***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND Eosinophil cationic protein ( ECP ) is a cytotoxic agent secreted by activated eosinophils during allergic and inflammatory processes . The aim of the study was to determine the  ECP level , absolute and relative eosinophil count and IgE antibodies in children with atopic dermatitis ( AD ) compared with those of nonatopic children , and to assess the correlation of these laboratory parameters with the clinical severity of AD . METHODS This prospect i ve study comprised 70 children . There were 49 children with AD aged 3 - 36 months , and the control group comprised 21 children with a negative personal and family history for atopic diseases . Detailed history , serum  ECP  levels ( UniCAP FEIA ) , relative and absolute eosinophil counts and total serum IgE antibodies were determined in both groups . In the children with AD , skin involvement was measured by the SCORAD index . RESULTS The calculated SCORAD index was between 16 and 83 . IgE antibodies , relative and absolute eosinophil counts showed a significantly wider range of values and a statistically higher median ( P < 0.001 ) in the patients with AD compared with the control group . These laboratory parameters did not correlate with the severity of AD . The serum ECP median level , in the children with AD , was 16.2 microg/L ( range 3.01 - 65.30 ) compared with 5.92 microg/L ( range 2.76 - 21.90 ) in the control group . Correlation of the total SCORAD index and the serum ECP levels was negative , weak ( r = -0.065 ) and statistically not significant ( P > 0.05 ) . The same was found for the correlation of serum ECP and intensity of skin changes ( r = -0.095 ) and serum ECP and subjective symptoms ( r = -0.045 ) . The correlation was positive , but weak and statistically not significant for the serum ECP and extent of the skin lesions ( r = 0.079 , P > 0.05 ) . CONCLUSION Elevated levels of ECP , relative and absolute eosinophil counts , as well as IgE antibodies were determined in the patients with AD . As these laboratory findings did not correlate with the severity of AD , they can be considered only as additional methods in the evaluation of patients with AD BACKGROUND The gastrointestinal microflora is an important constituent of the gut mucosal defense barrier . We have previously shown that a human intestinal floral strain , Lactobacillus GG ( ATCC 53103 ) , promotes local antigen-specific immune responses ( particularly in the IgA class ) , prevents permeability defects , and confers controlled antigen absorption . OBJECTIVE The aim of this study was to evaluate the clinical and immunologic effects of cow 's milk elimination without ( n = 14 ) and with ( n = 13 ) the addition of Lactobacillus GG ( 5 x 10(8 ) colony-forming units/gm formula ) in an extensively hydrolyzed whey formula in infants with atopic eczema and cow 's milk allergy . The second part of the study involved 10 breast-fed infants who had atopic eczema and cow 's milk allergy . In this group Lactobacillus GG was given to nursing mothers . METHODS The severity of atopic eczema was assessed by clinical scoring . The concentrations of fecal alpha 1- antitrypsin , tumor necrosis factor-alpha , and eosinophil cationic protein were determined as markers of intestinal inflammation before and after dietary intervention . RESULTS The clinical score of atopic dermatitis improved significantly during the 1-month study period in infants treated with the extensively hydrolyzed whey formula fortified with Lactobacillus GG . The concentration of alpha 1-antitrypsin decreased significantly in this group ( p = 0.03 ) but not in the group receiving the whey formula without Lactobacillus GG ( p = 0.68 ) . In parallel , the median ( lower quartile to upper quartile ) concentration of fecal tumor necrosis factor-alpha decreased significantly in this group , from 709 pg/gm ( 91 to 1131 pg/gm ) to 34 pg/gm ( 19 to 103 pg/gm ) ( p = 0.003 ) , but not in those receiving the extensively hydrolyzed whey formula only ( p = 0.38 ) . The concentration of fecal eosinophil cationic protein remained unaltered during therapy . CONCLUSION These results suggest that probiotic bacteria may promote endogenous barrier mechanisms in patients with atopic dermatitis