Combined skin prick and patch testing enhances identification of peanut-allergic patients with atopic dermatitis

BACKGROUND: Food atopy patch tests (APTs) are considered a useful tool for the diagnosis of food allergy. Hypersensitivity to peanuts has not been investigated by means of APTs so far. METHODS: APTs and skin prick tests (SPTs) with peanuts were performed in 136 atopic dermatitis (AD) patients. Relevance of positive and negative responses to these tests was assessed by repeated open challenges with peanuts. RESULTS: Nine percent of our AD patients reacted to the challenge. Positive responses to APTs were recorded in 19% of the patients, whereas in 12% positive SPTs were observed. APTs were more frequently positive in subjects with eczematous responses after challenge with respect to those with urticarial reactions. SPT reactivity proved to be higher in patients above 12 years of age, whereas APT positivity was more frequent in children under 6 years. APT sensitivity proved significantly higher than SPT sensitivity, in particular in children under 12 years of age. On the contrary, SPT specificity and positive predictive value were significantly higher with respect to those of APT in the age group of subjects under 6 years of age. CONCLUSIONS: Our data suggest that APTs with peanuts may represent a useful integration to standard testing modalities employed for the diagnosis of peanut allergy in AD patients.     

IgE autoantibodies in atopic dermatitis -occurrence of different antibodies against the CH3 and the CH4 epitopes of IgE

Levels of "free" anti-IgE autoantibodies and IgE/anti-IgE immune complexes were measured in the sera of patients with atopic dermatitis before and after treatment, psoriasis patients, and nonatopic controls. In this measurement, we used two monoclonal antibodies with distinct in vitro functions (LE 27, BSW 17), directed against the epsilon CH3 and CH4 domains of the IgE Fc-fragment, in a novel immunobinding assay. In patients with atopic dermatitis, elevated levels of "free" anti-IgE antibodies and IgE/anti-IgE immune complexes were detected in comparison to psoriasis patients and controls. In addition, there was a positive correlation between total IgE and the amount of IgE/anti-IgE complexes detected by LE 27 ( r =0.7; P < 0.001) or BSW 17 ( r = 0.64; P < 0.001) in patients with atopic dermatitis. In contrast, an inverse correlation was observed between total IgE and "free" anti-IgE antibodies ( r =−0.34; P < 0.05) in atopic dermatitis. However, serum levels of anti-IgE autoantibodies before and after therapy in patients with atopic dermatitis did not differ, and levels of anti-IgE antibodies did not correlate with clinical severity, as evaluated by an established clinical scoring system. Our data clearly indicate that significantly elevated amounts of anti-IgE antibodies could be observed in patients with atopic dermatitis, which are directed against different epitopes on the IgE molecule. It is tempting to speculate that these autoantibodies exert different effects on IgE-receptor-bearing effector cells and may play an important role in IgE regulation.     

Dual function of Langerhans cells in skin TSLP-promoted TFH differentiation in mouse atopic dermatitis

1. Download : Download high-res image (187KB)
2. Download : Download full-size image

     

遗传过敏性皮炎患者血清IL—4水平与IgE的关系

采用酶联免疫技术检测２１例遗传过敏性皮炎患者血清白细胞介素４（ＩＬ－４）及ＩｇＥ水平。实验结果发现，ＡＤ患者血清ＩＬ－４水平比正常人显著增高，并且与ＩｇＥ密切相关。说明ＡＤ的发病与ＩＬ－４产一失调，从而导致Ｂ细胞合成ＩｇＥ增加有关。人ＩＬ－４酶联免疫检测具有敏感、特异、简便、快速及结果可靠等特点。     

Blood endotyping distinguishes the profile of vitiligo from that of other inflammatory and autoimmune skin diseases

1. Download : Download high-res image (180KB)
2. Download : Download full-size image

     

Staphylococcus epidermidis protease EcpA can be a deleterious component of the skin microbiome in atopic dermatitis

1. Download : Download high-res image (400KB)
2. Download : Download full-size image