Assessment of IgE-mediated food allergies in children with atopic dermatitis

Mavroudi, Antigoni; Karagiannidou, Agathi; Xinias, Ioannis; Cassimos, Dimitrios; Karantaglis, Nikolaos; Farmaki, Evangelia; Ιmvrios, G.; Fotoulaki, Maria; Eboriadou, Maria; Tsanakas, John

doi:10.1016/j.aller.2016.06.006

Cited by 16 publications

(20 citation statements)

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“…The increased of serum levels of total IgE in severe atopic patients suggest that IgE levels in the serum of these subjects are associated with increased disease activity in these atopic patients. These results are well supported by previous findings, showed that eczema patients with IgE antibodies against common environmental allergens were at higher risk for the development/progression of atopic disorders especially in pediatric patients [ 33 , 34 ]. The increased levels of IgE observed in the patients with AD, AR or BA in the present study, together with significant increases of filaggrin protein and eosinophil MBP, provide strong evidences of their involvement in these disorders and clearly indicating that filaggrin protein, eosinophil MBP and total IgE are useful in evaluating of AD, AR or BA disease activity, and would therefore be helpful for predicting the progression of these atopic disorders in pediatric patients.…”

Section: Discussionsupporting

confidence: 90%

Markers of atopic dermatitis, allergic rhinitis and bronchial asthma in pediatric patients: correlation with filaggrin, eosinophil major basic protein and immunoglobulin E

et al. 2018

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BackgroundAllergic reactions have been implicated as contributions in a number of atopic disorders, including atopic dermatitis (AD), allergic rhinitis (AR) and bronchial asthma (BA). However, the potential for filaggrin protein, eosinophil major basic protein (MBP) and immunoglobulin E (IgE) to elicit allergic response or to contribute to atopic disorders remains largely unexplored in pediatric patients. This study was undertaken to investigate the status and contribution of filaggrin protein, eosinophil MBP and total IgE in pediatric patients with AD, AR and BA.MethodsSera from 395 pediatric patients of AD, AR or BA with varying levels of disease activity according to the disease activity index and 410 age-matched non-atopic healthy controls were evaluated for serum levels of atopic markers, including filaggrin, eosinophil MBP and IgE.ResultsSerum analysis showed that filaggrin levels were remarkably high in pediatric patients with AD, followed by BA and AR, whereas its levels were low in non-atopic pediatric controls. Eosinophil MBP levels in sera of atopic patients were significantly high as compared with their respective controls, but its levels were highest in AR patients, followed by AD and BA. Total IgE in sera of AD patients was markedly high, followed by AR and BA patients, whereas its levels were low in non-atopic pediatric controls. Interestingly, not only was an increased number of subjects positive for filaggrin protein, eosinophil MBP or total IgE, but also their levels were statistically significantly higher among those atopic patients whose disease activity scores were higher as compared with atopic patients with lower disease activity scores.ConclusionsThese findings strongly support a role of filaggrin protein, eosinophil MBP and IgE in the onset of allergic reactions in pediatric patients with AD, AR and BA. The data suggest that filaggrin, eosinophil MBP or IgE might be useful in evaluating the progression of AD, AR or BA and in elucidating the mechanisms involved in the pathogenesis of these pediatric disorders.

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Section: Discussionsupporting

confidence: 90%

Markers of atopic dermatitis, allergic rhinitis and bronchial asthma in pediatric patients: correlation with filaggrin, eosinophil major basic protein and immunoglobulin E

et al. 2018

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“…In approximately one third of patients, AD is associated with allergic manifestations (e.g. asthma, food allergies, seasonal allergies) 4 , 7 . Recently, associations have also been reported with other inflammatory diseases, including rheumatoid arthritis, inflammatory bowel disease 8 , and systemic lupus erythematosus 9 .…”

Section: Introductionmentioning

confidence: 99%

The atopic dermatitis blood signature is characterized by increases in inflammatory and cardiovascular risk proteins

