$346 A b s t r a c t s J ALLERGY CLIN IMMUNOL

JANUARY 2002

t ~ r l , ~ Persistent Helminth Infections and Changed Environment I U / J Increase Prevalence of Allergy: Prospective Study of

Ethiopian Immigrants to Israel Stein Miguel*, Weisman Ziva*, Greenberg Zalman§, Galai Noia*, Handzel Zeev*, Bentwich Zvi* *Hebrew University, Rehovot, Israel §Lab- oratory for Public Health, Jerusalem, Israel

BACKGROUND AND PURPOSE: Ethiopian immigrants (ETH), highly infected with helminths, have recently settled in rural and urban areas in Israel, where marked changes in nutritional and hygienic condi- tions also took place. This unique situation allowed us to study prospective- ly the contribution of helminth infections (HI), host immunity and changed environment, to the development of allergy in the new immigrants.

METHODS: 178 recently arrived ETH were studied within three months after arrival in Israel, and 115 of them also one year later. All filled a questionnaire for allergic diseases, had Prick Test (PT) for 10 indoors and outdoors allergens, a tuberculin (PPD) skin test for delayed type hypersen- sitivity, and had their stools assayed for parasite ova. Immune profile, con- sisting of blood IgE, eosinophils (Eos), peripheral blood lymphocyte sub- sets and cytokine secretion, was studied in most participants.

RESULTS: On arrival, 141/178 (79.2%) had HI, the most common being Ascaris, Hookworm and Schistosoma. Allergy (asthma and/or aller- gic rhinitis), prick tests and positive PPD skin tests, were significantly less in individuals with HI (p<0.03). A year later, marked increase of allergy was observed in ALL participants, in both rural and urban settlements. The most significant increase in allergy occurred in individuals with persistent HI, independent of the type of environment (p<0.0001). Marked immune changes were observed in ETH with HI characterized by marked immune activation, T cell subset changes, and dominant Th2 immune profile. Study of thirty ETH both before and 6-12 months after eradication of HI, showed marked reversion of most immune changes to normal after helminth eradi- cation, while remaining in those with persistent HI, despite the changed environment and the nutritional and hygienic conditions.

CONCLUSIONS: a) Helminthic infections (HI) in new Ethiopian immigrants are associated with decreased prevalence of allergy and decreased positive skin test reactivity, b) The change in environment and living conditions with immigration, is associated with increased allergy in ALL immigrants, but is more pronounced with persistent HI. c) HI more than any other factor, is responsible for a dominant TH2 profile and wide immune changes in the host. d) This immune profile present in persistent helminth infection may account for the significant increase in allergy after change of environment, in this group, e) Both environmental changes and helminthic infections increase allergy, following immigration.

1 ~ 1 ' ~ Effect of Staphylococcal Enterotoxin B on Specific Antibody I ,JF/ ' I ' Production in Children With Atopic Dermatitis

Gwang-Cheon Jang*, Myung-Hyun Sohn§, Cheol-Hong Kim§, Woo Kyung Kirn~, Kyung-Eun Lee§, Kyu-Earn Kim~, Ki-Young Lee§ *Depart- ment of Pediatric, Yonsei University College of Medicine, Seoul (South Korea), Korea §Department of Pediatric, Yonsei University College of Medicine, Seoul, Korea YYonsei University, Seoul, Korea

Exotoxins secreted by Staphylococcus aureus have been identified as a possible trigger factor in atopic dermatitis (AD). We investigated the pro- duction and role of circulating antibodies with specificity to staphylococcal enterotoxin B (SEB) in children with AD and compared them with those of healthy controls. Forty children with AD and 40 nonatopic healthy children were studied. The severity was determined by the criteria of Rajka. The serum levels of specific antibodies (IgG, IgM, IgE) against SEB were deter- mined by ELISA. The levels and positive rates were compared between two groups. The correlation between the levels of specific antibodies and the severity of AD or their ages was studied. The children with AD had signifi- cantly higher levels of serum SEB specific IgG (p--0.0193), IgM (p=0.011) and IgE (p=0.0001) than the nonatopic children. The proportions of chil- dren with AD showed positive to IgG, IgM and IgE were 52.5% (21/40), 62.5% (25/40) and 67.5% (27/40), respectively. The levels of SEB-specific lgE were correlated with the severity ofAD (p=0.0004), but no such corre- lation was seen with IgG or IgM. SEB may be involved in exacerbation of

AD. The SEB-specific IgE may be an important index of the clinical severi- ty of AD. The SEB-specific IgG or IgM be produced during the exposure to the SEB antigen but may not be protective against SEB in AD.

