Atopic Dermatitis Clinical Trial
Official title:
Impact of Narrowband UVB Phototherapy on Systemic Inflammation in Patients With Atopic Dermatitis
Atopic dermatitis (eczema) is a chronic inflammatory disease that causes significant morbidity and is now known to be associated with cardiovascular disease. Research such as this will add to the understanding of the skin as a contributor to systemic inflammation, and it is important to clarify whether skin-only treatment can alleviate systemic inflammation, and potentially influence cardiovascular risk factors.
Globally, the leading cause of death is cardiovascular disease, which is often linked to
chronic inflammation.
Recently, it has been shown that atopic dermatitis (AD), the most common chronic inflammatory
skin disease, shows increases in inflammatory and cardiovascular risk markers in patient
blood (proteins, microparticles, circulating inflammatory cells). Consistently, it has been
demonstrated that atopic dermatitis is associated with increased cardiovascular disease.
Whether these increases in inflammatory and/or cardiovascular risk markers in the peripheral
blood are due to skin inflammation, or due to other body sources (e.g. lung, lymphatic
system) is unknown.
To investigate whether some (or all) risk proteins present in patient blood are produced in
inflamed skin, the investigators want to treat patients suffering from moderate-to-severe AD
with ultra-violet light B (UVB) therapy, as this therapy is thought to be an exclusive skin
treatment, without direct systemic effects. This notion is corroborated by the fact that only
skin regions directly treated with UVB light, and not covered skin regions, respond to
phototherapy.
Ultra-violet light B (UVB) therapy has been used by dermatologists to treat AD for decades,
and in the 1990ies, narrow band-UVB (NB-UVB) wavelengths (311-312nm) were found to have the
best treatment effects. This is a safe and effective therapy for the majority of patients,
with the main drawback being that it is inconvenient, as patients need to attend the clinic
three times a week for at least 8 weeks. The mechanism of action appears to include killing
of skin immune cells, and it also appears to down regulate inflammatory molecules such as
IFNg, IL-12 and IL-23. However, a systematic study of the impact of NBUVB on blood biomarkers
has never been performed. In this study, participants will be treated with an appropriate
dose of NB-UVB three times a week for up to 12 weeks or a total of 36 treatments, and blood
will be drawn to assess inflammatory and cardiovascular risk markers (proteins,
microparticles, circulating blood cells). Results will be compared to levels in blood from
healthy control participants. This study could lead to a new understanding on the role of the
skin as a source of systemic inflammation, which would help to guide future treatment
approaches for this debilitating, chronic skin disease.
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