An issue of eradicating measles and rubella virus-induced infections currently remains unresolved, despite existing effective methods for specific prophylaxis and WHO’s commitment to a mass vaccination policy. While improving epidemic situation, analysis of new challenges, such as measles incidence in adults, especially in adults vaccinated in childhood, is of particular interest. The aim of the study was to analyze serum measles and rubella virus-specific IgG antibodies in young healthy people and estimate antigen-specific cellular immune response in seronegative subjects. There were examined 100 healthy adults aged 18–30 years old. Level of serum specific IgG was measured by ELISA (Vector-Best, Russia). Antigen-specific cellular immune response was assessed by magnitude of surface CD107a expression on CD8hi T cells challenged by measles and rubella virus-derived antigens. It was found that average level of antibodies against rubella virus comprised 175.5 IU/ml, 49% of which recovered after rubella, 46% were vaccinated, whereas 5% subjects contained no virus-specific antibodies. In addition, mean level of anti-measles virus antibodies was below protective magnitude, among which 1% subjects recovered after measles, 31% displayed post-vaccination immunity, 55% subjects were seronegative, and 13% had equivocal levels of specific antibodies. Thus, 68% subjects were unprotected against measles virus based on the level of serum virus-specific antibodies. Moreover, 40 out of 68 subjects were vaccinated against measles in childhood. Additional screening adult subjects for intensity of measles and rubella virus-specific cellular immunity demonstrated that 57.37% of them contained peripheral blood CD8 T cells against measles virus and 59.01% — against rubella virus. Further analysis allowed to identify 4 subgroups displaying: 1) high level of virus-specific antibodies and T cells; 2) neither antibodies nor specific T-cells reaching as low as 20% of baseline group; 3) high antibody level combined with low amount of specific T cells; and 4) low antibody level combined with high level of specific T cells. thus, it may be assumed that cellular and humoral immune arms are maintained independently and being active for a long term after vaccination. Preserving a specific T-cell immunity seems to provide protection against infection, thereby accounting for the lack of measles manifestation in all seronegative subjects.

Topical glucocorticoids are conventionally used to treat psoriasis, but such treatment provides a short-term effect, and may cause various complications during long-term usage. A detailed study of the immunopathogenesis of psoriasis has made it possible to use bioengineered drugs that block the main cytokines. It has been shown that IL-36 plays an important regulatory role in pathogenesis of psoriasis. The aim of the study was to study therapeutic effect of patients with psoriasis using topical glucocorticoid hormone versus IL- 36 receptor antagonist (RAIL-36), with respect to clinical course of psoriasis and the subsets of mononuclear cells in venous and capillary blood taken close to the focus of inflammation. 16 patients with psoriasis (group 1a) received 0.1% mometasone cream for 14 days; 20 patients of group 1b received a gel containing 0.4% recombinant RAIL-36 for 14 days. Control group included 20 healthy adults. Treatment efficacy was assessed by PASI, DISHS and DLQI indices. 19 lymphocyte subsets and 3 monocyte subsets were assessed by four-color staining of whole capillary and venous blood with erythrocyte lysis using BD Biosciences (USA) technologies and reagents. It was shown that both drugs led to a decrease in the severity of the disease at the end of treatment. However, 2 weeks after the end of treatment in group 1a, the disease indexes nearly returned to the initial values. Meanwhile, the reduced index levels persisted 2 weeks later in group 1b. Significant deviations (more pronounced in capillary blood) were revealed for the levels of several leukocyte subsets in the psoriasis patients compared with healthy persons. As a result of treatment, we have revealed some changes in the levels of leukocyte subsets common to the two groups, and special differences for the two treatment options, that were more pronounced in capillary blood samples. Both medical preparations used are suitable for treatment of psoriasis.

