Clinical relevance of eosinophils, basophils, serum total IgE level, allergen‐specific IgE, and clinical features in atopic dermatitis

Yong-fang, HU; Liu, Shuoshuo; Liu, Ping; Mu, Zhanglei; Zhang, Jianzhong

doi:10.1002/jcla.23214

Cited by 49 publications

(34 citation statements)

References 22 publications

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“…We also determined the effects of dupilumab on the serum levels of total IgE (normal range, ≤170 IU/ml) during the course of dupilumab treatment, based on the reported association of the total IgE level with the long-term response to treatment in AD patients. [19][20][21][22][23] Total IgE levels were measured in 7, 10, 13, 15, 9, and 5 of the 40 patients at 2, 4, 8, 16, 24, and 32 weeks after the start of dupilumab administration, respectively ( Fig. 3c and Table 5).…”

Section: Effects Of Dupilumab On Serum Levels Of Total Igementioning

confidence: 99%

Dupilumab treatment ameliorates clinical and hematological symptoms, including blood eosinophilia, in patients with atopic dermatitis

et al. 2020

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Background Atopic dermatitis (AD) is an allergic disease that affects individuals of various ages. Recently, the IL‐4/13 inhibitor dupilumab has gained regulatory approval for clinical use in AD patients. Dupilumab has been reported to reduce several markers of AD, including the serum levels of thymus and activation‐regulated chemokine (TARC/CCL17), blood lactate dehydrogenase (LDH), and serum total immunoglobulin E (IgE). Methods We retrospectively reviewed data from 40 AD patients who were treated with dupilumab. Eczema Area and Severity Index (EASI), Investigator’s Global Assessment (IGA), body surface area (BSA) scores, TARC, LDH, total IgE, and eosinophil count in peripheral blood were assessed for a total of 32 weeks. Results The EASI, IGA, and BSA scores improved significantly with treatment, indicating a reduction in AD severity. Serum TARC and LDH levels also significantly decreased with treatment. Serum IgE levels were unchanged at 2 weeks of treatment but decreased significantly between 4 and 32 weeks. The number of eosinophils in the peripheral blood decreased at 4, 16, and 32 weeks after treatment initiation. Conclusions Several studies have reported that serum TARC, LDH, and total IgE levels are reduced by dupilumab treatment. Our real‐world data are the first to demonstrate a reduction in blood eosinophilia in patients who receive clinical treatment with dupilumab.

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Section: Effects Of Dupilumab On Serum Levels Of Total Igementioning

confidence: 99%

Dupilumab treatment ameliorates clinical and hematological symptoms, including blood eosinophilia, in patients with atopic dermatitis

et al. 2020

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“…In addition, some laboratory abnormalities can be found in the majority of eczema patients, such as serum total IgE level. IgE is a key molecule which can activate mast cells and basophils in allergic inflammation, and increased serum total IgE level is significantly correlated with the disease severity [ 50 ]. The current study showed that the serum total IgE level of the RZC combined with AH group was significantly lower than that of the AH group, which was also consistent with the change of EASI score.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and Safety of Runzao Zhiyang Capsule as an Add-On Therapy for Chronic Eczema: A Systematic Review and Meta-Analysis

