The participants of this study were 142 children in the age from 29 days to 3 years old: 90 children with AtD (atopic dermatitis) (the main group) and 52 of healthy children (the control group). According to the form of AtD, erythematous (48 %), erythematosquamous (39 %), exudative (2.2 %), and lichenoid (1.1 %) forms were noted. The scales SCORAD and EASI were tested; and the conclusion was made about the benefits of EASI scale as more objective due to the absence of subjective components. For the first time in Ukraine, the quality of life (QoL) in young children with AtD was investigated. The significant dissension of all indicators were found (in descending order): emotional (59.1-72.2 %), physical (62.4-76.2 %), and social (64.2-82.1 %) spheres. Statistical analysis identified the significant decline of QoL in the patients with mild (1.5-1.9 times) and moderate (1.6-2.0 times) forms of AtD. The subjective assessment of severity in 22.2 ± 2.5 % of patients exceeded the objective condition that can be an indicator for improvement therapy by the way of referral these children to an allergy school with emphasis on the psychological correction of behavior. During study of allergy to the distinct fractions of cow’s milk proteins, monosensitization was found in 53.3 % of children, from them: to the α-lactalbumin – 13.3 %, beta-lactoglobulin – 13.3 %, bovine serum albumin – 26.6 % of children, to the casein was not detected. Polysensitization was observed in 46.6 % of patients. The clinical features of AtD were analyzed depending on the type of sensitization- there was determined that sensitization to casein occurs 4 times less often than to serum proteins, not in the form of monosensitization, but it is characterized by a more severe course of AtD. The reasoned recommendations regarding the most complete elimination of the causative allergen were done. Amino acid mixture was tested on 3 children with the severe form of AtD. The levels of fractalkine and eotaxin in the serum of blood were investigated. The level of fractalkine was significantly increased in all forms of the severity of AtD: in mild form – 8.55 [6.11;10.79] ng/ml, in moderate – 10.97 [5.61;14.01] ng/ml, in severe – 12.53 [16.68;9.01] ng/ml in comparison with reference values (4.29 [3.52;5.27] ng/ml). It was found direct correlations of the level of fractalkine with overall value of scale SCORAD (r = 0.271; p = 0.007); total intensity of all the morphological elements of exanthema (r = 0.235; p = 0.011); erythema (r = 0.258; p = 0.016); excoriation (r = 0.209; p = 0.037); pruritus (r = 0.249; p = 0.009); sleep disturbance (r = 0.272; p = 0.005). Probable direct correlations were found between the level of fractalkine and the number of neutrophils, CD8, stimulated neutrophil activation index and lysosomal cationic proteins and inverse correlations – with the number of lymphocytes. Thus, using fractalkine quantification as a marker of neutrophilic phenotype of AtD and as an objective indicator of the severity of AtD acute phase was proposed. The level increase of eotaxin in comparison with the reference value (46.05 [27.9;61.4] pg/mL) was not found, also, depending on the severity of AtD, we separated patients with high (50.2-189.78 pg/mL) and low (2.79-19.54 pg/mL) levels of eotaxin for defining of the pathogenetic role of eotaxin and setting up of its influence on the formation of AtD. The statistical analysis of the main signs of AtD in the groups with high and low levels of eotaxin determined probably higher numbers SCORAD in the patients with high level of eotaxin. Conducted study allowed to separate and characterize the phenotype of AtD associated with increased levels of eotaxin. It’s characterized: the probable quantity increase numbers of CD3, CD4, CD8, CD16, CD22, CD25 of lymphocytes, Ig G and the total Ig E in blood serum in comparison with the patients with low levels of eotaxin. Thus, this research has expanded the idea regarding the pathogenesis of AtD and allowed to formulate the practical recommendations as for improvement of the therapy of the patients with AtD.
