Atopic disease and serum immunoglobulin-E

Fifty-seven subjects, forty-three with various combinations of atopic disease and fourteen non-atopic controls, were studied using a battery of immediate skin test allergens and a radio-immunoassay for serum Immunoglobulin-E (IgE). The geometric mean serum IgE level (units/ml) was 50 in strictly nonatopic controls, 170 in atopic respiratory disease (ARD) patients, 320 in atopic dermatitis (AD) patients and 772 in those patients with both AD-ARD. The marked elevation of the serum IgE in the latter group was not associated with respiratory disease activity and not closely correlated with extent of the dermatitis, but may relate to patients with both AD-ARD being 'highly atopic'. Overall, there was no correlation between the serum IgE level and the frequency of positive skin tests. Compared to ARD patients, the serum of AD patients contained more IgE, yet they reacted significantly less frequently to common extrinsic allergens.     

Heterogeneity of serum IgE levels in atopic dermatitis

To determine whether serum IgE levels in patients with atopic dermatitis (AD) have a relationship to familial background of atopic respiratory disease (ARD), serum IgE levels were measured in 50 AD patients who had personal history of ARD, 37 AD patients who did not have personal history of ARD but had family history of ARD, and 52 "pure" AD patients who had neither personal nor family history of ARD. The "pure" AD patients showed significantly lower serum IgE levels than AD patients who had personal or family history of ARD. It is suggested that AD patients may be classified into at least two subgroups: those with ARD predisposition who have an enhanced IgE producing potential, and those without ARD predisposition who have a low or not-enhanced ability for IgE production.     

Atopy patch test reactions to Malassezia allergens differentiate subgroups of atopic dermatitis patients

BACKGROUND: The yeast Malassezia is considered to be one of the factors that can contribute to atopic dermatitis (AD). OBJECTIVES: To investigate the reactivity to Malassezia allergens, measured as specific serum IgE, positive skin prick test and positive atopy patch test (APT), in adult patients with AD. METHODS: In total, 132 adult patients with AD, 14 with seborrhoeic dermatitis (SD) and 33 healthy controls were investigated for their reactions to M. sympodialis extract and three recombinant Malassezia allergens (rMal s 1, rMal s 5 and rMal s 6). RESULTS: Sixty-seven per cent of the AD patients, but only one of the SD patients and none of the healthy controls, showed a positive reaction to at least one of the Malassezia allergens (extract and/or recombinant allergens) in at least one of the tests. The levels of M. sympodialis-specific IgE in serum correlated with the total serum IgE levels. Elevated serum levels of M. sympodialis-specific IgE were found in 55% and positive APT reactions in 41% of the AD patients with head and neck dermatitis. A relatively high proportion of patients without head and neck dermatitis and patients with low total serum IgE levels had a positive APT for M. sympodialis, despite lower proportions of individuals with M. sympodialis-specific IgE among these groups of patients. CONCLUSIONS: These results support that Malassezia can play a role in eliciting and maintaining eczema in patients with AD. The addition of an APT to the test battery used in this study reveals a previously overlooked impact of Malassezia hypersensitivity in certain subgroups of AD patients.     

特应性皮炎患者过敏原两种检测方法的相关性

目的探讨皮肤点刺试验和血清变应原特异性IgE检测的相关性。方法同时采用皮肤点刺试验(SPT)和德国MEDIwlss敏筛过敏原检测系统检测60例特应性皮炎(AD)患者的过敏原,并对检测结果进行比较。结果皮肤点刺试验和血清变应原特异性IgE的阳性率分别为3.89%(140/3600)和7.42%(89/1200),后者明显高于前者,差异有统计学意义(P=0.000),且这两种检测方法不相关(P=0.207)。结论皮肤点刺试验和血清变应原特异性IgE检测特应性皮炎过敏原不相关,必要时可同时进行这两种方法检测,并结合病史判断病情。     

Selected eosinophil proteins as markers of inflammation in atopic dermatitis patients

