Introduction
Methods
Identification of relevant studies
Inclusion criteria
Language
Types of studies
Types of participants
References | Study design and size | Diagnostic criteria for AD | Methods | Prevalence of AR in control subjects | Prevalence of AR in patients with AD |
---|---|---|---|---|---|
Aichberger et al. [17] | Case–control study 12 patients with eczema 11 patients with rhinoconjunctivitis 6 healthy controls 6 control subjects with chronic dermatoses (All adults. Patients with AD ranged from 20 to 72 years, with a mean age of 38.4. Control subjects had a mean age of 38.6. Insufficient data to calculate SD) |
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Western Blot
Serum IgE against epithelial cell line A431 and rHom s 4 |
0%
No control subjects produced serum IgE against epithelial cells (A431) or Hom s 4 |
91.7%
11/12 patients produced serum IgE against epithelial cells (A431)
16.7%
2/12 patients produced serum IgE against Hom s 4 |
Altrichter et al. [18] |
Case series
192 patients with eczema 5 healthy control subjects (All adults. AD patients ranged from 18 to 80 years, with a mean age of 39. Control subjects ranged from 25 to 64 years, with a mean age of 31. Insufficient data to calculate SD) |
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Western blot
Serum IgE against epithelial cell line A431 + epidermis |
0%
0/26 control subjects displayed any autoreactivity |
28%
54/192 eczema patients displayed autoreactivity against A431 and/or epidermis |
Guarneri et al. [19] | Case–control study 27 patients with AD 27 control subjects (10 children and 17 adults. All participants ranged from 5 to 49 years. AD patients and controls had a mean age of 22.2 ± 12.2) |
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Skin prick test
against hMnSOD |
0%
0/27 control patients |
14.8%
4/27 patients |
Hiragun et al. [20] IgE and IgG | Case–control study 63 patients with AD 24 patients with Cholinergic Urticaria 32 patients with bronchial asthma 14 patients with allergic rhinitis 23 normal control patients (Patients with AD ranged from 0 to 65 years, with a mean age of 29.9 ± 11.5. Other participants in this study varied from 0 to 82) |
Moderately Clear
‘severity of AD was evaluated using severity index of Japanese guideline for AD’ |
ELISA
Specific to QRX-specific IgE and rMGL_1304-specifc IgE |
26.1%
6/23 controls were QRX-specific IgE positive
39.1%
9/23 controls were rMGL_1304-specific IgE Positive |
66.7%
42/63 AD patients were QRX-specific IgE positive (P = 0.0012)
61.9%
39/63 AD patients were rMGL_1304-specific IgE Positive (P = 0.0857) |
Ilves, Virolainen and Harvima [21] | Case–control study 50 patients with AD 24 control subjects (All adults. Patients with AD ranged from 21 to 64 years, with a mean age of 38. Control subjects ranged from 21 to 68 years, with a mean age of 42. Insufficient data to calculate SD) | Clear Rajka and Langeland |
Intracutaneous injection and ImmunoCAP
against autologous sweat |
50%
1/24 positive 11/24 weakly positive 12/24 negative |
72%
19/50 positive 17/50 weakly positive 14/50 negative (difference P < 0.008) |
Kawamoto et al. [22] IgE and IgG | Case–control study 40 patients with AD 26 control patients (no clinical history of allergic diseases and serum IgE within normal levels) (Patients with AD ranged from 12 to 44 years, with a mean age of 26.4. Control subjects ranged from 19 to 54 years, with a mean age of 29.2 No SD provided and insufficient data to calculate) |
Clear
UK Working Party’s Diagnostic Criteria for Atopic Dermatitis |
ELISA
Peptide Specific | – | No significant difference in IgG levels or number of positive samples for 5 peptides Significant difference in both IgG levels and number of positive samples for SART2161, SART2899, and ART413 |
Kortekangas-Savolainen et al. [23] | Case–control study 27 patients with IgE-mediated AEDS 13 control subjects (6 healthy controls, 4 patients with urticaria, 3 patients with psoriasis) (All adults. Patients with AD had a mean age of 33 ± 11. Control subjects had a mean age of 47 but insufficient data to calculate SD.) |
