아토피피부염에서 포도상구균 집락과 장독소 유무에 따른 임상양상
Staphylococcus aureus Colonization and Atopic Dermatitis: Relation to Clinical Characteristics
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Background: Atopic dermatitis (AD) is a chronically relapsing allergic skin inflammatory disease with a high incidence in the early childhood. Staphylococcus aureus colonization (S. aureus) is frequent in the skin of patients with AD and is one of the important environmental factors that develop or exacerbate this disorder. Objective: The aim of this study was to investigate the different clinical features of AD with S. aureus colonization and to seek its relation with the clinical features of AD. Method: We recruited 342 children with AD who visited the pediatric allergy clinic in Asan Medical Center from July 2003 to January 2007. They were divided into 2 groups based on the results of skin cultures: group 1 with no bacteria cultured and group 2 with S. aureus cultured. The clinical and laboratory data, such as SCORAD (SCORing Atopic Dermatitis), total eosinophil count (TEC), eosinophil fraction (%), serum total IgE, serum eosinophil cationic protein (ECP) and staphylococcal enterotoxin A and B - specific IgE levels, were evaluated and were compared between individual groups. Result: There was a statistical difference between groups 1 and 2 in TEC, eosinophil fraction (%), total IgE, serum ECP and SCORAD index. There was a significant difference in total IgE between the enterotoxin-negative and enterotoxin- positive groups. S. aureus colony counts were significantly correlated with total eosinophil count (r=0.259, P= 0.003), eosinophil (%) (r=0.196, P=0.009), and serum ECP (r= 0.212, P=0.035). Total IgE levels were significantly correlated with specific IgE levels to enterotoxins A and B (r= 0.335, P=0.012; r=0.393, P=0.002). S. aureus colonization and specific IgE levels to staphyloccal enterotoxins A were correlated with SCORAD index and total IgE levels. Conclusion: Skin infections with S. aureus may be associated with pathogenesis of AD. (Korean J Asthma Allergy Clin Immunol 2008;28:105-112)
Abstract
Background: Atopic dermatitis (AD) is a chronically relapsing allergic skin inflammatory disease with a high incidence in the early childhood. Staphylococcus aureus colonization (S. aureus) is frequent in the skin of patients with AD and is one of the important environmental factors that develop or exacerbate this disorder. Objective: The aim of this study was to investigate the different clinical features of AD with S. aureus colonization and to seek its relation with the clinical features of AD. Method: We recruited 342 children with AD who visited the pediatric allergy clinic in Asan Medical Center from July 2003 to January 2007. They were divided into 2 groups based on the results of skin cultures: group 1 with no bacteria cultured and group 2 with S. aureus cultured. The clinical and laboratory data, such as SCORAD (SCORing Atopic Dermatitis), total eosinophil count (TEC), eosinophil fraction (%), serum total IgE, serum eosinophil cationic protein (ECP) and staphylococcal enterotoxin A and B - specific IgE levels, were evaluated and were compared between individual groups. Result: There was a statistical difference between groups 1 and 2 in TEC, eosinophil fraction (%), total IgE, serum ECP and SCORAD index. There was a significant difference in total IgE between the enterotoxin-negative and enterotoxin- positive groups. S. aureus colony counts were significantly correlated with total eosinophil count (r=0.259, P= 0.003), eosinophil (%) (r=0.196, P=0.009), and serum ECP (r= 0.212, P=0.035). Total IgE levels were significantly correlated with specific IgE levels to enterotoxins A and B (r= 0.335, P=0.012; r=0.393, P=0.002). S. aureus colonization and specific IgE levels to staphyloccal enterotoxins A were correlated with SCORAD index and total IgE levels. Conclusion: Skin infections with S. aureus may be associated with pathogenesis of AD. (Korean J Asthma Allergy Clin Immunol 2008;28:105-112)
참고문헌 (39)
- Oh JW, "Epidemiological change of atopic dermatitis and food allergy in school-aged children in Korea between 1995 and 2000", J Korean Med Sci, 19, pp.716~723 (2004)
- Leyden JJ, "Staphylococcus aureus in the lesion of atopic dermatitis", Br J Dermatol, 90, pp.525~530 (1974)
- Hanifin JM, "Staphylococcal infections in patients with atopic dermatitis", Arch Dermatol, 113, pp.1383~1386 (1997)
- Leung DY, "The role of superantigens in human disease: therapeutic implications for the treatment of skin disease", Br J Dermatol, 139, pp.17~29 (1998)
- Kotzin BL, "Superantigen and their potential role in human disease", Adv Immunol, 54, pp.99~166 (1993)
- Strange P, "Baadsgaard O. Staphylococcal enterotoxin B applied on intact normal and intact atopic skin induces dermatitis", Arch Dermatol, 132, pp.27~33 (1996)
