Komparativna analiza imunskog odgovora i oksidativnog stresa kod pacijenata sa psorijazom i atopijskim dermatitisom

Abstract

Aim: Psoriasis (PsO) and atopic dermatitis (AD) are chronic inflammatory, immune-mediated diseases characterized by activation of Th22 T-cells and the Th1 pathway with increased production of IL- 22 and IFN-γ. Oxidative stress plays a significant role in the pathogenesis of PsO and AD. Therefore, the aim of our research was to perform a comparative analysis of the immune response of cytokines, protein and non-protein mediators of inflammation and oxidative stress for both diseases. In line with this, we investigated the possibility of detecting a sufficiently sensitive and specific biomarker that could indicate the presence of one of the two pathophysiological entities that are the subject of this research, as well as the detection of a biomarker or a group of biomarkers (models) that would enable the prediction of the presence of comorbidities in certain patients, and the prediction of high values of the severity of the clinical picture in psoriasis, as well as the impact on the quality of life of patients affected by psoriasis and atopic dermatitis. Methodology: Eighty patients underwent anthropometric measurements, evaluation of the severity of the clinical picture, as well as blood sampling for biochemical and hematological analyzes, on the basis of which cellular parameters and indices of immune response activation, acute phase proteins, cytokines IL-22 and IFN-γ, markers of oxidative stress, as well as markers of systemic inflammation were determined. Results: Catalase enzyme was detected as a marker for distinguishing between psoriasis and atopic dermatitis. The antioxidant score showed diagnostic accuracy in predicting the risk values of the severity of the clinical picture of psoriasis and the impact on the quality of life. Certain groups of biomarkers were detected as predictors of the type of disease, predictors of the presence of comorbidities, as well as predictors of high values of the quality of life index of the examined patients.Conclusion: Our results indicate that catalase enzyme has good diagnostic accuracy in separating patients with AD from patients with PsO. Also, biomarkers were detected as predictors of the type of disease, comorbidity, and high values of the quality of life index of patients in both diseases. No statistically significant difference was found in the concentration of the inflammation marker, CRP, new inflammatory indices derived from hematological parameters (NLR and Tr/Ly ratio), and immune markers, IFN-γ and IL-22. Further longitudinal studies involving a greater number of subjects are needed to confirm our results and determine the most reliable diagnostic and prognostic biomarkers for PsO and AD.