Wang I J, Hsieh W S, Guo Y L, Jee S H, Hsieh C J, Hwang Y H, Chen P C
Department of Pediatrics, Taipei Hospital, National Taiwan University College of Public Health, Taipei, Taiwan.
Clin Exp Allergy. 2008 Aug;38(8):1302-8. doi: 10.1111/j.1365-2222.2008.03026.x. Epub 2008 May 28.
Attempts to identify predictors of atopic dermatitis (AD) have focused on genetic and immunologic factors. However, the role of neuro-mediators remains to be elucidated.
To evaluate nerve growth factor (NGF) and vaso-active intestinal peptide (VIP) in predicting paediatric AD and assess their correlation with intrinsic and extrinsic types of AD.
We performed a nested case-control study in the prospective Taiwan birth panel cohort study. Cord and maternal plasma and questionnaires were gathered at birth. During follow-up, we identified 40 available AD cases, which were matched to 80 unaffected controls chosen from this cohort. The concentrations of IgE, NGF, and VIP in cord and maternal plasma of these subjects were performed by ELISA. Receiver-operating characteristic (ROC) curves were generated to see how well each biomarker could predict AD.
The NGF levels were significantly higher in AD patients than controls (mean+/-SD: 65.47+/-44.45 vs. 49.21+/-12.18 pg/mL for cord plasma and 89.68+/-41.04 vs. 66.96+/-23.05 pg/mL for maternal plasma) (P<0.05). VIP levels were also higher but not statistically significant. Plasma NGF may be a better biomarker than IgE in detecting paediatric AD (area under the ROC curve=0.65 vs. 0.61 for cord plasma and 0.69 vs. 0.61 for maternal plasma). Maternal NGF levels were significantly higher in patients with both intrinsic (96.18+/-48.15 pg/mL) and extrinsic (86.18+/-37.23 pg/mL) types of AD compared with controls (66.96+/-23.05 pg/mL) (P<0.05). We assessed a significant correlation between self-reported stress during pregnancy and maternal NGF levels (r=0.22, P=0.02).
Our results suggest that NGF is a good alternative biomarker in predicting children with a risk of AD.
识别特应性皮炎（AD）预测指标的研究主要集中在遗传和免疫因素上。然而，神经介质的作用仍有待阐明。
评估神经生长因子（NGF）和血管活性肠肽（VIP）在预测儿童AD中的作用，并评估它们与AD内在型和外在型的相关性。
我们在台湾前瞻性出生队列研究中进行了一项巢式病例对照研究。在出生时收集脐带血和母血样本以及问卷。在随访期间，我们确定了40例确诊的AD病例，并从该队列中选取80例未患病的对照进行匹配。采用酶联免疫吸附测定法（ELISA）检测这些受试者脐带血和母血中IgE、NGF和VIP的浓度。绘制受试者工作特征（ROC）曲线，以观察每个生物标志物预测AD的能力。
AD患者的NGF水平显著高于对照组（脐带血血浆：均值±标准差为65.47±44.45 vs. 49.21±12.18 pg/mL；母血血浆：89.68±41.04 vs. 66.96±23.05 pg/mL）（P<0.05）。VIP水平也较高，但无统计学意义。在检测儿童AD方面，血浆NGF可能是比IgE更好的生物标志物（脐带血血浆ROC曲线下面积=0.65 vs. 0.61；母血血浆：0.69 vs. 0.61）。与对照组（66.96±23.05 pg/mL）相比，内在型（96.18±48.15 pg/mL）和外在型（86.18±37.23 pg/mL）AD患者母血中的NGF水平均显著升高（P<0.05）。我们评估了孕期自我报告的压力与母血NGF水平之间存在显著相关性（r=0.22，P=0.02）。
我们的结果表明，NGF是预测有AD风险儿童的良好替代生物标志物。