- Bieber T, "Human epidermal Langerhans cells express the high affinity receptor for immunoglobulin E (Fc epsilon RI)", J Exp Med, 175, pp.1285~1290 (1992)
- Hanifin JM, "Diagnostic features of atopic dermatitis", Acta Derm Venerol, 92, pp.44~47 (1980)
- Chung HJ, "Epidemiologic characteristics of Staphylococcus aureus isolated from atopic dermatitis of pediatric patients" (2006), Ulsan: Univ. of Ulsan,
- Stalder J, "European Task Force on Atopic dermatitis. Severity scoring of atopic dermatitis: the SCORAD index", Dermatology, 186, pp.23~31 (1993)
- Spergel JM, "Atopic dermatitis and atopic march", J Allergy Clin Immunol, 112, pp.118~127 (2003)
- Chan LS, "Expression of interleukin-4 in the epidermis of transgenic mice results in a pruritic inflammatory skin disease: an experimental animal model to study atopic dermatitis", J Invest Dermatol, 117, pp.977~983 (2001)
- Leung DY, "New concepts in the pathogenesis of atopic dermatitis", Curr Opin Immunol, 15, pp.634~638 (2003)
- Novak N, "Immune mechanisms leading to atopic dermatitis", J Allergy Clin Immunol, 112, pp.128~139 (2003)
- Spergel JM, "Roles of TH1 and TH2 cytokines in a murine model of allergic dermatitis", J Clin Invest, 103, pp.1103~1111 (1999)
- Aly R, "Shinefield HR. Microbial flora of atopic dermatitis", Arch Dermatol, 113, pp.780~782 (1977)
- Hauser C, "Staphylococcus aureus skin colonization in atopic dermatitis patients", Dermatologica, 170, pp.35~39 (1985)
- Nishijima S, "Staphylococcus aureus on hand surface and nasal carriage in patients with atopic dermatitis", J Am Acad Dermatol, 32, pp.677~679 (1995)
- Williams RE, "Assessment of a contact-plate sampling technique and subsequent quantitative bacterial studies in atopic dermatitis", Br J Dermatol, 123, pp.493~501 (1990)
- Rhim JW, "An investigation into the actual condition of outbreak and treatment in atopic dermatitis", Pediatr Allergy Respir Dis, 15, pp.44~52 (2005)
- Lever R, "Staphylococcal colonization in atopic dermatitis and the effect of topical mupirocin therapy", Br J Dermatol, 119, pp.189~198 (1988)
- Cho SH, "Preferential binding of Staphylococcus aureus to skin sites of Th2-mediated inflammation in a murine model", J Invest Dermatol, 116, pp.658~663 (2001)
- Higaki S, "Comparative study of staphylococci from the skin of atopic dermatitis patient and from healthy subjects", Int J Dermatol, 38, pp.265~269 (1999)
- Lever R, "Staphylococcal colonization in atopic dermatitis and the effect of topical mupirocin therapy", Br J Dermatol, 119, pp.189~198 (1998)
- Nilsson EJ, "Topical corticosteroids and staphylococcus aureus in atopic dermatitis", J Am Acad Dermatol, 27, pp.29~34 (1992)
- Leung DYM, "Role of staphylococcus aureus in atopic dermatitis. In Leung DYM, Bieber T (ed)", pp.401~418 (2002), Marcel Dekler Inc., New York
- Jandolo JJ, "Genetic analysis of extracellular toxins of Staphylococcus aureus", Annu Rev Microbiol, 43, pp.375~402 (1989)
- Fleischer B, "T cell stimulation by staphylococcal enterotoxins. Clonally variable response and requirement for major histocompatibility complex class II molecules on accessory or target cells", J Exp Med, 167, pp.1697~1707 (1988)
- Kappler J, "V beta-specific stimulation of human T cells by staphylococcal toxins", Science, 244, pp.811~813 (1989)
- Skov L, "Application of Staphylococcal enterotoxin B on normal and atopic skin induces up-regulation of T cells by a superantigen- mediated mechanism", J Allergy Clin Immunol, 105, pp.820~826 (2000)
- Cho SH, "Fibronectin and fibrinogen contribute to the enhanced binding of Staphylococcus aureus to atopic skin", J Allergy Clin Immunol, 108, pp.269~274 (2001)
- Leung DY, "Presence of IgE antibodies to staphylococcal exotoxins on the skin of patients with atopic dermatitis. Evidence for a new group of allergens", J Clin Invest, 92, pp.1374~1380 (1993)
- Lin YT, "Comparison of serum specific IgE antibodies to staphylococcal enterotoxins between atopic children with and without atopic dermatitis", Allergy, 55, pp.641~646 (2000)
- Ide F, "Mukouyama T, Furukawa S. Staphylococcal enterotoxin-specific IgE antibodies in atopic dermatitis", Pediatr Int, 46, pp.337~341 (2004)
- Nomura I, "Evaluation of the staphylococcal exotoxins and their specific IgE in childhood atopic dermatitis", J Allergy Clin Immunol, 104, pp.441~446 (1999)
- Sager N, "House dust mite-specific T-cells in the skin of subjects with atopic dermatitis: frequency and lymphokine profile in the allergen patch test", J Allergy Clin Immunol, 89, pp.801~810 (1992)
- Werfel T, "Allergen-specificity of skin-infiltrating T-cells is not restricted to a type 2 cytokine pattern in chronic skin lesions of atopic dermatitis", J Invest Dermatol, 107, pp.871~876 (1996)
- Kapp A, "The role of eosinophils in the pathogenesis of atopic dermatitis: eosinophil granule proteins as markers of disease activity", Allergy, 48, pp.1~5 (1993)
- Czech W, "Serum eosinophil cationic protein is a sensitive measure for disease activity in atopic dermatitis", Br J Dermatol, 126, pp.351~355 (1992)