Psoriasis is considered an autoimmune disease with a predominantly cellular mechanism for the development of disorder. Studies in immune pathogenesis of psoriasis were performed either in animal model, which is not just similar to humans, or the data were obtained in patients by means of skin window method, which is traumatic, or by examining venous blood. However, it is difficult to discern parameters of the local immune response in venous blood samples. We have attempted to find an adequate method which would be convenient both for the patient and for the researcher, in order to assess local immune processes occurring in the skin affected by psoriasis. We examined 20 patients with a verified diagnosis of psoriasis, the average age was 44.3 years. The control group included 15 healthy adults, with average age of 46.6 years. Capillary blood was taken by fingerprick, whereas, in psoriatic patients, the samples were taken near the psoriatic lesion at a final volume of 400 μL in two microvettes. Venous blood (3 mL) was taken from the cubital vein into a vacuum tube with EDTA. Clinical analysis of venous and capillary blood was performed in automated hematological analyzer. Immunophenotyping was performed by four-color staining of whole capillary and venous blood followed by lysis of erythrocytes. Cytofluorometry was performed using techniques and reagents from BD Biosciences (USA). Plasma cytokines were determined by multiplex approach (MagPix, BioRad, USA). Upon clinical analysis of blood, the difference between capillary and venous blood was not found, either in healthy group, or among patients with psoriasis. In healthy people, the subsets of mononuclear cells, did not differ between venous and capillary blood. The samples of capillary and venous blood in the patients with psoriasis showed significantly increased levels of double-positive lymphocytes (CD45RA+/CD45R0+), B lymphocytes and NKT lymphocytes (both for relative and and absolute values). A significant increase in the percentage of naive T lymphocytes, activated helpers (Thact) and Treg, as well as B1 cells and Breg, and a significant decrease in B2 lymphocytes was registered in capillary blood of the patients with psoriasis. In venous blood samples from psoriatic patients, only a significant increase in Thact, Treg, and Breg was revealed. In the capillary blood of patients with psoriasis, we found a significant increase in the levels of non-classical M2 monocytes and inflammatory Minfl monocytes, and a decrease in classical M1 monocyte levels; in venous blood of psoriatic patients, only an increase in inflammatory Minfl monocytes was revealed. In capillary blood, all the studied cytokines in psoriasis patients significantly exceeded the levels of corresponding cytokines in healthy controls, except of IL-10. The levels of this cytokine did not differ from healthy group. In venous blood, the levels of most studied cytokines in the group of patients with psoriasis did not differ from the group of healthy ones. Approximately two-fold increase was revealed for IL-4, IL-21, IL-23 and TNF. First, the subsets of mononuclear cells and the cytokine profile of capillary and venous blood of healthy people did not differ significantly. Secondly, our proposed method for determining the subsets of mononuclear cells and capillary blood cytokines profile from the area of psoriatic lesions may be used to monitor local immunity in the patients with psoriasis. This approach is significantly less traumatic than the skin window method and more informative than the studies of venous blood.

