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Chitosan Coated Textiles May Improve Atopic Dermatitis Severity by Modulating Skin Staphylococcal Profile: A Randomized Controlled Trial.

Lopes C, Soares J, Tavaria F, Duarte A, Correia O, Sokhatska O, Severo M, Silva D, Pintado M, Delgado L, Moreira A - PLoS ONE (2015)

Bottom Line: Comparisons were made using analysis of variance supplemented by repeated measures analysis for the primary outcome.Chitosan group improved SCORAD from baseline in 43.8%, (95%CI: 30.9 to 55.9), P = 0.01, placebo group in 16.5% (-21.6 to 54.6); P = 0.02 with no significant differences between groups; Dermatology Quality of life Index Score significantly improved in chitosan group (P = 0.02) and a significant increase of skin Coagulase negative Staphylococci (P = 0.02) was seen.Moreover, a potential effect in quality of life may be considered.

View Article: PubMed Central - PubMed

Affiliation: Laboratory of Immunology, Basic and Clinical Immunology Unit, Faculty of Medicine, University of Porto, Porto, Portugal.

ABSTRACT

Background: Atopic dermatitis (AD) patients may benefit from using textiles coated with skin microbiome-modulating compounds. Chitosan, a natural biopolymer with immunomodulatory and antimicrobial properties, has been considered potentially useful.

Objective: This randomized controlled trial assessed the clinical utility of chitosan-coated garment use in AD.

Methods: Of the 102 patients screened, 78 adult and adolescents were randomly allocated to overnight use of chitosan-coated or uncoated cotton long-sleeved pyjama tops and pants for 8 weeks. The primary outcome was change in disease severity assessed by Scoring Atopic dermatitis index (SCORAD). Other outcomes were changes in quality of life, pruritus and sleep loss, days with need for rescue medication, number of flares and controlled weeks, and adverse events. Changes in total staphylococci and Staphylococcus aureus skin counts were also assessed. Comparisons were made using analysis of variance supplemented by repeated measures analysis for the primary outcome. Interaction term between time and intervention was used to compare time trends between groups.

Results: Chitosan group improved SCORAD from baseline in 43.8%, (95%CI: 30.9 to 55.9), P = 0.01, placebo group in 16.5% (-21.6 to 54.6); P = 0.02 with no significant differences between groups; Dermatology Quality of life Index Score significantly improved in chitosan group (P = 0.02) and a significant increase of skin Coagulase negative Staphylococci (P = 0.02) was seen.

Conclusions: Chitosan coated textiles may impact on disease severity by modulating skin staphylococcal profile. Moreover, a potential effect in quality of life may be considered.

Trial registration: ClinicalTrials.gov NCT01597817.

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Related in: MedlinePlus

Mean (95% CI) Log10 total staphylococci and Log10 Staphylococcus aureus counts for all regions sampled in chitosan and placebo groups before and after intervention.CI-confidence interval *P = 0.01, Wilcoxon signed rank test.
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pone.0142844.g005: Mean (95% CI) Log10 total staphylococci and Log10 Staphylococcus aureus counts for all regions sampled in chitosan and placebo groups before and after intervention.CI-confidence interval *P = 0.01, Wilcoxon signed rank test.

Mentions: Most patients had identification of Staphylococci species in at least one sampled region with no significant changes after the intervention or for changes between groups (Table 3). There a was a decrease in the percentage of patients with identification of S.aureus from 68% to 55% in chitosan group in contrast with an increase in placebo group (from 53% to 64%) that did not reach statistical significance (Table 3). The mean proportion of S.aureus counts versus total staphylococcal counts showed no significant differences after intervention for both groups on the five sample regions (right arm, left arm, right leg, left leg, neck) (Table 3) neither when considering all regions (Fig 4). When considering total bacterial counts there was a significant increase of the mean total staphylococcal count in the chitosan group (P = 0.02), with no other differences (Fig 5).