Atopic dermatitis (AD) is an inflammatory skin disease characterized by chronic and recurrent course, beginning primarily in early childhood. The etiopathogenesis of AD has not yet been fully understood, although various types of inflammatory cells including eosinophils may be involved in its pathomechanism. The basic aim of the study was to evaluate the usefulness of selected eosinophil proteins in serum and urine of AD patients, as markers of disease severity. The study also aimed to analyze correlations between the level of examined proteins and parameters such as skin prick test (SPT) results, serum concentration of total IgE, and coexistence of symptoms of other atopic diseases. The study included 30 AD patients and two control groups: 30 patients suffering from chronic urticaria and 30 healthy individuals. The mean level of eosinophil proteins measured in serum and urine of AD patients was higher than that in controls, although a significant difference was only recorded for serum and urine level of eosinophil protein X (EPX). Patients with very severe/severe AD presented higher levels of eosinophil proteins than patients presenting with mild/moderate AD, although no significant difference was found between these two groups. AD patients with positive SPT results and detectable specific IgE in serum, and with coexisting symptoms of other atopic diseases presented with higher mean levels of serum and urine eosinophil proteins than AD cases with negative SPT results and without any symptoms of other atopic diseases. In children suffering from AD, serum eosinophil cationic protein level, EPX level and urine EPX level were higher than those in healthy children, however, without statistical significance. Study results suggested a significant role of eosinophils in the etiopathogenesis of AD. Serum and urine levels of selected eosinophil proteins may serve as an important part of diagnostic approach to AD patients, especially in differentiation of allergic and non-allergic forms of AD. The results are also promising for the usefulness of selected eosinophil proteins in the diagnosis of AD in children, however, thorough analysis on a larger group of patients is needed.     

Prevalence of atopic dermatitis and serum IgE values in nursery school children in Ishigaki Island, Okinawa, Japan

There have been many studies of the prevalence of atopic dermatitis (AD), but few population-based epidemiologic studies measure the prevalence in Japan among children aged 5 years and younger. We examined the prevalence of AD, serum total IgE levels and specific IgE antibodies to 10 common allergens among children in Ishigaki Island, Okinawa, Japan in 2001. We also obtained information on the predictability of the U.K. Working Party diagnostic questionnaire criteria for AD in this population. Five hundred and sixty five children aged 5 years and younger were enrolled in this study with informed consent from their parents. The questionnaire of the U.K. Working Party diagnostic criteria for AD was translated into Japanese, and the parents completed the questionnaire sheet. Physical examination and blood sampling were done for all children. Thirty-nine out of the 565 (6.9%) children were diagnosed with AD by physical examination. The total and specific IgE levels were significantly higher in the children with AD than in those without AD. High levels of total IgE were found in 33.3% of the children with AD. A specific IgE to one or more allergens was detected in 64.1% of children with AD. However, a substantial population of children without AD also had high levels of total IgE (12.7%) and a specific IgE to one or more allergens (30.2%), and the increment of total and specific IgE levels was significantly associated with age. The percentage of positive answers to the questionnaire of the U.K. Working Party diagnostic criteria for AD was significantly higher in children with AD (59.0%) than in children without AD (5.3%) (P<0.0001). Its specificity was 94.7%. The false negative rate was 41%. In conclusion, the prevalence of AD was relatively low in children in Ishigaki Island. High levels of total IgE were found in only one third of children with AD under 5 years of age. The Japanese translated form of the questionnaire of the U.K. Working Party diagnostic criteria for AD should be refined to improve its sensitivity.     

特应性皮炎167例皮肤点刺试验结果分析

目的通过皮肤点刺试验(skin prick test,SPT)结果的分析,了解特应性皮炎(atopic dermatitis,AD)患者在不同年龄组、不同人群及伴有不同变应性疾病的变应原分布及种类。方法将167例患儿分为≤2岁组和>2岁组,采用德国默克集团Allergopharma公司的皮肤点刺液,选择标准化变应原:鸡蛋白、蛋黄、虾等,在前臂屈侧做点刺试验。结果167例患者中,SPT阳性65例,阴性102例,阳性率38.9%。2岁以下和2岁以上变应原种类明显不同,即2岁以下以食物过敏为主,如鸡蛋白、蛋黄、牛奶等。2岁以上逐渐过渡为以吸入物过敏为主,如艾蒿、粉尘螨、藜草等。合并哮喘的AD病人SPT阳性率较高。结论AD从婴幼儿以食物过敏为主,逐渐演变为儿童期及青春期以吸入性过敏为主。SPT易于操作,灵敏度高,对于儿童AD患者较为适用。     

