度普利尤单抗对成人中重度特应性皮炎金黄色葡萄球菌定殖的影响

Effect of dupilumab on Staphylococcus aureus colonization in adults with moderate to severe atopic dermatitis

目的:明确度普利尤单抗治疗成人中重度特应性皮炎对金黄色葡萄球菌定殖的影响及作用机制。方法:选取2022年7月至2023年8月中重度特应性皮炎患者作为实验组,健康体检者作为对照组。实验组接受度普利尤单抗治疗,分别在治疗前、治疗8周后检测实验组皮损处和对照组对应部位金黄色葡萄球菌定殖量及血清IL-4,IL-13,IL-19,IL-33及总IgE水平。结果:治疗前实验组(30例)金黄色葡萄球菌的定殖率为100%,健康组(30名)为3.33%(P<0.05);治疗8周后,实验组金黄色葡萄球菌定殖量[(3394±1837)CFU/cm^(2)]较治疗前[(108741±56758)CFU/cm^(2)]明显降低,有统计学意义;血清IL-4、IL-13、IL-19、IL-33及总IgE水平较治疗前显著降低,有统计学差异(P<0.05)。AD积分指数(SCORAD)评分、湿疹面积及严重程度指数(EASI)评分、瘙痒严重程度(NRS)评分治疗后均显著降低。结论:度普利尤单抗可以降低成人中重度特应性皮炎患者皮损处金黄色葡萄球菌定殖量,可能与2型炎症因子水平和特应性皮炎严重程度的降低相关。

Objective:To explore the effect of dupilumab on Staphylococcus aureus colonization in adult moderate to severe atopic dermatitis and its mechanism.Methods:Patients with moderate to severe atopic dermatitis from July 2022 to August 2023 were enrolled into the experimental group,and healthy subjects were selected as the controls.The patients in the experimental group were treated with duprizumab.Before treatment and at 8 week after treatment,the colonization of Staphylococcus aureus at the skin lesions,as well as the levels of serum IL-4,IL-13,IL-19,IL-33,and total IgE,were measured in both groups.Results:The colonization rate of Staphylococcus aureus was 100%in the experimental group(30 cases)before treatment and 3.33%in the healthy group(30 cases)(P<0.05).After 8 weeks of treatment,the colonization amount of Staphylococcus aureus in the experimental group(3394±1837 CFU/cm^(2))was significantly lower than that before treatment(108741±56758 CFU/cm^(2)),with statistical significance.The levels of serum IL-4,IL-13,IL-19,IL-33 and total IgE after treatment were significantly lower than those before treatment,with statistically significant differences(P<0.05).Conclusion:Dupilumab can rapidly reduce the colonization of Staphylococcus aureus in skin lesions of patients with atopic dermatitis,which may be related to the reduction of type 2 inflammatory factors and the severity of atopic dermatitis.