Chitosan Coated Textiles May Improve Atopic Dermatitis Severity by Modulating Skin Staphylococcal Profile: A Randomized Controlled Trial.

Lopes C, Soares J, Tavaria F, Duarte A, Correia O, Sokhatska O, Severo M, Silva D, Pintado M, Delgado L, Moreira A - PLoS ONE (2015)

Mean (95% CI) Log10 total staphylococci and Log10 Staphylococcus aureus counts for all regions sampled in chitosan and placebo groups before and after intervention.CI-confidence interval *P = 0.01, Wilcoxon signed rank test.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4664262&req=5

pone.0142844.g005: Mean (95% CI) Log10 total staphylococci and Log10 Staphylococcus aureus counts for all regions sampled in chitosan and placebo groups before and after intervention.CI-confidence interval *P = 0.01, Wilcoxon signed rank test.
Mentions: Most patients had identification of Staphylococci species in at least one sampled region with no significant changes after the intervention or for changes between groups (Table 3). There a was a decrease in the percentage of patients with identification of S.aureus from 68% to 55% in chitosan group in contrast with an increase in placebo group (from 53% to 64%) that did not reach statistical significance (Table 3). The mean proportion of S.aureus counts versus total staphylococcal counts showed no significant differences after intervention for both groups on the five sample regions (right arm, left arm, right leg, left leg, neck) (Table 3) neither when considering all regions (Fig 4). When considering total bacterial counts there was a significant increase of the mean total staphylococcal count in the chitosan group (P = 0.02), with no other differences (Fig 5).

Bottom Line: Comparisons were made using analysis of variance supplemented by repeated measures analysis for the primary outcome.Chitosan group improved SCORAD from baseline in 43.8%, (95%CI: 30.9 to 55.9), P = 0.01, placebo group in 16.5% (-21.6 to 54.6); P = 0.02 with no significant differences between groups; Dermatology Quality of life Index Score significantly improved in chitosan group (P = 0.02) and a significant increase of skin Coagulase negative Staphylococci (P = 0.02) was seen.Moreover, a potential effect in quality of life may be considered.

View Article: PubMed Central - PubMed

Affiliation: Laboratory of Immunology, Basic and Clinical Immunology Unit, Faculty of Medicine, University of Porto, Porto, Portugal.

ABSTRACT

Background: Atopic dermatitis (AD) patients may benefit from using textiles coated with skin microbiome-modulating compounds. Chitosan, a natural biopolymer with immunomodulatory and antimicrobial properties, has been considered potentially useful.

Objective: This randomized controlled trial assessed the clinical utility of chitosan-coated garment use in AD.

Methods: Of the 102 patients screened, 78 adult and adolescents were randomly allocated to overnight use of chitosan-coated or uncoated cotton long-sleeved pyjama tops and pants for 8 weeks. The primary outcome was change in disease severity assessed by Scoring Atopic dermatitis index (SCORAD). Other outcomes were changes in quality of life, pruritus and sleep loss, days with need for rescue medication, number of flares and controlled weeks, and adverse events. Changes in total staphylococci and Staphylococcus aureus skin counts were also assessed. Comparisons were made using analysis of variance supplemented by repeated measures analysis for the primary outcome. Interaction term between time and intervention was used to compare time trends between groups.

Results: Chitosan group improved SCORAD from baseline in 43.8%, (95%CI: 30.9 to 55.9), P = 0.01, placebo group in 16.5% (-21.6 to 54.6); P = 0.02 with no significant differences between groups; Dermatology Quality of life Index Score significantly improved in chitosan group (P = 0.02) and a significant increase of skin Coagulase negative Staphylococci (P = 0.02) was seen.

Conclusions: Chitosan coated textiles may impact on disease severity by modulating skin staphylococcal profile. Moreover, a potential effect in quality of life may be considered.

Trial registration: ClinicalTrials.gov NCT01597817.

Show MeSH
Related in: MedlinePlus