A group of atopic dermatitis without IgE elevation or barrier impairment shows a high Th1 frequency: Possible immunological state of the intrinsic type
A group of atopic dermatitis without IgE elevation or barrier impairment shows a high Th1 frequency: Possible immunological state of the intrinsic type
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DOI：
10.1016/j.jdermsci.2012.04.004
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发表时间：
2012-07-01
影响因子：
4.6
通讯作者：
Tokura, Yoshiki
中科院分区：
文献类型：
--
作者：
Kabashima-Kubo, Rieko;Nakamura, Motonobu;Tokura, Yoshiki
目的：探讨日本AD患者辅助性T细胞极化与屏障状态的关系。方法：入选21例特应性皮炎患者(低IgE组；82.5+59.6kU/L)为无屏障损害的AD患者；48例IgE和GT正常的AD患者(高IgE组)；8.050+/-10.400 Ku/L)。用细胞内细胞因子染色和流式细胞术检测日本患者外周血中Th1、Th2和Th17细胞的微丝蛋白基因(flaggrin，Flg)突变，用ELISA法检测血中CCL17/TARC、IL-18和P物质的水平。结果：IgE低表达组的Flg突变发生率(10.5%)显著低于IgE高表达组(44.4%)(正常者为3.7%)。低IgE组产生Th1干扰素的百分率显著高于高IgE组，而Th2和Th17无显著差异。相应地，低IgE组Th2趋化因子CCL17/TARC显著低于高IgE组。两组患者血清IL-18水平、血浆P物质水平及其与瘙痒的相关性均无显著差异。结论：低IgE组与高IgE组不同，其Flg基因突变较少，Th1细胞增多，CCL17水平较低。在内生型中，非蛋白抗原能够穿透未受损的屏障，可能会引起Th1湿疹反应。(C)2012年日本皮肤病研究学会。爱思唯尔爱尔兰有限公司出版。版权所有。
Background: Atopic dermatitis (AD) can be classified into the major extrinsic type with high serum IgE levels and impaired barrier, and the minor intrinsic type with normal IgE levels and unimpaired barrier.Objective: To characterize the intrinsic type of Japanese AD patients in the T helper cell polarization in relation to the barrier condition.Methods: Enrolled in this study were 21 AD patients with IgE < 200 kU/L (IgE-low group; 82.5 +/- 59.6 kU/L) having unimpaired barrier, and 48 AD patients with IgE > 500 kU/L (IgE-high group; 8.050 +/- 10.400 kU/L). We investigated filaggrin gene (FLG) mutations evaluated in the eight loci common to Japanese patients, circulating Th1, Th2 and Th17 cells by intracellular cytokine staining and flow cytometry, and blood levels of CCL17/TARC, IL-18, and substance P by ELISA.Results: The incidence of FLG mutations was significantly lower in the IgE-low group (10.5%) than the IgE-high group (44.4%) (normal individuals, 3.7%). The percentage of IFN-gamma-producing Th1, but not Th2 or Th17, was significantly higher in the IgE-low than IgE-high group. Accordingly, Th2-attracting chemokine CCL17/TARC, was significantly lower in the IgE-low than the IgE-high group. There were no differences between them in serum IL-18 levels, or the plasma substance P levels or its correlation with pruritus.Conclusion: The IgE-low group differed from the IgE-high group in that it had much less FLG mutations, increased frequency of Th1 cells, and lower levels of CCL17. In the intrinsic type, non-protein antigens capable of penetrating the unimpaired barrier may induce a Th1 eczematous response. (C) 2012 Japanese Society for Investigative Dermatology. Published by Elsevier Ireland Ltd. All rights reserved.