CHARACTERIZATION OF CENTRAL AND EFFECTOR CD4⁺ MEMORY CELLS IN PSORIASIS

Psoriasis is a chronic autoimmune disease in which the skin and joints are involved in the pathological process. It was found that the recurrence of rashes in this disease occurs due to the resident memory cells of the skin. The number of CD4+CCR3+ effector memory cells in peripheral blood correlates with the severity of the disease. Therefore, the aim of our work is to study the phenotype of peripheral blood memory cells in patients with psoriasis.The study included 6 healthy donors: average age – 45.4 (min – 29, max – 55), women – 3, men – 3; 10 patients with psoriasis: women – 4, men – 6, average age – 37.3 (min – 23, max – 57), of which 5 patients with PASI > 10 and 5 patients with PASI < 10. The exclusion criteria for the study were the presence of autoimmune, oncological and hematological diseases, systemic therapy with immunosuppressive drugs for 1 month. Patients signed informed consent to participate in the study. Isolation of peripheral blood mononuclear cells was performed in a density gradient of ficoll-urographin (p = 1.082 g/L). Then cells were stained with fluorochrome-conjugated monoclonal antibodies to surface markers of central (Tcm) and effector (Tem) CD4+ memory cells (CD4, CD45RO, CD197), the α-chain of the IL-7 receptor (CD127), and the γ-chain of the IL-7 receptor (CD132). Statistical analysis of the data obtained was performed using the Statistica 6.0 software package.The percent of Tcm in the peripheral blood of donors was 33.4% (in – 18.2, max – 43.7), Tem – 28.7% (min – 13.6, max – 38.9), in patients with psoriasis: Tcm – 28.65% (min – 13.3, max – 59.6), Tem – 21.5% (min – 9.3, max – 38.6). In the peripheral blood of patients with psoriasis, among the central CD4+ memory cells, the proportion of CD127+CD132- -cells is 26.00%, CD127+CD132+ – 1.69%, CD127+CD132- – 69.00%, CD127- CD132+ – 1.94%. Among effector CD4+ memory cells, the proportion of CD127+CD132- -cells is 23.58%, CD127+CD132+ – 1.18%, CD127+CD132- – 69.84%, CD127- CD132+ – 0.70%. A direct correlation was found between the number of CD127- CD132+ central memory cells and the PASI value (r = 0.639, p < 0.05).In patients with psoriasis, the proportion of central memory cells is higher than in healthy donors, while the number of effector memory cells is lower. A direct correlation was found between the number of central cells expressing the γ-chain of the IL-7 receptor and the severity of the disease. Activated memory cells are characterized by high expression of CD132. It can be assumed that this population of memory cells plays a role in maintaining autoimmune inflammation in patients with this disease, and also participates in the repopulation of skin resident memory cells

Современное состояние методов коррекции инволюционных изменений кожи и место фотодинамической терапии среди них

This work is a review of modern scientific data on the process of aging, as well as the prospect of using photodynamic therapy for correction of involutional skin changes in the age cohorts, cohorts with a burdened medical history, including cancerous and precancerous skin neoplasms. The data on the predicted increase in life expectancy and, as a consequence, the potential risk of pathologies, including those with skin localization, progression of malignancy processes, as well as the formation of de novo elements, is presented. The increase in life expectancy also demonstrates the socialization of the elderly population, along with the increasing need for correction of involutional skin changes. However, considering the risks associated with the chronic diseases and increased malignancy in this cohort, methods have to be carefully selected. One such technique is photodynamic therapy (PDT). PDT is actively used in oncology, and recently has been increasingly showing its aesthetic effectiveness. It can be predictably used not only on cancer patients, but also in an age cohort.Данная работа представляет собой обзор современных научных данных о процессах старения кожи, а также о перспективе использования метода фотодинамической терапии для коррекции инволюционных изменений кожи у возрастного населения. Приводятся данные прогнозируемого увеличения продолжительности жизни и, как следствие, потенциального риска возникновения патологий, в том числе кожной локализации. Увеличение продолжительности жизни также демонстрирует и социализацию пожилого населения, вместе с тем возрастающую потребность в преображении и коррекции инволюционных изменений кожи, но, учитывая риски в связи с наличием хронических заболеваний и возрастающей малигнизации данной когорты, следует тщательно подбирать методики, учитывая вышеперечисленные особенности. Одним из таких методов является фотодинамическая терапия. Фотодинамическая терапия активно применяется в онкологии, а в последнее время все чаще показывает свою эффективность в эстетическом направлении, соответственно прогнозируемо может использоваться не только у онкологических больных, но и возрастной когорты

