Levels of eosinophils and interleukin-5 and severity of atopic dermatitis in the presence of psychosocial stress

BACKGROUND: Skin damage in atopic dermatitis is caused by the participation of several immune cells and their inflammatory mediators. However, data on correlations between the severity of atopic dermatitis, combined with and without food allergies (severity of atopic dermatitis (SCORAD) index, etc.), and the levels of eosinophils and interleukin-5 are scarce and contradictory. No studies have compared the frequency of eczematous reactions occurring at different times or immediate allergic reactions in the above patients. Moreover, no studies or certain studies have reported results on the frequency of the combination of atopic dermatitis and food allergies, its various degrees of severity depending on these indicators, levels and relationships of the concentration of eosinophils, and interleukin-5 in the presence of psychosocial stress.

AIM: To study the frequency and severity of the course, skin reactions in patients with atopic dermatitis, with and without food allergies, and levels and correlations of interleukin-5 and eosinophils in the presence of psychosocial stress in patients in the Donbass region.

MATERIALS AND METHODS: A total of 165 patients with atopic dermatitis were examined. Questionnaire survey, anamnesis collection, and general clinical and specific allergological examinations were performed, and the levels of interleukin-5, absolute quantity, and percentage of eosinophils in the peripheral blood were determined. Two subgroups of patients with atopic dermatitis were analyzed: 1) those with food allergies and 2) those without food allergies. Persons living in areas with high and low shelling intensities were also identified. Data were statistically processed using the domestic program Medstat (Donetsk).

RESULTS: In patients with atopic dermatitis, randomly selected from those who applied for an appointment with allergists-immunologists, this disease was combined with food allergy in 81.2% of cases. The severity of atopic dermatitis and eosinophil levels were significantly higher in the group with food allergies. Stable direct reliable correlations of varying strength have been established between the severity of atopic dermatitis (SCORAD index and its indicators) and the absolute quantity, percentage of eosinophils, and interleukin-5 level, as well as between the above laboratory parameters. Differences were found in the frequency of recording eczematous and immediate skin reactions. The residence of patients with atopic dermatitis with and without food allergies in areas that differed in shelling intensity was associated with the severity of atopic dermatitis and the level of eosinophils and interleukin-5.

CONCLUSION: In most patients, atopic dermatitis is combined with food allergy, and the severity of its combination with food allergy increases. Therefore, reliable correlations of the SCORAD index with blood eosinophilia and interleukin-5 levels are revealed. The severity of atopic dermatitis and biomarkers in both subgroups increased when they lived in areas with high intensity of shelling.