Differences of Serum Cytokine Levels and Sensitization Rates to Allergen

S U N D A Y 378 Biomarkers of Disease Severity and Th2 Polarity Are Predictors of Atopic Dermatitis Subjects Who Are Colonized with S. Aureus Lisa A. Beck, MD, FAAAAI, Takeshi Yoshida, PhD, Anna De Benedetto, MD, FAAAAI, Seungshin Rhee, MS, I-Hsin Kuo, MS, Jamie Reese, Gloria David, PhD, Lynda C. Schneider, MD FAAAAI, Amy Paller, MD, Jon M. Hanifin, MD FAAAAI, Mark Boguniewicz, MD, FAAAAI, Kathleen C. Barnes, PhD FAAAAI, Donald Y. M. Leung, MD, PhD, FAAAAI; Department of Dermatology, University of Rochester Medical Center, Rochester, NY, University of Rochester Medical Center, Rho, Inc., Chapel Hill, NC, Rho, Inc, Boston Children’s Hospital, Boston, MA, Division of Allergy/Immunology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, Northwestern University Feinberg School of Medicine, Chicago, IL, Oregon Health & Science University, Portland, OR, National Jewish Health, Denver, CO, Division of Allergy and Clinical Immunology, Department of Medicine, Johns Hopkins University, Baltimore, MD, National Jewish Health, Department of Pediatrics, Denver, CO. RATIONALE: Atopic dermatitis (AD) is complicated by cutaneous colonization/infection with Staphylococcal aureus. Understanding the mechanisms for this susceptibility is a primary objective of the NIH/ NIAID Atopic Dermatitis Research Network. Herein we report our observations on disease severity and T helper subsets in AD subjects based on their S. aureus colonization status (ADStaph vs ADStaph). METHODS: AD severity was assessed by Eczema Area and Severity Index (EASI), eosinophil counts (Eos), serum IgE and LDH (n5907). Serum biomarkers of Th1 (IP-10 [CXCL10]), Th2 (TARC [CCL17]) and Th17 (MIP-3a [CCL20]) polarity were measured by ELISA from a subset of Caucasian adult AD subjects whowere gender and age-matched (n530/ group). Differences were evaluated with two sample t-tests. RESULTS: Nonlesional or lesional skin was culture positive for S. aureus in 39% (352/907) of AD subjects. EASI was higher (p<0.001) in ADStaph (geometric mean 12.9; n5354) than ADStaph (geometric mean 5.3; n5556). Total IgE was significantly (p<0.001) elevated in ADStaph (geometric mean 705 IU/L; n5289) than ADStaph (mean 126 IU/L; n5475) as were Eos (p5<0.001; geometric mean 296 cells/ mm; n5349 vs 180 cells/mm; n5548, respectively). LDH and CCL17 were significantly (p50.028 and 0.012) elevated in ADStaph (geometric mean 187.1 vs 160.6 U/L and mean 657.7 vs 316.2 pg/ml, respectively). CXCL10 and CCL20 were not different between the two groups. CONCLUSIONS: ADStaph subjects have more severe disease based on clinical scoring and biomarkers (IgE, CCL17, LDH, Eos) and are more Th2 polarized based on biomarkers (IgE, Eos, CCL17) than AD subjects who are not colonized.