Introduction: Scientific studies devoted to the particularities of the immune response in various evolutionary forms of atopic dermatitis (AD) in patients of different age denote controversial character. Humoral immune factors and cytokines play an obvious role in AD evolution. The testing of humoral indexes in AD patients would make it possible to identify spe-cific particular lesional forms that would facilitate the treatment with immunotropic remedies.
Material and Methods: The study included 110 AD patients and 110 apparently healthy children who were assigned to two age groups (group I – up to two years and group II – 2 to 18 years). Immunological testing of blood serum included assessment of IgG, IgG, IgA, IgE – total) immunoglobulin concentration as well as cytokines (IL-2, IL-4, TNFα) depending on the severity of the disease (SCORAD) of lesional forms and association with IgE.
Results: The analysis of the obtained materials demonstrated a decrease of the IgA level with the increase of the total IgE concentration and the cytokines studied in the blood serum of the AD patients compared to the respective control groups. These changes were more pronounced in group II patients in severe and moderate forms. There was a more signifi-cant increase in TNFα cytokines and less expressed IL-2 in exudative form in both groups. There was a significant increase in IL-4 in the lichenified form of group II. Evolutionary growth trend of TNFα was recorded in exudative form in children of group II and decreased in subjects up to 2 years of age. There was a decrease in IgA concentration in both groups, more significant in the intrinsic form. We also established a positive correlations between IgE total and IL-4 in eritemato-scuamous and eritemato-scuamous lichenified forms. Total IgE dynamics was net ascending in extrinsic form.
Conclusions: A biphasic evolution of the immune response in patients with AD has been established, which in incipient (under 2 years), erythemato-squamous and exudative, extrinsic forms are accompanied by increases in total IgE and IL-4. After 2 years of age, patients with lichenified, intrinsic forms, demonstrated an immune response with increased TNFα and IL-2.