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血清胸腺和活化调节趋化因子(TARC)水平与 < 6 个月的特应性皮炎患者的疾病严重程度相关。

Serum thymus and activation-regulated chemokine (TARC) levels correlate with atopic dermatitis disease severity in patients < 6 months.

机构信息

From the Department of Pediatrics, Ehime Prefectural Central Hospital, Matsuyama, Ehime, Japan.

Department of Pediatrics, The University of Texas Medical Branch, Galveston, Texas.

出版信息

Allergy Asthma Proc. 2022 Sep 1;43(5):461-467. doi: 10.2500/aap.2022.43.220034.

DOI:10.2500/aap.2022.43.220034
PMID:36065100
Abstract

Atopic dermatitis (AD) may develop by 6 months of age, and its severity assessment is essential for appropriate treatments. Scoring Atopic Dermatitis (SCORAD) is suggested to evaluate the severity of AD but is cumbersome for routine clinical use. The serum thymus and activation-regulated chemokine (TARC) is used as a marker of AD severity. However, the normal range of the TARC levels varies by age, and its usefulness for the evaluation of AD severity has not been established in patients ages < 6 months. Here, we evaluated the correlation between serum TARC levels and SCORAD scores in early infancy and sought the optimal cutoff level to indicate AD severity. The subjects were 35 patients with AD (16 girls and 19 boys; 3-5 months of age) who visited our clinic between April 2015 and March 2017. All the patients were physically examined by a board-certified allergist. The AD severity was determined by using the SCORAD, together with serum levels of TARC, total immunoglobulin E (IgE), lactate dehydrogenase, and peripheral eosinophil counts. Receiver operating characteristic curve analysis was performed to determine the cutoff levels of serum TARC to indicate AD severity. Significant correlations were observed between SCORAD scores and the serum TARC levels, peripheral eosinophil counts, and serum IgE levels (r = 0.640, r = 0.723, r = 0.533, respectively). The optimal cutoff levels of serum TARC to indicate mild and severe AD were <3523 pg/mL (area under the curve [AUC] = 0.856) and >6192 pg/mL (AUC = 0.833), respectively. Although this study had limitations, we suggest that serum TARC is useful as a marker of AD severity in patients <6 months of age.

摘要

特应性皮炎(AD)可能在 6 个月龄时发病,对其严重程度进行评估对选择合适的治疗方法至关重要。建议使用 SCORAD 评分系统评估 AD 的严重程度,但该评分系统繁琐,不便于临床常规使用。血清胸腺和活化调节趋化因子(TARC)可作为 AD 严重程度的标志物,但 TARC 水平的正常范围因年龄而异,其在 <6 月龄患者中的 AD 严重程度评估中的作用尚未得到证实。本研究旨在评估婴儿早期血清 TARC 水平与 SCORAD 评分之间的相关性,并寻找指示 AD 严重程度的最佳截断值。

研究对象为 2015 年 4 月至 2017 年 3 月期间在我院就诊的 35 例 AD 患儿(16 名女孩,19 名男孩,3-5 月龄),所有患儿均由经过认证的过敏症专家进行体格检查。采用 SCORAD 评分联合血清 TARC、总 IgE、乳酸脱氢酶和外周血嗜酸性粒细胞计数评估 AD 严重程度。采用受试者工作特征曲线分析确定指示 AD 严重程度的血清 TARC 截断值。

SCORAD 评分与血清 TARC 水平、外周血嗜酸性粒细胞计数和血清 IgE 水平呈显著正相关(r = 0.640,r = 0.723,r = 0.533)。血清 TARC 指示轻度和重度 AD 的最佳截断值分别为 <3523 pg/ml(曲线下面积 [AUC] = 0.856)和 >6192 pg/ml(AUC = 0.833)。

尽管本研究存在一定局限性,但我们认为血清 TARC 可作为 <6 月龄 AD 患儿严重程度的标志物。

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