Efficacy of narrow-band medium-wave phototherapy in correcting the cytokine status of eczema patients

Abstract

Background: Eczema is one of the most common skin diseases. Despite the success of systemic and local pharmacotherapy, effective treatment of patients with eczema is hampered by the lack of clear ideas about the etiology and the multifactorial nature of the disease pathogenesis. The research results available to date indicate that it is possible to increase the effectiveness of treatment of eczema patients using phototherapy methods. Aim: To evaluate the possibilities of narrow-band phototherapy with a wavelength of 311 nm (UVB-311 nm) in increasing the effectiveness of drug therapy in patients with eczema. Methods: The dermatological index of the symptom scale (DISS) was used to assess the clinical manifestations of eczema. Serum levels of cytokines – interleukins (IL) -1β, -2, -6, -10, interferon gamma (INF-γ), tumor necrosis factor alpha (TNF-α) were determined by solid-phase enzyme immunoassay. UVB-311 nm therapy procedures (25 sessions) were performed with the Dermalight®1000 device (Germany). The results of the treatment were evaluated after 2 and 4 months from the beginning of treatment. Results: The study included 66 patients with eczema (mean age 58.6±3.4 years, 44 males, 22 females), randomized into 2 groups. Group 1 included 33 patients who received only basic drug therapy (BDT). In the 2nd group, there were 33 patients who, in addition to BDT, received narrow-band phototherapy UVB-311 nm (РT+BDT). In the BDT group, the indicators of DISS after 2 months decreased by 1.33 times (p=0.01), while in the РT+BDT group - by 1.95 times (p<0.001). The level of cytokines in the BDT group did not change significantly (p>0.05) after 2 months. In the РT+BDT group, after 2 months, the level of IL-1ß decreased by 1.25 times (p=0.001), IL-2 - by 1.44 times (p<0.001), IL-6 - by 1.69 times (p=0.001), INF-γ – by 1.28 times (p=0.001), TNF-α – by 1.29 times (p=0.002);the level of IL-10 increased by 1.22 times (p=0.002). Conclusions: Basic drug therapy contributes to a moderate decrease in the DISS by 1.33 times, but does not provide a significant decline in the pro-inflammatory cytokine potential of the blood. The use of UVB-311 nm phototherapy contributes to a more significant decrease in the levels of the complex of proinflammatory cytokines (IL-1β, -2, -6, TNF-α, INF-γ) and an increase in anti-inflammatory IL-10, which favorably affects the clinical course of dermatosis, manifesting by a decrease in the DISS by 1.95 times.