Omega-3 Versus Omega-6 Polyunsaturated Fatty Acids in the Prevention and Treatment of Inflammatory Skin Diseases.

Omega-3 (ω-3) and omega-6 (ω-6) polyunsaturated fatty acids (PUFAs) are nowadays desirable components of oils with special dietary and functional properties. Their therapeutic and health-promoting effects have already been established in various chronic inflammatory and autoimmune diseases through various mechanisms, including modifications in cell membrane lipid composition, gene expression, cellular metabolism, and signal transduction. The application of ω-3 and ω-6 PUFAs in most common skin diseases has been examined in numerous studies, but their results and conclusions were mostly opposing and inconclusive. It seems that combined ω-6, gamma-linolenic acid (GLA), and ω-3 long-chain PUFAs supplementation exhibits the highest potential in diminishing inflammatory processes, which could be beneficial for the management of inflammatory skin diseases, such as atopic dermatitis, psoriasis, and acne. Due to significant population and individually-based genetic variations that impact PUFAs metabolism and associated metabolites, gene expression, and subsequent inflammatory responses, at this point, we could not recommend strict dietary and supplementation strategies for disease prevention and treatment that will be appropriate for all. Well-balanced nutrition and additional anti-inflammatory PUFA-based supplementation should be encouraged in a targeted manner for individuals in need to provide better management of skin diseases but, most importantly, to maintain and improve overall skin health.

Elemental diet inhibits pro­inflammatory cytokine production in keratinocytes through the suppression of NF­κB activation.

An elemental diet (ED) has been reported to reduce oral mucositis and dermatitis induced by chemotherapy. However, its molecular mechanism of action as an anti­inflammatory agent is still unknown. The aim of the present study was to clarify whether ED confers its anti­inflammatory action via reduction of pro­inflammatory cytokine production in keratinocytes in vivo and in vitro. We evaluated the efficacy of ED in the treatment of 5­fluorouracil (5­FU)­induced dermatitis of nude mice, and examined the expression of pro­inflammatory cytokines such as tumor necrosis factor­α (TNF­α), interleukin (IL)­1ß and IL­6 using immunohistochemistry. Moreover, we assessed the expression and production of these pro­inflammatory cytokines by western blotting and ELISA assays, respectively, in immortalized human keratinocyte cell line, HaCaT. Furthermore, we investigated the effect of ED on a major inflammation­related factor, nuclear transcription factor­κB (NF­κB), since it controls many genes involved in the inflammation pathway. Our results indicated that ED reduced the expression of TNF­α, IL­1ß and IL­6. It also inhibited the nuclear transition of p65 NF­κB, which is known to regulate inflammatory cytokine expression in keratinocytes suffering from 5­FU­induced dermatitis. In addition, ED reduced the production of TNF­α, IL­1ß and IL­6 in HaCaT cells. Moreover, ED attenuated 5­FU­induced transcriptional activation of NF­κB. These findings revealed that ED suppresses the expression of pro­inflammatory cytokines by suppressing NF­κB in keratinocytes, suggesting the potential usefulness of ED in the treatment of various inflammatory diseases of the dermal region.

The nutrition of poultry as a factor affecting litter quality and foot pad dermatitis - an updated review.

Foot pad dermatitis (FPD), a condition of inflammation and necrotic lesions on the plantar surface of the footpads, is commonly observed in fast-growing broiler chickens and turkeys. FPD negatively affects the welfare of birds, performance indices and the economic profit of poultry meat production. Nutrition is an important factor affecting water intake, excreta moisture and litter quality and, in this way, the occurrence and intensity of FPD in birds. This article reviews and discusses the recent results published in the literature on the effects of nutritional factors on litter quality and FPD severity in broiler chickens and turkeys. Literature data on the efficacy of nutritional methods on the litter quality and FPD occurrence are not consistent. However, the results of several experiments indicate that the optimal level of crude protein, biotin and electrolytes (Na, K) in the diet, as well as feed additives such as feed enzymes hydrolysating non-starch polysaccharides and organic sources of microelements (zinc), may reduce the litter moisture as well as FPD incidence and severity in broiler chickens and turkey.

