Phenotype of atopic dermatitis subjects with a history of eczema herpeticum.
Phenotype of atopic dermatitis subjects with a history of eczema herpeticum.
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DOI：
10.1016/j.jaci.2009.05.020
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发表时间：
2009-08
影响因子：
14.2
通讯作者：
Leung, Donald Y. M.
中科院分区：
文献类型：
--
作者：
Beck, Lisa A.;Boguniewicz, Mark;Hata, Tissa;Schneider, Lynda C.;Hanifin, Jon;Gallo, Rich;Paller, Amy S.;Lieff, Susi;Reese, Jamie;Zaccaro, Daniel;Milgrom, Henry;Barnes, Kathleen C.;Leung, Donald Y. M.
关键词：
特应性皮炎（AD）患者的一个亚群易受单纯疱疹病毒（称为疱疹性湿疹）或牛痘病毒（称为牛痘性湿疹）的严重感染。这项由美国国家过敏和传染病研究所资助的多中心研究旨在建立一个关于有和无疱疹性湿疹病史的AD受试者（分别为ADEH+和ADEH-）和健康对照（CTL）的临床信息和生物样本数据库。仔细的AD亚型的表型分析可能提示播散性病毒感染的机制，并有助于识别高危个体。我们分析了2006年5月11日至2008年9月16日在美国7家医疗中心入组的901例受试者（ADEH+ n=134，ADEH- n=419，CTL n=348）的数据。基于评分系统（兴奋面积和严重程度指数和Rajka-Langeland）、受影响的体表面积和生物标志物（循环嗜酸性粒细胞计数、血清IgE、TARC和CTACK），ADEH+受试者比ADEH-受试者具有更严重的疾病（p<0.001）。ADEH+受试者也更可能有食物过敏史（69 vs 40%; p<0.001）或哮喘史（64 vs 44%; p<0.001），并且更常见于对许多常见过敏原过敏（p<0.001）。皮肤感染的S。金黄色葡萄球菌或传染性软疣病毒在ADEH+患者中（分别为78%和8%）比ADEH-患者（29%和2%; p<0.001）更常见。发生ADEH的AD受试者具有更严重的Th 2极化疾病，具有更大的过敏原致敏性，并且更常见地具有食物过敏和/或哮喘。他们也更有可能经历皮肤感染的S。金黄色或传染性软疣。
A subset of atopic dermatitis (AD) subjectsare susceptible to serious infections with herpes simplex virus, called eczema herpeticum or vaccina virus, called eczema vaccinatum. This National Institute of Allergy and Infectious Disease-funded, multicenter study was performed to establish a database of clinical information and biological samples on subjects with AD with and without a history of eczema herpeticum (ADEH+ and ADEH-, respectively) and healthy controls (CTL). Carefully phenotyping of AD subsets may suggest mechanisms responsible for disseminated viral infections and help identify at-risk individuals. We analyzed the data from 901 subjects (ADEH+ n=134, ADEH- n=419, CTL n=348) enrolled between 5.11.2006 and 9.16.2008 at seven US medical centers. ADEH+ subjects had more severe disease based on scoring systems (Eczema Area and Severity Index and Rajka-Langeland), body surface area affected and biomarkers (circulating eosinophil counts, serum IgE, TARC and CTACK) than ADEH- subjects (p<0.001). ADEH+ subjects were also more likely to have a history of food allergy (69 vs 40%; p<0.001) or asthma (64 vs 44%; p<0.001) and were more commonly sensitized to many common allergens (p<0.001). Cutaneous infections with S. aureus or molluscum contagiosum virus were more common in ADEH+ (78% and 8%, respectively) than in ADEH-subjects (29% and 2%; p<0.001). AD subjects who develop ADEH have more severe, Th2-polarized disease with greater allergen sensitization and more commonly have food allergy and/or asthma. They are also much more likely to experience cutaneous infections with S. aureus or molluscum contagiosum.
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