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Selective Up-regulation of HLA-DR, Interleukin-2R, and CD30 and Decrease After Combined UV-A and UV-B Phototherapy

Pierre A. Piletta, MD; Susanne Wirth, PhD; Lucette Hommel, MD; Jean H. Saurat, MD; Conrad Hauser, MD

Arch Dermatol. 1996;132(10):1171-1176.

Abstract
Background
As the cutaneous lymphocyte-associated antigen appears to detect circulating T cells that migrate to the skin in atopic dermatitis but not T cells that migrate to mucosal sites in allergic asthma and rhinitis, we investigated T-cell activation markers and CD30 on the cutaneous lymphocyte-associated antigen—positive circulating T-cell subset in atopic dermatitis to see whether these markers are different from those in normal controls and related to disease activity.

Design
Open study.

Setting
University referral center.

Patients
Twelve patients with atopic dermatitis and 12 healthy controls.

Intervention
Combined UV-A and UV-B treatment for 2 months.

Main Outcomes Measures
Percentage of circulating cutaneous lymphocyte-associated antigen—positive T cells that express HLA-DR, interleukin-2 receptor, CD69, CD71, and CD30 (triple-color flow cytometric analysis). Clinical score, Dermatology Life Quality Index, pruritus score, and consumption of topical corticosteroids were determined.

Results
Increased relative numbers of cutaneous lymphocyte-associated antigen—positive T cells expressing HLA-DR, interleukin-2 receptor, and CD30 were found in patients with atopic dermatitis before treatment. Treatment with UV-A and UV-B was associated with clinical improvement and a decrease of levels of HLA-DR, interleukin-2 receptor, and CD30 in cutaneous lymphocyteassociated antigen—positive T cells. HLA-DR on cutaneous lymphocyte-associated antigen—positive T cells correlated significantly with the clinical score.

Conclusion
Expression of HLA-DR and interleukin-2 receptor is a sensitive marker of disease activity in atopic dermatitis. Apart from giving information on disease activity in atopic dermatitis, the availability of skin-seeking T cells in the blood offers the opportunity to obtain further information on T cells that may have effector function in the skin.

Arch Dermatol. 1996;132:1171-1176

Author Affiliations
From the Department of Dermatology (Drs Piletta, Wirth, Hommel, Saurat, and Hauser) and the Allergy Unit, Division of Allergy and Clinical Immunology (Drs Wirth and Hauser), Hôpital Cantonal, University of Geneva (Switzerland).

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