The role of Dermatophagoides pteronyssinus in atopic dermatitis

The role of Dermatophagoides (D.) pteronyssinus in atopic dermatitis (AD) was investigated by use of skin prick test (SPT) and total and specific IgE (RAST) to D. pteronyssinus. The study included 43 patients (17 male and 26 female), mean age 42.3 (range 19-77) years. All study patients met the Hanifin and Rajka criteria. Patients were divided into two groups: "pure" AD (n=27; 12 male and 15 female), mean age 46.3 (range 19-77) years; and AD with respiratory symptoms (AD+RS, n=16; 5 male and 11 female), mean age 38.4 (range 17-75) years. Control group consisted of 15 healthy subjects (7 male and 8 female; mean age 49.0, range 24-64 years), with no personal or family history and signs of atopy. Both patient groups had a higher total serum IgE than control subjects (p<0.05). In the "pure" AD group, SPT was positive in 5/27 (18.5%) and RAST to D. pteronyssinus in 4/27 patients. In the AD+RS group, SPT was positive in 10/16 (62.5%) and RAST to D. pteronyssinus in 8/16 (50%) patients. Concordance between SPT and RAST was observed in both groups; 80% of SPT positive patients were RAST positive. D. pteronyssinus was found to play an important role as a trigger factor in AD patients.     

过敏专科门诊3 051例湿疹皮炎患者血清特异性IgE检测结果分析

目的分析湿疹皮炎患者血清特异性IgE检测结果。方法回顾2021年4月1日至2022年3月31日于华山医院过敏专科门诊就诊的3 051例湿疹皮炎患者, 利用Phadia过敏原检测系统检测患者的血清特异性IgE水平, 计算各项过敏原的检测阳性率, 分析湿疹皮炎患者的常见吸入性过敏原和食物过敏原。计数资料组间比较采用χ2检验。结果 3 051例湿疹皮炎患者中, 特应性皮炎1 412例, 其他湿疹/皮炎1 639例。1 629例(53%)过敏原阳性, 阳性过敏原数为(3.0 ± 1.6)个。最常见的3种吸入性过敏原分别是粉尘螨(904/1 522例, 59%)、户尘螨(891/1 513例, 59%)和链格孢霉(206/1 068例, 19%);最常见的3种食物过敏原分别是虾(251/1 432例, 18%)、鸡蛋白(165/992例, 17%)和牛奶(149/994例, 15%)。3 051例中, 25例(1%)年龄< 2岁, 571例(19%)2 ～ 12岁, 285例(9%)12 ～ 18岁, 2 170例(71%) > 18岁。在< 2岁、2 ～ 12岁患者组中, 最...     

儿童期特应性皮炎145例临床分析

目的探讨儿童期特应性皮炎(AD)患儿临床特征及常见特异性变应原分布。方法回顾性分析2013年7月-2014年7月在湖南省儿童医院皮肤科门诊就诊的145例儿童期AD患儿的临床资料,总结其性别比例、地域、加重季节、临床表现及血清特异性变应原分布等特征。结果 145例患儿年龄2~12岁,66.9%有过敏性疾病家族史,其中以过敏性鼻炎(40.7%)最为常见。居住在城市患儿明显高于农村,两者间比值为1.7:1;皮损加重季节以夏、秋季为主,占63.4%。根据AD评分(scoring atopic dermartitis,SCORAD)标准,中度儿童期AD患儿多见(61.4%),且男童比女童较为严重,差异有统计学意义(P<0.05)。血清特异性IgE以吸入性过敏原为主(61.5%),其中户尘螨、粉尘满、屋尘最为常见。结论儿童期AD患儿城市多于农村,常夏秋季节加重,男患儿皮损较女患儿严重,多并发过敏性鼻炎,过敏原以吸入性变应原为主。     

特应性皮炎患儿唾液中分泌型IgA及溶菌酶含量的变化

目的探讨特应性皮炎患儿发作期唾液中分泌型IgA及溶菌酶含量的变化及其临床意义。方法对40例特应性皮炎患儿和20例健康婴儿分别采用放射免疫法和比浊法检测唾液中分泌型IgA及溶菌酶含量,采用"敏筛"定量过敏原检测系统检测血清总IgE。结果①特应性皮炎患儿唾液中分泌型IgA、溶菌酶含量及血清总IgE阳性率均高于健康儿童,两组比较差异有显著性(P<0.01);②特应性皮炎患儿唾液分泌型IgA及溶菌酶含量与SCORAD评分均呈正相关(P均<0.01),血清总IgE阳性组患儿分泌型IgA含量高于阴性组,差异有显著性(P<0.01)。结论特应性皮炎患儿发作期唾液中分泌型IgA及溶菌酶含量可能增加,从而发挥了抗感染和清除过敏原的作用。     

