Abstract
Atopic dermatitis (AD) is a chronic inflammatory skin disease, with itching predominant symptom, which usually develope in infancy and associated with an increase in serum IgE and history of atopies, such as allergic rhinitis or bronchial asthma. The etiology of AD remains unclear. However, there are many predisposing factors, such as genetic, immunological disorders, infections, foods, irritants, and psychological stress. Many research has conclude that stress is one of the risk factor for AD, but the current understanding for the underlying mechanism remain unclear. Recent research shows that stress can suppress interferon gamma (IFN-γ), which plays an important role in the pathogenesis of AD. This study aims to determine the role of stress and serum levels of IFN-γ to AD. Study design using a case-control study with a sample consisting of 31 cases and 28 controls. Stress indexes were measured using Holmes & Rahe Stress Scale and serum IFN-γ levels were examined. Statistical analysis was performed to determine the differences between the mean stress index and serum IFN-γ level between cases and controls, the magnitude of psychological stress as a risk factor for AD, and the correlation between psychological stress and serum IFN-γ level against the severity of AD. This study concluded that stress is a risk factor for AD with an odds ratio of 5.3, and the stress index is positively correlated with the severity of AD. Serum IFN-γ levels were significantly lower in cases group. There was a strong negative correlation between IFN-γ with the severity of AD (r = -0.905; p <0.05). Current study conclude that psychological stress is a risk factor for AD and stress can suppress serum IFN-γ levels.
Highlights
Atopic dermatitis (AD) is a chronic inflammatory skin disease, with itching predominant symptom, which usually develope in infancy and associated with an increase in serum immunoglobulin E (IgE) and history of atopies, such as allergic rhinitis or bronchial asthma
This study concluded that stress is a risk factor for AD with an odds ratio of 5.3, and the stress index is positively correlated with the severity of AD
Pavlovsky et al (2007), reported that psychological stress activates the production of several neuropeptides, which trigger T-helper 2 cells (Th2) to release proinflammatory cytokines, resulting in neurogenic inflammatory process in person suffering from atopic disease.[3,4,10]
Summary
Atopic dermatitis (AD) is a chronic inflammatory skin disease, with itching predominant symptom, which usually develope in infancy and associated with an increase in serum IgE and history of atopies, such as allergic rhinitis or bronchial asthma. Many research has conclude that stress is one of the risk factor for AD, but the current understanding for the underlying mechanism remain unclear. This study aims to determine the role of stress and serum levels of IFN-γ to AD. This study concluded that stress is a risk factor for AD with an odds ratio of 5.3, and the stress index is positively correlated with the severity of AD. Current study conclude that psychological stress is a risk factor for AD and stress can suppress serum IFN-γ levels. AD is commonly associated with atopy diatheses such as bronchial asthma, allergic rhinoconjunctivitis, genetic, immunological abnormalities, skin barrier disorder, irritation, infection and psychological stress.1,2,3,11. Pavlovsky et al (2007), reported that psychological stress activates the production of several neuropeptides, which trigger T-helper 2 cells (Th2) to release proinflammatory cytokines, resulting in neurogenic inflammatory process in person suffering from atopic disease.[3,4,10]
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