title: A prospective study in children with a severe form of atopic dermatitis: clinical outcome in relation to cytokine gene polymorphisms.
abstract: OBJECTIVE
  The course of atopic dermatitis (AD) in childhood is characterized by typical changes in phenotype, including a shift from skin involvement to respiratory allergy usually around the third year of age. We thus designed a prospective study to monitor the outcome of severe AD and to investigate the association between cytokine gene polymorphisms and clinical manifestations.
  
  
  METHODS
  Clinical and laboratory follow-up of 94 patients with severe AD and 103 healthy controls was performed using routine methodology. Allele, genotype, and haplotype frequencies of single nucleotide polymorphisms of 13 selected cytokine/receptor genes were analyzed using PCR with sequence-specific primers.
  
  
  RESULTS
  In our study, genotypes of 7 polymorphisms--LL-4 -1098G/T and -590C/T, IL-6 -174C/G and nt565A/G, and IL-10 -1082A/G, -819C/T, and -592A/C were significantly associated with atopic AD (P < .05). A significant association was also found for TNF-alpha AA and IL-4 GC haplotypes and AD. We confirm the progressive clinical improvement of AD together with a decrease in the severity index SCORAD (SCORing atopic dermatitis) during childhood (P < .05). We found significant differences between IL-4Ralpha +1902 A/G and positivity of tree pollen-specific IgE (P < .05) in the AD group. Moreover, a weak association was also found between IL-10 -819C/T and IL-10 -590A/C and the appearance of allergic rhinitis (P < 0.1).
  
  
  CONCLUSIONS
  We confirmed a clinical shift in allergic phenotype in the first 3 years of life, and showed an association between IL-4, IL-6, and IL-10 polymorphisms and AD. Our data indicate that IL-4alpha and IL-10 polymorphisms may be considered predictive factors of respiratory allergy in children with AD.
authors.affiliation: Department of Immunology, Charles University, 2nd Faculty of Medicine, University Hospital Motol, Prague, Czech Republic.
authors.forename: J
authors.initials: J
authors.lastname: Kayserova
authors.forename: K
authors.initials: K
authors.lastname: Sismova
authors.forename: I
authors.initials: I
authors.lastname: Zentsova-Jaresova
authors.forename: S
authors.initials: S
authors.lastname: Katina
authors.forename: E
authors.initials: E
authors.lastname: Vernerova
authors.forename: A
authors.initials: A
authors.lastname: Polouckova
authors.forename: S
authors.initials: S
authors.lastname: Capkova
authors.forename: V
authors.initials: V
authors.lastname: Malinova
authors.forename: I
authors.initials: I
authors.lastname: Striz
authors.forename: A
authors.initials: A
authors.lastname: Sediva
mesh_terms: D000483:Alleles; D016022:Case-Control Studies; D002675:Child, Preschool; D003876:Dermatitis, Atopic / Q000235:genetics*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D005787:Gene Frequency; D020022:Genetic Predisposition to Disease; D005838:Genotype; D006239:Haplotypes / Q000235:genetics; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007378:Interleukins / Q000235:genetics*; D008297:Male; D020641:Polymorphism, Single Nucleotide; D011446:Prospective Studies; D006255:Rhinitis, Allergic, Seasonal / Q000235:genetics; D014409:Tumor Necrosis Factor-alpha / Q000235:genetics*
chemical_list: D007378:Interleukins; D014409:Tumor Necrosis Factor-alpha