Raap U, Werfel T, Goltz C, Deneka N, Langer K, Bruder M, Kapp A, Schmid-Ott G, Wedi B
Department of Dermatology and Allergology, Hannover Medical University, Hannover, Germany.
Allergy. 2006 Dec;61(12):1416-8. doi: 10.1111/j.1398-9995.2006.01210.x.
Recent studies have shed light on the complex regulation of genetic, environmental, immunologic and pharmacologic factors, which contribute to the development of atopic dermatitis (AD). However, it is still unclear to which extent neuroimmune mediators have a role in AD.
To assess peripheral neurotrophin levels and their correlation with scoring atopic dermatitis (SCORAD) scores in both the intrinsic and extrinsic types of AD compared with patients with psoriasis and nonatopic healthy subjects.
Levels of brain-derived neurotrophic factor (BDNF) and nerve growth factor (NGF) were assessed in peripheral blood with enzyme-linked immunosorbent assay. Based on IgE-mediated sensitization, AD was divided into the extrinsic and intrinsic type. Severity of AD was assessed with SCORAD score and with psoriasis area and severity index (PASI) in patients with psoriasis.
Brain-derived neurotrophic factor and NGF were detectable in all the subjects studied. However, the levels of both neurotrophins were significantly higher in patients with extrinsic and intrinsic types of AD compared with patients with psoriasis and nonatopic healthy subjects (NGF: P < 0.001, BDNF: P < 0.001). NGF and BDNF levels were similar in the intrinsic and extrinsic type of AD. There was a significant correlation between BDNF and SCORAD score only in patients with the intrinsic type of AD (r = 0.57, P < 0.05).
This study shows for the first time that NGF and BDNF are increased in both, the extrinsic type and the intrinsic type of AD. This finding points to a similar pathophysiologic background implicating a neuroimmune network in both variants of this chronic inflammatory skin disease. Future studies are needed to show the direct mechanisms of neurotrophin action in chronic inflammatory skin.
近期研究揭示了遗传、环境、免疫和药理因素的复杂调控作用，这些因素均与特应性皮炎（AD）的发病有关。然而，神经免疫介质在AD中发挥作用的程度仍不明确。
评估与银屑病患者和非特应性健康受试者相比，内源性和外源性AD患者外周神经营养因子水平及其与特应性皮炎评分（SCORAD）的相关性。
采用酶联免疫吸附测定法评估外周血中脑源性神经营养因子（BDNF）和神经生长因子（NGF）的水平。根据IgE介导的致敏情况，将AD分为外源性和内源性。采用SCORAD评分评估AD的严重程度，采用银屑病面积和严重程度指数（PASI）评估银屑病患者的病情。
在所研究的所有受试者中均检测到BDNF和NGF。然而，与银屑病患者和非特应性健康受试者相比，外源性和内源性AD患者的两种神经营养因子水平均显著升高（NGF：P < 0.001，BDNF：P < 0.001）。内源性和外源性AD患者的NGF和BDNF水平相似。仅在内源性AD患者中，BDNF与SCORAD评分之间存在显著相关性（r = 0.57，P < 0.05）。
本研究首次表明，外源性和内源性AD患者的NGF和BDNF均升高。这一发现表明，在这种慢性炎症性皮肤病的两种变体中，存在类似的病理生理背景，涉及神经免疫网络。未来需要进一步研究以揭示神经营养因子在慢性炎症性皮肤病中的直接作用机制。
