all posts, nutrition, treatments

why you might want to follow news on filaggrin

yellow health medicine wellness
Photo by Pixabay on Pexels.com

I mentioned in a post last week that I was reading a book called Living with Itch by doctors Gil Yosipovitch and Shawn G. Kwatra. Well I’ve since finished it and determined it’s another book that I think everyone should read.

While reading said book I came to the following image:

2018-10-28 09.50.04

As I stared at my own palms, which do look remarkably like that illustration (as in I would make a palm reader dizzy trying to interpret all my lines), I pondered about this protein, filaggrin, and about all of us filaggrin-lacking individuals. This led me to wonder if there were existing treatments out there to replace filaggrin in those deficient.

But first, I had to understand what filaggrin does. Cue google scholar searching for studies! Filaggrin is a protein that binds keratin fibers together. Keratin is the protein that helps create the structure of the outer layer of our skin (and nails and other things). So not having functioning filaggrin means that outer skin barrier is not as strong and impervious to the external environment (germs, mechanical stressors like scratching, chemicals, temperature, water retention, etc).

Armed with that knowledge I did a cursory search which brought me to two studies, one in 2014, and one brand spanking new one done this year. The 2014 one looked into filaggrin injections, but I’m getting ahead of myself. To start, the study (done presumably in Europe as it talks about Europeans in particular and as I could only access the study’s abstract) gives background information that 1 in 10 European people have this filaggrin (FLG) loss of function mutation (or what they call a LOF mutation) and that so far this LOF mutation is the biggest genetic risk of atopic dermatitis. They also give other fun likelihoods like that someone with said mutation is more likely ” to develop asthma, to have more severe and more persistent disease, to have allergic sensitizations, and to develop eczema herpeticum”. At this point you may be thinking, ‘all of us FLG LOF’ers are off to a rough start!’ The study then went on to describe why they think filaggrin replacement therapy may help with eczema management (specifically atopic dermatitis, but I’m going to continue using the blanket term of eczema from now on). Basically they talk about how gene replacement therapy of this protein is difficult because the protein is so large and they need to get it through the stratum corner layer of the skin into the cytoplasmic space for it to work. So instead of trying to inject the big protein into the skin, they did some science-magic and used some mouse genetic material linked to a compound that could penetrate cells (a peptide) to make a recombinant protein (which can help get a mutant gene to express the normal function, in this case getting filaggrin to bind keratin fibers together). They tested their work on cell cultures, flaky mice tails, and human skin equivalents and results showed that the flaky tails’ stratum corneum (the outermost layer of the skin) seemed to be restored. They ended the study by saying that there would need to be further studies to determine how safe this would be for humans, as well as things like how much to use, how well it works, and how long to use it, etc. They also noted that though mice didn’t have any problems with the foreign protein injected into their tails, that there is still a possibility that humans’ skin/immune system could reject the forgiven material.

The newer study, rather than trying to inject filaggrin into the skin, took the approach of trying to create a nutritional supplemental to ingest (as they were particularly interested in making a convenient and safe treatment, especially for children). They noted that an amino acid called L-histidine gets used in filaggrin production, and when the filaggrin gets broken down, the L-histidine is released and used as a natural-moisturizing factor (or NMF) and is said to “contribute to barrier function through skin hydration and maintenance of stratum corneum acidity” (hey look, skin acidity mentioned once again). This study also goes on to mention how eczema may be caused by either the FLG mutation or messed up profilaggrin processing but either way can lead to the skin barrier issues we see with eczema, and for either issue the L-histidine amino acid has a beneficial effect. Their overall results were that an L-histidine supplement once a day for 4 weeks showed positive changes to eczema and those benefits lasts even when the L-histidine was discontinued. They even said that their results indicated using the L-histidine was on par with using a mid-potency topical steroid while being steroid free (so none of the side effects)!

Both the L-histidine supplement and the filaggrin injection sound extremely promising and exciting for the world of people living with eczema, though I, in particular am leaning towards the supplement, if I had my pick (I would love to be part of the study for L-histidine, but that will have to wait until I’m done breastfeeding).

 

REFERENCES

Irvine AD. Crossing Barriers; Restoring Function? Filaggrin Protein Replacement Takes a Bow. Journal of Investigative Dermatology. 2014 Feb; 134(2): 313-314.

Sandilands A, Sutherland C, Irvine AD, McLean WHI. Filaggrin in the frontline: role in skin barrier function and disease. J Cell Sci. 2009; 122: 1285-1294. 

