考虑免疫系统紊乱的特发性和微生物性湿疹患者的治疗

K. Lysenko
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引用次数: 0

摘要

本研究旨在分析具有免疫调节作用的药物对特发性湿疹(IE)和微生物性湿疹(ME)患者免疫系统各项指标变化的影响。材料和方法。本文对18 ~ 63岁慢性湿疹患者43例(特发性湿疹19例,微生物性湿疹24例)进行了分析。使用EASI评估湿疹严重程度。治疗前后的免疫学研究包括用流式细胞荧光法测定血液淋巴细胞亚群组成(CD3+、CD4+和CD8+),用适当的商业测试系统用免疫酶法测定白细胞介素(IL)- 4、- 10、- 17和干扰素(IFN) γ、乳铁蛋白(LF)和人β-防御素2 (hBD2)。采用吞噬指数(phagocytic index, PhI)、吞噬数(phagocytic number, PhN)和吞噬完成指数(phagocytosis completion index, PhCI)评价先天免疫系统。在传统治疗背景下,IE患者在接受胆骨化醇(维生素D3)、ME -氨基葡萄糖五肽(GMPP)治疗的基础上再接受胆骨化醇治疗。HMPP给药的持续时间和维生素D3的剂量取决于皮肤病的严重程度。结果和结论。改进的治疗方法有助于临床表现的改善,EASI的减少。IE和ME患者的临床缓解率分别为31.6%和29.2%,显著改善率分别为57.9%和54.1%,改善率分别为10.5%和16.7%。在免疫调节剂的作用下,除部分先天免疫参数(ME中的PhCI和LF)、IL水平(IE中的IL-17)外,大部分免疫指标均能恢复正常。
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TREATMENT OF PATIENTS WITH IDIOPATHIC AND MICROBIAL ECZEMA TAKING INTO ACCOUNT DISORDERS OF THE IMMUNE SYSTEM
The purpose of the study is to analyze the effect of drugs with immunomodulatory effect on the changed indicators of the immune system of patients with idiopathic eczema (IE) and microbial eczema (ME). Materials and methods. 43 patients with chronic eczema (19 with idiopathic and 24 with microbial) aged 18–63 were examined. Eczema severity was assessed using the EASI. The immunological study carried out before and after treatment included the determination of the subpopulation composition of blood lymphocytes (CD3+, CD4+ and CD8+) by flow cytofluorimetry, interleukins (IL)- 4, –10, –17 and interferon (IFN) γ, lactoferrin (LF) and human β-defensin 2 (hBD2) by immunoenzymatic method using appropriate commercial test systems. The innate immune system was assessed by the phagocytic index (PhI), phagocytic number (PhN) and phagocytosis completion index (PhCI). Patients with IE against the background of traditional therapy additionally received cholecalciferol (vitamin D3), ME – glucosaminylmuramylpentapeptide (GMPP), than cholecalciferol. The duration of HMPP administration and the dose of vitamin D3 depended on the severity of the dermatosis. Results and conclusions. The developed therapy contributed to regression of clinical manifestations, reduction of EASI. With IE and ME, clinical remission was achieved in 31.6% and 29.2%, significant improvement in 57.9% and 54.1%, and improvement in 10.5% and 16.7% of patients, respectively. Under the influence of immunomodulatory agents, it was possible to normalize most indicators of immunity, except for some parameters of innate immunity (PhCI and LF in ME), the level of IL (IL-17 in IE).
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CiteScore
1.20
自引率
0.00%
发文量
2950
审稿时长
12 weeks
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