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Evaluation of Oxidant–Antioxidant Balance in Children with Atopic Dermatitis: A Case–Control Study

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Abstract

Background

Increased reactive oxygen species (ROS) and oxidative stress (OS) has been reported in many allergic and inflammatory skin diseases, including urticaria, psoriasis, and atopic dermatitis (AD). Melatonin is a hormone secreted from the pineal gland and is a potent antioxidant.

Objective

The aim of the study was to measure serum antioxidant melatonin, oxidants of nitric oxide (NO), and malondialdehyde levels to calculate the serum oxidant–antioxidant balance based on the NO/melatonin and malondialdehyde/melatonin ratios and to determine the correlation with the disease severity in children with AD.

Methods

Seventy-three children with AD and 67 healthy controls were included in the study. The clinical diagnosis of AD was based on the diagnostic criteria of Hanifin-Rajka. The severity of AD was evaluated by the scoring AD (SCORAD) index, and atopy was determined by skin prick tests (SPTs) with commercial extracts. The OS-related parameters of serum melatonin, NO, malondialdehyde, and the NO/melatonin and malondialdehyde/melatonin ratios were calculated and compared with the results of healthy controls.

Results

Serum melatonin levels were higher (p < 0.0001) and serum NO levels and the NO/melatonin and malondialdehyde/melatonin ratios were lower in children with AD than in healthy controls (p = 0.045, p < 0.0001, p < 0.0001, respectively). There was no difference between children with AD and healthy controls in terms of serum malondialdehyde levels (p = 0.119). Serum melatonin levels were significantly lower in severe AD than in mild AD (p = 0.012). However, in terms of serum melatonin levels, there was no difference between mild and moderate AD (p = 0.742) and moderate to severe AD (p = 0.301). There was no significant difference in serum NO and malondialdehyde levels and NO/melatonin and malondialdehyde/melatonin ratios among children with mild, moderate, and severe AD (p > 0.05). A negative correlation was found between serum melatonin levels and the SCORAD index (r = −0.252, p = 0.031), and a positive correlation was found between NO/melatonin and malondialdehyde/melatonin ratios (r = 0.511, p < 0.0001). There was no statistically significant relationship between age (≤24 or >24 months), disease duration (≤6 or >6 months), and sex for the OS-related parameters (p > 0.05).

Conclusion

The serum oxidant–antioxidant balance was impaired in children with AD. Serum melatonin levels were higher in children with AD; however, this was negatively correlated with disease severity. Serum NO levels and NO/melatonin and malondialdehyde/melatonin ratios were lower in children with AD than in healthy controls. Melatonin might be used as a promising antioxidant to evaluate disease severity in children with AD. Thus, further studies are needed to clarify the role of melatonin in AD pathogenesis.

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Authors and Affiliations

  1. Department of Pediatric Allergy and Immunology, Adnan Menderes University Hospital, 09200, Aydın, Turkey

    Pınar Uysal

  2. Department of Child and Adolescent Psychiatry, Adnan Menderes University Hospital, 09200, Aydın, Turkey

    Sibelnur Avcil

  3. Department of Biochemistry, Adnan Menderes University Hospital, 09200, Aydın, Turkey

    Burçin İrem Abas & Çiğdem Yenisey

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  1. Pınar Uysal
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  4. Çiğdem Yenisey
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Correspondence to Pınar Uysal.

Ethics declarations

All authors have read and approved this manuscript, the requirements for authorship have been met, and each author believes the manuscript represents honest work.

Funding

No sources of funding were used to conduct this study or to prepare this manuscript. Study expenses were financed by the authors.

Conflict of interest

Pınar Uysal, Sibelnur Avcil, Burçin İrem Abas, and Çiğdem Yenisey have no conflicts of interest.

All authors of this manuscript followed the protocols for publication of patient data. The study protocol was approved by our institution’s local ethics committee (protocol number 2015/715). The parents of each participant were informed in detail about the research and provided informed consent for the scientific reporting of the data based on the study protocol. All of the investigators conformed to the ethical standards as reported in the revised Declaration of Helsinki (2000).

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Uysal, P., Avcil, S., Abas, B.İ. et al. Evaluation of Oxidant–Antioxidant Balance in Children with Atopic Dermatitis: A Case–Control Study. Am J Clin Dermatol 17, 527–537 (2016). https://doi.org/10.1007/s40257-016-0210-8

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  • DOI: https://doi.org/10.1007/s40257-016-0210-8

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