The influence of a course of complex application of supravenous laser irradiation of blood and phototherapy on indicators of the neurohormonal status of patients with true eczema

Cover Page

Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription Access

Abstract

BACKGROUND: In the pathogenesis of true eczema, an important place is occupied by stress, under the influence of which stimulation of the hypothalamus and brain stem occurs, as well as activation of the hypothalamic-pituitary-adrenal axis and the autonomic nervous system. Stress-induced secretion of neurotransmitters impairs the barrier function of the epidermis, slows wound healing, increases itching and inflammation, and suppresses immunity by changing the immune response of T-helper cells.

AIM: Assessment of the severity of the corrective effect of a course of application of supravenous laser irradiation of blood and broadband medium-wave phototherapy on the blood levels of adrenocorticotropin, cortisol and beta-endorphin in patients with true eczema with a moderate form of the course.

MATERIALS AND METHODS: The study was carried out with the participation of 120 patients with a moderate form of true eczema. Using simple fixed randomization, all patients were divided into 4 groups. The first group (control, n=30) received only basic drug therapy, including the use of detoxification, hyposensitizing, antihistamines and topical glucocorticosteroids. Patients of the second group (comparison group 1, n=30) additionally underwent a course of supravenous laser irradiation of blood. In the third group (comparison group 2, n=30), broadband medium-wave phototherapy was performed against the background of basic therapy. Patients of the fourth group (main group, n=30) in addition to basic therapy received a course of combined exposure to supravenous laser blood irradiation and phototherapy. The concentrations of adrenocorticotropin, cortisol and beta-endorphin were determined in the blood of patients twice (before the start of treatment and 1 month after the start of therapy) using ELISA. The clinical condition of patients in the groups was assessed by changes in the EASI index. Additionally, we studied the dynamics of the level of reactive and personal anxiety using the Spielberger–Khanin questionnaire.

RESULTS: Positive dynamics of adrenocorticotropin, cortisol and beta-endorphin were noted only in the comparison groups and the main group, which proves the high efficiency of correction of the neurohumoral status of patients through a course of complex use of supravenous laser blood irradiation and broadband mid-wave phototherapy. Quantitative changes in the assessed parameters during complex therapy with therapeutic physical factors indicate a supra-additive version of their interaction, realized through different modalities, points of application and mechanisms for realizing the biological potential of physiotherapeutic effects.

CONCLUSION: The results obtained convincingly prove the effectiveness of an additional course of use of supravenous laser irradiation of blood in combination with broadband medium-wave phototherapy when correcting the neuroendocrine status in patients with true eczema. The close correlation between neurohumoral indicators and clinical and psychological patterns of the disease proves the pathogenetic significance of the studied neuroendocrine indicators, which allows us to consider their dynamics as informative criteria for the effectiveness of the treatment.

About the authors

Emma E. Arutyunyan

RUSMEDDOK

Email: drnag@mail.ru
ORCID iD: 0000-0001-5402-5009
SPIN-code: 7219-5306
Russian Federation, Moscow

Sergey N. Nagornev

Central State Medical Academy of Department of Presidential Affairs

Email: drnag@mail.ru
ORCID iD: 0000-0002-1190-1440
SPIN-code: 2099-3854

MD, Dr. Sci. (Med.), Professor

Russian Federation, Moscow

Irina I. Ivanova

Central State Medical Academy of Department of Presidential Affairs

Email: i.ivanova@mail.ru
ORCID iD: 0000-0002-8943-9321
SPIN-code: 6308-1355

MD, Dr. Sci. (Med.), Associate Professor

Russian Federation, Moscow

Elena V. Dontsova

Voronezh State Medical University

Author for correspondence.
Email: ledn89@mail.ru
ORCID iD: 0000-0001-6119-2120
SPIN-code: 5227-3284