Enfermedad celíaca y nuevas patologías relacionadas con el gluten / Celiac disease and new diseases related to gluten

La enfermedad celíaca es la enfermedad crónica intestinal más frecuente que existe. Actualmente se sabe que se trata de una patología multisistémica de mecanismo inmunitario, provocada por el gluten, que se da en individuos genéticamente susceptibles. Afecta aproximadamente al 1% de la población mundial, lo que supone una prevalencia muy elevada, afecta a todos los grupos de edad y tiene síntomas de presentación muy variados, tanto digestivos como extradigestivos. Ya que es una enfermedad que exige el mantenimiento de una dieta sin gluten y un seguimiento médico de por vida, es importante conocerla y establecer adecuadamente su diagnóstico. Junto a la enfermedad celíaca se diagnostican cada vez más una serie de nuevas patologías relacionadas con el gluten, entre las que destacan la sensibilidad al gluten no celíaca o la alergia al trigo. El padecimiento de enfermedad celíaca, o de otras patologías relacionadas, al condicionar cambios en la alimentación del individuo afectado, puede asociarse con desequilibrios nutricionales que es necesario vigilar e intentar resolver. Por ello los pacientes con esta problemática necesitan un asesoramiento nutricional especial (AU)

Celiac disease is the most common chronic intestinal disease. Nowadays it´s known that this is a multisistemic pathology of immune mechanism, triggered by gluten, which occurs in genetically susceptible individuals. It affects approximately 1% of the world population, which is a very high prevalence, affects all age groups and has symptoms both digestive and extra-digestive. Since it is a disease that requires maintaining a gluten-free diet and medical monitoring for life, it is important to know it and establish its diagnosis properly. Along with celiac disease a number of new diseases related to gluten are diagnosed increasingly, including the non celiac gluten sensitivity or wheat allergy. The suffering of celiac disease, or other related diseases, by conditioning diet changes of the affected individual, it may be associated with nutritional imbalances that need to monitor and try to solve. Therefore patients with this problem need special nutritional advice (AU)

Sex differences in skin carotenoid deposition and acute UVB-induced skin damage in SKH-1 hairless mice after consumption of tangerine tomatoes.

SCOPE: UVB exposure, a major factor in the development of skin cancer, has differential sex effects. Tomato product consumption reduces the intensity of UVB-induced erythema in humans, but the mechanisms are unknown. METHODS AND RESULTS: Four-week-old SKH-1 hairless mice (40 females, 40 males) were divided into two feeding groups (control or with 10% tangerine tomatoes naturally rich in UV-absorbing phytoene and phytofluene) and two UV exposure groups (with or without UV). After 10 weeks of feeding, the UV group was exposed to a single UV dose and sacrificed 48 h later. Blood and dorsal skin samples were taken for carotenoid analysis. Dorsal skin was harvested to assess sex and UV effects on carotenoid deposition, inflammation (skinfold thickness, myeloperoxidase levels), and DNA damage (cyclobutane pyrimidine dimers, p53). Females had significantly higher levels of both skin and blood carotenoids relative to males. UV exposure significantly reduced skin carotenoid levels in females but not males. Tomato consumption attenuated acute UV-induced increases in CPD in both sexes, and reduced myeloperoxidase activity and percent p53 positive epidermal cells in males. CONCLUSION: Tangerine tomatoes mediate acute UV-induced skin damage in SKH-1 mice via reduced DNA damage in both sexes, and through reduced inflammation in males.

Low-nickel diet scoring system for systemic nickel allergy.

BACKGROUND: Consumption of nickel in the diet leads to spongiotic dermatitis in a dose-related fashion in individuals who are allergic to nickel. Dietary modification to reduce nickel intake leads to resolution of this dermatitis. OBJECTIVE: This study aims to create an evidence-based, user-friendly diet to assist patients in reducing dietary nickel intake. METHODS: Food and Drug Administration data on the nickel content of foods were combined with serving size information to calculate the upper limit of nickel per serving for a variety of foods. Based on these calculations, a point system was created that allows patients to reduce their nickel intake below the typical threshold for elicitation of the spongiotic dermatitis. CONCLUSIONS: A simplified point-based diet can help patients with dermatitis due to dietary nickel consumption.

Dietary polyunsaturated fatty acids and non-digestible oligosaccharides reduce dermatitis in mice.

BACKGROUND: Oral administration of specific food ingredients can modify mucosal and systemic inflammatory processes. Such food components are fatty acids or carbohydrates. Nevertheless, little is known about the impact of oral administration of polyunsaturated fatty acids (PUFA) and non-digestible oligosaccharides on allergen-induced dermatitis. METHOD: In this pilot study, skin inflammation was induced by serial epicutaneous OVA applications in OVA-sensitized mice. In parallel, mice were fed with solid food containing arachidonic acid/docosahexaenoic acid (AA/DHA), galactooligosaccharide/polydextrose (GOS/PDX) or their combination. Skin lesions were assessed by clinical skin score, but also skin barrier parameters, immunohistochemical analyses, and local cytokine expression profile. RESULTS: Both dietary AA/DHA and GOS/PDX significantly ameliorated the severity of allergen-induced dermatitis. The clinical improvement upon oral AA/DHA and GOS/PDX supplementation was associated with a reduction in transepidermal water loss and reduced KI-67 expression in the skin. Lesional CD8+ and mast cells were reduced in all treatment groups, but appeared to be most pronounced in combined AA/DHA/GOS/PDX-treated mice. Moreover, in GOS/PDX-treated mice, IFNγ and TGFß expression was increased in skin lesions. CONCLUSION: Dietary supplementation with DHA/AA and GOS/PDX ameliorates symptoms of allergen-induced dermatitis and may thus be beneficial in the dietary management of human atopic eczema.

