{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T17:21:18Z","timestamp":1775841678784,"version":"3.50.1"},"reference-count":55,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2024,11,4]],"date-time":"2024-11-04T00:00:00Z","timestamp":1730678400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100003196","name":"Ministero della Salute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003196","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Allergy"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The role of autoimmune IgE responses in atopic dermatitis (AD) is highly debated. While IgE targeting self\u2010proteins has been extensively studied, IgE responses induced by human\u2010homologous exogenous molecular allergens (HEMAs) remains less understood.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To investigate whether IgE antibody responses to HEMAs are associated with AD, its severity, and response to dupilumab.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We enrolled 3325 participants with a history of allergic diseases, including 577 (17.3%) diagnosed with AD. Serum IgE antibodies against 183 exogenous allergenic molecules were measured using the IgE microarray (Allergy Explorer\u2010ALEX\u20102\u00ae, MADX, Vienna). Based on international classification criteria, participants were stratified by AD severity and clinical phenotypes. For each patient, we developed an \u2018IgE molecular\u2010mimicry index\u2019 (IgE\u2010MMI), calculated from IgE reactivity to a panel of five HEMA protein families: arginine kinase, enolase (ENO), cyclophilin (CYP), lipocalin, and MnSOD. Logistic regression was employed to assess the association between IgE to HEMAs or IgE\u2010MMI and AD, its severity, and response to dupilumab.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>IgE sensitization to most HEMAs (32\/48, 67%), but only to a small fraction of non\u2010HEMAs (3\/135, 2.2%), was significantly more common in patients with severe AD compared to other patient groups. The IgE\u2010MMI was positive in 295\/2748 (10.7%) of allergic patients without AD, and in 58\/283 (20%), 52\/134 (39%), and 86\/160 (54%) of patients with remitting, moderate, or severe AD, respectively. It was strongly associated with specific phenotypes, such as flexural dermatitis (OR 8.4, 95% CI: 6.3\u201311.2), head and neck dermatitis (OR: 16.5, 95% CI: 7.4\u201337.2), and generalized eczema (OR: 8.6, 95% CI: 4.9\u201315.6). Poor response to dupilumab was associated with IgE antibodies to ENO (OR: 22.7, 95% CI: 1.7\u2013302.9), but inversely associated with IgE antibodies to MnSOD (OR: 0.1, 95% CI: 0.02\u20130.8) and NPC\u20102 from dust mites (OR: 0.1, 95% CI: 0.01\u20130.9).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>IgE microarrays are useful for broadly assessing IgE to HEMAs in allergic patients. IgE reactivity to HEMAs and a positive IgE\u2010MMI may serve as valuable biomarkers for severe AD, its clinical phenotypes, and the response to dupilumab.<\/jats:p><\/jats:sec>","DOI":"10.1111\/all.16377","type":"journal-article","created":{"date-parts":[[2024,11,4]],"date-time":"2024-11-04T14:29:46Z","timestamp":1730730586000},"page":"3415-3429","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["A microarray\u2010based <scp>IgE<\/scp>\u2010molecular mimicry index (<scp>IgE<\/scp>\u2010<scp>MMI<\/scp>): A biomarker for disease severity, clinical phenotypes, and therapeutic response in atopic dermatitis?"],"prefix":"10.1111","volume":"79","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9391-9168","authenticated-orcid":false,"given":"Enrico","family":"Scala","sequence":"first","affiliation":[{"name":"Fondazione Luigi Maria Monti IDI\u2010IRCCS  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefania","family":"Madonna","sequence":"additional","affiliation":[{"name":"Fondazione Luigi Maria Monti IDI\u2010IRCCS  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Damiano","family":"Abeni","sequence":"additional","affiliation":[{"name":"Fondazione Luigi Maria Monti IDI\u2010IRCCS  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0658-2449","authenticated-orcid":false,"given":"Lorenzo","family":"Cecchi","sequence":"additional","affiliation":[{"name":"SOSD Allergology and Clinical Immunology USL Toscana Centro  Prato Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barbara","family":"Cocuroccia","sequence":"additional","affiliation":[{"name":"Fondazione Luigi Maria Monti IDI\u2010IRCCS  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Dattolo","sequence":"additional","affiliation":[{"name":"Fondazione Luigi Maria Monti IDI\u2010IRCCS  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gaia","family":"Moretta","sequence":"additional","affiliation":[{"name":"Fondazione Luigi Maria Monti IDI\u2010IRCCS  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessia","family":"Provini","sequence":"additional","affiliation":[{"name":"Asl roma2, Ospedale Sandro Pertini  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Filomena","family":"Russo","sequence":"additional","affiliation":[{"name":"Fondazione Luigi Maria Monti IDI\u2010IRCCS  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Donatella","family":"Sordi","sequence":"additional","affiliation":[{"name":"Fondazione Luigi Maria Monti IDI\u2010IRCCS  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sabatino","family":"Pallotta","sequence":"additional","affiliation":[{"name":"Fondazione Luigi Maria Monti IDI\u2010IRCCS  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco","family":"Galluzzo","sequence":"additional","affiliation":[{"name":"Dermatology Unit Fondazione Policlinico \"Tor Vergata\"  Rome Italy"},{"name":"Department of Systems Medicine University of Rome \"Tor Vergata\"  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marina","family":"Talamonti","sequence":"additional","affiliation":[{"name":"Dermatology Unit Fondazione Policlinico \"Tor Vergata\"  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valeria","family":"Villella","sequence":"additional","affiliation":[{"name":"Fondazione Luigi Maria Monti IDI\u2010IRCCS  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mauro","family":"Giani","sequence":"additional","affiliation":[{"name":"Fondazione Luigi Maria Monti IDI\u2010IRCCS  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elisabetta","family":"Caprini","sequence":"additional","affiliation":[{"name":"Fondazione Luigi Maria Monti IDI\u2010IRCCS  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristina","family":"Albanesi","sequence":"additional","affiliation":[{"name":"Fondazione Luigi Maria Monti IDI\u2010IRCCS  Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Danilo","family":"Villalta","sequence":"additional","affiliation":[{"name":"S.C. di Immunologia e Allergologia di Laboratorio, PO S. 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