MD, Dr. Sci. (Med.), Associate Professor

Russian Federation, Voronezh

References

  1. Clinical guidelines. Eczema. Moscow: Russian Society of Dermatovenerologists and Cosmetologists; 2021. 60 p. (In Russ).
  2. Kruglova LS, Dontsova EV, Novikova LA, et al. Phototherapy and a janus kinase 1 inhibitor to increase the effectiveness of medicamentous therapy in patients with eczema. Kremlin Med. Clin Bulletin. 2023;(2):41–45. EDN: PKHEEQ doi: 10.48612/cgma/pd2u-eh87-pz62
  3. Schmitt J, Apfelbacher CJ, Flohr C. Eczema. BMJ Clin Evid. 2011;2011:1716.
  4. Dontsova EV, Novikova LA, Chernov AV, et al. The possibilities of janus kinase 1 inhibitor upadacitinib in increasing the effectiveness of drug therapy for eczema. Lechebnoe delo. 2023;(2):120–126. EDN: FVQSAQ doi: 10.24412/2071-5315-2023-12887
  5. Irvine AD, Eichenfield LF, Friedlander SF, et al. Review of critical issues in the pathogenesis of atopic dermatitis. Semin Cutan Med Surg. 2016;35(5 Suppl):89–91. doi: 10.12788/j.sder.2016.042
  6. Lin TK, Zhong L, Santiago JL. Association between stress and the HPA axis in the atopic dermatitis. Int J Mol Sci. 2017;18(10):2131. doi: 10.3390/ijms18102131
  7. Novikova LA, Dontsova EV, Chernov AV, et al. Features of the cytokine status, lipid peroxidation and the state of the antioxidant system in patients with true eczema. Pharmateka. 2022;29(14):73–77. EDN: EXPIGA doi: 10.18565/pharmateca.2022.14.73-77
  8. Arck P, Paus R. From the brain-skin connection: The neuroendocrine-immune misalliance of stress and itch. Neuroimmunomodulat. 2006;13(5-6):347–356. doi: 10.1159/000104863
  9. Estefan J, Ferreira DC, Cavalcante FS, et al. Investigation of possible relationship between atopic dermatitis and salivary biomarkers, stress, and sleep disorders. World J Clinical Cases. 2023;11(17):3958–3966. doi: 10.12998/wjcc.v11.i17.3958
  10. Meštrović-Štefekov J, Novak-Bilić G, Kuna M, et al Psychological stress in patients with atopic dermatitis. Acta Dermatovenerol Croat. 2018;26(4):297–303.
  11. Hunter HJ, Momen SE, Kleyn CE. The impact of psychosocial stress on healthy skin. Clin Exp Dermatol. 2015;40(5):540–546. doi: 10.1111/ced.12582
  12. Solomon I, Ilie MA, Draghici C, et al. The impact of lifestyle factors on the evolution of atopic dermatitis: An alternative approach. Exp Ther Med. 2019;17(2):1078–1084. doi: 10.3892/etm.2018.6980
  13. Reztsova PA, Raznatovsky KI, Vashkevich AA. Treating of patients with microbial eczema with narrow-band phototherapy (literature review). Problems Med Mycology. 2019;21(2):11–14. EDN: DQABPL
  14. Reztsova PA, Raznatovsky KI, Vashkevich AA, et al. Evaluation of phototherapy efficacy for the treatment of patients with microbial eczema. Clin Dermatol Venereol. 2020;19(5):655–660. EDN: FNFJBI doi: 10.17116/klinderma202019051655.
  15. Hanifin JM, Baghoomian W, Grinich E, et al. The Eczema area and severity index — a practical guide. Dermatitis. 2022;33(3):187–192. doi: 10.1097/DER.0000000000000895
  16. Dontsova EV. Combined with phototechnologies methods in complex treatment of psoriasis patients with metabolic syndrome [dissertation abstract]: 14.01.10; 14.03.11. Place of defence: First Moscow State Medical University named after I.M. Sechenov. (Sechenov University). Voronezh; 2019. 277 p. (In Russ).
