Elevated levels of soluble HLA class I (sHLA-I) in children with severe atopic dermatitis.
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 production of interferon-gamma. Soluble HLA-I molecule levels are elevated in conditions where T cells are activated such as viral infections, autoimmune diseases, and organ transplantation.


OBJECTIVE
We wished to determine if sHLA-I heterodimers were also elevated in patients with atopic dermatitis and if sHLA-I elevations correlated with disease activity.


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 and HLA-I levels were determined at the time of enrollment into the study. Additional sHLA-I levels were measured after 4 and 8 weeks of therapy.


RESULTS
Mean sHLA-I levels were significantly elevated in atopic dermatitis patients, 2.07 +/- 1.14 versus 1.00 +/- 0.22 microg/mL in controls (P < .0001). Nine of 14 patients (64%) had elevated sHLA-I antigens. Soluble HLA-I levels did not correlate with the extent of disease, 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.


CONCLUSIONS
We conclude that sHLA-I heterodimers are elevated in 64% of our patients with atopic dermatitis and that elevations persist after clinically effective therapy. This conclusion supports recommendations for prolonged preventative and treatment measures in this atopic disease.
Moore
C
C
Department of Pediatrics, Louisiana State University Medical Center, New Orleans 70112-2822, USA.
Ehlayel
M
M
Inostroza
J
J
Leiva
L E
LE
Sorensen
R U
RU
D002648:Child; D002675:Child, Preschool; D004205:Cromolyn Sodium / Q000627:therapeutic use; D018592:Cross-Over Studies; D003876:Dermatitis, Atopic / Q000097:blood* / Q000188:drug therapy / Q000276:immunology*; D004311:Double-Blind Method; D005260:Female; D006680:HLA Antigens / Q000097:blood; D015395:Histocompatibility Antigens Class I / Q000097:blood*; D006801:Humans; D007223:Infant; D008297:Male; D012720:Severity of Illness Index; D012867:Skin / Q000276:immunology; D012995:Solubility
D006680:HLA Antigens; D015395:Histocompatibility Antigens Class I; D004205:Cromolyn Sodium