Prominent involvement of activated Th1-subset of T-cells and increased expression of receptor for IFN-gamma on keratinocytes in atopic dermatitis acute skin lesions.
BACKGROUND
Atopic dermatitis (AD) is an allergic skin disease mediated by antigen-specific IgE and an important role has been ascribed to CD4+ cells (Th cells). The objective of the study was to evaluate humoral and cellular immunological factors in the blood and the skin lesions of AD patients, and to analyze the presence of inflammatory cell-surface markers in blood and skin biopsies.


METHODS
The parameters for monitoring of 40 AD patients included results of prick test to inhalant allergens and epicutaneous (patch) test to contact allergens; values of total IgE, serum immunoglobulins (IgG, IgA, IgM) and different cell markers in the sera (CD3, CD4, CD8, CD20, CD21, CD23, HLA-DR). We also analyzed the presence of inflammatory cell-surface markers (CD3, CD4, CD8, CD20, CD20, CD1a, CD23, CD29, CD45Ro, IFNgamma+ markers) in the biopsies of skin lesions from 10 AD patients and 5 healthy controls (HCs) by immunohistochemical analysis (method of avidin-biotin immunoperoxidase).


RESULTS
Beside increased total serum IgE and positive skin tests, a significantly higher percentage of CD23+ cells with lower percentage of CD21+ cells was revealed in peripheral blood of AD patients in comparison to HCs. A positive epidermal expression of the majority of markers of T cells (CD3+, CD4+, CD8+, CD29+, CD45Ro+, IFNgamma+) and those of Langerhans' cells (LCs) (CD1a, CD23+), without those of B cells (CD20+) were noted in AD patients, but no in the skin of HCs. Furthermore, significant difference was also found between the two groups for increased expression of CD3, CD4, CD8, CD29, CD45Ro, IFNgamma+ markers (markers for IFNgamma receptor) and higher intraepidermal CD23+ LCs and intradermal CD1a+ LCs in AD skin lesions.


CONCLUSIONS
The obtained results suggest involvement of various humoral factors with increased production of IgE and cooperation between Th subsets and LCs, with higher production of related cytokines, and disturbed cellular immunity, including epidermal LCs with IgE receptors of high and low affinity in AD. The annotation of activated Th1 cells with increased producing of IFNgamma in acute AD skin lesions is notable, and might lead to IFNgamma binding to keratinocytes and consequently inflammatory skin changes in the disease.
Lugović
Liborija
L
Department of Dermatology and Venereology, University Hospital 'Sestre milosrdnice', Zagreb, Croatia. liborija@yahoo.com
Lipozencić
Jasna
J
Jakić-Razumović
Jasminka
J
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003876:Dermatitis, Atopic / Q000276:immunology* / Q000473:pathology; D005260:Female; D006801:Humans; D007136:Immunoglobulins / Q000097:blood; D007223:Infant; D015603:Keratinocytes / Q000276:immunology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D017471:Receptors, Interferon / Q000378:metabolism*; D012867:Skin / Q000276:immunology / Q000473:pathology*; D012882:Skin Tests; D018417:Th1 Cells / Q000276:immunology*; D000096743:Interferon gamma Receptor
D007136:Immunoglobulins; D017471:Receptors, Interferon; D000096743:Interferon gamma Receptor