Not clear
|
Western blot
Serum IgE against keratinocytes |
0%
0/13 control subjects displayed IgE autoantibodies against keratinocytes |
37%
10/27 patients displayed IgE autoantibodies against keratinocytes |
Mittermann et al. [24] | Case–control study 11 patients with AD 7 patients with rhinoconjuntivitus 5 patients with contact allergy 9 non-atopic individuals (All adults, except 1 child with AD. Patients with AD ranged from 13 to 59 years, with a mean of 31.9 ± 14.9. Control subjects ranged from 26 to 63 years, with a mean of 35.2 ± 10.9.) |
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Immunoblotting
Against human epithelial cell extracts |
0%
0/12 control subjects |
72.7%
8/11 patients |
Mittermann et al. (2016) [25] | Case–control study 179 patients with AD (53 severe and 126 moderate) 140 patient control group (43 patients with seborrheic eczema and 97 individuals with no previous allergies or skin conditions) (All adults. All participants ranged from 18 to 65 years. AD patients had a mean age of 28, control subjects had a mean age of 36. No SD provided and insufficient data to calculate) |
Clear
UK Working Party’s Diagnostic Criteria for Atopic Dermatitis |
Immunoblotting
Against human A431 extract |
0%
0/140 control subjects |
18%
32/179 patients with AD |
Mothes et al. [26] | Case–control study 174 patients with eczema 10 patients with psoriasis 26 healthy controls (All adults. Eczema patients had a mean age of 35.4 ± 14.8. Control subjects had a mean age of 36.5 ± 16.5.) |
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Hanifin and Rajka |
Immunoblotting
IgE reactivity to a variety of human epithelial antigens |
0%
0/10 patients with psoriasis and 0/26 healthy controls displayed autoreactivity |
23%
40/174 patients displayed autoreactivity |
Natter et al. [27] |
Case series
51 patients with eczema (14 children and 37 adults. Patients with eczema ranged from 1 to 63 years, with a mean age of 26.9 ± 18.6) |
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Hanifin and Rajka |
Western Blot
Whole serum IgE against endothelial cells and A431 | – |
43.1%
22/51 patients |
Schmid-Grendelmeier et al. (2005) [28] | Case–control study 69 patients with eczema 5 healthy controls13 patients with psoriasis 11 patients with ABPA 13 patients with allergy to A fumigatus (All adults. Eczema patients had a mean age of 29.3 ± 5.6. Other participants had a mean age of 25.3, but insufficient data to calculate SD) |
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Hanifin and Rajka |
ELISA and SPT
against rhMnSOD |
100%
11/11 patients with ABPA
0%
0/31 other control subjects |
42%
29/69 patients with eczema |
Valenta et al. [29] | Case–control study 20 patients with AD 28 control patients including patients with various allergic conditions and non-allergic healthy individuals (Patients with AD ranged from 17 to 52 years with a mean age of 35.3 ± 12.3. Control subjects ranged from 18 to 64 years with a mean age of 33.0 ± 11.4) |
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Hanifin and Rajka |
Western Blot
IgE antibodies against endothelial cells, platelets, fibroblasts and epithelial cells |
0%
0/28 tested positive for IgE against human proteins from most cell extracts |
60%
12/20 tested positive for IgE against human proteins from most cell extracts |
Zeller et al. [30] IgG, IgA, IgE | Case–control study 71 patients with AE 12 patients with psoriasis 24 healthy control subjects (Patients with AE had a mean age of 33.35 ± 12.70. Patients with non-atopic AE had a mean age of 39.35 ± 13.5. Patients with psoriasis had a mean age of 45.17 ± 9.20. Healthy control subjects had a mean age of 29.00 ± 3.71) |
Clear
Hanifin and Rajka and European Academy of Allergology and Clinical Immunology |
Immunoblotting and ELISA
Specific to actin-α, eIF6, RP1, HLA-DR-α and tubulin-α |
0%
0/36 control patients |
