Лікування хворих на істинну та мікробну екзему з урахуванням порушень імунної системи

Abstract

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).