Features of CD-­­phenotype of peripheral blood lymphocytes in adult patients with atopic dermatitis during the exacerbation

O. Aleksandruk
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Abstract

Objective — to study the dynamics of peripheral blood lymphocytic populations in adult patients with atopic dermatitis (AD) with the onset of the disease in childhood, depending on the level of IgE secretion and the method of treatment. Materials and methods. We examined 67 adult patients with AD, which were divided into 4 groups depending on the level of total serum IgE and the basic treatment or treatment in combination with Glycine and Ketotifen. The severity of AD was determined by the SCORAD index. The content of peripheral blood lymphocytes according to the phenotype CD3+, CD4+, CD8+, CD19+, CD65+, HLADR+ and CD95+ was assessed during hospitalization of patients, at the end of the inpatient stage of treatment and after 1 month of outpatient follow-up. The obtained data were compared with the indices of the control group and between the groups of examined patients with AD in the dynamics of their treatment and observation. The results were processed statistically using the methods of parametric and nonparametric statistics. Results and discussion. The indices of the number of cells of peripheral lymphocytic populations of different CD pheno­type in the groups in the dynamics of observation were determined, their relationship with the severity of the course of AD was established, and differences were found depending on the pathogenetic variant of AD. Against the background of an exacerbation of AD, a significant increase in the number of cells in most of the defined populations was revealed, with its gradual decrease as the clinical manifestations of AD subsided. It was established that 1 month after achievement of clinical/subclinical remission, a part of the peripheral blood lymphocytic populations was characterized by higher values compared to the norm. In patients with an IgE-dependent AD variant, aggravation is accompanied by high levels of peripheral lymphocytes with CD3+, CD4+, CD8+, CD19+ and HLA-DR phenotypes, which more often than in the case of an IgE-independent variant of AD, remain above the norm after 1 month of outpatient monitoring. Introduction of glycine and ketotifen to the treatment complex for patients with AD is accompanied by a faster return of peripheral lymphocyte cells to normal values, which is more evident in patients with an IgE-dependent variant of AD. Conclusions. In adult AD patients, the dynamics of the number of peripheral lymphocyte population cells depends on the severity of the disease, its pathogenetic variant and the treatment received by the patient. Against the background of the use of glycine and ketotifen, the normalization of indicators of peripheral lymphocytic populations occurs significantly faster than with only standard basic therapy.
成人特应性皮炎加重期外周血淋巴细胞CD表型特征
目的-研究儿童发病的成人特应性皮炎(AD)患者外周血淋巴细胞群的动态变化,这取决于IgE分泌水平和治疗方法。材料和方法。我们检查了67例成年AD患者,根据血清总IgE水平和基础治疗或联合甘氨酸和酮替芬治疗分为4组。通过SCORAD指数判断AD的严重程度。在患者住院期间、住院治疗期结束时及门诊随访1个月后,根据外周血淋巴细胞表型CD3+、CD4+、CD8+、CD19+、CD65+、HLADR+、CD95+的含量进行评估。将所得数据与对照组及检查组AD患者的各项指标进行比较,观察其治疗动态。采用参数统计和非参数统计方法对结果进行统计处理。结果和讨论。动态观察各组不同CD表型外周淋巴细胞群细胞数指标,建立其与AD病程严重程度的关系,并根据AD的致病变异发现差异。在阿尔茨海默病病情加重的背景下,大多数定义人群的细胞数量显著增加,随着阿尔茨海默病临床表现的消退,细胞数量逐渐减少。研究发现,在达到临床/亚临床缓解1个月后,一部分外周血淋巴细胞的数值高于正常水平。在ige依赖性AD变异体患者中,病情加重伴随着高水平的外周血淋巴细胞(CD3+、CD4+、CD8+、CD19+和HLA-DR表型),这些细胞比ige依赖性AD变异体患者更常见,在门诊监测1个月后仍高于正常水平。在AD患者的治疗组合中引入甘氨酸和酮替芬,外周血淋巴细胞恢复正常的速度更快,这在ige依赖性AD患者中更为明显。结论。在成年AD患者中,外周血淋巴细胞群细胞数量的动态取决于疾病的严重程度、发病变异和患者接受的治疗。在使用甘氨酸和酮替芬的背景下,外周血淋巴细胞群指标的正常化明显快于仅使用标准基础治疗。
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