Kaneko Sakae, Liu Lijuan, Kakamu Takeyasu, Minami-Hori Masako, Morita Eishin
Department of Dermatology, Shimane University Faculty of Medicine, Izumo, Japan.
Department of Hygiene and Preventive Medicine, Fukushima Medical University School of Medicine, Fukushima, Japan.
J Dermatol. 2017 Aug;44(8):920-926. doi: 10.1111/1346-8138.13852. Epub 2017 Apr 13.
Stress-induced scratching is an issue in patients with adult atopic dermatitis (AD). Although itching and stress are believed to be intimately related, no objective index is available; therefore, most evaluations are subjective. Using saliva, which is easily collected, we investigated the degree to which AD severity and patient stress levels are reflected in stress proteins in the saliva. Here, we evaluated the severity (Scoring Atopic Dermatitis [SCORAD] score), stress (State-Trait Anxiety Index [STAI] score), personality (Tokyo University Egogram [TEG] II score) and quality of life (Dermatology Life Quality Index [DLQI] score) of 51 patients with AD who were examined in the Department of Dermatology of Shimane University between April and December 2015. We collected saliva and measured salivary chromogranin A (CgA), amylase and cortisol. The amount of salivary CgA per protein in patients with AD was correlated with their SCORAD score (r = 0.458, P < 0.001). There was no correlation between cortisol or amylase levels and SCORAD score. SCORAD score was correlated with DLQI (r = 0.390, P = 0.006). CgA per protein was correlated with DLQI (r = 0.393, P = 0.004). There was no correlation between scores for the anxiety component of the STAI, TEG II or DLQI. Our results suggested that patients with more severe AD may have high stress levels. The personalities of these patients with AD tended to involve elevated anxiety levels.
压力诱导的搔抓是成年特应性皮炎（AD）患者面临的一个问题。尽管瘙痒和压力被认为密切相关，但尚无客观指标；因此，大多数评估都是主观的。我们利用易于采集的唾液，研究了AD严重程度和患者压力水平在唾液应激蛋白中的反映程度。在此，我们评估了2015年4月至12月间在岛根大学皮肤科接受检查的51例AD患者的严重程度（特应性皮炎评分[SCORAD]）、压力（状态-特质焦虑量表[STAI]评分）、性格（东京大学自我评定图[TEG]II评分）和生活质量（皮肤病生活质量指数[DLQI]评分）。我们采集了唾液并测量了唾液嗜铬粒蛋白A（CgA）、淀粉酶和皮质醇。AD患者唾液中每蛋白的CgA量与其SCORAD评分相关（r = 0.458，P < 0.001）。皮质醇或淀粉酶水平与SCORAD评分之间无相关性。SCORAD评分与DLQI相关（r = 0.390，P = 0.006）。每蛋白的CgA与DLQI相关（r = 0.393，P = 0.004）。STAI焦虑分量表、TEG II或DLQI评分之间无相关性。我们的结果表明，AD更严重的患者可能压力水平较高。这些AD患者的性格往往涉及焦虑水平升高。
