儿童特应性皮炎急性发作期的血浆氨基酸代谢分析

目的 通过靶向代谢组学分析儿童特应性皮炎(atopic dermatitis,AD)急性发作期的血浆氨基酸代谢变化,从代谢通路方面探讨特应性皮炎发病机制;探讨特应性皮炎亚型外源型和内源型急性发作期血浆氨基酸代谢差异.方法 将收集的符合儿童特应性皮炎诊断标准的患者40例(其中22例为外源型AD组,18例为内源型AD组)和...     

儿童特应性皮炎患者肠道菌群中益生菌的构成比研究

目的：比较特应性皮炎(AD)患儿与正常儿童肠道菌群中益生菌的构成差异。方法：应用Illumina MiSeq测序平台对特应性皮炎患儿和健康对照儿童粪便细菌的16SrRNA基因V3-V4区进行高通量测序,比较两组益生菌属、种水平的构成差异。结果: 共纳入35例 AD 患儿和27例正常对照,在属水平,AD组患者双歧杆菌属(Bifidobacterium)物种丰度较对照组升高,而乳酸杆菌属(Lactobacillus)物种丰度较对照组降低,但二者差异均无统计学意义（P＞0.05）。在种水平,AD组患者双歧杆菌属下Bifidobacterium pseudocatenulatum DSM 20438 JCM 1200 LMG 10505、unclassified_g__Bifidobacterium、Bifidobacterium_adolescentis、Bifidobacterium_animalis 物种丰度较对照组升高,而Bifidobacterium_breve物种丰度降低,差异均无统计学意义（P＞0.05）;AD组患者乳酸杆菌属下Lactobacillus_salivarius物种丰度较对照组降低,差异无统计学意义（P＞0.05）,而unclassified_g__Lactobacillus、Lactobacillus_plantarum_subsp._plantarum物种丰度升高,差异有统计学意义（P＜0.05）。结论:特应性皮炎患儿肠道菌群中益生菌物种丰度与正常儿童存在差异。     

儿童特应性皮炎严重程度与血清25-羟维生素D和总IgE水平的相关性

目的：明确儿童特应性皮炎患者特应性皮炎严重程度与血清25-羟维生素D和IgE水平的相关性。方法：参考SCORAD评分法评估60例特应性皮炎患者疾病严重程度，并检测特应性皮炎患者及55例对照组血清25-羟基维生素D3水平以及特应性皮炎患者总IgE水平。结果：特应性皮炎组患者血清25-羟维生素D水平(16.13±6.68)ng/mL低于对照组(19.81±8.24)ng/mL，差异有统计学意义（P<0.05）。根据SCORAD评分，特应性皮炎患者中33例为轻度、20例为中度，7例为重度。轻度组血清25-羟基维生素D3水平为(18.69±7.01)ng/mL，高于中度(12.81±4.35)ng/mL，差异有统计学意义（P<0.05）。血清25-羟维生素D与SCORAD评分之间有显著负相关（P<0.05）。IgE水平与SCORAD评分之间无相关性（P>0.05）。结论：AD患者血清25-羟基维生素D与AD严重程度呈负相关。     

高通量测序研究儿童特应性皮炎患者肠道菌群生物多样性特点

目的 探讨特应性皮炎(Atopic dermatitis,AD)儿童患者肠道菌群生物多样性特点。方法 根据纳入标准选取35例AD儿童患者为AD组,27例健康儿童作为对照组(N组)。应用Illumina Miseq测序平台对研究对象粪便细菌的16SrRNA基因V3～V4区进行高通量测序,将测序结果进行肠道菌群差异分析。结果 物种分析显示:在N组中,厚壁菌门、拟杆菌门、变形菌门、放线菌门、其他(低丰度物种),分别占到51.79%、39.06%、5.83%、2.43%和0.90%;在AD组中,厚壁菌门、拟杆菌门、变形菌门、放线菌门、其他(低丰度物种),分别占到58.36%、29.16%、7.47%、4.39%和0.62%。Pan/Core物种分析显示:AD组较N组总物种丰富度低、核心物种数少。多样性指数比较显示:AD组较N组Shannon数值降低,Simpson数值升高,但二者差异均无统计学意义(P0.05)。结论 AD患儿肠道菌群物种丰度及生物多样性与正常儿童存在差异。     

