title: Profile of skin barrier proteins (filaggrin, claudins 1 and 4) and Th1/Th2/Th17 cytokines in adults with atopic dermatitis.
abstract: BACKGROUND
  Atopic dermatitis (AD) in adults and profile of skin barrier proteins and inflammatory cytokines.
  
  
  OBJECTIVE
  Evaluation of the expression of skin barrier proteins such as filaggrin, claudins 1 and 4 and of circulating inflammatory cytokines (Th1/Th2/Th17) in adults with AD.
  
  
  METHODS
  Thirty-three adult patients with AD diagnosed according to the Hanifin & Rajkacriteria, and 25 healthy controls were enrolled in the study. AD severity was measured by Eczema Area and Severity Index (EASI). Laboratory assays included immunohistochemistry analysis of skin barrier proteins, such as filaggrin, claudins 1 and 4 and interleukin-17 (IL-17) from skin samples and determination of circulating cytokine levels (IL-2, 4, 5, 6, 10, 17A, TNF and IFN-γ) by flow cytometry (Cytometric Bead Array).
  
  
  RESULTS
  We observed a reduced expression of filaggrin and claudin 1 in lesional skin of AD patients, when compared to controls. There was an inverse correlation of filaggrin expression and disease severity. In addition, IL-17 expression was enhanced in AD patients. Similarly, higher levels of inflammatory cytokines (IL-2, 5, 6, 10, 17A and IFN-γ) were found in AD patients.
  
  
  CONCLUSIONS
  Our data reinforce the role of an altered skin barrier in the pathogenesis of AD. Our results show not only reduced expression of filaggrin and claudin 1 in lesional atopic skin but also inverse correlation of filaggrin expression and disease severity. Moreover, elevation of in situ IL-17 and of circulating interleukin levels in AD emphasize the systemic, inflammatory profile of this defective skin barrier dermatosis.
authors.affiliation: Department of Dermatology, University of Sao Paulo School of Medicine, Sao Paulo, Brazil.
authors.forename: D I S
authors.initials: DI
authors.lastname: Batista
authors.affiliation: Department of Dermatology, University of Sao Paulo School of Medicine, Sao Paulo, Brazil.
authors.forename: L
authors.initials: L
authors.lastname: Perez
authors.affiliation: Department of Dermatology, University of Sao Paulo School of Medicine, Sao Paulo, Brazil.
authors.forename: R L
authors.initials: RL
authors.lastname: Orfali
authors.affiliation: Department of Dermatology, University of Sao Paulo School of Medicine, Sao Paulo, Brazil.
authors.forename: M C
authors.initials: MC
authors.lastname: Zaniboni
authors.affiliation: Department of Dermatology, University of Sao Paulo School of Medicine, Sao Paulo, Brazil.
authors.forename: L P
authors.initials: LP
authors.lastname: Samorano
authors.affiliation: Laboratory of Medical Investigation in Dermatology and Immunodeficiency, University of Sao Paulo School of Medicine, Sao Paulo, Brazil.
authors.forename: N V
authors.initials: NV
authors.lastname: Pereira
authors.affiliation: Department of Dermatology, University of Sao Paulo School of Medicine, Sao Paulo, Brazil.
authors.forename: M N
authors.initials: MN
authors.lastname: Sotto
authors.affiliation: Department of Dermatology, University of Sao Paulo School of Medicine, Sao Paulo, Brazil.
authors.forename: A S
authors.initials: AS
authors.lastname: Ishizaki
authors.affiliation: Laboratory of Medical Investigation in Dermatology and Immunodeficiency, University of Sao Paulo School of Medicine, Sao Paulo, Brazil.
authors.forename: L M S
authors.initials: LM
authors.lastname: Oliveira
authors.affiliation: Laboratory of Medical Investigation in Dermatology and Immunodeficiency, University of Sao Paulo School of Medicine, Sao Paulo, Brazil.
authors.forename: M N
authors.initials: MN
authors.lastname: Sato
authors.affiliation: Department of Dermatology, University of Sao Paulo School of Medicine, Sao Paulo, Brazil.
authors.forename: V
authors.initials: V
authors.lastname: Aoki
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D062445:Claudin-1 / Q000032:analysis / Q000378:metabolism; D062506:Claudin-4 / Q000032:analysis / Q000378:metabolism; D003876:Dermatitis, Atopic / Q000378:metabolism*; D005260:Female; D000091344:Filaggrin Proteins; D006801:Humans; D007371:Interferon-gamma / Q000097:blood; D020381:Interleukin-17 / Q000378:metabolism; D007378:Interleukins / Q000097:blood*; D007381:Intermediate Filament Proteins / Q000032:analysis / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D012867:Skin / Q000737:chemistry*; D012879:Skin Physiological Phenomena; D014409:Tumor Necrosis Factor-alpha / Q000097:blood; D055815:Young Adult
chemical_list: D062445:Claudin-1; D062506:Claudin-4; C000717249:FLG protein, human; D000091344:Filaggrin Proteins; D020381:Interleukin-17; D007378:Interleukins; D007381:Intermediate Filament Proteins; D014409:Tumor Necrosis Factor-alpha; D007371:Interferon-gamma