Specific IgE antibodies to Pityrosporum orbiculare in patients with atopic dermatitis

By means of RAST investigations, we detected specific IgE antibodies against Pityrosporon orbiculare in the plasma of patients with atopic dermatitis. The patients suffering from the so-called head and neck dermatitis showed an average specific IgE antibody titer of RAST class 3, whereas in those with predominant involvement of the extremities we found an average antibody titer of RAST class 1.     

Active participation of eosinophils in patch test reactions to inhalant allergens in patients with atopic dermatitis

Intracutaneous testing and patch tests with house dust mite and grass pollen allergens were performed in patients with atopic dermatitis. Only patients with an immediate type skin reaction to house dust mite or grass pollen allergens showed a positive patch test reaction to these allergens 24-48 h after testing. Occasionally positive patch test reactions at 20 min, 2 h and 6 h were also observed. Patch test reactions were not found in normal controls or atopic patients without atopic dermatitis. Analysis of the cellular infiltrate demonstrated an influx of eosinophils into the dermis, starting from 2-6 h after patch testing. Immunostaining with antibodies against granular constituents of the eosinophils revealed that the infiltrating eosinophils were in an activated state and had lost part of their granular contents. At 24 h eosinophils also appeared in the epidermis. Electron microscopy showed that in the epidermis, some eosinophils were in close contact with Langerhans cells, suggesting a cell-cell interaction. Taken together, these results strongly suggest an active role for eosinophils in patch test reactions to inhalant allergens in atopic dermatitis patients.     

IgE antibodies to Staphylococcus aureus. Prevalence in patients with atopic dermatitis

We determined the prevalence of IgE antibodies to Staphylococcus aureus by optimized immunoradiometric assay methods in serum specimens from 69 patients with atopic dermatitis. All patients had positive aerobic cultures for S aureus from skin. Significant binding attributable to IgE antibodies was noted in three of 25 patients with atopic dermatitis and superimposed impetiginization or pustules, but antibodies were not detected in the remaining 44 patients whose lesions were colonized with S aureus. By comparison, IgE antibodies to S aureus were uniformly present in high titer in serum samples from patients with the hyperimmunoglobulin E syndrome. We conclude that most patients with atopic dermatitis do not have detectable levels of IgE antibodies to S aureus.     

Total and specific IgE levels in patients with atopic dermatitis

Ten young adults with chronic atopic dermatitis have been followed for up to 18 months through periods of clinical exacerbation and remission. Sequential estimation of total levels of circulating IgE and specific IgE by the radioallergosorbent technique (RAST) showed no significant correlation between IgE levels and severity of skin involvement. However, a clear correlation between clinical history, prick tests and RAST tests was obtained in several cases. Serum IgE levels in seven patients with ‘pure’ atopic dermatitis were elevated to levels similar to those found in three patients with additional respiratory symptoms.     

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.     

Late-onset of IgE sensitization to microbial allergens in young children with atopic dermatitis

Background  A significant proportion of young children with atopic dermatitis (AD) is sensitized to microbial allergens, which play a potential role in the pathogenesis of AD inflammation.
Objective  To study the timing of IgE sensitization to microbial allergens including staphylococcal superantigens, Malassezia species and Candida albicans in young children with AD.
Method  Specific IgE antibodies to staphylococcal superantigens, Malassezia species, C. albicans and control inhalant/food allergens were measured in 53 young children with mild to moderate AD. The presence of IgE sensitization relative to age (≥ 3 years vs. < 3 years) was analysed by logistic regressions.
Results  IgE sensitization to the staphylococcal superantigen group, Malassezia species and C. albicans was significantly associated with older age in children with AD [ P  =   0·02, odds ratio (OR) 4·9; P  =   0·02, OR 4·7; and P  =   0·05, OR 4·0, respectively].
Conclusion  IgE sensitization to microbial allergens is associated with an older age group in young children with mild to moderate AD.     

Polymorphisms within the C3 gene are associated with specific IgE levels to common allergens and super-antigens among atopic dermatitis patients

Abstract:  Atopic dermatitis (AD) is a chronic inflammatory skin disease. Twin and family studies suggest a strong genetic component of the disease. The keratinocytes secrete high amounts of C3 after stimulation with pro-inflammatory cytokines, which may play a functional role in skin inflammation. In this study, we genotyped four different single nucleotide polymorphisms (SNPs) by melting curve analysis using sequence specific hybridization probes in a well-characterized cohort of AD patients. Among four SNPs within C3 gene, higher frequencies of rs10410674 (23.5% vs 12.2%) and rs366510 (13.8% vs 6.5%) were observed in AD patients as compared with control group. None of the tested polymorphisms showed significant association with the risk of the disease phenotype. Analysis of rs10402876 SNP revealed its association with less severe AD disease expression (low SCORAD). Total serum IgE levels were not different among AD patients having any of the four SNPs. However, we observed significantly less serum-specific IgE levels to common allergens ( Dermatophagoides pteronyssinus and birch pollens) and Staphylococcal enterotoxin B in AD patients having rs366510 SNP. Thus, associations of polymorphism within C3 gene with less severe AD disease expression and a weaker sensitization to common allergens suggest the role of these SNPs in the development of AD.     

