Assessment of allergen-specific IgE by immunoblotting method in atopic dermatitis

Abstract

Stimulating the immune system by exposure to various allergens to produce specific IgE has a significant role in the pathogenesis of atopic dermatitis. Identifying disease-causing allergens, prevention of exposure to those allergens, and immunotherapy will play an important role in the treatment of Atopic Disease. The purpose of this study was to determine the common allergens of northwest of Iran in patients with atopic dermatitis that are resistant to treatment. In this descriptive-analytical study, serum levels of total IgE and frequency of specific IgE were measured by Immunoblotting against 20 common allergens in 150 cases of patients with atopic dermatitis, attending to dermatology and asthma and allergy clinics from 2010 to 2011. The control group consisted of individuals who had been clinically healthy. In the 90% of patients that were included in this study, total IgE levels were higher than in healthy people with mean serum levels of total IgE 227.51 ± 103 IU/ml. 136 patients (90.6%) had specific IgE for at least one allergen. The frequency of positive allergens among the patients who were included in this study were 53.34%, 26.8%, and 19.56% respectively in plants and fungus allergens group, animal allergens group and food allergens group. After avoiding of the allergens (which they had been sensitized to), 60% of patients were cured with immune therapy, and total IgE serum levels in the control group were not increased. Identifying the abundant allergens such as cultivated rye, Timothy grass, house dust mite, birch, cat, horse, potato, dog, egg white, cow milk, in order to advise patients to avoid them or to do immunotherapy and desensitization, is useful in this area.

Dupilumab progressively improves systemic and cutaneous abnormalities in patients with atopic dermatitis

“…In our study dupilumab significantly suppressed serum levels of all of these biomarkers, as well as total and allergen-specific IgE concentrations. Although serum total and allergen-specific IgE concentrations were previously associated with greater severity of AD and other type 2 atopic/allergic diseases, [90][91][92][93][94][95] broad-based treatments have largely failed to cause downregulation of IgE. 47,[96][97][98] Further studies are needed to evaluate the clinical effect on other atopic comorbidities of the dupilumab-induced modulation of circulatory type 2 biomarkers in our study.…”

“…These included allergen-specific IgEs previously associated with AD and other atopic or allergic type 2 manifestations (eg, staphylococcal enterotoxin A, 261% vs 0%; Dermatophagoides farinae, 239% vs 0%; see Table E12 in this article's Online Repository at www.jacionline.org). [90][91][92][93][94][95] Although concentrations of most specific IgEs were significantly reduced only with dupilumab (except that of sage mugwort [Artemisia vulgaris], P 5 .10), particularly large (>50%) and significant reductions were seen in those of cockroach, staphylococcal enterotoxin A, Cladosporium species, Bermuda grass, silver birch, white oak, elm, white ash, Johnson grass, and cat dander (see Table E12). Baseline serum total IgE concentrations were greater than the normal range (119 kU/L) in both groups (see Table E5).…”

“…[82][83][84][85][86][87][88][89] Most patients with AD (or other atopic diseases) have increased IgE levels and antigen-specific IgE sensitization, as demonstrated by increased serum concentrations of various IgEs specific to common allergens (eg, house dust mite, staphylococcal enterotoxins, cat and dog dander, Cladosporium species, and grass). [90][91][92][93][94][95] Nevertheless, although higher concentrations of total and specific IgEs have been associated with higher clinical AD severity at baseline, 11,90 treatment with broad-target agents, such as CsA or phototherapy, does not consistently reduce IgE levels, an observation suggesting that these treatments do not adequately suppress IL-4 and IL-13 activity 47,96,97 and might even lead to increased IgE levels. 98 Previously, we reported that in a short (4-week) phase 1b trial, inhibition of type 2 inflammation with dupilumab modifies molecular mechanisms in skin of patients with AD, thus establishing a central pathogenic role for IL-4 and IL-13.…”

Allergen-specific immunoglobulin E and interleukin 33 in atopic dermatitis

“…Identifying allergen-specific IgE in patients with AD provides the possibility for the prevention of accidental exposure to such allergens [15]. Food allergens can penetrate the skin via the bloodstream, whereas airborne allergens can enter the skin through Stężenia obliczono z krzywej standardowej wygenerowanej przez program do dopasowywania krzywych.…”

“…dySkuSJA Identyfikacja swoistych IgE u pacjentów z AZS umożliwia zapobieganie przypadkowemu narażeniu na te alergeny [15]. Alergeny pokarmowe mogą przenikać do skóry przez krew, natomiast alergeny wziewne mogą docierać do warstwy rogowej naskórka.…”