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Abstract
Atopic diseases are complex familial disorder with multiple manifestations. The aim of this work was to identify several immunological and biochemical markers in atopic asthma, atopic dermatitis, and atopic rhinitis and its relation to disease severity; and also to genotype R576 IL-4Rα allele and to clarify its segregation with atopic diseases and its usefulness as a clinical marker of atopic diseases. The immunological and biochemical markers had been planned to include serum interleukin-4 (IL-4), peripheral blood eosinophil cell count, serum eosinophil cationic protein (ECP) (as a marker of eosinophil activity), serum total immunoglobulin E (IgE) and specific IgE by skin testing. The genetic variation in IL-4 function aimed to provide a mean of assessing the genetic mechanisms that underlie the patho-physiology of atopy.
The present study was carried out at the Medical Biochemistry Department and Chest Clinic, Dermatology Clinic, ENT Clinic, and the Allergy Clinic of Allergy and Immunology Unit of Chest Department, Faculty of Medicine, Zagazig University. Seventy five patients suffering from atopic disorders and 25 age-matched healthy unrelated volunteers taken as a control group. The atopic patients were planned to include nonsmoker patients with no parasitic infestation; 25 atopic asthmatics (asthma group), 25 patients with atopic dermatitis, and 25 patients with atopic rhinitis.
Full history and clinical examination, laboratory investigations were done to all patients including: complete blood picture, stool and urine analysis, determination of total IgE and IL-4 by ELISA, determination of specific IgE by prick skin test, determination of R576 IL-4 α allele by PCR-based restriction fragment length polymorphism, determination of eosinophil cationic protein by chemoluminescence technique. For asthmatic patients, chest X-ray and pulmonary function tests were done.
The results of this study showed that the most common allergens causing (+ve)skin test among atopic patients were mixed pollens (46.6%), hay dust (33.3%), smoke (21.3%), house dust mite (18.6%) and mixed fungus (16%), cotton and wool (9.3%), mixed feather (6.6%), and animals dander (5.3%.