A prospective study in children with a severe form of atopic dermatitis: Clinical outcome in relation to cytokine gene polymorphisms

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-specifi c 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 signifi cantly associated with atopic ad (p<.05). a signifi cant association was also found for tnf-α aa and il-4 gc haplotypes and ad. we confi rm 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-specifi c 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 confi rmed 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. © 2012 esmon publicidad.