71.8%
51/71 of all patients with Atopic Eczema
72.2%
13/18 patients with the non-atopic form of AD |
Marker of autoimmunity | Papers that indicate autoreactivity is more common in patients with AD | Papers that do not indicate autoreactivity is more common in patients with AD |
---|---|---|
IgE autoantibodies |
13
Aichberger et al. [17] Altrichter et al. [18] Guarneri et al. [19] Hiragun et al. (for QRX) [20] Ilves, Virolainen and Harvima [21]* Kortekangas-Savolainen et al. [23] Mothes et al. [26] Natter et al. [27] Schmid-Grendelmeier et al. [28] Valenta et al. [29] Zeller et al. [30] |
2
Hiragun et al. (for rMGL_1304) [20]† Kawamoto et al. [22]§ |
IgG autoantibodies |
4
Bergman et al. [31]* (for CCL-3) Neuber et al. [32]* Ochs et al. [33] Szakos et al. [34]* |
5
Ambrozic et al. [35] Bergman et al. [31] (for 5 autoantigens)† Du Toit et al. [16] El-Rachkidy et al. [36] Kawamoto et al. [22] (for 5 peptides)**, (for 3 peptides)§ |
IgA autoantibodies |
0
|
1
Ress et al. [37] |
ANAs |
7
Dhar, Kanwar and Deodhar [38] Higashi et al. [39] Ochs et al. [33] Ohkouchi et al. [40]* Szakos et al. [34] Tada et al. [41] Taniguchi et al. [42] |
1
Ress et al. [43]† |
References | Study design and size | Diagnostic criteria for AD | Methods | Prevalence of AR in control subjects | Prevalence of AR in patients with AD |
---|---|---|---|---|---|
Ambrozic et al. [35] | Case–control study 45 patients with AD 26 patients with other atopic conditions (controls) (All children. Patients with AD ranged from 2 months to 16.8 years, with a mean age of 3.7. Control subjects ranged from 2.1 to 17.8 years, with a mean age of 11.0. Insufficient data to calculate SD) |
Moderately Clear
‘Sera selected from the serum banks of the Pediatrics Clinic and Department of Rheumatology (University Medical Centre, Ljubljana)’ |
ELISA
Specific to Anti-β2GPI |
38%
10/26 control patients |
42%
19/45 patients with AD
No significant difference
|
Bergman et al. [31] | Case–control study 37 Patients with Psoriasis 18 patients with AD 56 healthy controls (All adults. Patients with psoriasis ranged from 20 to 76 years, with a median age of 43.5. Patients with AD ranged from 19 to 69 years, with a median age of 30. Healthy subjects ranged from 27 to 62 years, with a median age of 45.5) |
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Hanifin and Rajka |
ELISA
Against a variety of autoantigens | Mean Log2Ab Titer of autoantibody (HCs) TNF-α: 7.61 IFN-α: 7.43 CCL-5: 7.48 CCL-2: 7.84 CCL-3: 7.59 IL-17: 7.41 | Mean Log2Ab Titer of autoantibody TNF-α: 7.94 IFN-α: 7.76 CCL-5: 7.47 CCL-2: 7.41 CCL-3: 8.71 (P = 0.035) IL-17: 7.59 |
Du Toit et al. (2006) [16] | Case–control study 33 patients with AEDS 78 patients with Chronic Urticaria (All children. Patients with AEDS ranged from 1.25 to 19 years, with a mean age of 7.6. Patients with Chronic Urticaria were age matched) |
Not clear
|
Anti–Fcε receptor assays
Specific to IgG FcεR1α autoantibodies |
47%
37/78 patients with CU |
0%
0/33 patients with AEDS |
El-Rachkidy et al. [36] | Case–control study Patients with psoriasis (number varies based on test) 5 pooled patients with AD (Age of patients with AD not specified. Psoriasis patients ranged from 22 to 66 years). |
Not clear
|
Immunoblotting and ELISA
Specific to stratum corneum antigens | Psoriasis patients were autoreactive against stratum corneum antigens | AD patients were not autoreactive against stratum corneum antigens |
Kawamoto et al. [22] (IgE and IgG) | Case–control study 40 patients with AD 26 control patients (no clinical history of allergic diseases and serum IgE within normal levels) (Patients with AD ranged from 12 to 44 years, with a mean age of 26.4. Control subjects ranged from 19 to 54 years, with a mean age of 29.2). Insufficient data to calculate SD |
Clear
UK Working Party’s Diagnostic Criteria for Atopic Dermatitis |
ELISA
Peptide Specific | – | No significant difference in IgG levels or number of positive samples for 5 peptides Significant difference in both IgG levels and number of positive samples for SART2161, SART2899, and ART413 |