IgE antibodies to Pityrosporum ovale in atopic dermatitis

An enzyme-linked immunosorbent assay (ELISA) was developed to assess serum IgE antibodies directed against Pityrosporum ovale in patients with atopic dermatitis (AD), atopic patients with allergic respiratory disease (ARD: rhinitis or asthma) but without eczema, and in healthy controls. IgE binding to P. ovale extract was demonstrated in 49% (35/72) of AD patients. In contrast, anti-P. ovale IgE was found in only one of 27 atopic controls without eczema; all healthy control sera (n = 17) were negative. Of 37 AD patients tested intracutaneously with P. ovale, 31 showed immediate-type reactivity, and 20 of these 31 patients had anti-P. ovale IgE detectable by ELISA, while sera from the six non-responders were all negative. Levels of anti-P. ovale IgE were highest in AD patients aged 20-30 years. No correlation was found with the severity of AD, but there was a non-significant tendency (P = 0.06) to higher levels in AD patients with concomittant respiratory allergy. Anti-P. ovale IgE was significantly correlated with total serum IgE, with specific IgE against various aeroallergens as measured by RAST, and with levels of anti-Candida albicans IgE, measured with a similar ELISA. Thus, production of IgE antibodies against P. ovale occurs very frequently in AD, and rarely in patients with atopic disease without skin involvement.     

Specific IgE to Staphylococcus aureus in patients with atopic dermatitis

It is a well-known feature of atopic dermatitis (AD) that the patient's skin is heavily colonized by Staphylococcus aureus. S. aureus-derived antigens may be important triggers of the immune response and may significantly contribute to the genesis of the cutaneous pathology of AD. Therefore, serum samples of 52 patients with AD, all of whom had signs of moderate to severe disease activity, were tested for antistaphylococcal IgE antibodies with RAST discs coupled to antigens derived from Wood 46 strain. Total IgE concentrations and specific IgE to nine different common allergens were also determined. Only 2 patients showed significant levels of specific IgE antibodies to S. aureus (RAST class greater than or equal to 2). Both these patients were found to have high total IgE and significant levels of specific IgE to all nine common allergens tested. One of the patients had marked eosinophilia. We conclude that the presence of specific IgE to S. aureus is not correlated with the disease activity in AD. Specific antistaphylococcal IgE does not represent an important diagnostic feature in AD, but may be of importance for the detection of subgroups within patients affected by AD.     

Are age‐specific high serum IgE levels associated with worse symptomatology in children with atopic dermatitis?

BACKGROUND: Atopic dermatitis (AD) is a distressing disease associated with excoriations, pruritus, sleep disturbance, and elevation of serum total immunoglobulin E (IgE) levels. OBJECTIVE: To evaluate whether serum IgE levels correlate with the symptomatology and plasma chemokine levels in children with AD. METHODS: AD patients aged younger than 18 years were recruited from the pediatric dermatology clinic of a university teaching hospital, and the AD severity was evaluated using the SCORing Atopic Dermatitis (SCORAD) index. Concentrations of serum total IgE, eosinophil count, and plasma AD-associated chemokines [cutaneous T-cell-attracting cytokine (CTACK), thymus and activation-regulated chemokine (TARC)] were measured. RESULTS: One hundred and seventeen Chinese children with AD (64 boys and 53 girls), with an age (mean +/- standard deviation) of 10.7 +/- 4.4 years, were recruited. Their overall SCORAD index (mean +/- standard deviation) was 51.1 +/- 22.8. The total serum IgE level divided by the age-specific upper limit (AE) correlated well with the extent and intensity of AD, except for oozing/crusting, which was significant only in males. There was a significant correlation between AE and pruritus or sleep loss only in females. Levels of IgE, CTACK, and TARC, and eosinophil count, differed significantly between patients with mild, moderate, and severe disease. AE correlated well with TARC (r = 0.50, P < 0.001) and eosinophil count (r = 0.41, P < 0.001), but not with CTACK (r = 0.11, P = 0.270). The prediction of moderate to severe eczema by AE gave an area under the receiver-operating characteristic curve of 0.76 (95% confidence interval, 0.65-0.86; P = 0.004). An optimum positive predictive value of 94.2% was achieved with a cut-off point of AE of 2.95, sensitivity of 75.0%, and specificity of 66.7%. CONCLUSION: AE correlates significantly with various objective clinical scores and chemokine markers of AD, and is a useful indicator for predicting moderate to severe AD in children.     

