Abstract BACKGROUND: In allergic responses, a distinction is made between an early-phase response, several minutes after allergen exposure, and a late-phase response after several hours. During the late phase, eosinophils and T cells infiltrate the mucosa and play an important role in inflammation. OBJECTIVE: The aim of this study was to examine the relationship between allergen-induced late-phase skin responses and in vitro T cell reactivity. In addition, the relationship between allergen-induced skin or T cell responses and the severity of self-reported symptoms was studied in children with house dust mite allergy. METHODS: A total of 59 house dust mite-allergic children (6-18 years) were recruited in general practice. These children or their parents rated their nasal and asthma symptoms on diary cards during 1 month. Allergen skin tests were performed and read after 15 min (early phase) and 6 h (late phase). Allergen-specific T cell proliferation was determined, and Th2 cytokine (IL-5 and IL-13) secretion was analysed. RESULTS: The size of the late-phase skin response correlated with in vitro T cell proliferation (r(s)=0.38, P=0.003) but not with Th2 cytokine secretion (r(s)=0.16, P=0.2 for both IL-5 and IL-13). Moreover, the late-phase skin response and T cell proliferation correlated with asthma symptoms (r(s)=0.30, P=0.02 for skin response and r(s)=0.28, P=0.03 for T cell proliferation) but not with nasal symptoms (r(s)=0.19, P=0.15 for skin response and r(s)=0.09, P=0.52 for T cell proliferation). The early-phase skin response correlated with the nasal symptom score (r(s)=0.34, P=0.01) but not with asthma symptom scores (r(s)<0.005, P=0.97). CONCLUSION: In this study, the late-phase skin test response correlated with in vitro T cell proliferation but not with Th2 cytokine secretion. We found weak or no correlations between late-phase skin responses and symptoms of asthma or rhinitis in children with house dust mite allergy. This suggests that late-phase skin responses reflect certain T cell properties but are of limited value for the evaluation of airway symptoms in atopic children.

Adolescent, Animals, Asthma/diagnosis/*immunology, Breath Tests, Child, Dermatophagoides pteronyssinus/*immunology, Female, Humans, Hypersensitivity, Delayed/immunology, Interleukin-13/metabolism, Interleukin-5/metabolism, Lymphocyte Activation/immunology, Male, Medical Records, Nitric Oxide/analysis/metabolism, Rhinitis, Allergic, Perennial/diagnosis/*immunology, Skin Tests, T-Lymphocytes/*immunology/metabolism
dx.doi.org/10.1111/j.1365-2222.2008.03130.x, hdl.handle.net/1765/22206
Clinical and Experimental Allergy
Erasmus MC: University Medical Center Rotterdam

Moed, H, Gerth van Wijk, R, de Jongste, J.C, & van der Wouden, J.C. (2009). Skin tests, T cell responses and self-reported symptoms in children with allergic rhinitis and asthma due to house dust mite allergy. Clinical and Experimental Allergy, 39(2), 222–227. doi:10.1111/j.1365-2222.2008.03130.x