C. Moore et al., ELEVATED LEVELS OF SOLUBLE HLA CLASS-I (SHLA-I) IN CHILDREN WITH SEVERE ATOPIC-DERMATITIS, Annals of allergy, asthma, & immunology, 79(2), 1997, pp. 113-118
Background: Atopic dermatitis is characterized by increased production
of IgE and interleukin-4, immediate skin test reactivity to allergens
, increased expression of CD23 on mononuclear cells, and decreased pro
duction of interferon-gamma. Soluble HLA-I molecule levels are elevate
d in conditions where T cells are activated such as viral infections,
autoimmune diseases, and organ transplantation. Objective: We wished t
o determine if sHLA-I heterodimers were also elevated in patients with
atopic dermatitis and if sHLA-I elevations correlated with disease ac
tivity. Methods: Fourteen children with atopic dermatitis resistant to
conventional treatment were followed over an 8-week period during an
ongoing trial of treatment with topical sodium cromoglycate. Extent of
skin involvement, disease severity, absolute eosinophil counts, IgE a
nd HLA-I levels were determined at the time of enrollment into the stu
dy. Additional sHLA-I levels were measured after 4 and 8 weeks of ther
apy. Results: Mean sHLA-I levels were significantly elevated in atopic
dermatitis patients, 2.07 +/- 1.14 versus 1.00 +/- 0.22 mu g/mL in co
ntrols (P < .0001). Nine of 14 patients (64%) had elevated sHLA-I anti
gens. Soluble HLA-I levels did not correlate with the extent of diseas
e, disease severity score, eosinophil count, or IgE levels. There was
a remarkable consistency in sHLA-I levels at baseline and after 4 and
8 weeks of therapy, even with significant clinical improvement. Conclu
sion: We conclude that sHLA-I heterodimers are elevated in 64% of our
patients with atopic dermatitis and that elevations persist after clin
ically effective therapy. This conclusion supports recommendations for
prolonged preventative and treatment measures in this atopic disease.