title: Significance of interleukin-16, macrophage-derived chemokine, eosinophil cationic protein and soluble E-selectin in reflecting disease activity of atopic dermatitis--from laboratory parameters to clinical scores.
abstract: BACKGROUND
  The search for the ideal clinical score reflecting atopic dermatitis (AD) severity has developed in parallel with unveiling key events in disease pathogenesis and finding laboratory parameters for monitoring disease activity. A major difficulty in assessing the relevance of reported serum markers of AD severity is the use of nonvalidated referent tools, which compromises comparison of results across studies.
  
  
  OBJECTIVE
  The aim of our study was to compare the significance of serum levels of interleukin (IL)-16, macrophage-derived chemokine (MDC), soluble E-selectin (sE-selectin) and eosinophil cationic protein (ECP) in reflecting AD severity and identify the most relevant parameter for monitoring the course of disease. Serum levels were tested against the same referent severity score in the same time frame and group of patients.
  
  
  METHODS
  The Severity Scoring of Atopic Dermatitis (SCORAD) index was used for assessment of disease severity in 21 adult patients in acute stage of AD and after complete resolution of clinical findings. Serum levels of IL-16, MDC, ECP and sE-selectin were measured at the same time points in 18 patients and compared with healthy nonatopic controls. The correlation between SCORAD and each laboratory parameter was tested for significance and compared.
  
  
  RESULTS
  Serum levels of IL-16, MDC, ECP and sE-selectin were significantly higher in patients in acute stage of AD compared with controls and decreased significantly after treatment, in parallel with clinical improvement. All monitored parameters reflected disease severity assessed by the clinical score. We found the highest significance level of correlation with SCORAD for IL-16 (r = 0.68, P =0.0019), followed by ECP (r = 0.65, P = 0.0032) and MDC (r = 0.55, P =0.0326). There was significant correlation between serum levels of IL-16 and MDC (r = 0.53, P = 0.0443) and ECP and sE-selectin (r = 0.48, P = 0.0427).
  
  
  CONCLUSIONS
  The study established a significant correlation between serum levels of IL-16 and SCORAD in adult AD patients. We report a significant correlation between IL-16 and MDC, both T-helper 2 activation markers. Our data suggested that IL-16 reflects most convincingly disease severity and may be used as a marker in clinical studies preferentially in combination with a clinical activity score.
authors.affiliation: Department of Dermatology, University of Medicine, 1 S.G. Sofiiski Boulevard, 1431 Sofia, Bulgaria.
authors.forename: I
authors.initials: I
authors.lastname: Angelova-Fischer
authors.forename: U C
authors.initials: UC
authors.lastname: Hipler
authors.forename: A
authors.initials: A
authors.lastname: Bauer
authors.forename: J W
authors.initials: JW
authors.lastname: Fluhr
authors.forename: N
authors.initials: N
authors.lastname: Tsankov
authors.forename: T W
authors.initials: TW
authors.lastname: Fischer
authors.forename: P
authors.initials: P
authors.lastname: Elsner
mesh_terms: D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood*; D054422:Chemokine CCL22; D019742:Chemokines, CC / Q000097:blood; D003876:Dermatitis, Atopic / Q000097:blood* / Q000188:drug therapy / Q000473:pathology; D003879:Dermatologic Agents / Q000627:therapeutic use; D019040:E-Selectin / Q000097:blood; D047150:Eosinophil Cationic Protein / Q000097:blood; D005260:Female; D006801:Humans; D019410:Interleukin-16 / Q000097:blood; D008297:Male; D012720:Severity of Illness Index
chemical_list: D015415:Biomarkers; C515482:CCL22 protein, human; D054422:Chemokine CCL22; D019742:Chemokines, CC; D003879:Dermatologic Agents; D019040:E-Selectin; D019410:Interleukin-16; D047150:Eosinophil Cationic Protein