Exploring CCL18, eczema severity and atopy.

BACKGROUND

Childhood atopic dermatitis (AD) is a distressing disease associated with pruritus, sleep disturbance, and impaired quality of life. The pathophysiology of AD is complex, and the chemokine CCL18/pulmonary and activation-regulated chemokine (PARC) may be involved.

OBJECTIVE

To evaluate whether CCL18 was associated with disease severity, quality of life, nocturnal scratching, serum eosinophil, and IgE levels.

PATIENTS AND

METHODS

Patients with AD aged 20 yr or younger were recruited. Disease severity was assessed with the SCORing Atopic Dermatitis (SCORAD) index, quality of life with the Children's Dermatology Life Quality Index (CDLQI), and nocturnal scratching with a wrist motion monitor. Concentrations of plasma CCL18/PARC, serum total IgE, and eosinophil counts were measured in these patients.

RESULTS

One hundred and eight patients with AD (mean [s.d.] age of 10.5 [4.4] yr) were recruited. The mean (s.d.) plasma concentration of CCL18/PARC was 162.2 (129.0) pg/ml, respectively. CCL18/PARC was significantly correlated with objective SCORAD (r = 0.44, p < 0.001), extent (r = 0.45, p < 0.001), intensity (r = 0.43, p < 0.001), the symptoms of pruritus (r = 0.20, p = 0.04), and sleep loss (r = 0.19, p = 0.049) but not with CDLQI or nocturnal scratching activities. CCL18/PARC levels were also correlated with eosinophil counts (r = 0.37, p < 0.001) and IgE(log) (r = 0.27, p = 0.005). Positive correlation with SCORAD was present even in patients without bronchial hyper-reactivity.

CONCLUSIONS

Serum levels of CCL18 correlate with the clinical severity score, serum eosinophil, and IgE levels. CCL18 is associated with AD and atopy.