and food allergy , and by alleviating intestinal inflammation , may act as a useful tool in the treatment of food allergy ABSTRACT Background : Specific subcutaneous immunotherapy ( SCIT ) with house dust mite ( HDM ) preparation has recently been shown to improve eczema in patients with atopic dermatitis ( AD ) . So far , there is less data regarding efficacy and safety of specific sublingual immunotherapy ( SLIT ) in patients with AD . Study aim : To evaluate in an open non-controlled , non-r and omized pilot trial the effect of SLIT with HDM allergen extracts preparation ( SLITone , ALK Abellò Italy ) on SCORAD in adult patients with mild – moderate AD . Patients and methods : 86 Subjects ( 53 females and 33 males ) between 3 and 60 years of age with AD and IgE-proved ( Class > 2 ) HDM sensitization were enrolled after their informed consent in the trial . Exclusion criteria were severe asthma and treatment with systemic or high potent topical corticosteroids or immunosuppressant agents . Patients were treated with SLIT ( Dermatophagoides pteronyssinus and Dermatophagoides farinae extracts : SLITone , ALK-Abellò ) for at least 12 months . SCORAD was evaluated at baseline and after 12 months of treatment . Results : Baseline SCORAD value , mean ± SD , was 43.3 ± 13.7 ( range 15–84 ) . After 1 year of SLIT , mean ± SD , SCORAD value was reduced to 23.7 ± 13.3 ( range : 0–65 ) ( p = 0.0001 ; unpaired t-test vs. baseline ) . This was a 46 % reduction in SCORAD in comparison with baseline value . A significant improvement , defined as a SCORAD reduction of > 30 % , was observed in 51 out of 86 patients ( 59 % ) . In 5 patients ( 5.8 % ) SCORAD values did not change at the end of the observation period . In 30 patients ( 35 % ) the SCORAD reduction after SIT was ≤ 30 % in comparison with baseline . Total and specific IgE serum levels were significantly ( p = 0.001 ) reduced after SLIT . No severe adverse events were observed during the trial . Conclusion : In this open non-controlled trial SLIT with HDM extracts in patients with mild to moderate AD was effective in reducing the SCORAD after 1 year of SLIT treatment . In addition the treatment was very well tolerated . Treatment with SLIT , furthermore , has allowed a gradual and relevant reduction of concomitant therapies with topical corticosteroids or immunosuppressants . Present results require further controlled trials in order to confirm the potential clinical benefit of SLIT in this clinical setting Background : Several studies on avoidance of house‐dust‐mite ( HDM ) and cat allergens have been carried out , most of them in asthmatic patients and only a few in patients with atopic dermatitis ( AD ) . No study so far has focused on which subgroup of AD patients benefits from avoidance measures BACKGROUND Studies suggest that low concentrations of n-6 long-chain polyenes in early life are correlated to atopic disease in later life . OBJECTIVE The purpose of the study was to investigate the possible preventive effect of gamma-linolenic acid ( GLA ) supplementation on the development of  atopic dermatitis in infants at risk . DESIGN In a double-blind , r and omized , placebo-controlled trial , formula-fed infants ( n = 118 ) with a maternal history of atopic disease received borage oil supplement ( containing 100 mg GLA ) or sunflower oil supplement as a placebo daily for the first 6 mo of life . Main outcome measures were the incidence of atopic dermatitis in the first year of life ( by UK Working Party criteria ) , the severity of atopic dermatitis ( SCORing Atopic Dermatitis ; SCORAD ) , and the total serum immunoglobulin E ( IgE ) concentration at the age of 1 y. RESULTS The intention-to-treat analysis showed a favorable trend for severity of atopic dermatitis associated with GLA supplementation ( x+/- SD SCORAD : 6.32 + /- 5.32 ) in the GLA-supplemented group as compared with 8.28 + /- 6.54 in the placebo group ( P = 0.09 ; P = 0.06 after adjustment for total serum IgE at baseline , age 1 wk ) , but no significant effects on the other atopic outcomes . The increase in GLA concentrations in plasma phospholipids between baseline and 3 mo was negatively associated with the severity of atopic dermatitis at 1 y ( Spearman 's correlation coefficient = -0.233 , P = 0.013 ) . There was no significant effect on total serum IgE concentration . CONCLUSION Early supplementation with GLA in children at high familial risk does not prevent the expression of atopy as reflected by total serum IgE , but it tends to alleviate the severity of atopic dermatitis in later infancy in these children BACKGROUND Besides glucocorticosteroids , there is currently no known effective therapy for patients with acute atopic dermatitis . OBJECTIVE The therapeutic effectiveness of high-dose UVA1 irradiation in the management of patients with acute exacerbation of atopic dermatitis was examined . METHODS Patients in the  high-dose UVA1 group ( n = 15 ) were irradiated with 130 joules/cm2 UVA1 ; the control group ( n = 10 ) was treated with UVA-UVB therapy in a minimal erythema dose-dependent manner ( total number of treatments 15 ) . RESULTS High-dose UVA1 irradiation was found to induce a significant clinical improvement of atopic dermatitis ( p less than 0.001 ) . In comparison with UVA-UVB therapy , significant differences in favor of high-dose UVA1 were observed ( p less than 0.01 ) . High-dose UVA1 , but not UVA-UVB treatment , significantly reduced the elevated serum level of eosinophil cationic protein in patients with atopic dermatitis ( p less than 0.003 ) . CONCLUSION These studies indicate that high-dose UVA1 irradiation may represent a novel phototherapeutic modality for the treatment of patients with an acute exacerbation of atopic dermatitis Atopic dermatitis ( AD ) is a common chronic or chronically relapsing , severely pruritic , eczematous skin disease . Recently , substance P ( SP ) has been demonstrated to be one of the important neuropeptides for mediating itch-scratch and stress-scratch cycles . In this study , we examined the severity scores , itch scores and plasma SP levels in 19 patients with AD treated with st and ard topical therapy with or without an oral antihistamine , olopatadine hydrochloride , for 4 weeks . The st and ard therapy decreased SCORAD scores , itch behavioral rating scores and plasma SP levels at post-treatment in the mass , but the topical therapy with olopatadine was more effective than the topical therapy alone , suggesting a potential additive effect Background Intravenous immune globulin ( IVIG ) therapy has been tried in the treatment of atopic dermatitis . Recently , the presence of serum‐soluble CD5 ( ssCD5 ) in atopic dermatitis was reported Atopic dermatitis ( AD ) is a chronic inflammatory skin disease frequently associated with asthma , rhinitis , and food allergy . Lymphocytes producing Th2‐type cytokines ( such as interleukin [IL]‐3 , IL‐4 , and IL‐5 ) have been thought to have a key role in the pathogenesis of the disease . We have recently demonstrated that elevated serum levels of the soluble form of CD30 ( sCD30 ) , an activation marker of Th2‐cell clones , correlates with disease activity in pediatric patients suffering from AD . Clinical trials have demonstrated that cyclosporin A ( CyA ) treatment result ed in significant improvement of clinical symptoms in patients affected with AD . In this study , we evaluated the role of CyA in modulating sCD30 release in a group of adult patients affected by severe AD treated with CyA at the dosage of 3.5 mg/kg body weight for 12 weeks . Our results demonstrated , in parallel with an improvement of clinical symptoms , a significant reduction of serum levels of both IL‐4 and sCD30 , thus suggesting that CyA can prevent the activation of Th2 cells observed in AD Many patients with atopic dermatitis are dissatisfied with conventional treatments based on topical steroids and have experienced some traditional remedies and alternative therapies . However , most of such therapies have not been evaluated scientifically and clinical ly by specialists . This study was design ed to assess whether a certain vegetarian diet might be effective for atopic dermatitis and if so , to identify the mechanisms of this remedy through analyses 
    Output:
    
Additional biomarkers that could prove useful but require additional research include serum cutaneous T-cell attracting chemokine ( CTACK ) , sE-selectin , macrophage-derived chemokine ( MDC ) , lactate dehydrogenase ( LDH ) and interleukin (IL)-18