Relationship between skin prick and atopic patch test reactivity to aeroallergens and disease severity in children with atopic dermatitis

Background: The immunological mechanism in aetiology of atopic dermatitis (AD) shows significant differences from other allergic diseases. Allergen inhalation exacerbates AD lesions and AD patients’ complaints decrease in house dust mite (HDM) low level environments, which reveals the importance of inhalant allergens. Objective: We evaluated the skin prick test (SPT) and atopy patch test (APT) positivity rates with aeroallergens and studied the effect of test results, and aimed to determine the value of allergic test reactivity on the clinical characteristics of children with AD. Methods: Forty-five children aged 2–15 years with AD were included to study between May 2006 and May 2007 in GATA Haydarpasa Teaching Hospital, Allergy Department. The reactivity to inhalant allergens using SPT and APT was evaluated. The severity of AD, which was assessed with SCORAD, was compared with aeroallergen hypersensitivity. Results: The highest positivity of APT was seen against HDM (48.9%). HDM SPT positivity and subjective symptoms score were statistically correlated (P < 0.05). Patients with strong SPT positivity to HDM had a higher total SCORAD score (P < 0.05). Although there was no statistical correlation between HDM APT and SCORAD parameters, APT positive patients had generally higher SCORAD parameters. The statistical significance was only shown between the extent of the disease and strong APT positive reactions to Dermatophagoides pteronyssinus. Conclusion: HDM allergens play an important role in determining the clinical severity of AD and strong APT positivity could be more meaningful clinically (AU)

Relationship between skin prick and atopic patch test reactivity to aeroallergens and disease severity in children with atopic dermatitis.

BACKGROUND: The immunological mechanism in aetiology of atopic dermatitis (AD) shows significant differences from other allergic diseases. Allergen inhalation exacerbates AD lesions and AD patients' complaints decrease in house dust mite (HDM) low level environments, which reveals the importance of inhalant allergens. OBJECTIVE: We evaluated the skin prick test (SPT) and atopy patch test (APT) positivity rates with aeroallergens and studied the effect of test results, and aimed to determine the value of allergic test reactivity on the clinical characteristics of children with AD. METHODS: Forty-five children aged 2-15 years with AD were included to study between May 2006 and May 2007 in GATA Haydarpasa Teaching Hospital, Allergy Department. The reactivity to inhalant allergens using SPT and APT was evaluated. The severity of AD, which was assessed with SCORAD, was compared with aeroallergen hypersensitivity. RESULTS: The highest positivity of APT was seen against HDM (48.9%). HDM SPT positivity and subjective symptoms score were statistically correlated (P<0.05). Patients with strong SPT positivity to HDM had a higher total SCORAD score (P<0.05). Although there was no statistical correlation between HDM APT and SCORAD parameters, APT positive patients had generally higher SCORAD parameters. The statistical significance was only shown between the extent of the disease and strong APT positive reactions to Dermatophagoides pteronyssinus. CONCLUSION: HDM allergens play an important role in determining the clinical severity of AD and strong APT positivity could be more meaningful clinically.

Adiponectin and visfatin levels in extremely low birth weight infants; they are also at risk for insulin resistance.

AIM: The aim of this study was to assess adiponectin, visfatin, HOMA-IR, glucose and triglyceride levels in term, preterm and extremely low birth weight (ELBW) babies. Each of these three groups was subdivided into two groups as small-for-gestational age (SGA), and appropriate-for-gestational age (AGA). 30 term, 30 preterm and 30 extremely low birth weight infants were included into the study. RESULTS: There was no significant difference in term and preterm infants for serum adiponectin, visfatin, and HOMA-IR levels. There were also no significant differences between term and preterm infants for glucose and triglycerides. The serum visfatin, insulin and HOMA-IR levels (p = 0.001, p = 0.001 and p < 0.05, respectively) were higher in ELBW group than preterm group. Comparing the subgroups as SGA and AGA in all main groups, only in ELBW group there were no significant differences in serum adiponectin, visfatin, HOMA-IR and insulin levels. CONCLUSIONS: We suggest that visfatin can be used as an early indicator of insulin resistance. Independent of being SGA, ELBW itself may be a risk factor for insulin resistance. In the follow-up of these babies the risk of obesity, metabolic syndrome and cardiovascular diseases may be increased as in SGA babies.  

Mean platelet volume in very preterm infants: a predictor of morbidities?

BACKGROUND: Mean platelet volume [MPV] is an important predictor for many diseases and larger platelets are more reactive and associated with shortened bleeding time. Although elevated MPV values are related to respiratory distress syndrome [RDS] in neonates, there are, to our knowledge, no data investigating the relationship between MPV and other diseases of preterm infants. AIM: To assess the correlation between MPV and the occurrence of various morbidities of prematurity such as necrotizing enterocolitis [NEC], bronchopulmonary dysplasia [BPD], sepsis, retinopathy of prematurity [ROP], and intraventricular hemorrhage [IVH] in a cohort of very preterm infants. SUBJECTS: We studied infants with a gestational age of < 34 weeks and a birth weight of < 1500 g admitted to a third level Neonatal Intensive Care Unit. Enrolled infants were divided into NEC and non-NEC, sepsis and non-sepsis, ROP and non-ROP, BPD and non-BPD and IVH and non-IVH groups. MPV was evaluated at birth [cord blood] and repeated at 48-72 hours of life. RESULTS: Two hundred and seventy two infants were studied. MPV measured at birth was similar between sepsis and non-sepsis, and ROP and non-ROP groups. MPV values were higher in infants with BPD [9.08±1.3 fl], IVH [8.4±1.1fl] and NEC [8.6±0.7 f] when compared to the control group [7.6±0.6 fl] in the first day of life. CONCLUSIONS: High MPV in the first hours of life may reflect the presence of a risk factor for the development of NEC, BPD and IVH in extremely preterm infants. This might be associated with inflammatory and oxidative process. However, our data indicate that higher MPV values are not associated with the development of sepsis or ROP in this study population.        

Vitamin B12, folate, homocysteine and urinary methylmalonic acid levels in infants.

Serum vitamin B12 and folate, and their functional markers, plasma homocysteine and urinary methylmalonate (uMMA) were measured in 204 healthy, term infants at birth, and at 2 and 6 months. Compared with infants receiving formula food, those fed mother's milk had lower vitamin B12 and folate at 2 and 6 months. In infants receiving mother's milk, vitamin B12 levels were similar at birth (238 pg/ml) and 2 months (243 pg/ml), whereas with formula milk the level was significantly higher at 2 months (558 pg/ml) than at birth (257 pg/ml). Vitamin B12 was negatively correlated with homocysteine at birth and 6 months. The level of uMMA (mmol/mol creatinine) was higher at 2 (mother's milk, 25.5; formula, 23.97) and 6 months (19.77; 15) than at birth (11.97; 10.88), and was not correlated with vitamin B12 levels. Homocysteine may be a reliable marker of vitamin B12 status in neonates and infants; however, uMMA is not suitable as a marker of vitamin B12 status.