mimmunМедицинская иммунологияMedical Immunology (Russia)1563-06252313-741XSPb RAACI10.15789/1563-0625-2009-6-531-540mimmun-362Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL ARTICLESИММУНОЛОГИЧЕСКИЕ ОСОБЕННОСТИ АЛЛЕРГИЧЕСКОЙ И НЕАЛЛЕРГИЧЕСКОЙ ФОРМЫ АТОПИЧЕСКОГО ДЕРМАТИТАIMMUNOLOGICAL FEATURES OF ALLERGIC AND NON-ALLERGIC FORMS OF ATOPIC DERMATITISШестаковаН. А.ShestakovaN. A.

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barsk@rambler.ruБорисовВ. И.BorisovV. I.barsk@rambler.ruПронкинаН. В.PronkinaN. V.barsk@rambler.ruТруфакинаЕ. В.TrufakinaE. V.barsk@rambler.ruШишковаИ. В.ShishkovaI. V.barsk@rambler.ruДеминаД. В.DeminaD. V.barsk@rambler.ruЛеоноваМ. И.LeonovaM. I.barsk@rambler.ruНепомнящихВ. М.NepomnyashikhV. M.barsk@rambler.ruКожевниковВ. С.KozhevnikovV. S.barsk@rambler.ruГУ НИИ клинической иммунологии СО РАМН, г. НовосибирскРоссия200920072014116531540Copyright © Шестакова Н.А., Борисов В.И., Пронкина Н.В., Труфакина Е.В., Шишкова И.В., Демина Д.В., Леонова М.И., Непомнящих В.М., Кожевников В.С., 20142014Шестакова Н.А., Борисов В.И., Пронкина Н.В., Труфакина Е.В., Шишкова И.В., Демина Д.В., Леонова М.И., Непомнящих В.М., Кожевников В.С.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.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.mimmun.ru/mimmun/article/view/362

Резюме. 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. Аллергическая форма АД характеризуется более тяжелым течением и участием в патогенезе реакций гиперчувствительности как немедленного типа, выражающихся в гиперпродукции IgE и снижении количества клеток, продуцирующих IFNγ, так и замедленного типа в виде снижения индексов миграции, ингибиции миграции и повышения ПЭФ. Важную роль в развитии этой формы играют CD8+ лимфоциты. 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. Таким образом, более выраженные нарушения в иммунной системе при аллергической форме заболевания, по-видимому, обусловливают ее более тяжелое течение.

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.

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The authors declare that there are no conflicts of interest present.