Progress in laboratory diagnostics of IgE-mediated allergies is being made through the use of component-resolved diagnosis. The aim of our study is to analyze the sensitization profile to allergen reagents in patients suffering from atopic dermatitis with the use of the ALEX 2-Allergy Explorer and especially to show the sensitization to molecular components of molds and yeast. The complete dermatological and allergological examination including the examination of the sensitization to allergen reagents with Allergy Explorer ALEX 2 testing was performed. The relation between the sensitization to molecular components of molds and yeast and the severity of atopic dermatitis, and the occurrence of bronchial asthma and allergic rhinitis was evaluated. Altogether, 100 atopic dermatitis patients were examined-48 men and 52 women, with an average age of 40.9 years. The sensitization to Mala s 6, Mala s 11, Sac c, Asp f 6, Cla h and Cla h 8 correlates to the severity of atopic dermatitis. The sensitization to Sac c, Alt a 6, Cla h, Cla h 8 was observed significantly more frequently in patients suffering from bronchial asthma to Mala s 6 in patients suffering from allergic rhinitis. In patients with severe form of atopic dermatitis (AD), a very high level of specific IgE was recorded to Mala s 11 (in 36%) and to Asp f 6 (in 12%).

Department of Clinical Immunology and Allergy Faculty Hospital Medical Faculty of Charles University 50002 Hradec Králové Czech Republic

Department of Dermatology and Venereology Faculty Hospital Medical Faculty of Charles University 50002 Hradec Králové Czech Republic

Department of Medical Biophysic Medical Faculty of Charles University 50002 Hradec Králové Czech Republic

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Montero-Vilchez T., Segura-Fernández-Nogueras M.V., Pérez-Rodríguez I., Soler-Gongora M., Martinez-Lopez A., Fernández-González A., Molina-Leyva A., Arias-Santiago S. Skin Barrier Function in Psoriasis and Atopic Dermatitis: Transepidermal Water Loss and Temperature as Useful Tools to Assess Disease Severity. J. Clin. Med. 2021;10:359. doi: 10.3390/jcm10020359. PubMed DOI PMC

Czarnowicki T., Krueger J., Guttman-Yassky E. Novel concepts of prevention and treatment of atopic dermatitis through barrier and immune manipulations with implications for the atopic march. J. Allergy Clin. Immunol. 2017;139:1723–1734. doi: 10.1016/j.jaci.2017.04.004. PubMed DOI

Fukutomi Y., Taniguchi M. Sensitization to fungal allergens: Resolved and unresolved issues. Allergol. Int. 2015;64:321–331. doi: 10.1016/j.alit.2015.05.007. PubMed DOI

De Benedetto A., Kubo A., Beck L.A. Skin barrier disruption: A requirement for allergen sensitization? J. Investig. Dermatol. 2012;132:949–963. doi: 10.1038/jid.2011.435. PubMed DOI PMC

Oh J., Byrd A.L., Deming C., Conlan S., Program N.C.S., Kong H.H., Segre J.A. Biogeography and individuality shape function in the human skin metagenome. Nature. 2014;514:59–64. doi: 10.1038/nature13786. PubMed DOI PMC

Kong H.H., Oh J., Deming C., Conlan S., Grice E.A., Beatson M.A., Nomicos E., Polley E.C., Komarow H.D., Murray P.R., et al. Temporal shifts in the skin microbiome associated with disease flares and treatment in children with atopic dermatitis. Genome Res. 2012;22:850–859. doi: 10.1101/gr.131029.111. PubMed DOI PMC

Anto J.M., Bousquet J., Akdis M., Auffray C., Keil T., Momas I., Postma D.S., Valenta R., Wickman M., Cambon-Thomsen A., et al. Mechanisms of the development of allergy (MeDALL): Introducing novel concepts in allergy phenotypes. J. Allergy Clin. Immunol. 2017;139:388–399. doi: 10.1016/j.jaci.2016.12.940. PubMed DOI

