Abdullraheem Yasser F, Alzolibani Abullateef A, Mahmoud Khaleed H, Korsni Amani H, Al-Harbi Muhmmad Helyel, Hassanin Kaleed M, Al-Dhubaibi Mohammed S
Department of Pediatric, College of Medicine, Qassim University, Saudi Arabia.
Department of Dermatology, College of Medicine, Qassim University, Saudi Arabia.
Int J Health Sci (Qassim). 2017 Sep-Oct;11(4):3-7.
Atopic dermatitis (AD) is a skin disorder clinically seen in the pediatric population. It is well recognized that patients with AD have an increased susceptibility to cutaneous colonization and infection with bacteria, fungi, and viruses. This study was undertaken to investigate the phagocytic activity and chemotactic response of mononuclear and polymorphonuclear leukocytes in severe AD patients.
A total of 50 children with severe AD were selected according to severity scoring of AD (the SCORAD index) and 30 healthy children of same age and sex were also selected as controls. The mononuclear and neutrophilic leukocytes were separated and the phagocytic ingestion of zymosan particles was determined. Migration distance in response tobacterial lipopolysaccharide chemotactic factor was also determined. Immunological disturbance in AD patients was determined by sandwich enzyme-liked immunosorbent assays for total serum immunoglobulin E (IgE), complement 3 (C3) C4.
Of 50 AD patients with severe disease activity, 36 patients (72%) showed reduction in mononuclear and neutrophilic phagocytic activity. Children with AD had higher levels of total serum IgE, C3, and C4 compared to healthy children (P < 0.01).
The study results demonstrated an inhibition in the chemotactic response and phagocytic activity by mononuclear and/or neutrophilic leukocytes in severe AD patients. We further observed an involvement of perturb complement system in patients with AD. Hence, we clearly showed that AD is exacerbated with compromised immunological response, especially the innate immune response.
特应性皮炎（AD）是一种临床上见于儿童群体的皮肤疾病。众所周知，AD患者皮肤被细菌、真菌和病毒定植及感染的易感性增加。本研究旨在调查重度AD患者单核细胞和多形核白细胞的吞噬活性及趋化反应。
根据AD严重程度评分（SCORAD指数）选取50例重度AD患儿，并选取30例年龄和性别相同的健康儿童作为对照。分离单核细胞和嗜中性白细胞，测定酵母聚糖颗粒的吞噬摄取情况。还测定了对细菌脂多糖趋化因子的迁移距离。通过夹心酶联免疫吸附测定法检测AD患者血清总免疫球蛋白E（IgE）、补体3（C3）、C4，以确定免疫紊乱情况。
在50例疾病活动度严重的AD患者中，36例（72%）表现出单核细胞和嗜中性白细胞吞噬活性降低。与健康儿童相比，AD患儿血清总IgE、C3和C4水平更高（P < 0.01）。
研究结果表明重度AD患者单核细胞和/或嗜中性白细胞的趋化反应和吞噬活性受到抑制。我们进一步观察到AD患者补体系统紊乱。因此，我们明确表明AD因免疫反应受损，尤其是先天性免疫反应受损而加重。
