Pathogenic aspects of palmoplantar keratodermas

Objective — to study level of pro- and anti-inflammatory cytokines and expression of the endogenous intoxication in the patients of palmoplantar keratodermas (PPK).Materials and methods. We examined 23 patients with different variants of PPK in the age from 3 to 60 years. Indicators of cytokines (interleukin4 and TNF-a) in blood serum were determined by the method of immunoassay. The results of the immunoassay (ELISA) were recorded using a spectrophotometer, measuring the optical density in the two-wave mode: the main filter — 450 nm, the reference filter — in the range 620—650 nm. The presence of endogenous intoxication was established using laboratory tests according to A.A. Togobayeva et al. (sorption capacity of erythrocytes) and N.I. Gabrie­lyan et al. (mediomolecular peptides) methods.Results and discussion. With the use of ELISA we studied parameters of proinflammatory (TNF-a) and anti-inflammatory (IL-4) cytokines in the blood serum of the patients with palmoplantar keratoderma. Biochemical methods were used to determine levels of the sorption ability of the erythrocytes (%) and mean molecular peptides (un. ext.). A reliable increase of TNF-a was established in the blood of patients with PPK in comparison with control group: (86.7 ± 11.4) vs (4.0 ± 0.31) pg/ml, respectively, p < 0.001. The level of proinflammatory cytokine IL-4 was unreliably lower than in the control group: (1.65 ± 0.17) and (1.9 ± 0.28) pg/ml, respectively, p < 0.05. The revealed disorders of the cytokine status resulted in increase of endogenous intoxication, which was expressed by reliable rising of values of the erythrocyte sorption ability of erythrocytes (32.4 ± 2.8) vs (29.62 ± 1.69) % at p < 0.05 and the level of mediomolecular peptides ((0.286 ± 0.02) vs (0.215 ± 0.003) un. ext. with p < 0.05).Conclusions. The results obtained show the presence of endogenous intoxication in the patients with palmoplantar keratoderma along with disorders of cytokine status of patients. The data received allow development of the methods of anticytokine and detoxication therapy in the patients suffering from palmoplantar keratoderma as pathogenically confirmed methods of treatment.

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