Role of serum nitrate and soluble E-selectin in infants and children with atopic dermatitis

ABSTRACT

The pathogenesis of atopic dermatitis [AD] is still unknown. A recent study has shown that inducible nitric oxide synthase [i NOS] is expressed in the atopic skin lesion, suggesting the involvement of nitric oxide [NO] in the skin inflammation of AD. Soluble E-selectin [sE-selectin] is also known to be a serological marker in AD which reflects disease activity. Therefore, the aim of this study was to evaluate the role of serum nitrate and sE-selectin concentrations in the pathogenesis, relation to the disease severity and clinical course of infants and children with AD. Serum Nitrate and sE-selectin levels were assessed in 54 patients with AD [28 boys and 26 girls] aged 4-84 months median 17months, and 16 nonatopic controls [9 boys and 7 girls] aged 6-60 months; median 18 months. Serum nitrate was measured by an enzymatic one step assay with nitrate reductase and serum sE-selectin was measured by radioimmunoassay. Serum nitrate and sE-selectin concentrations in patients with AD were significantly increased as compared to non-atopic controls and there were also significant differences between subgroups of AD [mild, moderate and severe] as compared to controls and among subgroups themselves. The levels of both markers were significantly diminished after treatment of severe cases of AD. Significant correlations were present between serum nitrate levels, sE-selectin levels, disease activity and eosinophilic count, but no correlation was found between serum nitrate and sE-selectin levels. Our results indicate that NO may be involved in the pathogenesis of vasodilatation and erythema in AD skin, also sE-selectin may be a useful parameter in the monitoring of AD. NO and sE-selectin are good and useful markers for assessment of the severity and clinical course of AD in infants and children