Generic selectors
Exact matches only
Search in title
Search in content
Post Type Selectors
Search in posts
Search in pages
Filter by Categories
15th National Conference of the IAOMFP, Chennai, 2006
Abstract
Abstracts from current literature
Acne in India: Guidelines for management - IAA Consensus Document
Addendum
Announcement
Art & Psychiatry
Article
Articles
Association Activities
Association Notes
Award Article
Book Review
Brief Report
Case Analysis
Case Letter
Case Letters
Case Notes
Case Report
Case Reports
Clinical and Laboratory Investigations
Clinical Article
Clinical Studies
Clinical Study
Commentary
Conference Oration
Conference Summary
Continuing Medical Education
Correspondence
Corrigendum
Cosmetic Dermatology
Cosmetology
Current Best Evidence
Current Issue
Current View
Derma Quest
Dermato Surgery
Dermatopathology
Dermatosurgery Specials
Dispensing Pearl
Do you know?
Drug Dialogues
e-IJDVL
Editor Speaks
Editorial
Editorial Remarks
Editorial Report
Editorial Report - 2007
Editorial report for 2004-2005
Errata
Erratum
Focus
Fourth All India Conference Programme
From Our Book Shelf
From the Desk of Chief Editor
General
Get Set for Net
Get set for the net
Guest Article
Guest Editorial
History
How I Manage?
IADVL Announcement
IADVL Announcements
IJDVL Awards
IJDVL AWARDS 2015
IJDVL Awards 2018
IJDVL Awards 2019
IJDVL Awards 2020
IJDVL International Awards 2018
Images in Clinical Practice
In Memorium
Inaugural Address
Index
Knowledge From World Contemporaries
Leprosy Section
Letter in Response to Previous Publication
Letter to Editor
Letter to the Editor
Letter to the Editor - Case Letter
Letter to the Editor - Letter in Response to Published Article
LETTER TO THE EDITOR - LETTERS IN RESPONSE TO PUBLISHED ARTICLES
Letter to the Editor - Observation Letter
Letter to the Editor - Study Letter
Letter to the Editor - Therapy Letter
Letter to the Editor: Articles in Response to Previously Published Articles
Letters in Response to Previous Publication
Letters to the Editor
Letters to the Editor - Letter in Response to Previously Published Articles
Letters to the Editor: Case Letters
Letters to the Editor: Letters in Response to Previously Published Articles
Medicolegal Window
Messages
Miscellaneous Letter
Musings
Net Case
Net case report
Net Image
Net Images
Net Letter
Net Quiz
Net Study
New Preparations
News
News & Views
Obituary
Observation Letter
Observation Letters
Oration
Original Article
ORIGINAL CONTRIBUTION
Original Contributions
Pattern of Skin Diseases
Pearls
Pediatric Dermatology
Pediatric Rounds
Perspective
Presedential Address
Presidential Address
Presidents Remarks
Quiz
Recommendations
Regret
Report
Report of chief editor
Report of Hon : Treasurer IADVL
Report of Hon. General Secretary IADVL
Research Methdology
Research Methodology
Resident page
Resident's Page
Resident’s Page
Residents' Corner
Residents' Corner
Residents' Page
Retraction
Review
Review Article
Review Articles
Reviewers 2022
Revision Corner
Self Assessment Programme
SEMINAR
Seminar: Chronic Arsenicosis in India
Seminar: HIV Infection
Short Communication
Short Communications
Short Report
Snippets
Special Article
Specialty Interface
Studies
Study Letter
Study Letters
Supplement-Photoprotection
Supplement-Psoriasis
Symposium - Contact Dermatitis
Symposium - Lasers
Symposium - Pediatric Dermatoses
Symposium - Psoriasis
Symposium - Vesicobullous Disorders
SYMPOSIUM - VITILIGO
Symposium Aesthetic Surgery
Symposium Dermatopathology
Symposium-Hair Disorders
Symposium-Nails Part I
Symposium-Nails-Part II
Systematic Review and Meta-Analysis
Systematic Reviews
Systematic Reviews and Meta-analyses
Systematic Reviews and Meta-analysis
Tables
Technology
Therapeutic Guideline-IADVL
Therapeutic Guidelines
Therapeutic Guidelines - IADVL
Therapeutics
Therapy
Therapy Letter
Therapy Letters
View Point
Viewpoint
What’s new in Dermatology
Generic selectors
