PURPOSE:Many patients with atopic dermatitis have shown different responses to treatment or different prognosis dependenting on the kinds of offending allergens. We attempted to evaluate the difference of mechanism in allergic inflammation between food allergens and aeroallergens by measuring chemokines, including TARC (Thymus and activation regulated chemokine), MDC (Marcrophage-derived chemokine), IL-18, CCL-28 (Chemokine receptor ligand-28) and ECP (Eosinophil cationic protein), and to investigate the correlation between the clinical severity and chemokine levels induced by food allergens and aeroallergens in atopic dermatitis. METHODS:Sixty-seven children with atopic dermatitis (39 males and 28 females) were recruited. Thirteen nonatopic children without atopic dermatitis (6 males and 7 females) were selected as controls. RESULTS:We obtained SCORAD index cut-off points that were similar to those established by clinical criteria. Comparisons between the groups of mild, moderate and severe atopic dermatitis revealed significant differences in serum total IgE and ECP levels. SCORAD index significantly correlated with total IgE, TARC, MDC and ECP levels. Serum IgE levels correlated with TARC and ECP. SCORAD index and total IgE strongly correlated to HDM. While IL-18, TARC, MDC and ECP levels strongly correlated to egg white and milk. In soybean, IgE and TARC and ECP levels significantly correlated with specific IgE levels. CONCLUSION:TARC, MDC and ECP might play a crucial role in the chronic inflammatory process of food-specific atopic dermatitis. In contrast, IgE-mediated mechanisms might have implications for HDM, when compared with food specific atopic dermatitis. These results suggest that pathogenic mechanisms of atopic dermatitis might be different according to relevant allergens.
Allergens* ; Chemokine CCL17 ; Chemokines* ; Child ; Dermatitis, Atopic* ; Egg White ; Eosinophil Cationic Protein ; Humans ; Immunoglobulin E ; Inflammation ; Interleukin-18 ; Male ; Milk ; Prognosis ; Soybeans