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Elizabeth THAM
Atopic Dermatitis in early childhood |
Abstract
One in 5 children in Singapore are afflicted with atopic dermatitis (AD), a chronic relapsing inflammatory skin disease, which commonly begins in the first few years of life. Apart from the significant socioeconomic, psychological and healthcare burden of this disease, children with AD are at increased risk of food allergies, allergic rhinitis and asthma in later childhood. There are still many unmet needs in the management of childhood AD. The role of the skin microbiome in modulating AD risk, control and treatment response has been of much interest in recent years. This talk covers clinical research findings in childhood AD from the Growing Up in Singapore Towards healthy Outcomes (GUSTO) birth cohort and other clinical cohorts, with a focus on risk factors, pathogenesis and the role of the microbiome and future therapeutics.
One in 5 children in Singapore are afflicted with atopic dermatitis (AD), a chronic relapsing inflammatory skin disease, which commonly begins in the first few years of life. Apart from the significant socioeconomic, psychological and healthcare burden of this disease, children with AD are at increased risk of food allergies, allergic rhinitis and asthma in later childhood. There are still many unmet needs in the management of childhood AD. The role of the skin microbiome in modulating AD risk, control and treatment response has been of much interest in recent years. This talk covers clinical research findings in childhood AD from the Growing Up in Singapore Towards healthy Outcomes (GUSTO) birth cohort and other clinical cohorts, with a focus on risk factors, pathogenesis and the role of the microbiome and future therapeutics.
Bio
Dr Elizabeth Tham is currently Head and Consultant, Division of Paediatric Allergy, Immunology & Rheumatology, Department of Paediatrics, Khoo Teck Puat - National University Children's Medical Institute, National University Hospital and Assistant Professor, Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore. She is a Clinician-Scientist with a research focus on atopic dermatitis, food allergy, early life immunomodulation and Developmental Origins of Health and Disease (DoHAD). Her research focuses on elucidating endophenotypes of atopic dermatitis/food allergy, the role of the skin, gut and environmental microbiome in modulating AD risk and disease control in children and their translational relevance for improvement of clinical care.
Dr Elizabeth Tham is currently Head and Consultant, Division of Paediatric Allergy, Immunology & Rheumatology, Department of Paediatrics, Khoo Teck Puat - National University Children's Medical Institute, National University Hospital and Assistant Professor, Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore. She is a Clinician-Scientist with a research focus on atopic dermatitis, food allergy, early life immunomodulation and Developmental Origins of Health and Disease (DoHAD). Her research focuses on elucidating endophenotypes of atopic dermatitis/food allergy, the role of the skin, gut and environmental microbiome in modulating AD risk and disease control in children and their translational relevance for improvement of clinical care.
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Anand ANDIAPPAN
From allergies to eczema: A molecular perspective |
Abstract
Allergies are a common chronic condition in Singapore affecting nearly 50% of children and more than 30% of adults. Skin allergies and in particular atopic dermatitis (AD) commonly referred to as eczema causes significant healthcare burden and direct and indirect costs as managing the disease is difficult. Current treatments for AD are mostly generic adopting a “one-size fits all” approach. Additionally, long term usage of steroids results in side-effects such as kidney toxicity, further highlighting needs for alternative treatment options. AD is still an ongoing clinical and societal problem and requires additional research to improve care and provide personalised treatment tailored to the individual patient rather than generic treatment. Better classification of patients would enable early proactive treatment leading to improved disease management and enhanced quality of life of AD patients. Recent clinical trials targeting immune candidates for AD have yielded promising results, with Dupilumab (targeting Interleukin-4 receptor) already approved by FDA. However molecular endotypes in Asian populations have not been well-characterised and need targeted studies in non-Caucasian populations. This would allow clinicians to stratify their patients and provide personalised treatment which enables long-term efficacy and better disease management. Hence our current effort aims to integrate existing efforts in characterising the skin and clinical phenotypes with molecular phenotyping to develop a greater understanding of the endotypes that exist in Singapore for AD and skin allergies. Our research will help improve our understanding of the molecular mechanisms and candidate targets important in AD and would hopefully aid with patient management. Also, as new therapies such as biologics are expensive, we need to match the right patients with the right treatment.
