IL-22, IL-33, IL-36 and IL-18, are accumulating. There is still an unmet need for real-world-evidence studies and head-to-head studies for both currently available and future agents in AD treatment. Establishing predictive biomarkers of treatment response in a disorder of such considerable heterogenicity might help physicians pursue a patient-tailored therapeutic response.
Language	English
Publishing date	2024-04-24
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	1182884-5
ISSN	1744-7658 ; 0967-8298 ; 1354-3784
ISSN (online)	1744-7658
ISSN	0967-8298 ; 1354-3784
DOI	10.1080/13543784.2024.2347294
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Article: Atopic Dermatitis and Water: Is There an Optimum Water Intake Level for Improving Atopic Skin?

Douladiris, Nikolaos / Vakirlis, Efstratios / Vassilopoulou, Emilia

Children (Basel, Switzerland)

2023 Volume 10, Issue 2

Abstract: Water is a vital nutrient with innumerable functions for every living cell. The functions of human skin include protection against dehydration of the body. Atopic dermatitis (AD) is a chronic pruritic inflammatory skin disease that presents with dry skin, ...

Abstract	Water is a vital nutrient with innumerable functions for every living cell. The functions of human skin include protection against dehydration of the body. Atopic dermatitis (AD) is a chronic pruritic inflammatory skin disease that presents with dry skin, erythematous and eczematous lesions, and lichenification. This paper discusses the question of whether extra water intake in children with AD affects skin hydration and the skin barrier function. Among the methods used to treat dry skin, topical leave-on products are the first-line treatment, intended to improve hydration and the skin barrier function. The effectiveness of adequate water intake as a measure to treat dry skin is still under debate. Normal skin hydration increases with dietary water intake, particularly in those with prior lower water consumption. Skin dryness in AD is instrumental to the itch and inflammation cycle, contributing to barrier impairment and aggravating disease severity and flares. Certain emollients provide significant hydration to AD skin, with relief of dryness and reduction in barrier impairment, disease severity, and flares. Further investigations are needed to evaluate the optimum water intake levels in children with AD, as important questions remain unanswered, namely, does oral hydration provide relief of skin dryness and reduce barrier impairment, disease severity, and flares; is there any additional benefit from using mineral or thermal spring water; or is there a need to specifically study the fluid/water intake in children with AD and food allergy (FA) restrictions?
Language	English
Publishing date	2023-01-31
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2732685-8
ISSN	2227-9067
ISSN	2227-9067
DOI	10.3390/children10020273
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Article: The Role of Tight Junctions in Atopic Dermatitis: A Systematic Review.

Katsarou, Spyridoula / Makris, Michael / Vakirlis, Efstratios / Gregoriou, Stamatios

Journal of clinical medicine

2023 Volume 12, Issue 4

Abstract: Background: Tight junctions are transmembrane proteins that regulate the permeability of water, solutes including ions, and water-soluble molecules. The objective of this systematic review is to focus on the current knowledge regarding the role of tight ...

Abstract	Background: Tight junctions are transmembrane proteins that regulate the permeability of water, solutes including ions, and water-soluble molecules. The objective of this systematic review is to focus on the current knowledge regarding the role of tight junctions in atopic dermatitis and the possible impact on their therapeutic potential. Methods: A literature search was performed in PubMed, Google Scholar, and Cochrane library between 2009 and 2022. After evaluation of the literature and taking into consideration their content, 55 articles were finally included. Results: TJs' role in atopic dermatitis extends from a microscopic scale to having macroscopic effects, such as increased susceptibility to pathogens and infections and worsening of atopic dermatitis features. Impaired TJ barrier function and skin permeability in AD lesions is correlated with cldn-1 levels. Th2 inflammation inhibits the expression of cldn-1 and cldn-23. Scratching has also been reported to decrease cldn-1 expression. Dysfunctional TJs' interaction with Langerhans cells could increase allergen penetration. Susceptibility to cutaneous infections in AD patients could also be affected by TJ cohesion. Conclusions: Dysfunction of TJs and their components, especially claudins, have a significant role in the pathogenesis and vicious circle of inflammation in AD. Discovering more basic science data regarding TJ functionality may be the key for the use of specific/targeted therapies in order to improve epidermal barrier function in AD.
Language	English
Publishing date	2023-02-15
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm12041538
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Article ; Online: Intergenic Regions of Saccharomycotina Yeasts are Enriched in Potential to Encode Transmembrane Domains.

