Table 5.

Association between autoantibodies of IgE class and the 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)