Atopy patch test reactions to Malassezia allergens differentiate subgroups of atopic dermatitis patients

Johansson, Catharina; Sandström, Monica; Bartosik, Jacek; Särnhult, Tore; Christiansen, J; Zargari, Arezou; Bäck, Ove; Wahlgren, Carl-Fredrik; Faergemann, Jan; Scheynius, Annika; Linder, Maria Tengvall

doi:10.1046/j.1365-2133.2003.05093.x

Cited by 100 publications

(93 citation statements)

References 40 publications

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“…When combining APT and in vitro peripheral blood analysis on 64 AE patients, we found that a majority of the AE patients reacted to the investigated allergen M. sympodialis in accordance with previous reports [17, 24]. The number of peripheral T cells responding to M. sympodialis by IL-4 production was correlated with the APT score and was, if above a certain level, predictive for a positive APT reaction.…”

Section: Discussionsupporting

confidence: 70%

“…But in contrast to this proposed mechanism, the relationship between AE patients’ allergen-specific plasma-IgE levels and their skin reactivity is not clear. Positive APT reactions are found both in patients with intrinsic AE [14, 29] and in extrinsic AE patients lacking detectable IgE against the allergen in question [11, 14, 16, 24, 29]. This could possibly be explained by the need for a minimal amount of circulating allergen-specific IgE, and/or local IgE production.…”

Section: Discussionmentioning

confidence: 99%

“…This could possibly be explained by the need for a minimal amount of circulating allergen-specific IgE, and/or local IgE production. However, the fact that often less than 50% of the AE patients with detectable plasma IgE for a specific allergen respond with a positive APT [14, 24] argues against that. Instead, it suggests that non-IgE mediated mechanisms may also be critical for a skin reaction, in line with the lack of correlation between the IgE levels and APT score observed herein.…”

Section: Discussionmentioning

confidence: 99%

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Elevated Peripheral Allergen-Specific T Cell Response Is Crucial for a Positive Atopy Patch Test Reaction

Johansson

Ahlborg

Andersson

et al. 2009

Int Arch Allergy Immunol

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Background: Atopic eczema is a chronic inflammatory skin disease in which several subgroups of cases can be identified. Atopy patch testing (APT) reveals allergen sensitization also in atopic eczema patients devoid of detectable allergen-specific IgE, suggesting the importance of factors other than IgE in the reaction. Here we investigate the relationship between APT reactions and allergen-specific peripheral IgE and T cell reactivity in atopic eczema patients. Methods: Adult patients with atopic eczema (n = 64) and healthy controls (n = 24) were analyzed for reactivity to Malassezia sympodialis extract by APT, measurement of specific plasma IgE and in vitro determination of the frequency of allergen-reactive peripheral blood mononuclear cells producing interleukin-4 and interleukin-5 using the ELISpot method. Results: When combining the results of the APT, IgE measurements and the ELISpot analyses, reactivity to M. sympodialis was found in a majority of the atopic eczema patients (69%), whereas the healthy controls were negative throughout. T cell reactivity to M. sympodialis, manifested by production of both interleukins 4 and 5, was highly predictive for a positive APT reaction and displayed a strongly positive correlation with the APT score. In contrast, the allergen-specific IgE levels did not predict the APT outcome, and no correlation could be found between the IgE levels and the APT score. Conclusion: Peripheral allergen-specific T helper 2 cell-mediated reactivity appears to be required for a positive APT reaction to M. sympodialis. The diagnostic potential of measuring peripheral allergen-specific T cell responses should be considered in atopic eczema.

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Section: Discussionsupporting

confidence: 70%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Elevated Peripheral Allergen-Specific T Cell Response Is Crucial for a Positive Atopy Patch Test Reaction

Johansson

Ahlborg

Andersson

et al. 2009

Int Arch Allergy Immunol

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“…Skin prick tests were first used in the diagnosis of this allergy. The literature results are recapitulated in table 2 [12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22]. In all the studies except one [21], the percentage of skin prick test positivity was higher in patients with HNAD than in patients with non-HNAD.…”

Section: Discussionmentioning

confidence: 68%

Head and Neck Atopic Dermatitis and <i>Malassezia-furfur</i>-Specific IgE Antibodies

Bayrou¹,

Pecquet²,

Flahault

et al. 2005

Dermatology

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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.

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“…A Swedish multicenter study of 132 subjects with AD revealed that 60% had a positive skin test response to Malassezia species in comparison with no positive test responses in the non-atopic subjects [42].…”

Section: Immunologic Triggers Bacteria Viruses Fungimentioning

confidence: 99%

Atopic Dermatitis: Insights on Pathogenesis, Evaluation and Management

S¹

2014

J Allergy Ther

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Background: Atopic Dermatitis (AD) is a highly pruritic chronic inflammatory skin disease that commonly presents during early childhood. Several studies indicate that the disease is very common in western world with lifetime prevalence in children of 10% to 20%. Data sources:We make recommendations regarding the evaluation and management of AD in children based on systematic literature searches using the best-available evidence from PubMed, Medline, Google Scholar, NICE, the American Academy of Dermatology and the World Allergy Organization.Results: AD has an immunologic basis. Both innate and adaptive immune responses are impaired in AD patients. Intense pruritus is a hallmark of the disease which leads to extensive scratching and further breakdown of the skin barrier. Treatment of AD may be topical or systemic. Topical corticosteroids and calcineurin inhibitors are used as topical anti-inflammatory agents. Patients should be carefully instructed in the use of topical glucocorticoids to avoid side effects. Conclusions:Treatment of atopic eczema should be based on a "stepped-care plan" where treatments are stepped up or down depending on the assessment of the state of the child's skin by the physician. Physicians who treat children with mild to moderate AD should tell children and their caregivers that AD is a lifelong illness.

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Atopy patch test reactions to Malassezia allergens differentiate subgroups of atopic dermatitis patients

Cited by 100 publications

References 40 publications

Elevated Peripheral Allergen-Specific T Cell Response Is Crucial for a Positive Atopy Patch Test Reaction

Elevated Peripheral Allergen-Specific T Cell Response Is Crucial for a Positive Atopy Patch Test Reaction

Head and Neck Atopic Dermatitis and <i>Malassezia-furfur</i>-Specific IgE Antibodies

Atopic Dermatitis: Insights on Pathogenesis, Evaluation and Management

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