title: Elevated levels of soluble HLA class I (sHLA-I) in children with severe atopic dermatitis.
abstract: 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.
authors.affiliation: Department of Pediatrics, Louisiana State University Medical Center, New Orleans 70112-2822, USA.
authors.forename: C
authors.initials: C
authors.lastname: Moore
authors.forename: M
authors.initials: M
authors.lastname: Ehlayel
authors.forename: J
authors.initials: J
authors.lastname: Inostroza
authors.forename: L E
authors.initials: LE
authors.lastname: Leiva
authors.forename: R U
authors.initials: RU
authors.lastname: Sorensen
mesh_terms: 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
chemical_list: D006680:HLA Antigens; D015395:Histocompatibility Antigens Class I; D004205:Cromolyn Sodium