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Why do some patients develop a more severe form of eczema than others? How do moisturising treatments help protect new-borns from developing eczema? These are just some of the questions that scientists have been able to answer using a mathematical model of this common disease.
Atopic dermatitis is the most common form of eczema. It is a long-term condition that affects up to 25% of children worldwide. Indeed, it is the most common skin disease of children in the developed world. Often starting in infancy, symptoms include intense itch, blistering, and loss of sleep. For those affected, the impact on their lives can be devastating.
Researchers from Imperial College London, the NCRC, and the Japanese research institute RIKEN, have developed a new method of studying atopic dermatitis. Using data from previous studies, Dr Tanaka and her colleagues, including the NCRC’s Professor Alan Irvine, have developed a complex mathematical model that explains how interactions between the skin, the immune system and the environment can lead to disease.
The team identified four types of patient with atopic dermatitis, ranging from those with no active symptoms to those with severe disease. They then went on to show that the immune systems’ response to skin damage, and /or environmental factors, is key to disease severity. If the immune activation is short-lived, the symptoms of disease will disappear when the immune response comes to an end naturally. But if immune activation lasts too long, or happens too often, then the immune system becomes overwhelmed, and can’t ‘switch-off’. In this case, the symptoms of disease continue, often worsening with time. Thus, using their new model, Dr Tanaka and her colleagues have been able to explain how it is that disease can remain mild for some patients with atopic dermatitis, while for others it becomes severe.
Not only can this model help us better understand atopic dermatitis, it can also predict how changes to the system will affect disease. Indeed, the team were able to explain how moisturising treatments help protect new-borns from developing atopic dermatitis. By reducing water loss and creating a barrier, moisturising treatments break the itching and scratching cycle, and thus protect against skin damage, and subsequent immune activation. They also showed that moisturising treatments could help prevent all new-borns, not just those with genetic risk factors, from developing atopic dermatitis.
This new mathematical model of atopic dermatitis has exciting implications. Not only is it a potentially powerful tool for identifying and testing new treatments for atopic dermatitis, but it may provide a blueprint for scientists to develop mathematical models of other diseases such as cancer, diabetes and cardiovascular disease.
The research was published in the Journal of Allergy and Clinical Immunology, and was a collaboration between the Imperial College London, the Japanese research institute RIKEN, the National Children’s Research Centre and Trinity College Dublin.