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

Soon Jung Shin; Min Jee Kim; Min Hee Jung; Hyun-Seong Jin; Myung Ki Han; Kie Young Park; Mi Young Oh; Bong-Seong Kim

doi:10.7581/pard.2012.22.3.302

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Shin, Kim, Jung, Jin, Han, Park, Oh, and Kim: Association of SCORAD Index and Aeroallergen Sensitization on Urinary Leukotriene E4 in Children with Atopic Dermatitis

Original Article

Pediatric Allergy and Respiratory Disease

Pediatric Allergy and Respiratory Disease 2012; 22(3): 302-311.

Published online: 30 September 2012

DOI: https://doi.org/10.7581/pard.2012.22.3.302

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

Soon Jung Shin, MD¹, Min Jee Kim, MD¹, Min Hee Jung, MD², Hyun-Seong Jin, MD², Myung Ki Han, MD², Kie Young Park, MD², Mi Young Oh³, Bong-Seong Kim, MD, PhD²

¹Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

²Department of Pediatrics, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea.

³Biomedical Research Center, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea.

Corresponding author (bskim@gnah.co.kr)

Received 23 July 2012 Revised 29 August 2012 Accepted 4 September 2012

Abstract

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.

Keywords: Atopic dermatitis, Leukotrien E4, Aeroallergen, Symptom score

Figures and Tables

Fig. 1

Relationship between urine log-leukotrienes E4 (LTE4) concentration in pg/mg Cr and overall scoring of atopic dermatitis (SCORAD). The correlation of log-LTE4 concentration to the total SCORAD was detected.(γ=0.340, P = 0.021) (Pearson's correlation coefficient)

Fig. 2

Relationship between urine leukotrienes E4 (LTE4) concentration in pg/mg Cr and blood total eosinophil counts (A : γ=0.347, P=0.018), serum total immunoglobulin E (IgE) (B : γ=0.390, P=0.007) and number of sensitized allergen (C : γ=0.340, P=0.021; D : γ=0.414, P=0.004). (Pearson's correlation coefficient)

Table 1

Clinical Characteristics of Study Subjects (n=46)

^*Values are presented as mean±SD. ^†Values are presented as mean (standard error).

SCORAD, scoring of atopic dermatitis; ECP, eosinophil cationic protein; IgE, immunoglobulin E; LTE4, leukotrienes E4.

Table 2

Relationship between Urine Leukotrienes E4 Concentration in pg/mg Cr (mean±SE) and History of Other Allergic Diseases

SE, standard error.

^*Mann-Whitney U test.

Table 3

Relationship between Urine Leukotrienes E4 Concentration in pg/mg Cr and Overall and Objective SCORAD

SCORAD, scoring of atopic dermatitis.

^*Pearson correlation method.

Table 4

Relationship between Changes of Urine Leukotrienes E4 Concentration in pg/mg Cr and changes of SCORAD during 6 months

SCORAD, scoring of atopic dermatitis.

Spearman's rank correlation coefficient.

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