De Marchi Federica, Piacentini Giorgio L, Piazza Michele, Sandri Marco, Boner Attilio L, Peroni Diego G
Section of Pediatrics, Department of Life and Reproduction Sciences, University of Verona, Verona, Italy.
Allergy Asthma Proc. 2015 Nov-Dec;36(6):e127-33. doi: 10.2500/aap.2015.36.3872.
Atopic dermatitis (AD) often predates the development of allergic sensitization in the so-called atopic march. Several studies have pointed out epidermal barrier impairment as a major cause of this evolution.
The present study aimed to assess atopic skin integrity by means of transepidermal water loss (TEWL) and Corneometer, and to investigate possible correlations between barrier integrity measurements and the degree of sensitization to aeroallergens (allergy score).
Sixty-one children (6 months to 17 years old) with AD were clinically evaluated by the Scoring Atopic Dermatitis index. TEWL and Corneometer evaluations were performed on lesion sites as well as on healthy skin. The subjects underwent skin-prick testing, and the severity of allergic sensitization was assessed for each patient by summing all wheal diameters (the allergy score). The same tests were performed in 20 children without AD.
In patients with AD, TEWL and Corneometer results were found to be higher and lower, respectively, on eczematous areas in comparison with healthy skin, and differences were significantly correlated to the Scoring Atopic Dermatitis index (p < 0.0001 and p = 0.007, respectively). The TEWL result was significantly higher in nonlesional skin of the patients with AD compared with that of individuals without AD (p = 0.017). Of the patients with AD, 59% were sensitized to inhalant allergens; allergy scores were positively correlated with both AD duration (r = 0.63; p < 0.0001) and nonlesional skin TEWL values (r = 0.46; p = 0.002). No significant correlation was found between allergy scores and skin parameters in subjects without AD.
Patients with AD are affected by barrier function impairment, even on noneczematous skin. This defect is associated with greater aeroallergen sensitization and may contribute to allergic respiratory symptom development.
在所谓的特应性进程中，特应性皮炎（AD）通常早于过敏性致敏的发生。多项研究指出表皮屏障受损是这一演变的主要原因。
本研究旨在通过经表皮水分流失（TEWL）和角质层水合度测定仪评估特应性皮肤的完整性，并研究屏障完整性测量值与对气传变应原的致敏程度（过敏评分）之间的可能相关性。
采用特应性皮炎评分指数对61例患有AD的儿童（6个月至17岁）进行临床评估。在皮损部位以及健康皮肤上进行TEWL和角质层水合度测定仪评估。受试者接受皮肤点刺试验，通过将所有风团直径相加来评估每位患者的过敏性致敏严重程度（过敏评分）。对20例无AD的儿童进行相同测试。
在AD患者中，与健康皮肤相比，湿疹部位的TEWL结果更高，而角质层水合度测定仪结果更低，且差异与特应性皮炎评分指数显著相关（分别为p < 0.0001和p = 0.007）。AD患者非皮损皮肤的TEWL结果显著高于无AD个体（p = 0.017）。在AD患者中，59%对吸入性变应原致敏；过敏评分与AD病程（r = 0.63；p < 0.0001）和非皮损皮肤TEWL值均呈正相关（r = 0.46；p = 0.002）。在无AD的受试者中，未发现过敏评分与皮肤参数之间存在显著相关性。
AD患者即使在无湿疹的皮肤上也存在屏障功能受损。这种缺陷与更强的气传变应原致敏相关，可能导致过敏性呼吸道症状的发展。
