健康教育对儿童特应性皮炎的干预效果

目的 探讨健康教育对儿童特应性皮炎（AD）的干预效果。方法 选择我院2017年5月~8月门诊收治的120例儿童AD患儿,按时间先后顺序分为实验组和对照组,每组60例。实验组给予常规治疗并给予相关知识健康教育,定期电话回访。对照组给予常规治疗,定期电话回访。比较两组入组时、入组1年后AD病情严重程度评分（SCORAD评分）、家长护理依从性、AD家庭影响调查问卷（DFI）评分。结果 入组1年后与对照组比较,实验组SCORAD评分为（3.28±0.87）分,家长护理依从性评分为（13.10±4.12）分,DFI评分为（6.82±2.15）分,均优于对照组的（6.23±1.23）分、（8.38±3.19）分和（10.38±2.47）分,差异具有统计学意义（P＜0.05）。结论 儿童AD患儿在常规治疗基础上实施健康教育,可促使家长了解疾病相关知识,提高治疗依从性,从而促使疗效提高,降低因疾病对家庭的影响。     

Ⅱ型固有淋巴细胞在特应性皮炎中作用机制的研究进展

Ⅱ型固有淋巴细胞(typeⅡinnate lymphoid cell,ILC2)是一种新型的固有淋巴细胞群体,活化后可以分泌大量的Th2型细胞因子IL-5、IL-13,主要介导Ⅱ型免疫应答,在抵御寄生虫感染、呼吸道疾病和组织修复中发挥了重要作用。特应性皮炎(atopic dermatitis,AD)是一种慢性复发性皮肤疾病,急性期病理过程主要表现为Th2细胞所介导的Ⅱ型免疫反应。近来发现,ILC2大量存在于人类皮肤的真皮层中,在AD患者的病损皮肤中数量增加并且呈现激活状态,提示ILC2参与了AD的发生发展过程。本文就ILC2在AD中作用机制的研究进展做一综述。     

MOR106通过阻断JAK2/STAT3信号通路抑制IL-17C介导的Tfh细胞分化来减轻特应性皮炎小鼠炎症

目的 探讨特应性皮炎(AD)模型中白细胞介素17C(IL-17C)介导滤泡辅助性T(Tfh)细胞分化的意义。方法BALB/c小鼠分为对照组、AD模型组、低剂量MOR106处理组、高剂量MOR106处理组,每组8只。除对照组外,其余各组均用2,4-二硝基氯苯(DNCB)处理建立AD模型,低剂量和高剂量MOR106处理组分别给与5 mg/kg或10 mg/kg MOR106(抗IL-17C huIgG1)处理。通过流式细胞术分析小鼠外周血中Tfh细胞亚群的分化,并采用Western blot法检测皮肤组织中Janus激酶2/信号转导子与转录激活子3(JAK2/STAT3)信号通路蛋白表达。结果 与对照组相比,AD模型组皮炎严重程度评分、两耳之间的质量差异、脾脏质量、脾脏指数均显著增加,AD组小鼠的Tfh细胞亚群显示去调节分化,导致外周血中CD4⁺ CXC趋化因子受体5(CXCR5)⁺ γ干扰素(IFN-γ)⁺ Tfh1细胞、 CD4⁺CXCR5⁺IL-17A⁺...     

特应性皮炎患者外周血细胞亚群DC1/DC2、Th1/Th2检测的临床意义

为探讨特应性皮炎（AD）患者外周血细胞亚群DC（DC1/DC2）与细胞亚群Th（Th1/Th2）分化状态及其临床意义,采用免疫荧光三标记流式细胞术检测35例特应性皮炎患者外周血DC1/DC2亚群（DC1/CD11 c＋和DC2/CD123＋）、Th1/Th2亚群（CD3＋CD4＋CD30-/CD3＋CD4＋CD30＋）,并以35名正常人作为对照组。结果表明,特应性皮炎患者DC CD123＋百分率比对照组明显增高（P＆lt;0.05）,而CD11 c＋DC百分率与对照组相比,无统计学意义（P＆gt;0.05）;Th2（CD3＋CD4＋CD30＋）显著增高（P＆lt;0.05）,Th1亚型（CD3＋CD4＋CD30-）与对照组比较,差异无统计学意义（P＆gt;0.05）。特应性皮炎患者外周血细胞亚群DC2呈优势,导致向细胞亚群Th2的免疫反应偏移,这可能与特应性皮炎的发病有关。     

