Differences in antigen-specific T-cell responses between infants with atopic dermatitis with and without cow's milk allergy: relevance of TH2 cytokines.
BACKGROUND
Cow's milk is the most important food antigen in infancy and may lead to acute cutaneous symptoms and atopic dermatitis (AD). The role of circulating allergen-specific T cells in the pathogenesis of food-allergic skin symptoms is still under investigation.


OBJECTIVE
This study was designed to analyze the cow's milk protein (CMP)-specific T-cell response at the clonal level in infants with AD and cow's milk allergy (CMA) in comparison with infants with AD without CMA.


METHODS
We used an antigen-specific culturing system with autologous B cells as antigen-presenting cells to establish CMP-specific T-cell clones derived from PBMCs in infants with AD. T-cell reactivity, measured by using a lymphocyte stimulation test, and cytokine production, measured by using ELISA, was compared between infants with AD with and without CMA.


RESULTS
Both infants with and without allergy to cow's milk had a CMP-specific T helper cell response directed against the major proteins in milk. Analysis of antigen-specific cytokine production showed that this response was T(H)2 skewed in infants with CMA, with production of high levels of IL-4, IL-5, and IL-13. In contrast, infants without CMA had a T(H)1-skewed response, with high levels of IFN-gamma and low levels of IL-4, IL-5, and IL-13.


CONCLUSIONS
These data confirm for the first time at the clonal level that food allergy in infants with AD is associated with production of T(H)2 cytokines by circulating antigen-specific CD4(+) T cells, whereas tolerance to food antigens is associated with low levels of these cytokines. This suggests a key role for the T helper cell-derived T(H)2 cytokines in food allergy-related skin symptoms.
Schade
R P
RP
Department of Dermatology/Allergology, University Medical Center, Utrecht, The Netherlands.
Van Ieperen-Van Dijk
A G
AG
Van Reijsen
F C
FC
Versluis
C
C
Kimpen
J L
JL
Knol
E F
EF
Bruijnzeel-Koomen
C A
CA
Van Hoffen
E
E
D000818:Animals; D002417:Cattle; D016207:Cytokines / Q000378:metabolism; D003876:Dermatitis, Atopic / Q000150:complications / Q000276:immunology*; D006801:Humans; D007111:Immunity, Cellular / Q000502:physiology; D007223:Infant; D007371:Interferon-gamma / Q000096:biosynthesis; D018793:Interleukin-13 / Q000378:metabolism; D015847:Interleukin-4 / Q000096:biosynthesis; D015848:Interleukin-5 / Q000378:metabolism; D008213:Lymphocyte Activation; D016269:Milk Hypersensitivity / Q000150:complications*; D013601:T-Lymphocytes / Q000276:immunology; D018418:Th2 Cells / Q000378:metabolism
D016207:Cytokines; D018793:Interleukin-13; D015848:Interleukin-5; D015847:Interleukin-4; D007371:Interferon-gamma