Combinations of IgE values and lymphocyte proliferative responses for consideration of the clinical course of infantile hen's-egg-sensitive atopic dermatitis.

We have attempted a new approach, using peripheral blood mononuclear cells (PBMCs), to predict the clinical course of infantile food-sensitive atopic dermatitis (AD). In this study, we investigated the relationships between the clinical course of infantile hen's-egg-sensitive AD and laboratory data obtained at the early stage of AD, particularly on combinations of specific IgE antibodies to hen's egg and proliferative responses of PBMCs to ovalbumin (OA). Total IgE concentrations, specific IgE antibodies to hen's egg and proliferative responses of PBMCs to OA were measured in 31 hen's-egg-sensitive AD patients within 6 months after development of AD symptoms. After the acquisition of laboratory data, the clinical courses of all patients were followed up for 1 year. The stimulation index of proliferative responses of PBMCs to OA in hen's-egg-sensitive AD patients whose symptoms did not improve was significantly (p < 0.05) higher than that in hen's-egg-sensitive AD patients whose symptoms improved. On the other hand, the radioallergosorbent test (RAST) scores for hen's egg were not statistically different between the two groups. The degree of refractoriness of AD symptoms tended to be higher in the patients who showed a higher total IgE concentration at the beginning of the clinical course than in those who showed a lower one. These results might be attributed to the underlying cause of AD, i.e., a cell-mediated and an IgE-mediated allergy. We concluded that, in addition to total IgE concentrations, combinations of RAST values and lymphocyte proliferative responses to OA are important to predict the clinical course of infantile hen's-egg-sensitive AD.