Immunoglobulin E autoantibodies in atopic dermatitis associate with Type‐2 comorbidities and the atopic march

• Published in: Allergy (Copenhagen) 2023-12, Vol.78 (12), p.3178-3192
• Main Authors: Kortekaas Krohn, Inge, Badloe, Fariza Mishaal Saiema, Herrmann, Nadine, Maintz, Laura, De Vriese, Shauni, Ring, Johannes, Schmid‐Grendelmeier, Peter, Traidl‐Hoffmann, Claudia, Akdis, Cezmi, Lauener, Roger, Brüggen, Marie‐Charlotte, Rhyner, Claudio, Bersuch, Eugen, Dreher, Anita, Hammel, Gertrud, Luschkova, Daria, Lang, Claudia, Reiger, Matthias, Bieber, Thomas, Gutermuth, Jan
• Format: Article
• Language: English
• Subjects: Allergic rhinitis; Asthma; Atopic dermatitis; Autoantibodies; autoreactive IgE; Comorbidity; Dermatitis; Dermatitis, Atopic - diagnosis; Dermatitis, Atopic - epidemiology; Eczema; Environmental factors; Epidermis; Food allergies; Humans; IgE‐mediated autoreactivity; Immunoglobulin E; Immunoglobulins; Keratinocytes; Pets; Risk factors; Type‐2 diseases
• ISSN: 0105-4538; 1398-9995
• DOI: 10.1111/all.15822

Background Autoreactive immunoglobulin E (IgE) antibodies to self‐peptides within the epidermis have been identified in patients with atopic dermatitis (AD). Prevalence, concomitant diseases, patient characteristics, and risk factors of IgE autoantibody development remain elusive. We aimed to determine IgE autoantibodies in serum samples (n = 672) from well‐characterized patients with AD and controls (1.2–88.9 years). Methods Atopic dermatitis patients were sub‐grouped in AD with comorbid Type‐2 diseases (“AD + Type 2”; asthma, allergic rhinitis, food allergy, n = 431) or “solely AD” (n = 115). Also, subjects without AD but with Type‐2 diseases (“atopic controls,” n = 52) and non‐atopic “healthy controls” (n = 74) were included. Total proteins from primary human keratinocytes were used for the immunoassay to detect IgE autoantibodies. Values were compared to already known positive and negative serum samples. Results Immunoglobulin E autoantibodies were found in 15.0% (82/546) of all analyzed AD‐patients. “AD + Type 2” showed a higher prevalence (16.4%) than “solely AD” (9.6%). “Atopic controls” (9.6%) were comparable with “solely AD” patients, while 2.7% of healthy controls showed IgE autoantibodies. Of those with high levels of IgE autoantibodies, 15 out of 16 were patients with “AD + Type 2”. AD patients with IgE autoantibodies were younger than those without. Patients with IgE autoreactivity also displayed higher total serum IgE levels. Factors that affected IgE autoantibody development were as follows: birth between January and June, cesarean‐section and diversity of domestic pets. Conclusions Immunoglobulin E autoantibodies in AD seem to associate with the presence of atopic comorbidities and environmental factors. The potential value of IgE autoantibodies as a predictive biomarker for the course of AD, including the atopic march, needs further exploration. This study investigates the prevalence of immunoglobulin E (IgE)‐mediated autoreactivity in serum samples from a well‐characterized large cohort of atopic dermatitis (AD) patients and controls and their correlation with clinical characteristics and environmental factors potentially related to the development of IgE autoantibodies in AD. IgE autoantibodies in AD associate with the presence of atopic comorbidities and the atopic march. AD patients with IgE autoantibodies were younger than those without, and higher total serum IgE levels were found. Environmental factors that affected IgE autoantibodi