Studying the role of cortisol in the pathogenesis of atopic dermatitis during pregnancy

Introduction. Atopic dermatitis (AD) is one of the most common dermatitis, characterized by complex pathogenetic mechanisms. Psychological stress is recognized as one of the triggers of AD. Stress causes a high release of cortisol and epinephrine or norepinephrine, stimulating the immune system, primarily T helper cells type 1 (Th1 cells), to produce pro-inflammatory cytokines, leading to a cellular immune response and inflammation. In recent years, there has been an increase in incidence among pregnant women, however, the specific mechanisms of the development of AD during pregnancy still remain poorly understood. Aim. To study the role of cortisol in AD during pregnancy. Materials and methods. The study included 76 pregnant women during an exacerbation of AD, 20 non-pregnant women during an exacerbation of AD, 20 non-pregnant women without AD, 20 pregnant women without AD. The severity of AD was determined using the SCORAD index. Cortisol levels were determined in blood serum using enzyme-linked immunosorbent assay (ELISA). Anxiety level was determined using the Beck Anxiety Inventory. The level of itching was determined using a 5D itching scale. Results. Cortisol levels in pregnant women with AD (629.8 pg/ml) were significantly higher than in non-pregnant women with AD (386.15 pg/ml) (p < 0.05). Cortisol levels were correlated with the severity level (Spearman coefficient = 0.203, p = 0.018), anxiety level (Spearman coefficient = 0.411, p = 0.001), and level of itching (Spearman coefficient = 0.352, p = 0.001). Conclusions. Cortisol is important in the pathogenesis of AD during pregnancy. During pregnancy with exacerbation of AD, higher values were observed than outside pregnancy.