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Nocturnal wrist movements are correlated with objective clinical scores and plasma chemokine levels in children with atopic dermatitis.
Br J Dermatol 2006; 154(4):629-35BJ

Abstract

BACKGROUND

Atopic dermatitis (AD) is a distressing disease associated with pruritus and sleep disturbance. Scratching due to pruritus is an important mechanism in the exacerbation of AD but is difficult to document in the home environment.

OBJECTIVES

To evaluate whether nocturnal wrist activities, defined as average acceleration in the early hours of sleep, were correlated with components of the SCORing Atopic Dermatitis (SCORAD) index and various AD-associated chemokine markers.

METHODS

Patients with AD aged under 18 years were recruited and the severity of eczema was assessed with the SCORAD index. Concentrations of plasma AD-associated chemokines [cutaneous T-cell attracting cytokine (CTACK); macrophage-derived chemokine (MDC); thymus and activation regulated chemokine (TARC)], interleukin (IL)-18, serum total IgE, and eosinophil counts were measured in these patients. Healthy children with noninflammatory and nonitchy skin conditions as well as healthy children of staff volunteers were recruited as controls. All children were instructed to wear the DigiTrac monitor on their dominant wrist before sleeping. The monitor was programmed to record limb motion between 22.00 and 08.00 h the following morning.

RESULTS

Twenty-four Chinese children with AD (mean +/- SD age 12.6 +/- 3.7 years) and 15 normal children (mean +/- SD age 11.9 +/- 3.4 years) were recruited. The median (interquartile range) SCORAD was 54.8 (32.8-70.2). Plasma concentrations in pg mL(-1) of CTACK, MDC, TARC and IL-18 in the patients were 105 (92-172), 1648 (973-4214), 258 (100-850) and 415 (304-539), respectively. When compared with controls, most wrist activities occurred at frequencies between 1 and 3 Hz. These activities were most consistent over the first 3 h of sleeping and correlated significantly with disease severity, extent, intensity, and AD-associated chemokine markers CTACK, MDC and TARC. However, there was no significant correlation between wrist activities and the subjective symptom of pruritus or sleep loss.

CONCLUSIONS

This is the first study to demonstrate that wrist activities, nonintrusively measured by the DigiTrac monitor at home, are closely correlated with the objective clinical scores and levels of peripheral blood chemokine markers for AD but not with the reported symptoms of pruritus or sleep loss. We propose that wrist activities between 1 and 3 Hz for the first 3 h are a good indicator of AD severity in children and should substitute for the pruritus and sleep-loss components of the SCORAD.

Authors+Show Affiliations

Department of Paediatrics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong, China. ehon@hotmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16536804

Citation

Hon, K-L E., et al. "Nocturnal Wrist Movements Are Correlated With Objective Clinical Scores and Plasma Chemokine Levels in Children With Atopic Dermatitis." The British Journal of Dermatology, vol. 154, no. 4, 2006, pp. 629-35.
Hon KL, Lam MC, Leung TF, et al. Nocturnal wrist movements are correlated with objective clinical scores and plasma chemokine levels in children with atopic dermatitis. Br J Dermatol. 2006;154(4):629-35.
Hon, K. L., Lam, M. C., Leung, T. F., Kam, W. Y., Lee, K. C., Li, M. C., ... Ng, P. C. (2006). Nocturnal wrist movements are correlated with objective clinical scores and plasma chemokine levels in children with atopic dermatitis. The British Journal of Dermatology, 154(4), pp. 629-35.
Hon KL, et al. Nocturnal Wrist Movements Are Correlated With Objective Clinical Scores and Plasma Chemokine Levels in Children With Atopic Dermatitis. Br J Dermatol. 2006;154(4):629-35. PubMed PMID: 16536804.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Nocturnal wrist movements are correlated with objective clinical scores and plasma chemokine levels in children with atopic dermatitis. AU - Hon,K-L E, AU - Lam,M-C A, AU - Leung,T-F, AU - Kam,W-Y C, AU - Lee,K-C K, AU - Li,M-C A, AU - Fok,T-F, AU - Ng,P-C, PY - 2006/3/16/pubmed PY - 2006/8/10/medline PY - 2006/3/16/entrez SP - 629 EP - 35 JF - The British journal of dermatology JO - Br. J. Dermatol. VL - 154 IS - 4 N2 - BACKGROUND: Atopic dermatitis (AD) is a distressing disease associated with pruritus and sleep disturbance. Scratching due to pruritus is an important mechanism in the exacerbation of AD but is difficult to document in the home environment. OBJECTIVES: To evaluate whether nocturnal wrist activities, defined as average acceleration in the early hours of sleep, were correlated with components of the SCORing Atopic Dermatitis (SCORAD) index and various AD-associated chemokine markers. METHODS: Patients with AD aged under 18 years were recruited and the severity of eczema was assessed with the SCORAD index. Concentrations of plasma AD-associated chemokines [cutaneous T-cell attracting cytokine (CTACK); macrophage-derived chemokine (MDC); thymus and activation regulated chemokine (TARC)], interleukin (IL)-18, serum total IgE, and eosinophil counts were measured in these patients. Healthy children with noninflammatory and nonitchy skin conditions as well as healthy children of staff volunteers were recruited as controls. All children were instructed to wear the DigiTrac monitor on their dominant wrist before sleeping. The monitor was programmed to record limb motion between 22.00 and 08.00 h the following morning. RESULTS: Twenty-four Chinese children with AD (mean +/- SD age 12.6 +/- 3.7 years) and 15 normal children (mean +/- SD age 11.9 +/- 3.4 years) were recruited. The median (interquartile range) SCORAD was 54.8 (32.8-70.2). Plasma concentrations in pg mL(-1) of CTACK, MDC, TARC and IL-18 in the patients were 105 (92-172), 1648 (973-4214), 258 (100-850) and 415 (304-539), respectively. When compared with controls, most wrist activities occurred at frequencies between 1 and 3 Hz. These activities were most consistent over the first 3 h of sleeping and correlated significantly with disease severity, extent, intensity, and AD-associated chemokine markers CTACK, MDC and TARC. However, there was no significant correlation between wrist activities and the subjective symptom of pruritus or sleep loss. CONCLUSIONS: This is the first study to demonstrate that wrist activities, nonintrusively measured by the DigiTrac monitor at home, are closely correlated with the objective clinical scores and levels of peripheral blood chemokine markers for AD but not with the reported symptoms of pruritus or sleep loss. We propose that wrist activities between 1 and 3 Hz for the first 3 h are a good indicator of AD severity in children and should substitute for the pruritus and sleep-loss components of the SCORAD. SN - 0007-0963 UR - https://www.unboundmedicine.com/medline/citation/16536804/Nocturnal_wrist_movements_are_correlated_with_objective_clinical_scores_and_plasma_chemokine_levels_in_children_with_atopic_dermatitis_ L2 - https://doi.org/10.1111/j.1365-2133.2006.07213.x DB - PRIME DP - Unbound Medicine ER -