The importance of cytokines for the atopic dermatitis pathogenesis

Селезнёв

2020

Vopr. sovr. pediatr.

General information on atopic dermatitis (AD), its history and epidemiological significance are presented. Multiple etiopathogenetic factors affecting disease manifestation are identified. The absence of specific tests, laboratory and histological studies, that can help in correct AT diagnosis, is mentioned. Most of AT diagnostic schemes clarify main (major) and additional (minor) signs of disease. Clinical manifestations of AD minor signs crucial for revealing of subacute and chronic course, as well as onset of incomplete remission of disease are described. Topical AD management regimens are presented. Pathogenetic verifications for emollients and regenerating agents use are presented.

Section: патогенезunclassified

The Role of Minor Signs in Atopic Dermatitis Diagnostics

Селезнёв

2020

Vopr. sovr. pediatr.

Time course of autoantibodies to collagen type I and III in blood serum and skin exudate in atopic dermatitis

et al. 2022

In accordance with Clinical Guidelines of the Russian Society of Dermatovenerologists and Cosmetologists, atopic dermatitis is a chronic allergic genetically determined dermatosis of a multifactorial nature. There are, however, some aspects that challenge the allergic nature of dermatosis. For example, according to literature data, not all the patients have increased synthesis of immunoglobulin E, some of them are torpid to antihistamine treatment, and, when examining the skin of some patients with atopic dermatitis, an absolute polymorphism of rashes is revealed, thus being not typical to the reagin-type allergic reactions. According to modern data, autoimmune theory is assumed for the mechanisms of atopic dermatitis. However, objective proofs of this theory have not been presented, thus drawing our attention to the studies of this issue. The aim of this study was to identify autoimmune pathogenetic mechanisms of atopic dermatitis. The study included 40 adolescents and 40 adult patients with limited and extended forms of atopic dermatitis. The patients were evaluated during the period of exacerbation and remission of the disease. Blood and skin exudates samples were taken from all the patients. The control group consisted of 30 practically healthy volunteers in whom skin exudate was obtained by the “skin window” technique as proposed by Klimov V.V. et al. “A method for assessing minimal inflammatory activity of skin in atopic dermatitis in remission”. Concentrations of IgG autoantibodies to collagen types I and III were determined in blood serum and skin exudate samples applying ELISA techniques with ready-made panels AEA571Hu ELISA Kit for Anti-Collagen Type I Antibody (USA), AEA176Hu ELISA Kit for Anti-Collagen Type III Antibody (USA), according to the manufacturer’s protocols. For the first time, the contents of autoantibodies to skin collagen types I and III in the patients with atopic dermatitis we studied in parallel, i.e., at systemic level and in affected skin. If compared to the group of healthy volunteers, the concentration of autoantibodies to collagen types I and III was found to be increased in all the patients with atopic dermatitis, both during exacerbation and in remission of the disease. The maximal values of autoantibodies to collagen types I and III were recorded in blood serum upon development of clinical symptoms of dermatosis, along with low contents of these antibodies detectable in their skin exudates. Permanently high concentrations of autoantibodies to collagen types I and III in blood serum at exacerbation and remission of atopic dermatitis, and their low level in their skin exudate suggest emergence of circulating and precipitating immune complexes, thus allowing us to consider atopic dermatitis as an autoimmune process.

Dynamics of the level of interleukin 31 and 33, cortisol and filaggrin in the blood serum of pregnant women with atopic dermatitis during treatment with a combination of an emollient and a topical antipruritic agent

Orlova,

Kandrashkina,

Levashova

et al. 2024

Medicinskij sovet

Introduction. The widespread prevalence of atopic dermatitis and decreased quality of life make the problem urgent and require the search for new treatment methods. In atopic dermatitis, excessive expression of interleukins 31 and 33 in keratinocytes is noted. In patients with atopic dermatitis, there is an increase in serum cortisol and filaggrin levels. In recent years, active development of drugs has been carried out, aimed mainly at the immune component of the pathogenesis of atopic dermatitis. However, clinical trials of these drugs are not conducted on pregnant women. For the treatment of atopic dermatitis during pregnancy, we have proposed a regimen of external therapy, including a topical moisturizer and a topical antipruritic agent.Aim. To evaluate the levels of interleukins 31, 33, cortisol and filaggrin in blood serum before and after treatment of atopic dermatitis with a combination of emollient and topical antipruritic agent.Materials and methods. The examination included 76 pregnant women during an exacerbation of atopic dermatitis. The levels of interleukins 31, 33, cortisol and filaggrin were determined in the blood serum at the first visit and after 4 weeks of using the proposed combination of emollient and topical antipruritic agent using enzyme-linked immunosorbent assay (ELISA).Results. Against the background of the proposed therapy, a statistically significant decrease in the concentration of interleukins 31 was noted from 28.98 to 2.08 pg/ml, filaggrin from 9.72 to 5.26 ng/ml, cortisol from 629.80 to 472.25 pg/ml (p = 0,001). There were no statistically significant fluctuations in interleukins 33 levels (p = 0,124).Conclusion. The combination of external therapy with the use of an emollient and a topical antipruritic agent reduces the production of interleukins 31, cortisol and filaggrin in the blood serum, but the content of interleukins 33 does not change significantly.