Russian Journal of AllergyRussian Journal of AllergyРоссийский Аллергологический Журнал1810-88302686-682XPublishing House ABV Press1696310.36691/RJA16963Original studiesОригинальные исследованияResearch ArticleTryptase levels in children with cutaneous mastocytosis: a prospective studyАнализ уровней триптазы у детей с кожным мастоцитозом: проспективное исследованиеhttps://orcid.org/0000-0002-9578-54908862-5688PotekaevNikolay N.ПотекаевНиколай Николаевич
Russian Federation

MD, Dr. Sci. (Medicine), Professor

доктор медицинских наук, профессор

klinderma@mail.ruhttps://orcid.org/0000-0002-0767-88212244-5426KasikhinaElena I.КасихинаЕлена Игоревна
Russian Federation

MD, Cand. Sci. (Medicine), Assistant Professor

кандидат медицинских наук, доцент

kasprof@bk.ruhttps://orcid.org/0000-0001-5723-65738584-7564ZhukovaOlga V.ЖуковаОльга Валентиновна
Russian Federation

MD, Dr. Sci. (Medicine), Professor

доктор медицинских наук, профессор

klinderma@inbox.ruhttps://orcid.org/0000-0003-3386-14675767-7621OstretsovaMaria N.ОстрецоваМария Николаевна
Russian Federation

MD, Cand. Sci. (Medicine), Assistant Professor

кандидат медицинских наук, доцент

ostretsova-mn@rudn.ruhttps://orcid.org/0009-0002-1193-32473873-9444NadaAhmed Y.НадаАхмед Яссер
Russian Federation

MD

ahmed_nada391@yahoo.comMoscow Scientific and Practical Center of Dermatovenereology and CosmetologyМосковский научно-практический Центр дерматовенерологии и косметологииThe Russian National Research Medical University named after N.I. PirogovРоссийский национальный исследовательский медицинский университет имени Н.И. ПироговаPeoples’ Friendship University of RussiaРоссийский университет дружбы народов имени Патриса Лумумбы26092024241020242133373472008202410092024Copyright ©; 2024, Pharmarus Print MediaCopyright ©; 2024, Фармарус Принт Медиа2024Pharmarus Print MediaФармарус Принт Медиаhttps://creativecommons.org/licenses/by-nc-nd/4.0https://rusalljournal.ru/raj/article/view/16963

BACKGROUND: Serum tryptase levels are used as a diagnostic marker in mastocytosis and are considered an indicator of clonal mast cell load.

AIM: To analyze tryptase levels in children with different clinical types of cutaneous mastocytosis.

MATERIALS AND METHODS: A single-center prospective study was conducted for the period 2022–2024. The results of examination of 202 children aged from 6 months to 17 years with a diagnosis of cutaneous mastocytosis, who were undergoing outpatient treatment at the Moscow scientific and practical Center of dermatovenereology and cosmetology, were analyzed. Serum tryptase levels were determined by enzyme immunoassay.

RESULTS: The median basal tryptase level for the entire group (n=202) was 5.09 μg/L (range 1.3–57.0 μg/L). Serum tryptase values exceeding 11.0 μg/L were detected in 17.3% of patients, and 20.0 μg/L in 7.4%. The mean enzyme level in the control group was 2.55 μg/L. There were significant differences in tryptase concentrations between the maculopapular cutaneous mastocytosis and control groups (p=0.05). The median tryptase level in children with maculopapular cutaneous mastocytosis was 8.7 μg/L. The most pronounced differences were observed between the enzyme levels in children with the monomorphic type of maculopapular cutaneous mastocytosis and in the control group (p=0.01). Analysis of tryptase levels depending on gender and clinical type of maculopapular cutaneous mastocytosis showed that children and adolescents with the monomorphic type of maculopapular cutaneous mastocytosis had higher enzyme levels.

CONCLUSION: Further studies are needed to determine which tryptase levels in children are indicative of mast cell activation and primary mast cell diseases. A detailed understanding of tryptase levels in children may facilitate the development of new specific therapeutic approaches to the management of various clinical forms of cutaneous mastocytosis.

Обоснование. Уровень триптазы в сыворотке крови используется в качестве диагностического маркера при мастоцитозе и считается показателем медиаторной нагрузки клональных тучных клеток.

Цель исследования ― провести анализ уровней триптазы у детей с разными клиническими формами кожного мастоцитоза.

Материалы и методы. Проведено одноцентровое проспективное исследование за период 2022–2024 годов. Анализировали результаты обследования детей (n=202) в возрасте от 6 месяцев до 17 лет с диагнозом «кожный мастоцитоз», находившихся на амбулаторном лечении в ГБУЗ «Московский научно-практический Центр дерматовенерологии и косметологии». Уровни триптазы в сыворотке крови определяли методом иммуноферментного анализа.

Результаты. Медианный базальный уровень триптазы для всей группы (n=202) составил 5,09 мкг/л (диапазон 1,3–57,0 мкг/л). У 17,3% пациентов выявлено превышение значений сывороточной триптазы выше 11,0 мкг/л, у 7,4% ― выше 20,0 мкг/л. Среднее значение уровня фермента в контрольной группе составило 2,55 мкг/л. Выявлены достоверные различия концентрации триптазы в группах пятнисто-папулёзного кожного мастоцитоза и контроля (р=0,05). Медианное значение уровня триптазы у детей с пятнисто-папулёзным кожным мастоцитозом составило 8,7 мкг/л. Наиболее выраженные различия отмечались между показателями фермента у детей с мономорфным типом пятнисто-папулёзного кожного мастоцитоза и в контрольной группе (р=0,01). При анализе уровней триптазы в зависимости от пола и клинического типа пятнисто-папулёзного кожного мастоцитоза более высокие значения фермента определены у детей и подростков с мономорфным типом.

Заключение. Необходимы дальнейшие исследования, чтобы выяснить, какая концентрация триптазы у детей является индикатором активации тучных клеток и первичных заболеваний тучных клеток. Наконец, детальное понимание уровней триптазы у детей может способствовать разработке новых специфических терапевтических подходов к ведению различных клинических форм кожного мастоцитоза.

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