Abstract

Background: Recent data suggest that patients with atopic dermatitis (AD) have increased systemic immune activation and cardiovascular risk. However, unlike psoriasis, evaluation of active vascular inflammation using state-of-the-art imaging is lacking in AD. Objective: To assess aortic and carotid vascular inflammation using 18F-fluorodeoxyglucose-positron emission tomography/magnetic resonance imaging (18F-FDG-PET/MRI) imaging in moderate-to-severe AD versus healthy individuals. Methods: A total of 27 patients with moderate-to-severe AD and 12 healthy controls were imaged using 18F-FDG-PET/MRI. Target-to-background ratio (TBR) values were calculated in multiple segments of the aorta and carotid vessels. Results: Patients with AD had elevated aortic max TBR (fold change [FCH] = 1.45, P =.057) versus healthy controls and significantly elevated mean TBR (FCH = 1.20; P <.05) in the right carotid (RC) arteries versus controls. When examining greatest focal inflammation (most diseased segment [MDS] TBR), patients with AD had higher aortic inflammation (FCH = 1.28; P =.052). AD clinical severity significantly correlated with C-reactive protein (ρ = 0.60, P <.01) and with RC mean TBR levels (ρ = 0.60, P =.04). Stratifying patients into moderate-to-severe and very severe AD showed greater RC mean TBR in patients with very severe AD versus controls (FCH = 1.31; P =.02) and versus patients with moderate/severe AD (FCH = 1.23, P =.05). Aortic inflammation was also significantly greater in patients with very severe AD versus controls (max TBR: FCH = 1.6, P =.04; MDS TBR: FCH = 1.73, P =.03). Conclusions: This preliminary study is the first that establishes greater vascular (aorta and carotid) inflammation in moderate-to-severe AD versus healthy controls. Furthermore, very severe AD showed higher inflammation than both moderate/severe patients and healthy controls. Future studies with larger patient cohorts and evaluation before and after treatment are needed to determine the extent to which vascular inflammation in AD is modifiable.

Original languageEnglish
Pages (from-to)3500-3506
Number of pages7
JournalJournal of Allergy and Clinical Immunology: In Practice
Volume8
Issue number10
DOIs
StatePublished - 1 Nov 2020

Keywords

  • Aorta
  • Atopic dermatitis
  • Cardiovascular inflammation
  • Carotid arteries
  • F-FDG-PET/MRI
  • Inflammatory skin disease
  • Systemic inflammation

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