Skin tests, T cell responses and self-reported symptoms in children with allergic rhinitis and asthma due to house dust mite allergy


Heleen Moed, Department of General Practice, Erasmus MC – University Medical Center Rotterdam, Room Ff337, PO Box 2040, 3000 CA Rotterdam, The Netherlands.


Background In allergic responses, a distinction is made between an early-phase response, several minutes after allergen exposure, and a late-phase response after several hours. During the late phase, eosinophils and T cells infiltrate the mucosa and play an important role in inflammation.

Objective The aim of this study was to examine the relationship between allergen-induced late-phase skin responses and in vitro T cell reactivity. In addition, the relationship between allergen-induced skin or T cell responses and the severity of self-reported symptoms was studied in children with house dust mite allergy.

Methods A total of 59 house dust mite-allergic children (6–18 years) were recruited in general practice. These children or their parents rated their nasal and asthma symptoms on diary cards during 1 month. Allergen skin tests were performed and read after 15 min (early phase) and 6 h (late phase). Allergen-specific T cell proliferation was determined, and Th2 cytokine (IL-5 and IL-13) secretion was analysed.

Results The size of the late-phase skin response correlated with in vitro T cell proliferation (rs=0.38, P=0.003) but not with Th2 cytokine secretion (rs=0.16, P=0.2 for both IL-5 and IL-13). Moreover, the late-phase skin response and T cell proliferation correlated with asthma symptoms (rs=0.30, P=0.02 for skin response and rs=0.28, P=0.03 for T cell proliferation) but not with nasal symptoms (rs=0.19, P=0.15 for skin response and rs=0.09, P=0.52 for T cell proliferation). The early-phase skin response correlated with the nasal symptom score (rs=0.34, P=0.01) but not with asthma symptom scores (rs<0.005, P=0.97).

Conclusion In this study, the late-phase skin test response correlated with in vitro T cell proliferation but not with Th2 cytokine secretion. We found weak or no correlations between late-phase skin responses and symptoms of asthma or rhinitis in children with house dust mite allergy. This suggests that late-phase skin responses reflect certain T cell properties but are of limited value for the evaluation of airway symptoms in atopic children.