Uysal Pınar, Avcil Sibelnur, Abas Burçin İrem, Yenisey Çiğdem
Department of Pediatric Allergy and Immunology, Adnan Menderes University Hospital, 09200, Aydın, Turkey.
Department of Child and Adolescent Psychiatry, Adnan Menderes University Hospital, 09200, Aydın, Turkey.
Am J Clin Dermatol. 2016 Oct;17(5):527-537. doi: 10.1007/s40257-016-0210-8.
Increased reactive oxygen species (ROS) and oxidative stress (OS) has been reported in many allergic and inflammatory skin diseases, including urticaria, psoriasis, and atopic dermatitis (AD). Melatonin is a hormone secreted from the pineal gland and is a potent antioxidant.
The aim of the study was to measure serum antioxidant melatonin, oxidants of nitric oxide (NO), and malondialdehyde levels to calculate the serum oxidant-antioxidant balance based on the NO/melatonin and malondialdehyde/melatonin ratios and to determine the correlation with the disease severity in children with AD.
Seventy-three children with AD and 67 healthy controls were included in the study. The clinical diagnosis of AD was based on the diagnostic criteria of Hanifin-Rajka. The severity of AD was evaluated by the scoring AD (SCORAD) index, and atopy was determined by skin prick tests (SPTs) with commercial extracts. The OS-related parameters of serum melatonin, NO, malondialdehyde, and the NO/melatonin and malondialdehyde/melatonin ratios were calculated and compared with the results of healthy controls.
Serum melatonin levels were higher (p < 0.0001) and serum NO levels and the NO/melatonin and malondialdehyde/melatonin ratios were lower in children with AD than in healthy controls (p = 0.045, p < 0.0001, p < 0.0001, respectively). There was no difference between children with AD and healthy controls in terms of serum malondialdehyde levels (p = 0.119). Serum melatonin levels were significantly lower in severe AD than in mild AD (p = 0.012). However, in terms of serum melatonin levels, there was no difference between mild and moderate AD (p = 0.742) and moderate to severe AD (p = 0.301). There was no significant difference in serum NO and malondialdehyde levels and NO/melatonin and malondialdehyde/melatonin ratios among children with mild, moderate, and severe AD (p > 0.05). A negative correlation was found between serum melatonin levels and the SCORAD index (r = -0.252, p = 0.031), and a positive correlation was found between NO/melatonin and malondialdehyde/melatonin ratios (r = 0.511, p < 0.0001). There was no statistically significant relationship between age (≤24 or >24 months), disease duration (≤6 or >6 months), and sex for the OS-related parameters (p > 0.05).
The serum oxidant-antioxidant balance was impaired in children with AD. Serum melatonin levels were higher in children with AD; however, this was negatively correlated with disease severity. Serum NO levels and NO/melatonin and malondialdehyde/melatonin ratios were lower in children with AD than in healthy controls. Melatonin might be used as a promising antioxidant to evaluate disease severity in children with AD. Thus, further studies are needed to clarify the role of melatonin in AD pathogenesis.
在许多过敏性和炎性皮肤病中，包括荨麻疹、银屑病和特应性皮炎（AD），已报道活性氧（ROS）增加和氧化应激（OS）。褪黑素是一种由松果体分泌的激素，是一种有效的抗氧化剂。
本研究旨在测量血清抗氧化剂褪黑素、一氧化氮（NO）氧化剂和丙二醛水平，根据NO/褪黑素和丙二醛/褪黑素比值计算血清氧化-抗氧化平衡，并确定其与AD患儿疾病严重程度的相关性。
本研究纳入了73例AD患儿和67例健康对照。AD的临床诊断基于Hanifin-Rajka诊断标准。通过AD严重程度评分（SCORAD）指数评估AD的严重程度，通过使用商业提取物的皮肤点刺试验（SPT）确定特应性。计算血清褪黑素、NO、丙二醛以及NO/褪黑素和丙二醛/褪黑素比值等与OS相关的参数，并与健康对照的结果进行比较。
AD患儿的血清褪黑素水平较高（p < 0.0001），血清NO水平以及NO/褪黑素和丙二醛/褪黑素比值低于健康对照（分别为p = 0.045、p < 0.0001、p < 0.0001）。AD患儿与健康对照在血清丙二醛水平方面无差异（p = 0.119）。重度AD患儿的血清褪黑素水平显著低于轻度AD患儿（p = 0.012）。然而，就血清褪黑素水平而言，轻度与中度AD之间（p = 0.742）以及中度至重度AD之间（p = 0.301）无差异。轻度、中度和重度AD患儿在血清NO和丙二醛水平以及NO/褪黑素和丙二醛/褪黑素比值方面无显著差异（p > 0.05）。血清褪黑素水平与SCORAD指数之间存在负相关（r = -0.252，p = 0.031），NO/褪黑素和丙二醛/褪黑素比值之间存在正相关（r = 0.511，p < 0.0001）。年龄（≤24或>24个月）、病程（≤6或>6个月）和性别与OS相关参数之间无统计学显著关系（p > 0.05）。
AD患儿的血清氧化-抗氧化平衡受损。AD患儿的血清褪黑素水平较高；然而，这与疾病严重程度呈负相关。AD患儿的血清NO水平以及NO/褪黑素和丙二醛/褪黑素比值低于健康对照。褪黑素可能作为一种有前景的抗氧化剂用于评估AD患儿的疾病严重程度。因此，需要进一步研究以阐明褪黑素在AD发病机制中的作用。
