Background. Several studies have investigated levels of T-cell-derived interleukin (IL)-10 in individuals with atopic dermatitis, with conflicting results. Aims ⁄ Hypothesis. In order to address whether stratification of disease severity may help resolve the different findings, the hypothesis was tested that individuals with severe atopic dermatitis have a lower frequency of circulating IL-10-producing, allergenspecific CD4+ T cells than do individuals with mild disease. Methods. Using peripheral blood mononuclear cells derived from individuals with severe (n ¼ 12) and mild atopic dermatitis (n ¼ 10) and from nonatopic controls (n ¼ 10), we investigated production by CD4+ T cells of tumour necrosis factor (TNF)-a, IL-4, IL-5, IL-13 and IL-10 in response to phorbol myristate acetate ⁄ ionomycin and Der p1 allergen. Results. It was observed that there were significantly higher frequencies of allergenspecific circulating CD4+ T cells producing TNF-a- IL-4-, IL-5- and IL-13, and lower frequencies of these cells producing IL-10 in individuals with severe atopic dermatitis compared with mildly affected individuals and nonatopic controls (P < 0.01 for all comparisons). Furthermore, the Der p1-specific CD4+ T cells were enriched within the subset of cells positive for cutaneous lymphocyte-associated antigen. Conclusions. Analysis of levels of allergen-specific CD4+ T-cell production of IL-10 in relation to disease severity argues in favour of a role for IL-10 in the control of atopic dermatitis. |