Cytokine release from cultured peripheral blood mononuclear cells of patients with severe atopic dermatitis.

Peripheral blood mononuclear cells (PBMC) from 14 patients with severe atopic dermatitis (AD) and 11 healthy donors were tested for their capacity to produce tumour necrosis factor-alpha (TNF-alpha) after PHA stimulation and compared with their in vitro production of interferon-gamma (IFN-gamma). The mean TNF-alpha production in AD patients did not differ vis-à-vis controls. However, a significant portion of patients with AD which was defective in generating IFN-gamma in vitro showed in addition significantly a decreased production of TNF-alpha. No correlation could be found between TNF-alpha and neopterin production in either group, whereas there was a close overall correlation between the amount of TNF-alpha and IFN-gamma detectable in culture supernatants of patients and controls. Furthermore, a significant correlation was found between TNF-alpha and IFN-gamma generation in vitro and serum IgE concentration in AD. Based on cytokine production in vitro and IgE concentration in vivo, patients with severe AD could be divided into two groups. Furthermore, 3 AD patients with normal IFN-gamma generation and low serum IgE concentration but suffering from eczema herpeticum formed a subgroup which showed an increased TNF-alpha production in vitro. The data suggest alterations in cytokine production in a subgroup of patients with AD which bear a reciprocal relationship to abnormal IgE regulation.