Exact matches only
Search in title
Search in content
Post Type Selectors
Search in posts
Search in pages
Filter by Categories
15th National Conference of the IAOMFP, Chennai, 2006
Abstract
Abstracts from current literature
Acne in India: Guidelines for management - IAA Consensus Document
Addendum
Announcement
Art & Psychiatry
Article
Articles
Association Activities
Association Notes
Award Article
Book Review
Brief Report
Case Analysis
Case Letter
Case Letters
Case Notes
Case Report
Case Reports
Clinical and Laboratory Investigations
Clinical Article
Clinical Studies
Clinical Study
Commentary
Conference Oration
Conference Summary
Continuing Medical Education
Correspondence
Corrigendum
Cosmetic Dermatology
Cosmetology
Current Best Evidence
Current Issue
Current View
Derma Quest
Dermato Surgery
Dermatopathology
Dermatosurgery Specials
Dispensing Pearl
Do you know?
Drug Dialogues
e-IJDVL
Editor Speaks
Editorial
Editorial Remarks
Editorial Report
Editorial Report - 2007
Editorial report for 2004-2005
Errata
Erratum
Focus
Fourth All India Conference Programme
From Our Book Shelf
From the Desk of Chief Editor
General
Get Set for Net
Get set for the net
Guest Article
Guest Editorial
History
How I Manage?
IADVL Announcement
IADVL Announcements
IJDVL Awards
IJDVL AWARDS 2015
IJDVL Awards 2018
IJDVL Awards 2019
IJDVL Awards 2020
IJDVL International Awards 2018
Images in Clinical Practice
In Memorium
Inaugural Address
Index
Knowledge From World Contemporaries
Leprosy Section
Letter in Response to Previous Publication
Letter to Editor
Letter to the Editor
Letter to the Editor - Case Letter
Letter to the Editor - Letter in Response to Published Article
LETTER TO THE EDITOR - LETTERS IN RESPONSE TO PUBLISHED ARTICLES
Letter to the Editor - Observation Letter
Letter to the Editor - Study Letter
Letter to the Editor - Therapy Letter
Letter to the Editor: Articles in Response to Previously Published Articles
Letters in Response to Previous Publication
Letters to the Editor
Letters to the Editor - Letter in Response to Previously Published Articles
Letters to the Editor: Case Letters
Letters to the Editor: Letters in Response to Previously Published Articles
Medicolegal Window
Messages
Miscellaneous Letter
Musings
Net Case
Net case report
Net Image
Net Images
Net Letter
Net Quiz
Net Study
New Preparations
News
News & Views
Obituary
Observation Letter
Observation Letters
Oration
Original Article
ORIGINAL CONTRIBUTION
Original Contributions
Pattern of Skin Diseases
Pearls
Pediatric Dermatology
Pediatric Rounds
Perspective
Presedential Address
Presidential Address
Presidents Remarks
Quiz
Recommendations
Regret
Report
Report of chief editor
Report of Hon : Treasurer IADVL
Report of Hon. General Secretary IADVL
Research Methdology
Research Methodology
Resident page
Resident's Page
Resident’s Page
Residents' Corner
Residents' Corner
Residents' Page
Retraction
Review
Review Article
Review Articles
Reviewers 2022
Revision Corner
Self Assessment Programme
SEMINAR
Seminar: Chronic Arsenicosis in India
Seminar: HIV Infection
Short Communication
Short Communications
Short Report
Snippets
Special Article
Specialty Interface
Studies
Study Letter
Study Letters
Supplement-Photoprotection
Supplement-Psoriasis
Symposium - Contact Dermatitis
Symposium - Lasers
Symposium - Pediatric Dermatoses
Symposium - Psoriasis
Symposium - Vesicobullous Disorders
SYMPOSIUM - VITILIGO
Symposium Aesthetic Surgery
Symposium Dermatopathology
Symposium-Hair Disorders
Symposium-Nails Part I
Symposium-Nails-Part II
Systematic Review and Meta-Analysis
Systematic Reviews
Systematic Reviews and Meta-analyses
Systematic Reviews and Meta-analysis
Tables
Technology
Therapeutic Guideline-IADVL
Therapeutic Guidelines
Therapeutic Guidelines - IADVL
Therapeutics
Therapy
Therapy Letter
Therapy Letters
View Point
Viewpoint
What’s new in Dermatology
View/Download PDF

