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Abstract
Purpose
Endotoxin exposure is associated with the development and pathogenesis of allergic diseases. The present study aimed to determine whether plasma endotoxins are elevated in children with atopic dermatitis (AD) and whether the plasma endotoxins are associated with the AD severity.
Methods
This study included 42 children with AD and 16 controls. The AD severity was assessed and skin prick tests were performed along with serum total IgE, total eosinophil count, and ImmunoCAP analyses for common allergens. For plasma endotoxin levels, kinetic turbidimetric assay and limulus amebocyte lysate reagent were used.
Results
The endotoxin levels were significantly higher in children with AD than in controls (0.039 [interquartile range {IQR}, 0.031 to 0.046] EU/mL vs. 0.031 [IQR, 0.019 to 0.035] EU/mL, P<0.05). The endotoxin levels showed a significantly inverse correlation with the disease severity in the extrinsic AD (r=-0.414, P=0.017) but not in the intrinsic AD (r=0.222, P=0.426). No significant correlation was observed between plasma endotoxin levels, serum total eosinophil count, and serum total IgE.
Conclusion
Our results suggest that plasma endotoxin level is increased in the AD subjects than in the normal controls and affects the disease severity only in the extrinsic AD subjects. Further studies with larger sample sizes are warranted to investigate whether plasma endotoxin levels have a different effect on the AD severity depending on the presence of atopy.
Figures and Tables
Fig. 1
This figure shows the comparison of the plasma level of endotoxins in children with atopic dermatitis and controls. P-value was calculated by the Mann-Whitney U test. *P<0.05, atopic dermatitis versus controls.
Fig. 2
This figure presents the correlation between the severity of atopic dermatitis and plasma endotoxin levels in children with atopic dermatitis. Spearman correlation analysis was used to calculate the correlation between plasma endotoxin levels and the SCORing Atopic Dermatitis (SCORAD) index.
Fig. 3
These figures demonstrate the correlations between the severity of atopic dermatitis and plasma endotoxin levels in children with extrinsic atopic dermatitis (A) and with intrinsic atopic dermatitis (B). Spearman correlation analyses were used to calculate the correlations between plasma endotoxin levels and the SCORing Atopic Dermatitis (SCORAD) index.
Table 1
Clinical characteristics of the subjects and SCORAD index, total eosinophil count, total IgE, and plasma endotoxin levels in the three groups
Values are presented as mean±standard deviation or median (interquartile range). SCORAD, SCORing Atopic Dermatitis.
*P-value was calculated by the chi-square, Fisher exact test, Mann-Whitney U test, or Kruskal-Wallis test when appropriate. †P-value was calculated by Mann-Whitney test to compare the values between extrinsic and intrinsic atopic dermatitis subjects. ‡There was a significant difference in plasma endotoxin levels between extrinsic and intrinsic atopic dermatitis and controls by the Kruskal-Wallis test.
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