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Original Article


A Prospective Study in Children With a Severe Form of Atopic Dermatitis: Clinical Outcome in Relation to Cytokine Gene Polymorphisms


J Kayserova,1 K Sismova1 I Zentsova-Jaresova,1 S Katina,2,3 E Vernerova,1 A Polouckova,1 S Capkova,4 V Malinova,5 I Striz,6 A Sediva1

1Department of Immunology, Charles University, 2nd Faculty of Medicine, University Hospital Motol, Prague, Czech Republic
2Department of Applied Mathematics and Statistics, Faculty of Mathematics, Physics and Informatics, Comenius University, Bratislava, Slovakia
3Institute of Normal and Pathological Physiology, Slovak Academy of Sciences, Bratislava, Slovakia
4Paediatric Department of Dermatology, Paediatric Outpatient Department, University Hospital Motol, Prague, Czech Republic
5Department of Paediatrics and Adolescent Medicine, 1st Faculty of Medicine, General University Hospital, Prague, Czech Republic
6Department of Immunogenetics, Institute for Clinical and Experimental Medicine, Prague, Czech Republic

J Investig Allergol Clin Immunol 2012; Vol. 22(2): 92-101



Background and 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—IL-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-α 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 signifi cant differences between IL-4Rα +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 fi rst 3 years of life, and showed an association between IL-4, IL-6, and IL-10 polymorphisms and AD. Our data indicate that IL-4α and IL-10 polymorphisms may be considered predictive factors of respiratory allergy in children with AD.

Key words: Allergic rhinitis. Allergy. Atopic dermatitis. Single nucleotide polymorphism. Cytokines.