The expression level of cutaneous lymphocyte antigen on T-cells as a predictor for the tolerance to hen's egg-induced eczema.

Abstract

Low levels of the expression of cutaneous lymphocyte antigen (CLA) on peripheral blood T-cells stimulated with chicken ovalbumin can be a predictive marker for the acquisition of tolerance to hen’s egg in patients with egg-induced atopic dermatitis (AD). Skin manifestations associated with food allergy are clinically classified into two types, immediate and nonimmediate, i.e. delayed. These are urticaria and AD, respectively. The radio-allergosorbent test (RAST) is a sensitive in vitro procedure for diagnosis and sometimes can be used as a marker for disease activity in immediate-type food allergy [4]. In contrast, there have been few sensitive allergen-specific blood tests reported as disease activity markers for delayed-type food allergy [4]. Some years ago, Abernathy-Carver et al. [1] reported that T-cells, especially those expressing CLA, play an important role in food-induced AD. After in vitro stimulation of peripheral blood mononuclear cells (PBMCs) with casein, milk-allergic patients with AD showed a significantly greater percentage of CLA+ Tcells than patients with milk-induced gastroenteritis or non-atopic, healthy control subjects. Later, Reekers, et al. [3] reported the induction of CLA on allergenstimulated T-cells in pollen-related food-induced AD. However, as far as we know, CLA expression on egg allergen-stimulated T-cells, especially in relation to disease activity, has not been reported, although hen’s egg is the most common cause of food-related AD in early childhood [6]. In this study we examined the expression of CLA on T-cells stimulated with ovalbumin (OVA) in egg-allergic AD patients in whom hen’s egg was eliminated from the diet, and compared the level with the results of the hen’s egg challenge test to test the efficiency of CLA expression on T-cells as a disease marker for hen’s egg induced AD. A group of 17 patients (age 10–94 months, mean age, 40 months) with a history of eczema when exposed to hen’s egg in whom hen’s egg was eliminated from the diet were included in the study. RAST score to egg white was 0–4 (mean 2.7). All patients underwent a doubleblind, placebo-controlled food challenge test to hen’s egg as previously described [5]. PBMCs (2.0·10 5 ) were