Contact allergy to aeroallergens in children with atopic dermatitis: comparison with allergic contact dermatitis

Immediate and delayed cutaneous hypersensitivity are believed to be implicated in the physiopathology atopic dermatitis (AD). The purpose of this study was to evaluate Type I and Type IV allergy to aeroallergens in children with AD. 59 children (mean age 5.2 years), presenting with AD according to Hanifin and Rajka's criteria, were skin tested (patch and corresponding prick tests) with common environmental aeroallergens and a restricted panel of the European standard series over a 1-year period. History and clinical data were carefully recorded using a standardized evaluation sheet: total and specific IgE serum levels were evaluated 17 of 59 patients (28.8%) had at least 1 positive patch test, 32 of 59 patients (54.2%) had at least 1 positive prick test. Corresponding patch and prick tests were observed in 8 out of 17 patients. 5 children with positive patch tests had negative prick tests. Irritant pustular reactions (2/59, i.e. 3%), "angry back" reactions (6/59, i.e. 10%) and doubtful reactions (3/59, i.e. 5%) were excluded from the positive group. Positive patch tests observed included, in decreasing order: D. pteronyssinus and D. farinæ (26.8%) garden trees (12.2%), plantain (9.8%), timothy grass, mugwort and damp area trees (4.9% each), and orchard grass (2.44%). 6 children with positive aeroallergen patch tests and 11 children with negative aeroallergen patch tests had at least 1 positive patch test to standard allergens. All children with an irritant reaction to aeroallergens had no reaction to standard patch tests. The relevance of aeroallergens in upgrading the severity of AD lesions has still to be explored by challenge studies and by long-term follow-up.     

诱发儿童特应性皮炎的三疣梭子蟹过敏原研究

目的 探讨诱发儿童特应性皮炎的三疣梭子蟹过敏原。 方法 对入选的儿童特应性皮炎患儿进行血清蟹过敏原特异性IgE抗体检测或蟹过敏原皮肤点刺试验,阳性者进行三疣梭子蟹口服食物激发试验,选择出对蟹过敏的患儿33例,留取血清作为实验组;选择同期健康体检儿童30例,留取血清作为对照组。选择新鲜的三疣梭子蟹,提取总蛋白,用十二烷基硫酸钠-聚丙烯酰胺凝胶电泳（SDS-PAGE）、免疫印迹检测诱发儿童特应性皮炎的蟹过敏原。 结果 三疣梭子蟹蛋白粗提液可见条带有11条,相对分子质量分别为94 000、70 000、58 000、49 000、36 000、34 000、32 000、27 000、21 000、19 000、17 000。能引起实验组免疫反应的条带有4条,相对分子质量分别为70 000、58 000、49 000、36 000,实验组阳性率分别为93.9%、45.4%、39.4%、100%;对照组无阳性条带。将实验组相对分子质量70 000、58 000、49 000及36 000免疫条带阳性率分别与健康对照组比较,χ2分别为55.483、17.898、14.891、63.000,均P < 0.05。 结论 70 000、36 000蛋白是诱发儿童特应性皮炎的三疣梭子蟹主要过敏原。     

Serum IgE reactivity to Malassezia furfur extract and recombinant M. furfur allergens in patients with atopic dermatitis

IgE reactivity to the opportunistic yeast Malassezia furfur can be found in patients with atopic dermatitis (AD). We have previously cloned and expressed 6 recombinant allergens (rMal f 1, rMal f 5-9) from M. furfur. In the present study, we used ImmunoCAP to investigate whether these rMal f allergens can be useful in the diagnosis of M. furfur-associated AD compared with the M. furfur extract. A total of 156 adult patients with a clinical diagnosis of AD participated in the study. Sixty-four percent had increased total serum IgE levels, 79% had specific IgE antibodies to common inhalant allergens and 47% had IgE antibodies to M. furfur extract. IgE antibodies to any of the rMal f allergens were detected among 86 (55%) of the patients, 14 (16%) of whom did not react to the M. furfur extract. Any individual rMal f allergen detected between 32% and 89% of the patients ImmunoCAP-positive to the M. furfur extract, with the highest sensitivity for rMal f 9. Therefore, a couple of individual rMal f allergens can improve the diagnosis of M. furfur-associated IgE allergies in patients with AD.     

