Abstract
In spite of similar clinical patterns, there are numerous differences in immunopathogenesis of intrinsiс and extrinsiс forms of atopic dermatitis. Patients with both forms have decreased levels of CD8+CD25+ lymphocytes, decreased telomere DNA length of CD4+T-cells, decreased migration inhibition index in delayedtype hypersensitivity, decreased levels of CD16+NK-cells, decreased Fc-dependent monocyte and granulocyte phagocytosis, increased hydrogen peroxide production by neutrophils, increased levels of CD19+B-cells, as well as high IgA and IgG immunoglobulin levels. Extrinsiс form of atopic dermatitis are characterized by more severe clinical course, and by involvement of both immediate hypersensitivity (hyperproduction of IgE and decreased T-cells with intracellular IFNγ production), like as delayed-type hypersensitivity (decreased migration index along with decreased migration inhibition index). CD8+ play a large role in extrinsiс form of atopic dermatitis that may be traced as decreased telomere length of CD8+T- cells, decreased levels of CD8+CD45RO+ cells, increased levels of CD8+CD45RA+ naive cells and increased levels of CD28+ costimulatory molecules on CD8+cells. Increased levels of CD4+CD25+bright cells and strongly alterations of innate immunity determined of decreased H2O2 production by monocytes are shown in extrinsiс form. Hence, the severity index of atopic dermatitis is more expressed in extrinsic form of bronchial asthma and it is, probably, determined by more exaggerated immunological alterations.
Highlights
Lymphocytes, decreased telomere DNA length of CD4+T-cells, decreased migration inhibition index in delayedtype hypersensitivity, decreased levels of CD16+NK-cells, decreased Fc-dependent monocyte and granulocyte phagocytosis, increased hydrogen peroxide production by neutrophils, increased levels of CD19+B-cells, as well as high IgA and IgG immunoglobulin levels
Increased levels of CD4+CD25+bright cells and strongly alterations of innate immunity determined of decreased H2O2 production by monocytes are shown in extrinsiс form
С аллергической формой заболевания обследован 31 пациент (74%), с неаллергической формой – 11 (26%) пациентов
Summary
ИММУНОЛОГИЧЕСКИЕ ОСОБЕННОСТИ АЛЛЕРГИЧЕСКОЙ И НЕАЛЛЕРГИЧЕСКОЙ ФОРМЫ АТОПИЧЕСКОГО ДЕРМАТИТА. Несмотря на схожую клиническую картину, аллергическая и неаллергическая формы атопического дерматита имеют различный иммунопатогенез. Общими изменениями при обеих формах является снижение числа CD8+CD25+ клеток, уменьшение числа теломерных повторов ДНК в субпопуляции CD4+Т-лимфоцитов, снижение индекса ингибиции миграции в реакции ГЗТ, уменьшение количества CD16+ клеток, подавление фагоцитоза гранулоцитами и моноцитами, повышение продукции перекиси водорода нейтрофилами, а также повышение числа CD19+В-лимфоцитов и увеличение продукции иммуноглобулинов IgA и IgG. Она отражается в уменьшении числа теломерных повторов ДНК в этой субпопуляции клеток, повышении числа CD8+CD45RA+ наивных клеток, увеличении экспрессии молекулы костимуляции CD28 на CD8+ лимфоцитах и уменьшении количества CD8+CD45RО+ клеток. При этой форме АД выявлено увеличение числа CD4+CD25+bright клеток и более глубокие нарушения факторов врожденного иммунитета, обусловленные снижением продукции перекиси водорода моноцитами. Shestakova N.A., Borisov V.I., Pronkina N.V., Trufakina E.V., Shishkova I.V., Demina D.V., Leonova M.I., Nepomnyashikh V.M., Kozhevnikov V.S
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