Dynamics of antioxidant protection factors, cytokines in patients with chronic streptodermia, correction methods

Abstract

Certain relationships exist between different biological systems, i.e., lipid peroxidation/ antioxidant defense system; changing balance of Th1/Th2 immune response and cytokines; a decrease of interleukin 2 (IL-2) concentration; lower number of IL-2 receptors on CD25+ lymphocytes, impaired activity of protective antioxidant enzymes (superoxide dismutase and catalase); decreased general antioxidant status. These connections justify an approach to treatment of chronic streptoderma, using combined effects upon all components of the pathological process, by restoring the cytokine balance, eliminating oxidative stress and chronic inflammatory foci on the skin surface. The study group consisted of 50 male patients with chronic streptoderma, lasting for more than 2 years. Average age of the patients was 32.25±4.23 years; for comparison, the indexes of healthy volunteers were used on the basis of informed consent. The aim of the present study was to propose a method for treating chronic streptoderma using recombinant interleukin-2 and low-intensity laser irradiation justified by assessment of immune profile, pro-oxidant and antioxidant status. Standard therapy included local treatment of the affected surface with 1% aqueous solution of chlorhexidine bigluconate; 2% ointment with mupirocin as an active substance, applied to the area of rashes for 7 days; treatment of the skin surface with a low-intensity laser at the wavelength 40 ±10 nm (blue light) using a Mustang device (Moscow, registration certificate No. RZN 2014/1410 of 06.02.2014), according to technical conditions TU 9444-005720850602008. The irradiation exposure mode corresponded to recommendations of the device manufacturer. The radiation power was 80.0±5.0 mW, applied for 10 days, along with subcutaneous administration of recombinant IL-2 (Roncoleukin®) 500,000 IU, diluted with saline at the interval of 24 hours for 5 days. Positive clinical dynamics was noted during complex treatment which involved recombinant IL-2 and low-intensity laser exposure in the patients with chronic streptoderma, according to evaluation by a visual analogue scale, normalization of the cytokine balance (decreased contents of pro-inflammatory cytokines), and normalization of antioxidant status. Thus, the use of blue light exposure at the visible range (wavelength of 450.0±10.0 nm) and subcutaneous injections of recombinant IL-2 (Roncoleukin®, 500,000 IU) is a justified method in complex therapy of chronic streptoderma.