Translate this page into:

Study Letter
89 (
3
); 458-459
doi:
10.25259/IJDVL_514_2021
pmid:
36461799

Concentration of substance P in patients with atopic dermatitis with and without past history of treatment

Department of Dermatology and Venereology, Universitas Sumatera Utara Hospital, Universitas Sumatera Utara, Medan, Indonesia

Corresponding author: Dr. Nova Zairina Lubis, Department of Dermatology and Venereology, Universitas Sumatera Utara Hospital, Universitas Sumatera Utara, Medan, Indonesia. novazai82@gmail.com

Licence
This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, transform, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

How to cite this article: Lubis NZ, Nasution K, Paramita DA. Concentration of substance P in patients with atopic dermatitis with and without past history of treatment. Indian J Dermatol Venereol Leprol 2023;89:458-9.

Dear Editor,

Atopic dermatitis is a chronic, inflammatory skin disease that initially appears in childhood. Itching is the primary symptom in atopic dermatitis patients. It causes sleep disturbances and skin infections.1 The prevalence rate of atopic dermatitis has proliferated in the last decade, that is, 10–20% cases in infants and children and around 1–3% in adults. Atopic dermatitis was present in about 1.1% of patients aged 13–14 years in 2012.2 The International Study of Asthma and Allergies in Childhood found that the morbidity rate reached 20% in Asian countries, including South Korea, Taiwan and Japan. In developing countries, an estimated 10–20% of children suffer from atopic dermatitis. Additionally, 60% of atopic dermatitis patients live until adulthood.3

The pathogenesis of atopic dermatitis is poorly understood. Skin neuropeptides, particularly substance P, contribute to the pathogenesis of various skin diseases, such as atopic dermatitis. Substance P promotes nerve growth factors from keratinocytes, histamine release, leukotriene or tumour necrosis factor from mast cells. This condition causes the growth of sensory nerve fibres and augmentation of skin inflammation. Therefore, substance P is currently considered a pruritogenic factor.4 Substance P induces an itching response in humans and mice and is mediated through the activation of the neurokinin 1 receptor on mast cells and keratinocytes. Moreover, it causes an increased inflammatory response and supports substance P’s indirect effect in mediating pruritus.5 Several studies have shown that blocking itching signals through neurokinin 1 receptor reduces itching complaints.6

This study aimed to evaluate the relationship between treatment history and substance P levels in atopic dermatitis in children.

This was a cross-sectional study conducted from February to June 2020 at the outpatient Department of Dermatology and Venereology, Division of Pediatric and Adolescent Dermatology at Universitas Sumatera Utara in Medan, Indonesia. Blood samples were analysed at the Integrated Laboratory.

Female and male patients with atopic dermatitis were enrolled in this study based on Hanifin and Rajka’s criteria. All participants who were willing to participate had signed informed consents. The exclusion criteria were: participants who had any other skin disease or a systemic disease and patients whose parents were unable to answer the questions.

Blood samples were obtained to measure the substance P levels using an ELISA kit (R&D Systems) according to the manufacturer’s instructions. Determination of the optical density of each sample was conducted in 30 min using a microplate reader set at 450 nm. The results were presented in units of pg/mL. This study was conducted in accordance with the Declaration of Helsinki.

A total of 46 participants with atopic dermatitis, 29 males (63%) and 17 females (37%) [Table 1] were enrolled in this study. The mean age of subjects with atopic dermatitis was 10.35 years (standard deviation = 4.01), with the youngest being 1 year and the oldest being 17 years old [Table 1].

