TREATMENT OF PATIENTS WITH IDIOPATHIC AND MICROBIAL ECZEMA TAKING INTO ACCOUNT DISORDERS OF THE IMMUNE SYSTEM

About the author:	Lysenko K.I.	
Heading	CLINICAL OBSERVATIONS	
Type of article	Scientific Article	
Annotation	The purpose of the study is to analyze the effect of drugs with immunomodulatory 
effect on the changed indicators of the immune system of patients with idiopathic 
eczema (IE) and microbial eczema (ME).
Materials and methods. 43 patients with chronic eczema (19 with idiopathic and 24 
with microbial) aged 18–63 were examined.
Eczema severity was assessed using the EASI. The immunological study carried out 
before and after treatment included the determination of the subpopulation 
composition of blood lymphocytes (CD3+, CD4+ and CD8+) by flow cytofluorimetry,
 interleukins (IL)-4, –10, –17 and interferon (IFN) γ, lactoferrin (LF) and human 
β-defensin 2 (hBD2) by immunoenzymatic method using appropriate commercial test
 systems. The innate immune system was assessed by the phagocytic index (PhI), 
phagocytic number (PhN) and  phagocytosis completion index (PhCI). Patients with IE 
against the background of traditional therapy additionally received cholecalciferol 
(vitamin D3), ME – glucosaminylmuramylpentapeptide (GMPP), than cholecalciferol. 
The duration of HMPP administration and the dose of vitamin D 3 depended on the 
severity of the dermatosis.Results and conclusions. The developed therapy 
contributed to regression of clinical manifestations, reduction of EASI. With IE and
ME, clinical remission was achieved in 31.6% and 29.2%, significant improvement in 
57.9% and 54.1%, and improvement in 10.5% and 16.7% of patients, respectively.
Under the influence of immunomodulatory agents, it was possible to normalize most
 indicators of immunity, except for some parameters of innate immunity (PhCI and LF
 in ME), the level of IL (IL-17 in IE).	
Tags	treatment, idiopathic eczema, microbial eczema, cholecalciferol, 
glucosaminylmuramylpentapeptide, efficacy	
Bibliography	 1. Kutasevych Ya.F., Bilozorov O. P., Manhusheva V. Yu. Doslidzhennya 
polimorfizmu henu Tol-podibnykh retseptoriv TLR1-I602S u khvorykh na 
alerhodermatozy [Study of TLR1-I602S Toll-like receptor gene polymorphism in 
patients with allergic dermatoses]. Art of medicine. 2018; 3(7): 63–65.
2. Meskal΄ A.M., Kuts L. V. Doslidzhennya zalezhnosti tyazhkosti perebihu 
ekzemy ruk vid deyakykh pokaznykiv tsytokinovoho profilyu, vmistu vitaminu D 
ta henetychnoho polimorfizmu hlyukokortykoyidnoho retseptoru [Study of the 
dependence of the severity of the course of hand eczema on some indicators 
of the cytokine profile, vitamin D content and genetic polymorphism of the 
glucocorticoid receptor]. Ukrayinsúkyy zhurnal medytsyny, biolohiyi ta sportu. 
2020; 5(27): 164–169.
3. Svyrid S. G., Innab M. H. Complex therapy of patients with microbial 
eczema, taking into account the state of the nitric oxide system [Complex 
therapy of patients with microbial eczema, taking into account the state of the
 nitric oxide system]. Ukrainian journal of dermatology, venereology, 
cosmetology. 2023; 1(88): 4–8.
4. Khrushch V. I., Pavlenko O. V., Shukhtin V. V., Shukhtina I. M. Stan 