Matricardi P.M., Kleine-Tebbe J., Hoffmann H.J., Valenta R., Hilger C., Hofmaier S., Aalberse R.C., Agache I., Asero R., Ballmer-Weber B., et al. EAACI molecular Allergology User’s guide. Pediatr. Allergy Immunol. 2016;27(Suppl. S23):1–250. doi: 10.1111/pai.12563. PubMed DOI

Van Hage M., Hamsten C., Valenta R. ImmunoCAP assays: Pros and cons in allergology. J. Allergy Clin. Immunol. 2017;140:974–977. doi: 10.1016/j.jaci.2017.05.008. PubMed DOI

Heffler E., Puggioni F., Peveri S., Montagni M., Canonica G.W., Melioli G. Extended IgE profile based on an allergen macroarray: A novel tool for precision medicine in allergy diagnosis. World Allergy Organ. J. 2018;11:7. doi: 10.1186/s40413-018-0186-3. PubMed DOI PMC

Čelakovská J., Bukač J., Vaňková R., Krcmova I., Krejsek J., Andrys C. ISAC multiplex testing—Results of examination in 100 patients suffering from atopic dermatitis. Food Agric. Immunol. 2020;31:1014–1035. doi: 10.1080/09540105.2020.1799947. DOI

Čelakovská J., Bukač J., Vaňková R., Cermakova E., Krcmova I., Krejsek J., Andrýs C. Cluster analysis of molecular components in 100 patients suffering from atopic dermatitis according to the ISAC Multiplex testing. Food Agric. Immunol. 2020;31:827–848. doi: 10.1080/09540105.2020.1776224. DOI

Hanifin J., Rajka G. Diagnostic features of atopic dermatitis. Acta Derm. Venereol. 1980;92:44–47.

European Task Force on Atopic Dermatitis Severity scoring of atopic dermatitis: The SCORAD Index (consensus report of the European Task Force on Atopic Dermatitis) Dermatology. 1993;186:23–31. doi: 10.1159/000247298. PubMed DOI

Jakob T., Forstenlechner P., Matricardi P., Kleine-Tebbe J. Molecular allergy diagnostics using multiplex assays: Methodological and practical considerations for use in research and clinical routine. Allergol. J. Int. 2015;24:320–332. doi: 10.1007/s40629-015-0087-8. PubMed DOI PMC

Choi J., Roh J., Lee J. Clinical Availability of Component-Resolved Diagnosis Using Microarray Technology in Atopic Dermatitis. Ann. Dermatol. 2014;26:437–446. doi: 10.5021/ad.2014.26.4.437. PubMed DOI PMC

Wang X., Du K., She W., Ouyang Y., Sima Y., Liu C., Zhang L. Recent advances in the diagnosis of allergic rhinitis. Expert Rev. Clin. Immunol. 2018;14:957–964. doi: 10.1080/1744666X.2018.1530113. PubMed DOI

Panzner P., Vachová M., Vítovcová P., Brodská P., Vlas T. A comprehensive analysis of middle-european molecular sensitization profiles to pollen allergens. Int. Arch. Allergy Immunol. 2014;164:74–82. doi: 10.1159/000362760. PubMed DOI

Panzner P., Vachová M., Vlas T., Vítovcová P., Brodská P., Malý M. Cross-sectional study on sensitization to mite and cockroach allergen components in allergy patients in the Central European region. Clin. Transl. Allergy. 2018;8:19. doi: 10.1186/s13601-018-0207-x. PubMed DOI PMC

Vachová M., Panzner P., Vlas T., Vítovcová P. Analysis of Sensitization Profiles in Central European Allergy Patients Focused on Animal Allergen Molecules. Int. Arch. Allergy Immunol. 2020;181:278–284. doi: 10.1159/000505518. PubMed DOI

