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Defining the Percentage of T Helper 17 Cells in Patients with Eczema and Allergic Disease
Saturday, March 5, 2016
South Exhibit Hall H (Convention Center)
Ranjeet Minocha, MD, John M. Routes, MD FAAAAI, Mary Hintermeyer, APNP, Trivikram Dasu, PhD, Erin Hammelev, Tucker Keuter, Aniko Szabo, PhD, James W. Verbsky, MD PhD
Rationale: Decreased percentage of Th17 is seen in Hyperimmunoglobulin E Syndrome (HIES), although reports have suggested that TH17 levels are also low in atopic disease. Since eczema is often the first, and sometimes only presenting symptom of HIES, it is important to differentiate between the two entities. The purpose of this project was to define age dependent normal percentages of Th17 cells in healthy control, patients with eczema and allergic disease, and compare that to known patients with HIES.

Methods: In this retrospective study, 47 patients suspected of having HIES from the Children’s Hospital of Wisconsin (Milwaukee, WI) were analyzed using Flow Cytometry. Cells were activated with PMA/ionomycin, stained with antibodies to CD4/CD8, and then stained for intracellular IL17a.  Patients selected for the study had a pretest diagnosis of eczema, recurrent infections, or both.

Results: The mean percentage of Th17 was 0.78 ± SE 0.11. The mean age was 13.40 ± SE 1.95. Th17 levels increased significantly as age increased (p<0.005) with no significant differences between sexes. Th17 levels trended lower in patients with eczema and atopic disease, but were not statistically significant compared to controls. Several patients with HIES were included in this analysis and demonstrated very low levels of Th17 cells.

Conclusions: There is an age dependent increase in Th17. While patients with eczema and atopic disease had decreased production of Th17, they were not significantly different from healthy controls. Very low levels of Th17 tend to favor a diagnosis of HIES.