Neuroendocrine and circadian aspects (melatonin and β‐endorphin) of atopic dermatitis in the child

Abstract

Atopic dermatitis (AD) is a disease of increasing incidence among paediatric patients. Among the factors involved in its pathogenesis is the alteration of the immune response, and so the objective of this study was to evaluate the involvement of certain neuroendocrine factors with immune properties in the development of the disease. Fifty-five subjects were selected and divided into the following three groups: healthy subjects, those diagnosed with symptomatic AD and those with asymptomatic AD. Plasma levels of melatonin and beta-endorphins were measured by radioimmunoassay, in serum samples obtained at 9 am and 9 pm, with two samples being obtained from each of the patients and controls. In the phases of AD outbreaks, there is a reduction in the serum levels of both melatonin and beta-endorphin. In the case of melatonin, the difference is statistically significant only during the day, although nocturnal levels are greater for both hormones. In AD, a central neuroendocrine dysfunction may be a primary pathogenic event. Our hypothesis is that the physiological nocturnal peak of melatonin due to pineal gland production may mask the decline of melatonin of possibly extrapineal (immunological) origin during episodes of dermatitis outbreaks. Further studies are required, particularly of neurovegetative and hormonal aspects, to better define this process. Such a definition would also be of therapeutic interest.

Atopic Dermatitis, Melatonin, and Sleep Disturbance

“…Contrary to our results, a reduced morning serum melatonin level has been reported in AD. 38 However, previous studies have primarily measured serum melatonin levels in patients with AD, 13,38 but melatonin is secreted with a circadian rhythm in which serum levels peak between midnight and 3 AM, while the daytime levels are low. 39 This makes it difficult to make comparisons or draw conclusions from a serum sample at a single time point.…”

Correlation of Serumβ-Endorphin and the Quality of Life in Allergic Rhinitis

“…In their studies, they measured the serum IgE and found that it is a marker in atopic dermatitis; however, in our study, we found no relationship between serum IgE and AR severity. A pediatric study also observed a reduction in the serum β -endorphin level in patients with atopic dermatitis [21]. Investigations into lower airway allergic diseases, such as asthma and chronic obstructive pulmonary disease, have demonstrated that the β -endorphin response has been shown to decrease the activation of respiratory muscles and change the pattern of breathing to a more rapid and shallow one [22].…”

Melatonin and Atopy: Role in Atopic Dermatitis and Asthma

“…Moreover Muñoz-Hoyos et al demonstrated that in the phases of AD outbreaks, patients presented a diurnal reduction in the serum levels of melatonin and β-endorphin, although nocturnal levels were greater for both hormones. They hypothesized that the physiological nocturnal peak of melatonin due to pineal gland production might balance the possible decline of melatonin of extrapineal (immunological or cutaneous) origin during episodes of dermatitis outbreaks [56]. …”