Autoimmunity in atopic dermatitis: Biomarker or simply epiphenomenon?

Abstract

The idea that a mechanism of autoimmunity could play a role in the pathogenesis of atopic dermatitis gained support from the observation that patients with atopic dermatitis display IgE reactivity to a variety of human protein antigens, several of which have been characterized at molecular level. A broad spectrum of at least 140 IgE-binding self-antigens associated with atopic dermatitis has been demonstrated; they might promote, perpetuate, or both, skin inflammation by binding IgE antibodies or activating specific T cells. Even if the presence of autoreactivity seems to be associated with the severity of the disease and may be used as a parameter reflecting chronic tissue damage, at the state of art the role of autoimmunity in atopic dermatitis is far from clear. Data from the literature show that the use of autoantibodies as biomarkers of atopic dermatitis are still limited by the evidence that the epiphenomenon of autoreactivity is detectable only in a percentage of patients and that the involved selfallergens often are not the same; further longitudinal case-control studies are needed to investigate and to clarify the pathogenethic role of autoimmunity in the course of atopic dermatitis.

The effects of vitamin K1 and vitamin K2 on the proliferation, cytokine production and regulatory T‐cell frequency in peripheral blood mononuclear cells of paediatric atopic dermatitis patients

“…Atopic dermatitis (AD) is a chronic inflammatory skin disease with pruritus that predominantly occurs in early childhood . Immunological aberrations are suggested to be the main inducers of AD . However, side effects of immunosuppressants are reported in 70% of patients .…”

Identification of B Cell Epitopes of Blo t 13 Allergen and Cross-Reactivity with Human Adipocytes and Heart Fatty Acid Binding Proteins

“…Cross-reactivity among environmental allergens and human antigens has been suggested as a mechanism to trigger IgE mediated autoreactivity and to promote exacerbations of symptoms in allergic diseases [3,20]. Some allergic subjects exhibited IgE reactivity to Blo t 13, FABP3 and FABP4, and the inhibition assay demonstrated cross-reactivity among them.…”

Recent advances in epidemiology and prevention of atopic eczema

“…The pathogenetic mechanisms underlying AD are heterogenous in different patients and may change over time even in the same patient. Therefore, many different clinical phenotypes and endotypes of AD can be observed according to the following characteristics: (i) an onset in childhood vs. adulthood; (ii) the degree of disease severity, persistence, and duration; (iii) presence of FLG and/or FLG‐like genetic null mutations; (iv) IgE sensitization to food or airborne allergens; (v) immunologic reactivity to cutaneous self‐antigens ; and (vi) colonization by microbial agents (e.g., HSV, S. aureus ). The study of all these characteristics in the individual patient is essential to achieve a personalized preventive and therapeutic approach .…”