Clinical features of atopic dermatitis in a hospital‐based setting in China

Background Atopic dermatitis (AD) is a chronic relapsing inflammatory skin disease. There have been few detailed reports of the clinical evaluation of Chinese patients with AD. Objectives To give a profile of the clinical features of Chinese AD patients in a university hospital setting. Methods A total of 1008 cases met Hanifin and Rajka diagnostic criteria of AD were recruited at Xinhua Hospital, Shanghai Jiaotong University School of Medicine, China. Results In our survey, 22.7% patients were mild, 66.6% were moderate and 10.7% were severe according to the SCORAD index. Both the frequency and severity of the male patients were slightly higher. The frequency of asthma among the AD patients was 16.7% and it was increased with the age (χ² = 205.20, P = 0.000). The frequencies of objective minor signs were demonstrated with age‐related changes. Besides, three localized variants including eyelid eczema (49.8%), scalp dermatitis (49.7%), infra‐auricular and retroauricular fissuring (44.8%) were commonly observed, especially in the infantile phase (P < 0.01). It was showed significant differences in serum total immunoglobulin E (IgE) and eosinophil cationic protein (ECP) levels of different age groups. The positive rate of Phadiatop was raised after 3 years old and that of the common food allergens were decreased after 6 years old. Conclusions More males than females had ongoing AD in our survey. Most AD debuted in the first year of the cases. High incidence of the three clinical signs: eyelid eczema, scalp dermatitis and infra‐auricular and retroauricular fissuring among the patients suggests it can be a potential valuable diagnostic clue to AD.     

Diagnostic Usefulness of the Serum-Specific IgE, the Skin Prick Test and the Atopy Patch Test Compared with That of the Oral Food Challenge Test

Background

Atopic dermatitis (AD) is frequently associated with food allergies. In addition to the skin prick test (SPT) and serum-specific IgE, the atopy patch test (APT) has been introduced as a diagnostic procedure for food allergies.

Objective

Our aim was to evaluate the diagnostic value of the APT, the SPT and the serum-specific IgE levels compared with that of oral food challenge test against milk and egg in AD patients.

Methods

We conducted the SPT and APT, and determined the serum-specific IgE levels against milk and egg antigens for 101 patients. Oral food challenge tests were conducted for 86 out of 101 AD patients. The sensitivity, specificity and positive and negative predictable values were calculated for all the tests.

Results

Twenty-five patients were positive to oral food challenges. The sensitivity of the APT for milk was 66.7%, while the figures for the SPT and the serum-specific IgE were 35.5% and 14.2%. The sensitivity of the APT for egg was 50%, while that for the SPT and serum-specific IgE were 21.4% and 6.7%.

Conclusion

We were able to conclude that the APT test seems to be a valuable additional tool for the diagnostic method of food allergies in AD.     

Correlation of serum total IgE, eosinophil granule cationic proteins, sensitized allergens and family aggregation in atopic dermatitis patients with or without rhinitis

Atopic dermatitis (AD) is a complex disease with both a genetic background and environmental interactions. Although multiple linkage-analyses about AD have been studied, there have been only a few family aggregation tests of AD or perennial allergic rhinitis (AR) to date. The association of allergen-specific IgE in AD and atopic dermatitis with allergic perennial rhinitis (ADR) have also been seldom discussed. The purpose of this study was to evaluate family aggregation and assess allergen-specific IgE in patients with AD and ADR. We also planned to investigate the effect of family history of AD on the prevalence of allergen-specific antibodies. The serum levels of IgE, eosinophil cationic protein (ECP) and major basic protein (MBP) were measured and compared in patients with AD and those with ADR. Proportional analysis compared allergen-specific IgE between AD and ADR. The family aggregation was conducted to estimate the odds ratio for various atopic diseases in different family members. Total IgE and allergen-specific antibodies in serum were compared between those patients who had AD with AR and those without. The result revealed that allergic rhinitis is the most common concomitant atopic disease associated with AD. The ADR group was more likely to have serum mite-, cockroach-, and feather-specific IgE. The positive rates for wheat, peanut and soybean were higher in those AD without rhinitis. In the family aggregation of AD, the odds ratio for siblings was higher than for parents, the ratios for brother and sister were 9.91 and 8.75, respectively. However, the odds ratio for parents of ADR was higher than siblings; the ratios for father and mother of ADR were 8.22 and 2.94, respectively. AD patients with family histories of AD were more likely to have mite-, soybean-, and peanut-specific antibodies in their serum. We concluded that aeroallergens are the most important allergens aggravating atopic diseases in Taiwan. Food plays an important role in the pathogenesis of AD. Measurement of serum total IgE combined with the MAST-CLA test could be helpful in the diagnosis of atopic diseases. The differential aggregation tendency for AD and ADR implicated the complexity of the gene-environment interaction in these atopic diseases.