CYTOKINES AND ANTIMICROBIAL PEPTIDES AS PREDICTORS OF SEVERE MULTIFORME EXUDATIVE ERYTHEMA

Abstract

The aim of the study was to evaluate the production of humoral immune factors (inflammatory cytokines and antimicrobial peptides) in patients with erythema multiforme exudative (MEE).

Materials and methods. The study included 42 patients divided into two clinical groups. The first group (27 patients) consisted of patients with mild EME, whose primary complaint was a polymorphic target-like rash, without mucosal lesions or general deterioration. The second group (15 patients) included patients with moderate MEE, whose clinical presentation, along with generalized skin rashes, included oral mucosal lesions and intoxication syndrome. To assess the cytokine profile, serum interleukins (IL-1β, IL-6, IL-4, IL-17), interferon-gamma (IFN-γ), and AMP (α-defensin – HNP1-3) levels were measured.

Results. Analysis of the cytokine and α-defensin levels in patients with mild and moderate MEE revealed significant deviations compared to similar parameters in the control group. When comparing the levels of the studied cytokines between the groups of patients with mild and moderate forms of MEE, statistically significant results were observed for IL-1β, IL-6, and IFN-γ. Specifically, their concentrations were 1.9-, 2.3-, and 1.5-fold higher, respectively, in the latter group of patients with moderate MEE compared to the former group of patients with mild MEE. Results for α-defensins (HNP 1-3) also revealed a significant difference between patients with mild and moderate forms of the disease, characterized by a 2.4-fold (p<0.05) increase in this parameter in the latter group.

Conclusions. The study results revealed significant changes in cytokine status and AMP production, which were more pronounced in patients with moderate MEE. The study of the production of IL-1β, IL-6, IFN-γ and α-defensins can serve as markers of a severe inflammatory process and predictors of the development of severe acute toxic-allergic reactions.