Skin barrier in atopic dermatitis: beyond filaggrin

Abstract: Atopic dermatitis is a chronic inflammatory skin disease with a complex pathogenesis, where changes in skin barrier and imbalance of the immune system are relevant factors. The skin forms a mechanic and immune barrier, regulating water loss from the internal to the external environment, and protecting the individual from external aggressions, such as microorganisms, ultraviolet radiation and physical trauma. Main components of the skin barrier are located in the outer layers of the epidermis (such as filaggrin), the proteins that form the tight junction (TJ) and components of the innate immune system. Recent data involving skin barrier reveal new information regarding its structure and its role in the mechanic-immunological defense; atopic dermatitis (AD) is an example of a disease related to dysfunctions associated with this complex.

Diagnostic Performances of Anti-Cyclic Citrullinated Peptides Antibody and Antifilaggrin Antibody in Korean Patients with Rheumatoid Arthritis

Rheumatoid arthritis (RA) is a systemic autoimmune disease of unknown etiology. We studied the diagnostic performances of anti-cyclic citrullinated peptides antibody (anti-CCP) assay and recombinant anti-citrullinated filaggrin antibody (AFA) assay by enzyme linked immunosorbent assay (ELISA) in patients with RA in Korea. Diagnostic performances of the anti-CCP assay and AFA assay were compared with that of rheumatoid factor (RF) latex fixation test. RF, anti-CCP, and AFA assays were performed in 324 RA patients, 251 control patients, and 286 healthy subjects. The optimal cut off values of each assay were determined at the maximal point of area under the curve by receiver-operator characteristics (ROC) curve. Sensitivity (72.8%) and specificity (92.0%) of anti-CCP were better than those of AFA (70.3%, 70.5%), respectively. The diagnostic performance of RF showed a sensitivity of 80.6% and a specificity of 78.5%. Anti-CCP and AFA showed positivity in 23.8% and 17.3% of seronegative RA patients, respectively. In conclusion, we consider that anti-CCP could be very useful serological assay for the diagnosis of RA, because anti-CCP revealed higher diagnostic specificity than RF and AFA at the optimal cut off values and could be performed by easy, convenient ELISA method.

Immunohistochemistry for intestinal ganglion cells and nerve fibers: aid in the diagnosis of Hirschsprung's disease.

Hirschsprung's disease is a disease of congenital abnormalities characterized by absence of the enteric ganglion cell of the colon. To make a definite diagnosis, biopsy of the aganglionic zones of colon is required. A specimen from submucosal biopsy of the colon is very small and difficult to identify submucosal ganglion cells. Our study reports an immunohistochemical technique to detect submucosal ganglion cells. Six antineural markers, peripherin, cathepsin D, PGP 9.5, synaptophysin, chromogranin and S-100 protein, were used. The best antibody for the detection of submucosal ganglion cells in our study was peripherin. The additional measurement of nerve fiber caliber using S-100 protein staining is a valuable aid in the diagnosis of Hirschsprung's disease. It can be applied to the suction submucosal biopsy in a patient suspected of having Hirschsprung's disease, therefore, the complicated full thickness colonic and rectal biopsy can be avoided.