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The Relationships among Severity Score, Behavioral Problem, Parental Stress, Maternal Depression, and Social Support in Children with Atopic Dermatitis
S280 Abstracts
1095
Altered Expression of Epidermal Differentiation Proteins in Atopic Dermatitis compared to Psoriasis or Nonatopic, Healthy Controls A. De Benedetto1, L. Y. McGirt2, M. Brummet3, C. Cheadle3, K. C. Barnes3, L. A. Beck1; 1Department of Dermatology and Division of Allergy/Immunology and Reumatology, University of Rochester School of Medicine and Dentistry, Rochester, NY, 2Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, 3Division of Allergy and Clinical Immunology, Johns Hopkins University School of Medicine, Baltimore, MD. RATIONALE: Genetic studies have demonstrated strong linkage (chromosome 1q21) to the epidermal differentiation complex in subjects with Atopic Dermatitis (AD) and Psoriasis (PS). Genomic studies were performed using high-throughput expression profiling from nonlesional skin samples of subjects with AD, PS and nonatopic, healthy controls (NA) to further dissect the genetic basis of these diseases. METHODS: We employed the suction-blister approach to lift epithelium from a nonlesional site on the volar forearm of AD (n55), PS (n54) and NA (n55). Expression profiles were generated using Illumina’s Sentrix HumanRef-8 Expression BeadChips (>23,000sequences), analyzed using Gene Set Matrix Analysis (modification of PAGE method). Genes with Z ratio values 6;2.0 were considered significantly affected. RESULTS: Both AD and PS subjects had a significant upregulation of S100A7, Small Proline-Rich Proteins (SPRR) 1B and 2A compared to NA. The magnitude of this upregulation was greater for AD compared to PS. Several LCE (1B, 1C, 1F, 2C, 2D, 4A) were downregulated in both AD and PS. Some genes were differentially regulated between AD and PS. Late Cornified Envelope (LCE) 3D, SPRR2B and S100A9, A8, A6 were upregulated only in AD. Loricrin and LCE2B were downregulated in AD, whereas involucrin was downregulated only in PS. CONCLUSIONS: These results support and extend the evidence that there is dysregulation of proteins important for epidermal maturation/differentiation and barrier function in both AD and PS with some distinct signatures. The fact that these abnormalities are observed in nonlesional skin suggests that they are not simply a consequence of disease-specific inflammation. Funding: NIH N01 40029
1096
TUESDAY
Association Of Interleukin-10 Gene Promoter Polymorphism In Korean Children With Atopic Dermatitis K. Kim, J. Hong, J. Park, K. Kim, E. Kim, M. Sohn; Department of Pediatrics, Yonsei University College of Medicine, Seoul, REPUBLIC OF KOREA. RATIONALE: The IL-10 gene promoter polymorphisms may affect the transcription of IL-10 genes and has been associated with an increased production of the IL-10 cytokine. However, data regarding the pathogenesis of atopic dermatitis in childhood are scarce. The aim of this study is to evaluate the possible role of IL-10 promoter polymorphisms in Korean children with atopic dermatitis. METHODS: We genotyped 276 children with atopic dermatitis, 82 children with non-atopic eczema, and 140 control children for allelic determinants at three polymorphic sites in the promoter region at positions -1082A>G, -819T>C, and -592A>C by restriction fragment length polymorphism methods. RESULTS: The -819T>C and -592A>C polymorphisms in the IL-10 promoter gene are associated with atopic dermatitis susceptibility and blood eosinophil counts. The IL-10 promoter haplotypes ATA, ACC, and GCC were 65.3%, 22.6%, and 5.7%, respectively. In addition, haplotype 1 consisting of ATA was observed at significant levels in patients with atopic dermatitis compared with non-atopic eczema patients (P50.00). CONCLUSIONS: IL-10 promoter polymorphisms are associated with the phenotype of atopic dermatitis in Korean children.