Фотодинамическая репаративная регенерация кожи с применением наружного геля-фотосенсибилизатора на основе хлорина е6

The results of a study of the clinical effectiveness of the correction of involutional changes in the skin by the method of photodynamic therapy (PDT) with the use of a photosensitizer gel (PS), the active substance of which is the trismeglumine salt of chlorin e6, are presented. The data of fluorescence spectroscopy for monitoring the level of PS fluorescence in order to determine the optimal time of its exposure are demonstrated. The study of the optimal exposure time involved 80 patients with different skin phototypes. The study of the effectiveness of PDT involved 42 patients aged 44–68 years with signs of chrono- and photoaging. The PDT procedure was performed by irradiating the entire surface treated with the PS with a power density of 100 mW/cm2, a light dose of 120–140 J/cm2, a laser radiation wavelength of 660 nm, and a light beam area of 400–800 cm2. It was found that exposure to PS for 10–20 min gives the highest fluorescence and does not depend on the skin phototype. The clinical effect of PDT was achieved in 85.7% of patients; there were no negative subjective sensations. Moisture metrics increased on the skin of the face by 53%, reaching the control values in young healthy volunteers, on the skin of the hands - by 64%. Elastometry indicators on the skin of the face and hands increased by 19% and 16%, respectively. Thus, the PDT procedure with PS based on chlorin e6 is an effective method for correcting involutional changes in the skin, leads to a pronounced clinical effect, improves the parameters of skin moisture measurement and elastometry, and passes without undesirable local reactions. Optical coherence tomography showed an increase in collagen ordering.Представлены результаты изучения клинической эффективности коррекции инволюционных изменений кожи методом фотодинамической терапии (ФДТ) с применением геля–фотосенсибилизатора (ФС), активным веществом которого является трисмеглюминовая соль хлорина е6. Продемонстрированы данные флуоресцентной спектроскопии для контроля уровня флуоресценции ФС с целью определения оптимального времени его экспозиции. В исследовании оптимального времени экспозиции участвовали 80 пациентов с различным фототипом кожи. В исследовании эффективности ФДТ участвовали 42 пациента в возрасте 44–68 лет с признаками хроно– и фотостарения. Процедуру ФДТ выполняли путем облучения всей обрабатываемой ФС поверхности с плотностью мощности 100 мВт/см2, световой дозой 120–140 Дж/см2, длина волны лазерного излучения 660 нм, площадь светового пучка 400–800 см2. Установлено, что экспозиция ФС в течение 10–20 мин дает наибольшую флуоресценцию и не зависит от фототипа кожи. Клинический эффект ФДТ достигнут у 85,7% пациентов, субъективных ощущений негативного характера не отмечалось. Показатели влагометрии увеличились на коже лица на 53%, достигнув контрольных значений у молодых здоровых добровольцев, на коже кистей рук – на 64%. Показатели эластометрии на коже лица и рук увеличились на 19% и 16%, соответственно. Таким образом, процедура ФДТ с ФС на основе хлорина е6 является эффективным методом коррекции инволюционных изменений кожи, приводит к выраженному клиническому эффекту, улучшает показатели влагометрии и эластометрии кожи и проходит без нежелательных местных реакций. При оптической когерентной томографии установлено увеличение упорядоченности коллагена

Current state of methods of correction of involutional changes of skin and the place of photodynamic therapy among them

This work is a review of modern scientific data on the process of aging, as well as the prospect of using photodynamic therapy for correction of involutional skin changes in the age cohorts, cohorts with a burdened medical history, including cancerous and precancerous skin neoplasms. The data on the predicted increase in life expectancy and, as a consequence, the potential risk of pathologies, including those with skin localization, progression of malignancy processes, as well as the formation of de novo elements, is presented. The increase in life expectancy also demonstrates the socialization of the elderly population, along with the increasing need for correction of involutional skin changes. However, considering the risks associated with the chronic diseases and increased malignancy in this cohort, methods have to be carefully selected. One such technique is photodynamic therapy (PDT). PDT is actively used in oncology, and recently has been increasingly showing its aesthetic effectiveness. It can be predictably used not only on cancer patients, but also in an age cohort