Skin tests, T cell responses and self-reported symptoms in children with allergic rhinitis and asthma due to house dust mite allergy.
BACKGROUND
In allergic responses, a distinction is made between an early-phase response, several minutes after allergen exposure, and a late-phase response after several hours. During the late phase, eosinophils and T cells infiltrate the mucosa and play an important role in inflammation.


OBJECTIVE
The aim of this study was to examine the relationship between allergen-induced late-phase skin responses and in vitro T cell reactivity. In addition, the relationship between allergen-induced skin or T cell responses and the severity of self-reported symptoms was studied in children with house dust mite allergy.


METHODS
A total of 59 house dust mite-allergic children (6-18 years) were recruited in general practice. These children or their parents rated their nasal and asthma symptoms on diary cards during 1 month. Allergen skin tests were performed and read after 15 min (early phase) and 6 h (late phase). Allergen-specific T cell proliferation was determined, and Th2 cytokine (IL-5 and IL-13) secretion was analysed.


RESULTS
The size of the late-phase skin response correlated with in vitro T cell proliferation (r(s)=0.38, P=0.003) but not with Th2 cytokine secretion (r(s)=0.16, P=0.2 for both IL-5 and IL-13). Moreover, the late-phase skin response and T cell proliferation correlated with asthma symptoms (r(s)=0.30, P=0.02 for skin response and r(s)=0.28, P=0.03 for T cell proliferation) but not with nasal symptoms (r(s)=0.19, P=0.15 for skin response and r(s)=0.09, P=0.52 for T cell proliferation). The early-phase skin response correlated with the nasal symptom score (r(s)=0.34, P=0.01) but not with asthma symptom scores (r(s)<0.005, P=0.97).


CONCLUSIONS
In this study, the late-phase skin test response correlated with in vitro T cell proliferation but not with Th2 cytokine secretion. We found weak or no correlations between late-phase skin responses and symptoms of asthma or rhinitis in children with house dust mite allergy. This suggests that late-phase skin responses reflect certain T cell properties but are of limited value for the evaluation of airway symptoms in atopic children.
Moed
H
H
Department of General Practice, Erasmus MC - University Medical Center, Rotterdam, The Netherlands. h.moed@erasmusmc.nl
van Wijk
R Gerth
RG
de Jongste
J C
JC
van der Wouden
J C
JC
D000293:Adolescent; D000818:Animals; D001249:Asthma / Q000175:diagnosis / Q000276:immunology*; D001944:Breath Tests; D002648:Child; D040002:Dermatophagoides pteronyssinus / Q000276:immunology*; D005260:Female; D006801:Humans; D006968:Hypersensitivity, Delayed / Q000276:immunology; D018793:Interleukin-13 / Q000378:metabolism; D015848:Interleukin-5 / Q000378:metabolism; D008213:Lymphocyte Activation / Q000276:immunology; D008297:Male; D008499:Medical Records; D009569:Nitric Oxide / Q000032:analysis / Q000378:metabolism; D012221:Rhinitis, Allergic, Perennial / Q000175:diagnosis / Q000276:immunology*; D012882:Skin Tests; D013601:T-Lymphocytes / Q000276:immunology* / Q000378:metabolism
D018793:Interleukin-13; D015848:Interleukin-5; D009569:Nitric Oxide