Atopic dermatitis (AD) is a chronic inflammation of the skin, with thickened plaques of itchy, red, erosive and scaling skin, affecting ca. 20% in children and 3% in adults. Due to an impaired quality of life, AD exerts a major disease burden. While most patients are well-controlled with conventional therapies, about 2 million Europeans suffer from severe uncontrolled AD. AD usually appears in early childhood and is associated with development of food allergy, asthma and hay fever. Pathophysiology of AD is highly complex. Therefore, disease endotyping may improve disease management. However, no classification of AD endotypes exist and defines a gap in the understanding of AD-pathophysiology. Autoreactive IgE antibodies (auto-IgE) and self-reactive T cells were observed in 30-90% of adult patients with severe and chronic AD, suggesting a progression from allergic inflammation to severe autoimmune processes against the skin. We confirmed the disease association of auto-IgE in adults, but observed high prevalence of auto-IgE in healthy children, suggesting a protective effect at this age. To date, the mechanisms of auto- allergy and their pathophysiologic relevance is unclear, but are believed to have consequences for diagnosis and therapy. We aim to characterize pathomechanisms and relevance of auto-IgE and self-reactive T cells in AD. The outcome of the study will provide more insights in disease endotypes with direct impact on diagnosis, AD endotyping and future therapies.
|Effective start/end date||1/10/18 → 30/09/21|
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