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)和注意力缺陷/多动障碍(ADHD)是一种共病。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1.5倍。AE和ADHD之间联系的潜在病理生理机制尚不清楚。该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共同的病理相关因素，以及(B)过敏性炎症过程是否可以触发或加重ADHD症状。对AE患者和AE和ADHD患者在治疗前(T1)、急性加重期(T2)以及治疗后(T3)进行了研究。在T1、T2和T3时评估炎性细胞因子水平、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(儿童特里尔社会压力测试；TSST-C)和头发中的皮质醇。作为对照组，健康受试者和ADHD患者被调查。研究结果具有启发性和临床相关性。他们可以阐明(A)功能失调的内分泌和免疫过程对涉及执行功能和注意力的脑区的影响，以及(B)AE特有的炎症过程和/或应激是否可能是AE和ADHD共病的相关因素。

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.