Recent Developments

Green Living Environments Don’t Protect Kids From Eczema

Greenness or the significant presence of living vegetation around the home in early childhood does not seem to protect children from atopic eczema, a new Finnish study shows. Instead, the proximity of coniferous, mixed forests and agricultural areas was associated with elevated risk of eczema, especially in children who were born in the spring.

“General greenness around the home did not protect children against eczema, which was contrary to our expectations and to the hypothesised allergy protective effect of nature contacts. Eczema is, however, only one of the allergic diseases in children, albeit generally the first to emerge,” says Minna Lukkarinen, MD, a pediatric specialist from the FinnBrain Birth Cohort Study at the University of Turku, Finland, in a news release.

The present study analyzed material from six Finnish birth cohorts, involving a total of 5,085 children. In a birth cohort, the same children are followed-up from birth, which allows studying associations between environmental early-life exposures and the disease development prior to its onset. This study examined the associations between the season of birth, the greenness and land cover types, surrounding the early-life home, and the development of eczema by the age of 2 years.

“Although greenness around the home did not protect against eczema, surrounding vegetation can have other beneficial effects. We also must note that greenness is a rather rough measure of nature presence and relatively poor indicator of biodiversity. The observed predisposing association of coniferous forest may indicate that the effects of nature on child’s immunological development vary depending on the type of nature and the biodiversity and the exact timing of the exposures. Further studies are needed to confirm the result and to reveal the possible mechanisms,” says Anne Karvonen, the Chief Researcher at Finnish Institute for Health and Welfare (THL).

The study used data from the FLORA, LUKAS, STEPS, FinnBrain, Kuopio Birth Cohort, and HELMi cohorts from the University of Turku, THL, the University of Helsinki, the University of Eastern Finland, and the children’s clinics of the central hospitals of Helsinki, Kuopio, and Turku. The study was based on the FINMIC collaborative project funded by the Academy of Finland.

The study appears in Pediatric Allergy and Immunology.

Smart Wound Dressing Can Spot Infection Early

A nanocellulose wound dressing that can reveal early signs of infection without interfering with the healing process has been developed by researchers at Linköping University, Sweden.

The study is published in Materials Today Bio.

Researchers at Linköping University, in collaboration with colleagues from Örebro and Luleå Universities, have now developed a wound dressing made of nanocellulose that can reveal early signs of infection without interfering with the healing process.

The dressing is made of tight mesh nanocellulose, preventing bacteria and other microbes from getting in. At the same time, the material lets gases and liquid through, something that is important to wound healing. The idea is that once applied, the dressing will stay on during the entire healing process. Should the wound become infected, the dressing will show a color shift.

Non-infected wounds have a pH value of about 5.5. When an infection occurs, the wound becomes increasingly basic and may have a pH value of 8, or even higher. This is because bacteria in the wound change their surroundings to fit their optimal growth environment. An elevated pH value in the wound can be detected long before any pus, soreness or redness, which are the most common signs of infection.

To make the wound dressing show the elevated pH value, the researchers used bromthymol blue, BTB, a dye that changes colour from yellow to blue when the pH value exceeds 7. For BTB to be used in the dressing without being compromised, it was loaded onto a silica material with pores only a few nanometres in size. The silica material could then be combined with the dressing material without compromising the nanocellulose. The result is a wound dressing that turns blue when there is an infection.

Wound infections are often treated with antibiotics that spread throughout the body. But if the infection is detected at an early stage, local treatment of the wound may suffice. This is why researchers at Örebro University are also developing anti-microbial substances based on so-called lipopeptides that kill off all types of bacteria.

The new wound dressing and the anti-microbial substance are part of developing a new type of wound treatment in out-patient care. But as all products to be used in medical care settings have to pass rigorous and expensive testing, he thinks that it will be 5 to 10 years before it will be available there.

Both studies are part of the HEALiX research project financed by the Swedish Foundation for Strategic Research with the objective of developing a new type of wound treatment.

Close Up with Donald YM Leung, MD, PhD

Thymic stromal lymphopoietin (TSLP) is an epithelial cell-derived cytokine that is expressed in the skin, gut, and lungs and drives Th2-mediated inflammation. And now a new skin tape stripping study shows that increased TSLP expression in the epidermis precedes the development of atopic dermatitis (AD) in infants as young as 2 months,¹ suggesting that TSLP may serve as an early biomarker for AD and provide a window to intervene and stop the atopic march. Study author Donald Y. M. Leung, MD, PhD, a Distinguished Professor of Pediatrics, allergist, and immunologist at National Jewish Health in Denver, CO discussed the results of the study with Practical Dermatology®. Here’s what we learned:

Why is this topic important to study?

“AD is the most common inflammatory skin disease. It can lead to food allergy, asthma, and allergic rhinitis. There are no cures for allergic diseases. Therefore, it is important to find an approach for the prevention of AD and the so-called atopic march. The first step in this research was to identify molecules in the skin which could predict AD before clinical rash was seen.”

Describe the research and your findings.

“A non-invasive skin tape sampling approach was used to assess skin composition of asymptomatic infants at two months of age and more than one year before they developed clinical eczema or AD. We found that there were skin barrier abnormalities and evidence of atopic immune activation at two months although no rash was evident. The release of a molecule called TSLP is known to occur after skin keratinocytes are exposed to environmental stimuli like pollution of staphylococcus aureus, TSLP can impair the skin barrier which creates lipid and protein abnormalities that lead to AD. These biomarkers can predict babies at high risk of AD who need stepped-up therapy to build their skin barrier.”

What is the next step?

“We hope to optimize skin creams that can strengthen the skin barrier in infants to reduce triggers of TSLP release and develop safe anti-inflammatory drugs that can interfere with the cytokines that interfere with barrier function.”

1. Berdyshev E, Kim J, Kim BE, et al. Stratum corneum lipid and cytokine biomarkers at age 2 months predict the future onset of atopic dermatitis. J Allergy Clin Immunol. 2023. Feb 23;S0091-6749(23)00227-0. https://doi.org/10.1016/j.jaci.2023.02.013