rospedРоссийский педиатрический журнал имени М.Я. СтуденикинаM.Ya. Studenikin Russian Pediatric JournalФГАУ «НМИЦ здоровья детей» Минздрава России10.46563/1560-9561-2022-25-1-46-51uwkvhorosped-350Research ArticleОБЗОРЫREVIEWSЭффективность и безопасность иммунобиологической терапии атопического дерматита у детейThe efficacy and safety of immunobiological therapy of atopic dermatitis in childrenhttps://orcid.org/0000-0001-7640-0754ЛарьковаИнна АнатольевнаLarkovaInna A.

Канд. мед. наук, ст. науч. сотр. ФГБУН «ФИЦ центр питания, биотехнологии и безопасности пищи», ФГАУ «НМИЦ здоровья детей».

e-mail: inna_larkova@mail.ru

MD, PhD, senior researcher, Federal Research Center of Nutrition, Biotechnology and Food Safety, National Medical Research Center for Children’s Health, Moscow, Russian Federation.

e-mail: inna_larkova@mail.ru

inna_larkova@mail.ruhttps://orcid.org/0000-0002-3004-6646ГлуховаЕвгения АлександровнаGlukhovaEvgeniya A.

Врач-дерматовенеролог Федеральный исследовательский центр питания, биотехнологии и безопасности пищи, Детская городская клиническая больница им. З.А. Башляевой, УДКБ ФГАОУ ВО «Первый МГМУ им. И.М. Сеченова».

e-mail: evgeniya.shmeleva1994@yandex.ru

evgeniya.shmeleva1994@yandex.ruhttps://orcid.org/0000-0002-1149-7927РевякинаВера АфанасьевнаRevyakinaVera A.

Доктор мед. наук, проф., Федеральный исследовательский центр питания, биотехнологии и безопасности пищи, ФГАУ «НМИЦ здоровья детей».

e-mail: 5356797@mail.ru

5356797@mail.ruФГБУН «Федеральный исследовательский центр питания, биотехнологии и безопасности пищи»; ФГАУ «Национальный медицинский исследовательский центр здоровья детей»Federal Research Center of Nutrition, Biotechnology and Food Safety; National Medical Research Center for Children’s HealthФГБУН «Федеральный исследовательский центр питания, биотехнологии и безопасности пищи»; ГБУЗ «Детская городская клиническая больница имени З.А. Башляевой»; Университетская детская клиническая больница ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский Университет)Federal Research Center of Nutrition, Biotechnology and Food Safety; Z.A. Bashlyeva Children’s City Clinical Hospital; University Children’s Clinical Hospital of the I.M. Sechenov First Moscow State Medical University2022111020232514651Copyright © Ларькова И.А., Глухова Е.А., Ревякина В.А., 20232023Ларькова И.А., Глухова Е.А., Ревякина В.А.Larkova I.A., Glukhova E.A., Revyakina V.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.rosped.ru/jour/article/view/350

В обзоре показано, что атопический дерматит (АтД) является хроническим воспалительным заболеванием кожи, возникающим в раннем возрасте у детей с наследственной предрасположенностью. В основе патогенеза АтД у большинства пациентов лежит воспалительная реакция 2-го типа, заключающаяся в сложном взаимодействии Т-хелперов 2-го типа (Th2), врождённых лимфоидных клеток, гранулоцитов (включая эозинофилы, тучные клетки и базофилы), цитокинов (интерлейкина (ИЛ)-4, -5, -13 и др.) и иммуноглобулина E. ИЛ-4 и ИЛ-13 заслуживают особого внимания, поскольку влияют сразу на несколько звеньев патогенеза АтД. Оба цитокина взаимодействуют с α-цепью рецептора ИЛ-4. Именно данная молекула является мишенью для дупилумаба — первого генно-инженерного биологически активного препарата, показавшего высокую эффективность в лечении АтД у детей 6–18 лет. Имеющиеся данные свидетельствуют о наличии у препарата как неспецифических (болезненность в месте инъекции, аллергическая реакция), так и специфических (конъюнктивиты, вторичные герпетические инфекции, эозинофилия) побочных реакций, что следует учитывать при назначении иммунобиологической терапии АтД.

Заключение

Заключение. Иммунобиологическая терапия препаратом дупилумаб детей разного возраста со среднетяжёлым и тяжёлым течением АтД обеспечивает высокую клиническую эффективность и хорошую безопасность.

Участие авторов

Участие авторов:Ларькова И.А. — концепция статьи и написание текста;Глухова Е.А. — сбор и подготовка материала;Ревякина В.А. — концепция статьи, редактирование;Ларькова И.А., Глухова Е.А., Ревякина В.А. — утверждение окончательного варианта статьи, ответственность за целостность всех ее частей.

Финансирование

Финансирование. Исследование не имело финансовой поддержки.

Конфликт интересов

Конфликт интересов. Авторы заявляют об отсутствии конфликта интересов.

Поступила 24

Поступила 24.12.2021Принята в печать 17.02.2022Опубликована 15.03.2022

The review shows аtopic dermatitis (AD) as a chronic inflammatory skin disease that develops in early childhood in infants with a hereditary predisposition. The inflammatory response type 2, including a complex interaction of type 2 T-helpers (Th2), congenital lymphoid cells, granulocytes (including eosinophils, mast cells and basophils), cytokines (IL-4, IL-5, IL-13 etc.) and immunoglobulin E (IgE) underlie at the base of the AD pathogenesis. IL-4 and IL-13 deserve special attention since they affect several links of pathogenesis at once. Both cytokines interact with receptors. Their critical subunit is the alpha chain of the IL-4 receptor. This molecule is the target for dupilumab, the first genetically engineered biologically active drug that demonstrated the high efficacy in the treatment of AD in 6 to 18-year children patients. At the same time, the data available in the literature indicates the drug to have both nonspecific (soreness at the injection site, allergic response) and specific (conjunctivitis, secondary herpetic infections, eosinophilia) adverse effects, which should be taken into account by practitioners when prescribing immunobiological therapy.

Conclusion

Conclusion. In randomised, double-blind, placebo-controlled trials in children of different ages with the moderate to severe course of AD, immunobiological therapy with dupilumab has demonstrated high clinical efficacy in the form of a rapid remission of the disease and exemplary safety.

Contribution

Contribution:Larkova I.A. — article concept and text writing;Glukhova E.A. — collection and processing of material;Revyakina V.A. — article concept, editing.Аll co-authors — аpproval of the final version of the article, responsibility for the integrity of all parts of the article.

Acknowledgement

Acknowledgement. The study had no sponsorship.

Conflict of interest

Conflict of interest. The authors declare no conflict of interest.

Received

Received: December 24, 2021Accepted: February 17, 2022Published: March 15, 2022

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The authors declare that there are no conflicts of interest present.