Litus Oleksandr, Derkach Nadiya, Litus Viktor, Bisyuk Yuriy, Lytvynenko Bohdan
Shupyk National Medical Academy of Postgraduate Education, Kiev, Ukraine.
Open Access Maced J Med Sci. 2019 Apr 10;7(7):1053-1058. doi: 10.3889/oamjms.2019.242. eCollection 2019 Apr 15.
The C-159T polymorphism of the receptor gene can be associated with the development of atopic dermatitis. Probiotics can modulate chronic inflammation through activation of the CD14 receptor. So, the efficacy of probiotic therapy can be dependent on this genetic polymorphism.
The purpose of the study was to investigate the efficacy of adding probiotic (. ) to standard treatment (ointment of fluticasone propionate 0.005% and emollient) of atopic dermatitis in adults during 28 days, depending on the stratification of patients on CC or TT genotypes of the receptor gene.
The study included 37 adult patients with AD. There were identified 19 patients with exogenous (IgE-dependent) and 18 with endogenous (IgE-dependent) AD. To evaluate the efficacy of the probiotics all patients were divided into three groups for both exogenous and endogenous AD. The first group was selected from patients with CC genotype (C-159T) who received standard therapy (ointment of fluticasone propionate 0.005% - 2 times a day, emollients - 2 times a day) and probiotic (, LA-5 and , BB-12 - 1 capsule 2 times per day) The second group included patients with CC genotype, who received only standard therapy. The third group was presented by patients with TT genotype (C-159T) who received standard therapy and probiotic. The SCORAD and DLQI parameters were evaluated on Day 0, 14 and 28. The level of IL-4, IL-5, IL-10, TGF-β cytokines was determined on Day 0 and Day 28.
The results of our study found that the addition of probiotics (, LA-5 and , BB-12) to standard treatment (ointment of fluticasone propionate 0.005%, emollient) significantly increased the effectiveness of treatment of atopic dermatitis in adults with exogenous form and CC genotype (C-159T), confirmed by clinical (a significant decrease of SCORAD and DLQI indices) and immunological criteria (a significant decrease of IL-4 and an increase of TGF-β).
Simultaneous determination of the exogenous or endogenous form, identification of the C-159T genotypes, evaluation of the serum level of IL-4 and TGF-β can serve as an algorithm for the personalised treatment of patients with atopic dermatitis.
受体基因的C-159T多态性可能与特应性皮炎的发生有关。益生菌可通过激活CD14受体来调节慢性炎症。因此，益生菌治疗的疗效可能取决于这种基因多态性。
本研究旨在根据患者受体基因CC或TT基因型分层，调查在28天内将益生菌（. ）添加到成人特应性皮炎标准治疗（0.005%丙酸氟替卡松软膏和润肤剂）中的疗效。
该研究纳入了37例成年特应性皮炎患者。其中确定有19例为外源性（IgE依赖型）特应性皮炎患者和18例为内源性（IgE非依赖型）特应性皮炎患者。为评估益生菌的疗效，所有外源性和内源性特应性皮炎患者均被分为三组。第一组选自CC基因型（C-159T）患者，他们接受标准治疗（0.005%丙酸氟替卡松软膏，每天2次；润肤剂，每天2次）和益生菌（，LA-5和，BB-12，每天2次，每次1粒胶囊）。第二组包括仅接受标准治疗的CC基因型患者。第三组由接受标准治疗和益生菌的TT基因型（C-159T）患者组成。在第0、14和28天评估SCORAD和DLQI参数。在第0天和第28天测定IL-4、IL-5、IL-10、TGF-β细胞因子水平。
我们的研究结果发现，将益生菌（，LA-5和，BB-12）添加到标准治疗（0.005%丙酸氟替卡松软膏、润肤剂）中，显著提高了外源性形式且CC基因型（C-159T）的成年特应性皮炎患者的治疗效果，这在临床（SCORAD和DLQI指数显著降低）和免疫学标准（IL-4显著降低和TGF-β升高）上得到了证实。
同时确定外源性或内源性形式、鉴定C-159T基因型、评估血清IL-4和TGF-β水平可作为特应性皮炎患者个性化治疗的一种算法。
