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Daily Archives: November 4, 2019
Posted: November 4, 2019 at 6:47 pm
"My patients understand itch is transferred like nerve pain," said Gil Yosipovitch, MD, director of the Miami Itch Center and chair of the National Eczema Association scientific advisory committee.
But clinicians have argued whether atopic dermatitis is a "rash that itches" or an "itch that rashes," he acknowledged.
New evidence supports the patient-reported sensation that "eczema is the itch that rashes," Yosipovitch told Medscape Medical News.
The research, published in Nature and presented during the President's Symposium at the 28th European Academy of Dermatology and Venereology Congress in Madrid, shows that neurons serving the skin directly interact with mast cells to trigger the massive histamine release associated with atopic dermatitis inflammation.
These new findings confirm a direct role for the nervous system, which is responsible for the itchiness and was already implicated in the inflammation.
"We, as a profession, have this thinking that eczema is an immune condition, and we forget that the immune system works with nerves," Yosipovitch explained. "Ten years ago, you wouldn't accept it because there weren't any data."
Atopic dermatitis, a form of eczema, is far more than just itching skin. The condition cycles through flares and remissions and can take over the entire body, leading to discomfort and inflammation. In fact, the root of "eczema" is a Greek word for boiling, which is an apt description of the burning inflammation and itching people experience.
Eczema affects about one in five children, some of whom show signs of it shortly after birth. Genetic variants can increase susceptibility.
For newborns at high risk for eczema, the pre-emptive application of petroleum jelly might delay onset or limit escalation, one study suggests. However, studies on the use of cream emollients and oil baths have yielded disappointing results, as reported by Medscape Medical News.
The investigators used dust mite antigens from the skin of reactive patients to induce a reaction in mice.
The condition is so similar in mice and humans that it is difficult to distinguish samples from one another at the microscopic level, presenter Nicolas Gaudenzio, PhD, an immunologist at INSERM in Toulouse, France, told Medscape Medical News.
For their study, Gaudenzio and his colleagues used several mouse models to show that sensory neurons and immune cells work together to detect allergens related to the common dust mite.
The team pursued this research question because levels of neuropeptides signaling molecules produced by sensory neurons called nociceptors are elevated in people with atopic dermatitis, as are markers for mast cells.
To examine the association between neurons and mast cells, the researchers exposed mice to dust mite allergens and monitored their skin. They found that nociceptors, which transmit pain and itch messages, and mast cells do not chat with each other from a distance. Instead, they cluster together and make physical contact, with the mast cells gathering around the nociceptors like bees around a hive.
We don't really know why some people are reacting and others are not.
We don't really know why some people are reacting and others are not.
Although these neuronmast cell units seem to be part of normal immune defense, not everyone reacts to ubiquitous dust mite allergens. In some people, "they can literally fire up the nerve fibers," he pointed out, "but we don't really know why some people are reacting and others are not. That's a black box."
Nociceptors and mast cells occur in other tissues that show an allergic response, the researchers explain, including the lungs, upper airways, and gut.
After his presentation, audience questions to Gaudenzio homed in on the same subject: Does this discovery mean new therapeutic possibilities for this sometimes-intractable condition?
That is not clear, Gaudenzio said, but the next steps will be to block the interaction between the sensory neuron and the mast cells to see if doing so forestalls the cascade of events that leads to the inflammation.
28th European Academy of Dermatology and Venereology (EADV) Congress. Presented October12, 2019.
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Evidence Growing That Eczema Itch More Than Skin Deep - Medscape
Posted: at 6:46 pm
Why do we itch? The reasons are many and varied. But what's becoming ever clearer is many who experience chronic itching due to skin conditions also shoulder a profound psychological burden no scratching can relieve.
While the nature of this link around conditions like eczema and psoriasis has been investigated before, scientists say we're still only beginning to understand how skin disorders, mental health problems, and quality of life all intersect.