The interleukin-36 (IL-36) family was discerned in the superfamily of interleukin-1 (IL-1) ten years ago. This family includes three isoforms of IL-36α, IL-36β, IL-36γ, which have pro-inflammatory activity and a specific receptor antagonist, IL-36ra, which implements anti-inflammatory function. All of them bind to the same IL-1R6 receptor. The pro-inflammatory isoforms also involve an accessory IL-1RAcP protein into signaling; resulting into conduction of a signal into the cell via the assembling heterodimer receptor. In contrast, IL-36ra inhibits the formation of a heterodimer and blocks the signal transmission. The cytokines of the IL-36 family and appropriate receptors are normally expressed on epithelial cells in barrier tissues such as the respiratory, intestinal tract and skin. Like all cytokines of the IL-1 superfamily, IL-36 is synthesized as inactive form and requires activation, but not due to caspases, but being mediated by neutrophil enzymes, such as cathepsin G, proteinase-3, and elastase, which are constantly present in barrier tissues. In this regard, IL-36 is involved in homeostasis of barrier tissues. Apparently, the IL-36 cytokine system appeared in response to the developing ability of some microorganisms to avoid immune recognition and activation of innate immune response, and, in particular, the IL-1 pro-inflammatory system. An imbalance between the pro- and anti-inflammatory pathways readily causes inflammation in the corresponding tissue. This review discusses participation of cytokines from the IL-36 family in homeostasis of barrier tissues, as well as potential role of the IL-36 family in pathogenesis of bacterial, viral, and fungal skin diseases, atopic dermatitis, autoimmune diseases, such as rheumatoid arthritis, systemic lupus erythematosus, Sjogren's syndrome, ulcerative colitis and Crohn's disease. The role of IL-36 family cytokines in the immunopathogenesis of psoriasis has been well studied. This review is presenting the modern ideas about immune pathogenesis of psoriasis. The special role of cytokines from the IL-36 family was shown both for induction of psoriatic inflammation and evolving a positive feedback loop that supports and enhances the immune component of inflammation, which leads to progression of the disease. Moreover, modern methods of treating psoriasis are discussed, in particular, a possible promising approach to IL-36 blockade, or usage of recombinant IL-36ra for the treatment of psoriatic patients. Experimental studies in this area in mice provide some grounds for optimism.

РЕЗЮМЕ. Псориаз – хроническое аутоиммунное заболевание кожи, с вовлечением Т-клеточного звена иммунитета. Цитокиновая ось интерлейкин (IL)-23/IL-17/IL-22 является ключевой в иммунопатогенезе псориаза. Показана роль подсемейства IL-36, регулирующего воспаление в коже. Для лечения псориаза используют топические препараты. Цель работы: изучение изменений в цитокиновом профиле венозной и капиллярной крови, взятой вблизи очага псориатического воспаления в зависимости от лечения топическими препаратами. Обследованы 40 пациентов с диагнозом псориаз, средний возраст 43,7 лет, Группа 1а (20 чел.) получала местное лечение мометазоном, Группа 1б (20 чел.) получала местно гель, содержащий  рецепторный антагонист IL-36.  20 здоровых, средний возраст 46,6 года, составили контрольную группу 2. Капиллярную кровь собирали из пальца кисти, у больных рядом с очагом поражения 200 мкл в микровету с ЭДТА. Венозную кровь отбирали из локтевой вены 3 мл в вакуумную пробирку с ЭДТА. Концентрацию 15-и цитокинов в плазме крови тестировали мультиплексным методом (MagPix, BioRad, США). Эффективность терапии оценивали с помощью индексов PASI и DLQI. На момент окончания лечения (14-й день) в обеих группах индексы PASI и DLQI значимо снизились. На 28-й день индекс PASI в Группе 1а вернулся к исходному уровню, в группе 1б остался стабильно сниженным. До лечения в капиллярной крови больных псориазом уровни всех цитокинов кроме IL-10 были значимо повышены по сравнению с Группой 2, в венозной крови были повышены уровни 5-и цитокинов. Через 14 дней в Группе 1а в капиллярной крови значимо снизились уровни IL-1, IL-4, IL-6, IL-21, IL-22, IL-23, IL-25, IL-33, а в венозной крови – только IL-17F, IL-21, IL-33 и TNF. На 28-й день концентрации практически всех цитокинов вернулись к исходному уровню. В Группе 1б на 14-й день в капиллярной крови значимо снизились уровни IFN-γ, IL-1, IL-4, IL-17F, IL-21, IL-22, IL-23, IL-25, IL-33, а в венозной крови – IFN-γ, IL-21, IL-22, IL-23, IL-33. На 28-й день продолжалось снижение концентрации, либо сохранялся сниженный уровень указанных цитокинов, в вене значимо снизился IL-6. Таким образом, метод определения профиля цитокинов капиллярной крови из зоны псориатического поражения можно использовать для мониторинга эффекта лечения у больных псориазом.