Characteristics of clinical phenotypes of atopic dermatitis in pregnant women

Kandrashkina Yu.A., Orlova E.A.

1) Penza State University, Department of Obstetrics and Gynecology, Penza, Russia; 2) Penza Institute for Advanced Medical Training – Branch of the RMACPE, Department of Allergology and Immunology with a Course in Dermatovenereology and Cosmetology, Penza, Russia

Background: Genotypes, phenotypes, and endotypes of atopic dermatitis (AD) are currently being actively studied. It is known that AD endotypes depend on the presence of mutations in the filaggrin gene (FLG). However, determining the blood FLG level seems promising due to the availability of the enzyme-linked immunosorbent assay (ELISA) method and the relatively low cost of the study compared to identifying genetic mutations in FLG. Interleukin-33 (IL-33) is produced in large quantities in keratinocytes of patients with AD. IL-33 induces the expression of IL-31, thereby promoting itching and scratching, as well as aggravating the dysfunction of the skin barrier in AD. AD in pregnancy is a poorly studied issue, which explains the relevance of the study. Objective: Determination of the clinical AD phenotypes and the blood FLG, IL-31 and IL-33 protein levels during pregnancy. Materials and methods: The object of the study was 70 pregnant women with an exacerbation of AD. Clinical examination included a history of the disease and an assessment of the severity using the SCORAD index. The level of FLG, IL-31 and IL-33 was determined by ELISA in the blood serum. Statistical analysis was performed using IBM SPSS Statistics 23. Results and discussion: Based on the SCORAD index results and anamnesis data, four phenotypes of AD during pregnancy were identified. The FLG level was higher in the phenotype characterized by a severe course and ineffectiveness of topical therapy. The IL-33 level did not have statistically significant differences between the AD phenotypes, but the IL-31 level was statistically significantly different (p<0.05). Conclusion: The most common clinical phenotypes of AD during pregnancy are isolated AtD and AtD in combination with other allergopathology. The blood FLG level is highest in the AD phenotype with a severe course and resistance to topical therapy. The concentration of IL-31 is important for the diagnosis of AD phenotypes.

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About the Authors

Yulia A. Kandrashkina, Cand. Sci. (Med.), Associate Professor, Department of Obstetrics and Gynecology, Penza State University, Penza, Russia; novikova10l@mail.ru, ORCID: https://orcid.org/0000-0002-5537-5729 (corresponding author)
Ekaterina A. Orlova, Dr. Sci. (Med.), Associate Professor, Head of the Department of Obstetrics and Gynecology, Penza State University, Penza, Russia; Department of Allergology and Immunology with a Course in Dermatovenereology and Cosmetology, Penza Institute for Advanced Medical Training – Branch of RMACPE, Penza, Russia; lisaorl@yandex.ru, ORCID: https://orcid.org/0000-0002-3902-2018

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