  17. Bilovol AN. State of some estimated indicators of hormonal status in patients with psoriatic pathology. Bukovynskyi Medichnyi Visnik. 2010;14(2):20–23. 2010;14(2):20–23. (In Russ).
  18. Kim JE, Cho BK, Cho DH, et al. Expression of hypothalamic-pituitary-adrenal axis in common skin diseases: Evidence of its association with stress-related disease activity. Acta Derm Venereol. 2013;93(4):387–393. doi: 10.2340/00015555-1557
  19. Demori I, Grasselli E. The role of the stress response in metabolic dysfunction-associated fatty liver disease: A psychoneuroendocrine immunology-based perspective. Nutrients. 2023;15(3):795. doi: 10.3390/nu15030795
  20. Aguilera G. HPA axis responsiveness to stress: Implications for healthy aging. Exp Gerontol. 2011;46(2-3):90–95. doi: 10.1016/j.exger.2010.08.023
  21. Theoharides TC, Alysandratos KD, Angelidou A, et al. Mast cells and inflammation. Biochim Biophys Acta. 2012;1822(1):21–33. doi: 10.1016/j.bbadis.2010.12.014
  22. Turchin I, Bourcier M. The role of interleukins in the pathogenesis of dermatological immune-mediated diseases. Adv Ther. 2022;39(10):4474–4508. doi: 10.1007/s12325-022-02241-y
  23. Woźniak E, Owczarczyk-Saczonek A, Lange M, et al. The role of mast cells in the induction and maintenance of inflammation in selected skin diseases. Int J Mol Sci. 2023;24(8):7021. doi: 10.3390/ijms24087021
  24. Slominski AT, Zmijewski MA, Skobowiat C, et al. Sensing the environment: Regulation of local and global homeostasis by the skin's neuroendocrine system. Adv Anat Embryol Cell Biol. 2012;212(v, vii):1–115. doi: 10.1007/978-3-642-19683-6_1
  25. Revyakina VA, Agafonov AS, Sentsova TB, et al. Participation of neuropeptides and β-endorphin in pathogenesis of atopic dermatitis. Evaluation of levocetirizine effectiveness upon neuropeptides' levels at children with atopic dermatitis. Russ J Allergol. 2010;(2):74–80. EDN: MWGLXP
  26. Moskvin SV. Fundamentals of laser therapy. Vol. 1. Tver: Triada; 2016. 896 р. (Series: Effective laser therapy). (In Russ).
  27. Alexeeva LA, Makarenkova EV, Skripchenko NV, et al. Diagnostic value of cortisol determination in biological fluids in infectious diseases (literature review). Paediatr. 2021;12(5):59–69. EDN: ORAZWY doi: 10.17816/PED12559-69
  28. Lightman SL, Birnie MT, Conway-Campbell BL. Dynamics of ACTH and cortisol secretion and implications for disease. Endocr Rev. 2020;41(3):bnaa002. doi: 10.1210/endrev/bnaa002
  29. Nartikoeva ZD. Effect of low-intensity laser radiation on the level of melatonin, cortisol and some indicators of microcirculation in patients with rheumatoid arthritis [dissertation]: 14.01.04. Place of defence: First St. Petersburg State Medical University named after I.P. Pavlov. Vladikavkaz; 2018. 120 p. (In Russ).
  30. Zhukov VV, Pismensky AV, Kozhin AA. The complex ozone laser therapy for patients with neurodermitis. Laser Med. 2018;22(1):34–37. EDN: URRSJB.
  31. Titova LA. Clinical efficacy of low-intensity laser radiation in the treatment of elderly patients with asthma and hormonal disorders. Clin Gerontol. 2010;16(7-8):60–61. EDN: NCVBHZ
  32. Osipova NV, Bruk TM. Some blood parameters of highly skilled football players with different types of cardiac rhythm regulation under the combined effect of physical loading and low-level laser irradiation. Laser Med. 2018;22(3):14–19. EDN: YCMGKL.
