Jenerowicz Dorotaz, Czarnecka-Operacz Magdalena, Silny Wojciech
Department of Dermatology and Allergic Diseases Diagnostic Center, University of Medical Sciences, Przybyszewski Str. 49 60-355 Poznań, Poland.
Acta Dermatovenerol Croat. 2006;14(2):73-80.
Atopic dermatitis (AD) is an inflammatory skin disease characterized by chronic and recurrent course, beginning primarily in early childhood. The etiopathogenesis of AD has not yet been fully understood, although various types of inflammatory cells including eosinophils may be involved in its pathomechanism. The basic aim of the study was to evaluate the usefulness of selected eosinophil proteins in serum and urine of AD patients, as markers of disease severity. The study also aimed to analyze correlations between the level of examined proteins and parameters such as skin prick test (SPT) results, serum concentration of total IgE, and coexistence of symptoms of other atopic diseases. The study included 30 AD patients and two control groups: 30 patients suffering from chronic urticaria and 30 healthy individuals. The mean level of eosinophil proteins measured in serum and urine of AD patients was higher than that in controls, although a significant difference was only recorded for serum and urine level of eosinophil protein X (EPX). Patients with very severe/severe AD presented higher levels of eosinophil proteins than patients presenting with mild/moderate AD, although no significant difference was found between these two groups. AD patients with positive SPT results and detectable specific IgE in serum, and with coexisting symptoms of other atopic diseases presented with higher mean levels of serum and urine eosinophil proteins than AD cases with negative SPT results and without any symptoms of other atopic diseases. In children suffering from AD, serum eosinophil cationic protein level, EPX level and urine EPX level were higher than those in healthy children, however, without statistical significance. Study results suggested a significant role of eosinophils in the etiopathogenesis of AD. Serum and urine levels of selected eosinophil proteins may serve as an important part of diagnostic approach to AD patients, especially in differentiation of allergic and non-allergic forms of AD. The results are also promising for the usefulness of selected eosinophil proteins in the diagnosis of AD in children, however, thorough analysis on a larger group of patients is needed.
特应性皮炎(AD)是一种炎症性皮肤病,其特征为病程慢性且反复发作,主要始于幼儿期。尽管包括嗜酸性粒细胞在内的多种炎症细胞可能参与其发病机制,但AD的病因发病机制尚未完全明确。本研究的基本目的是评估AD患者血清和尿液中所选嗜酸性粒细胞蛋白作为疾病严重程度标志物的实用性。该研究还旨在分析所检测蛋白的水平与皮肤点刺试验(SPT)结果、总IgE血清浓度以及其他特应性疾病症状共存等参数之间的相关性。该研究纳入了30例AD患者以及两个对照组:30例慢性荨麻疹患者和30名健康个体。AD患者血清和尿液中测得的嗜酸性粒细胞蛋白平均水平高于对照组,不过仅嗜酸性粒细胞蛋白X(EPX)的血清和尿液水平有显著差异。与轻度/中度AD患者相比,重度/极重度AD患者的嗜酸性粒细胞蛋白水平更高,尽管两组之间未发现显著差异。SPT结果呈阳性且血清中可检测到特异性IgE以及伴有其他特应性疾病症状的AD患者,其血清和尿液嗜酸性粒细胞蛋白的平均水平高于SPT结果呈阴性且无其他特应性疾病症状的AD病例。在患AD的儿童中,血清嗜酸性粒细胞阳离子蛋白水平、EPX水平和尿液EPX水平高于健康儿童,然而无统计学意义。研究结果表明嗜酸性粒细胞在AD的病因发病机制中起重要作用。所选嗜酸性粒细胞蛋白的血清和尿液水平可能是AD患者诊断方法的重要组成部分,尤其是在区分AD的过敏性和非过敏性形式方面。这些结果对于所选嗜酸性粒细胞蛋白在儿童AD诊断中的实用性也很有前景,不过需要对更大规模的患者群体进行深入分析。