Tassios, Emilios / Nikolaou, Christoforos / Vakirlis, Nikolaos

Molecular biology and evolution

2023 Volume 40, Issue 3

Abstract: Intergenic genomic regions have essential regulatory and structural roles that impose constraints on their sequences. But regions that do not currently encode proteins also carry the potential to do so in the future. De novo gene emergence, the evolution ...

Abstract	Intergenic genomic regions have essential regulatory and structural roles that impose constraints on their sequences. But regions that do not currently encode proteins also carry the potential to do so in the future. De novo gene emergence, the evolution of novel genes out of previously noncoding sequences has now been established as a potent force for genomic novelty. Recently, it was shown that intergenic regions in the genome of Saccharomyces cerevisiae harbor pervasive cryptic potential to, if theoretically translated, form transmembrane domains (TM domains) more frequently than expected by chance given their nucleotide composition, a property that we refer to as TM-forming enrichment. The source and biological relevance of this property is unknown. Here, we expand the investigation into the TM-forming potential of intergenic regions to the entire Saccharomycotina budding yeast subphylum, in an effort to explain this property and understand its importance. We find pervasive but variable enrichment in TM-forming potential across the subphylum regardless of the composition and average size of intergenic regions. This cryptic property is evenly spread across the genome, cannot be explained by the hydrophobic content of the sequence, and does not appear to localize to regions containing regulatory motifs. This TM-forming enrichment specifically, and not the actual TM-forming potential, is associated, across genomes, with more TM domains in evolutionarily young genes. Our findings shed light on this newly discovered feature of yeast genomes and constitute a first step toward understanding its evolutionary importance.
MeSH term(s)	DNA, Intergenic/genetics ; Yeasts/genetics ; Saccharomyces cerevisiae/genetics ; Genomics ; Genome ; Saccharomycetales/genetics
Chemical Substances	DNA, Intergenic
Language	English
Publishing date	2023-03-14
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	998579-7
ISSN	1537-1719 ; 0737-4038
ISSN (online)	1537-1719
ISSN	0737-4038
DOI	10.1093/molbev/msad059
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Zs.A 2137: Show issues

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Article ; Online: From the Cochrane Library: Leukotriene Receptor Antagonists for Eczema.

Toledo, Lauren Marie / Rodriguez, Ramiro / Sivesind, Torunn E / Vakirlis, Efstratios / Kojima, Reiji / Dellavalle, Robert P

JMIR dermatology

2024 Volume 7, Page(s) e50434

Language	English
Publishing date	2024-04-12
Publishing country	Canada
Document type	Journal Article
ISSN	2562-0959
ISSN (online)	2562-0959
DOI	10.2196/50434
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Article: Insights into Early Systemic Treatment in Atopic Dermatitis: Scientific Facts and Practical Considerations.

Vakirlis, Efstratios / Gregoriou, Stamatios / Bakirtzi, Katerina / Paschou, Eleni / Tsiogka, Aikaterini / Papadimitriou, Ilias / Sotiriou, Eleni

Dermatology and therapy

2024 Volume 14, Issue 3, Page(s) 563–568

Abstract: Atopic dermatitis (AD) is a chronic inflammatory skin disease characterized clinically by pruritus, and pathophysiologically by immune dysregulation, and compromised skin barrier function. While topical therapies are currently the cornerstone of AD ... ...

Abstract	Atopic dermatitis (AD) is a chronic inflammatory skin disease characterized clinically by pruritus, and pathophysiologically by immune dysregulation, and compromised skin barrier function. While topical therapies are currently the cornerstone of AD management, especially in mild disease, recent advancements in systemic treatments and a deeper understanding of similar skin diseases, such as psoriasis, have highlighted the importance of early intervention. In this commentary, we explore the potential benefits of early systemic intervention in AD, with pruritus determining such a decision. Building on this concept, we assume that, through the timely systemic treatment that targets the immune dysregulation present in AD, the progression of the disease could be modified, improving overall patient outcomes. Early systemic intervention may minimize systemic inflammation, halting the "atopic march" and disrupting the "itch-scratch" cycle. Managing pruritus at its root could prevent secondary complications and reduce the psychosocial burden of the disease. This paradigm shift fosters a collaborative healthcare approach that empowers patients with long-term disease control strategies. In conclusion, the safety and efficacy of novel systemic treatments offer a compelling scenario for early intervention in atopic dermatitis care.
Language	English
Publishing date	2024-02-27
Publishing country	Switzerland
Document type	Letter
ZDB-ID	2680284-3
ISSN	2190-9172 ; 2193-8210
ISSN (online)	2190-9172
ISSN	2193-8210
DOI	10.1007/s13555-024-01110-6
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Article: Photodynamic Therapy for Field Cancerization in the Skin: Where Do We Stand?

