Effects of Medical Nutrition Therapy on Dietary Quality, Plasma Fatty Acid Composition and Immune Parameters in Atopic Dermatitis Patients / 대한지역사회영양학회지

Atopic dermatitis (AD) is one of the major public health problem. It has been reported that the prevalence of AD in children and adults are 10-20% and 1-3%, respectively. Westernization of food habits, urbanization, and environmental pollution are contributing factors toward the recent rise in prevalence. Excessive dietary restriction leads to chronic malnutrition in atopic dermatitis patients. The purpose of this study was to investigate the effects of medical nutrition therapy (MNT) on quality of diet and blood immune parameters in atopic dermatitis patients. The 19 atopic dermatitis patients (7 men and 12 women) admitted to K University Medical Center were studied. During the 12 weeks of intervention, the subjects were given MNT by a dietitian for 30-45 minutes every other week. MNT was comprised with general dietary therapy, intake of balanced meals, emphasis on n-3 fatty acid contents in foods, and food allergies. Anthropometric and dietary assessment and blood analysis were taken at baseline and after 12 weeks of MNT. After 12 weeks of MNT, the subjects' dietary qualities, including dietary diversity score (DDS), meal balance score (MBS) and dietary variety score (DVS) were significantly increased (p < 0.05). According to significantly increased intake of EPA and DHA, dietary n-6/n-3 fatty acid ratio decreased to the recommended level for the atopic dermatitis patients (p < 0.05). These changes of dietary fatty acid consumption were reflected rythrocyte fatty acid composition. After 12 weeks of MNT, serum levels of IgE and IL-4 levels were significantly decreased, however, the levers of INF-gamma, WBC, lymphocyte and TLC were not changed. As a conclusion, the individualized MNT improved the quality of diet in atopic dermatitis patients thereby influenced RBC fatty acid composition and IgE and IL-4 levels.

Study of Dietary Fatty acids, Blood Fatty Acid Composition, and Immune Parameters in Atopic Dermatitis Patients

The prevalence of atopic dermatitis (AD) continues to rise in industrialized countries related to Western lifestyle, including dietary habits, especially imbalance of intake of dietary fatty acids. The purpose of this study was to evaluate the dietary fatty acids and the assess the blood fatty acid composition and immune parameters in AD patients. AD (n = 50) patients and gender.age matched healthy controls (HC) were studied in case-control clinical trail. Current fatty acids intake status was determined by 3-day food record method. Blood sample were collected from 30 subjects in each group and blood fatty acid composition and immune parameters were analysed. AD patients consumed less PUFA and their n-6/n-3 PUFA ratio was higher than that of HC. Both the ratios of PUFA and MUFA were positively correlated with SCORAD in AD patients (p < 0.05). In the AD patients, there were abnormalities in the fatty acid composition of the RBC and WBC, SFA being significantly high and most n-3 PUFA being significantly low. Moreover, both the ratios of EPA and DHA in WBC were negatively correlated with dietary n-6/n-3 PUFA ratio in AD patients (p < 0.05). Serum total IgE and IL-4 levels of AD patients increased significantly compared with the levels of HC (p < 0.01). Ratios of monocyte and eosinophil in WBC of AD patients increased signi-ficantly compared with the levels of HC including total WBC count (p < 0.01), and ratios of lymphocyte and basophil in WBC of AD patients decreased significantly compared with the levels of HC (p < 0.05). Moreover, the ratios of eosinophil in WBC were positively correlated with dietary P/M ratio (p < 0.05), and the ratios of monocyte in WBC were positively correlated with n-6/n-3 PUFA ratio (p < 0.05) in AD patients. This results indicated that AD patients had significantly high intake of dietary n-6/n-3 PUFA compared with HC. Imbalance of intake of dietary fatty acids affected fatty acid compositions in the RBC and WBC, and these lead to immune imbalance and grow worse of AD.

A Study of Immunologic Difference Between Responders and Non-responders to Diphencyprone in Patients with Alopecia Areata

BACKGROUND: The pathogenesis of alopecia areata is still unknown, however autoimmune mechanism is strongly suggested. The topical immunotherapy using potent sensitizer has been used as new therapeutic modality. By this method in one half and to one third of the patients, hair growth is observed. OBJECTIVE: To evaluate the immunological profile between responders and non-responders to dphencyprone (DPCP) topical immunotherapy in alopecia areata patients. METHODS: Aker sensitization, DPCP was applied to the patients' scalp weekly for three months. Before and after treatment the therapeutic effect was evaluated by clinical observation by following items: complete baldness, baldness+vellus, baldness+terminal hair and normal hair. Peripheral T cell and T cell subsets, B cell and delayed hypersensitivity with various antigens were evaluated before and after treatment. RESULTS: The immunologic difference between responders and non-responders was not statistically different. CONCLUSION: It is suggested that no major immunologic difference was observed between responders and non-responders before and after DPCP topical immunotherapy. Local mechanism seems to be related in the response to immunotherapy.

A Study of Immunologic Difference Between Responders and Non-responders to Diphencyprone in Patients with Alopecia Areata

BACKGROUND: The pathogenesis of alopecia areata is still unknown, however autoimmune mechanism is strongly suggested. The topical immunotherapy using potent sensitizer has been used as new therapeutic modality. By this method in one half and to one third of the patients, hair growth is observed. OBJECTIVE: To evaluate the immunological profile between responders and non-responders to dphencyprone (DPCP) topical immunotherapy in alopecia areata patients. METHODS: Aker sensitization, DPCP was applied to the patients' scalp weekly for three months. Before and after treatment the therapeutic effect was evaluated by clinical observation by following items: complete baldness, baldness+vellus, baldness+terminal hair and normal hair. Peripheral T cell and T cell subsets, B cell and delayed hypersensitivity with various antigens were evaluated before and after treatment. RESULTS: The immunologic difference between responders and non-responders was not statistically different. CONCLUSION: It is suggested that no major immunologic difference was observed between responders and non-responders before and after DPCP topical immunotherapy. Local mechanism seems to be related in the response to immunotherapy.