Phenotype of atopic dermatitis subjects with a history of eczema herpeticum

被引：208

作者：

Beck, Lisa A. ^{[1
]}

Boguniewicz, Mark ^{[2
]}

Hata, Tissa ^{[3
]}

Schneider, Lynda C. ^{[4
]}

Hanifin, Jon ^{[5
]}

Gallo, Rich ^{[3
]}

Paller, Amy S. ^{[8
,9
]}

Lieff, Susi ^{[6
]}

Reese, Jamie ^{[6
]}

Zaccaro, Daniel ^{[6
]}

Milgrom, Henry ^{[2
]}

Barnes, Kathleen C. ^{[7
]}

Leung, Donald Y. M. ^{[2
]}

机构：

[1] Univ Rochester, Dept Dermatol, Med Ctr, Rochester, NY 14642 USA

[2] Natl Jewish Hlth, Dept Pediat, Denver, CO USA

[3] Univ Calif San Diego, Div Dermatol, San Diego, CA 92103 USA

[4] Childrens Hosp, Div Immunol, Boston, MA 02115 USA

[5] Oregon Hlth & Sci Univ, Dept Dermatol, Portland, OR 97201 USA

[6] Rho Inc, Chapel Hill, NC USA

[7] Johns Hopkins Univ, Sch Med, Johns Hopkins Asthma & Allergy Ctr, Baltimore, MD USA

[8] Northwestern Univ, Dept Dermatol, Chicago, IL 60611 USA

[9] Childrens Mem Hosp, Dept Dermatol, Chicago, IL 60614 USA

来源：

JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY | 2009年 / 124卷 / 02期

基金：

美国国家卫生研究院;

关键词：

Atopic dermatitis; herpes simplex virus; eczema herpeticum; eczema vaccinatum; biomarkers; Staphylococcus aureus; ACTIVATION-REGULATED CHEMOKINE; INNATE IMMUNE-RESPONSE; ANTIMICROBIAL PEPTIDES; VACCINIA VIRUS; TH2; CYTOKINES; SERUM THYMUS; FOOD ALLERGY; SKIN; EXPRESSION; DISEASE;

D O I：

10.1016/j.jaci.2009.05.020

中图分类号：

R392 [医学免疫学];

学科分类号：

100102 ;

摘要：

Background: A subset of subjects with atopic dermatitis (AD) are susceptible to serious infections with herpes simplex virus, called eczema herpeticum, or vaccina virus, called eczema vaccinatum. Objective: This National Institute of Allergy and Infectious Diseases-funded multicenter study was performed to establish a database of clinical information and biologic samples on subjects with AD with and without a history of eczema herpeticum (ADEH(+) and ADEH(-) subjects, respectively) and healthy control subjects. Careful phenotyping of AD subsets might suggest mechanisms responsible for disseminated viral infections and help identify at-risk individuals. Methods: We analyzed the data from 901 subjects (ADEH(+) subjects, n = 134; ADEH(-) subjects, n = 419; healthy control subjects, n = 348) enrolled between May 11, 2006, and September 16, 2008, at 7 US medical centers. Results: ADEH(+) subjects had more severe disease based on scoring systems (Eczema Area and Severity Index and Rajka-Langeland score), body surface area affected, and biomarkers (circulating eosinophil counts and serum IgE, thymus and activation-regulated chemokine, and cutaneous T cell-attracting chemokine) than ADEH(-) subjects (P < .001). ADEH(+) subjects were also more likely to have a history of food allergy (69% vs 40%, P < .001) or asthma (64% vs 44%, P < .001) and were more commonly sensitized to many common allergens (P < .001). Cutaneous infections with Staphylococcus aureus or molluscum contagiosum virus were more common in ADEH(+) subjects (78% and 8%, respectively) than in ADEH(-) subjects (29% and 2%, respectively; P < .001). Conclusion: Subjects with AD in whom eczema herpeticum develops have more severe T(H)2-polarized disease with greater allergen sensitization and more commonly have a history of food allergy, asthma, or both. They are also much more likely to experience cutaneous infections with S aureus or molluscum contagiosum. (J Allergy Clin Immunol 2009;124:260-9.)

引用

页码：260 / 269

页数：10

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