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Phenotypes of lymphocytes in exudate in atopic dermatitis

Aim. To determine subpopulations of lymphocytes in exudate in atopic dermatitis. 
Material and methods. The study included 80 patients with atopic dermatitis according to predetermined inclusion and exclusion criteria, who were under dispensary supervision at the Regional Dermatovenerologic Dispensary (Chita) from 2018 to 2021. Two groups (adolescents and adults) and two subgroups (patients with limited and widespread lesions) were formed. Skin exudate sampling was carried out during the period of exacerbation of the disease. The control group consisted of 30 practically healthy volunteers undergoing a medical examination at the same dispensary, having primary health records and meeting the inclusion criteria for the study. Lymphocyte phenotypes were determined in skin exudate by flow cytofluorometry. Statistical analysis was performed using Microsoft Excel, IBM SPSS Statistics version 25.0, and the ShapiroWilk test, MannWhitney and Wilcoxon U-test, KruskalWallis nonparametric analysis of variance were used. The data were presented by median and interquartile intervals Me (25%; 75%). The critical indicator of the significance level of the differences was p 0.05. 
Results. In the exudate of practically healthy volunteers, obtained by the skin window method, no subpopulations of lymphocytes were detected. In the skin exudate of adolescents with limited lesions, the content of lymphocytes was 149.00 (129.75; 157.75) cells/l, T-lymphocytes (CD3+CD19) 109.5 (96.25; 113.75) cells/l, among them 48.95% active, T-helpers 42.5 (39.25; 57.50) cells/l, natural killers (CD3+CD16+CD56+) 38.50 (36.25; 41.00) cells/l, however, with the widespread process, the level of lymphocytes increased by 11% (p1=0.002), T-helpers by 45%, natural killers by 27%, T-lymphocytes up to 125.00 (110.5;135.75) cells/l (p1=0.00001). These indicators in adults and the level of cytotoxic T-lymphocytes (CD3+CD8+) in adolescents and adults had no significant differences. The number of T-NK-killers (CD3+CD16+CD56+) in adolescents was higher with a widespread process 23.00 (11.75; 29.75) cells/l (p1=0.0001), in adults with a limited process 18.00 (10.25; 20.75) cells/l (p2=0.0001). The number of NKCD8+ (CD3CD16+CD56+CD8+) in adolescents with limited dermatosis was 22.50 (18.25; 26.00) cells/l, with widespread dermatosis 1.6 times more (p1=0.0001), in adults with a limited process 29.50 (25.25; 33.75) cells/l, with widespread 27% less (p1=0.0001). 
Conclusion. In the skin exudate in atopic dermatitis, cytotoxic T-lymphocytes, T-NK-killers, natural killers, CD8-positive NK-killers are detected.