Eosinophilic proteins and neuropeptides, cytokine profile in children with atopic dermatitis and chronic gastroduodenitis

Introduction. Chronic upper gastrointestinal diseases in children with atopic dermatitis (AD) have endoscopic and morphological features. Objective: to examine the relationship between cytokine profiles (IL-4, IL-5, and IL-13), neuropeptide levels (neuropeptide Y (NPY)), and eosinophilic inflammation markers (eosinophil cationic protein (ECP) and eosinophil neurotoxin (EDN)) and the morphological appearance of the esophageal mucosa in children with AD combined with chronic gastritis. Materials and Methods. The study included 90 children with HP-induced chronic gastritis (HP+CG). Group 1 included 60 children with HP+CG combined with AD, and Group 2 included 30 children with HP+CG without AD. All children underwent esophagogastroduodenoscopy (EGD) and morphological examination of the gastric mucosa (MM) and three sections of the esophagus (upper, middle, and lower). Serum levels of IL-4, IL-5, IL-13, eosinophil cationic protein (ECP), eosinophil neurotoxin (EDN), neuropeptide Y (NPY), and substance P (SP) were measured. Statistical analysis was performed using IBM SPSS Statictics26. Results. Esophageal morphological assessment revealed that the group with AD and HP+CG significantly more frequently had an increased number of papillae and elongation of the lamina propria papillae throughout the esophageal MM. Patients with AD and HP+CG significantly more frequently had lymphocytic, mast cell, and eosinophilic infiltration of the esophageal MM, which was more pronounced in the lower sections. In Group 1, IL-5 and IL-13 levels were significantly lower than in the comparison group. No differences in the levels of eosinophil cationic protein, eosinophil neurotoxin, neuropeptide Y, or substance P were found between the study groups. Analysis of the relationship between cytokine levels, eosinophilic and neuropeptide inflammation markers, and the cellular composition of the esophageal mucosal infiltrate in the compared groups revealed a positive relationship between the deep mucosal eosinophil count and neuropeptide Y levels (r - 0.516, p < 0.01) and the superficial mucosal eosinophil count and IL-13 (r 0.411, p < 0.05) and neuropeptide Y (r 0.459, p < 0.05). Conclusion. In patients with AD and HP + CG, the morphological picture is characterized by the presence of low-intensity inflammation. Correlation relationships between the morphological picture and immunological parameters in patients with AD in combination with chronic gastritis suggest a significant role of allergic and neuropeptide inflammation in the genesis of the development of pathology of the upper gastrointestinal tract

Eosinophilic proteins, neuropeptides, cytokine profile in children with atopic dermatitis

1. Atopic Dermatitis: Clinical Guidelines/ Ministry of Health of the Russian Federation, Russian Association of Allergists and Clinical Immunologists, Union of Pediatricians of Russia, All-Russian Public Organization “Russian Society of Dermatovenereologists and Cosmetologists”, Interregional Public Organization “National Alliance of Dermatovenereologists and Cosmetologists”. 2024, 100 P. (In Russ.) Available at: URL: https://cr.minzdrav.gov.ru/view-cr/265_3 (Accessed: 01.05.2025.)@@ Атопический дерматит: клинические рекомендации/Министерство Здравоохранения Российской Федерации, Российская ассоциация аллергологов и клинических иммунологов, Союз педиатров России, Общероссийская общественная организация «Российское общество дерматовенерологов и косметологов», Межрегиональная общественная организация «Национальный альянс дерматовенерологов и косметологов».2024: 100. Текст электронный/ Рубрикатор клинических рекомендаций МЗ РФ: [сайт]. URL: https://cr.minzdrav.gov.ru/view-cr/265_3.

2. McGirt L.Y., Beck L.A. Innate immune defects in atopic dermatitis. J Allergy Clin Immunol. 2006; 118 (1): 202-208. doi: 10.1016/j.jaci.2006.04.033.

3. Bao L., Zhang H., Chan L.S. The involvement of the JAK-STAT signaling pathway in chronic inflammatory skin disease atopic dermatitis. JAKSTAT. 2013; 2(3): e24137. doi: 10.4161/jkst.24137.

4. Gandhi N.A., Pirozzi G., Graham N.M.Commonality of the IL-4/IL-13 pathway in atopic diseases. Expert Rev Clin Immunol. 2017; 13 (5): 425-437. doi: 10.1080/1744666X.2017.1298443.

