Neuroimmune changes in atopic dermatitis during pregnancy

Introduction. An increase in the number of patients with atopic dermatitis (AD) among pregnant women is recorded annually. However, the pathogenesis of AD during pregnancy is not fully understood. Exacerbations of AD during pregnancy require in-depth study, since at the moment there are no uniform recommendations for the treatment and management of such patients. The aim of the study. To study the role of cytokines (IL-31 and IL-33), neuropeptide - substance P (SP) and cortisol in the pathogenesis of AD during pregnancy before and after combined topical treatment. Material and methods. The study included 110patients, including 70 pregnant women with exacerbation of AD, 20 - non-pregnant women with exacerbation of AD, 20 - healthy pregnant women. A group of pregnant women with exacerbation of AD received combined therapy "emollient + topical antipruritic agent" for 30 days. Patients were assessed in dynamics: control of symptoms and severity of AD (SCORAD index), IL-31 and IL-33, SP, cortisol. Statistical processing was carried out using the Statistica 6.0 software package. Results. When assessing the severity of AD, no significant differences were found between the groups. In the group of pregnant women with exacerbation, higher levels of IL-31, IL-33, cortisol, and SP were noted. At the end of a 30-day course of treatment for exacerbation of AD during pregnancy with a combination of "emollient + topical antipruritic agent", a significant change in the SCORAD index, IL-31, IL-33 and cortisol was recorded. Conclusion. Exacerbation of AD during pregnancy is accompanied by more pronounced changes in neuro-immunological parameters (IL-31 and IL-33, SP), as well as in the level of the stress hormone cortisol than in the control groups. The combination "emollient + topical antipruritic agent" in the course of the study showed clinical efficacy in eliminating the skin inflammatory process and contributed to a decrease in neuroimmune parameters.