J ALLERGY CLIN IMMUNOL JANUARY 2007
1097
Transepidermal Water Loss As A Biological Marker In Atopic Dermatitis In Children J. Gupta1,2, E. Grube2, A. Lucky2, A. Sheth2, A. Assa’ad2, G. K. Khurana Hershey2; 1University of Cincinnati, Cincinnati, OH, 2Cincinnati Children’s Hospital Medical Center, Cincinnati, OH. RATIONALE: Studies which have compared transepidermal water loss (TEWL) between atopic and non-atopic skin have yielded conflicting results; furthermore, most of these studies were done in Asian and Caucasian populations; there is insufficient data in African-Americans. METHODS: Caucasian and African-American subjects with atopic dermatitis (AD) were sequentially recruited from Allergy and Dermatology clinics at Cincinnati Children’s Hospital Medical Center. TEWL was measured to assess barrier function on non-lesional normal appearing skin at 4 different sites (volar forearm, dorsal arm, lower leg and cheek) in 4 groups of children: (1) AD, atopic; (2) AD, non-atopic; (3) controls with asthma or allergic rhinitis, but no AD; (4) non-atopic, healthy controls. Skin prick testing and/or RAST for common aeroallergens were done on all study subjects, and AD severity was assessed by objective SCORAD. RESULTS: Caucasian cases had consistently higher TEWL measurements than African-Americans, and this difference was significant (p < 0.05) at volar forearm and lower leg. TEWL values were significantly higher (p < 0.05) in AD patients (Groups 1 and 2) compared to both control groups at most of the anatomical sites in both races. There was no significant difference in TEWL between Groups 1 and 2 for both races at any of the body sites. CONCLUSIONS: TEWL in normal appearing skin was significantly increased in children with AD compared to atopic and non-atopic control groups. Caucasian children with AD had consistently higher TEWL measurements than African-Americans. TEWL may be a useful biomarker for AD and should be evaluated in prospective studies. Funding: NIH
1098
The Relationships among Severity Score, Behavioral Problem, Parental Stress, Maternal Depression, and Social Support in Children with Atopic Dermatitis M. Shin1, S. Chung2, S. Lee2; 1Soonchunhyang university hospital, Bucheon, REPUBLIC OF KOREA, 2Samsung seoul hospital, Seoul, REPUBLIC OF KOREA. RATIONALE: This study was conducted in order to find out whether there are differences in behavioral characteristics, parental stress, maternal depression, and social support between children with atopic dermatitis (AD) and normal children. Furthermore it was examined the relative influence of symptom severity, parental stress, maternal depression, and social support contributing to behavioral characteristics of children with AD. METHODS: Forty children with AD who showed higher than 15 of SASSAD(Six Area, Six Score in AD) score were enrolled. Their ages ranged from 4 to 16 years. Their mothers were subjected to parent-report questionnaire. The matched normal control group of 39 children was selected in terms of age and sex, and socioeconomic status of parents. RESULTS: 1) Children with AD showed higher behavioral problem score in comparison to the children in control group. A statistically significant increase in behavioral symptoms, notably withdrawal, depression/anxiety, aggression, social immaturity, and attention problem was found in children with AD. 2) Mothers of children with AD perceived themselves as suffering from higher parental stress and depression compared to mothers of the control group. On the other hand there was no statistically significant difference in social support between two groups. 3) In relative influences of behavioral score, parental stress was the most significant variable. The higher parental stress was, the higher behavioral score the children with AD showed. CONCLUSIONS: Our results suggest that the psychological dimensions of AD should be taken into account as part of routine intervention. Furthermore these results consistently underline the importance of psychological support for the mothers of children with AD.
1095
Altered Expression of Epidermal Differentiation Proteins in Atopic Dermatitis compared to Psoriasis or Nonatopic, Healthy Controls A. De Benedetto1, L. Y. McGirt2, M. Brummet3, C. Cheadle3, K. C. Barnes3, L. A. Beck1; 1Department of Dermatology and Division of Allergy/Immunology and Reumatology, University of Rochester School of Medicine and Dentistry, Rochester, NY, 2Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, 3Division of Allergy and Clinical Immunology, Johns Hopkins University School of Medicine, Baltimore, MD. RATIONALE: Genetic studies have demonstrated strong linkage (chromosome 1q21) to the epidermal differentiation complex in subjects with Atopic Dermatitis (AD) and Psoriasis (PS). Genomic studies were performed using high-throughput expression profiling from nonlesional skin samples of subjects with AD, PS and nonatopic, healthy controls (NA) to further dissect the genetic basis of these diseases. METHODS: We employed the suction-blister approach to lift epithelium from a nonlesional site on the volar forearm of AD (n55), PS (n54) and NA (n55). Expression profiles were generated using Illumina’s Sentrix HumanRef-8 Expression BeadChips (>23,000sequences), analyzed using Gene Set Matrix Analysis (modification of PAGE method). Genes with Z ratio values 6;2.0 were considered significantly affected. RESULTS: Both AD and PS subjects had a significant upregulation of S100A7, Small Proline-Rich Proteins (SPRR) 1B and 2A compared to NA. The magnitude of this upregulation was greater for AD compared to PS. Several LCE (1B, 1C, 1F, 2C, 2D, 4A) were downregulated in both AD and PS. Some genes were differentially regulated between AD and PS. Late Cornified Envelope (LCE) 3D, SPRR2B and S100A9, A8, A6 were upregulated only in AD. Loricrin and LCE2B were downregulated in AD, whereas involucrin was downregulated only in PS. CONCLUSIONS: These results support and extend the evidence that there is dysregulation of proteins important for epidermal maturation/differentiation and barrier function in both AD and PS with some distinct signatures. The fact that these abnormalities are observed in nonlesional skin suggests that they are not simply a consequence of disease-specific inflammation. Funding: NIH N01 40029
1096
TUESDAY
Association Of Interleukin-10 Gene Promoter Polymorphism In Korean Children With Atopic Dermatitis K. Kim, J. Hong, J. Park, K. Kim, E. Kim, M. Sohn; Department of Pediatrics, Yonsei University College of Medicine, Seoul, REPUBLIC OF KOREA. RATIONALE: The IL-10 gene promoter polymorphisms may affect the transcription of IL-10 genes and has been associated with an increased production of the IL-10 cytokine. However, data regarding the pathogenesis of atopic dermatitis in childhood are scarce. The aim of this study is to evaluate the possible role of IL-10 promoter polymorphisms in Korean children with atopic dermatitis. METHODS: We genotyped 276 children with atopic dermatitis, 82 children with non-atopic eczema, and 140 control children for allelic determinants at three polymorphic sites in the promoter region at positions -1082A>G, -819T>C, and -592A>C by restriction fragment length polymorphism methods. RESULTS: The -819T>C and -592A>C polymorphisms in the IL-10 promoter gene are associated with atopic dermatitis susceptibility and blood eosinophil counts. The IL-10 promoter haplotypes ATA, ACC, and GCC were 65.3%, 22.6%, and 5.7%, respectively. In addition, haplotype 1 consisting of ATA was observed at significant levels in patients with atopic dermatitis compared with non-atopic eczema patients (P50.00). CONCLUSIONS: IL-10 promoter polymorphisms are associated with the phenotype of atopic dermatitis in Korean children.