systemu homeostazu u khvorykh na infektsiynu ekzemu [The state of the 
homeostasis system in patients with infectious eczema]. Vrachebnoe delo. 
2019;4:8–15.
5. Stepan N. A., Denisenko O. I. Dinamika oksidantno-antioksidantnogo 
gomeostaza u bol’nykh ekzemoy pri ispol’zovanii raznykh metodov lecheni 
[Dynamics of oxidant-antioxidant homeostasis in patients with eczema using 
different methods of treatment]. Georgian Medical News. 2015; 5(242): 39–45.
6. Fomina L. V., Dashchuk A. M., Dobrzhans΄ka YE.I. Optymizatsiya 
likuvannya i prohnozuvannya perebihu hostroyi ta khronichnoyi ekzemy u 
khvorykh z vyyavamy dysbiozu kyshechnyka [Optimization of treatment and 
prognosis of acute and chronic eczema in patients with intestinal dysbiosis].
 Ukrayins΄kyy zhurnal dermatolohiyi, venerolohiyi, kosmetolohiyi. 2021; 2(81): 
10–15.
7. Shtybel΄ H. D. Klinichna otsinka efektyvnosti zastosuvannya 
hlyukozaminilmuramilpentapeptydu i pokhidnoho metylksantynatu v kompleksniy 
terapiyi khvorykh na mul΄tyrezystentnyy tuberkul΄oz [Clinical evaluation of the 
effectiveness of the use of glucosaminylmuramylpentapeptide and its derivative 
methylxanthinate in the complex therapy of patients with multidrug-resistant 
tuberculosis]. Tuberkul΄oz. Lehenevi khvoroby. VIL-infektsiya. 2017; 4(31): 59–64
8. Zhang Q.-Y., Yan Z.-B., Meng Y.-M., et al. Antimicrobial peptides:
 mechanism of action, activity and clinical potential. Mil. Med. Res. 2021; 8: 
48. http://doi.org/10.1186/s40779–021–00343–2
9. Athanassiou L., Mavragani C. P., Koutsilieris M. The Immunomodulatory 
properties of vitamin D. Mediterr. J. Rheumatol. 2022; 33(1): 7–13. 
http://doi.org/10.31138/mjr.33.1.7
10. Bolotna L. A., Narozhna M. V., Sarian О. I. New approaches to the 
treatment of patients with seborrheic dermatitis. Inter Collegas. 2018; 5(1): 
50–54.
11. Cherill R., Graeber M., Hanifin J. Eczema area and severity index (EASI): 
a new tool to evaluate atopic dermatitis. J. Eur. Acad. Dermatol. Venereol. 
1998; 11(2): 48–54.
12. Jaime J., Vargas-Bermúdez D.S., Yitbarek A., et al. Differential 
immunomodulatory effect of vitamin D (1,25 (OH)(2) D(3)) on the innate 
immune response in different types of cells infected in vitro with infectious 
bursal disease virus. Poult. Sci. 2020; 99(9): 4265–4277. 
http://doi.org/10.1016/j.psj.2020.06.006
13. Guryanova S. V., Khaitov R. M. Strategies for using muramyl peptides –
modulators of innate immunity of bacterial origin –  in medicine. Front. 
Immunol. 2021; 12(607178). http://doi.org/10.3389/fimmu.2021.607178.
14. Topal F. A., Zuberbier T., Makris M. P., Hofmann M. The role of IL-17, 
IL-23 and IL-31, IL-33 in allergic skin diseases. Curr. Opin. Allergy. Clin. 
Immunol. 2020; 20: 367–373. http://doi.org/10.1097/ACI.0000000000000658
15. Samanta S. Vitamin D and immunomodulation in the skin: a useful 
affirmative nexus. Explor. Immunol. 2021; 1: 90–111. 
http://doi.org/10.37349/ei.2021.00009
16. Sassi F., Tamone C., D’Amelio P. Vitamin D: nutrient, hormone, and 
immunomodulatory. Nutrients. 2018; 10: 1656. http://doi.org/10.3390/nu10111656
	
Publication of the article	«DERMATOLOGY AND VENEREOLOGY» №2(100), 2023 year, 23-26 pages,
	
DOI	10.33743/2308-1066-2023-2-23-26