Vestnik dermatologii i venerologiiVestnik dermatologii i venerologiiВестник дерматологии и венерологии0042-46092313-6294Rossijskoe Obschestvo Dermatovenerologov i Kosmetologov23810.25208/0042-4609-2016-92-3-46-55ORIGINAL STUDIESНАУЧНЫЕ ИССЛЕДОВАНИЯAssessing the itching intensity using visual analogue scales in atopic dermatitis patients against the background of a therapy with calcineurin inhibitorsОценка интенсивности зуда с помощью визуально-аналоговых шкал у больных атопическим дерматитом на фоне терапии ингибиторами кальциневринаChikinV. V.ЧикинВ. В.
Russian Federation
SmolyannikovaV. A.СмольянниковаВ. А.
Russian Federation
ProshutinskayaD. V.ПрошутинскаяД. В.
Russian Federation
diana.dika@mail.ruNefedovaM. A.НефедоваМ. А.
Russian Federation
State Research Center of Dermatovenereology and Cosmetology, Ministry of Healthcare of the Russian FederationФГБУ «ГНЦДК» Минздрава РоссииI. M. Sechenov First Moscow State Medical UniversityГБОУ ВПО Первый МГМУ им. И.М. Сеченова Минздрава России24062016923465524082017Copyright ©; 2016, Chikin V.V., Smolyannikova V.A., Proshutinskaya D.V., Nefedova M.A.Copyright ©; 2016, Чикин В.В., Смольянникова В.А., Прошутинская Д.В., Нефедова М.А.2016Chikin V.V., Smolyannikova V.A., Proshutinskaya D.V., Nefedova M.A.Чикин В.В., Смольянникова В.А., Прошутинская Д.В., Нефедова М.А.https://creativecommons.org/licenses/by/4.0https://vestnikdv.ru/jour/article/view/238

Goal. To assess the effect of topical treatment of atopic dermatitis patients with the 0.1% tacrolimus ointment on the itching intensity and skin expression level of growth factor proteins affecting the intensity of cutaneous innervation. Materials and methods. Fifteen patients suffering from atopic dermatitis underwent treatment with the 0.1% tacrolimus ointment. The SCORAD index was calculated to assess the severity of clinical manifestations. The itching intensity was assessed using a visual analogue scale. The skin expression of nerve growth factors, amphiregulin, semaphorin 3A and PGP9.5 protein (a nerve fiber marker) was assessed by the indirect immunofluorescence method. Results. An increased expression of the nerve growth factor and reduced semaphorin 3A expression levels were noted in the patients’ epidermis; there was an increase in the quantity, mean length and fluorescence intensity of PGP9.5+ nerve fibers. As a result of the treatment, the disease severity and itching intensity were reduced, the nerve growth factor expression level was reduced while semaphorin 3A expression level increased in the epidermis, and the mean length and fluorescence intensity of PGP9.5+ nerve fibers was also reduced. A positive correlation among the itching intensity and nerve growth factor expression level, quantity and mean length of PGP9.5+ nerve fibers in the epidermis was revealed, and negative correlation between the itching intensity and semaphorin 3A expression level in the epidermis was established. Conclusion. Topical treatment with the 0.1% Tacrolimus ointment reduces the itching intensity in atopic dermatitis patients, which is related to the therapy-mediated reduction in the epidermis innervation level, decreased expression of epidermal nerve growth factor and increased semaphorin 3A expression level.

Материал и методы. 15 больным атопическим дерматитом проводили наружное лечение 0,1% мазью такролимуса. Для оценки тяжести клинических проявлений рассчитывали индекс SCORAD. Интенсивность зуда определяли с использованием визуальной аналоговой шкалы. Экспрессию в коже фактора роста нервов, амфирегулина, семафорина-3А и маркера нервных волокон белка PGP9.5 исследовали методом непрямой иммунофлюоресценции. Результаты. В эпидермисе больных обнаружены повышенный уровень экспрессии фактора роста нервов и сниженный уровень экспрессии семафорина-3А, были увеличены количество, средняя длина и интенсивность свечения PGP9.5+-нервных волокон. После проведенной терапии уменьшились степень тяжести заболевания и интенсивность зуда, в эпидермисе снизился уровень экспрессии фактора роста нервов и повысился уровень экспрессии семафорина-3А, уменьшились средняя длина и интенсивность свечения PGP9.5+-нервных волокон. Выявлены положительные корреляционные связи между интенсивностью зуда и уровнем экспрессии фактора роста нервов, количеством и средней длиной PGP9.5+-нервных волокон в эпидермисе, а также отрицательная корреляционная связь между интенсивностью зуда и уровнем экспрессии семафорина-3А в эпидермисе. Заключение. Наружная терапия 0,1% мазью такролимуса способствует уменьшению интенсивности зуда у больных атопическим дерматитом, что связано со снижением под влиянием терапии выраженности иннервации эпидермиса, уменьшением уровня экспрессии в эпидермисе фактора роста нервов и повышением уровня экспрессии семафорина-3А.

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