The Investigation of the Dependence between Hand Eczema Severity and Some Cytokine Profile Parameters, Vitamin D Level, and Glucocorticoid Receptor Gene Polymorphism

Hand eczema is one of the most important chronic diseases in the dermatology. There are a lot of researches presenting the role of individual cytokines in eczema development. However, currently, the complex analysis of cytokines, hormones, and gene polymorphisms' impact on the development of hand eczema and its severity is absent. Therefore, the purpose of our work was to study the possible association between hand eczema severity and rs41423247 SNP, the blood level of IL-17A, IL-2, and 25(OH)2D3. Material and methods. The venous blood of 143 patients with hand eczema aged (42.2±11.1) years was used in the study. During the patients examination the data on age, sex, BMI kg/m2, BMI ≥25 kg/m2 (%), smoking, IgE (iu/ml), IL-17A (pg/ml), IL-2 (pg/ml), and 25(OH)2D3 (ng/ml) were obtained. The HECSI index (Hand Eczema Severity Index) was also assessed in each subject. According to HECSI value all patients were divided into three subgroups: mild, moderate and severe eczema. BclI SNP (rs41423247) of the glucocorticoid receptor gene (NR3C1) was determined using PCR-RFLP method. The statistical analysis was performed using the program SPSS 22.0. Results and discussion. The obtained results showed that the number of overweight people was higher among patients with severe hand eczema compared to patients with mild to moderate disease (P = 0.052). It was also revealed that the concentration of IL-17A in the blood serum of patients with severe hand eczema was significantly higher than in patients with mild to moderate disease (P = 0.037). The distribution of BclI polymorphism genotypes (NR3C1 gene), the blood level of IgE, IL-2, and 25(OH)2D3 were statistically equal between patients with different degrees of hand eczema severity (P > 0.05). Conclusion. Thus, the IL-17A serum concentration and body mass index are related to hand eczema severity. However, the link between NR3C1 gene BclI polymorphism, the blood level of IgE, IL-2, 25(OH)2D3, and hand eczema severity was not detected

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Topical Tacrolimus in Patients with Hands Eczema Taking into Account the Severity of Dermatoses, Some Cytokine Profile Indicators, Content of Vitamin D and Genetic Polymorphism of the Glucocorticoid Receptor Gene

Ukraïnsʹkij žurnal medicini bìologìï ta sportu ◽

10.26693/jmbs06.04.099 ◽

2021 ◽

Vol 6 (4) ◽

pp. 99-104

Author(s):

A. M. Methkal ◽

Keyword(s):

Body Mass Index ◽

Glucocorticoid Receptor ◽

Receptor Gene ◽

Interleukin 2 ◽

Severity Index ◽

Hand Eczema ◽

Glucocorticoid Treatment ◽

Topical Tacrolimus ◽

Interleukin 17A ◽

Glucocorticoid Receptor Gene

The purpose of the study was to evaluate and compare the therapeutic capacity of 0.1% topical tacrolimus ointment in patients with hand eczema who were resistant to glucocorticoid treatment, taking into account the severity of dermatosis, interleukin-17A and interleukin-2 concentrations, vitamin D and genetic polymorphism of the glucocorticoid receptor gene. Materials and methods. The venous blood of 143 patients with hand eczema aged (42.2±11.1) years was used in the study. During the patients examination the data on age, sex, body mass index (kg/m2), body mass index ≥25 kg/m2 (%), smoking, IgE (iu/ml), interleukin-17A (pg/ml), interleukin-2 (pg/ml), and 1,25(OH)2D3 (ng/ml) were obtained. The Hand Eczema Severity Index was also assessed in each subject. According to the Hand Eczema Severity Index value all patients were divided into three subgroups: mild, moderate and severe eczema. Patients with mild and moderate eczema were appointed topical glucocorticoid 0.1% mometasone furoate cream twice a day for 2 weeks. Patients with severe hand eczema was appointed additionally systemic corticosteroid – a solution of dexamethasone by intramuscular injection at the dose of 8 mg/day No. 3, then another 4 mg/day for other 2 days. After 2 weeks, individuals who did not respond well to glucocorticoid treatment were prescribed tacrolimus 0.1% ointment twice a day for 2 weeks. BclI SNP (rs41423247) of the glucocorticoid receptor gene (NR3C1) was determined using the polymerase chain reaction-restriction fragment length polymorphism method (Fleury et al. 2003). The statistical analysis was performed using the program SPSS 22.0. The quantitative variables were tested for normal distribution by the Shapiro-Wilk method. The comparisons of the means between the two subgroups were performed using Student's t-test for independent samples. The comparison of the frequencies distribution in the subgroups was performed using the Pearson test. The P value <0.05 was considered as significant. Results and discussion. Findings in a previous study showed that not all people with hand eczema responded well to treatment with topical 0.1% mometasone furoate cream and systemic glucocorticoid. After 2 weeks of topical tacrolimus, of 51 patients who were not responsive to glucocorticoid treatment, 39 responded well to therapy. The concentration of interleukin-17A in the blood serum of such people was significantly lower than in people who did not respond to treatment. Conclusion. We did not find any differences in the content of immunoglobulin E, interleukin-2, 1α,25(OH)2D3 and BclI polymorphism of the glucocorticoid receptor gene in the subjects under study

