DEMODEKOZ VA UNGA HAMROH ROZATSEA BILAN OG‘RIGAN BEMORLARNING KLINIK-MIKROBIOLOGIK TAVSIFI
Maqola yon paneli
Maqolaning asosiy mazmuni
Abstrak
Dolzarbligi. Demodekoz, ayniqsa rozatsea bilan birga kelganda, yallig'lanish belgilarining kuchayishi, yaqqol eritema, papulo-pustulyoz elementlar va terapiyaga rezistentlik tufayli sezilarli klinik muammoni tashkil etadi. Zamonaviy tadqiqotlar Demodex spp. zichligining ortishi va terining yaqqol disbiozi immun-yallig'lanish reaksiyalarini kuchaytirishini hamda kasallik kechishini og'irlashtirishini ko'rsatmoqda. Yuqori tarqalganligi va kuzatuvlar sonining ortib borishiga qaramay, bunday bemorlarning kompleks klinik-mikrobiologik xususiyatlari yetarlicha o'rganilmagan; bu esa tashxisni optimallashtirish va samarali terapevtik yondashuvlarni tanlash uchun keyingi tadqiqotlar zaruratini belgilaydi. Tadqiqot maqsadi. Yuz terisi demodekozi va unga hamroh rozatsea bilan og'rigan bemorlarning kompleks klinik-mikrobiologik tavsifini o'tkazib, klinik belgilar og'irligini va mikrob disbiozi xususiyatlarini belgilovchi omillarni aniqlash. Materiallar va usullar. 86 bemorni qamrab olgan «case–control» turidagi bir vaqtli qiyosiy tadqiqot o'tkazildi: asosiy guruh — klinik tasdiqlangan rozatsea bilan birga demodekoz bo'lgan 46 bemor, nazorat guruhi — izolyatsiyalangan demodekozli 40 bemor. Eritemaning ifodalanganligi (IGA Rosacea Severity Score), yallig'lanish elementlari (IGA), subyektiv simptomlar (VAS), Demodex invaziyasi zichligi (SSSB, dona/sm²), asosiy mikroorganizmlarning (Staphylococcus epidermidis, Cutibacterium acnes, Bacillus spp., grammanfiy bakteriyalar) ajratib olinish chastotasi va mikrob yuklamasi, shuningdek polimikroblik baholandi. Statistik tahlil Styudent t-mezoni, χ² mezoni va Pirson korrelyatsion tahlilini o'z ichiga oldi (p < 0,05). Natijalar. Asosiy guruh bemorlarida yaqqolroq eritema (3,1 ± 0,6 ga qarshi 1,8 ± 0,5 ball; p < 0,001), Demodex invaziyasining yuqoriroq zichligi (13,2 ± 3,4 ga qarshi 8,1 ± 2,7 dona/sm²; p < 0,001) va kuchaygan subyektiv simptomlar qayd etildi. S. epidermidis, C. acnes, Bacillus spp. va grammanfiy bakteriyalarning aniqlanish chastotasi, shuningdek ularning mikrob yuklamasi va polimikrobligi demodekoz rozatsea bilan birga kelganda ishonchli darajada yuqori bo'ldi. Demodex zichligi bilan eritema, papulo-pustulyoz elementlar va achishishning ifodalanganligi o'rtasida, shuningdek S. epidermidis, C. acnes bilan kolonizatsiya va polimikroblik bilan ishonchli korrelyatsiyalar aniqlandi. Xulosa. Demodekozning rozatsea bilan birga kelishi og'irroq klinik kechish va terining yaqqol disbiozi bilan kechadi; bu Demodex spp. ning yuqori yuklamasi va shartli patogen mikrobiotaning sinergetik ta'siri bilan bog'liq. Olingan ma'lumotlar patogenezning parazitar, mikrob va immun-yallig'lanish komponentlarini hisobga oluvchi multimodal terapevtik yondashuv zarurligini asoslaydi.
Maqola tafsilotlari
Nashr
Bo'lim
Ushbu asar Creative Commons Attribution 4.0 International litsenziyasi asosida litsenziyalangan.
Qanday iqtibos keltirish kerak
Adabiyotlar
Forton F., De Maertelaer V. Demodicosis: descriptive classification and status of rosacea, blepharitis and acne. J Eur Acad Dermatol Venereol. 2018;32(6):794–802.
Liu J., Sheha H., Tseng S.C.G. Pathogenic role of Demodex mites in blepharitis. Curr Opin Allergy Clin Immunol. 2010;10(5):505–510.
Baima B., Sticherling M. Demodicidosis revisited. Acta Derm Venereol. 2002;82(1):3–6.
Zhao Y.E., Guo N., Wu L.P., et al. Demodex infestation as a risk factor for rosacea: a meta-analysis. Parasitol Res. 2021;120(2):567–578.
Steinhoff M., Schauber J., Leyden J.J. Rosacea—insights into pathogenic mechanisms and potential therapeutic targets. Nat Rev Dis Primers. 2016;2:16029.
Dajnoki Z., Beke G., Kapitány A., et al. Cathelicidin LL-37 in rosacea: involvement in disease pathogenesis and correlation with severity. Exp Dermatol. 2017;26(3):217–221.
Two A.M., Wu W., Gallo R.L., Hata T.R. Rosacea: part I. Epidemiology, pathogenesis, and risk factors. J Am Acad Dermatol. 2015;72(5):749–758.
Rufli T., Mumcuoglu K.Y. The hair follicle mites Demodex folliculorum and Demodex brevis: biology and medical importance. Arch Dermatol. 1981;117(5):329–334.
Lacey N., Delaney S., Kavanagh K., Powell F.C. Mite-related bacterial antigens stimulate inflammatory cells in rosacea. Br J Dermatol. 2007;157(3):474–481.
Yamasaki K., Di Nardo A., Bardan A., et al. Increased serine protease activity and cathelicidin promote skin inflammation in rosacea. Nat Med. 2007;13(8):975–980.
O’Reilly N., Mannion G., O’Reilly A., et al. Bacillus oleronius antigens induce inflammatory responses in patients with papulopustular rosacea. Br J Dermatol. 2012;167(5):1037–1043.
Rainer B.M., Fischer A.H., Kubo A., et al. Rosacea is associated with dysbiosis of the facial skin microbiome. J Dermatol Sci. 2017;88(1):66–72.
Thadchanamoorthy V., Lai J.Y., De Benedetto A. Microbiome changes in rosacea: current evidence. Dermatology. 2021;237(3):421–430.
Holmes A.D., Spoendlin J., Chosidow O., et al. Rosacea pathophysiology and global prevalence. Dermatoendocrinol. 2013;5(1):34–39.
Buczek A., Zając Z., Kawa I., et al. Demodex mites and typical clinical symptoms of demodicosis. Acta Parasitol. 2015;60(4):677–684.
Forton F., Seys B. Density of Demodex folliculorum in rosacea: a case–control study using standardized skin-surface biopsy. Br J Dermatol. 1993;128(6):650–659.
Casas C., Vaissiere C., Boniface K., et al. Quantification of Demodex folliculorum: a new standardized method. Acta Derm Venereol. 2012;92(2):150–151.