NO RELATIONSHIP BETWEEN SKIN-INFILTRATING T-H2-LIKE CELLS AND ALLERGEN-SPECIFIC IGE RESPONSE IN ATOPIC-DERMATITIS

More than 500 CD4(+) T-cell clones (TCCs) derived from the skin of eig ht patients with atopic dermatitis (AD), two patients with nonatopic d ermatologic disorders, two patients with allergic rhinitis, and one he althy nonatopic donor were analyzed for both their pattern of cytokine production and their antigen specificity. The proportions of TCCs fro m patients with AD producing interleukin-4 in response to stimulation with phorbol 12-myristate 13-acetate pins anti-CD3 antibody were highe r, whereas the proportions of interferon-gamma-producing TCCs were low er than those of control subjects. In two patients with AD, the majori ty of TCCs had a T-H2/T-H0-like phenotype, whereas in six patients wit h AD a T-H1/T-H0-like phenotype was prevalent. TCCs with a T-H2/T-H0-l ike phenotype wets also isolated from the healthy skin of two patients with allergic rhinitis and one nonatopic donor: In contrast, no T-H2- like TCCs were derived from the skin of the two patients with dermatol ogic disorders of nonallergic origin. No unambiguous correlation was f ound between the proportions of TCCs producing interleukin-4 or interf eron-gamma (or of TCCs with T-H2- or T-H1-like profile) and the level of total serum IgE, suggesting that CD4(+) T cells infiltrating the at opic skin do not play a major role in the production of serum IgE anti bodies. When TCCs from five patients with AD were examined for their s pecificity, the proportions of allergen-specific (Dermatophagoides pte ronyssinus and Lol p 1) clones were consistently 6% or lower even in p atients with high titers of ryegrass- or D. pteronyssinus-specific IgE antibodies. Because similar percentages of allergen-specific TCCs wer e found in skin from two healthy control subjects, the role of aeroall ergens in favoring and maintaining skin lesions in patients with AD re mains unclear.