Serum thymus and activation-regulated chemokine, macrophage-derived chemokine and eotaxin as markers of severity of atopic dermatitis

BACKGROUND

Expression of CCR4 ligands, such as thymus and activation-regulated chemokine (TARC) and macrophage-derived chemokine (MDC), leads to preferential influx of T-helper (Th) 2-type lymphocytes to the lesional skin in atopic dermatitis (AD). Eotaxin, like the CCR3 ligand, is an important contributor of eosinophils recruitment in the course of AD. These chemokines are assumed to play an important role in the pathomechanism of AD.

METHODS

In this study, the serum concentration of TARC, MDC, eotaxin and total immunoglobulin E (IgE) in AD patients and healthy people were compared. Correlation between the studied indices and activity of AD was established. Severity of AD was assessed according to the SCORAD score. The study comprised 44 healthy people and 43 patients with AD. The serum concentrations of TARC, MDC, eotaxin and IgE were measured with the use of enzyme-linked immunosorbent assay kits.

RESULTS

The serum levels of TARC, MDC, eotaxin and IgE appeared to be significantly higher in patients with AD than in healthy people. A strong positive correlation was revealed between the levels of TARC, MDC, total IgE in serum of patients with AD and SCORAD. In contrast, no significant relationship was found for the serum eotaxin concentration and TARC, MDC, IgE or disease severity.

CONCLUSION

Our findings indicate that TARC and MDC are actively involved in the pathogenesis of AD and their expression, opposite to that of eotaxin, is strongly associated with clinical picture of atopic dermatitis.

[The effect of specific immunotherapy on serum eotaxin level in patients with pollinosis: preliminary studies]

Eotaxin belongs to CC chemokines with selective activity for eosinophils and basophils. Specific immunotherapy (SIT) represents the only curative approach for allergic inflammation. The aim of this study was an evaluation of the effect of SIT on serum eotaxin level in patients with seasonal allergy. 40 patients (mean age 26 +/- 8.15 with seasonal allergy to birch, 25 with seasonal allergy to grasses) and 35 persons (mean age 27 +/- 8) of the control group took part in this study. Preseasonal immunotherapy (Allergovit, Germany) was performed in conventional schedule in patients with pollinosis. Clinical assessment of symptoms in season (score) was done by all of the patients studied. ELISA test was used to measure serum eotaxin level (pg/ml, kits from R&D) before, after immunotherapy, in pollen season and after season in patients with disease. There was observed increased eotaxin concentration in patients with allergy to birch (140.6 +/- 53.7) as compared to the eotaxin level in the control group (102.1 +/- 53.7) (p < 0.05). There was observed decreased eotaxin level after immunotherapy (115.9 +/- 49.9) (p < 0.05) in patients with allergy to birch, but no with allergy to grasses. When patients with clinical improvement were taken into account, the significant difference (p < 0.05) in eotaxin concentration was showed before (126.7 +/- 52.4) and after immunotherapy (102.5 +/- 44.8). The eotaxin level in pollen season of patients with clinical improvement was significantly (p < 0.05) decreased (116.5 +/- 54.3) as compared to the eotaxin level in patients without clinical improvement (139.8 +/- 46.3). The results suggest an involvement of eotaxin in pathomechanism of SIT. The effect depends on kind of allergen evaluated. Further longitudinal controlled investigations should establish the role measuring serum eotaxin level in the clinical evaluation of SIT.

[Pulmonary function tests and bronchial reactiveness with histamine in patients with atopic dermatitis and bronchial asthma]

Atopic dermatitis and bronchial asthma are genetically dependent diseases, connected with an over-synthesis of IgE antibodies, in which a chronic inflammation is characteristic for their pathogenesis. The coincidence of bronchial hyperresponsiveness and symptoms of atopic dermatitis suggests to investigate the degree of bronchial reactions in atopic dermatitis or asthma patients. The main goal of this analysis was to compare the pulmonary functional tests and the bronchial histamine induced reactiveness in 71 patients. The investigation included 27 atopic dermatitis patients, 12 asthma-prurigo patients and 32 bronchial asthma patients. All of them were tested with "Pneumoscreen" (Jaeger), in order to define: VC, FEV1, FEF50, and Raw. The bronchial reactiveness with 1% histamine solution, was tested on "Bronchoscreen" (Jaeger). In atopic dermatitis and asthma-prurigo patients, no obstructive ventilation impairment was found. The bronchial hyper-reactiveness to histamine was found in 11.1% of atopic dermatitis patients, 16.7% of asthma-prurigo patients and 78.1% of bronchial asthma patients. The coexistence of bronchial asthma and atopic dermatitis increases the degree of bronchial reactiveness.