title: Diverse activation and differentiation of multiple B-cell subsets in patients with atopic dermatitis but not in patients with psoriasis.
abstract: BACKGROUND
  Atopic dermatitis (AD) and psoriasis pathogeneses involve skin barrier impairment and immune dysregulation; however, the contribution of B-cell imbalances to these diseases has not yet been determined.
  
  
  OBJECTIVE
  We sought to quantify B-cell populations and antibody-secreting cells in the blood of patients with AD, patients with psoriasis, and control subjects.
  
  
  METHODS
  We studied 34 adults with moderate-to-severe AD (mean SCORAD score, 65), 24 patients with psoriasis (mean Psoriasis Area and Severity Index score, 16), and 27 healthy subjects using an 11-color flow cytometric antibody panel. IgD/CD27 and CD24/CD38 core gating systems were used to determine frequencies of plasmablasts and naive, memory, transitional, and activated B cells.
  
  
  RESULTS
  We measured increased CD19(+)CD20(+) B-cell counts in the skin and blood of patients with AD (P < .01). Significantly higher frequencies of chronically activated CD27(+) memory and nonswitched memory B cells were observed in patients with AD (P < .05), with lower values of double-negative populations (4% for patients with AD vs. 7% for patients with psoriasis [P = .001] and 6% for control subjects [P = .02]). CD23 expression was highest in patients with AD and correlated with IgE levels (P < .01) and disease severity (r = 0.6, P = .0002). Plasmablast frequencies and IgE expression were highest in all memory subsets of patients with AD (P < .01). Finally, CD19(+)CD24(++)CD38(++) transitional and CD19(+)CD24(-)CD38(-) new memory B-cell counts were higher in patients with AD versus those in patients with psoriasis (2.8% vs. 1.4% [P = .001] and 9.2% vs. 5.7% [P = .02], respectively).
  
  
  CONCLUSIONS
  AD is accompanied by systemic expansion of transitional and chronically activated CD27(+) memory, plasmablast, and IgE-expressing memory subsets. These data create a critical basis for the future understanding of this debilitating skin disease.
authors.affiliation: Laboratory for Investigative Dermatology, The Rockefeller University, New York, NY. Electronic address: tczarnowic01@rockefeller.edu.
authors.forename: Tali
authors.initials: T
authors.lastname: Czarnowicki
authors.affiliation: Translational Technology Core Laboratory, The Rockefeller University, New York, NY.
authors.forename: Juana
authors.initials: J
authors.lastname: Gonzalez
authors.affiliation: Laboratory for Investigative Dermatology, The Rockefeller University, New York, NY.
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: Bonifacio
authors.affiliation: Department of Dermatology, Tel-Hashomer hospital, Tel Aviv, Israel.
authors.forename: Avner
authors.initials: A
authors.lastname: Shemer
authors.affiliation: Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY.
authors.forename: Peng
authors.initials: P
authors.lastname: Xiangyu
authors.affiliation: Laboratory for Investigative Dermatology, The Rockefeller University, New York, NY.
authors.forename: Norma
authors.initials: N
authors.lastname: Kunjravia
authors.affiliation: Laboratory for Investigative Dermatology, The Rockefeller University, New York, NY; Columbia University College of Physicians and Surgeons, New York, NY.
authors.forename: Dana
authors.initials: D
authors.lastname: Malajian
authors.affiliation: Laboratory for Investigative Dermatology, The Rockefeller University, New York, NY.
authors.forename: Judilyn
authors.initials: J
authors.lastname: Fuentes-Duculan
authors.affiliation: Laboratory for Investigative Dermatology, The Rockefeller University, New York, NY; Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY.
authors.forename: Hitokazu
authors.initials: H
authors.lastname: Esaki
authors.affiliation: Laboratory for Investigative Dermatology, The Rockefeller University, New York, NY.
authors.forename: Shinji
authors.initials: S
authors.lastname: Noda
authors.affiliation: Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY.
authors.forename: Yeriel
authors.initials: Y
authors.lastname: Estrada
authors.affiliation: Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY.
authors.forename: Hui
authors.initials: H
authors.lastname: Xu
authors.affiliation: Laboratory for Investigative Dermatology, The Rockefeller University, New York, NY.
authors.forename: Xiuzhong
authors.initials: X
authors.lastname: Zheng
authors.affiliation: Laboratory for Investigative Dermatology, The Rockefeller University, New York, NY.
authors.forename: James G
authors.initials: JG
authors.lastname: Krueger
authors.affiliation: Laboratory for Investigative Dermatology, The Rockefeller University, New York, NY; Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY.
authors.forename: Emma
authors.initials: E
authors.lastname: Guttman-Yassky
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015703:Antigens, CD / Q000276:immunology; D016175:B-Lymphocyte Subsets / Q000276:immunology*; D003876:Dermatitis, Atopic / Q000097:blood / Q000276:immunology*; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D008213:Lymphocyte Activation; D008297:Male; D008875:Middle Aged; D011565:Psoriasis / Q000276:immunology*
chemical_list: D015703:Antigens, CD; D007073:Immunoglobulin E
keywords: Atopic dermatitis; B cells; psoriasis