IgE and IgG4 Levels in Children with Atopic Dermatitis

Abstract

Serum IgE and IgG4 concentrations were determined in 102 children with atopic dermatitis (AD) of varying severity and activity. Total as well as specific IgE levels, determined by the radioallergosorbent test (RAST), were correlated with disease severity and the coexistence of atopic respiratory diseases. The IgG 4 levels of children with only AD, even in severe cases, were within the normal ranges of healthy children. In contrast, the IgG4 levels of children with both cutaneous and respiratory atopic manifestations were elevated, suggesting that IgG4 are probably associated with respiratory diseases but do not play any role in the pathogenesis of the skin disorder.

Epidemiology, clinical features, and immunology of the “intrinsic” (non‐IgE‐mediated) type of atopic dermatitis (constitutional dermatitis)

“…Although most patients with AD have high concentrations of total and allergen‐specific serum IgE levels and positive skin prick and intracutaneous test reactions of the immediate type to common environmental allergens, a subgroup of AD patients, both children and adults, suffer from a skin disease with features that clinically resemble the skin lesions and distribution pattern of AD, but that is not associated with sensitization to aero‐ or food allergens (3, 4, 7, 10–12). As the main clinical characteristic, these patients suffer from a “pure” type of AD, without previous or actual associated respiratory diseases (7, 11, 12).…”

Differential in vivo cytokine mRNA expression in lesional skin of intrinsic vs. extrinsic atopic dermatitis patients using semiquantitative RT‐PCR

“…Although most patients with AD have high concentrations of total and allergen-specific serum IgE levels and positive skin prick test reactions to common environmental allergens, a subgroup of AD patients, both children and adults, suffer from AD without sensitization to aero or food allergens [3,[6][7][8]. The diagnostic criteria of AD [9,10] can be fulfilled in the absence of elevated total IgE and specific IgE to food and inhalant allergens.…”

Staphylococcal enterotoxin B induces specific IgG4 and IgE antibody serum levels in atopic dermatitis

“…29 Other data describe that both total and specific IgE levels were elevated and correlated to disease severity; IgG4 levels in children with exclusive skin involvement in AD were within normal ranges, in contrast with those children with both AD and respiratory symptoms. 30 Studies performed in humans showed that the production of IgM, IgG4, and IgE in cultures of in vitro stimulated B cells has been interpreted to reflect a sequential IgM/IgG4/IgE switch. 31 In the normal population, IgG4 is usually found in reduced circulating levels; it is augmented under specific conditions, such as in patients taking immunotherapy, where IgG4 is used as a predictive marker, 32 or in autoimmune diseases, 33 such as endemic pemphigus foliaceus, where IgG4 is pathogenic.…”