"There are already studies showing evidence of a correlation between itch and mental health problems in general, and in specific skin disorders, but there is a lack of a cross-sectional study across chronic skin diseases," says dermatologist Florence J. Dalgard from Lund University in Sweden.
To help fill that gap, Dalgard and her team analysed data collected from thousands of dermatology patients with skin issues in 13 European countries, including the UK, France, Germany, Russia, and elsewhere.
In total, over 3,500 patients with varying skin diseases took part in the study, undergoing physical examinations and filling out a questionnaire which asked questions about their socio-economic background and experiences with itching, while also measuring symptoms of depression, anxiety, and suicidal ideation.
More than 1,300 people without skin conditions acted as a control group, self-reporting the same information.
When the research team analysed the responses, they found a number of associations between skin conditions, itching, mood disorders, and quality of life impairments.
In patients with skin conditions who reported itching, the prevalence of depression was 14.1 percent. This lowered to 5.7 percent in patients who didn't itch.
Controls without skin disorders who reported itching also had around a 6 percent prevalent of depression - while only 3.2 percent in the control group members who didn't have itching reported depression.
Anxiety bore a similar pattern, showing up in 21.4 percent of the patients with skin conditions and itching, and dropping to 12.3 percent in patients without itching, while approximately 8 percent of the controls reported anxiety.
The prevalence of suicidal ideation was higher in patients with itch (15.7 percent) than in patients without itch (9.1 percent); similarly, it was higher in controls with itch (18.6 percent) than controls without (8.6 percent).
Patients with itch further reported experiencing more negative life events than the patients without itch did (38.2 percent compared to 32.4 percent respectively), and the patients who experienced itching were also likely to experience more economic problems.
While the team acknowledge their data can prove nothing about causation one way or the other (and submit that mental health suffering could potentially induce itch to some degree), they suggest it is much more likely that skin diseases are the cause of itching, which then leads to mental health effects.
"Speculative reasons for this correlation is that itch correlates with skin inflammation and skin inflammation induces serotonin network in the brain leading to depression and anxiety," the authors write in their paper.
While more research is needed to explore the hypothesis, for now at least, the link between itching and depression looks more firmly established than ever.
And that, the researchers say, should be reflected in how we treat patients with skin conditions with a multidisciplinary team of physicians to help support these people, and everything they may be dealing with.
At the same time, preventative programs might be able to play a role in helping to ease itching and maybe reducing the development of the serious psychological symptoms that appear to stem from it.
"Our findings demonstrate that the presence of itch in dermatological patients is significantly associated with clinical depression, suicidal ideation and stress," the researchers conclude.
"The study reveals that itch contributes substantially to the psychological burden of dermatological patients and confirms the multi-dimensional suffering of dermatological patients with itch."
The findings are reported in Journal of Investigative Dermatology.
Posted: at 6:43 pm
This is a rush transcript and may contain errors. It will be updated.
Alexandria O.: You announced recently that the official policy of Facebook now allows politicians to pay to spread disinformation. Do you see a potential problem here with a complete lack of fact checking on political advertisements?
Mark Zuckerberg: Well, Congresswoman, I think lying is bad and I think if you were to run an ad that had a lie, that would be bad.
Alexandria O.: So you wont take down lies or you will take down lies? I mean, its just a pretty simple yes or no.
Mark Zuckerberg: In democracy, I believe that people should be able to see for themselves what politicians that they may or may not vote for are saying [crosstalk 00:00:30]
Alexandria O.: So you wont take them down.
Marc Steiner: I dont want to be on her bad side. That was of course, Congresswoman Alexandria Ocasio-Cortez pushing Mark Zuckerberger over the false advertising that Facebook allows with no fact checking by right-wing candidates.
