The potential role of psychoimmunological and psychoendocrine processes in the comorbidity of atopic eczema and attention deficit/hyperactivity disorder.

越来越多的流行病学数据表明特应性湿疹（AE）和注意缺陷/多动障碍（ADHD）的共病。最近，我们可以证明患有AE的儿童在以后的生活中患ADHD的风险增加了1.5倍。AE和ADHD之间联系的潜在病理生理机制尚不清楚。拟制研究项目的具体目标是调查(a)应激和功能失调的生物应激反应是否是AE和ADHD的常见病理相关因素，以及(b)过敏性炎症过程是否会触发或加剧ADHD症状。研究AE患者和AE合并ADHD患者在AE治疗前（t1）、急性加重期（t2）和AE治疗后（t3）。在t1、t2和t3时评估炎症细胞因子水平、执行认知功能和注意力。此外，还测定了皮质醇对心理社会压力的反应（Trier Social stress Test for Children; TSST-C）和头发中的皮质醇。以健康受试者和ADHD患者为对照组。所提出的研究结果具有启发式和临床相关性。它们可能阐明(a)内分泌功能失调和免疫过程对涉及执行功能和注意力的大脑区域的影响，以及(b) AE特异性炎症过程和/或应激是否可能是AE和ADHD合并症的相关因素。

A growing number of epidemiological data indicate a comorbidity of atopic eczema (AE) and attention deficit/hyperactivity disorder (ADHD). Recently, we could demonstrate that children with AE have a 1.5 fold increased risk for ADHD in later life. The underlying pathophysiological mechanisms of a link between AE and ADHD are unknown. The specific goal of the proposed research project is to investigate (a) whether stress and a dysfunctional biological stress response is a common pathologically relevant factor in AE and ADHD and (b) whether allergic inflammatory processes can trigger or exacerbate ADHD symptomatology.Patients with AE and patients with AE and ADHD were studied before (t1), during acute exacerbation (t2) as well as after treatment of AE (t3). Inflammatory cytokine levels, executive cognitive functions and attention were assessed on t1, t2 and t3. Further, cortisol responses to psychosocial stress (Trier Social Stress Test for Children; TSST-C) and cortisol in hair were determined. As control groups, healthy subjects and and patients with ADHD are investigated.The results of the proposed study are of heuristic and clinical relevance. They may elucidate (a) the impact of dysfunctional endocrine and immunological processes on brain regions involved in executive functions and attention and (b) whether AE-specific inflammatory processes and/or stress may be relevant factors in the comorbidity of AE and ADHD.