Eicosanoids in skin inflammation.

Eicosanoids play an integral part in homeostatic mechanisms related to skin health and structural integrity. They also mediate inflammatory events developed in response to environmental factors, such as exposure to ultraviolet radiation, and inflammatory and allergic disorders, including psoriasis and atopic dermatitis. This review article discusses biochemical aspects related to cutaneous eicosanoid metabolism, the contribution of these potent autacoids to skin inflammation and related conditions, and considers the importance of nutritional supplementation with bioactives such as omega-3 and omega-6 polyunsaturated fatty acids and plant-derived antioxidants as means of addressing skin health issues.

Recognition of epidermal transglutaminase by IgA and tissue transglutaminase 2 antibodies in a rare case of Rhesus dermatitis.

Tissue transglutaminase 2 (tTG2) is an intestinal digestive enzyme which deamidates already partially digested dietary gluten e.g. gliadin peptides. In genetically predisposed individuals, tTG2 triggers autoimmune responses that are characterized by the production of tTG2 antibodies and their direct deposition into small intestinal wall. The presence of such antibodies constitutes one of the major hallmarks of the celiac disease (CD). Epidermal transglutaminase (eTG) is another member of the transglutaminase family that can also function as an autoantigen in a small minority of CD patients. In these relatively rare cases, eTG triggers an autoimmune reaction (a skin rash) clinically known as dermatitis herpetiformis (DH). Although the exact mechanism of CD and DH pathogenesis is not well understood, it is known that tTG2 and eTG share antigenic epitopes that can be recognized by serum antibodies from both CD and DH patients. In this study, the confocal microscopy examination of biopsy samples from skin lesions of two rhesus macaques (Macaca mulatta) with dermatitis (Table 1, Fig. 1 and 2) was used to study the affected tissues. In one animal (EM96) a spectral overlap of IgA and tTG2 antibodies (Fig. 3) was demonstrated. The presence of double-positive tTG2+IgA+ cells was focused in the deep epidermis, around the dermal papillae. This is consistent with lesions described in DH patients. When EM96 was placed on a gluten-free diet, the dermatitis, as well as tTG2+IgA+ deposits disappeared and were no longer detectable (Figs. 1-3). Dermatitis reappeared however, based on re-introduction of dietary gluten in EM96 (not shown). In other macaques including animal with unrelated dermatitis, the tTG2+IgA+ deposits were not detected. Gluten-free diet-dependent remission of dermatitis in EM96 together with presence of tTG2+IgA+ cells in its skin suggest an autoimmune, DH-like mechanism for the development of this condition. This is the first report of DH-like dermatitis in any non-human primate.

Probiotics and the skin.

A review of the relationships between probiotics and the skin is presented. After a brief historical introduction, the main pathophysiological data on intestinal microflora, the immune system and the skin are presented. Clinical studies with probiotics in atopic children are discussed in detail. Many experimental studies have found that probiotics exert specific effects in the luminal lumen and on epithelial cells and immune cells with antiallergic potential. Not all probiotics have the same immunological properties. Moreover, although rarely, complications of probiotic use can occur and must be known and taken into account. This review underlines the potential interest in probiotics for the management of skin pathology.

Rice nightmare: Kwashiorkor in 2 Philadelphia-area infants fed Rice Dream beverage.

A 14-month-old girl and a 7-month-old boy each presented with a diffuse dermatitis, whole body edema, and hypoalbuminemia. The diets of both infants consisted almost entirely of Rice Dream, a rice-based, protein-poor beverage. Both infants were diagnosed with kwashiorkor, which resolved with protein supplementation. Clues from the physical examination, a diet history, appropriate laboratory examinations, and an index of suspicion are crucial in promptly diagnosing and treating infants with kwashiorkor. Manufacturers of rice beverages should appropriately warn parents about the dangers of using their products as infant nourishment.

The effect of the addition of oil preparation with increased content of n-3 fatty acids on serum lipid profile and clinical condition of cats with miliary dermatitis.