培土清心方对特应性皮炎儿童肠道菌群的影响

目的通过高通量测序手段检测比较特应性皮炎(AD)患儿与健康对照儿童肠道菌群结构差异,并对比培土清心方干预前后对AD患儿的临床疗效及肠道菌群的改变情况,初步探索培土清心方对肠道菌群的影响。方法共纳入60例受试者(实验组、健康对照组各30例),实验组分别在口服培土清心方0周(AD.0W)、4周(AD.4W)进行SCORAD评分并采集粪便样品,对照组在0周时采集粪便样品,统一对粪便样品进行16S rRNA基因测序检测。结果实验组用药4周(AD.4W)SCORD评分降低,差异有统计学意义(P0.05)。肠道菌群测序结果:①Alpha多样性:AD.0W组AD.4W组健康对照组(P0.05)。②差异菌门水平:Firmicutes(厚壁菌门)相对丰度:AD.0W组健康对照组AD.4W组(P0.05);Bacteroidetes(拟杆菌门)相对丰度:AD.4W组健康对照组AD.0W组(P0.05);Faecalibacterium(柔嫩梭菌属)相对丰度:AD.0W组AD.4W组健康对照组,差异有统计学意义(P=0.000.05)。结论特应性皮炎儿童和健康儿童肠道菌群多样性方面无差异,柔嫩梭菌属为健康人优势菌属;培土清心方可改善AD患儿病情,对肠道菌群多样性无明显影响,其可能通过上调厚壁菌门、柔嫩梭菌属,下调拟杆菌门丰度来达到减轻肠道炎症、改善AD的作用。     

湿疹及皮炎

20130752特应性皮炎患儿与健康儿童皮肤屏障功能的对比/刘秋慧(首都医科大学北京儿童医院皮肤科),徐子刚,李丽…∥中国皮肤性病学杂志.-2012,26(2).-109～1110～7岁的特应性皮炎(AD)患儿和健康儿童各60名,根据不同年龄段分成两组,0～2岁组和2～7岁组各30例。依次进行角质层含水量、pH值、经表皮水分     

血清载脂蛋白A1、B、E与儿童特应性皮炎的相关性研究

目的 研究血清载脂蛋白A-1、B、E(apo A1、apo B、apo E)的含量与儿童特应性皮炎(AD)的发生是否存在相关性.方法 收集于本院皮肤科就诊的2～7岁儿童AD患者血清标本共300例,其中男126例,女174例,平均年龄(4.0±1.4)岁,检测患者血清中过敏原和总IgE水平.收集年龄、性别与病例组匹配的健...     

特应性皮炎外周血白介素17水平检测

目的: 检测特应性皮炎(AD)患者血中白介素17(IL-17)水平.方法: 采用双抗体夹心ELISA法检测66例特应性皮炎患者和50名正常对照者血中IL-17含量.结果: 患者组血中IL-17水平明显高于对照组(P<0.001).重度组高于中度组(P<0.001),中度组与轻度组无统计学差异.结论: IL-17可能在AD患者的免疫发病机制中发挥作用.     

特应性皮炎的中西医结合治疗

<正>0094中医辨证联合开瑞坦治疗特应性皮炎43例临床观察吴允波(江西中医药大学附属医院),邱桂荣,许来宾//江苏中医药.-2014,46(6).-49~50将72例符合入选条件的特应性皮炎(AD)患者随机分为治疗组(43例)和对照组(29例)。对照组:口服氯雷他定片,成人10mg,儿童体重30kg者10mg,体重30kg者5mg,1次/d;维生素     

特应性皮炎与肠道微生物组的相关性

近期研究表明肠道的生态失调与免疫反应的改变和特应性皮炎(atopic dermatitis, AD)有关。通过总结AD和肠道菌群相关的实验和测序结果发现,肠道菌群通过免疫、代谢和神经内分泌途径对AD的发生发展有重要影响。本文就特应性皮炎与肠道微生物的相关性进行综述。     