  33. Brooke TM, Pleshkova NN, Lifke MV, et al. Reaction of the endogenous opioid system to physical load in individuals of different sport specialisations. Mechanisms of prevention of psychoactive substances consumption. Theory Pract Physical Culture. 2009;(1):20–23. EDN: JWICSF
  34. Strelycheva KA. Features of the functional state of the organism of highly skilled short-trackers under the influence of specific physical load and low-intensity laser radiation [dissertation abstract]: 03.03.01. Place of defence: Institute of Experimental Medicine. St. Petersburg; 2019. 23 р. (In Russ).
  35. Voronkova NA. Application of combined phototherapy and regulatory polypeptide in complex treatment of patients with atopic dermatitis [dissertation]: 14.03.11; 14.01.10. Place of defence: Central State Medical Academy of the Management of Affairs of the President of the Russian Federation. Voronezh; 2021. 135 р. (In Russ).
  36. Ortiz-Salvador JM, Pérez-Ferriols A. Phototherapy in atopic dermatitis. Adv Exp Med Biol. 2017;996:279–286. doi: 10.1007/978-3-319-56017-5_23
  37. Androulakis IP. Circadian rhythms and the HPA axis: A systems view. WIREs Mech Dis. 2021;13(4):e1518. doi: 10.1002/wsbm.1518
  38. Robertson-Dixon I, Murphy MJ, Crewther SG, et al. The influence of light wavelength on human HPA axis rhythms: A systematic review. Life (Basel). 2023;13(10):1968. doi: 10.3390/life13101968
  39. Petrowski K, Bührer S, Albus C, et al. Increase in cortisol concentration due to standardized bright and blue light exposure on saliva cortisol in the morning following sleep laboratory. Stress. 2021;24(3):331–337. doi: 10.1080/10253890.2020.1803265
  40. Petrowski K, Buehrer S, Niedling M, et al. The effects of light exposure on the cortisol stress response in human males. Stress. 2021;24(1):29–35. doi: 10.1080/10253890.2020.1741543
  41. Ishida A, Mutoh T, Ueyama T, et al. Light activates the adrenal gland: Timing of gene expression and glucocorticoid release. Cell Metab. 2005;2(5):297–307. doi: 10.1016/j.cmet.2005.09.009
  42. Kageyama K, Iwasaki Y, Daimon M. Hypothalamic regulation of corticotropin-releasing factor under stress and stress resilience. Int J Mol Sci. 2021;22(22):12242. doi: 10.3390/ijms222212242
  43. Kruglova LS, Novikova LA, Borzunova LN, et al. Clinical effectiveness of combined phototherapy in the treatment of patients with atopic dermatitis Physiotherapy Balneol Rehabilitat. 2020;19(4):239–243. EDN: UVVEIE doi: 10.17816/1681-3456-2020-19-4-6
  44. Mousa RF, Smesam HN, Qazmooz HA, et al. A pathway phenotype linking metabolic, immune, oxidative, and opioid pathways with comorbid depression, atherosclerosis, and unstable angina. CNS Spectr. 2022;27(6):676–690. doi: 10.1017/S1092852921000432
  45. Kim HS, Kim HJ, Hong YD, et al. β-Endorphin suppresses ultraviolet B irradiation-induced epidermal barrier damage by regulating inflammation-dependent mTORC1 signaling. Sci Rep. 2023;13(1):22357. doi: 10.1038/s41598-023-49886-5
  46. Pandey V, Yadav V, Singh R, et al. β-Endorphin (an endogenous opioid) inhibits inflammation, oxidative stress and apoptosis via Nrf-2 in asthmatic murine model. Sci Rep. 2023;13(1):12414. doi: 10.1038/s41598-023-38366-5

Copyright (c) 2023 Eco-Vector

License URL: https://eco-vector.com/for_authors.php#07
 


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies