Antigen-specific T cell balance reveals why patients with atopic dermatitis fail to achieve immune tolerance

Tsukuba, Japan—Atopic dermatitis, the most prevalent chronic skin disease affecting 2-5% of adults, poses a perplexing question regarding the role of regulatory T cells (Tregs) in its pathogenesis. Previously, studies have indicated a higher abundance of Tregs in patients with atopic dermatitis compared with that in healthy individuals. Nevertheless, it remains paradoxical that individuals with atopic dermatitis experience symptoms despite having a surplus of Tregs responsible for allergy regulation. To address this contradiction, researchers conducted an analysis focusing on T cells specific to mite antigen—an allergen commonly associated with atopic dermatitis—to shed light on this issue.

The study's findings reaffirmed prior reports, revealing a general tendency for a greater number of Tregs in the atopic dermatitis patient group than that in the healthy control group. However, when examining T cells specific to a particular mite antigen, the researchers discovered a higher proportion of mite-specific effector T cells, which contribute to atopic symptoms, in the atopic dermatitis patient group compared to that in the healthy control group. Moreover, the mite antigen-specific effector T cells in the patient group demonstrated heightened production of inflammatory cytokines IL-4 and IL-13—key players in the development of atopic dermatitis—compared to healthy controls. There were no discernible differences in the immunosuppressive function of mite-specific Tregs between patients and healthy controls.

These findings suggest that the prevalence of proinflammatory mite-specific effector T cells, numerically surpassing suppressive mite-specific Tregs, may contribute to the failure in achieving immune tolerance to mites and the subsequent development of atopic symptoms in patients with atopic dermatitis.

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This work was supported by the Japan Society for the Promotion of Science (JSPS) KAKENHI from the Ministry of Education, Culture, Sports, Science and Technology of Japan; under grants [Scientific Research (C) (21K08293)].
 

_{Original Paper}

Title of original paper:
Antigen-specific T cell balance reveals why patients with atopic dermatitis fail to achieve immune tolerance

Journal:
Clinical Immunology

DOI:
10.1016/j.clim.2023.109649

_{Correspondence}

Professor TAKADA Hidetosh
Institute of Medicine, University of Tsukuba

Professor OKIYAMA Naoko
Department of Dermatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University

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Institute of Medicine