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.
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.
J Allergy Clin Immunol. 2017 Jul;140(1):134-144.e9. doi: 10.1016/j.jaci.2016.09.060. Epub 2016 Dec 10.
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).
We sought to define the frequency of B-cell subsets associated with progressive B-cell maturation and IgE class-switching.
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.
Compared with adults, children showed T-cell predominance in the skin. Circulating CD19CD20 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, T1, T2, total IgE levels, and B-cell memory subsets.
Peripheral B and T cells are altered in pediatric patients with early AD, but T cells predominate in skin lesions.
B 细胞在抗原暴露和 T 细胞辅助下经历成熟和类别转换。早期 B 细胞分化在早发性特应性皮炎（AD）患者中尚未确定。
我们旨在确定与 B 细胞渐进成熟和 IgE 类别转换相关的 B 细胞亚群的频率。
我们研究了 27 名儿童和 34 名成人中重度 AD 患者（平均 SCORAD 评分分别为 55 和 65）以及年龄匹配的对照者（15 名儿童和 27 名成人）。使用 IgD/CD27 和 CD24/CD38 核心门控系统和 11 色流式细胞术面板来确定循环 B 细胞亚群的频率。通过 ImmunoCAP 测量血清总和过敏原特异性 IgE（sIgE）水平。
与成人相比，儿童皮肤中 T 细胞占优势。与对照组相比，患有儿科 AD 的儿童患者的循环 CD19CD20 B 细胞计数较低（24%比 33%，P=0.04），而 CD3 T 细胞计数较高（62%比 52%，P=0.05）。仅在儿科对照组中观察到随着年龄增长 B 细胞/T 细胞淋巴细胞比值下降（r=-0.48，P=0.07）。在儿科 AD 患者中，B 细胞/T 细胞比值与未转换记忆 B 细胞计数呈正相关（r=0.42，P=0.03）。患有 AD 的儿科患者的 sIgE 水平较高（P<0.0001）。儿科 AD 患者的不同 sIgE 水平与 SCORAD 评分和年龄相关（P<0.01）。活化的 B 细胞与记忆 T 细胞计数之间存在正相关（P<0.02）。在 AD 患者中，对大多数过敏原的 IgE 致敏与年龄、T1、T2、总 IgE 水平和 B 细胞记忆亚群聚类。
早期 AD 儿科患者外周 B 和 T 细胞发生改变，但皮肤病变中 T 细胞占主导地位。
