Participation of Neuropeptides and β-endorphin in Pathogenesis of Atopic Dermatitis. Evaluation of Levocetirizine Effectiveness upon Neuropeptides' Levels at Children with Atopic Dermatitis

Objective. Determination of the role of neuropeptides and p-endorphin in developmental mechanisms ofatopic dermatitis, and assessment of the effectiveness of levocetirizine, a modern Hl-antihistamine, on atopicdermatitis symptoms and its influence on the SCORAD index in children with atopic dermatitis.Materials and methods. 84 children with atopic dermatitis of moderate-to-severe or severe clinical nature,aged 1 to 17 years, were enrolled in this (double-blind or open, randomised, etc.) study. Patients were treatedwith levocetirizine 5 mg once daily during 14 days. The levels of P substance, neurokinin A, neurokinin B,and p-endorphin in blood serum, as well as levocetirizine effectiveness on disease symptoms and the SCORADindex were evaluated.Results. Lower neuropeptide levels were associated with disease severity; children with severe atopicdermatitis had lower neuropeptide values. Before treatment, SCORAD index in children with severe atopicdermatitis was 76,5±11,3, and after 7 days of therapy SCORAD index was 14±6,2 points (p< 0,01). By the 7thday after treatment initiation, the acute atopic dermatitis became of subacute nature and was accompaniedby a regression of the cutaneous eruption in the form of significant decreasing of skin manifestations andpruritus, absence of new eruption and normalized sleep.In children with moderate-to-severe atopic dermatitis the SCORAD index before levocetirizine treatmentwas 44,2±3,4 points; on the 3rd day, this index was 20,4±2,6 points; and on the 7th day there was a completeabsence of clinical symptoms of the main disease.Levocetirizine administration led to the disappearance of the disease clinical symptoms and pruritus inchildren with moderate-to-severe atopic dermatitis.Conclusion. This trial demonstrated that neuropeptides are involved in the developmental mechanisms ofatopic dermatitis and that levocetirizine can significantly improve the signs and symptoms of children withmoderate-to-severe or severe atopic dermatitis.