Immunoglobulin E autoantibodies in atopic dermatitis associate with Type-2 comorbidities and the atopic march

Inge Kortekaas Krohn, Fariza Badloe, Nadine Herrmann, Laura Maintz, Shauni De Vriese, Johannes Ring, Thomas Bieber, Jan Gutermuth

Research output: Contribution to journalArticlepeer-review


Background: Autoreactive immunoglobulin E (IgE) antibodies to self-peptides within the epidermis have been identified in patients with atopic dermatitis (AD). Prevalence, concomitant diseases, patient characteristics, and risk factors of IgE autoantibody development remain elusive. We aimed to determine IgE autoantibodies in serum samples (n = 672) from well-characterized patients with AD and controls (1.2-88.9 years).

Methods: Atopic dermatitis patients were sub-grouped in AD with comorbid Type-2 diseases ("AD + Type 2"; asthma, allergic rhinitis, food allergy, n = 431) or "solely AD" (n = 115). Also, subjects without AD but with Type-2 diseases ("atopic controls," n = 52) and non-atopic "healthy controls" (n = 74) were included. Total proteins from primary human keratinocytes were used for the immunoassay to detect IgE autoantibodies. Values were compared to already known positive and negative serum samples.

Results: Immunoglobulin E autoantibodies were found in 15.0% (82/546) of all analyzed AD-patients. "AD + Type 2" showed a higher prevalence (16.4%) than "solely AD" (9.6%). "Atopic controls" (9.6%) were comparable with "solely AD" patients, while 2.7% of healthy controls showed IgE autoantibodies. Of those with high levels of IgE autoantibodies, 15 out of 16 were patients with "AD + Type 2". AD patients with IgE autoantibodies were younger than those without. Patients with IgE autoreactivity also displayed higher total serum IgE levels. Factors that affected IgE autoantibody development were as follows: birth between January and June, cesarean-section and diversity of domestic pets.

Conclusions: Immunoglobulin E autoantibodies in AD seem to associate with the presence of atopic comorbidities and environmental factors. The potential value of IgE autoantibodies as a predictive biomarker for the course of AD, including the atopic march, needs further exploration.
Original languageEnglish
Pages (from-to)3178-3192
Number of pages15
Issue number12
Early online date24 Jul 2023
Publication statusPublished - Dec 2023

Bibliographical note

Funding Information:
We would like to thank our colleagues at the Helmholtz Zentrum München and Technical University Munich: Francesca Allessandrini and Benjamin Schnautz for their technical support. We also acknowledge the Central Biobank UZ Brussel. We are very grateful to all our study participants, to Svenja Müller and Regina Havenith for their help in recruitment of participants in this study and to all other co-workers of the prospective longitudinal study investigating the remission phase in patients with atopic dermatitis and other allergy-associated diseases (ProRaD).

Funding Information:
IKK was holder of the Fonds Wetenschappelijk Onderzoek (FWO) Post‐Doctoral mandate (12W2219N), and an unrestricted Sanofi Genzyme Type 2 Innovation Grant, 2018 (0000000122). We further thank the Christine Kühne‐Center for Allergy Research and Education (CK‐CARE), Davos, Switzerland, for funding of the recruitment, clinical and epidemiological characterization of the ProRaD cohort. Laura Maintz was supported by CK‐CARE. The funding sources did not participate in the study design and conduct, nor in the data collection, management, analysis, and interpretation, nor in preparation, review, or approval of the manuscript nor in the decision to submit the article for publication.

Publisher Copyright:
© 2023 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd.


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