The aim of this study is to assess the level of Toll-like receptor level 2 (TLR-2) and thymic stromal lymphopoietin (TSLP) in the blood serum of children and to establish the relationship between these parameters and the severity of clinical manifestations of atopic dermatitis (AD) and the degree of microbial contamination of the gut. Research materials and methods: 68 children aged from 3 months to 6 years with an AD and 31 conditionally healthy children of the corresponding age were examined. Determination of the level of TLR-2 and TSLP in blood serum was carried out by enzyme immunoassay, and the composition of the intestinal microflora was assessed by MALDITOF mass spectrometry. Results: in children with AD, the median serum TLR-2 level was 2,88 [1,60; 4,91] ng/ml, TSLP – 6,01 [1,11; 9,5] pg/ml, which is statistically significantly higher than in conventionally healthy children (p<0,0001). The highest levels of TLR-2 and TSLP were found in erythematoussquamous with lichenification of the AD form – Me=6,10 [3,55; 10,62] ng/ml and Ме=12,73 [5,81; 22,70] pg/ml respectively. In children with moderate severity of AD, TLR-2 and TSLP values were statistically significantly higher (p<0,0001) compared to mild AD (Me=5,58 [2,29; 8,18] ng/ml versus 0,72 [0,22; 2,02] ng/ml and 7,48 [4,25; 12,95] pg/ml versus 0,64 [0,39; 0,75] pg/ml, respectively). The level of TLR-2 and TSLP increased with the degree of intestinal dysbiosis: Me=6,27 [4,14; 8,02] ng/ml at grade 3 dysbiosis versus 1,25 [0,46; 2,15] ng/ml at the 1st degree of dysbiosis and 16,28 [10,01; 22,6] pg/ml at the 3rd degree of dysbiosis versus 0,63 [1,33; 0,70] pg/ml at the 1st degree of dysbiosis, respectively (p<0,0001). Results: the obtained data on the activation of TLR-2 and TSLP in AD emphasize the systemic nature of the inflammatory response; however, the causal relationship between the level of TLR-2 and TSLP and AD activity requires further verification.
Impaired Toll-like receptor 2-mediated Th1 and Th17/22 cytokines secretion in human peripheral blood mononuclear cells from patients with atopic dermatitis
