Garibeh E. Pathogenetic significance of endothelial dysfunction, markers of allergic inflammation, antimicrobial peptide, vitamin D and VDR gene polymorphism for diagnosis and treatment of atopic dermatitis

The study is dedicated to solving the current problem of modern medicine - the scientific justification of improving the diagnosis and treatment of atopic dermatitis based on the study of the pathogenetic mechanisms of its development by determining the indicators of endothelial dysfunction, markers of allergic inflammation, antimicrobial peptide, vitamin D and the role of the single nucleotide polymorphism of the VDR gene. It was established that the older the patient, both the level of total IgE and the frequency of the extrinsic (ADe) form of the clinical-pathogenetic variant of AD decreased, while the number of individuals with the intrinsic (ADi) form of the disease increased (p<0.001). It was found that with age in AD patients, the value of total IgE in allergic inflammation is lost and, accordingly, its importance and feasibility of determination in elderly people. For the first time in Ukraine, the pathogenetic value of eosinophilic-derived neurotoxin (EDN) in blood serum was proven as a marker of allergic inflammation in atopic dermatitis For the first time in Ukraine, the polymorphism of the VDR gene rs1544410 in patients with atopic dermatitis was investigated. It was established that the A/A genotype of the rs1544410 variant occurs with a high frequency in patients with atopic dermatitis, p=0.341 with a likely increased risk of vitamin D deficiency (χ2=18.73; p<0.001. Carriers of the G/G genotype had a negative association with atopic dermatitis and were characterized by vitamin D insufficiency, p=0.017. For the first time in Ukraine, the polymorphism of the VDR gene rs1544410 in patients with atopic dermatitis was investigated. The expediency and clinical effectiveness of the use of the developed and improved complex method of treatment by patients with atopic dermatitis, which is based on the use of vitamin D and the drug, the active ingredient of which is L-arginini hydrochloridum, against the background of basic therapy, is substantiated.