Tan SP, Brown SB, Griffiths CEM, Weller RB, Gibbs NK. Feeding filaggrin: effects of L-histidine supplementation in atopic dermatitis. Clin Cosmet Investig Dermatol. 2017; 10: 403-411.

Advertisements
all posts, community, miscellaneous

hot flashes with a side of holidays

close up creepy dark darkness
Photo by Toni Cuenca on Pexels.com

Happy belated Halloween! Yes, I know I’m a day late but I’m including other holidays to pad my belated holiday post.

I started writing this at 3am on Halloween, and boy was I feeling it. I’d say I was doing about as well as an old cracking, stiff black leather couch on a dry heat kind of day when hot human flesh sprawls on top it (aka I was both drying out and exuding an uncomfortable amount of heat). To compound that, Fi kept waking up around every 2 hours, and it takes me at least 15-45 minutes to go back to sleep after she’s cared for, so deep healing sleep was not in my repertoire the other night, folks.

And so, instead of sleeping, I got all ready to chat about my once favorite holiday, Halloween. Did I mention how I absolutely love to dress up (or did before my skin started raging against the machine that is my body)? Anyway, I truly believe this day (or days) of year is (are) incredibly magical. For one, there are so many different cultural holidays, from our Halloween roots of Samhain, to All Saints’ Day to Latin America’s Día de los Muertos, to harvest festivals, to Guy Fawkes Day, etc.

Let’s start with the American classic holiday, Halloween. We all know how the holiday is celebrated today, at least in North America (though I’ve got a fun example of how it’s changing in an eczema-friendly direction that I’ll talk about later in the post), so for now let’s skip back a few decades to talk about Halloween’s origins.

Here’s the shortened history. Halloween had its roots from the Celtic festival Samhain, a celebration of the end of summer and the start of the harvest season. Because of the weather changes from summer to winter, it was also believed that this was a time when the worlds of the living and the death overlapped, and spirits could return to earth. To celebrate, the Celtic priests (Druids) made large bonfires where people brought sacrifices from their farm production, and they dressed up in animal skins. When the Roman Empire conquered the Celtic territory, they introduced other festivals that blended into our current holiday lore, such as commemorating the dead and festivals of fruit and trees (one which may have inspired the old tradition of bobbing for apples). The blending of Christianity into the Celtic territories led to holidays like All Souls’ Day, which was like Samhain but people dressed up as angels, devils, and saints, and eventually All Saints Day was moved to November 1st and Samhain (which became All Hallows Eve, and then Halloween) became the night before or October 31st. Halloween in America started out more similarly to the harvest festivals, then formed into an amalgam of folklore, ghost stories, mischief, and asking for treats. Over time it was reformed to try to be more community-based with parties, and with treats being given out to avoid tricks becoming the norm. At some point costumes were encouraged, first as a way to deter roaming spirit from recognizing living people, and then it was more for fun as it was modernized to what we know it as today.

Speaking of modernizing, there’s a new version of Sabrina the Teenaged Witch redone as a Netflix original (called Chilling Adventures of Sabrina) that definitely takes a much darker take on the 90s sitcom. In it, Sabrina is a half-witch, half-mortal who is constantly taking on the patriarchy, which is particularly creative when the patriarchy in question is not always that of humanity. But that’s where I’ll stop just in case anyone is planning on watching it (noting that some of the themes and violence are not appropriate for young children). If I were to try to liken the show’s general theme to that of eczema, I’d say it would be that you should always feel free to fight to create your own space, your own identity, and your own world even when the options seem to be telling you that you have a limited amount of choice. I’d elaborate more but I’m trying not to give away too many thematic spoilers.

And as promised, here’s a fun eczema-friendly movement that’s developed. Called the Teal Pumpkin Project, it’s a movement that is in recognition of the growing amount of life-threatening food allergies. Pioneered by a mom named Becky Basalone from Tennessee in 2012, she painted a pumpkin teal to indicate that she would offer alternatives to candy on Halloween, as her son had anaphylaxis and she wanted to have a way for him to still enjoy the holiday without worry. The Food Allergy Research and Education organization picked up the Teal Pumpkin Project and helped it gain country-wide recognition in 2014, encouraging people around the nation to put out these teal pumpkins to let families know that there are allergy-free (non-edible) treats available. So now, for those children out there that may be going through some sort of systematic inflammation disorder (be it food allergies, eczema, or something else), they also have a way to still partake in the festivities of All Hallow’s Eve. If you want to be involved, you can paint a pumpkin teal and put it outside your house, and then add your house to the teal pumpkin project map.