Serum eosinophil cationic protein in children with atopic dermatitis

BACKGROUND: Eosinophil cationic protein (ECP) is a cytotoxic agent secreted by activated eosinophils during allergic and inflammatory processes. The aim of the study was to determine the ECP level, absolute and relative eosinophil count and IgE antibodies in children with atopic dermatitis (AD) compared with those of nonatopic children, and to assess the correlation of these laboratory parameters with the clinical severity of AD. METHODS: This prospective study comprised 70 children. There were 49 children with AD aged 3-36 months, and the control group comprised 21 children with a negative personal and family history for atopic diseases. Detailed history, serum ECP levels (UniCAP FEIA), relative and absolute eosinophil counts and total serum IgE antibodies were determined in both groups. In the children with AD, skin involvement was measured by the SCORAD index. RESULTS: The calculated SCORAD index was between 16 and 83. IgE antibodies, relative and absolute eosinophil counts showed a significantly wider range of values and a statistically higher median (P < 0.001) in the patients with AD compared with the control group. These laboratory parameters did not correlate with the severity of AD. The serum ECP median level, in the children with AD, was 16.2 microg/L (range 3.01-65.30) compared with 5.92 microg/L (range 2.76-21.90) in the control group. Correlation of the total SCORAD index and the serum ECP levels was negative, weak (r = -0.065) and statistically not significant (P > 0.05). The same was found for the correlation of serum ECP and intensity of skin changes (r = -0.095) and serum ECP and subjective symptoms (r = -0.045). The correlation was positive, but weak and statistically not significant for the serum ECP and extent of the skin lesions (r = 0.079, P > 0.05). CONCLUSION: Elevated levels of ECP, relative and absolute eosinophil counts, as well as IgE antibodies were determined in the patients with AD. As these laboratory findings did not correlate with the severity of AD, they can be considered only as additional methods in the evaluation of patients with AD.     

血清维生素D水平与儿童特应性皮炎的相关性分析

目的研究儿童血清中维生素D与特应性皮炎(AD)积分指数评分(SCORAD)之间的关系,同时分析血常规的嗜酸粒细胞百分比及嗜酸粒细胞绝对值、血清总IgE、血清钙离子及身高、体质量、身体质量指数与SCORAD之间的关系。方法选取2016年6月—2016年12月于我院诊治的44例AD患儿的临床资料作为观察组,并收集同时期相同数量健康儿童的资料作为对照组。观察组用SCORAD进行评分,观察组及对照组均测定其血常规、血清总IgE、血清钙离子和血清维生素D,并根据体质量、身高计算出身体质量指数(BMI),由同1名医师对患儿进行SCORAD计算。结果观察组中血清维生素D与SCORAD呈负相关(r=-0.305,P=0.044),与钙离子浓度呈正相关(r=0.366,P=0.015)。另外,SCORAD与嗜酸粒细胞百分比、绝对值及总IgE值呈正相关(r1=0.355,r2=0.398,r3=0.397;P1=0.018,P2=0.008,P3=0.008)。观察组的25(OH)D浓度低于对照组(Z=-2.028,P=0.043),嗜酸粒细胞百分比及绝对值、总IgE和钙离子浓度高于对照组(Z1=-3.965,Z2=-4.112,Z3=-2.479;P1<0.001,P2<0.001,P3=0.013)。结论儿童25(OH)维生素D可能与SCORAD有负相关。     

特应性皮炎患儿与正常儿童肠道菌群差异性研究

【摘要】 目的 探讨特应性皮炎（AD） 患儿与正常儿童肠道菌群的差异。方法 收集2015年4月至2017年4月在上海市嘉定区中医医院皮肤科门诊就诊的AD患儿35例,以27例健康儿童作为对照组。取受试者粪便,提取总DNA后,PCR扩增细菌的16SrRNA基因V3 ~ V4区,应用Illumina Miseq测序平台行高通量测序,分析菌群丰度差异。选择两组丰度排名前15的门、属、种分别比较物种差异,采用Wilcoxon秩和检验。结果 两组肠道菌群主要由厚壁菌门、拟杆菌门、变形菌门、放线菌门组成。在菌门水平,AD组与健康对照组拟杆菌门丰度分别为29.16% ± 19.96%、39.06% ± 15.98%（P = 0.042）,梭杆菌门分别为0.06% ± 0.17%、0.50% ± 1.71%（P = 0.041）;在菌属水平,两组拟杆菌属丰度分别为23.77% ± 18.08%、33.1% ± 15.75%（P = 0.029）;在菌种水平,丰度排名前15的菌种两组间分布差异均无统计学意义（均P > 0.05）。结论 特应性皮炎患儿与正常儿童肠道菌群构成及菌群相对丰度存在一定差异。     

