CONVERSION OF THE CD4(-CELL PROFILE FROM T-H2-DOMINANT TYPE TO T-H1-DOMINANT TYPE AFTER VARICELLA-ZOSTER VIRUS-INFECTION IN ATOPIC-DERMATITIS() T)

Skin lesions of atopic dermatitis were examined for cytokine expressio n by reverse transcription-polymerase chain reaction. The profile of m RNA for various cytokines revealed that both T-H1 and T-H2 types of CD 4(+) T cells, probably including T-H0 type, infiltrate into the skin l esion. We observed that atopic skin lesions improved after varicella i nfection. In such lesions, expression of T-H1 type cytokines predomina ted. The peripheral blood T cells from atopic patients exhibited a dif ferentiation into T-H2 type cells upon in vitro stimulation with mite antigen. In contrast they differentiated into T-H1 type cells upon sti mulation by varicella antigen. Since IL-12 has been reported to switch the in vitro recall response of allergen-specific T cells of atopic d onors from a T-H2- to a T-H1-like phenotype, we examined its local pro duction in varicella lesions. IL-12 p35 and p40 mRNA were expressed in fresh lesions. Peripheral blood mononuclear cells from atopic patient s expressed p40 mRNA upon in vitro stimulation with live varicella tes ter virus, but they did not show p40 mRNA without stimulation. This fi nding suggested that in atopic skin lesions containing the virus, IL-1 2 was produced and the cell type was changed to T-H1 type-predominance . These results suggested that patients with atopic dermatitis always have highly reactive CD4(+) T cells infiltrating into their skin, and that the snitch to T-H1 or T-H2 dominance is related to whether the le sion is improved or exacerbated.