Bakirtzi, Katerina / Papadimitriou, Ilias / Vakirlis, Efstratios / Lallas, Aimilios / Sotiriou, Eleni

Dermatology practical & conceptual

2023 Volume 13, Issue 4

Abstract: Introduction: Photodynamic therapy (PDT) with a photosensitizer is available for the treatment of multiple actinic keratoses (AKs) in a restricted skin area or, as it is established, for the field-cancerized skin.: Objectives: Our review aims to ... ...

Abstract	Introduction: Photodynamic therapy (PDT) with a photosensitizer is available for the treatment of multiple actinic keratoses (AKs) in a restricted skin area or, as it is established, for the field-cancerized skin. Objectives: Our review aims to present the up-to-date literature on skin field cancerization using PDT employing different topical photosensitizers, modified light delivery protocols and combination treatments to obtain excellent efficacy and safety in everyday clinical practice. Methods: We sought PubMed, MEDLINE, Scopus, OVID, Embase, Science Direct, Cochrane Library, Research Gate and Google Scholar for [(aminolevulinic acid OR aminolevulinate) AND photodynamic therapy] with (field-directed OR field cancerization, (actinic keratosis), and (efficacy OR effectiveness OR pain OR tolerability) for studies published until February 2023. Results: Advantages of PDT compared to the other field treatments, including imiquimod, 5-fluorouracil, ingenol mebutate gel and diclofenac, reported better cosmetic outcomes and greater patient satisfaction. On the other hand, some drawbacks of field PDT include pain and treatment duration. Alternate illumination methods have also been investigated, including daylight as a light source. Pretreating the affected area may enhance photosensitizer absorption leading to better therapeutic results, while combinational treatments have also been tested. Patients prefer daylight PDT to traditional light sources since it is more well-tolerated and equally effective. Even as a preventive treatment, field PDT yields promising outcomes, especially for high-risk individuals, including organ transplant recipients. Conclusions: This review provides a thorough display of the field of PDT on cancerized skin, which will facilitate physicians in applying PDT more efficiently and intuitively.
Language	English
Publishing date	2023-10-01
Publishing country	Austria
Document type	Journal Article ; Review
ZDB-ID	2685397-8
ISSN	2160-9381
ISSN	2160-9381
DOI	10.5826/dpc.1304a291
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Article: Alport Syndrome and Oral Mucous Membrane Pemphigoid: An Interesting Case.

Zisis, Vasileios / Dimitrios, Andreadis / Kasimatis, Eustratios / Vakirlis, Eustratios / Poulopoulos, Athanasios

Cureus

2023 Volume 15, Issue 7, Page(s) e41519

Abstract: Alport syndrome (AS) is a hereditary progressive glomerular disease associated with sensorineural hearing loss and ocular abnormalities. It is attributed to the altered structure and the subsequent dysfunction of the glomerular basement membrane (GBM) ... ...

