Biologic Therapy of Moderate and Severe Forms of Atopic Dermatitis in Children

Мурашкин, Н. Н.; Намазова-Баранова, Л. С.; Опрятин, Л. А.; Епишев, Р. В.; Материкин, А. И.; Амбарчян, Э. Т.; Иванов, Р. А.; Фёдоров, Д. В.; Куколева, Д. С.

doi:10.15690/vsp.v19i6.2145

Vopr. sovr. pediatr.

2020

DOI: 10.15690/vsp.v19i6.2145

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Biologic Therapy of Moderate and Severe Forms of Atopic Dermatitis in Children

Н. Н. Мурашкин

Л. С. Намазова-Баранова

Л. А. Опрятин

et al.

Abstract: Atopic dermatitis (AD) is the disease with chronic inflammation, epidermal barrier dysfunction and microbial dysbiosis. AD is widespread, including pediatric population. The article discusses the disease’s pathogenesis: skin barrier deficiency, immunological causes of chronic inflammation, characteristics of normal skin microbiome and its disorders on both affected and unaffected skin of children with AD. Main principles of systemic treatment for moderate and severe forms of disease are considered. Features of… Show more

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Cited by 6 publications

References 58 publications

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Controversial Issues of Immunopathogenesis of Psoriasis and Atopic Dermatitis

Ambarchian,

Namazova-Baranova,

Kuzminova

et al. 2024

Annals RAMS

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Psoriasis (PsO) and atopic dermatitis (AD have much in common: both diseases are widespread, characterized by a chronic relapsing course, primarily affect the skin and lead to a quality reduction of life of patients, regardless of their age. The pathogenesis of these two dermatoses, which are the most common in the practice of a pediatric dermatologist, is quite different. PsO is a chronic inflammatory skin disease, the pathogenesis of which is associated with the involvement of the Th1 pathway: Th17 cells and the IL-23/IL-17 axis. AD, in turn, is usually associated with high levels of IL-4, IL-5, IL-13, IL-31 and IFN-γ produced by activated T-helper 2 (Th2) cells. The clinical symptoms and immunopathological responses of these two skin conditions tend to differ. However, patients with PsO may sometimes present with a skin rash resembling AD combined with intense itching and laboratory increase in immunoglobulin E (IgE) which may indicate the need to change the paradigm of dominance of only one type of T-inflammation in patients with these diseases.

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Controversial Issues of Immunopathogenesis of Psoriasis and Atopic Dermatitis

Ambarchian,

Namazova-Baranova,

Kuzminova

et al. 2024

Annals RAMS

View full text Add to dashboard Cite

show abstract

The role of epigenetic factors in childhood atopic dermatitis

Bystritskaia,

Murashkin,

Naumova

et al. 2024

Med. immunol.

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Atopic dermatitis (AD) is a genetically determined chronic inflammatory skin disease characterized by itching, relapsing course, age-related features of the lesion morphology and localization. The etiological factors contributing to the development of AD are: allergic reactions, inflammatory reactions in the skin, leading to a barrier disfunction, the affect and interaction of genetic and environmental factors. Epigenetic mechanisms also play a key role in immune regulation. The aim of this work is to study the genome-wide methylation profile in the skin of children with AD in the acute stage, as well as to determine changes in the expression level of immune response genes associated with common signaling pathways during therapy. Whole-genome sequencing was conducted to examine methylation in the skin samples from AD patients and controls. The stages of bioinformatics data processing were carried out. Changes in the expression levels of the TLR2, TLR9, IL4, IL13, CAMP, and DEFB1 genes before and after treatment were carried out using RT-PCR-RT on samples of mononuclear blood cells. When comparing samples from patients with AD and healthy children, changes were shown in the methylation of 2364 regions of genomic DNA with their corresponding specific genes. Among the identified genes, those related to processes associated with the pathogenesis of AD were selected. At the next stage, changes in the expression of the described immunity factors (TLR2, TLR9, IL-4, IL-13, DEFB1, CAMP) were assessed over time according to the type of treatment. For this purpose, patients were divided into 2 groups depending on the prescription of systemic therapy. Three months after treatment, the level of expression for all studied immune factors decreased. However, a significant decrease in expression for almost all parameters (except for the DEFB1 gene) was recorded in the group in which systemic therapy (dupilumab) was used in addition to topical treatment. At the same time, the SCORAD index after treatment improved by an average of 63% and amounted to 17±6.0 points. Thus, systemic therapy aimed at suppressing signaling of IL-4 and IL-13 cytokines indirectly leads to normalization of the expression levels of innate immune factors. Studying the regulation of molecular genetic mechanisms of immunity involved in the processes of inflammation in AD helps to clarify the immunopathogenesis of this disease, determine diagnostic markers and targets for drug therapy.

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Modern vision of pathogenesis, clinical and immunological features and new methods of atopic dermatitis treatment

et al. 2022

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The article provides a literature review of one of the modern medical social problems in the world atopic dermatitis. Epidemiological data, current view on the pathogenesis of this disease, the role of genetic factors and epigenetic mechanisms in the development of dermatosis and modern treatment approaches are highlighted. Atopic dermatitis is a chronic inflammatory skin disease which common for children and adolescents, as well as for adults. Epidemiological studies conducted in different countries reveal the high prevalence and increased incidence of atopic dermatitis over the past three decades. Atopic dermatitis significantly affects the quality of patients and their relatives lives and also results in considerable social and economic burdens. Atopic dermatitis is a heterogeneous disease which pathogenesis is associated with mutations in genes encoding epidermal structural proteins, as well as genes that regulate innate and adaptive immune responses to environmental factors. In addition, the review reflects studies on the mechanisms of epigenetic regulation underlying the development of atopic dermatitis: Deoxyribonucleic acid (DNA) methylation, histone modification, and micro ribonucleic acid (microRNA)-mediated mechanisms of gene expression regulation. Epigenetic modifications in parents are realized in offspring in several generations, causing a wide range of clinical differences in the course of the disease in different age and gender groups. Currently available treatments for atopic dermatitis achieve remission but not a cure. The study of the disease pathogenesis, combined with the continuation of research on finding effective drugs, determines the prospects for developing prevention and treatment of atopic dermatitis.

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Biologic Therapy of Moderate and Severe Forms of Atopic Dermatitis in Children

Cited by 6 publications

References 58 publications

Controversial Issues of Immunopathogenesis of Psoriasis and Atopic Dermatitis

Controversial Issues of Immunopathogenesis of Psoriasis and Atopic Dermatitis

The role of epigenetic factors in childhood atopic dermatitis

Modern vision of pathogenesis, clinical and immunological features and new methods of atopic dermatitis treatment

Contact Info

Product

Resources

About

Biologic Therapy of Moderate and Severe Forms of Atopic Dermatitis in Children

Cited by 6 publications

References 58 publications

Controversial Issues of Immunopathogenesis of Psoriasis and Atopic Dermatitis

Controversial Issues of Immunopathogenesis of Psoriasis and Atopic Dermatitis

The role of epigenetic factors in childhood atopic dermatitis

Modern vision of pathogene­sis, clinical and immunological features and new methods of atopic dermatitis treatment

Contact Info

Product

Resources

About

Modern vision of pathogenesis, clinical and immunological features and new methods of atopic dermatitis treatment