CD4+IL‐13+ cells in peripheral blood well correlates with the severity of atopic dermatitis in children

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Abstract
Background: In atopic dermatitis (AD) a Th1/Th2 imbalance has been reported, and interleukin (IL)‐13 seems to play a pivotal role in the inflammatory network. We tried to assess the correlation between the immunological marker CD4+IL‐13+ and the clinical phase of extrinsic AD in children. Methods: Twenty children with AD were studied. Assessed parameters were: clinical severity (SCORAD index), total serum immunoglobulin E (IgE), blood eosinophil count, and percentage of CD4+IFNγ+, CD4+IL‐4+, CD4+IL‐13+ T cells. Determinations were carried out in the acute phase and after clinical remission were achieved. Ten nonatopic‐matched children served as controls. Results: At baseline, AD was mild in 25%, moderate in 50% and severe in 25% of children. In the acute phase a significant relationship between the eosinophil count and the SCORAD index was found (P = 0.0001). Blood CD4+IL‐4+ were significantly higher in the AD group (median 17.0, range: 13.7–21.4) than in controls (12.6, 6.4–17.2, P < 0.0001). CD4+IL‐13+ cells in the AD group well correlated (P = 0.0007) with SCORAD index. At remission, a significant correlation between SCORAD index and eosinophil count was found (P < 0.03) and the percentage of CD4+IL‐13+ cells globally decreased (P < 0.0001), while no difference was found among SCORAD classes. Conclusion: This study confirms the Th2 profile predominance in the peripheral blood of children with AD, and evidences close relationship between the number of CD4+IL‐13+ T cells and the disease's severity.