IMBALANCE OF THE CELLULAR IMMUNE SYSTEM IN ALLERGIC VASCULITIS: IMMUNOPATHOGENETIC FEATURES AND CLINICAL IMPLICATIONS

Abstract

Allergic vasculitis is a heterogeneous group of immune-mediated vascular disorders characterized by inflammatory damage to small and medium-sized blood vessels, predominantly affecting the skin. Despite extensive investigation of humoral immune mechanisms, the role of cellular immunity and its regulatory balance remains insufficiently elucidated. The present study aims to analyze the state of the cellular arm of the immune system in patients with superficial and deep forms of allergic vasculitis, with particular emphasis on T- and B-lymphocyte subpopulations and the immunoregulatory index. A comprehensive clinical and immunological examination was conducted in 226 patients with allergic vasculitis and 40 healthy controls. Quantitative assessment of immunocompetent cells revealed a significant reduction in total T-lymphocytes, CD4⁺ T-helper cells, and natural killer cells, accompanied by relative activation of the B-cell compartment and marked disturbances in the CD4/CD8 ratio. The severity of immune imbalance correlated with disease duration and clinical depth of vascular involvement. The findings indicate that allergic vasculitis is associated with progressive dysregulation of cellular immunity, leading to impaired immunological cooperation and persistence of chronic inflammation. These results highlight the pathogenetic significance of cellular immune imbalance in allergic vasculitis and support the rationale for immunomodulatory approaches in disease management.