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All Journal BALI MEDICAL JOURNAL (BMJ) Medicina INDONESIAN JOURNAL OF BIOMEDICAL SCIENCES E-Jurnal Medika Udayana JURNAL BIOMEDIK Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Journal of Applied Studies in Language ISM (Intisari Sains Medis) : Jurnal Kedokteran Bali Dermatology and Venereology Journal Journal of Global Pharma Technology Journal of General Procedural Dermatology and Venereology Indonesia Bali Dermatology Venereology and Aesthetic Journal
Made Wardhana
Dermatology And Venereology Departement, Faculty Of Medicine, Udayana University, Sanglah General Hospital Denpasar, Bali-Indonesia
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Languange, Linguistic, Communication & Media Medicine & Pharmacology Neuroscience Public Health

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Journal : INDONESIAN JOURNAL OF BIOMEDICAL SCIENCES

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LOW PLASMA CORTISOL LEVEL IS A RISK FACTOR FOR ADULT ATOPIC DERMATITIS AND NEGATIVELY CORRELATED TO PLASMA LEVELS OF NOREPINEPHRINE AND INTERLEUKIN-4 Wardhana, Made; Suata, Ketut; Suastika, Ketut
INDONESIAN JOURNAL OF BIOMEDICAL SCIENCES Vol. 4, No. 1 Januari 2010
Publisher : Udayana University

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Abstract

Atopic dermatitis is a skin inflammatory disease characterized by hyperactivity of the humoral immune system with a typical onset in infancy or early childhood. Many studies have focused on the patho-physiological role of the immune system in atopic dermatitis, but since the stress hormone receptor was recognized on the surface of immune cells, it appeared that cortisol was prominent stress hormones in regulating the immune system. Some studies have shown that individuals with atopic diseases such as atopic dermatitis, allergic rhinitis and bronchial asthma had lower concentration of saliva cortisol than those with non-atopic conditions. With this evidence, it can be assumed that lower concentration of cortisol as the result of hypo-response of hypothalamus-pituitary-adrenal to stressor can increase and interleukin (IL-4) concentrations. Both substances stimulate lymphocyte T helper 2 (Th2) cells to synthesize IL-4, which has an important role in atopic dermatitis pathogenesis to increase hypersensitivity to various environmental allergens. Until recently, few studies are available concerning the low concentration of plasma cortisol as a risk factor for atopic dermatitis, as well as its correlation with plasma levels of and IL-4. The purpose of this study was to show that low concentration of plasma cortisol is a risk factor for atopic dermatitis and it is negatively correlated with and plasma IL-4. Matched pair case control design, involving 36 cases and 36 controls, was used to show that low concentration of cortisol is a risk factor for atopic dermatitis, and cross sectional design was applied to find out the negative correlation between cortisol and IL-4 in 88 samples consisting of 52 patients with atopic dermatitis and 36 healthy person or persons without atopy. The result of the case-control study showed that plasma cortisol concentration of the case group was significantly lower (4.89 + 2.1 ug/dl; CI 95 %; p < 0.001) than in those of the control group (9.12 + 2.33 ug/dl) at confidence level of 95%; p < 0.001. Multiple logistic regression analysis showed odd ratio of cortisol 3.45, which was higher than the ratio of other parameters such as IL-4, history of atopy and skin moisture. Plasma and IL-4 concentrations of the patients with atopic dermatitis were significantly higher than in the subjects without atopy. The correlation test indicated that plasma cortisol was negatively correlated to norepinephrine (r = - 0.68; p < 0.05), and IL-4 (r = - 0.55; p = 0.05) levels in patients with atopic dermatitis. Based on the above findings, it can be deduced that low concentration of plasma cortisol, being correlated to increased plasma levels of norepinephrne and interleukin-4, is a risk factor for atopic dermatitis in adult
Co-Authors Adeline Santoso Ana Rahmawati Anak Agung Gde Putra Wiraguna Anak Agung Gde Putra Wiraguna Ariana Ariana Ariana Ariana Batan, Putu Nila Wardhani Dewi Gotama Ermon Naftali Limbara Ermon Naftali Limbara Fresa Nathania Rahardjo Fresa Nathania Rahardjo Gde Ngurah Arya Ariwangsa Gde Somayana GK Darmaputra I Dewa Nyoman Wibawa I Gde Nengah Adhilaksman I Gde Nengah Adhilaksman I Gde Nengah Adhilaksman Sunyamurti Wirawan I Gusti Ayu Agung Dwi Karmila I Gusti Ayu Agung Elis Indira I Gusti Ayu Agung Praharsini I Gusti Ayu Agung Praharsisni I Gusti Nyoman Darmaputra I Ketut Mariadi I Ketut Suastika I.G.A. Karmila Ida Ayu Intan Pratiwi Ida Ayu Trisna Dewi IGAA Ratna Medikawati, IGAA Ratna IGN Darma Putra Ivana Sugiarto Ketut Suata Limbara, Ermon Naftali Luh Made Mas Rusyati Made Kusuma Dewi Maharani Made Kusuma Dewi Maharani Made Martina Windari Made Puspawati Made Swastika Adiguna Maharani, Made Kusuma Dewi Marrietta Sugiarti Sadeli Marrietta Sugiarti Sadeli Martima W Martina Windari Martina Windari Nareswari, Putu Ayu Diah Natih, Sintha Aprillia Gita Ni Luh Putu Ratih Vibriyanti Karna Ni Luh Putu Sri Widhiastuty Ni Made Dwi Puspawati Ni Putu Tiza Murtia Margha Nila Puspasari Nila Wardani Nila Wardhani Batan Nyoman Suryawati Nyoman Yoga Maya Pramita Nyoman Yoga Maya Pramita Pande Agung Mahariski Prima Sanjiwani Puspawati . Putu Ayu Diah Nareswari Putu Ayu Diah Nareswari Putu Kurniawan Dhana Rahardjo, Fresa Nathania Ratih Vebrianti Ricky Fernando Maharis Rikcy Fernando Maharis Sadeli, Marrietta Sugiarti Sissy Sissy Sunny Wangko Suryawati . Wiraguna, Swastika Adiguna