Milk-responsive atopic dermatitis is associated with a casein-specific lymphocyte response in adolescent and adult patients

J Allergy Clin Immunol. 1997 Jan;99(1 Pt 1):124-33. doi: 10.1016/s0091-6749(97)70309-9.


Background: Specific T-cell responses to food antigens have been described in children with atopic dermatitis (AD). However, a subgroup of adolescent and adult patients still experiences food-responsive AD.

Objective: This study was designed to evaluate lymphocyte responses to bovine casein in adult patients with AD.

Methods: The stimulatory capacity of lipopolysaccharide-depleted bovine casein was tested in proliferation assays and in limiting dilution assays. Casein-specific T-cell clones (TCCs) were generated and characterized.

Results: Higher proliferative responses to casein and modulation of cytokine receptors were observed in patients with milk-responsive AD compared with individuals without clinical reactions on milk ingestion. The results did not correlate with the amount of casein-specific IgE in the serum. The frequencies of T cells that grew in the presence of casein or house dust mite antigens were similar. Only 27% of CD4+ casein-specific TCCs from these patients, but the majority of house dust mite-specific TCCs, produced IL-4 on mitogen stimulation. Interferon-gamma, on the other hand, was produced by the majority of TCCs with both specificities.

Conclusion: A specific T-cell-mediated immune response to casein can be found in the blood of adolescent and adult patients with milk-related exacerbation of AD. In contrast to house dust mite-specific T cells, casein-specific T cells of adult patients who respond to cow's milk with worsening of AD produce little or no IL-4.

Publication types

  • Clinical Trial
  • Controlled Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Allergens / immunology
  • Allergens / pharmacology
  • Animals
  • Caseins / adverse effects*
  • Cattle
  • Clone Cells / immunology
  • Dermatitis, Atopic / immunology*
  • Double-Blind Method
  • Evaluation Studies as Topic
  • Flow Cytometry
  • Humans
  • Immunity, Cellular / drug effects
  • Immunity, Cellular / immunology
  • Immunoglobulin E / biosynthesis
  • Lipopolysaccharides / pharmacology
  • Lymphocyte Activation / drug effects*
  • Lymphocyte Activation / immunology
  • Middle Aged
  • Milk Hypersensitivity / immunology*
  • Milk Hypersensitivity / metabolism
  • Mites / immunology
  • Placebos
  • Sensitivity and Specificity
  • T-Lymphocytes / cytology
  • T-Lymphocytes / drug effects*
  • T-Lymphocytes / immunology*


  • Allergens
  • Caseins
  • Lipopolysaccharides
  • Placebos
  • Immunoglobulin E