Markers of atopic dermatitis, allergic rhinitis and bronchial asthma in pediatric patients: correlation with filaggrin, eosinophil major basic protein and immunoglobulin E

Abstract

Background: Allergic reactions have been implicated as contributions in a number of atopic disorders, including atopic dermatitis (AD), allergic rhinitis (AR) and bronchial asthma (BA). However, the potential for filaggrin protein, eosinophil major basic protein (MBP) and immunoglobulin E (IgE) to elicit allergic response or to contribute to atopic disorders remains largely unexplored in pediatric patients. This study was undertaken to investigate the status and contribution of filaggrin protein, eosinophil MBP and total IgE in pediatric patients with AD, AR and BA.

Methods: Sera from 395 pediatric patients of AD, AR or BA with varying levels of disease activity according to the disease activity index and 410 age-matched non-atopic healthy controls were evaluated for serum levels of atopic markers, including filaggrin, eosinophil MBP and IgE.

Results: Serum analysis showed that filaggrin levels were remarkably high in pediatric patients with AD, followed by BA and AR, whereas its levels were low in non-atopic pediatric controls. Eosinophil MBP levels in sera of atopic patients were significantly high as compared with their respective controls, but its levels were highest in AR patients, followed by AD and BA. Total IgE in sera of AD patients was markedly high, followed by AR and BA patients, whereas its levels were low in non-atopic pediatric controls. Interestingly, not only was an increased number of subjects positive for filaggrin protein, eosinophil MBP or total IgE, but also their levels were statistically significantly higher among those atopic patients whose disease activity scores were higher as compared with atopic patients with lower disease activity scores.

Conclusions: These findings strongly support a role of filaggrin protein, eosinophil MBP and IgE in the onset of allergic reactions in pediatric patients with AD, AR and BA. The data suggest that filaggrin, eosinophil MBP or IgE might be useful in evaluating the progression of AD, AR or BA and in elucidating the mechanisms involved in the pathogenesis of these pediatric disorders.

Keywords: Allergic rhinitis; Atopic dermatitis; Atopic disorders; Bronchial asthma; Eosinophil MBP; Filaggrin; IgE; Pediatric patients.

Fig. 1

Filaggrin in pediatric patients with atopic dermatitis, allergic rhinitis and bronchial asthma. a Levels of human filaggrin (FLG) in the sera of all studied atopic pediatric patients (n = 395) and non-atopic pediatric controls (n = 410). *p < 0.01 versus all tested atopic patients. b Levels of human FLG in the patients’ sera of atopic dermatitis pediatric patients (AD Ped. Patients; n = 130) and non-atopic pediatric controls (n = 410). ^#p < 0.001 versus AD Ped. Patients. c Levels of human FLG in the patients’ sera of allergic rhinitis pediatric patients (AR pediatric patients; n = 120) and non-atopic pediatric controls (n = 410). ^#p < 0.001 versus AR pediatric patients. d Levels of human FLG in the patients’ sera of bronchial asthma pediatric patients (BA Ped. Patients; n = 145) and non-atopic pediatric controls (n = 410). ^#p < 0.01 versus AR Ped. Patients

Fig. 2

Eosinophil major basic protein in pediatric patients with atopic dermatitis, allergic rhinitis and bronchial asthma. a Levels of eosinophil major basic protein (MBP) in the sera of all studied atopic pediatric patients (n = 395) and non-atopic pediatric controls (n = 410). *p < 0.001 versus all tested atopic patients. b Levels of eosinophil MBP in the patients’ sera of atopic dermatitis pediatric patients (AD Ped. Patients; n = 130) and non-atopic pediatric controls (n = 410). ^#p < 0.001 versus AD Ped. Patients. c Levels of eosinophil MBP in the patients’ sera of allergic rhinitis pediatric patients (AR pediatric patients; n = 120) and non-atopic pediatric controls (n = 410). ^#p < 0.0001 versus AR pediatric patients. d Levels of eosinophil MBP in the patients’ sera of bronchial asthma pediatric patients (BA Ped. Patients; n = 145) and non-atopic pediatric controls (n = 410). ^#p < 0.001 versus AR Ped. Patients

Fig. 3

Immunoglobulin E in pediatric patients with atopic dermatitis, allergic rhinitis and bronchial asthma. a Levels of human immunoglobulin E (Human IgE) in the sera of all studied atopic pediatric patients (n = 395) and non-atopic pediatric controls (n = 410). *p < 0.01 versus all tested atopic patients. b Levels of human IgE in the patients’ sera of atopic dermatitis pediatric patients (AD Ped. Patients; n = 130) and non-atopic pediatric controls (n = 410). ^#p < 0.001 versus AD Ped. Patients. c Levels of human IgE in the patients’ sera of allergic rhinitis pediatric patients (AR pediatric patients; n = 120) and non-atopic pediatric controls (n = 410). ^@p < 0.01 versus AR pediatric patients. d Levels of human IgE in the patients’ sera of bronchial asthma pediatric patients (BA Ped. Patients; n = 145) and non-atopic pediatric controls (n = 410). ^$p < 0.05 versus AR Ped. Patients

Fig. 4

Severity-related increased of filaggrin (FLG), eosinophil major basic protein (MBP) and immunoglobulin E (IgE) in pediatric patients with atopic dermatitis (AD), allergic rhinitis (AR) and bronchial asthma (BA). a Levels of human FLG protein in mild-moderate AD patients’ sera (n = 97), severe AD patients’ sera (n = 33), mild-moderate persistent AR (n = 93), severe persistent AR (n = 52), mild-moderate persistent BA (n = 83), severe persistent AR (n = 37). ^#p < 0.05 versus mild-moderate AD; ^@p < 0.05 versus mild-moderate AR; ^$p < 0.05 versus mild-moderate BA. b Levels of human MBP in mild-moderate AD patients’ sera (n = 97), severe AD patients’ sera (n = 33), mild-moderate persistent AR (n = 93), severe persistent AR (n = 52), mild-moderate persistent BA (n = 83), severe persistent AR (n = 37). ^#p < 0.05 versus mild-moderate AD; ^@p < 0.05 versus mild-moderate AR; ^$p < 0.05 versus mild-moderate BA. c Levels of human IgE in mild-moderate AD patients’ sera (n = 97), severe AD patients’ sera (n = 33), mild-moderate persistent AR (n = 93), severe persistent AR (n = 52), mild-moderate persistent BA (n = 83), severe persistent AR (n = 37). ^#p < 0.05 versus mild-moderate AD; ^@p < 0.05 versus mild/moderate AR; ^$p < 0.05 versus mild-moderate BA