Neuber et al. 32] | Case–control study 16 patients with AD 72 healthy control subjects (All adults. Patients with anti-CD28 autoantibodies had a mean age of 52.3 ± 18.8, patients without anti-CD28 autoantibodies were had a mean age of 58.7 ± 19.9) |
Moderately clear
Treated at the Department of Dermatology, University Hospital Eppendorf, Hamburg |
ELISA
Specific to Anti-CD28 |
11.1%
8/72 control patients |
87.5%
14/16 AD patients (P < 0.0001) |
Ochs et al. [33] ANA and IgG | Case–control study 64 patients with eczema 39 control patients (study also included a range of other atopic conditions) (Patients with eczema ranged from 4 to 43 years, with a mean age of 24.4. No ages provided for control subjects. Insufficient data to calculate SD) |
Clear
Hanifin and Rajka |
Indirect immunofluorescence
For ANAs
Western blot
Against anti-DFS70 IgG |
ANA not stated
WB-DFS70: 0%
0/39 healthy control subjects |
ANA: 41%
26/64 patients
WB-DFS70: 29.6%
19/64 patients |
Szakos et al. [34] IgG and IgM (including ANA) | Case–control study 72 patients with AEDS 22 healthy control patients (All children. Patients with AEDS ranged from 2 to 17 years, with a mean age of 8 years. Control subjects ranged from 1.5 to 14 years, with a mean age of 8.6 years. Insufficient data to calculate SD) |
Not Clear
|
Indirect immunofluorescence
For ANAs
ELISA
Specific to APLs |
9.1%
2/22 healthy control patients had non-allergen-specific IgG and/or IgM antibodies
9.1%
2/22 healthy control patients displayed ANAs |
29.3%
21/72 patients had non-allergen-specific IgG and/or IgM antibodies
13.9%
10/72 AD patients displayed ANAs
APL antibodies occurred significantly more often in AD patients
|
Types of publication
Outcome measures
Statistical analysis
Results
Association of autoantibodies with atopic dermatitis
Autoantibodies of IgE class
Autoantibodies of IgG class
Autoantibodies of IgA class
Anti-nuclear autoantibodies
References | Study design and size | Diagnostic criteria for AD | Methods | Prevalence of AR in control subjects | Prevalence of AR in patients with AD |
---|---|---|---|---|---|
Dhar et al. [38] | Case–control study 76 children with AD 58 age matched control subjects (All children. Patients with AD ranged from 6 months – 12 years, with a mean age of 3.4 years. Control subjects were age matched. Insufficient data to calculate SD.) |
Clear
Hanifin and Rajka |
FITC-conjugated goat antihumag [sic] IgG
|
0.0%
0/58 control subjects displayed ANAs at a titre of 1:40 |
2.6%
2/76 patients with AD displayed ANAs at a titre of 1:40 |
Higashi et al. [39] | Case–control study 100 patients with AD 1004 control subjects (Patients with AD ranged from 2 to 64 years, with a mean age of 28.2 years. Control subjects ranged from 20 to 70 years, with a mean age of 48.8 years. Insufficient data to calculate SD.) |
Clear
Hanifin and Rajka |
Indirect immunofluorescence
Against ANA |
6.8%
68/1004 control patients (between titres of 40X–640X) |
19%
19/100 patients with AD (between titres of 40X–640X) |
Ochs et al. [33] ANA and IgG | Case–control study 64 patients with eczema 39 control patients (study also included a range of other atopic conditions) (Patients with eczema ranged from 4 to 43 years, with a mean age of 24.4 years. Insufficient data to calculate SD. No ages provided for control subjects.) |
Clear
Hanifin and Rajka |
Indirect immunofluorescence
Against ANA |
Not stated
|
41%
26/64 patients |
Ohkouchi et al. [40] | Case–control study 256 patients with eczema 60 control subjects (All adults. Patients with eczema had a mean age of 23 years. Control subjects were age matched. Insufficient data to calculate SD.) |
Clear
Hanifin and Rajka |
Indirect immunofluorescence
Against ANA |
11.7%
7/60 control patients at a 40 fold dilution |
36.3%
93/256 AD patients at a 40 fold dilution (P < 0.001) |
Ress et al. (2015) [43] |
Cross-sectional study
