Association of SCORAD Index and Aeroallergen Sensitization on Urinary Leukotriene E4 in Children with Atopic Dermatitis / 소아알레르기및호흡기학회지

PURPOSE: Atopic dermatitis (AD) is a genetically determined, chronic relapsing skin disease. The pathogenesis of AD is complex and the course is unpredictable. Atopy is an important risk factor for the development of AD. Cysteinyl leukotrienes (Cys-LTs) were implicated in the pathophysiology of allergic diseases, and are being targeted for their diagnosis and treatments. Early detection of tissue inflammation of target organ is important to enable early prevention and management of allergic diseases. The aim of our study is to evaluate the differences in urinary leukotrienes E4 (LTE4) levels, according to AD symptom score and aeroallergen sensitization in children with AD by using noninvasive techniques. METHODS: We recruited 46 children with AD, using predetermined criteria. Clinical features of AD were evaluated by a physician, using scoring atopic dermatitis (SCORAD) index. Aeroallergen sensitization was measured by using a skin prick test and UniCap. Urine samples were also collected on day of the 1st and 2nd visits, and were analyzed for LTE4 with an enzyme-linked immunoassay kit. RESULTS: SCORAD indeces of children with AD were correlated with urinary LTE4 levels. Total immunoglobulin E (IgE) and eosinophil counts also had significant correlation with urinary LTE4 levels. Especially, aeroallergen sensitization of atopic AD significantly correlated with urinary LTE4 of these patients. CONCLUSION: Urinary LTE4 levels significantly correlated with serum total IgE and number of sensitized aeroallergen in children with AD. Clinical features of AD evaluated with SCORAD index related with urinary LTE4 level. Urinary LTE4 might be a valuable, noninvasive marker for different pathogenesis of AD.

Study of Urinary Leukotriene E4 and Eosinophil Cationic Protein in Nasopharyngeal Aspiration from Wheezing Infants / 소아알레르기및호흡기학회지

PURPOSE: Although early detection of airway inflammation is important to enable early prevention and treatment, it is not easy to differentiate clinically between respiratory virus- induced bronchiolitis and infantile asthma during a wheezing attack. Leukotriens (LTs) are known as a mediator of airway adhesions and inflammations, such as constricted airways and increased mucus secretions. Eosinophil cationic protein (ECP) is one of the cytotoxic proteins released from the granules of activated eosinophils, which have a role in the pathogenesis of airway inflammation. The aim of our study was to evaluate differences in urinary LTE4 and nasopharyngeal ECP levels between children with bronchiolitis and children with infantile asthma by using noninvasive techniques. METHODS: We recruited 32 children whose chief complaint was wheezing (20 non-atopic and 12 atopic children) and 18 controls without wheezing for this study. Urine and nasopharyngeal samples were collected on the day of admission. Samples were stored at -70degrees C until measurement. Nasopharyngeal ECP were measured by using UniCap (Pharmacia CAP FEIA, Pharmacia Diagostics, Uppsala, Sweden). Urine LTE4 level were measured by ACE enzyme immunoassay kit (Cayman Chemical, Ann Arbor, MI, USA). RESULTS: Children with infantile asthma have significantly higher LTE4 levels than children with bronchiolitis. Nasopharyngeal ECP levels were significantly different in children with/without wheezing. Furthermore, urinary LTE4 was significantly correlated with nasopharyngeal ECP, serum total eosinophil, serum IgE level, and respiratory symptoms. CONCLUSION: Urinary LTE4 and nasopharyngeal ECP were significantly different between children with bronchiolitis and infantile asthma. Further studies are needed to investigate the clinical application of our findings.