Abstract

<h3>Background</h3> Thymic stromal lymphopoietin (TSLP) is expressed at sites of allergic inflammation, including eczematous skin. This cytokine has been reported to exert its T<sub>H</sub>2-inducing properties through dendritic cells. Expression of TSLP receptor on the surface of activated T<sub>H</sub>2 cells could amplify T<sub>H</sub>2 responses at inflamed sites through the direct actions of TSLP. <h3>Objective</h3> To test rigorously whether T<sub>H</sub>2 cells induced by "proallergic" factors express TSLP receptor and characterize these cells using an experimental platform that combines flow cytometry with microscopic capabilities. <h3>Methods</h3> CD4<sup>+</sup> T cells isolated from patients with atopic dermatitis or normal healthy controls were cocultured with autologous dendritic cells in the presence of T<sub>H</sub>2-promoting stimuli (TSLP ± allergen and staphylococcal enterotoxin B ± TSLP). Surface expression of TSLP receptor was analyzed by image-based flow cytometry, and responsiveness of purified T cells to TSLP was assessed by phosphorylation of signal transducer and activator of transcription-5 and cytokine secretion. <h3>Results</h3> T<sub>H</sub>2-promoting stimuli induced a robust population of activated T<sub>H</sub>2 cells (CD25<sup>+</sup>IL-4<sup>+</sup>). Regardless of the nature of the stimulus, flow cytometry imaging confirmed that T cells expressing TSLP receptor were rare, constituting a minor fraction of the IL-4<sup>+</sup> T cell pool; however, TSLP responsiveness was nonetheless detectable. Analysis of cell size and nuclear morphology revealed preferential expression of TSLP receptor on IL-4–expressing cells undergoing mitosis. Analysis of lesional skin in atopic dermatitis supported the view that rare IL-4<sup>+</sup> T cells expressing TSLP receptor are present at inflamed sites. <h3>Conclusion</h3> In a "proallergic" milieu, TSLP receptor is preferentially expressed on rare actively dividing T<sub>H</sub>2 cells. The direct action of TSLP on T cells could amplify T<sub>H</sub>2 responses at sites of allergic inflammation.

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