Изменения уровней цитокинов в крови больных экземой при комплексном лечении с упадацитинибом

Abstract

Objective: to study changes in immunological parameters in patients with true eczema during complex therapy with the use of upadacitinib. Materials and methods. The work was performed with the participation of 131 patients aged 18 to 70 years (average age 58.7±3.6 years) with a diagnosis of true eczema, who were on inpatient treatment. The patients were divided into 4 groups: the first group received basic drug therapy (BMT), the second - phototherapy (FT) and BMT (BMT+FT), the third - upadacitinib (UPA) and BMT (BMT+ UPA), the fourth - BMT+FT+UPA. The content of IL-1ß, IL-2, IL-6, IL-10, INF-γ, TNF-α in the blood serum of patients was determined by enzyme immunoassay before the start of treatment and 2 and 4 months after its start. Results. Before the start of treatment, the values of IL-1ß, IL-2, IL-6, IL-10, INF-γ, TNF-α in the blood serum of patients in comparison with healthy individuals were significantly increased (3.7-4.2 times) against the background of a decrease in the level of IL-10 (2 times). In patients of the first group, the cytokine level did not change significantly after 2 and 4 months from the start of treatment in comparison with the indicators before the start of treatment. In the second group, at all follow-up periods, the content of IL-10 significantly increased with a decrease in the levels of IL-1ß, IL-2 and IL-6. When using UPA in the third group, the content of IL-10 increased against the background of a marked decrease in all other cytokines studied. The greatest changes were noted in the fourth group during the complex treatment of UPA with FT and BMT: a significantly significant decrease in the levels of IL-1, IL-2, IL-6, INF-γ, TNF-α (by 53-67%, p<0.001) against the background of an increase in the content of IL-10 (by 69%, p<0.001). The preservation of the orientation and severity of the identified shifts after 4 months indicates their stability. Conclusion. In patients with true eczema, the use of upadacitinib as part of complex treatment in combination with basic drug therapy and phototherapy causes a pronounced and prolonged correction of the cytokine profile in the blood.