Abstract
Atopic dermatitis (AD), a chronic inflammatory skin disease with no cure, currently
affects almost one-fifth of the population of industrialized nations. Treatment can
be challenging for physicians and patients, making it even more difficult to find
safe therapeutic options, especially in severe disease. Interest in diet and nutrition
has increased during the last few years. Nutritional interventions are both intriguing
and accessible for many patients. AD has two phases, acute and chronic. No therapeutic
attempts has yet been tried to target these phases rather than treatment according
to severity grade. Studies point to interleukin (IL)-18 as key player in the pathogenesis
of AD and the switch between its two phases. T helper (Th) cytokines (IL-4, IL-10,
IL-12, IL-18), interferon-γ (IFN-γ), tumor necrosis factor-α (TNF-α), immunoglobulin
E (Ig E), and vitamins E and C in children and adolescents with acute and chronic
AD. Sixty AD patients were classified into two groups; children (acute) and adolescents
(chronic) AD, with thirty in each. In addition, two corresponding healthy normal control
groups of thirty each were evaluated. Serum IL-4, IL-10, IL-12, IL-18, IFN-γ and serum
IgE were estimated by ELISA. IL-12, IL-18 and IFN-γ levels were 2–C-4 folds higher
in chronic AD as compared to normal controls. IL-18 and TNF-α levels were significantly
higher in chronic than acute AD patients. Vitamins C and E, on the other hand, were
significant decreased in chronic versus acute AD patients. Conclusion: ILs, IFN-γ,
TNF-α and serum IgE may play a role in AD. In addition, measurement of IL-18 may be
a valuable tool for assessment of age related disease severity. Also, vitamins C and
E appear to be reduced in acute and chronic AD patients.
Keywords
Atopic dermatitis - interleukins - TNF-α - INF-γ - vitamins C and E