Abstract	Alport syndrome (AS) is a hereditary progressive glomerular disease associated with sensorineural hearing loss and ocular abnormalities. It is attributed to the altered structure and the subsequent dysfunction of the glomerular basement membrane (GBM) due to the mutated type IV collagen a3/a4/a5 chains. It may emerge either as an X-linked disease, the most common, or as an autosomal disease, both recessive and dominant. A female patient, 26 years old, came in 2023 to the Department of Oral Medicine/ Pathology, Dental School, Aristotle University of Thessaloniki, complaining about pain and a burning sensation in her right cheek. Her medical history revealed the diagnosis of Alport syndrome in 2016 and kidney transplantation in 2022 with extensive post-transplantation drug administration. The clinical examination revealed an ulcer, partially covered by a pseudomembrane, on the oral mucosa of the right cheek, surrounded by an erythematous border. A biopsy was taken, and the histopathological examination showed the oral manifestation of mucous membrane pemphigoid. After communicating with the attending nephrologist, the prescription of methylprednisolone was decided, and the lesions receded. The differential diagnosis included both AS-induced pemphigoid and drug-induced pemphigoid. The thorough medical history, detailed clinical investigation, lesion biopsy, and collaboration of different dental and medical specialties constitute necessary prerequisites for a successful treatment, even in immunosuppressed patients.
Language	English
Publishing date	2023-07-07
Publishing country	United States
Document type	Case Reports
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.41519
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Article: Metformin in Hidradenitis Suppurativa: Is It Worth Pursuing Further?

Tsentemeidou, Aikaterini / Vakirlis, Efstratios / Papadimitriou, Ilias / Ioannides, Dimitrios / Sotiriou, Elena

Skin appendage disorders

2023 Volume 9, Issue 3, Page(s) 187–190

Abstract: Hidradenitis suppurativa (HS) often coexists with obesity, metabolic syndrome, diabetes mellitus, or impaired glucose tolerance and insulin resistance and polycystic ovarian syndrome. Metformin is a medication used for the treatment of diabetes, acting ... ...

Abstract	Hidradenitis suppurativa (HS) often coexists with obesity, metabolic syndrome, diabetes mellitus, or impaired glucose tolerance and insulin resistance and polycystic ovarian syndrome. Metformin is a medication used for the treatment of diabetes, acting in multiple ways. There is evidence that it decreases inflammatory cytokines, some of which are implicated in the pathogenesis of HS (TNF-α, IL-17). We performed a systematic review of data regarding the efficacy and safety of metformin for the treatment of HS. Four electronic databases (MEDLINE, ScienceDirect, Cochrane Library, and ClinicalTrials.gov), as well as the abstracts compendia of major dermatologic congresses, were searched. A total of 133 patients received metformin for HS across 6 studies, 117 of whom received it as monotherapy. The great majority of participants were female, in their thirties and overweight or obese, with one study including only children. The efficacy tools employed varied widely. Four studies (106 patients) documented improvement, 1 documented treatment failure, and 1 had mixed results. Only mild and transient side effects were noted. Metformin has been tried in few HS patients with acceptable efficacy in a fair number of them. As it is generally well tolerated and reasonably priced, carefully designed clinical trials comparing it with placebo are worth performing.
Language	English
Publishing date	2023-03-29
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2806972-9
ISSN	2296-9160 ; 2296-9195
ISSN (online)	2296-9160
ISSN	2296-9195
DOI	10.1159/000529359
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Article ; Online: Hidradenitis suppurativa-related expenditure, a call for awareness: systematic review of literature.

Tsentemeidou, Aikaterini / Sotiriou, Elena / Ioannides, Dimitrios / Vakirlis, Efstratios

Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG

2022 Volume 20, Issue 8, Page(s) 1061–1072

Abstract: Data regarding hidradenitis suppurativa (HS)-related expenditure is limited and non-homogeneous, but HS does incur significant expenses. We performed a systematic review of literature reports documenting financial data regarding any healthcare domain or ... ...

Abstract	Data regarding hidradenitis suppurativa (HS)-related expenditure is limited and non-homogeneous, but HS does incur significant expenses. We performed a systematic review of literature reports documenting financial data regarding any healthcare domain or other expenditure incurred by HS and/or HS impact on work, income and personal economic growth (indirect costs). Three electronic databases were searched (MEDLINE, ScienceDirect, and the Cochrane Library - last search date: September 14
MeSH term(s)	Delivery of Health Care ; Disease Progression ; Health Expenditures ; Hidradenitis Suppurativa/diagnosis ; Hidradenitis Suppurativa/therapy ; Hospitalization ; Humans
Language	English
Publishing date	2022-07-12
Publishing country	Germany
Document type	Journal Article ; Review ; Systematic Review
ZDB-ID	2093479-8
ISSN	1610-0387 ; 1610-0379
ISSN (online)	1610-0387
ISSN	1610-0379
DOI	10.1111/ddg.14796
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