title: Alterations in B-cell subsets in pediatric patients with early atopic dermatitis.
abstract: BACKGROUND
  B cells undergo maturation and class-switching in response to antigen exposure and T-cell help. Early B-cell differentiation has not been defined in patients with early-onset atopic dermatitis (AD).
  
  
  OBJECTIVE
  We sought to define the frequency of B-cell subsets associated with progressive B-cell maturation and IgE class-switching.
  
  
  METHODS
  We studied 27 children and 34 adults with moderate-to-severe AD (mean SCORAD score, 55 and 65, respectively) and age-matched control subjects (15 children and 27 adults). IgD/CD27 and CD24/CD38 core gating systems and an 11-color flow cytometric panel were used to determine the frequencies of circulating B-cell subsets. Serum total and allergen-specific IgE (sIgE) levels were measured by using ImmunoCAP.
  
  
  RESULTS
  Compared with adults, children showed T-cell predominance in the skin. Circulating CD19+CD20+B-cell counts were lower in patients with pediatric AD than in control subjects (24% vs 33%, P = .04), whereas CD3+T-cell counts were higher (62% vs 52%, P = .05). A decreased B-cell/T-cell lymphocyte ratio with age was observed only in pediatric control subjects (r = -0.48, P = .07). In pediatric patients with AD, a positive correlation was observed between B-cell/T-cell ratio and nonswitched memory B-cell counts (r = 0.42, P = .03). Higher frequencies of positive sIgE levels were seen in pediatric patients with AD (P < .0001). Diverse sIgE levels correlated with SCORAD scores and age of pediatric patients with AD (P < .01). Positive correlations were observed between activated B-cell and memory T-cell counts (P < .02). In patients with AD, IgE sensitization to most allergens clustered with age, TH1, TH2, total IgE levels, and B-cell memory subsets.
  
  
  CONCLUSIONS
  Peripheral B and T cells are altered in pediatric patients with early AD, but T cells predominate in skin lesions.
authors.affiliation: Laboratory for Investigative Dermatology, Rockefeller University, New York, NY; Department of Dermatology and the Laboratory for Inflammatory Skin Diseases, Icahn School of Medicine at Mount Sinai, New York, NY. Electronic address: tczarnowic01@rockefeller.edu.
authors.forename: Tali
authors.initials: T
authors.lastname: Czarnowicki
authors.affiliation: Laboratory for Investigative Dermatology, Rockefeller University, New York, NY; Department of Dermatology and the Laboratory for Inflammatory Skin Diseases, Icahn School of Medicine at Mount Sinai, New York, NY.
authors.forename: Hitokazu
authors.initials: H
authors.lastname: Esaki
authors.affiliation: Translational Technology Core Laboratory, Rockefeller University, New York, NY.
authors.forename: Juana
authors.initials: J
authors.lastname: Gonzalez
authors.affiliation: Department of Dermatology and the Laboratory for Inflammatory Skin Diseases, Icahn School of Medicine at Mount Sinai, New York, NY.
authors.forename: Yael
authors.initials: Y
authors.lastname: Renert-Yuval
authors.affiliation: Laboratory for Investigative Dermatology, Rockefeller University, New York, NY.
authors.forename: Patrick
authors.initials: P
authors.lastname: Brunner
authors.affiliation: Department of Dermatology and the Laboratory for Inflammatory Skin Diseases, Icahn School of Medicine at Mount Sinai, New York, NY.
authors.forename: Margeaux
authors.initials: M
authors.lastname: Oliva
authors.affiliation: Department of Dermatology and the Laboratory for Inflammatory Skin Diseases, Icahn School of Medicine at Mount Sinai, New York, NY.
authors.forename: Yeriel
authors.initials: Y
authors.lastname: Estrada
authors.affiliation: Department of Dermatology and the Laboratory for Inflammatory Skin Diseases, 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, Rockefeller University, New York, NY.
authors.forename: Xiuzhong
authors.initials: X
authors.lastname: Zheng
authors.affiliation: Departments of Dermatology and Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Ill.
authors.forename: Sreya
authors.initials: S
authors.lastname: Talasila
authors.affiliation: Departments of Dermatology and Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Ill.
authors.forename: Isabel
authors.initials: I
authors.lastname: Haugh
authors.affiliation: Departments of Dermatology and Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Ill.
authors.forename: Thy
authors.initials: T
authors.lastname: Huynh
authors.affiliation: Departments of Dermatology and Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Ill.
authors.forename: Sarah
authors.initials: S
authors.lastname: Lyon
authors.affiliation: Departments of Dermatology and Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Ill.
authors.forename: Gary
authors.initials: G
authors.lastname: Tran
authors.affiliation: Jaffe Food Allergy Institute, Icahn School of Medicine at Mount Sinai, New York, NY.
authors.forename: Hugh
authors.initials: H
authors.lastname: Sampson
authors.affiliation: Department of Dermatology and the Laboratory for Inflammatory Skin Diseases, Icahn School of Medicine at Mount Sinai, New York, NY; Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY; Department of Genetics and Genomics Science, Icahn Institute for Genomics and Multiscale Biology, New York, NY.
authors.forename: Mayte
authors.initials: M
authors.lastname: Suárez-Fariñas
authors.affiliation: Laboratory for Investigative Dermatology, Rockefeller University, New York, NY.
authors.forename: James G
authors.initials: JG
authors.lastname: Krueger
authors.affiliation: Laboratory for Investigative Dermatology, Rockefeller University, New York, NY; Department of Dermatology and the Laboratory for Inflammatory Skin Diseases, Icahn School of Medicine at Mount Sinai, New York, NY.
authors.forename: Emma
authors.initials: E
authors.lastname: Guttman-Yassky
authors.affiliation: Departments of Dermatology and Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Ill.
authors.forename: Amy S
authors.initials: AS
authors.lastname: Paller
mesh_terms: D000328:Adult; D000375:Aging / Q000276:immunology; D000485:Allergens / Q000276:immunology; D016175:B-Lymphocyte Subsets / Q000276:immunology*; D002675:Child, Preschool; D003876:Dermatitis, Atopic / Q000097:blood / Q000276:immunology*; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood / Q000276:immunology; D007223:Infant; D008297:Male; D008875:Middle Aged; D012867:Skin / Q000166:cytology / Q000276:immunology; D013601:T-Lymphocytes / Q000276:immunology
chemical_list: D000485:Allergens; D007073:Immunoglobulin E
keywords: Atopic dermatitis; B cells; T cells; allergen-specific IgE; atopic march