1 0 7 5 Increased CCR4+CD4+ Lymphocytes in Peripheral Blood From Infantile Atopic Dermatitis Patients

Noriaki Shinomiya, Masaru Kishida, Masako lzawa Toho University School of Medicine, Tokyo, Japan

Atopic dermatitis (AD) is a chronic inflammatory skin disorder that begins in infancy and manifests as pruritic and eczematous skin disease. The skin lesions in AD are characterized histologically by preferential infil- tration of activated TH2 type CD4+ cells, that play a key pathogenic role in AD. In this study, it is assessed the association to TH2 cells expressed CCR 4, which produce IL4, with the allergic inflammation in AD patients. Intra- cellular IL-4 or IFN-g production, and chemokine receptor CCR4 or CXCR3 expression in peripheral T cells were examined by flow cytome- tery. The serum levels of NO product, IL-8, RANTES and eotaxin, which is considered to be index of the inflamatory response, were measured using ELISA method. CCR4+CD4 cells predominantly produced IL-4, which belong to TH2 type cells. The frequency of CCR4+cells, the ratio of TH2 cells/THl cells and the ratio of CCR4+celIs/CXCR3+celIs were signifi- cantly higher in infantile AD patients than healthy control infant and signif- icantly correlated with the skin lesion expansion of AD. The serum levels of the NO products, RANTES and eotaxin were significantly higher in infan- tile AD patients with the systemic skin lesion compared with controls. The frequency of CCR4+ cells was positively correlated with the serum level of eotaxin. These results suggest that CCR4+TH2 cells, which were predomi- nant in peripheral blood from infantile AD patients, and the migration of TH2 cells through CCR4 receptor into AD skin lesion bear an important role for the skin lesion expansion in infantile AD.

1 ~ '~ '7~ Correlation Between the Disease-Severity of Atopic Der- V l t , JI matitis (AD) and the Serum Levels of Interleukin-4 (IL-4) and

Soluble Interleukin-2 Receptor (SIL-2R) Among Egyptian Children

Farag Ibrahim Farag*, Waheed Fawzy Hessam§, Atef Mohammed AI- Akhras§ *Faculty of Medicine, Suez Canal University, Portsaid, Egypt §Faculty of Medicine, Suez Canal University, Ismailia, Egypt

AD, one of the major allergic diseases of children in Egypt is charac- terised by marked elevation of serum IgE. IL-4 plays a pivotal role in IgE isotype switch and the Th-2 differentiation of T-helper cells. T-cell activa- tion is also associated with the enhanced expression of IL-2R. This study was conducted at the Allergy/Immunology Clinic of the Faculty of Medi- cine, Suez Canal University, Egypt in an attempt to detect the correlation, if any between the AD Disease-Severity and the serum levels of IL-4 and SIL- 2R. Thirty Egyptian children in the age group of 2-8 years diagnosed as having AD according to the major and minor criteria of Hanifin and Rajka (1980), were grouped into mild, moderate and severe AD cases based on the scoring atopic dermatitis (SCORAD) index of the European Task Force on AD of 1997. This index combines the evaluation of the extent, intensity of the lesion as well as the subjective symptoms of daytime pruritis and sleep loss in assessing the severity ofAD. Sera from these patients and 20 healthy matched controls were assayed for serum IL-4 and S1L-2R by ELISA. IL-4 and SIL-2R were significantly elevated among AD cases compared to con- trols with mean values of (33.1 pg/ml) and (1173 IU/ml) respectively. IL-4 serum levels were higher in the severe and moderate AD groups when both compared to the mild AD group with mean values of 39.1, 27.6 and 17 pg/ml respectively (p less than 0.01). SIL-2R levels were significantly ele- vated in the severe AD group of patients (1283 IU/ml) when compared to either the mild AD goup or the moderate AD group (mean values of 744 and 1074 IU/ml respectively). The data implicate that IL-4 and SIL-2R may play an important role in the immunopathogenesis of AD in Egyptian chil- dren and suggest that they could serve as potential targets for cytokine ther- apy in AD.