GENETICS OF ATOPIC DERMATITIS

这个子项目是许多利用 由NIH/NCRR资助的中心赠款提供的资源。子项目和 研究者（PI）可能从另一个NIH来源获得了主要资金， 因此可在其他CRISP条目中表示。所列机构为 研究中心，而研究中心不一定是研究者所在的机构。 今天，生物恐怖主义威胁的增加引起了人们对天花的新的关注。对平民人口进行大规模疫苗接种或重新接种，作为预防可能发生的生物恐怖袭击的一项措施，是目前一个重要的公共卫生问题。然而，天花疫苗并非没有风险。 由天花相关病毒牛痘组成的活病毒疫苗在所有疫苗中不良反应率最高。 最严重的是湿疹疫苗（EV），一个潜在的威胁生命的条件下，病毒蔓延整个皮肤不受控制。 如果不治疗，EV会引起严重的全身症状，类似于脓毒性休克，导致40%的病例死亡。2岁以下儿童的死亡率较高。 特别处于风险中的个体包括具有特应性皮炎（AD）病史的个体。AD在儿童和年轻人中最常见，AD和其他特应性疾病的全球患病率一直在上升。最近的研究表明，超过10%的儿童受到AD的影响。生物恐怖主义威胁的增加和天花病毒被用作生物武器的可能性，加上普通人群缺乏天然或疫苗诱导的免疫力，可以理解地导致了关于恢复常规天花疫苗接种的讨论。 虽然无法预测谁会感染EV，但由于40%的美国人口对牛痘免疫力不敏感，并且免疫妥协因素（如AD等皮肤病）今天比过去更普遍，EV的发病率很可能高于天花疫苗接种常规的时代。在任何关于天花疫苗接种的公共卫生讨论中，必须仔细考虑这些风险。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Today's increased threat of bioterrorism has caused renewed concern about smallpox. Large-scale vaccination or re-vaccination of the civilian population as a prophylactic measure against possible bioterrorist attack is currently an important public health concern. However, the smallpox vaccine is not without risk. The live-virus vaccine, composed of the smallpox-related virus vaccinia, has the highest rate of adverse reactions among all vaccines. Most serious is eczema vaccinatum (EV), a potentially life-threatening condition in which the virus spreads unchecked throughout the skin. When untreated, EV causes severe systemic symptoms resembling septic shock leading to death in 40% of cases. Mortality rates are higher in children under 2 years of age. Individuals particularly at risk include those with a history of atopic dermatitis (AD). AD is most common in children and young adults and the global prevalence of AD and other atopic disorders has been on the rise. Recent studies suggest that more than 10% of children are affected by AD. The increased threat of bioterrorism and the possibility of the smallpox virus for use as a biological weapon, coupled with the lack of natural or vaccine-induced immunity among the general population, have understandably led to discussion about reinstating routine smallpox vaccination. It cannot be predicted who will get EV, although, since 40% of the U.S. population is immunologically na¿ve to vaccinia and immuno-compromising factors (skin diseases such as AD) are more prevalent today than in the past, the rate of EV would most likely be higher than during the era when smallpox vaccination was routine. These risks must be carefully considered in any public health discussion regarding smallpox vaccination.