β-1,3-glucanase rOle e 9 and MnSOD rAsp f 6 IgE reactivity are the signature of Atopic Dermatitis in the Mediterranean Area.

Atopic Dermatitis (AD) represents a chronic skin disorder seriously affecting patients' QoL and is often associated with immunological imbalance, disorders of the skin barrier function and environmental factors OBJECTIVE: We extensively studied the proteomic IgE sensitization profile in a large AD Mediterranean cohort METHODS: 588 individuals with moderate-severe (70,6%) or mild and/or history of (29,4%) AD were evaluated in comparison to 1285 unselected atopic controls (AC) with a history of adverse reactions to foods, allergic rhinitis and/or bronchial asthma by means of ImmunoCAP ISAC₁₁₂ ® and Allergy Explorer-ALEX® microarray analysis.

The olive-tree pollen β-1,3-glucanase rOle e 9, and the manganese Superoxide Dismutase from Aspergillus rAsp f 6, were the molecules most significantly associated with AD occurrence, and allowed to discriminate among the moderate and severe forms of disease. An IgE hyper-reactivity to cypress, grasses, olive-tree, house dust mites (including rDer p 11), and to all cross-reactive components except profilin and polcalcin was observed. About 60% of adults with severe AD were sensitized to nsLTPs. Cross-reactive carbohydrate determinants (CCDs) IgE was found in about one third of AD participants. Hen eggs nGal d 1 IgE sensitization was more prevalent in paediatric population, whilst rAsp f 6 and rOle e 9 reactivity was found particularly in older patients. Despite the status of widespread IgE sensitization to both environmental and food allergens, a reduced frequency of patient reported severe reactions to food or of asthma was observed in AD patients compared to AC, particularly in case of concomitant Ole e 9 reactivity.Testing IgE reactivity to a large panel of molecular components unveils important associations between IgE reactivity profiles and AD clinical presentation, highlights the allergens useful for a precise AD signature, and allows the detection of interesting sensitisations patterns.