346 children with active AD 117 hospital controls without known skin diseases, at similar ages (All children. Patients with AD ranged from 0.5 to 18.8 years, with a mean age of 5.8 years. Control subjects ranged from 0.5 to 17.7 years, with a mean age of 7.9 years. Insufficient data to calculate SD.) |
Clear
UK Working Party’s Diagnostic Criteria for Atopic Dermatitis |
Indirect immunofluorescence
Against ANA |
12.8%
15/117 control patients were ANA Positive at a titre of 1:10 |
13.6%
47/346 patients with AD were ANA Positive at a titre of 1:10 (P > 0.05) |
Szakos et al. [34] IgG and IgM (including ANA) | Case–control study 72 patients with AEDS 22 healthy control subjects (All children. Patients with AEDS ranged from 2 to 17 years, with a mean age of 8.0 years. Control subjects ranged from 1.5 to 14 years, with a mean age of 8.6 years. Insufficient data to calculate SD.) |
Not clear
|
Indirect immunofluorescence
Against ANA |
9.1%
2/22 healthy control patients displayed ANAs |
13.9%
10/72 AD patients displayed ANAs |
Tada et al. [41] |
Case series
89 patients with AD (Patients with AD ranged from 5 to 49 years, with a mean age of 19.0 ± 7.4 years) |
Clear
Hanifin and Rajka |
Indirect immunofluorescence
Against ANA of the IgG subclass | - |
25.8%
23/89 displayed ANAs at dilutions of 1:40–1:640 |
Taniguchi et al. [42] | Case–control study 47 AD patient sera analysed using method 1 57 AD patient sera analysed using method 2 12 control subject sera analysed using methods 1 and 2 (all adults) All adults. Patients with AD ranged from 15 to 30 years. Insufficient data to calculate mean and SD. No data provided on control subjects |
Clear
Hanifin and Rajka |
FITC-conjugated polyvalent immunoglobulins
(method 1)
FITC-conjugated anti-IgG
(method 2)
|
25%
3/12 healthy control subjects had ANAs identified using method 1
16.7%
2/12 healthy control subjects had ANAs identified using method 2 |
34.0%
16/47 AD patients with ANA identified using method 1
26.3%
15/57 AD patients with ANA identified using method 2 |
Association of autoantibodies with severity of atopic dermatitis
References | Study design and size | Diagnostic criteria for eczema | Measure of severity | Autoreactivity measurement methods | Results |
---|---|---|---|---|---|
Altrichter et al. [18] |
Case series
192 patients with eczema (All adults. Patients with eczema ranged from 18 to 80 years, with a mean age of 39 years. Control subjects ranged from 25 to 64 years, with a mean age of 31 years. Insufficient data to calculate SD.) |
Clear
Hanifin and Rajka |
IGA Score
Eczema Area and Severity Index
|
Western blot
Serum IgE against epithelial cell line A431 + epidermis | ‘Disease activity…was also significantly higher in autoreactive patients than in non-autoreactive patients’ (P < 0.001) |
Hide et al. [47] | Case–control study* 66 patients with eczema (17 mild, 20 moderate, 26 severe and 3 undefined) (Patients with eczema ranged from 13 to 37 years, with a mean age of 24.7 ± 5.2 years.) |
Moderately clear
Severity based on grading by Rajka and Langeland |
Rajka and Langeland
|
Skin test
Intradermal injection of autologous sweat | No association between frequency of reaction to autologous sweat and severity of AD No statistical analysis shown Mild: 82.4% (14/17) Moderate: 90.0% (18/20) Severe: 80.8% (21/26) Undefined: 100% (3/3) |
Hiragun et al. [20] | Case–control study* 63 patients with AD (Patients with AD ranged from 0 to 65 years, with a mean age of 29.9 ± 11.5 years.) |
Moderately clear
‘severity of AD was evaluated using severity index of Japanese guideline for AD’ |
Severity index of Japanese guidelines for AD
|
ELISA
Specific to QRX and rMGL_1304 |
Spearman’s Correlation Coefficients
QRX-specific IgE R = 0.5468, P < 0.0001 rMGL_1304-specific IgE: R = 0.448, p < 0.0001 |
Ilves, Virolainen and Harvima [21] | Case–control study* 50 patients with AD (Patients with AD ranged from 21 to 64 years, with a mean age of 38 years. Insufficient data to calculate SD.) |
Clear
Rajka and Langeland |
