Moderate-to-severe atopic dermatitis patients show increases in serum C-reactive protein levels, correlating with skin disease activity

• Published in: F1000 research Vol. 6; p. 1712
• Main Authors: Vekaria, Anjali S., Brunner, Patrick M., Aleisa, Ahmad I., Bonomo, Lauren, Lebwohl, Mark G., Israel, Ariel, Guttman-Yassky, Emma
• Format: Journal Article
• Language: English
• Published: England Faculty of 1000 Ltd 2017; F1000 Research Limited; F1000 Research Ltd
• Subjects: Age; Atopic dermatitis; Atopic Dermatitis & Other Forms of Eczema; Biomarkers; C-reactive protein; Cardiovascular disease; Cardiovascular diseases; Comorbidity; Copyright; Dermatitis; Dermatology; Eczema; Ethnicity; Gender; Health risk assessment; Hispanic people; Immunoglobulin E; Inflammation; Medical laboratories; Minority & ethnic groups; Psoriasis; Skin; Skin diseases; Smoking; Studies; Triglycerides; systemic inflammation; C-reactive protein; Atopic dermatitis; disease biomarker
• ISSN: 2046-1402; 2046-1402
• DOI: 10.12688/f1000research.12422.2

Background : Atopic dermatitis (AD), the most common chronic inflammatory skin disease, is evolving as a systemic disease, and associated systemic inflammation is possibly linked to increases in cardiovascular disease. Methods : We assessed levels of the inflammatory marker CRP in 59 patients with moderate-to-severe AD compared to matched healthy controls, and to determine correlation with skin disease severity. Clinical severity was measured using SCORing of Atopic Dermatitis (SCORAD) and body surface area (BSA). Control subjects (n=118), matched by age, gender, smoking status and ethnicity, were obtained from the National Health and Nutrition Survey (NHANES). Results : AD patients had significantly increased serum CRP levels compared to controls (0.7±1.0 vs. 0.4±0.7mg/dl; p=0.001), and 52.5% of them showed CRP levels >0.3mg/dl, predicting high cardiovascular risk. CRP levels were significantly correlated with both SCORAD (r=0.427, p=0.0008) and BSA (r=0.407, p=0.0015).  IgE levels in AD were highly elevated (median 2903U/ml, IQR [234,10655]), but only weakly correlated with SCORAD (r=0.282, p=0.0427) and BSA (r=0.382, p=0.0052), but not with CRP levels. AD patients also showed increased LDH levels, but without significant correlations with disease severity (SCORAD, BSA) or CRP. Conclusions : Our study strongly supports CRP as a marker for disease severity in moderate-to-severe AD patients, further demonstrating its chronic systemic nature.