ATOPIC DERMATITIS: SKIN AND IMMUNE RESPONSE TO REDUCED ALLERGEN EXPOSURE

这个子项目是许多研究子项目中利用 资源由NIH/NCRR资助的中心拨款提供。子项目和 调查员(PI)可能从NIH的另一个来源获得了主要资金， 并因此可以在其他清晰的条目中表示。列出的机构是 该中心不一定是调查人员的机构。 特应性皮炎(AD)患者的总IgE和对猫和屋尘螨(HDM)等不同来源的过敏原的特异性IgE已被证实升高。据报道，当患者入院时，湿疹的皮损有所改善，这代表了一个“无过敏原”的环境。阿尔茨海默病患者的严重临床疾病被归因于免疫反应抑制或免疫调节失调。我们最近已经证明，AD过敏性患者对变应原的免疫反应在B细胞和T细胞水平上都发生了改变。我们将检验这样一种假设，即携带IgE抗体的受试者对常见过敏原的避免与皮肤状况的改善和对来自HDM和CAT的过敏原的免疫反应的变化有关。在医院环境中接受完整的过敏原避免方案的AD患者将每周(最多3周)监测一次血清抗体(IgG和IgE)和T细胞对常见过敏原和过敏原衍生多肽的反应。T细胞体外反应的详细分析将包括测量过敏原刺激的增殖和细胞因子产生，用流式细胞仪检测细胞表面标志的表达，以及不同T细胞亚群的计数。数据将在每个人体内的每个时间点进行比较，以确定在避免过敏原期间发生的变化。研究结果还将在有和没有常见过敏原的AD患者组之间进行比较。统计检验将包括学生t检验、交叉验证线性判别分析和线性回归分析。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Elevated total IgE and specific IgE to allergens from diverse sources including cat and house dust mite (HDM) have been demonstrated in patients with atopic dermatitis (AD). Improvement of eczematous lesions has been reported when patients are admitted to the hospital, which represents an "allergen-free" environment. Severe clinical disease in AD patients has been attributed to suppression of the immune response or immune dysregulation. We have recently demonstrated that the immune response to allergens is altered at both the B-cell and T-cell level in allergic patients with AD. We will test the hypothesis that allergen avoidance in subjects with IgE ab to common allergens is associated with improvement of skin condition and changes in the immune response to allergens derived from HDM and cat. Serum antibodies (IgG and IgE) and T cell responses to common allergens and allergen-derived peptides will be monitored at weekly intervals (3 weeks maximum) in AD patients who receive a complete allergen avoidance regimen in a hospital environment. Detailed analysis of in vitro T cell responses will include measurement of allergen-stimulated proliferation and cytokine production, expression of cell surface markers by flow cytometry and enumeration of different T cell subsets. Data will be compared at each time point within each individual in order to determine changes which occur during allergen avoidance. Results will also be compared between groups of AD patients with and without IgE ab to common allergens. Statisical tests will include student's t test, cross-validated linear discriminant analysis, and linear regression analysis.