Exploring on Efficacy and Mechanism to Treat Children's Atopic Dermatitis Jointly with Narrow-Band Ultraviolet B and Desonide Cream Based on Th22/Treg Cell Balance
Objective To investigate the efficacy and mechanism of the joint application of narrow-band ultraviolet B(NB-UVB)and desonide cream in treating children's atopic dermatitis based on the balance of helper T cell 22(Th22)/regulatory T(Treg)cells.Methods Altogether 108 children with atopic dermatitis admitted to Shijiazhuang Maternal and Child Health Hospital over the period from Jan.2021 to Dec.2022 were divided randomly into three groups:group A(n=36),group B(n=36)and group C(n=36).The children in group A,group B and group C were treated with NB-UVB,desonide cream and NB-UVB+desonide cream respectively.Having an irradiation wavelength of 311-313 nm,the NB-UVB was released 20cm away from the skin of the patients with an initial irradiation energy density of 0.3 J/cm2.70％of the minimum erythema dose was selected for the irradiation.The treatment was given 3 times per week and lasted for 3 weeks(9 treatments in total).Three weeks after two courses of treatment,the clinical efficacy of the three groups was observed,and changes to skin barrier functions(including surface water loss,stratum corneum water content and epidermal sebum content)were recorded before and after the treatment.The clinical efficacy was evaluated with scoring atopic dermatitis index(SCORAD),and the degree of itching with visual analog scale(VAS).At the same time,peripheral blood Th22 cell levels and Treg cell levels were measured before and 3 weeks after the treatment respectively.The clinical efficacy,skin barrier function,SCORAD,VAS,peripheral blood Th22/Treg cell level and adverse reactions during the treatment were observed for each group.Results The total effective rate(94.4％)in group C was significantly higher than that(72.2％)in group A and that(75.0％)in group B(P＜0.05).For all the groups,the SCORAD,VAS,Th22 cell level,surface water loss and Th22/Treg decreased significantly and cuticle water content,sebum content of epidermis and Treg cell level increased greatly after the treatment(P＜0.05).The SCORAD,VAS,Th22 cells level,surface water loss and Th22/Treg in group C were significantly lower than those in group A and group B,and the cuticle water content,epidermal sebum content and Treg cell level in group C much higher than those in group A and group B(P＜0.05).There was no significant difference in the incidence of adverse reactions among three groups(P＞0.05).Conclusions For the treatment of children with atopic dermatitis,the clinical efficacy of NB-UVB combine with desonide cream is better than that achieved solely with NB-UVB or desonide cream,which may be relate to the effective regulation of Th22/Treg cell balance.
Atopic dermatitisChildrenNarrow-band ultraviolet BDesonide creamEfficacyHelper T cell 22/Regula-tory T cell
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