關於 reactive oxygen species review ，我們在網路上蒐集到這些相關的討論、資訊與評價

你知道抽菸也跟異位性皮膚炎有關係嗎？

為何吸菸跟異位性皮膚炎有關目前還不清楚，但『菸』確實會影響角質細胞中的活性氧化物(reactive oxygen species)，直接傷害皮膚屏障。吸菸者血液中病原特定的免疫球蛋白(pathogen-specific immunoglobulins)濃度較低，且自體抗體的濃度升高，皆會影響過敏反應。再者，抽菸跟發炎反應有強烈相關性，而且尼古丁跟一氧化碳會干擾皮膚的供血及供氧系統，這些因素再加上過敏原進入皮膚，就產生了異位性皮膚炎。

過去不少研究發現懷孕婦女吸入二手菸，或是新生兒吸入二手菸，都會提高這個孩子得到異位性皮膚炎的機率。有學者甚至找出有特定基因(TNF-α/TLR4/GSTP1)多型性的孩子在產前接觸二手煙，比沒有那樣基因的孩子容易有異位性皮膚炎。有趣的是，另一個文獻指出媽媽在懷孕時抽菸，和寶寶得到異味性皮膚炎的機率無顯著相關，推測可能跟種族差異還有各地區公共衛生政策不同有關。但懷孕還是不要抽菸啦！會影響子宮血流還有胎兒生長喔！

此外，青少年和成年人不管是被動吸入二手菸，或是自己抽菸，都和異位性皮膚炎相關。而二手菸的作用在成年人的影響更大，可能是『活越久，吸越多』的累積效應。有一個研究還發現有異位性皮膚炎的成人，比沒有異位性皮膚炎的成人，在更年輕的時候就有抽菸的習慣！

抽菸跟異位性皮膚炎的嚴重度有關嗎？目前還沒有相關研究喔！
抽電子煙有影響嗎？證據不足，沒辦法釐清跟異位性皮膚的相關性。



Ref :

1. Atopic dermatitis is associated with active and passive cigarette smoking in adolescents. PLoS ONE 2017, 12 (11): e0187453.
2. Prenatal second-hand smoke increases atopic dermatitis in children with TNF-α/TLR4/GSTP1 polymorphisms. Pediatric Allergy, Immunology, and Pulmonology 2017 Vol. 30, No. 1.
3. Association of atopic dermatitis with smoking: A systematic review and meta-analysis. J Am Acad Dermatol. 2016 December ; 75(6): 1119–1125.e1.

#異位性皮膚炎
#抽菸的影響
#林政賢皮膚科
#從名畫看皮膚科

經常飲酒，即使是少量的酒精，都會增加女性患乳腺癌的風險，無論是更年期前或後。～AICR

研究人員回顧2000/1/1以後的15份相關統合分析，發現幾乎所有報告，#酒精 增加患 #乳腺癌 風險，從最低組別起，呈現一致性的劑量-反應(dose-response)關係。

某項研究中，少量飲酒是指每週飲用3-6份的酒，相當於每天10克乙醇(即酒精)。另一研究的少量飲酒者，則是每天喝一杯含有5-14.9克(0.5-1份)乙醇的酒。

此回顧報告從細胞和動物實驗找尋可能的機制，包括：
乙醇代謝可產生含氧氣活性分子(reactive oxygen species, ROS)，會損傷DNA；
酒精能增加雌激素與其他誘發乳腺癌生成的荷爾蒙濃度；
且乙醇會抑制葉酸吸收，這也可能增加乳癌風險。

AICR報導來源: http://www.aicr.org/…/cru-light-alcohol-intake-increases-br…

研究資料來源: Kevin D. Shield, Isabelle Soerjomataram, Jürgen Rehm. Alcohol Use and Breast Cancer: A Critical Review. Alcoholism: Clinical and Experimental Research, 2016; 40 (6)1166–1181
http://www.ncbi.nlm.nih.gov/pubmed/27130687

Understanding clinical signs of poor tissue perfusion during septic shock

Acute circulatory failure associated with infection, referred to as septic shock, is characterized by an inadequate tissue perfusion and oxygenation relative to metabolic requirements. This imbalance between delivery and tissue uptake is mainly due to altered microvascular blood flow regulation as a result of dysregulated and/or injured endothelial cells. Endothelial dysfunction is presumably induced by pathogenic bacterial products, inflammatory mediators, and reactive oxygen species produced by activated leukocytes [1]. Cellular and in fine tissue damages are related to ischemia and also to additional mechanisms that are out of the scope of this review such as mitochondria dysfunction. Direct microcirculation visualization using capillaroscopy has highlighted the heterogeneity of organ perfusion and the discrepancy between the overall hemodynamic status and local blood flow during sepsis [2]. In other words, in the presence of normal macro-hemodynamic, there may be regions of inadequate perfusion, underscoring the assessment of regional perfusion and oxygen delivery at the organ level [3]. Regional tissue perfusion has been investigated in different compartments such as the sublingual area or gastric mucosa using different devices, but in this mini-review, we will focus on skin peripheral perfusion, immediately available at the bedside.

http://bit.ly/1ShuXMs