Allergies are a common chronic condition in Singapore affecting nearly 50% of children and more than 30% of adults. Skin allergies and in particular atopic dermatitis (AD) commonly referred to as eczema causes significant healthcare burden and direct and indirect costs as managing the disease is difficult. Current treatments for AD are mostly generic adopting a “one-size fits all” approach. Additionally, long term usage of steroids results in side-effects such as kidney toxicity, further highlighting needs for alternative treatment options. AD is still an ongoing clinical and societal problem and requires additional research to improve care and provide personalised treatment tailored to the individual patient rather than generic treatment. Better classification of patients would enable early proactive treatment leading to improved disease management and enhanced quality of life of AD patients. Recent clinical trials targeting immune candidates for AD have yielded promising results, with Dupilumab (targeting Interleukin-4 receptor) already approved by FDA. However molecular endotypes in Asian populations have not been well-characterised and need targeted studies in non-Caucasian populations. This would allow clinicians to stratify their patients and provide personalised treatment which enables long-term efficacy and better disease management. Hence our current effort aims to integrate existing efforts in characterising the skin and clinical phenotypes with molecular phenotyping to develop a greater understanding of the endotypes that exist in Singapore for AD and skin allergies. Our research will help improve our understanding of the molecular mechanisms and candidate targets important in AD and would hopefully aid with patient management. Also, as new therapies such as biologics are expensive, we need to match the right patients with the right treatment.
Bio
Anand Kumar Andiappan obtained his undergraduate degree from St. Peters Engineering College, Anna University in 2006 where he studied Industrial Biotechnology. He started his research career in the department of Biological Sciences in NUS, specialising in genetics of atopy and allergies in Singapore. He then moved to A*STAR in 2012 where he started as a post-doc at Olaf Rotzschke laboratory where he published the comprehensive study on atopic sensitisation and allergies in Singapore. Together with NUH, they also characterised multiple functional candidates for allergic diseases like BDNF, ORMDL3, CTLA-4, FCER1A. He then started his laboratory in SIgN in July 2018 on receiving the NMRC Young Investigator award (OF-YIRG). Currently his lab focuses on molecular profiling of biomarkers for allergies, infection and respiratory disorders (AIR biomarkers). He recently was also awarded a career development award (CDA) from A*STAR for “Novel Treatment Directions for Atopic Dermatitis in Asia: From Clinical Phenotypes to Molecular Endotypes”. Currently his lab focuses on molecular profiling of biomarkers for allergies, infection and respiratory disorders (AIR biomarkers). Understanding the underlying pathophysiology of complex diseases is essential to strategize targeted therapy and effective treatment. Here we use gene expression and protein characterisation at the specific cell-type level to come up with immunopathophysiology of these allergic and respiratory phenotypes.
Anand Kumar Andiappan obtained his undergraduate degree from St. Peters Engineering College, Anna University in 2006 where he studied Industrial Biotechnology. He started his research career in the department of Biological Sciences in NUS, specialising in genetics of atopy and allergies in Singapore. He then moved to A*STAR in 2012 where he started as a post-doc at Olaf Rotzschke laboratory where he published the comprehensive study on atopic sensitisation and allergies in Singapore. Together with NUH, they also characterised multiple functional candidates for allergic diseases like BDNF, ORMDL3, CTLA-4, FCER1A. He then started his laboratory in SIgN in July 2018 on receiving the NMRC Young Investigator award (OF-YIRG). Currently his lab focuses on molecular profiling of biomarkers for allergies, infection and respiratory disorders (AIR biomarkers). He recently was also awarded a career development award (CDA) from A*STAR for “Novel Treatment Directions for Atopic Dermatitis in Asia: From Clinical Phenotypes to Molecular Endotypes”. Currently his lab focuses on molecular profiling of biomarkers for allergies, infection and respiratory disorders (AIR biomarkers). Understanding the underlying pathophysiology of complex diseases is essential to strategize targeted therapy and effective treatment. Here we use gene expression and protein characterisation at the specific cell-type level to come up with immunopathophysiology of these allergic and respiratory phenotypes.
Chairs
Srikala RAGHAVAN, SRIS
Leah VARDY, SRIS
Srikala RAGHAVAN, SRIS
Leah VARDY, SRIS
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