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RELATION BETWEEN GLUCOCORTICOID RESISTANCE AND GLUCOCORTICOID RECEPTOR GENE BclI-POLYMORPHISM AND SOME CYTOKINE PROFILE PARAMETERS IN PATIENTS WITH HAND ECZEMA

Актуальні проблеми сучасної медицини Вісник Української медичної стоматологічної академії ◽

10.31718/2077-1096.20.3.133 ◽

2020 ◽

Vol 20 (3) ◽

pp. 133-137

Author(s):

A. M. Methkal

Keyword(s):

Body Mass Index ◽

Glucocorticoid Receptor ◽

Body Mass ◽

Receptor Gene ◽

Interleukin 2 ◽

Hand Eczema ◽

Glucocorticoid Resistance ◽

Interleukin 17 ◽

Interleukin 17A ◽

Glucocorticoid Receptor Gene

Though glucocorticoids are widely used in dermatological practice, some patients with hand eczema may have resistance to glucocorticoids, even when they are taken in heavy doses. Glucocorticoids mediate their actions through glucocorticoid receptors. Polymorphism of the glucocorticoid receptor gene (NR3C1) can inhibit the cellular response to glucocorticoids and lead to reduced response to the therapy. Some cytokines can affect the production of various glucocorticoid receptor subunits, modulating the cell response to glucocorticoids. However, there is still need in detailed study of pathogenetic mechanisms and the detection of highly specific predictors of glucocorticoid resistance. The aim of this work was to investigate the possible relation between glucocorticoid resistance in patients with hand eczema, rs41423247 SNP, and blood concentration of interleukin-17A and interleukin-2. The venous blood of 143 patients with hand eczema (42% of women and 58% of men) mean age 42.2 ± 11.1 years was taken for the study. During the patients examination the data on age, sex, body mass index (kg/m2), body mass index ≥ 25 (kg/m2(%)), the habit of smoking, concemtration of immunoglobulin E (iu/ml), interleukin-17A (pg/ml) and interleukin-2 (pg/ml) were obtained. The еczema аrea and severity index was assessed in each subject before the therapy and in two weeks since the therapy started. According to index value, all the patients were divided into three subgroups: mild eczema, moderate eczema, and severe eczema. Patients with mild and moderate eczema were prescribed to apply topical glucocorticoid 0.1% mometasone furoate cream twice a day for 2 weeks. The patients with severe hand eczema were prescribed to receive additional systemic corticosteroid, a solution of dexamethasone by intramuscular injection in a dose of 8 mg / day, then 4 mg / day for another 2 days. BclI SNP (rs41423247) of the glucocorticoid receptor gene (NR3C1) was determined using PCR-RFLP method. The quantitative variables were tested for normal distribution by the Shapiro-Wilk test. The comparisons of the means between the two subgroups were performed by Student's t-test for independent samples. The comparison of the frequencies distribution in the subgroups was calculated by using the Pearson test. The P value < 0.05 was considered as significant. Thus, the obtained results revealed that insensitivity to glucocorticoids in patients with hand eczema is related to NR3C1 gene Bcl-1 polymorphism, eczema severity and plasma level of interleukin-17, interleukin-2. The plasma content of interleukin-17 and interleukin-2 in patients with glucocorticoid resistance was significantly higher compared to hormone-sensitive subjects. There were significantly more people with the C/G- and G/G genotypes in the group that did not have a clinical response to therapy.

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