There are presented modern data describing the current understanding of the pathogenesis of atopic dermatitis (AD): a genetic predisposition to atopy, disruptions of epidermal barrier integrity and a cascade of immune responses, contributing allergic inflammation in the skin. There are both described several mechanisms of acute and chronic phases of AD, the main directions of pathogenetically substantiated treatment of AD in children and indicated the prospects of new preparations specific blockers of proinflammatory cytokines involved in the development of AD - crisaborole, apremilast, dupilumab, lebrikizumab, tralokinumab, tezepelumab. There is especially presented in details external therapy of atopic skin lesions in children with the use of means of modern dermatological cosmetics.
The data of examination of 80 in-patients with the mixed form of cystic fibrosis (CF) are presented. All cases were divided into 3 groups according to the severity of the course of the disease. 16 conditionally healthy children made up a reference group. Determination of blood serum concentrations of interleukins (IL4, IL6), transforming growth factor-β1 (TGF-β1), matrix metalloproteinases MMP-2, MMP-8, MMP-9 and tissue inhibitor-TIMP-1 was performed by immunoassay ELISA method. The changes in the content of MMP and TIMP-1 in the blood serum of patients with various severity of the course of CF were found to be characterized by a significant decrease in MMP-8 and TIMP-1 concentrations, an increase in MMP-2 levels in children with moderate СF and a significant increase in MMP-9 concentrations, especially pronounced in patients with severe CF. At the same time, no definite dependence of the changes in MMP and TIMP-1 concentrations in the blood serum of patients on the frequency of exacerbations in the CF course and the dominant microbiota was found. Changes in the content of IL and TGF-β1 in the blood serum of children with the various severity of the course of CF were characterized by an increase in the concentrations of IL4 and TGFβ1 by more than 9.8 times, and IL6 - by 4.6 times if compared with the reference group. However, there no direct correlation was found between the changes in their production and the severity of the course of CF. The authors believe elevated levels of MMP, TIMP, and altered relationships between them can be used as biomarkers of the exacerbation of CF course in children.
Modern data describing the current understanding of the pathogenesis of atopic dermatitis (AD): a genetic predisposition to atopy, disturbances of the intestinal microbiome, disruptions of epidermal barrier integrity and a cascade of immune responses, contributing allergic inflammation in the skin are presented. There are both described several mechanisms of acute and chronic phases of AD, the main directions of pathogenetically substantiated treatment of AD in children and indicated the prospects of new preparations specific blockers of proinflammatory cytokines involved in the development of AD - crisaborole, dupilumab, apremilast et al. External therapy of atopic skin lesions in AD children with modern dermatological cosmetics is presented.
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