特应性皮炎患者血清中抗马拉色菌和白念珠菌特异性IgE抗体水平检测

目的:分析特应性皮炎(AD)患者血清抗马拉色菌及抗白念珠菌特异性IgE抗体水平与疾病严重程度的相关性.探讨其在AD发病中的作用.方法:收集符合Williams诊断标准的23例AD患者,对其严重程度以湿疹面积及严重度指数(EASI)评分法进行评分.以免疫荧光-酶技术测定23例AD患者、19名健康对照者的血清总IgE抗体水平、抗马拉色菌及抗白念珠菌特异性IgE抗体水平.分析该地区AD患者总IgE抗体水平、抗马拉色菌及抗白念珠菌特异性IgE抗体水平与疾病严重程度的相关性.结果:AD患者总IgE抗体水平、抗马拉色菌特异性IgE抗体水平高于健康对照者,并与EASI评分呈显著正相关(P＜0.01).结论:部分AD患者抗马拉色菌特异性IgE抗体水平升高,并与EASI评分呈正相关,提示马拉色菌在AD的发病中可能起一定作用.     

Most common inhalant allergens in atopic dermatitis, atopic dermatitis/allergic rhinitis, and atopic dermatitis/bronchial asthma patients: a five-year retrospective study

Atopic dermatitis (AD) is a chronic relapsing inflammatory skin disease with a distinctive clinical appearance and distribution. Around 85% of patients have positive immediate skin reaction or specific IgE to different airborne allergens that are in association with respiratory allergy. The aim of this retrospective, open and uncontrolled study was to identify the most common inhalant allergens in AD patients, AD/allergic rhinitis patients, and AD/bronchial asthma patients by skin prick test per year during the 2001-2005 period.     

Heterogeneity of atopic dermatitis defined by the immune response to inhalant and food allergens.

Although atopic dermatitis (AD) is a common disease, its etiopathogenesis is not well known. The diagnosis of AD is based solely on the clinical criteria proposed by Hanifin and Rajka. In order to understand the immunological mechanisms involved in the pathogenesis of AD, we have classified the patients affected by this disease in four groups according to the results of skin prick-tests, specific IgE and patch-tests. This classification is intended to separate and compare the patients affected by AD according to the involvement of immunological type I and/or type IV mechanisms. Our results show that, although all the patients studied are clinically affected by AD, there are four different groups of patients who present an apparently diverse immunopathological mechanism. There is a group that seems to have an IgE mediated mechanism, another group that suggests a cell mediated mechanism, another group which seems to involve both mechanisms, and yet another group that apparently does not show any of the above mentioned mechanisms. In the present article we hypothesize and argue that the imbalance of the immune system is a consequence of the still unknown etiopathogenetic mechanism of AD, but perhaps not the cause of AD.     

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.     

Eczematous reactions in atopic patients caused by epicutaneous testing with inhalant allergens

To determine whether inhalant allergens could induce eczematous lesions we studied 17 patients with atopic eczema (with or without allergic rhinitis), 13 patients with allergic rhinitis without atopic eczema and 10 healthy control subjects. The allergens, birch pollen (Betula verrucosa) and house dust mite (Dermatophagoides pteronyssinus), were applied in aluminium chambers for 48 h on clinically normal skin. In 17 patients with atopic eczema, six epicutaneous test reactions of the delayed type to birch pollen and three to house dust mite were seen at 48 or 72 h. In 13 patients with allergic rhinitis without eczema there was one delayed reaction to birch pollen and none to house dust mite. No delayed type test reactions to either allergen were seen in the controls. Biopsies of the positive test sites revealed an eczematous reaction with epidermal spongiosis and microvesiculation. Immunostaining of cryostat sections showed dermal cell infiltrates consisting of mainly T lymphocytes (ratio of T4:T8, 2-6:I) and to a lesser degree Langerhans and indeterminate T6+ cells. 50-90% of the cells were Ia+. The numbers of basophils and mast cells did not exceed 10-15%.     

225例特应性皮炎患儿血清中食物特异性IgE抗体检测及其意义

特应性皮炎的发病机制至今不是很清楚。本研究旨在通过检测患儿血清中食物特异性IgE（sIgE）抗体，明确北京及周边地区儿童特应性皮炎相关的食物变应原，探讨食物过敏与儿童特应性皮炎的相关性。     

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.     

Head and neck atopic dermatitis and malassezia-furfur-specific IgE antibodies

BACKGROUND: Atopic dermatitis of the head and neck (HNAD) has been recognized as a separate entity. Malassezia furfur, a lipophilic yeast, is considered to be a pathogenic allergen in this form of atopic dermatitis. OBJECTIVE: The purpose of this study was to determine the level of IgE anti-M.-furfur antibodies and their relation to the severity of the disease. METHODS: IgE anti-M.-furfur antibodies were assayed in 106 patients with HNAD. Controls included 25 patients with non-HNAD, 20 with nonatopic dermatitis and 16 with seborrheic dermatitis (including 4 with AIDS). RESULTS: There was a highly significant correlation between the level of anti-M.-furfur IgE and clinical severity. Furthermore, there was a significant but smaller correlation between total IgE and clinical severity. In patients with HNAD, total IgE was higher amongst men. CONCLUSION: IgE anti-M.-furfur antibodies are a good and specific marker for HNAD. IgE M. furfur levels are strongly correlated with the severity of the disease.