Own definition
1 = symptomless 2 = almost symptomless 3 = mild eczema 4 = moderate eczema |
Intracutaneous injection
Of autologous sweat |
Linear trend in Chi-squared test
(P = 0.009)
Moderately positive correlation
between disease severity and positive intracutaneous test (rs = 0.37, p = 0.008) |
Kinaciyan et al. [48] |
Case report
1 patient with eczema (The patient was 26 years) |
Not clear
|
SCORAD
|
Western blot
Whole serum IgE against human epithelial cell extracts | ‘association between severity of skin manifestations and IgE autoreactivity’ |
Kohsaka et al. [49] |
Case series
18 patients with mild AD 23 patients with moderate AD 12 patients with severe AD 11 patients with most severe AD (Patients with AD had a mean age of 28.2 ± 11.3. years.) |
Clear
Japanese Dermatological Association (JDA) criteria for AD |
Severity index of Japanese guidelines for AD
|
Western blot
Levels of IgE binding against MGL_1304 and its homologs |
Spearman’s Correlation coefficient significant for all tested antigens
TF-rMGL_1304 r = 0.3995, P < 0.005 TF-rMala s 8 r = 0.3094, P < 0.05 TF-rMala r 8 r = 0.3588, P < 0.005 |
Lucae et al. [50] |
Case reports
4 Patients with AD underwent treatment with Cyclosporine C (All adults. Patients with AD ranged from 31 to 54 years. Insufficient data to calculate mean and SD.) |
Clear
Hanifin and Rajka |
SCORAD
|
Western blot
IgE against Human Epithelial Cell Extracts | ‘The intensity of IgE autoreactivity…seemed to reflect skin inflammation’ |
Mittermann et al. (2016) [25] | Case–control study* 179 patients with AD (53 severe + 126 moderate) (All adults. Patients ranged from 18 to 65 years, with a median age of 28 years. Insufficient data to calculate mean and SD.) |
Clear
UK Working Party’s Diagnostic Criteria for Atopic Dermatitis |
SCORAD
| Immunoblot assay Specific to human A431 extract | 30% of patients with severe AD displayed autoreactivity compared to 13% of patients with moderate AD Significant Association (P < 0.01) |
Mothes et al. [26] | Case–control study* 174 patients with eczema (All adults. Eczema patients had a mean age of 35.4 ± 14.8 years. Control subjects had a mean age of 36.5 ± 16.5 years.) |
Clear
Hanifin and Rajka |
Diepgen score
|
Western blot
IgE reactivity to a variety of human epithelial antigens | Significantly higher total Diepgen score (P = 0.036) in AA + vs AA- patients |
Natter et al. (1998) [27] | Case series 51 patients with eczema (14 children and 37 adults. Patients with eczema ranged from 1 to 63 years, with a mean age of 26.9 ± 18.6 years) |
Clear
Hanifin and Rajka |
Own score
|
Western blot
Whole serum IgE against endothelial cells and A431 | 12/12 patients with ‘intensive IgE reactivity to human proteins’ had severe or moderate AD 16/29 patients without IgE autoreactivity displayed severe or moderate AD |
Schmid-Grendelmeier et al. [28] | Case–control study* 69 patients with eczema (All adults. Patients with eczema had a mean age of 29.3 ± 5.6 years. Other participants had a mean age of 25.3 years, but insufficient data to calculate SD) |
Clear
Hanifin and Rajka |
SCORAD
|
ELISA
Allergen-specific against rhMnSOD |
Correlation between SCORAD and anti-human MnSOD IgE level
R = 0.756 P < 0.0001 |
Tanaka et al. [51] | Case–control study* 61 patients with AD (Patients with AD ranged from 2 to 43 years, with a mean age of 24.0 ± 7.5 years) |
Moderately clear
Severity based on grading by Rajka and Langeland |
Rajka and Langeland
|
Histamine release
By basophils upon stimulation by semi-purified sweat antigen | ‘The extents of histamine release were not statistically correlated with disease severity’ |
Zeller et al. [30] | Case–control study* 71 patients with AE (Patients with AE had a mean age of 33.35 ± 12.70 years. Patients with non-atopic AE had a mean age of 39.35 ± 13.5 years.) |
Clear
Hanifin and Rajka and European Academy of Allergology and Clinical Immunology |
SCORAD
|
Western blot and ELISA
