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Multidisciplinary treatment in both moderate maritime and alpine climates can successfully reduce disease activity in children with <jats:styled-content style=\"fixed-case\">AD<\/jats:styled-content>. However, it remains unclear whether abnormalities in B cell and T cell memory normalize and whether this differs between treatment strategies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To determine whether successful treatment in maritime and alpine climates normalizes B\u2010 and T lymphocytes in children with moderate to severe <jats:styled-content style=\"fixed-case\">AD<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The study was performed in the context of a trial (<jats:styled-content style=\"fixed-case\">DAVOS<\/jats:styled-content> trial, registered at Current Controlled Trials <jats:styled-content style=\"fixed-case\">ISCRTN<\/jats:styled-content>88136485) in which eighty\u2010eight children with moderate to severe <jats:styled-content style=\"fixed-case\">AD<\/jats:styled-content> were randomized to 6\u00a0weeks of treatment in moderate maritime climate (outpatient setting) or in the alpine climate (inpatient setting). Before and directly after treatment, disease activity was determined with <jats:styled-content style=\"fixed-case\">SA<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">EASI<\/jats:styled-content> and serum <jats:styled-content style=\"fixed-case\">TARC<\/jats:styled-content>, and T cell and B cell subsets were quantified in blood.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Both treatment protocols achieved a significant decrease in disease activity, which was accompanied by a reduction in circulating memory Treg, transitional B cell and plasmablast numbers. Alpine climate treatment had a significantly greater effect on disease activity and was accompanied by a reduction in blood eosinophils and increases in memory B cells, <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>8+ Tem<jats:styled-content style=\"fixed-case\">RO<\/jats:styled-content>,<jats:styled-content style=\"fixed-case\"> CD<\/jats:styled-content>4+ Tcm and <jats:styled-content style=\"fixed-case\">CCR<\/jats:styled-content>7+ Th2 subsets.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions and clinical relevance<\/jats:title><jats:p>Clinically successful treatment of <jats:styled-content style=\"fixed-case\">AD<\/jats:styled-content> induces changes in blood B\u2010 and T cell subsets reflecting reduced chronic inflammation. In addition, multidisciplinary inpatient treatment in the alpine climate specifically affects memory B cells, <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>8+ T cells and Th2 cells. These cell types could represent good markers for treatment efficacy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cea.13136","type":"journal-article","created":{"date-parts":[[2018,3,25]],"date-time":"2018-03-25T13:51:34Z","timestamp":1521985894000},"page":"679-690","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Treatment for moderate to severe atopic dermatitis in alpine and moderate maritime climates differentially affects helper T cells and memory B cells in children"],"prefix":"10.1111","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0304-8977","authenticated-orcid":false,"given":"J. 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M.","family":"Bruins","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Allergology University Medical Center Utrecht The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E.","family":"van Hoffen","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Allergology University Medical Center Utrecht The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E. F.","family":"Knol","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Allergology University Medical Center Utrecht The Netherlands"},{"name":"Department of Immunology University Medical Center Utrecht The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S. G. M. 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