A group of atopic dermatitis without IgE elevation or barrier impairment shows a high Th1 frequency: Possible immunological state of the intrinsic type

Rieko Kabashima-Kubo, Motonobu Nakamura, Jun ichi Sakabe, Kazunari Sugita, Ryosuke Hino, Tomoko Mori, Miwa Kobayashi, Toshinori Bito, Kenji Kabashima, Koetsu Ogasawara, Yukiko Nomura, Toshifumi Nomura, Masashi Akiyama, Hiroshi Shimizu, Yoshiki Tokura

Research output: Contribution to journalArticlepeer-review

68 Citations (Scopus)

Abstract

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-γ-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.

Original languageEnglish
Pages (from-to)37-43
Number of pages7
JournalJournal of dermatological science
Volume67
Issue number1
DOIs
Publication statusPublished - 2012 Jul

Keywords

  • Atopic dermatitis
  • Extrinsic
  • Filaggrin
  • IgE
  • Intrinsic
  • Th1
  • Th2

ASJC Scopus subject areas

  • Biochemistry
  • Molecular Biology
  • Dermatology

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