Antigen specific cytokine response in pediatric patients with atopic dermatitis

Valentina Bordignon, Jo Linda Sinagra, Elisabetta Trento, Mario Pietravalle, Bruno Capitanio, Paola Cordiali Fei

Research output: Contribution to journalArticle

Abstract

The physiopathology of atopic dermatitis (AD) has still to be elucidated. T effector cells with cutaneous homing receptors or T-cell derived cytokines have been assumed to be implicated in the pathogenetic mechanisms in AD and to be responsible for the different immunologic responses of patients. In fact, the large majority of AD patients display high IgE levels while others do not develop an abnormal IgE response. Although, there are not significant clinical features characterizing the two different groups, patients with normal IgE belong to a younger age range, raising the possibility that the hypothesized dichotomy of AD might be due to age. In the present study we included 172 outpatient children attending the Pediatric Department of our institution. Serum IgE levels and percentages of peripheral T lymphocytes expressing the cutaneous homing antigen (CLA) were evaluated and results were analyzed in relation to the activity of the disease (SCORAD index) or age. In the overall patients, the IgE levels increased significantly with age (0-1 yr: 19.50 IU/ml; 1-3 yr: 62.0 IU/ml; 3-8 yr: 96.0 IU/ml; >8 yr: 148.5 IU/ml; p <0.001) and with the severity of the disease (SCORAD low: 46.80 IU/ml; medium: 42.90 IU/ml; high: 148.5 IU/ml; p = 0.01). Percentages of CLA+ peripheral T lymphocytes also increased with age (0-1 yr: 3.3; 1-3 yr: 4.85; 3-8 yr: 10.6; >8 yr: 12.5; p <0.001), although they were not significantly different in patients with different SCORAD (p = 0.89). We further investigated the cellular immune response to a specific antigen in 25 subjects, matched for age, SCORAD, and CLA+ T-cell percentages. Among them. 13 patients had casein serum specific IgE and 12 had no evidence of casein sensitization. Peripheral blood mononuclear cells were kept in short-term culture with endotoxin-free casein fractions and IFN-γ, TNF-α, IL-5, IL-10 cytokine-producing cells were detected by ELISpot. Statistical analysis showed significant higher numbers of TNF-α- or IL-10-producing cultures (stimulation index > 3) in the 'allergic' patients than in the milk tolerant subjects (p = 0.01 and 0.05). The analysis of individual responses confirmed this finding but also provide evidence of a significant increase in IFN-γ-producing cells (p = 0.05) induced by casein stimulation in the group of 'non-allergic' children. Our data showed that immunologic parameters as IgE levels or CLA+ T cells in AD pediatric patients are influenced by the age, confirming that age could represent a bias in the analysis of immune response in those patients. Although, we demonstrated in children with AD the existence of different cytokine patterns of the lymphocyte response that could account for the different immunologic features between the two hypothesized forms of AD, which are not dependent on age.

Original languageEnglish
Pages (from-to)113-120
Number of pages8
JournalPediatric Allergy and Immunology
Volume16
Issue number2
DOIs
Publication statusPublished - Mar 2005

Fingerprint

Atopic Dermatitis
Immunoglobulin E
Pediatrics
Cytokines
Antigens
Lymphocyte Homing Receptors
T-Lymphocytes
Skin
Caseins
Milk
Outpatients
Lymphocytes
Serum

Keywords

  • Atopic dermatitis
  • Children
  • CLA+ T lymphocytes
  • Cytokines
  • Total IgE

ASJC Scopus subject areas

  • Immunology and Allergy
  • Pediatrics, Perinatology, and Child Health
  • Immunology

Cite this

Antigen specific cytokine response in pediatric patients with atopic dermatitis. / Bordignon, Valentina; Sinagra, Jo Linda; Trento, Elisabetta; Pietravalle, Mario; Capitanio, Bruno; Cordiali Fei, Paola.

In: Pediatric Allergy and Immunology, Vol. 16, No. 2, 03.2005, p. 113-120.

Research output: Contribution to journalArticle

Bordignon, Valentina ; Sinagra, Jo Linda ; Trento, Elisabetta ; Pietravalle, Mario ; Capitanio, Bruno ; Cordiali Fei, Paola. / Antigen specific cytokine response in pediatric patients with atopic dermatitis. In: Pediatric Allergy and Immunology. 2005 ; Vol. 16, No. 2. pp. 113-120.
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