The Relationship between Atopic Dermatitis, Thymus and Activation-Regulated Chemokine/CCL17, Quality of Life, and Attention Deficit-Hyperactivity Disorder in Preschool Children

Dong Hyuk Park; Sun Hee Chung; Jae Won Shim; Deok Soo Kim; Hae Lim Jung; Moon Soo Park; Jung Yeon Shim

doi:10.7581/pard.2011.21.3.215

Journal List > Pediatr Allergy Respir Dis > v.21(3) > 1033129

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Park, Chung, Shim, Kim, Jung, Park, and Shim: The Relationship between Atopic Dermatitis, Thymus and Activation-Regulated Chemokine/CCL17, Quality of Life, and Attention Deficit-Hyperactivity Disorder in Preschool Children

Abstract

Pediatr Allergy Respir Dis 2011;21(3):215-225.

Published online: 20 January 2011

DOI: https://doi.org/10.7581/pard.2011.21.3.215

The Relationship between Atopic Dermatitis, Thymus and Activation-Regulated Chemokine/CCL17, Quality of Life, and Attention Deficit-Hyperactivity Disorder in Preschool Children

Dong Hyuk Park, MD, Sun Hee Chung, MD, Jae Won Shim, MD, Deok Soo Kim, MD, Hae Lim Jung, MD, Moon Soo Park, MD, Jung Yeon Shim, MD

Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea

책임저자: 심정연, 서울시 종로구 서문안길 78번지 성균관대학교 의과대학 강북삼성병원 소아청소년과 Tel: 02)2001-2200 Fax: 02)2001-2199 E-mail: jy7.shim@samsung.com

Received 4 August 2011 Revised 2 September 2011 Accepted 8 September 2011

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

Atopic dermatitis may impair quality of life and lead to attention deficit-hyperactivity disorder (ADHD). Thymus and activation-regulated chemokine (TARC)/CCL17 may serve as a new biomarker for atopic dermatitis. We investigated the relationship between TARC and the severity of atopic dermatitis, quality of life, and ADHD.

Methods

A total of 249 preschool children who had atopic dermatitis were enrolled. Parents of the patients filled out a questionnaire on the past history of allergic diseases, quality of life, and ADHD. In each patient, total immunoglobulin (Ig) E and specific IgE to nine foods and inhalant allergens, total eosinophil counts, and TARC levels were measured. We evaluated the severity of atopic dermatitis by using the scoring atopic dermatitis (SCORAD) score and divided the patients into three groups; mild (<15), moderate (15 to 40), and severe (>40).

Results

In a total of 249 children, 222 children (89.2%) had a history of atopic dermatitis. Children with allergic sensitization had a higher SCORAD score, total IgE levels, and total eosinophil counts, but not TARC levels. Three groups by the SCORAD score showed significant differences in quality of life index and TARC levels but not in ADHD index. TARC level was correlated with the SCORAD score, but not with the quality of life index and ADHD index. The SCORAD score was correlated with the quality of life index but not with the ADHD index.

Conclusion

Serum TARC levels may be associated with the severity of atopic dermatitis but not with the degree of quality of life and ADHD. Disease severity of atopic dermatitis in preschool children may be associated with the degree of quality of life but not with the level of ADHD.

Keywords: Atopic dermatitis, Chemokine CCL17, Quality of life, Attention deficit disorder with hyperactivity, Child

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Fig. 1.

Correlations of scoring atopic dermatitis (SCORAD) index with serum thymus and activation-regulated chemokine (TARC) level, quality of life (QoL) index and attention deficit/hyperactivity disorder (ADHD) index. SCORAD index showed significant correlation with serum TARC level (A) and QoL index (B), but not with ADHD index (C).

Fig. 2.

Correlation of serum thymus and activation-regulated chemokine (TARC) level with quality of life (QoL) index and attention deficit/hyperacti-vity disorder (ADHD) index. Serum TARC level was not correlated with either QoL index (A) or ADHD index (B).

Table 1.

Demographic Characteristics of the Study Subjects (n=249)

Demographic characteristics	Value
Male	126 (50.6)
Age (mo)	49±23
History of atopic dermatitis	222 (89.2)
History of asthma	38 (15.3)
History of History of allergic rhinitis	73 (29.3)
History of urticaria	136 (54.6)

Values are presented as number (%) or mean±SD.

Table 2.

Comparison of SCORAD Score, Total IgE Levels, Total Eosinophil Counts and TARC Levels between Atopy and Non-atopy Children

	Atopy^∗		P -value
	–(n=124)	+(n=125)	P -value
SCORAD score	12.9±9.8	16.6±11.1	0.005
Serum total IgE (IU/mL)	75.9±115.6	398.2±582.2	0.001
Total eosinophil count (/mm³)	408.0±704.6	727.0±1448.6	0.028
TARC (pg/mL)	1178.7±769.4	1171.0±634.4	0.931

Values are presented as mean±SD.

SCORAD, scoring atopic dermatitis; IgE, immunoglobulin E; TARC, thymus and activation-regulated chemokine.

^∗ Atopy, more than 1 specific IgE≥0.35 KUA/L.

Table 3.

Comparison of TARC Level, QoL Index and ADHD Index by Severity of Atopic Dermatitis

Severity of atopic dermatitis^∗	Mild (n=141)	Moderate (n=98)	Severe (n=10)	P-value
TARC (pg/mL)	1060.2±638.4	1278.1±699.8	1778.4±1137.7	0.008
QoL index	2.95±3.32	5.90±4.33	9.40±4.72	0.001
ADHD index	8.97±8.06	10.60±8.44	9.20±8.08	0.302

Values are presented as mean±SD.

TARC, thymus and activation-regulated chemokine; QoL, quality of life; ADHD, attention deficit/hyperactivity disorder.

^∗ Mild, SCORAD index <15; moderate, SCORAD index 15 to 40; severe, SCORAD index >40.

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