vspВопросы современной педиатрииCurrent Pediatrics1682-55271682-5535Издательство «ПедиатрЪ»10.15690/vsp.v22i5.2622vsp-3306Research ArticleКЛИНИЧЕСКОЕ НАБЛЮДЕНИЕCLINICAL OBSERVATIONSЭффективность и безопасность дупилумаба при тяжелом атопическом дерматите у детей в возрасте до 6 лет: два клинических случаяDupilumab Efficacy and Safety in Severe Atopic Dermatitis in Children under 6 Years of Age: Two Clinical Caseshttps://orcid.org/0000-0003-2252-8570МурашкинН. Н.MurashkinNikolay N.

Мурашкин Николай Николаевич - доктор медицинских наук, профессор, руководитель НИИ детской дерматологии, заведующий отделением дерматологии и аллергологии, заведующий лабораторией патологии кожи у детей отдела научных исследований в педиатрии ФГАУ «НМИЦ здоровья детей» Минздрава России, профессор кафедры дерматовенерологии и косметологии ФГБУ ДПО «ЦГМУ» УДП РФ, профессор кафедры педиатрии и детской ревматологии ФГАОУ ВО Первый МГМУ им. И.М. Сеченова Минздрава России (Сеченовский Университет).

119991, Москва, Ломоносовский пр-т, д. 2, стр. 1, тел.: +7 (495) 967-14-20

m_nn2001@mail.ruhttps://orcid.org/0000-0002-0858-8780ОпрятинЛ. А.OpryatinLeonid A.

Москва

Moscow

https://orcid.org/0009-0003-5367-3268ПавловаЕ. С.PavlovaEkaterina S.

Москва

Moscow

https://orcid.org/0000-0002-4107-4642ЕпишевР. В.EpishevRoman V.

Москва

Moscow

https://orcid.org/0000-0002-6034-8231МатерикинА. И.MaterikinAlexandr I.

Москва

Moscow

https://orcid.org/0000-0002-0081-0981ИвановР. А.IvanovRoman A.

Москва

Moscow

https://orcid.org/0000-0001-6884-5171СавеловаА. А.SavelovaAlena A.

Москва

Moscow

https://orcid.org/0000-0001-5739-0941ЛеоноваМ. А.LeonovaMaria A.

Москва

Moscow

НМИЦ здоровья детей; Первый МГМУ им. И.М. Сеченова (Сеченовский Университет); ЦГМАРоссияNational Medical Research Center of Children’s Health; Sechenov First Moscow State Medical University; Central State Medical Academy of Department of Presidential AffairsRussian FederationНМИЦ здоровья детейРоссияNational Medical Research Center of Children’s HealthRussian Federation202306112023225443–449Copyright © Мурашкин Н.Н., Опрятин Л.А., Павлова Е.С., Епишев Р.В., Материкин А.И., Иванов Р.А., Савелова А.А., Леонова М.А., 20232023Мурашкин Н.Н., Опрятин Л.А., Павлова Е.С., Епишев Р.В., Материкин А.И., Иванов Р.А., Савелова А.А., Леонова М.А.Murashkin N.N., Opryatin L.A., Pavlova E.S., Epishev R.V., Materikin A.I., Ivanov R.A., Savelova A.A., Leonova M.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://vsp.spr-journal.ru/jour/article/view/3306Обоснование

Обоснование. Атопический дерматит (АтД) в большинстве случаев манифестирует в первый год жизни. Ранняя манифестация болезни ассоциирована с развитием сопутствующих атопических состояний в рамках феномена «атопического марша». Патогенез АтД связан с наличием генетической предрасположенности, дисфункцией эпидермального барьера, а также иммунной дисрегуляцией. Именно Т2-воспаление, определяющее весь иммунный каскад воспалительных реакций, обусловливает необходимость ранней медикаментозной интервенции с целью модификации течения болезни. Описание клинического случая. В статье представлено описание двух клинических случаев тяжелого АтД у детей в возрасте до 6 лет. В обоих случаях лечение проведено с применением генно-инженерного биологического препарата дупилумаб. На фоне непрерывной терапии в течение 4–5 мес удалось купировать кожные проявления болезни.

Заключение

Заключение. АтД, манифестирующий в младенческом возрасте, ассоциирует с высоким риском развития в старшем возрасте других заболеваний атопического спектра. Своевременное назначение биологической терапии позволяет воздействовать на иммунную дисрегуляцию, тем самым помогая предотвратить развитие сопутствующих атопических состояний.

Background

Background. Atopic dermatitis (AD) manifests during the first year of life in majority of all cases. The early disease onset is associated with the development of comorbid atopic conditions within the «atopic march» phenomenon. The AD pathogenesis is associated with genetic predisposition, epidermal barrier dysfunction, and immune dysregulation. T2-inflammation specifically determines the entire immune cascade of inflammatory reactions, and, thus, dictates the need of early drug intervention to modify the disease course. Clinical case description. This article presents two clinical cases of severe AD in children under 6 years of age. The treatment of both cases included genetically engineered biologic drug dupilumab. Continuous therapy for 4–5 months made it possible to relieve the skin manifestations of the disease.

Conclusion

Conclusion. AD, manifesting in infancy, is associated with high risk of developing other atopic spectrum diseases in older age. The timely onset of biological therapy allows us to affect immune dysregulation, and thereby to prevent the comorbid atopic conditions development.

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The authors declare that there are no conflicts of interest present.