Table 1: Subject characteristics
Demographic n = 46 (%)
Gender
Male
Female
Old (years)
Mean
Standard deviation (SD)
Median
Min-max
Medication history
Yes
No
Substance P levels
Mean
Standard deviation (SD)
Median
Min-max

29 (63%)
17 (37%)

10.35
4.01
11
1–17

17 (37%)
29 (63%)

300.88
127.55
270.50
172.4–764.4

Based on treatment history, 17 subjects (37%) had a history of atopic dermatitis treatment, while 29 subjects (63%) had never received or had no history of atopic dermatitis treatment [Table 1]. The mean value of substance P levels from 46 atopic dermatitis patients was 300.88 (standard deviation = 127.55) with the lowest level of 172.4 pg/mL and the highest level of 764.4 pg/mL [Table 1].

There was no significant relationship between the history of atopic dermatitis treatment and the level of substance P based on the Mann–Whitney U test (P = 0.733) [Table 2]. Subjects with a history of atopic dermatitis treatment had a lower median value of 262.8 (range, 172.4–764.4), whereas subjects without a history of atopic dermatitis treatment had a median value of 275.2 (range, 172.4–546.8) [Figure 1].

Table 2: Relationship of medical history towards substance P level
Medication history n P level median (min–max) P-value
Yes 17 262.8 (172.4–764.4) 0.733
No 29 275.2 (172.4–546.8)
Boxplot graph of substance P level based on the history of atopic dermatitis treatment
Figure 1:
Boxplot graph of substance P level based on the history of atopic dermatitis treatment

Several inflammatory neuropeptides play a vital role in the pathophysiology of pruritus in atopic dermatitis, especially the substance P and the neurokinin 1 receptor. Substance P levels are associated with atopic dermatitis disease activity and increased pruritus symptoms.7 In atopic dermatitis, there were specific neurobiological changes, due to stress. Stress has the adjunct effect with the increase of substance P, which can increase the production of vascular cell adhesion, skin thickness and vascular eosinophilic infiltration parameters.8 Although there is no significant relationship between the treatment history and the substance P levels in our study, the median level of substance P levels was lower in subjects with a history of atopic dermatitis treatment and higher in subjects without atopic dermatitis treatment.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent.

Financial support and sponsorship

Research Foundation of Universitas Sumatera Utara Budget Period of 2020 supported this research with the Letter of Agreement for Research Implementation of the Mono Program for Basic Research in the fiscal year 2020 Number 62/UN5.2.3.1/PPM/SPP-TALENTA USU/2020 dated April 28th 2020

Conflict of interest

There are no conflicts of interest.

References

  1. , , , . Atopic Dermatitis In: , , , , , , eds. Fitzpatrick’s Dermatology in General Medicine (9th ed.). New York: Mc Graw Hill; . p. :363-381.
    [Google Scholar]
  2. . Panduan Diagnosis dan Tatalaksana Dermatitis Atopik di Indonesia [Diagnosis and Management Guidelines of Atopic Dermatitis in Indonesia] Jakarta: Centra Communications; . p. :1-2.
    [Google Scholar]
  3. . Atopic eczema in children: NICE quality standard. Community Pract. 2013;86:46.
    [PubMed] [Google Scholar]
  4. , , . Severity scores, itch scores and plasma substance P levels in atopic dermatitis treated with standard topical therapy with oral olopatadine hydrochloride. J Dermatol. 2009;36:185-90.
    [CrossRef] [PubMed] [Google Scholar]
  5. , . Itch in atopic dermatitis - Pathophysiology and treatment. Acta Dermatovenerol Croat. 2010;18:289-96.
    [PubMed] [Google Scholar]
  6. , . Substance P (SP) and Neurokinin 1 Receptor (NK1R) are new targets for the treatment of chronic pruritus. Br J Dermatol. 2019;181:932-8.
    [CrossRef] [PubMed] [Google Scholar]
  7. , , , , . Current pharmaceutical developments in atopic dermatitis. Curr Opin Pharmacol. 2019;46:7-13.
    [CrossRef] [PubMed] [Google Scholar]
  8. , . Atopic dermatitis: Allergic dermatitis or neuroimmune dermatitis? An Bras Dermatol. 2016;91:479-88.
    [CrossRef] [PubMed] [Google Scholar]

Fulltext Views
2,993

PDF downloads
1,244
View/Download PDF
Download Citations
BibTeX
RIS
Show Sections