Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY.
Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY; The BioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY.
J Allergy Clin Immunol Pract. 2020 Nov-Dec;8(10):3500-3506. doi: 10.1016/j.jaip.2020.07.018. Epub 2020 Jul 25.
Recent data suggest that patients with atopic dermatitis (AD) have increased systemic immune activation and cardiovascular risk. However, unlike psoriasis, evaluation of active vascular inflammation using state-of-the-art imaging is lacking in AD.
To assess aortic and carotid vascular inflammation using F-fluorodeoxyglucose-positron emission tomography/magnetic resonance imaging (F-FDG-PET/MRI) imaging in moderate-to-severe AD versus healthy individuals.
A total of 27 patients with moderate-to-severe AD and 12 healthy controls were imaged using F-FDG-PET/MRI. Target-to-background ratio (TBR) values were calculated in multiple segments of the aorta and carotid vessels.
Patients with AD had elevated aortic max TBR (fold change [FCH] = 1.45, P = .057) versus healthy controls and significantly elevated mean TBR (FCH = 1.20; P < .05) in the right carotid (RC) arteries versus controls. When examining greatest focal inflammation (most diseased segment [MDS] TBR), patients with AD had higher aortic inflammation (FCH = 1.28; P = .052). AD clinical severity significantly correlated with C-reactive protein (ρ = 0.60, P < .01) and with RC mean TBR levels (ρ = 0.60, P = .04). Stratifying patients into moderate-to-severe and very severe AD showed greater RC mean TBR in patients with very severe AD versus controls (FCH = 1.31; P = .02) and versus patients with moderate/severe AD (FCH = 1.23, P = .05). Aortic inflammation was also significantly greater in patients with very severe AD versus controls (max TBR: FCH = 1.6, P = .04; MDS TBR: FCH = 1.73, P = .03).
This preliminary study is the first that establishes greater vascular (aorta and carotid) inflammation in moderate-to-severe AD versus healthy controls. Furthermore, very severe AD showed higher inflammation than both moderate/severe patients and healthy controls. Future studies with larger patient cohorts and evaluation before and after treatment are needed to determine the extent to which vascular inflammation in AD is modifiable.
最近的数据表明，特应性皮炎（AD）患者存在全身性免疫激活和心血管风险增加。然而，与银屑病不同，AD 患者的活跃血管炎症尚未采用最先进的影像学技术进行评估。
使用 F-氟脱氧葡萄糖正电子发射断层扫描/磁共振成像（F-FDG-PET/MRI）评估中重度 AD 患者与健康个体的主动脉和颈动脉血管炎症。
对 27 名中重度 AD 患者和 12 名健康对照者进行 F-FDG-PET/MRI 检查。计算主动脉和颈动脉多个节段的靶标与背景比值（TBR）值。
AD 患者的主动脉最大 TBR 升高（FCH=1.45，P=.057），与健康对照组相比，右侧颈动脉（RC）动脉的平均 TBR 也显著升高（FCH=1.20，P<.05）。当检查最大焦点炎症（最病变节段[TBR]）时，AD 患者的主动脉炎症更高（FCH=1.28，P=.052）。AD 临床严重程度与 C 反应蛋白显著相关（ρ=0.60，P<.01），与 RC 平均 TBR 水平相关（ρ=0.60，P=.04）。将患者分为中重度和重度 AD 后，重度 AD 患者的 RC 平均 TBR 高于对照组（FCH=1.31，P=.02）和中重度 AD 患者（FCH=1.23，P=.05）。与对照组相比，重度 AD 患者的主动脉炎症也明显更严重（最大 TBR：FCH=1.6，P=.04；MDS TBR：FCH=1.73，P=.03）。
这项初步研究首次证实中重度 AD 患者的血管（主动脉和颈动脉）炎症高于健康对照组。此外，重度 AD 患者的炎症高于中重度 AD 患者和健康对照组。需要进一步开展更大规模患者队列的研究，并评估治疗前后的情况，以确定 AD 患者血管炎症的可变性程度。
