الفهرس 
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Abstract
Atopic eczema (AE), also known as atopic dermatitis, is a chronic inflammatory skin disorder, characterized by cutaneous dryness, intense itching, scratching, skin damage, and secondary infections. In chronic AE, flexural eczema becomes more prominent. The disease is closely associated with asthma and allergic rhinitis and results in significant morbidity, leading to school absenteeism and emotional stress in children. Its cause remains unknown, although it is probably a combination of genetic, environmental, and immunologic factors. The prevalence of AE has risen substantially in many countries in recent decades, and this increase has been attributed mainly to changes in lifestyle, nutrition, and environmental factors.
In recent decades, the prevalence of atopic dermatitis has increased considerably especially among children in well-developed countries. The incidence of childhood obesity has also shown a similar trend to atopic dermatitis, leading to raise a suspicion of a causal link between childhood obesity and atopic dermatitis.
Apelin is a bioactive peptide exerting its pro-angiogenic and pro-fibrotic effects in a context dependent manner through the activation of its receptor APJ, which is ubiquitously expressed on the surface of various cell types. The activation of apelin⁄APJ signalling appears to be involved in various pathological processes.
The aim of this study is to evaluate the serum level of Apelin in patients with atopic dermatitis and its correlation with disease severity in presence or absence of obesity.
The present study included twenty patients with atopic dermatitis, twenty patients with atopic dermatitis and obesity, twenty patients with obesity only and twenty age and sex matched normal control subjects. Venous blood samples were taken for measurement of serum concentration of apelin and IgE .
Exclusion criteria included: The patients treated with any systemic (antihistamines, steroid) during the preceding 8 weeks or any topical (steroids, calcineurin inhibitors) for at least 1 week before enrolment into the study (emollients only allowed). Patients with concomitant asthma, rhinitis and cardiovascular diseases was excluded from this study, to avoid any affection on Serum concentration of apelin and IgE.
All subjects were subjected to history taking with general and dermatological examination, serum level of apelin and IgE were measured using for both Enzyme-Linked immunosorbent assay (ELIZA).
The results presented in our study demonstrate that a statistically significant difference in the level of apelin and statistically non-significant difference in level of IgE between four studied groups.
The result showed that the mean serum level of apelin was higher in obese non atopic patients and lower in atopic non obese patients which suggest the role of apelin in etiopathogenesis of obesity and AD.
Our findings provided that apelin serum level increased with obesity and decreased with AD, with no correlation with both BMI and SCORAD which suggesting negative relation between apelin and severity of both diseases, also suggesting no association between severity of both diseases through our finding of no correlation between BMI and SCORAD.
Our finding also provided that IgE serum level cannot be used as specific test for diagnosis of AD, as there are multiple causes of IgE serum level elevations such as primary immunodeficiencies, infections, inflammatory diseases, and malignancies.