J ALLERGY CLIN IMMUNOL JANUARY 2007
1097
Transepidermal Water Loss As A Biological Marker In Atopic Dermatitis In Children J. Gupta1,2, E. Grube2, A. Lucky2, A. Sheth2, A. Assa’ad2, G. K. Khurana Hershey2; 1University of Cincinnati, Cincinnati, OH, 2Cincinnati Children’s Hospital Medical Center, Cincinnati, OH. RATIONALE: Studies which have compared transepidermal water loss (TEWL) between atopic and non-atopic skin have yielded conflicting results; furthermore, most of these studies were done in Asian and Caucasian populations; there is insufficient data in African-Americans. METHODS: Caucasian and African-American subjects with atopic dermatitis (AD) were sequentially recruited from Allergy and Dermatology clinics at Cincinnati Children’s Hospital Medical Center. TEWL was measured to assess barrier function on non-lesional normal appearing skin at 4 different sites (volar forearm, dorsal arm, lower leg and cheek) in 4 groups of children: (1) AD, atopic; (2) AD, non-atopic; (3) controls with asthma or allergic rhinitis, but no AD; (4) non-atopic, healthy controls. Skin prick testing and/or RAST for common aeroallergens were done on all study subjects, and AD severity was assessed by objective SCORAD. RESULTS: Caucasian cases had consistently higher TEWL measurements than African-Americans, and this difference was significant (p < 0.05) at volar forearm and lower leg. TEWL values were significantly higher (p < 0.05) in AD patients (Groups 1 and 2) compared to both control groups at most of the anatomical sites in both races. There was no significant difference in TEWL between Groups 1 and 2 for both races at any of the body sites. CONCLUSIONS: TEWL in normal appearing skin was significantly increased in children with AD compared to atopic and non-atopic control groups. Caucasian children with AD had consistently higher TEWL measurements than African-Americans. TEWL may be a useful biomarker for AD and should be evaluated in prospective studies. Funding: NIH
1098
The Relationships among Severity Score, Behavioral Problem, Parental Stress, Maternal Depression, and Social Support in Children with Atopic Dermatitis M. Shin1, S. Chung2, S. Lee2; 1Soonchunhyang university hospital, Bucheon, REPUBLIC OF KOREA, 2Samsung seoul hospital, Seoul, REPUBLIC OF KOREA. RATIONALE: This study was conducted in order to find out whether there are differences in behavioral characteristics, parental stress, maternal depression, and social support between children with atopic dermatitis (AD) and normal children. Furthermore it was examined the relative influence of symptom severity, parental stress, maternal depression, and social support contributing to behavioral characteristics of children with AD. METHODS: Forty children with AD who showed higher than 15 of SASSAD(Six Area, Six Score in AD) score were enrolled. Their ages ranged from 4 to 16 years. Their mothers were subjected to parent-report questionnaire. The matched normal control group of 39 children was selected in terms of age and sex, and socioeconomic status of parents. RESULTS: 1) Children with AD showed higher behavioral problem score in comparison to the children in control group. A statistically significant increase in behavioral symptoms, notably withdrawal, depression/anxiety, aggression, social immaturity, and attention problem was found in children with AD. 2) Mothers of children with AD perceived themselves as suffering from higher parental stress and depression compared to mothers of the control group. On the other hand there was no statistically significant difference in social support between two groups. 3) In relative influences of behavioral score, parental stress was the most significant variable. The higher parental stress was, the higher behavioral score the children with AD showed. CONCLUSIONS: Our results suggest that the psychological dimensions of AD should be taken into account as part of routine intervention. Furthermore these results consistently underline the importance of psychological support for the mothers of children with AD.