O. Syzon, M. Dashko

Danylo Halytsky Lviv National Medical University

Introduction. Acne is a chronic recurrent dermatosis represented with a complex of multifactorial subjective and objective symptoms pathogenetically united in a pathologic process, which is accompanied by the functional abnormalities of sebaceous glands and propagation of Propionibacterium acne, psycho-emotional disorders, and torpidity of treatment.

Today, it has been established that acne pathogenesis is a complex, multifactorial process, where changes in the immune response of an organism plays an important role. Hence, the establishment of the nature of changes in individual indicators of systemic immunity in acne patients as well as their dependence on the clinical variations of common acne forms is a topical task of modern dermatology since this will allow to clarify their basic pathogenetic mechanisms and develop differentiated treatment methods.

Study objective is to define the specific nature of changes in main indicators in acne patients systemic immunity and their dependence on clinical forms of dermatosis course.

Materials and methods. So far we have examined 134 patients (83 (61.94 %) females and 51 (38.06 %) males aged from 18 to 35), who were admitted to be treated in/out-patiently at the 1st and 2nd department of Municipal Institution of Lviv Regional Council “Lviv Regional Dermatovenerologic Dispensary”. According to the clinical classification of acne (Plewing G., Kligman A. M., 1994) in 27 (20.15 %) patients we have detected a comedonal form of acne, in 41 (30.60 %) – papular acne, in 11 (8.21 %) – papular-pustular acne, in 30 (22.39 %) – pustular acne, in 10 (7.46 %) – conglobate acne, and in 15 (11.19 %) – post-acne. In 42 (31.34 %) patients we have established mild acne, in 67 (50.00 %) – moderate acne, in 10 (7.46 %) – severe acne, and in 15 (11.19 %) – post-acne. Only 39 (29.10 %) patients were suffering from acne for one year, whilst 95 (70.90 %) – from one to three years.

To assess several systemic immune indicators in acne patients in general and, depending on the clinical variations of common acne forms, we have detected the total and relative quantity of T-lymphocytes (CD3+), T-helper (CD3+CD4+) and T-suppressor lymphocytes (CD3+CD8+), the number of B-lymphocytes (CD19+) and the content of serum immunoglobulins (Ig) pertaining to M, G, A classes by indirect immunofluorescence method using monoclonal antibodies to cell surface antigens. The control group consisted of 34 practically healthy individuals (donors) of the same sex and age.

Statistical analysis of the study results was carried out subjected to the methods of statistical analysis using Statistica 7.0 software; the relevant mean difference of p < 0.05 was considered.

Study results and discussion. Consequently, in the majority of examined acne patients different degree of change in certain indicators of systemic immunity has been established, i.e. a probable decrease in the relative and absolute number of general lymphocytes, T-lymphocytes and their sub-populations with the simultaneous increase in the number of B-lymphocytes and the content of IgM and IgG, which in general testifies to the formation of a secondary immunodeficiency state per the T-segment with the activation of immune humoral segment in response to the onset of skin inflammation. The most significant changes in the studied indicators of systemic immunity, associated with the depletion of T-cellular immunity segment, have been established in patients with papular-pustular and pustular acne forms, and, especially, in those with conglobate acne, which substantiates the differentiated administration of immunocorrective medications for such patients as a part of the integrated treatment.

Conclusions. Changes in the indicators of systemic immunity in acne patients have been established, which in­dicates the formation of a secondary immunodeficiency state per the T-cell segment with an adequate response of humoral immunity. The existence of relationship between the nature of changes in the indicators of systemic im­munity and clinical variations of common blemishes disease forms has been identified, which justifies the differen­tiated administration of immunocorrective medications for such patients as a part of their integrated treatment.

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