Department of Dermatology and Allergy, National Allergy Research Centre, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark.
Copenhagen Research Group for Inflammatory Skin (CORGIS), Herlev and Gentofte Hospital, Hellerup, Denmark.
J Eur Acad Dermatol Venereol. 2018 May;32(5):796-804. doi: 10.1111/jdv.14801. Epub 2018 Feb 12.
Atopic dermatitis (AD) is characterized by skin barrier dysfunction. Notably, a high number of nano-scale protrusions on the surface of corneocytes, which can be expressed by the Dermal Texture Index (DTI), were recently associated with paediatric AD, loss-of-function mutations in filaggrin gene (FLG) and reduced levels of natural moisturizing factors (NMF). No study has so far examined the association between these parameters and monomeric filaggrin levels in adults.
To determine DTI, monomeric filaggrin and NMF in healthy controls and a group of patients with controlled dermatitis.
A total of 67 adults (20 healthy controls and 47 dermatitis patients) were included. In the patient population, a personal history of AD was diagnosed by the U.K. Working Party's Diagnostic Criteria. All participants were tested for FLG mutations (R501X, 2282del4, R2447X). Transepidermal water loss, monomeric filaggrin, DTI and NMF were measured.
In the patient population, 78.7% (37/47) had a history of AD and 59.5% (28/47) had FLG mutations. Patients had significantly higher levels of DTI and significantly lower levels of monomeric filaggrin and NMF compared to the 20 healthy controls. Among patients, reduced level of monomeric filaggrin and NMF correlated with the presence of FLG mutations and clinical phenotypes such as xerosis, palmar hyperlinearity and AD. Among healthy controls, DTI was significantly higher in the oldest age group compared to the two younger age groups.
A significant difference in DTI, monomeric filaggrin and NMF levels was found when comparing dermatitis patients with healthy controls. These findings suggest that even mild dermatitis or non-visible inflammation has a significant and negative effect on the skin barrier as inflammation is known to reduce filaggrin levels. DTI was significantly increased in aged individuals in the healthy control group, suggesting a gradual change in corneocyte morphology with age.
特应性皮炎（AD）的特征是皮肤屏障功能障碍。值得注意的是，角质形成细胞表面的纳米级突起数量较多，可用真皮纹理指数（DTI）来表示，这些突起最近与儿科 AD、丝聚合蛋白基因（FLG）功能丧失突变和天然保湿因子（NMF）水平降低有关。目前尚无研究检查这些参数与成年人单体丝聚合蛋白水平之间的关系。
确定健康对照组和一组控制性皮炎患者的 DTI、单体丝聚合蛋白和 NMF。
共纳入 67 名成年人（20 名健康对照和 47 名皮炎患者）。在患者人群中，通过英国工作组的诊断标准诊断为特应性皮炎病史。所有参与者均接受丝聚合蛋白突变（R501X、2282del4、R2447X）检测。测量经皮水分流失、单体丝聚合蛋白、DTI 和 NMF。
在患者人群中，78.7%（37/47）有特应性皮炎病史，59.5%（28/47）有丝聚合蛋白突变。与 20 名健康对照相比，患者的 DTI 水平显著升高，单体丝聚合蛋白和 NMF 水平显著降低。在患者中，单体丝聚合蛋白和 NMF 水平降低与 FLG 突变和临床表型（如干燥、手掌线状纹理和 AD）有关。在健康对照组中，与两个年轻年龄组相比，最年长年龄组的 DTI 显著更高。
与健康对照组相比，皮炎患者的 DTI、单体丝聚合蛋白和 NMF 水平存在显著差异。这些发现表明，即使是轻度皮炎或不可见的炎症也会对皮肤屏障产生显著的负面影响，因为炎症已知会降低丝聚合蛋白水平。健康对照组中年龄较大的个体的 DTI 显著增加，表明角质形成细胞形态随年龄逐渐变化。