儿童特应性皮炎严重度与25羟维生素D、总IgE及IL-4水平的相关性研究

 目的:探讨儿童特应性皮炎（AD）的严重度与血清25羟维生素D［25(OH)D］、总免疫球蛋白E（tIgE）及IL 4水平的相关性。方法：选取本院就诊的160例AD患儿,以AD严重度评分（SCORAD）评估分级,采用高效液相色谱法检测血清25(OH)D,采用化学发光法检测血清tIgE,采用酶联免疫吸附法检测血清IL-4,分析血清25 (OH) D水平、tIgE、IL-4水平与 AD患者SCORAD评分的相关性。结果：根据SCORAD评分,AD患儿轻度55例（34.38%）、中度84例（52.50%）、重度21例（13.13%）。AD患儿血清25(OH)D与SCORAD评分、血清tIgE和IL-4水平均呈明显负相关(r值分别为-0.61、-0.48和-0.33,P值均＜0.001),SCORAD评分与血清tIgE和IL-4均呈明显正相关(r值分别为0.80、0.71, P值均＜0.001)。结论：AD患儿严重度与血清25(OH)D水平呈负相关,维生素D是AD的保护性因子。血清tIgE和IL-4水平均与AD的严重度呈负相关,维生素D可能通过影响血清tIgE和调控炎症因子IL-4参与皮肤的免疫调节,从而影响AD的严重程度。     

Quality of life and disease severity are correlated in children with atopic dermatitis

BACKGROUND: Atopic dermatitis (AD) in children may affect their daily activities and normal development. It can have a negative impact on the child's behaviour. Little is known about the quality of life (QOL) in children and its relationship to disease severity, especially from a community-based study. OBJECTIVES: To document the impact of AD on children's QOL and its relationship to disease severity. METHODS: The targeted population, before recruitment, comprised children with AD aged 5-10 years from a primary care setting. Their general practitioners identified potential patients and the U.K. diagnostic criteria for AD were used to verify the diagnosis. Eczema severity was assessed using the SCORAD (SCORing Atopic Dermatitis) index. The Children's Dermatology Life Quality Index (CDLQI) was used to quantify the impact of AD on children's QOL. These two parameters were evaluated on two occasions 6 months apart. The Spearman correlation coefficient and multiple regressions were used in statistical analysis. RESULTS: Of the 116 children attending the first QOL assessment visit, 78 (mean age 8.6 years, 44 girls and 34 boys) were able to complete the CDLQI. Of these 78 children, 71 (91%) attended the second visit, and were included in the analysis. The children's QOL was affected in 65 (92%) and 55 (77%) children attending the first and second visits, respectively. The CDLQI was significantly correlated with the SCORAD at the first and second visits (r=0.52, P<0.001 and r=0.59, P<0.001, respectively). Each unit change in the SCORAD was associated with a 0.12 (95% confidence interval 0.04-0.19, P=0.004) unit change in the children's QOL. CONCLUSIONS: We have shown a positive correlation between children's QOL and disease severity on cross-sectional and over time observation. This highlights the impact of AD on children's life. It also draws attention to the long-term effect on children's behaviour and development. In addition, these findings may imply that the CDLQI could be used as an extra measure of disease assessment in clinical practice and research studies.     

儿童特应性皮炎患者血清维生素D、总IgE及嗜酸性粒细胞水平的相关性研究

 目的 检测儿童特应性皮炎（AD）患者血清中维生素D（VitD）、总免疫球蛋白E（tIgE）水平及嗜酸性粒细胞（EOS)比例,评价VitD与AD患者病情相关性及其在AD发病中的免疫调节作用。方法采集120例AD患儿和60例健康体检儿童外周静脉血,酶联免疫吸附试验检测血清25-羟基维生素D［25(OH)D］水平以及AD组血清总IgE水平,血细胞分析仪检测AD组EOS比例。结果AD 组患儿血清25(OH)D 水平为(62.99±17.38) nmol/L,明显低于对照组的(72.44±18.07) nmol/L,差异有统计学意义(t=2.92,P<0.01)。轻度、中度及重度AD组三组患儿体内25(OH)D水平差异无统计学意义（F=1.32,P=0.275）。AD患儿血清维生素D水平与总IgE水平呈负相关（r=-0.38,P=0.003）,但与EOS比例无相关性（r=-0.03,P=0.827）。结论儿童AD患者体内25(OH)D水平较低,VitD不足与高水平tIgE存在一定的相关性,与EOS比例无相关性。     