FARE_TPP_NOURL

Now for Día de los Muertos (or Day of the Dead). This holiday has seen an increase in recognition in the states over the years (just look at movies such as Book of Life, or the newer Disney movie Coco). It entails a celebration of one’s deceased, honoring their lives by creating an ofrenda (or offerings) for them of food, flowers, colorful skeletons, and people don brightly colored clothing and have parades and music and festivities to celebrate their family. The belief (of which developed from a mix of Aztec culture and Catholicism) is that on the Day of the Dead one’s ancestors come back to visit on earth, but it is disrespectful to grieve for one’s deceased, so instead it is a day of reunion and remembrance and happiness.

And lastly we have Guy Fawkes Day. Many of you may be familiar with this holiday due to the 2006 movie V for Vendetta, that centers around this elusive date of November 5th (easily remembered by the ditty: “remember remember the 5th of November, the gunpowder treason and plot. I know of no reason why the gunpowder treason should ever be forgot.” The history behind this holiday was that under various monarchs in England, (but primarily under King James I’s rule), Catholics were persecuted, unable to marry, fined for refusing to attend non-Catholic services, etc. Various attempts to overthrow the ruling king were enacted but the most famous was that done by Guy Fawkes and company. Their plan was to use gunpowder to blow up parliament on November 5th, 1605. Somehow, a letter was delivered to parliament about the plot, and Fawkes was stopped November 4, and subsequently he and his team were sentenced to be drawn and quartered as punishment for high treason. Celebrations with bonfires started after the plot was revealed and November 5th became known as Guy Fawkes Day, (even spreading to America as Pope Day where people burned the Pope in effigy). Although America stopped celebrating their version, in Britain, Guy Fawkes Day entails (even today) bonfires, fireworks, parades, and of course, burning Fawkes in effigy. The holiday has taken a spin where Guy Fawkes is sometimes seen as a hero, a change which is attributed to the movie V for Vendetta, where V wears a Guy Fawkes mask as he attempts to topple a fascist government regime. Spoiler alert: in the movie, V goes on a last stand rampage to kill off the remaining “bad guys” and results in him sacrificing himself. While he is dying, he shares a “kiss” (put in quotes because the heroine, Evie, kisses his mask), and then he dies and she puts his body onto the train with all the explosives, that runs under parliament. Maybe if V had lived in this time period, instead of deciding to sacrifice himself he would have jumped into the bandwagon of #unhideECZEMA, but pioneered his own movement to be about unhiding burns, and then he could have removed the mask and gloves and found himself worthy of living a new life with Evie. But then there wouldn’t be a movie.

Speaking of movies, here’s a side note to end with (though it’s not family-friendly and it’s quite violent and whatnot): the movie Deadpool actually supports the idea really well of skin issues not being a big deal. Spoiler alert: Ryan Reynolds’ character Wade, aka Deadpool, becomes horribly disfigured from a mutant experiment and spends the first movie chasing after the psychopath doctor who did it to him to get the doctor to make him good-looking again before he is wiling to go back to see his beloved girlfriend/fiancée, Ness. When that plan ultimately fails and he is going to be forever scarred, he is still reunited with Ness and she is upset at him for wasting time away from her, but unfazed by his skin. The old adage holds true, love is goes deeper than skin deep.

And now here’s to me hoping my skin is cooler tonight and I can sleep.

 

REFERENCES

Born, Courtney. “Origin of the Teal Pumpkin Project- Interview with FACET’s Becky Basalone.” Living Allergic, https://www.allergicliving.com/2014/10/23/the-origin-of-the-teal-pumpkin-project-interview-with-becky-basalone-facet/. Accessed 30 Oct 2018.

Greenspan, Jesse. “Guy Fawkes Day: A Brief History.” History, https://www.history.com/news/guy-fawkes-day-a-brief-history. Accessed 30 Oct 2018.

“Halloween 2018.” History. https://www.history.com/topics/halloween/history-of-halloween. Accessed 30 Oct 2018.

Richman-Abdou, Kelly. “Día de los Muertos: How Mexico Celebrates Its Annual ‘Day of the Dead’.” My Modern Met, https://mymodernmet.com/dia-de-los-muertos-day-of-the-dead/. Accessed 1 Nov 2018.