酮替酚对重组Bla g2变应原诱导小鼠过敏性哮喘疗效的观察

支气管哮喘的发病率和死亡率逐年上升。研究发现对蟑螂变应原过敏和哮喘的发病相关。酮替酚是治疗哮喘的一种常用药物。Bla g2是德国小蠊变应原的主要组成之一，研究发现60％～80％的德国小蠊变应原过敏病人血清能检测出Bla g2特异的IgE。为此，我们观察了酮替酚对rBla g2致敏的哮喘小鼠预防性治疗的效果，     

Antibody-Dependent Monocyte-Mediated Cytotoxicity in Atopic Dermatitis

Antibody-dependent monocyte-mediated cytotoxicity was investigated in adult patients with atopic dermatitis. In patients with active dermatitis monocyte cytotoxicity was reduced. Serial studies of individual patients demonstrated that a reduced cytotoxicity in clinical exacerbation did not normalize during clinical remission. The reduced monocyte cytotoxicity was not caused by an abnormal influence of lymphocytes. During the cytotoxicity reaction a rapid and transient elevation of monocyte cyclic AMP occurred. In atopic dermatitis this elevation was decreased, but no relation was found between the monocyte cytotoxicity and the cyclic AMP response in these patients.     

Blood Rheological Properties in Patients with Atopic Dermatitis (AD)

Inflammatory processes and psychological states may mutually enhance each other as well as contribute to haemorheological alterations. The objective of the recent study was to determine blood rheological profile in patients with AD at different clinical stages. Blood rheology, as estimated by blood viscosity as well as deformability (elongation index—EI) and aggregation of erythrocytes (aggregation half time (AT1/2)—expressing the kinetic aspects and syllectogram amplitude (AMP)—representing total aggregation extent) were measured in 25 female AD patients, who showed clinical features of mild to severe AD and in 14 healthy subjects. There were no significant differences in blood rheological properties between patients with mild AD and the controls. A significant decrease in erythrocytes AT1/2 and AMP as well as EI were observed in severe AD patients as compared to other groups. Whole blood and plasma viscosity were similar in all groups. Both erythrocytes deformability and aggregation may be affected by pathophysiological processes associated with AD. Only AD patients with severe skin changes showed increased aggregability and decreased deformability of erythrocytes, suggesting that the phenomenon might be related to the disease activity. This study was supported by a research grant from the Committee for Scientific Research (NN-1-117/06).     

Impaired Monocyte Cyclic AMP Responses and Monocyte Cytotoxicity in Atopic Dermatitis

Purified monocytes from 21 patients with mild and severe atopic dermatitis (AD) were compared with 22 healthy controls with respect to antibody-dependent cell-mediated cytotoxicity (ADCC) and cyclic adenosine 3',5'-monophosphate (cAMP) responses to stimulatory agents. ADCC was depressed in both severe and mild atopic dermatitis. The patients showed decreased cAMP responses to isoproterenol and histamine, the decrement being more distinct in severe atopic dermatitis. Formation of cAMP was diminished with PGE, only in patients with severe AD. ADCC is inhibited by the agents that increase cAMP. In the severe dermatitis group reduced inhibition induced by isoproterenol, histamine, but not PGE₁, was obtained. It is suggested that a general suppression of membrane activation may explain the reduced cAMP responses to various stimulatory agents and the impaired monocyte cytotoxicity.     

Enhanced Platelet Activation in Patients with Atopic Eczema/Dermatitis Syndrome

Data gathered prove that circulating platelets are activated upon human allergic inflammation, partly as a result of direct IgE-mediated process. It has been indicated that platelets may contribute to pathogenesis of atopic eczema/dermatitis syndrome (AEDS). Authors of the recent study have investigated systemic platelet activation in patients with AEDS on the basis of blood level of beta-thromboglobulin (beta-TG) and platelet factor 4 (PF4), which are recognized markers of platelet activation, also belonging to C-X-C chemokine family. Plasma levels of beta-TG and PF4 were measured by enzyme-linked immunoassay (ELISA) in 18 AEDS patients with moderate disease activity and 23 healthy, nonatopic individuals. No differences in peripheral platelet count of the two groups were noted. Only four (33.3%) AEDS patients represented beta-TG and PF4 within the control range; plasma beta-TG and PF4 were significantly increased (p < 0.001) in the AEDS group compared as a whole with the control subjects. No association between circulating concentrations of beta-TG or PF4 and total IgE levels in AEDS patients was proved. The results suggest that some patients with AEDS may have enhanced blood platelet activity as expressed by beta-TG and PF4 level.     