Clinical severity correlates with impaired barrier in filaggrin-related eczema

Mutations in the gene-encoding filaggrin (FLG), a key molecule involved in skin barrier function, have been shown to be a major predisposing factor for atopic dermatitis (AD; eczema). To elucidate the pathomechanisms underlying filaggrin-related AD, we investigated stratum corneum (SC) hydration and transepidermal water loss (TEWL) as parameters of barrier function in AD patients harboring FLG mutations compared to AD patients without any FLG mutation. In filaggrin-related AD, SC hydration was both significantly reduced (P<0.01-0.05) and thicker (P<0.01-0.05) than that in healthy controls. TEWL was demonstrably increased in non-filaggrin AD compared to healthy controls (P<0.01-0.05). The objective score of atopic dermatitis (OSCORAD), a disease clinical severity index, significantly correlated with TEWL (r=0.81, P<0.005), SC hydration (r=-0.65, P<0.05), and SC thickness (r=0.59, P<0.05) in filaggrin-related AD. On the contrary, there was no correlation between these parameters and the OSCORAD in non-filaggrin AD. Furthermore, a significant correlation was obtained between the OSCORAD and specific IgE for house dust (r=0.66, P<0.05), mite allergen (r=0.53, P<0.05), and cat dander (r=0.64, P<0.05) in filaggrin-related AD, but not in non-filaggrin AD. All these data suggest that experimentally demonstrable skin barrier defects due to FLG mutations may play a crucial role in the pathogenesis of AD.     

Probiotic Supplement Reduces Atopic Dermatitis in Preschool Children

Background: The role of probiotics in the treatment of atopic dermatitis (AD) remains controversial. A recent systematic review of the available evidence called for further clinical trials with new probiotic formulations. Objective: To assess the clinical efficacy and impact of Lactobacillus acidophilus DDS-1, Bifidobacterium lactis UABLA-12 with fructo-oligosaccharide on peripheral blood lymphocyte subsets in preschool children with moderate-to-severe AD. Method: Randomized, double-blind, placebo-controlled, prospective trial of 90 children aged 1–3 years with moderate-to-severe AD who were treated with a mixture of L. acidophilus DDS-1, B. lactis UABLA-12 with fructo-oligosaccharide at a dosage of 5 billion colony-forming units twice daily for 8 weeks versus placebo. The primary outcome measure was the percentage change in Scoring of Atopic Dermatitis (SCORAD) value. Other outcome measures were changes in Infant Dermatitis Quality Of Life (IDQOL) and Dermatitis Family Impact (DFI) scores, frequency and amount of topical corticosteroid used, and lymphocyte subsets in peripheral blood measured by laser flow cytometry. Results: At the final visit, the percentage decrease in SCORAD was 33.7% in the probiotic group compared with 19.4% in the placebo group (p = 0.001). Children receiving probiotic showed a greater decrease in the mean [SD] SCORAD score than did children from the placebo group at week 8 (?14.2 [9.9] vs ?7.8 [7.7], respectively; p = 0.001). IDQOL and DFI scores decreased significantly from baseline by 33.0% and 35.2% in the probiotic group and by 19.0% and 23.8% in the placebo group, respectively (p = 0.013, p = 0.010). Use of topical corticosteroids during the 8-week trial period averaged 7.7 g less in probiotic patients (p = 0.006). CD3, CD16, and CD22 lymphocyte subsets remained unchanged, whereas the percentage of CD4, and the percentage and absolute count of CD25 decreased, and the percentage and absolute count of CD8 increased in the probiotic group at week 8 (p < 0.007 vs placebo). There was a significant correlation between CD4 percentage, CD25 percentage, CD25 absolute count, and SCORAD values (r = 0.642, r = 0.746, r = 0.733, respectively; p < 0.05) in the probiotic group at week 8. Conclusion: The administration of a probiotic mixture containing L. acidophilus DDS-1, B. lactis UABLA- 12, and fructo-oligosaccharide was associated with significant clinical improvement in children with AD, with corresponding lymphocyte subset changes in peripheral blood. The efficacy of probiotic therapy in adults with AD requires further investigation.     

Atopic dermatitis and melanocytic naevi

A study was performed to test the clinical impression that adults with severe atopic dermatitis (AD) have a low number of common naevi (CN). The number of CN > or = 2 mm was investigated in 51 Caucasian patients aged 20-63 years with severe AD since early childhood. The control group consisted of 379 randomly selected subjects, aged 30-50 years, investigated in an earlier study. Patients with AD had a significantly (P < 0.0001) lower total body count of CN (mean 9, median 5) compared with the control group (mean 67, median 53). It was also found that in the AD group there was a significant (P < 0.001) negative correlation between serum IgE and number of CN [r(s) = -0.50, 95% CI (-0.69; -0.24)]. The explanation for the low number of naevi that we have found in this highly selected subgroup of AD patients is not known. The atopic inflammation in the skin, genetics and treatment used for eczema are possible factors that may influence the formation of melanocytic naevi.