CIRCULATING SKIN-HOMING T-CELLS IN ATOPIC-DERMATITIS - SELECTIVE UP-REGULATION OF HLA-DR, INTERLEUKIN-2R, AND CD30 AND DECREASE AFTER COMBINED UV-A AND UV-B PHOTOTHERAPY
Pa. Piletta et al., CIRCULATING SKIN-HOMING T-CELLS IN ATOPIC-DERMATITIS - SELECTIVE UP-REGULATION OF HLA-DR, INTERLEUKIN-2R, AND CD30 AND DECREASE AFTER COMBINED UV-A AND UV-B PHOTOTHERAPY, Archives of dermatology, 132(10), 1996, pp. 1171-1176
Background: As the cutaneous lymphocyte-associated antigen appears to
detect circulating T cells that migrate to the skin in atopic dermatit
is but not T cells that migrate to mucosal sites in allergic asthma an
d rhinitis, we investigated T-cell activation markers and CD30 on the
cutaneous lymphocyte-associated antigen-positive circulating T-cell su
bset in atopic dermatitis to see whether these markers are different f
rom those in normal controls and related to disease activity. Design:
Open study. Setting: University referral center. Patients: Twelve pati
ents with atopic dermatitis and 12 healthy controls. Intervention: Com
bined UV-A and UV-B treatment for 2 months. Main Outcomes Measures: Pe
rcentage of circulating cutaneous lymphocyte-associated antigen-positi
ve T cells that express HLA-DR, interleukin-2 receptor, CD69, CD71, an
d CD30 (triple-color flow cytometric analysis). Clinical score, Dermat
ology Life Quality Index, pruritus score, and consumption of topical c
orticosteroids were determined. Results: Increased relative numbers of
cutaneous lymphocyte-associated antigen-positive T cells expressing H
LA-DR, interleukin-2 receptor, and CD30 were found in patients with at
opic dermatitis before treatment. Treatment with UV-A and UV-B was ass
ociated with clinical improvement and a decrease of levels of HLA-DR,
interleukin-2 receptor, and CD30 in cutaneous lymphocyte-associated an
tigen-positive T cells. HLA-DR on cutaneous lymphocyte-associated anti
gen-positive T cells correlated significantly with the clinical score.
Conclusion: Expression of HLA-DR and interleukin-2 receptor is a sens
itive marker of disease activity in atopic dermatitis. Apart from givi
ng information on disease activity in atopic dermatitis, the availabil
ity of skin-seeking T cells in the blood offers the opportunity to obt
ain further information on T cells that may have effector function in
the skin.