The aim of this study was to determine the influence of an oil preparation with increased n-3 fatty acids content on the serum lipid profile and clinical condition of cats with miliary dermatitis. The studies were performed on 22 cats of various breeds and both sexes, aged between 3 and 7 years, that had been fed a balanced diet, based on beef meat for the previous 6 months. The animals were divided into four groups: I, five clinically healthy cats; II, five clinically healthy cats, receiving 1 ml of oil preparation with food for 6 weeks; III, seven nonpruritic cats with miliary dermatitis, without treatment; and group IV, five nonpruritic cats with miliary dermatitis, receiving 1 ml of oil preparation per day with food for 6 weeks. Every 2 weeks all cats were clinically examined. Determination of the serum lipid profile and composition of the oil preparation was performed using gas chromatography. The concentration of total cholesterol (CHL), high-density lipoprotein (HDL) fraction and triacylglycerols (TG) were determined spectrophotometrically. In three sick animals, the dermatological signs disappeared completely. In cats with miliary dermatitis, who did not receive the oil preparation, the ratio of cholesterol and HDL to triacylglycerols was reversed compared with healthy cats and sick animals which had received the oil preparation. The addition of the oil preparation lowered the content of saturated fatty acids in serum, in particular palmitic acid, and increased the content of unsaturated acids, linolenic, eicosapentaenoic (EPA, n-3) and docosahexaenoic acid (DHA, n-3). Simultaneously, a nonsignificant rise in arachidonic acid (AA, n-6) and a decrease in dihomo-gamma-linolenic acid (DGLA, n-6) were found. These observations indicate that cats with miliary dermatitis require an increased amount of n-3 fatty acids in the diet. This was proved not only by the observed changes in the serum lipid profile but also by the clinical improvement.

Dermatologic therapy: 1992.

This article reviews therapeutic studies reported in the English-language literature during 1992. Readers should review the original article in full before attempting any experimental or controversial therapy.

Effect of varying proportions of evening primrose oil and fish oil on cats with crusting dermatosis ('miliary dermatitis')

Fourteen cats with crusting dermatoses ('miliary dermatitis') were supplemented with various combinations of evening primrose oil and fish oil. The cutaneous signs improved when the cats were supplemented with either evening primrose oil alone or with a combination of evening primrose oil and fish oil. Fish oil alone was unable to maintain the remission and the cutaneous signs deteriorated. The subsequent administration of a combination of the two oils resulted in a resolution of the dermatosis.

Management of feline miliary dermatitis by supplementing the diet with essential fatty acids.

Of eight cats with miliary dermatitis, six showed a good response to treatment with a dietary supplement of essential fatty acids. The analysis of serum fatty acids revealed significant abnormalities in cats with miliary dermatitis compared with normal cats.

alpha-Linolenic acid and long-chain omega-3 fatty acid supplementation in three patients with omega-3 fatty acid deficiency: effect on lymphocyte function, plasma and red cell lipids, and prostanoid formation.

alpha-Linolenic acid deficiency is described in three patients. Observed clinical symptoms were hemorrhagic dermatitis, hemorrhagic folliculitis, skin atrophy, and scaly dermatitis. Supplementation with ethyl alpha-linolenate followed by a purified fish oil (EPA-oil) began to normalize symptoms within 10 d. The mitogenic response in isolated lymphocytes was reduced whereas the number of T lymphocytes increased significantly. Serum thromboxanes, urinary excretion of 2,3-dinor-6-keto-prostaglandin F1 alpha (PGI2-M), and bleeding time were unaffected. The results indicate that omega-3 fatty acids are essential for normal accumulation of erythrocyte omega-6 acids. The dietary intake of long-chain omega-3 acids required to obtain midnormal concentrations of omega-3 acids in plasma and erythrocyte lipids was estimated to be 350-400 mg/d (0.4% of calories), whereas the corresponding mean intake of alpha-linolenic acid was 990 mg/d (1.0% of calories). It is suggested that essential fatty acid requirement should be stated as grams or milligrams per day, similarly to other essential nutrients.

Dermatitis induced or aggravated by selected foodstuffs.

The eczema of 113 patients with dermatitis other than classical urticaria or typical atopic dermatitis cleared or showed marked improvement after one to two months of dietary restriction. In their response to a questionnaire completed at least 6 months after the initiation of the diet, 61 (54%) of these patients said that diet restriction was effective in reducing the activity of or preventing recurrence of their dermatitis. Their most common symptoms were recurrent symmetrical hand eczema, anogenital eczema, pruritic papules and excoriations of the trunk as well as a "fixed" type of eczema. Forty-nine of the 113 patients were able to reproduce their symptoms at least 3 times with certain food items, most commonly eggs, milk, tomato, cheese and fish. It is likely that both the classical food allergens and foods containing or producing histamine or other vasoactive substances could be the cause of such dermatoses or act as a non-specific aggravating factor. This type of reactivity was most common among patients with a personal and/or family history of atopic diseases (asthma, hay fever and/or atopic dermatitis). Symptoms corresponding to those of contact urticaria to food items were commonly seen among the patients.