Abstract
Objective: to improve the efficacy of integrated assessment of immunity different links in patients with psoriasis and concomitant Malassezia skin infection. Materials and Methods. The results of this study are based on the data of comprehensive examination and monitoring of 80 patients with psoriasis, 60 of whom are suffered from both diseases - psoriasis and Malassezia skin infection (the main group) and 20 patients are suffered only from psoriasis without fungal infection (the comparison group). Research methods – the function of neutrophils, lymphocytic reactions, the level of immunoglobulins A, M, G and cytokines IL-1β, IL-4, TNF-α. Results. 60 patients with psoriasis and concomitant Malassezia infection (the main group) in contrast to the patients without fungal infection (comparison group) showed immunodeficiency, which manifested by increase in the number of CD22+ and decrease in the ratio CD4+/CD8+. Depressed T-cell immunity was characterized by the dissociation of CD3+ and CD4+, CD8+ levels, and particularly CD16+. The increase in IgG was found in the main group of patients and in the control group. The increase in IgM was identified only in patients with psoriasis and concomitant Malassezia infection. These patients had normal levels of IgA, which indicated an adverse effect of concomitant fungal infection on humoral immunity. Patients with psoriasis and concomitant Malassezia infection compared with patients, who suffered only from psoriasis without mycosis, had inhibition of the phagocytes protective capabilities. The most significant increase in levels of IL-1β, IL-4, TNF-α in the serum of patients with psoriasis was determined in the presence of concomitant Malassezia infection, which directly correlated with PASI and DLQI indices (namely with clinical manifestations of psoriasis and its course). Conclusions. Taking into account the different links of immunity violations in patients with psoriasis and concomitant Malassezia infection, compared with patients with psoriasis without fungal infection, it can be concluded: the effect of fungal infection on the clinical manifestations and course of psoriasis was extremely negative, which required new approaches to complex therapy of psoriasis complicated forms, especially to the prevention of relapses.
Highlights
60 patients with psoriasis and concomitant Malassezia infection in contrast to the patients without fungal infection showed immunodeficiency, which manifested by increase in the number of CD22+ and decrease in the ratio CD4+/CD8+
Depressed T-cell immunity was characterized by the dissociation of CD3+ and CD4+, CD8+ levels, and CD16+
The increase in IgM was identified only in patients with psoriasis and concomitant Malassezia infection. These patients had normal levels of IgA, which indicated an adverse effect of concomitant fungal infection on humoral immunity
Summary
У 60 хворих на псоріаз із супутнім маласезіозом (основна група) на відміну від хворих без мікозу (група порівняння) виявлений імунодефіцит, що проявлявся збільшенням числа CD22+ і зниженням коефіцієнта CD4+/CD8+. Збільшення імуноглобуліну G виявлено як в основній групі хворих, так і у групі порівняння, IgM – тільки у хворих на псоріаз із супутнім маласезіозом за нормального рівня IgA, що свідчить про несприятливий вплив супутньої грибкової інфекції на гуморальну ланку імунітету. З урахуванням виявлених порушень різних ланок імунітету у хворих на псоріаз із супутнім маласезіозом, на відміну від хворих на псоріаз без мікозу, можна зробити висновок: вплив мікозу на клінічні прояви та перебіг псоріазу вкрай негативний, що потребує нових підходів до комплексної терапії ускладнених форм псоріазу, особливо профілактики рецидивів. Методы исследования – функция нейтрофилов, лимфоцитарные реакции, уровень иммуноглобулинов А, М, G, цитокинов IL-1β, IL-4, ФНП-α
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