Influence of topical immunosuppressive therapy with tacrolimus on local immune response in skin of atopic dermatitis patients

Abstract

Background. To study tacrolimus 0,1% ointment influence on the skin local immune parameters in patients with moderate and severe atopic dermatitis (AD). Materials and methods. The study included 30 patients with moderate (n=20) and severe (n=10) AD. All patients underwent a topical continuous course of treatment with tacrolimus 0,1% ointment twice a day for 14 days. The clinical efficacy of tacrolimus 0,1% ointment was evaluated by the change of the following parameters: SCORAD index, Investigator Global Assessment (IGA) before and after the treatment. All patients underwent a study of local immune response before and after the treatment with the assessment of the expression of IL4, IL5, IL7, IL8, IL10, IL17A, IL23, IL23, IFNγ TGFB1, FOXP3 genes in irritated and treated skin lesions obtained by biopsy. Results. Positive clinical effect - reduction of infiltration, papular rash, dryness, intensity of itch, reflected in the significant decreasing of SCORAD index and IGA was found. The significant decreasing of TGFß (p=0,043308) and IL8 (p=0,038867) gene expression level was revealed, TGFβ and IL8 are the markers of chronic inflammation in atopic dermatitis. The decrease of these parameters during the topical tacrolimus treatment demonstrates local immune response changes in the skin, accompanied by improvement of AD symptoms. Conclusion. The study showed clinical efficacy as well as immunosuppressive activity of tacrolimus 0,1% ointment in patients with moderate and severe AD represented in decreasing of proinflammatory cytokines gene expression TGFβ and IL8 in skin lesions.