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Alterations in B-cell subsets in pediatric patients with early atopic dermatitis

Published:December 10, 2016DOI:https://doi.org/10.1016/j.jaci.2016.09.060

      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.

      Key words

      Abbreviations used:

      AD (Atopic dermatitis), BM (Bone marrow), CLA (Cutaneous lymphocyte antigen), DN (Double negative), ICOS (Inducible T-cell costimulator), IHC (Immunohistochemistry), NSM (Nonswitched memory), SEA (Staphylococcus aureus enterotoxin A), SEB (Staphylococcus aureus enterotoxin B), sIgE (Allergen-specific IgE), SM (Switched memory), Tcm (Central memory T), Tem (Effector memory T)
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