Immunomorphological Study of Langerhans Cells in the Skin of Patients with Atopic Dermatitis

Immunomorphological study of Langerhans cells in affected skin of patients with moderate exacerbation and remission of atopic dermatitis revealed an increase in numerical density (compared to healthy volunteers) and change in morphological characteristics and topography of these cells. Translated from Byulleten’ Eksperimental’noi Biologii i Meditsiny, Suppl. 1, pp. 70–72, 2008     

Oral Sodium Cromoglycate Treatment of Atopic Dermatitis Related to Food Allergy

Thirty-two children and two adults with chronic atopic dermatitis related to food allergy entered this double-blind crossover study comparing oral sodium cromoglycate (200–1600 mg/24 h) with placebo. Each treatment period comprised 6 weeks: 1 weeks on elimination diet, and 2 weeks on a normal. i.e. unrestricted diet. The diagnosis of food allergy was made after clinical improvement with elimination diet and relapse after challenge. Overall analysis of skin symptoms evaluated by means of clinical assessments and diary cards, opinions of treatment, and use of concomitant medication gave no evidence of any difference between sodium cromoglycate and placebo. Unusual symptoms were reported by 18 patients. In one case the patient was withdrawn during the sodium cromoglycate period because of side effects. The majority of symptoms with both treatments were stomach problems. Overall analysis of the laboratory data gave no significant differences between treatments.     

Ultrastructure of Epidermis of Mice with Chronic Proliferative Dermatitis

C57BL/Ka mice with chronic proliferative dermatitis (cpdm/cpdm) develop chronic persistent skin lesions characterized by epidermal hyperplasia, infiltration by granulocytes and macrophages, and vascular dilatation. Similar lesions are present in other orthokeratotic epithelia in affected mice, in particular the esophagus and forestomach. Here, we report on further characterization of epidermal hyperplasia and the granulocytes. Keratinocytes of lesional skin, but not of normal skin, show round and electron-dense mitochondrial inclusions that are present in all layers of the epidermis. Similar inclusions are also present in the esophagus and forestomach of affected mice. There appears to be a direct relation between the presence of intramitochondrial inclusions and epidermal hyperplasia in the mouse. Furthermore, the presence of keratinocyte-derived apoptotic bodies in the epidermis, esophagus, and forestomach was frequently observed in the lesions, which is consistent with previous light microscopic observations of single cell death of keratinocytes. The granulocytes present in the skin, esophagus, and forestomach were mainly eosinophils. There were widespread gaps observed in the lamina densa in the epidermis that were mostly directly associated with dermal or epidermal eosinophils. This type of gap is also observed in psoriasiform diseases in humans. This electron microscopic study demonstrated that this mouse model should be useful to screen potential therapeutic strategies for psoriasiform and other inflammatory skin disorders.     

Atopic Dermatitis With Coexisting Food Allergy in Early Life Is Associated With Childhood Asthma

PurposeAtopic dermatitis (AD) and food allergy (FA) are associated with respiratory comorbidities, in the concept of ‘atopic march.’ However, children with AD and a coexisting FA have various disease courses, and the mechanism of atopic march remains unclear. In this study, we investigated whether the phenotype of AD with coexisting FA in early life affected asthma or allergic rhinitis (AR) in school children.MethodsA total of 1,579 children from the Panel Study on Korean Children (PSKC) cohort were followed-up in 2013. The participants diagnosed with AD in this cohort were classified by the age of AD onset and persistence as well as FA history. We compared the presence of comorbidities—asthma and rhinitis—among different AD phenotypes.ResultsAsthma and AR with current symptoms within 12 months at age 6–8 years were associated with early-onset persistent AD phenotype, regardless of coexisting FA. AD with FA conferred a higher risk of recent wheezing at 8 years of age than AD without FA (adjusted odds ratio, 8.09; 95% confidence interval, 2.54–25.76). Children with early-onset persistent AD with FA manifested a distinctive trajectory with a higher prevalence of wheezing and AR at age 5–8 years than those without AD.ConclusionsAD with FA in early life is strongly associated with asthma and AR in school children, and the early-onset persistent AD with FA had a strong additive effect on the risk of asthma at school age. Classifying AD phenotypes regarding FA in early life will help predict and prevent asthma and AR in school children.     

Natural History and Risk Factors of Atopic Dermatitis in Children

Atopic dermatitis (AD) is one of the most common inflammatory allergic diseases with pruritic skin lesions particularly in infancy. It is considered to be the first step of atopic march and has variable disease courses. Many children with AD may resolve their AD symptoms with increasing age and may develop respiratory allergies such as asthma and rhinoconjunctivitis at certain ages. Natural course of AD has been supported by many cross-sectional and longitudinal studies in many countries. In general, atopic dermatitis tends to be more severe and persistent in young children, particularly if they have some risk factors including genetic factors. It appears that approximately 40%-70% of childhood AD will get resolved when they reach the age of 6-7 years. However, it is also observed that over half of the children with AD developed respiratory allergy during late childhood.