IMMUNOGENETIC CHARACTERISTICS OF THE CLINICAL COURSE OF PSORIASIS VULGARIS IN THE INHABITANTS OF KEMEROVO REGION

Introduction. Psoriasis pathogenesis is associated with determination through cytokine genes and with the immune imbalance of innate and adaptive immunity determining psoriatic inflammation. Aim. To study the clinical course features of psoriasis in the inhabitants of Kemerovo region, taking into account immunogenetic markers, i. e., levels of immunoglobulins (A, G, and E), lymphocyte subpopulations (CD4, CD8, CD16/56, and CD19), C-reactive protein, and associations of gene polymorphisms (IL1b rs16944, TNFa rs361525, IL10 rs1800896, IL8 rs2227306, IL6 rs1554606, and CRP rs1205). Materials and Methods. The study included patients with clinically confirmed diagnosis: Psoriasis vulgaris (170 patients) and conditionally healthy individuals (155 patients). Molecular-genetic, clinical-laboratory and biochemical research methods were used. Regression analysis was used to evaluate intergenic and gene-immune interactions in determining psoriasis. Results and Discussion. Psoriasis vulgaris severity (according to PASI score) was associated with statistically significant predictors, i. e., minor (mutant) allele T of the polymorphic region of IL8 gene rs2227306, erythrocyte sedimentation rate, serum immunoglobulin E concentration, and the relative content of CD3+ and CD8+ lymphocytes in peripheral blood. A significant psoriasis severity protector has been identified: Relative content of CD16/56 and CD19+ lymphocytes in peripheral blood. Frequent exacerbations of psoriasis (more than 2 times a year) are largely associated with the predictive role of alpha 2 globulin fraction concentrations and the protective role of total leukocyte levels. Relative levels of CD19+ lymphocytes make a significant protective contribution to the formation of psoriatic arthropathies. Conclusions. Skin lesions and the severity of psoriasis main symptoms are due to high humoral inflammatory activity and imbalance of the cellular immunity link and B-lymphocytes in determining high chemotaxis through a polymorphic variant of the IL8 rs2227306 gene. The risk of frequent psoriasis exacerbations (exceeding 2 times a year) is associated with high concentration of alpha 2 globulin fraction and low leukocyte count in peripheral blood. Psoriatic arthropathy is not determined through the polymorphic gene variants studied and considerably depends on the phenotypic response characteristics of adaptive (B-lymphocytes) immunity