So lets start there and hello and welcome to The Real News. Im Marc Steiner. Good to have you with us. What did he say? I think hes the new king of doublespeak. Facebook cut a news deal with the Breitbart. Breitbart, remember them? The news liars from the right and now employees there are revolting at Facebook because Zucc, as hes called by, some allows politicians to post ads that are clearly lies and from folks are taking full advantage of that. So when AOC asked if she could run an ad full of lies it inspired someone to post this ad on Facebook.
Speaker 4: When Teddy Roosevelt became president, our land, forests and wildlife had been exploited for more than 100. But the consequences of these lost resources had not yet dawned in the public conscience. President Teddy Roosevelt fired the imagination of the American people, shook our nation from its lethargy and began to rescue the public domain.
Speaker 5: Clean air and clean water, a wise is use of our land, with the protection of wildlife and natural beauty. These are part of the birthright of every American. To guarantee that birthright, we must act and act decisively. It is literally now or never.
Speaker 6: It breaks my heart to see that the conservative movement in America has really abandoned a century of tradition, of support for conservation and environment.
Senator Graham: Im Senator Graham from South Carolina. Im here to announce with my colleagues that we care about conservation. We care about the environment. From a Republican point of view, I think we need to look at the science. Admit that climate change is real. Simply put, we believe in the Green New Deal.
Alexandria O.: This should not be a partisan issue.
Senator Graham: Im not a scientist. I have the grades to prove it, but I have really taken this issue to heart.
Marc Steiner: So who knew? I mean this is a whole different Graham than anyones ever seen before. I kind of liked this Graham, might changing my whole idea of what to do. I dont know. Lets welcome the man who did this ad that was taken down by Facebook. Hes now running for governor of California. Adriel Hampton, welcome to The Real News. Good to have you with us.
Adriel Hampton: Hey, thank you Marc. Its good to be here.
Marc Steiner: So whyd you tell those lies?
Adriel Hampton: Well, during the hearing where Alexandria Ocasio-Cortez questioned Mark Zuckerberg, she laid out the scenario for an ad just like that one. And the interesting thing is what happens when you really do it, right? So we have a political action committee called The Really Online Lefty League. And Wednesday night after seeing that testimony, I got a flash of insight and I thought we need to make that ad and see what happens if we put it up on Facebook.
So I contacted a friend who works with me, Mike Ramsey, who is the founder of something called the Institute for Progressive Memetics and hes a very talented designer and obviously video editor. And we discussed the idea. I had thought about doing an image first. He said, its got to be a video. He cut that video for The Really Online Lefty League. And the next day, Thursday, we put it up and I thought after this hearing and Ocasio-Cortez said, Could I run an ad saying that my, the GOP candidates in the primaries support the Green New Deal? And I thought Zucc would have sent a missive around to make sure that that ad didnt get approved, but it did get approved. Facebook has a review process and then they, if they get complaints or media contact them, then they react.
And that ad ran for about a day, very little spend. The goal was never to intentionally deceive. It was to test the policies that are allowing a president whose campaign manager has run millions of Facebook ads, he claims to have, and he also is planning to spend $1 billion on Trumps re-elect. Thats on Facebook, thats enough money, even a 10th of that is enough to sway an election in my opinion, depending on what other candidates are doing. But its that exemption for falsehood is very big. Now then Facebook took down our ads saying that it is a political action committee, not a politician.
So then Mike Gravel, the former candidate for president, put it up on his page. They took it down again this time saying it had been debunked on our page, so it couldnt be run subsequently on someone elses page. And then Facebook fact checkers also indicated to me that they might rule that Mike is a former politician, even though hes actively doing interviews and hes promoting his book and hes clearly a politician, but hes not in elected office or actively seeking elected office.
So Monday morning I went and I filed to run for governor of California because I figured if you can launch a run for governor by attacking Trump, Mark Zuckerberg and the biggest recipient of PG&E, large S in California politics, thats a pretty good way to kick it off.
Marc Steiner: And you did. So of course in California, it doesnt cost anything to run for office, right?
Adriel Hampton: It doesnt. Not when you declare. You have to pay a fee thats not in consequential, much closer to the actual election in 2022. So yeah. Yeah. Just about anyone could go and file for office right now in California. You basically, you cant be a felon and you have to sign your name on it. Its a one page form.
But I think in this case, the interesting thing is we have the technical acuity to keep doing these kinds of ads. And we now have myself, Mike Gravel and one other federal candidate who are all all of us will run these fake ads if we have to, to beat up at the system until we get politicians and right wingers treated the same as everyone else. And I swear, Marc, if they dont change, it wouldnt take me very much money to defeat them. And I can explain why.
Marc Steiner: So I mean, so youre running for California, basically, so you can undermine Facebook and tell a lot of lies about the other side.
Adriel Hampton: Im running for California governor because this issue Ocasio-Cortez is doing a great job, it looks like, at the federal level, but shes not in House leadership. And you need someone like a governor or a chair of a powerful committee in California or in Congress to hold real hearings on this. We can hold hearings for months figuring out how in a democracy you police this kind of false speech, disinformation, the audience targeting that Facebook allows that is really more powerful than anything ever invented. And thats the whole Cambridge Analytica scandal, right? And Im very familiar with psychometric targeting. I have not run millions of Facebook ads, but I have run tens of thousands.
Marc Steiner: So, speaking of Zuckerberg, Im going to come back to this Cambridge Analytica thing and what happened with AOC, but this is Zuckerberg talking at Georgetown, I believe in Washington DC just a little bit ago.
Mark Zuckerberg: In times of social tension, our impulse is often to pull back on free expression, because we want the progress that comes from free expression, but we dont want the tension. Pulling back on free expression wasnt the answer. And in fact, it often ends up hurting the minority views that we seek to protect. We can either continue to stand for free expression, understanding its messiness, but believing that the long journey towards greater progress requires confronting ideas that challenge us. Or we can decide that the cost is simply too great, yet still a strict first amendment standard might require us to allow things like terrorist propaganda or bullying people that almost everyone agrees that we should stop, and I certainly do. So once were taking this content down, the question is, where do you draw the line?
Marc Steiner: Where do you draw the line? And he, I mean, he made it very clear when he was being questioned by Ocasio-Cortez. He sounded like a 12 year old. I dont lie, I dont like lies. So what do you make of Mr. Zuckerberg in this?
Adriel Hampton: Well, I heard the word free a lot of times from a man who runs a $531 billion advertising platform. So I find it to be incredibly disingenuous and in fact dishonest. And Mark Zuckerberg himself is dealing in gross misinformation. And before we came on air, and I think in some of the slides here, I saw references to Popular Information which is a newsletter that regularly talks about how Facebook is not enforcing its policies against Trump. And Facebook, I believe, explicitly clarified its policies to make sure that it was clear that it was okay for Trump to lie. They also use Tucker Carlsons Daily Caller as a fact-checking organization. I believe they created a foundation to be a fact checker.
Now Ive just refused my first Fox on air interview and will continue to do so, because these are the companies, Fox, Daily Caller, Daily Wire, Breitbart, that are really a part of the problem of gross right-wing propaganda. Its also interesting, you dont see The Real News being asked to provide a fact checking crew. You dont see Occupy Democrats being asked to be a news source inside. They have I think a publication called The Washington Times, thats not highly regarded for truthfulness, but neither was Daily Caller. And then Daily Wire has 14 Facebook pages coordinating to boost its content on a daily basis, making it more popular on Facebook than CNN and New York Times on many days.
Marc Steiner: So tell me. Theres this is tweet that AOC put out about Cambridge Analytica and I just looked, for our viewers to take a look at this a minute. I mean, heres what we know that Zuckerberg doesnt know when Facebook discovered, he discovered that Cambridge Analytica scandal, thats hard to believe. And so Zucc privately met with Trump and the far right. Hes now allowing pages for disinformation ads. He didnt tell the whole truth about his fact-checkers. So thats what you were alluding to. And, so what do you thinks afoot here when you have that and you had the News Wire and Ben Shapiro having 14, 16, 7 or the number of Facebook pages spewing out lies. He cut a deal with Breitbart, the right wing news media. I mean, is it all about money?
Adriel Hampton: Yeah, I want a smile, but I have to grimace through all of that. I think its about money and I think its about power, right? You consider, I gave a scenario of some both independent and very left organizations that could correlate to some of the organizations that are in power now with Facebook. And I guess the issue that were hammering on is that right now it appears that Facebook is either has a pure profit motive or it has the motive of kissing up to the administration, right? If you know that Trump is going to be really pissed off if you start censoring his content or if you start messing with the Daily Wire, then Facebook, they might do this stuff just to stay in Trumps good graces.
And weve also seen that Mark Zuckerberg does not want Elizabeth Warren to be president because shes openly called for the breakup of Facebook. So we have the CEO of a company manipulating an election here. And Im challenging their standing to be the arbiter of truth on their platform. Who gave Mark Zuckerberg the right to decide what the first amendment means.
Marc Steiner: I mean, thats the danger-
Adriel Hampton: Hes not a judge. Hes not a politician. Hes not democratically elected.
Marc Steiner: No. And thats the danger in part of this, is when the public commons is privately owned, it changes the nature of our democracy and could. I mean AOC put this other tweet up and when she.. the end of this tweet I think is shes really pushing hard here. When she writes to the end, they are making active and aggressive decisions that imperil our elections. And I think thats very real. And I think thats the point that were just beginning to uncover. I mean, Im not sure where this goes.
I mean, let me conclude with this, this last tweet here up from Carole Cadwalladr, who is in The Observer. And I thought what she said here was really something. Its not a crime. Its the coverup always, always, always. This weekend was he brought this fire out. And thats why I think theres trouble ahead for Zucc. This isnt the end of the Cambridge Analytical scandal. Its the beginning. I mean, so talk a bit about where you think this going to unfold and what this means for you and what youre about to do.
Adriel Hampton: Yeah. I think that we need democratic regulation of these companies. They should not be allowed to regulate themselves. If its a free speech issue from the first amendment, thats the government, not Facebook, that gets to decide how thats interpreted, right? We do, those of us on the progressive side of the spectrum, its challenging that we have more conservative Supreme Court than I would like to see these things. But Congress can act and also Sacramento can act and thats the importance of me running for governor. We will continue to challenge these policies.
Have I given you theres a Mitch McConnells scenario. Do you want to hear it?
Marc Steiner: Yep, please.
Adriel Hampton: So Mitchell McConnell right now is blocking action on any bills, right? Hes kind of saying Im the Grim Reaper of the Senate. Well, Mitch McConnell, how about we run a parody, a parody ad and well run it and it wont say that we want to elect or defeat you and it wont be an electioneering ad, but it will talk about how you secretly want to be president and you were secretly planning to stab Trump in the back in the impeachment hearings. And we will run that ad in Kentucky and well run it to, and these are real categories inside Facebooks ad targeting, and well run it too likely to engage with political content, (conservative) and people with a high school education.
Marc Steiner: Ill tell you what, well continue our conversations down the road for the next year. If you have you put something up, well try to do it and well put it out there on our sites as well and continue this conversation. And Im glad-
Adriel Hampton: Thanks.
Marc Steiner: its good to see a man whos not afraid to fight and have a sense of humor and keep pushing this so.
Adriel Hampton: Thank you Marc. Appreciate it.
Marc Steiner: Adriel Hampton, thanks so much for joining us today. Its been great.
Adriel Hampton: Absolutely.
Marc Steiner: Keep on telling them. And thank you all for watching The Real News. Im Marc Steiner. Good to have you with us. Let us know what you think. Take care.