목 적:아토피피부염은 질병 자체의 다양성(heterogeneity)이 존재하므로 질병 상태를 잘 반영하는 객관적인 실험실 지표가 유용할 수 있다. 아토피피부염 소아에서 요중 leukotriene E4 (LTE4)를 측정하고 증상 점수 혹은 흡입 항원 감작 정도와의 관련성을 분석하여 요중 LTE4가 아토피피부염에서 임상 지표와 상관관계가 좋은 생물학적 표지로서의 가능성이 있는지 알아보고자 하였다. 방 법:아토피피부염을 진단받은 5–12세 소아 46명을 대상으로 International Study of Asthma and Allergies in Childhood (ISAAC) 설문지를 이용하여 알레르기 질환의 병력을 조사하였고 증상 정도를 scoring atopic dermatitis (SCORAD) index로 평가하였다. 요중 LTE4의 분석은 ACE enzyme immunoassay kit를 사용하였다. 대상군에 대해 혈청 총 IgE와 UniCAP을 이용하여 흡입 알레르겐에 대한 특이 IgE 항체 검사를 시행하였고 피부 단자 검사를 흡입 및 식품 알레르겐 28종에 대해 시행하였다. 대상군에서 요중 LTE4농도와 천식 등 다른 동반 알레르기 질환의 병력의 상관관계를 분석하였고 요중 LTE4와 SCORAD를 이용한 증상 점수, 혈액 내 호산구 수, 혈청 총 IgE와 흡입 항원에 대한 특이 IgE 항체 감작 정도와의 상관관계를 분석하였다. 결 과:대상군의 전반적 SCORAD (total SCORAD, tSCORAD) 점수와 요중 LTE4 농도는 유의한 양의 상관관계를 보였다.(γ=0.340, P=0.021) 특히 SCORAD 항목 중 objective SCORAD (oSCORAD) 역시 유의한 양의 상관관계를 보였다.(γ=0.342, P=0.020) 대상군의 혈액 내 총 호산구 수 및 혈청 총 Ig와 요중 LTE4 농도는 유의한 양의 상관 관계를 보였다.(γ=0.347, P=0.018; γ=0.390, P=0.007) 그리고 대상군에서 감작된 흡입 알레르겐의 수와 요중 LTE4 농도는 강한 양의 상관 관계를 보였다.(γ=0.414, P=0.004)결 론:요중 LTE4의 측정이 아토피피부염에서 비침습적 방법이라는 장점이 있으며 알레르기 염증의 정도를 평가할 수 있는 생물학적 표지로서의 가능성이 있다. 단면적으로는 요중 LTE4 농도가 아토피피부염의 일부 증상과 연관성이 있었지만 SCORAD 점수의 변화와의 상관관계를 입증하기 위해서는 보다 많은 대상군에서 후속 연구가 필요하다.

Purpose:Atopic dermatitis (AD) is a genetically determined, chronic relapsing skin disease. The pathogenesis of AD is complex and the course is unpredictable. Atopy is an important risk factor for the development of AD. Cysteinyl leukotrienes (Cys-LTs) were implicated in the pathophysiology of allergic diseases, and are being targeted for their diagnosis and treatments. Early detection of tissue inflammation of target organ is important to enable early prevention and management of allergic diseases. The aim of our study is to evaluate the differences in urinary leukotrienes E4 (LTE4) levels, according to AD symptom score and aeroallergen sensitization in children with AD by using noninvasive techniques. Methods:We recruited 46 children with AD, using predetermined criteria. Clinical features of AD were evaluated by a physician, using scoring atopic dermatitis (SCORAD) index. Aeroallergen sensitization was measured by using a skin prick test and UniCap. Urine samples were also collected on day of the 1st and 2nd visits, and were analyzed for LTE4 with an enzyme-linked immunoassay kit. Results:SCORAD indeces of children with AD were correlated with urinary LTE4 levels. Total immunoglobulin E (IgE) and eosinophil counts also had significant correlation with urinary LTE4 levels. Especially, aeroallergen sensitization of atopic AD significantly correlated with urinary LTE4 of these patients. Conclusion:Urinary LTE4 levels significantly correlated with serum total IgE and number of sensitized aeroallergen in children with AD. Clinical features of AD evaluated with SCORAD index related with urinary LTE4 level. Urinary LTE4 might be a valuable, noninvasive marker for different pathogenesis of AD.

Purpose:Atopic dermatitis (AD) is a genetically determined, chronic relapsing skin disease. The pathogenesis of AD is complex and the course is unpredictable. Atopy is an important risk factor for the development of AD. Cysteinyl leukotrienes (Cys-LTs) were implicated in the pathophysiology of allergic diseases, and are being targeted for their diagnosis and treatments. Early detection of tissue inflammation of target organ is important to enable early prevention and management of allergic diseases. The aim of our study is to evaluate the differences in urinary leukotrienes E4 (LTE4) levels, according to AD symptom score and aeroallergen sensitization in children with AD by using noninvasive techniques. Methods:We recruited 46 children with AD, using predetermined criteria. Clinical features of AD were evaluated by a physician, using scoring atopic dermatitis (SCORAD) index. Aeroallergen sensitization was measured by using a skin prick test and UniCap. Urine samples were also collected on day of the 1st and 2nd visits, and were analyzed for LTE4 with an enzyme-linked immunoassay kit. Results:SCORAD indeces of children with AD were correlated with urinary LTE4 levels. Total immunoglobulin E (IgE) and eosinophil counts also had significant correlation with urinary LTE4 levels. Especially, aeroallergen sensitization of atopic AD significantly correlated with urinary LTE4 of these patients. Conclusion:Urinary LTE4 levels significantly correlated with serum total IgE and number of sensitized aeroallergen in children with AD. Clinical features of AD evaluated with SCORAD index related with urinary LTE4 level. Urinary LTE4 might be a valuable, noninvasive marker for different pathogenesis of AD.