5. Goryunova M.M. [Clinical and Morphological Features of Chronic Gastroduodenitis in Children with Atopic Dermatitis]. Diss… med science. St. Petersburg, 2011. (In Russ.)@@ Горюнова М.М. Клинико-морфологичесие особенности хронического гастродуоденита у детей с атопическим дерматитом, автореферат к. м. н., Санкт-Петербург.2011.

6. Belan E.B., Tibirkova E.V. Eosinophilic Esophagitis: What Do We Know and What Can We Do? RMJ. Medical Review. 2024; 8(3): 150-154. (In Russ.) doi: 10.32364/2587-6821-2024-8-3-5.@@ Белан Э.Б., Тибирькова Е.В. Эозинофильный эзофагит: что мы знаем и что мы можем? РМЖ. Медицинское обозрение. 2024; 8(3):150-154. doi: 10.32364/2587-6821-2024-8-3-5.

7. Panova I.V., Eliseeva N.D., Letifov G.M. et al. Eosinophilic gastritis in the structure of eosinophilic gastrointestinal diseases in children. A difficult-to-diagnose condition. Modern Problems of Science and Education. 2024; (5): 22. (in Russ.) doi: 10.17513/spno.33684. - EDN YFRVEW.@@ Панова И.В., Елисеева Н.Д., Летифов Г.М. и др. Эозинофильный гастрит в структуре эозинофильных гастроинтестинальных заболеваний у детей. Труднодиагностируемое состояние. Современные проблемы науки и образования. 2024;(5):22. doi: 10.17513/spno.33684. - EDN YFRVEW.

8. Oh M.H., Oh S.Y., Yu J., Myers A.C., Leonard W.J. et al. IL-13 induces skin fibrosis in atopic dermatitis by thymic stromal lymphopoietin. J Immunol. 2011; 186: 7232-7242. doi: 10.4049/jimmunol.110050436.20.

9. Tamrazova O.B., Stadnikova A.S., Novik G.A. et al. Therapeutic options for the treatment and control of severe recurrent atopic dermatitis. Medical Council. 2024; 18 (2): 8-16. (in Russ.) doi: 10.21518/ms2024-056.@@ Тамразова О.Б., Стадникова А.С., Новик Г.А. и др. Терапевтические возможности лечения и контроля рецидивирующего течения атопического дерматита тяжелой степени тяжести. Медицинский совет. 2024; 18(2): 8-16. doi: 10.21518/ms2024-056.

10. Kim H.S., Kim J.H., Seo Y.M. et al. Eosinophil-derived neurotoxin as a biomarker for disease severity and relapse in recalcitrant atopic dermatitis. Ann Allergy Asthma Immunol. 2017; 119(5): 441-445. doi: 10.1016/j.anai.2017.06.022.

11. Varlamov E.E., Pampura A.N., Sukhorukov V.S. The Role of Cytokines in the Pathogenesis of Atopic Dermatitis.Russian Bulletin of Perinatology and Pediatrics. 2018; 63(1): 28-33. (in Russ.) doi: 10.21508/1027-4065-2018-63-1-28-33.@@ Варламов Е.Е., Пампура А.Н., Сухоруков В.С. Значение цитокинов в патогенезе атопического дерматита. Рос. вестник перинатологии и педиатрии. 2018; 63(1): 28-33. doi: 10.21508/1027-4065-2018-63-1-28-33.

12. Novik G. A., Tamrazova O.B., Zhdanova M.V. and others. Modern possibilities of allergy diagnostics in real clinical practice.Russian Allergological Journal. 2024; 21(2): 321-332. (in Russ.) doi: 10.36691/RJA16937.@@ Новик Г.А., Тамразова О.Б., Жданова М.В. и др. Современные возможности аллергодиагностики в реальной клинической практике. Российский аллергологический журнал. 2024; 21(2): 321-332. doi: 10.36691/RJA16937.

13. Akiner U., Yener H.M., Gozen E.D., Kuzu S.B., Canakcioglu S. Helicobacter pylori in allergic and non-allergic rhinitis does play a protective or causative role? Eur. Arch. Otorhinolaryngol. 2020; 277(1): 141-145. (in Russ.) doi: 10.1007/s00405-019-05659-3.

14. Liu M., Wang Y., Du B. Update on the association between Helicobacter pylori infection and asthma in terms of microbiota and immunity. Allergy Asthma Clin Immunol. 2024; 20(1): 4. doi: 10.1186/s13223-024-00870-2.