Banerjee S., Resch Y., Chen K., Swoboda I., Focke-Tejkl M., Blatt K., Novak N., Wickman M., Van Hage M., Ferrara R., et al. Der p 11 is a major allergen for house dust miteallergic patients suffering from atopic dermatitis. J. Investig. Dermatol. 2015;135:102–109. doi: 10.1038/jid.2014.271. PubMed DOI PMC

Saunders C.W., Scheynius A., Heitman J. Malassezia fungi are specialized to live on skin and associated with dandruff, eczema, and other skin diseases. PLoS Pathog. 2012;8:e1002701. doi: 10.1371/journal.ppat.1002701. PubMed DOI PMC

Johansson C., Sandstr€om M.H., Bartosik J., Särnhult T., Christiansen J., Zargari A., Bäck O., Wahlgren C.F., Faergemann J., Scheynius A., et al. Atopy patch test reactions to Malassezia allergens differentiate subgroups of atopic dermatitis patients. Br. J. Dermatol. 2003;148:479–488. doi: 10.1046/j.1365-2133.2003.05093.x. PubMed DOI

Scheynius A., Johansson C., Buentke E., Zargari A., Linder M.T. Atopic eczema/ dermatitis syndrome and Malassezia. Int. Arch. Allergy Immunol. 2002;127:161–169. doi: 10.1159/000053860. PubMed DOI

Brodska P., Panzner P., Pizinger K., Schmid-Grendelmeier P. IgE-mediated sensitization to malassezia in atopic dermatitis: More common in male patients and in head and neck type. Dermatitis. 2014;25:120–126. doi: 10.1097/DER.0000000000000040. PubMed DOI

Glatz M., Buchner M., von Bartenwerffer W., Schmid-Grendelmeier P., Worm M., Hedderich J., Fölster-Holst R. Malassezia spp.-specific immunoglobulin E level is a marker for severity of atopic dermatitis in adults. Acta Derm. Venereol. 2015;95:191–196. doi: 10.2340/00015555-1864. PubMed DOI

Darabi K., Hostetler S.G., Bechtel M.A., Zirwas M. The role of Malassezia in atopic dermatitis affecting the head and neck of adults. J. Am. Acad. Dermatol. 2009;60:125–136. doi: 10.1016/j.jaad.2008.07.058. PubMed DOI

Schwienbacher M., Israel L., Heesemann J., Ebel F. Asp f6, an Aspergillus allergen specifically recognized by IgE from patients with allergic bronchopulmonary aspergillosis, is differentially expressed during germination. Allergy. 2005;60:1430–1435. doi: 10.1111/j.1398-9995.2005.00904.x. PubMed DOI

Kortekangas-Savolainen O., Lammintausta K., Kalimo K. Skin prick test reactions to brewer’s yeast (Saccharomyces cerevisiae) in adult atopic dermatitis patients. Allergy. 1993;48:147–150. doi: 10.1111/j.1398-9995.1993.tb00704.x. PubMed DOI

Reijula K., Leino M., Mussalo-Rauhamaa H., Nikulin M., Alenius H., Mikkola J., Elg P., Kari O., Mäkinen-Kiljunen S., Haahtela T. IgE-mediated allergy to fungal allergens in Finland with special reference to Alternaria alternata and Cladosporium herbarum. Ann. Allergy Asthma Immunol. 2003;91:280–287. doi: 10.1016/S1081-1206(10)63531-4. PubMed DOI

Gabriel M.F., Postigo I., Tomaz C.T., Martínez J. Alternaria alternata allergens: Markers of exposure, phylogeny and risk of fungi-induced respiratory allergy. Environ. Int. 2016;89–90:71–80. doi: 10.1016/j.envint.2016.01.003. PubMed DOI

Celakovská J., Josef B., Ettler K., Vaneckova J., Ettlerova K., Jan K. Sensitization to Fungi in Atopic Dermatitis Patients 14 Year and Older—Association with Other Atopic Diseases and Parameters. Indian J. Dermatol. 2018;63:391–398. doi: 10.4103/ijd.IJD_493_17. PubMed DOI PMC