Brunner

Suárez‐Fariñas

et al. 2017

Sci Rep

214

223

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Beyond classic “allergic”/atopic comorbidities, atopic dermatitis (AD) emerges as systemic disease with increased cardiovascular risk. To better define serum inflammatory and cardiovascular risk proteins, we used an OLINK high-throughput proteomic assay to analyze moderate-to-severe AD (n = 59) compared to psoriasis (n = 22) and healthy controls (n = 18). Compared to controls, 10 proteins were increased in serum of both diseases, including Th1 (IFN-γ, CXCL9, TNF-β) and Th17 (CCL20) markers. 48 proteins each were uniquely upregulated in AD and psoriasis. Consistent with skin expression, AD serum showed up-regulation of Th2 (IL-13, CCL17, eotaxin-1/CCL11, CCL13, CCL4, IL-10), Th1 (CXCL10, CXCL11) and Th1/Th17/Th22 (IL-12/IL-23p40) responses. Surprisingly, some markers of atherosclerosis (fractalkine/CX3CL1, CCL8, M-CSF, HGF), T-cell development/activation (CD40L, IL-7, CCL25, IL-2RB, IL-15RA, CD6) and angiogenesis (VEGF-A) were significantly increased only in AD. Multiple inflammatory pathways showed stronger enrichment in AD than psoriasis. Several atherosclerosis mediators in serum (e.g. E-selectin, PI3/elafin, CCL7, IL-16) correlated with SCORAD, but not BMI. Also, AD inflammatory mediators (e.g. MMP12, IL-12/IL-23p40, CXCL9, CCL22, PI3/Elafin) correlated between blood and lesional as well as non-lesional skin. Overall, the AD blood signature was largely different compared to psoriasis, with dysregulation of inflammatory and cardiovascular risk markers, strongly supporting its systemic nature beyond atopic/allergic association.

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“…In addition, children with AD often have high serum IgE levels. (26,27) We did not measure total serum IgE on most of our patients. Knowing these values may have helped place some of the sIgE values in better context.…”

Section: Discussionmentioning

confidence: 97%

Oral food challenge failures among foods restricted because of atopic dermatitis

Eapen

Kloepfer

Leickly

et al. 2019

Annals of Allergy, Asthma & Immunology

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BACKGROUND: Recent studies have suggested that removing foods from the diet to manage atopic dermatitis (AD), based on positive allergy tests, may lead to immediate allergic reactions on reintroduction of that food. OBJECTIVE: The purpose of this study was to examine the frequency of oral food challenge (OFC) failures among foods removed from the diet as suspected AD triggers, focusing on the five major food allergens in the US. METHODS: OFCs to egg, milk, peanut, soy, and wheat, performed from 2008-14, at a children's hospital's allergy clinics, were reviewed. OFCs were offered based on history and laboratory values. Reasons for food avoidance were classified as food allergy (IgE-mediated reaction occurring within two hours); sensitization only (lack of introduction due to positive test results); and removal due to test results during AD evaluation. RESULTS: There were 442 OFCs performed, with 89 failures (20.1%). Reasons for OFCs included a history of food allergy (320/442; 72.4%); food sensitization without any introduction (77/442; 17.4%); and AD (45/442; 10.2%). OFC failures among those who had food allergy (70/320; 21.9%); sensitization only (13/77; 16.9%); and suspected AD trigger (6/45; 13.3%) did not significantly differ (p=0.63). Wheat was more likely to be avoided than the other four foods for AD concerns (p<0.0001).

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Assessment of IgE-mediated food allergies in children with atopic dermatitis

Cited by 16 publications

References 20 publications

Markers of atopic dermatitis, allergic rhinitis and bronchial asthma in pediatric patients: correlation with filaggrin, eosinophil major basic protein and immunoglobulin E

Markers of atopic dermatitis, allergic rhinitis and bronchial asthma in pediatric patients: correlation with filaggrin, eosinophil major basic protein and immunoglobulin E

The atopic dermatitis blood signature is characterized by increases in inflammatory and cardiovascular risk proteins

Oral food challenge failures among foods restricted because of atopic dermatitis

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