Sensitization to skin-associated microorganisms in adult patients with atopic dermatitis is of importance for disease severity.
Atopic dermatitis (AD) is a chronic inflammatory skin disease. Environmental and genetic factors, as well as microbial products from yeasts and bacteria, play a role in triggering the disease. A cohort of 619 adult patients with AD was screened for severity of AD, sensitization to Malassezia sympodialis, Candida albicans, Staphylococcus aureus enterotoxins and Dermatophagoides pteronyssinus. Serum levels of interleukin (IL)-18 were measured. Immunoglobulin E (IgE) sensitization to the combination of both yeast and mite antigens was found to be associated with more severe disease and higher levels of total IgE. AD patients with IgE sensitization to several microbial antigens had more severe disease than those with no IgE sensitization to microbial antigens. Sera from patients with IgE-associated AD showed higher levels of IL-18. Skin-associated microorganisms are exogenous factors triggering IgE-response and severity of AD. These findings are clinically important, and sensitization to these organisms should be assessed and considered in treatment strategies.
Division of Dermatology and Venereology, Department of Clinical Sciences, Lund University, Biomedical center B14, Tornavägen 10, SE 221 84 Lund, Sweden. andreas.sonesson@med.lu.se
Andreas
A
Sonesson
Jacek
J
Bartosik
Julie
J
Christiansen
Ingrid
I
Roscher
Fredrik
F
Nilsson
Artur
A
Schmidtchen
Ove
O
Bäck
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000485:Allergens / Q000276:immunology*; D000818:Animals; D015415:Biomarkers / Q000097:blood; D002176:Candida albicans / Q000276:immunology*; D003876:Dermatitis, Atopic / Q000097:blood / Q000175:diagnosis / Q000276:immunology*; D040002:Dermatophagoides pteronyssinus / Q000276:immunology*; D004768:Enterotoxins / Q000276:immunology*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D020382:Interleukin-18 / Q000097:blood; D007428:Intradermal Tests; D008290:Malassezia / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D012867:Skin / Q000276:immunology* / Q000382:microbiology*; D013211:Staphylococcus aureus / Q000276:immunology*; D055815:Young Adult
D000485:Allergens; D015415:Biomarkers; D004768:Enterotoxins; D020382:Interleukin-18; D007073:Immunoglobulin E