Plasma complement and histamine changes in atopic dermatitis*

Ring, Johannes; Senter, Thomas P.; Cornell, Roger C.; Arroyave, Carlos M.; Tan, Eng M.

doi:10.1111/j.1365-2133.1979.tb05577.x

Cited by 45 publications

(14 citation statements)

References 39 publications

(18 reference statements)

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“…However, assessment methods are far from being standardized, and therapeutic studies are often difficult to interpret. Efforts have been done recently to classify patients in groups of severity [2][3][4] and to estab lish simple and reliable assessment methods [5][6][7][8][9][10][11]. Var iants of the scoring system proposed in psoriasis (PASI score [12]) have been published [13.…”

Section: Introductionmentioning

confidence: 99%

Severity Scoring of Atopic Dermatitis: The SCORAD Index

Schallreuter¹,

Levenig²,

Berger³

et al. 1993

Dermatology

1,881

270

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Background. Assessment methods for atopic dermatitis (AD) are not standardized, and therapeutic studies are difficult to interpret. Aims. To obtain a consensus on assessment methods in AD and to use a statistical method to develop a composite severity index.Methods. Consensus definitions were given for items used in the scoring system (extent, intensity, subjective) and illustrated for intensity items. Slides were reviewed to address within and between-observer variability by a group of 10 trained clinicians, and data were statistically evaluated with a two way analysis of variance. Two variants of an assessment system were compared in 88 patients at 5 different institutions. Data were analyzed using principal-component analysis. Results. For 5 intensity items studied (erythema, edema/papulation, oozing/crusts, excoriations, lichenification), within- and between-observer variability was good overall, except for edema/papulation which was difficult to assess with slides. In the series of 88 patients, principal-component analysis allowed to extract two unrelated components: the first one accounting for 33% of total variance was interpreted as a ‘severity’ component; the second one, accounting for 18% of variance, was interpreted as a ‘profile’ component distinguishing patients with mostly erythema and subjective symptoms and those with mostly lichenification and dryness and lower subjective symptoms. Of the two evaluation systems used, the one using the rule of nine to assess extent was found more workable than the one using a distribution × intensity product. A scoring index (SCORAD) combining extent, severity and subjective symptoms was mathematically derived from the first system and showed a normal distribution of the population studied. Conclusion. The final choice for the evaluation system was mostly made based on simplicity and easy routine use in outpatient clinics. Based on mathematical appreciation of weights of the items used in the assessment of AD, extent and subjective symptoms account for around 20% each of the total score, intensity items representing 60%. The so-designed composite index SCORAD needs to be further tested in clinical trials.

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Section: Introductionmentioning

confidence: 99%

Severity Scoring of Atopic Dermatitis: The SCORAD Index

Schallreuter¹,

Levenig²,

Berger³

et al. 1993

Dermatology

1,881

270

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“…Indeed, in creased amounts of histamine have been found to be released in vitro [28,30] and measured in the plasma of severely atopic patients [9,29,34]. In our study we ob served no significant correlation between the intensity of the clinical symptoms of dermatitis nor serum IgE concentration to the amount of change in intracellular cyclic nucleotides.…”

Section: Discussionmentioning

confidence: 34%

“…Ab normalities in the serotonin response have been described in patients with atopic der matitis [25,29]. Platelets represent the main reservoir of serotonin in humans.…”

Section: Discussionmentioning

confidence: 99%

In vitro Cyclic Nucleotide Responsiveness of Leukocytes and Platelets in Patients Suffering from Atopic Dermatitis

Ring¹,

Mathison²,

O’Connor³

1981

Int Arch Allergy Immunol

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Peripheral blood leukocytes from patients with severe atopic dermatitis (serum IgE levels between 1,560 and 28,000 U/ml) showed a significantly weaker increase in intracellular cAMP after stimulation with epinephrine (10^––⁵–10^––3M) than leukocytes from normals. At the same time stimulation with methylcholine (10^––10–10^––4M) induced a significantly higher increase in intracellular levels of cGMP in the atopic group compared to normals. The immunomodulating agent levamisole induced a slight increase in cAMP and cGMP response both in leukocytes from atopic patients and in normals. Platelet cAMP concentrations were lowered by epinephrine stimulation both in atopies and controls. There was no effect of methylcholine upon platelet cyclic nucleotide levels in the dose range examined. The data support the concept that abnormal cyclic nucleotide responsiveness – not only as β-adrenergic blockade but also as cholinergic hyperreactivity – may play a role in the pathogenesis of atopic dermatitis.

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“…Furthermore, complement activation has been demonstrated in plasma and skin of patients with atopic dermatitis [47,[49][50][51][52], Apart from the /^-adrenergic deficiency atopic patients seem to have an increased sensitivity to «-adrenergic and cholinergic stimuli in vivo and in vitro [27,33,43], both of them favouring the release of va soactive mediators.…”

Section: Release Of Vasoactive Mediatorsmentioning

confidence: 99%

“…Indeed, it was shown that patients with atopic dermatitis show elevations of plasma and skin histamine concentrations [43,47,55,56].…”

Section: Psychological Influencementioning

confidence: 99%

Atopic Dermatitis: A Disease of General Vasoactive Mediator Dysregulation

Ring¹

1979

Int Arch Allergy Immunol

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A simple hypothesis trying to explain the complex etiology of atopic dermatitis is presented. Based on the facts of various known immunologic and autonomic nervous system abnormalities the possible role of vasoactive mediators in this disease is stressed. There are several factors which favour a continuous tendency to release vasoactive substances, as for example histamine; the immunologically, IgE-mediated histamine release is only one of them. Basophils of atopic individuals show increased ‘releasability’ after stimulation with a variety of non-immunologic stimuli. Together with this increased releasability, a deficiency in control systems, as in the cyclic AMP-dependent mechanisms, is known, also favouring increased histamine release. Histamine as one of the mediators not only acts upon the capillaries, the bronchial and circulatory system, but on lymphocytes too: it is known that especially T cell functions can be inhibited by histamine in vitro and in vivo. Suppressor T cells are particularly sensitive to histamine being most likely the population of T lymphocytes bearing histamine receptors. In atopic dermatitis a specifically increased sensitivity of T cells to histamine has been described. Therefore, increased levels of histamine could explain the well-known cell-mediated immune deficiency in patients with atopic dermatitis as well as possibly their increased tendency to produce IgE antibodies. The latter hypothesis is based on animal experiments which clearly show that IgE production is favoured by a deficiency in the suppressor T cell system. This hypothesis puts together the most important pathological findings in this disease; a genetic defect as basis of ‘leaky’ mast cells and basophils seems likely.

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Plasma complement and histamine changes in atopic dermatitis*

Cited by 45 publications

References 39 publications

Severity Scoring of Atopic Dermatitis: The SCORAD Index

Severity Scoring of Atopic Dermatitis: The SCORAD Index

In vitro Cyclic Nucleotide Responsiveness of Leukocytes and Platelets in Patients Suffering from Atopic Dermatitis

Atopic Dermatitis: A Disease of General Vasoactive Mediator Dysregulation

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