title: Milk-responsive atopic dermatitis is associated with a casein-specific lymphocyte response in adolescent and adult patients.
abstract: BACKGROUND
  Specific T-cell responses to food antigens have been described in children with atopic dermatitis (AD). However, a subgroup of adolescent and adult patients still experiences food-responsive AD.
  
  
  OBJECTIVE
  This study was designed to evaluate lymphocyte responses to bovine casein in adult patients with AD.
  
  
  METHODS
  The stimulatory capacity of lipopolysaccharide-depleted bovine casein was tested in proliferation assays and in limiting dilution assays. Casein-specific T-cell clones (TCCs) were generated and characterized.
  
  
  RESULTS
  Higher proliferative responses to casein and modulation of cytokine receptors were observed in patients with milk-responsive AD compared with individuals without clinical reactions on milk ingestion. The results did not correlate with the amount of casein-specific IgE in the serum. The frequencies of T cells that grew in the presence of casein or house dust mite antigens were similar. Only 27% of CD4+ casein-specific TCCs from these patients, but the majority of house dust mite-specific TCCs, produced IL-4 on mitogen stimulation. Interferon-gamma, on the other hand, was produced by the majority of TCCs with both specificities.
  
  
  CONCLUSIONS
  A specific T-cell-mediated immune response to casein can be found in the blood of adolescent and adult patients with milk-related exacerbation of AD. In contrast to house dust mite-specific T cells, casein-specific T cells of adult patients who respond to cow's milk with worsening of AD produce little or no IL-4.
authors.affiliation: Department of Dermatology, Hannover Medical School, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Werfel
authors.forename: G
authors.initials: G
authors.lastname: Ahlers
authors.forename: P
authors.initials: P
authors.lastname: Schmidt
authors.forename: M
authors.initials: M
authors.lastname: Boeker
authors.forename: A
authors.initials: A
authors.lastname: Kapp
authors.forename: C
authors.initials: C
authors.lastname: Neumann
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000485:Allergens / Q000276:immunology / Q000494:pharmacology; D000818:Animals; D002364:Caseins / Q000009:adverse effects*; D002417:Cattle; D002999:Clone Cells / Q000276:immunology; D003876:Dermatitis, Atopic / Q000276:immunology*; D004311:Double-Blind Method; D005069:Evaluation Studies as Topic; D005434:Flow Cytometry; D006801:Humans; D007111:Immunity, Cellular / Q000187:drug effects / Q000276:immunology; D007073:Immunoglobulin E / Q000096:biosynthesis; D008070:Lipopolysaccharides / Q000494:pharmacology; D008213:Lymphocyte Activation / Q000187:drug effects* / Q000276:immunology; D008875:Middle Aged; D016269:Milk Hypersensitivity / Q000276:immunology* / Q000378:metabolism; D008925:Mites / Q000276:immunology; D010919:Placebos; D012680:Sensitivity and Specificity; D013601:T-Lymphocytes / Q000166:cytology / Q000187:drug effects* / Q000276:immunology*
chemical_list: D000485:Allergens; D002364:Caseins; D008070:Lipopolysaccharides; D010919:Placebos; D007073:Immunoglobulin E