Clinical study and assessment of leukocyte phagocytic function in children with atopic dermatitis in Qassim region of Saudi Arabia

OBJECTIVE: Atopic dermatitis (AD) is a skin disorder clinically seen in the pediatric population. It is well recognized that patients with AD have an increased susceptibility to cutaneous colonization and infection with bacteria, fungi, and viruses. This study was undertaken to investigate the phagocytic activity and chemotactic response of mononuclear and polymorphonuclear leukocytes in severe AD patients. METHODS: A total of 50 children with severe AD were selected according to severity scoring of AD (the SCORAD index) and 30 healthy children of same age and sex were also selected as controls. The mononuclear and neutrophilic leukocytes were separated and the phagocytic ingestion of zymosan particles was determined. Migration distance in response tobacterial lipopolysaccharide chemotactic factor was also determined. Immunological disturbance in AD patients was determined by sandwich enzyme-liked immunosorbent assays for total serum immunoglobulin E (IgE), complement 3 (C3) C4. RESULTS: Of 50 AD patients with severe disease activity, 36 patients (72%) showed reduction in mononuclear and neutrophilic phagocytic activity. Children with AD had higher levels of total serum IgE, C3, and C4 compared to healthy children (P < 0.01). CONCLUSIONS: The study results demonstrated an inhibition in the chemotactic response and phagocytic activity by mononuclear and/or neutrophilic leukocytes in severe AD patients. We further observed an involvement of perturb complement system in patients with AD. Hence, we clearly showed that AD is exacerbated with compromised immunological response, especially the innate immune response.