Against a variety of self-antigens | No significant difference in SCORAD between patients with and without IgE against self-antigens (P < 0.7625) |
Marker of autoimmunity | Papers that indicate a link between AD disease severity and autoimmunity | Papers that do not indicate a link between AD disease severity and autoimmunity |
---|---|---|
IgE autoantibodies |
10
Altrichter et al. [18]* Hiragun et al. [20]* Ilves, Virolainen and Harvima [21]* Kinaciyan et al. [48] Kohsaka et al. [49]* Lucae et al. [50] Mittermann et al. [25]* Mothes et al. [26]* Natter et al. [27] Schmid-Grendelmeier et al. [28]* |
3
Hide et al. [47] Tanaka et al. [51]† Zeller et al. [30]† |
ANAs |
0
|
2
Higashi et al. [39]† Ress et al. [43]† |
Multiple indicators |
0
|
1
Szakos et al., 2004 [34] |
Discussion
References | Study design and size | Diagnostic criteria for AD | Methods | Prevalence of AR in control subjects | Prevalence of AR in patients with AD |
---|---|---|---|---|---|
Heratizadeh et al. [54] | Case–control study 30 adult patients with eczema 12 healthy individuals 3 non-atopic patients with chronic plaque psoriasis (Patients with eczema ranged from 18 to 65 years. Insufficient data to calculate mean and SD. No information given about control subjects.) |
Clear
Hanifin and Rajka | Analysis of peripheral blood mononuclear cells via proliferation rate of blood-derived lymphocytes in response to α-NAC | Median: 9.3% with α-NAC, 0.8% with medium control | Median: 8.4% with α-NAC, 1.5% with medium control (both statistically significantly increased with α-NAC compared to control medium (P < 0.001), no analysis compared to control group) |
Hide et al. [47] Skin Patch Test | Case–control study 66 patients with eczema 7 patients with allergic rhinitis 27 healthy control patients (Patients with AD ranged from 13 to 37 years, with a mean age of 24.7 ± 5.2 years. Patients with allergic rhinitis ranged from 20 to 35 years, with a mean age of 24.6 ± 4.8 years. Control subjects ranged from 20 to 42 years, with a mean age of 27.8 ± 6.7 years.) |
Moderately clear
Severity based on grading by Rajka and Langeland |
Intradermal
injection
of autologous sweat |
11.1%
3/27 control patients
71.4%
5/7 patients with allergic rhinitis |
85%
56/66 eczema patients |
Kapitein et al. [53] | Case–control study 28 child patients with AD (of 55) 18 healthy control children (of 30) (Patients with AD ranged from 1.5 to 17.5 years, with a mean age of 8.8 years. Healthy controls ranged from 1.2 to 17.3 years, with a mean age of 8.6 years. Insufficient data to calculate SD.) |
Clear
Hanifin and Rajka |
Stimulation index
of peripheral blood mononuclear cells in response to hsp60 | – |
‘Significantly higher’
(P = 0.004) |
Lind et al. [52] IL-18 and iNKT cells | Case–control study 78 patients with eczema 45 healthy subjects (Patients with eczema ranged from 18 to 65 years, with a mean age of 29 years. Healthy controls ranged from 20 to 64 years with a mean age of 39 years. Insufficient data to calculate SD.) |
Clear
UK Working Party’s Diagnostic Criteria for Atopic Dermatitis |
Plasma IL-18 levels and iNKT autoreactivity
2 part hypothesis that IL-18 can activate iNKT cells ‘independently of exogenous ligands’ and that IL-18 correlates with AE disease severity | kawamom- | Levels of IL-18 significantly higher (P = 0.003) in AE patients than healthy controls |
Tanaka et al. [51] Histamine release | Case–control study 61 patients with AD 13 patients with psoriasis 46 healthy control patients (Patients with AD ranged from 2 to 43 years, with a mean age of 24.0 ± 7.5 years. Patients with psoriasis ranged from 29 to 73 years, with a mean age of 53.4 ± 17 years. Healthy controls ranged from 1 to 52 years, with a mean age of 28.4 ± 8.9 years.) |
Moderately Clear
Severity based on grading by Rajka and Langeland | Measurement of histamine released by basophils upon stimulation by semi-purified sweat antigen |
8.7%
4/46 healthy control subjects
0%
0/13 patients with psoriasis |
77%
47/61 patients with AD (P < 0.001 compared to healthy controls) |