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Atopic Multimorbidity in Adults With a Focus on Sensitization Patterns and T Cell Activation.

Ariane Bialas1, Marie Rabe1, Niklas Artz1

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Atopic multimorbidity, involving multiple allergic diseases, increases sensitization and IgE levels. T cell activation is linked to atopic dermatitis activity, not other co-occurring atopic conditions.

Keywords:
allergyatopic dermatitisatopytype 2 immunityurticaria

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Area of Science:

  • Immunology
  • Allergy Research
  • Dermatology

Background:

  • Atopic diseases like atopic dermatitis (AD), asthma (AA), and allergic rhinitis (AR) share Th2 inflammation pathways and often coexist as atopic multimorbidity.
  • The relationship between chronic spontaneous urticaria (CSU), an autoimmune mast cell disease, and classic atopic diseases is not well understood.
  • This study aimed to explore the association of CSU with atopic diseases, sensitization patterns, and T cell activation in patients with atopic multimorbidity.

Purpose of the Study:

  • To investigate the association of chronic spontaneous urticaria (CSU) with classical atopic diseases.
  • To analyze sensitization patterns and T cell activation status in individuals with atopic multimorbidity.
  • To differentiate the immunological characteristics of CSU from classical atopic diseases.

Main Methods:

  • A prospective, single-center study included 123 participants assessed via questionnaires for physician-diagnosed AD, AA, AR, and/or CSU.
  • Immunophenotyping was performed on 22 AD patients (with or without AR/AA, excluding CSU) and 20 healthy controls.
  • Peripheral blood T cell subsets and activation status were measured using flow cytometry.

Main Results:

  • Individuals with atopic multimorbidity showed higher rates of type I sensitizations, sleep disorders, and elevated serum IgE.
  • CSU presented distinct age of onset and duration compared to classical atopic diseases, leading to its exclusion from immunophenotyping.
  • T cell subsets and activation in AD patients did not vary with atopic multimorbidity but correlated with disease activity.

Conclusions:

  • Atopic multimorbidity is associated with a significant burden, evidenced by increased serum IgE and sensitization rates.
  • T cell activation in atopic dermatitis is more closely linked to disease activity than to the presence of other atopic comorbidities.
  • Further research is needed to clarify the specific role of CSU in the spectrum of allergic and autoimmune diseases.