CIRCULATING ALLERGEN-REACTIVE T-CELLS FROM PATIENTS WITH ATOPIC-DERMATITIS AND ALLERGIC CONTACT-DERMATITIS EXPRESS THE SKIN-SELECTIVE HOMING RECEPTOR, THE CUTANEOUS LYMPHOCYTE-ASSOCIATED ANTIGEN

The cutaneous lymphocyte-associated antigen (CLA) is the major T cell ligand for the vascular adhesion molecule E-selectin, and it has been proposed to be involved in the selective targeting of memory T cells reactive with skin-associated Ag to cutaneous inflammatory sites. To further investigate the relation of CLA and cutaneous T cell responses, we analyzed the CLA phenotype of circulating memory T cells in patients with allergic contact dermatitis and atopic dermatitis (AD) alone vs in patients manifesting bronchopulmonary atopy (asthma with or without AD) and nonallergic individuals. Significant T cell proliferative responses to Ni, a contact allergen, and to the house dust mite (HDM), an allergen to which sensitization is often observed in AD and/or asthma, was noted only in allergic and atopic individuals, respectively. When the minor circulating CLA(+)CD3(+)CD45RO(+) subset was separated from the major CLA(-)CD3(+)CD45RO(+) subpopulation in Ni-sensitive subjects, the Ni-dependent memory T cell response was largely confined to the CLA(+) subset. A similar restriction of the T cell proliferative response to the CLA(+) memory subset was observed for HDM in patients with AD alone. In HDM-sensitive patients with asthma with or without AD, however, the CLA(-) subset exhibited a strong antigen-dependent proliferation, in contrast to patients with AD alone, whose CLA(-) subset proliferated very weakly to HDM. In asthma with or without AD, the HDM-dependent proliferation slightly predominated in the CLA(-) when compared to the CLA(+) subset. The functional linkage between CLA expression and disease-associated T cell effector function in AD was also demonstrated by the finding that the circulating CLA(+) T cell subset in AD patients, but not nonatopic controls, selectively showed both evidence of prior activation (human histocompatibility antigen-DR expression) and spontaneous production of interleukin 4 but not interferon-gamma. Taken together, these observations demonstrate the correlation of CLA expression on circulating memory T cells and disease-associated memory T cell responses in cutaneous hypersensitivity, and they suggest the existence of mechanisms capable of sorting particular T cell Ag specificities and lymphokine patterns into homing receptor-defined memory subsets.