Zhou

et al. 2021

Evidence-Based Complementary and Alternative Medicine

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Background. Runzao Zhiyang capsule (RZC), an oral Chinese herbal medicine, has been widely used for chronic eczema in China for many years. This study aims to evaluate the efficacy and safety of RZC as an add-on therapy to conventional treatment for chronic eczema. Methods. Randomized controlled trials (RCTs) assessing the efficacy and safety of RZC as an add-on therapy for chronic eczema were retrieved from eight literature databases from their inception to 31 August, 2020, including CNKI, WanFang, VIP, Sinomed, PubMed, Cochrane Library, Web of Science, and Embase. The Cochrane risk of bias tool was used to assess the methodological quality of the included studies. The data were analyzed by RevMan5.3 software. Results. A total of 18 RCTs involving 1896 patients with chronic eczema were included. Compared with no oral treatment, RZC was superior on the total efficacy rate (TER) (RR = 1.45, 95% CI: 1.23 to 1.72, P < 0.0001 ), Eczema Area and Severity Index (EASI) (MD = −0.73, 95% CI: −0.90 to −0.56, P < 0.00001 ), and Visual Analogue Scale (VAS) for pruritus (MD = −2.76, 95%CI: −4.53 to −0.99, P = 0.002 ). Similar results were also seen in a randomized, placebo-controlled trial. Compared with the antihistamine (AH) group, TER in the RZC combined with AH group was significantly higher (RR = 1.32, 95% CI: 1.21 to 1.43, P < 0.00001 ), and the EASI score (MD = −0.29, 95% CI: −0.38 to −0.20, P < 0.001 ), the VAS score (MD = −0.19, 95% CI: −0.23 to −0.15, P < 0.00001 ), and the level of serum total IgE (MD = −9.83 ng/ml, 95% CI: −11.66 to −8.00 ng/ml, P < 0.00001 ) decreased more significantly in the RZC combined with AH group. In terms of safety, mild gastrointestinal diseases occurred more frequently in the RZC group, and no serious adverse effect was reported. Conclusions. RZC as an add-on therapy to conventional treatment shows good effects on chronic eczema, and there is no severe side effect from short-term use of RZC. However, due to suboptimal quality of the included studies, more large-sample and high-quality RCTs are needed to improve the evidence quality.

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“…In fact, a study involving 396 patients with AD revealed that high serum levels of total IgE were observed more frequently in AD patients than in non-AD patients. 53 Another study reported that patients with AD mount IgE antibody responses to various environmental allergens and autoantigens, and elevated level of total serum IgE are observed in approximately 80% of these patients. 54,55 However, 20% of patients with AD exhibit normal total IgE values and the absence of specific IgE directed against common environmental and food allergens.…”

Section: Environmental Irritants Affect Immunologic Functionmentioning

confidence: 99%

“…Therefore, IgE‐mediated allergic reactions play an important role in AD development. In fact, a study involving 396 patients with AD revealed that high serum levels of total IgE were observed more frequently in AD patients than in non‐AD patients 53 . Another study reported that patients with AD mount IgE antibody responses to various environmental allergens and autoantigens, and elevated level of total serum IgE are observed in approximately 80% of these patients 54,55 .…”

Section: Irritants In the Pathogenesis Of Admentioning

confidence: 99%

Exogenous factors in the pathogenesis of atopic dermatitis: Irritants and cutaneous infections

Yue

Umehara

Trujillo-Paez

et al. 2021

Clin Experimental Allergy

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Atopic dermatitis (AD) is a chronic relapsing inflammatory cutaneous disease that is often associated with other atopic symptoms, such as food allergy, allergic rhinitis and asthma, leading to significant morbidity and healthcare costs. The pathogenesis of AD is complicated and multifactorial. Although the aetiology of AD remains incompletely understood, recent studies have provided further insight into AD pathophysiology, demonstrating that the interaction among genetic predisposition, immune dysfunction and environmental provocation factors contributes to its development. However, the increasing prevalence of AD suggests that environmental factors such as irritation and cutaneous infection play a crucial role in triggering and/or aggravating the disease. Of note, AD skin is susceptible to bacterial, fungal and viral infections, and microorganisms may colonize the skin and aggravate AD symptoms. Overall, understanding the mechanisms by which these risk factors affect the cutaneous immunity of patients with AD is of great importance for developing a precision medicine approach for treatment. This review summarizes recent developments in exogenous factors involved in the pathogenesis of AD, with special emphasis on irritants and microbial infections.

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Clinical relevance of eosinophils, basophils, serum total IgE level, allergen‐specific IgE, and clinical features in atopic dermatitis

Cited by 49 publications

References 22 publications

Dupilumab treatment ameliorates clinical and hematological symptoms, including blood eosinophilia, in patients with atopic dermatitis

Dupilumab treatment ameliorates clinical and hematological symptoms, including blood eosinophilia, in patients with atopic dermatitis

Efficacy and Safety of Runzao Zhiyang Capsule as an Add-On Therapy for Chronic Eczema: A Systematic Review and Meta-Analysis

Exogenous factors in the pathogenesis of atopic dermatitis: Irritants and cutaneous infections

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