{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T19:45:17Z","timestamp":1790624717812,"version":"4.1.0"},"reference-count":35,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2016,6,10]],"date-time":"2016-06-10T00:00:00Z","timestamp":1465516800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Molecules"],"abstract":"<jats:p>Background: Atopic eczema is a common childhood disease associated with high IgE and eosinophilia. We characterized the clinical features associated with hyper-IgE (defined as IgE &gt; 2000 IU\/L) in eczema. Methods: Nottingham Eczema Severity Score (NESS), family and personal history of atopy, skin prick test (SPT) for common food and aeroallergens, highest serum IgE ever and eosinophil counts were evaluated in 330 children eczema patients. Childhood-NESS (NESS performed at &lt;10 years of age) and adolescent-NESS (NESS performed at &gt;10 years of age) were further analyzed. Results: IgE correlated with NESS (spearman coefficient 0.35, p &lt; 0.001) and eosinophil percentage (spearman coefficient 0.56, p = 0.001). Compared with IgE \u2264 2000IU\/L (n = 167), patients with hyper-IgE (n = 163) were associated with male gender (p = 0.002); paternal atopy (p = 0.026); personal history of atopic rhinitis (p = 0.016); asthma (p &lt; 0.001); dietary avoidance (p &lt; 0.001); use of wet wrap (p &lt; 0.001); traditional Chinese medicine use (TCM, p &lt; 0.001); immunomodulant use (azathioprine or cyclosporine, p &lt; 0.001); skin prick sensitization by dust mites (p &lt; 0.001), cats (p = 0.012), dogs (p = 0.018), food (p = 0.002); eosinophilia (p &lt; 0.001); more severe disease during childhood (p &lt; 0.0001) and during adolescence (p &lt; 0.0001), but not onset age of eczema or maternal atopy. Logistic regression showed that hyper-IgE was associated with personal history of asthma (exp(B) = 5.12, p = 0.002) and eczema severity during childhood and adolescence (p &lt; 0.001). For patients &lt;10 years of age, dust mite sensitization (p = 0.008) was associated with hyper-IgE. For patients &gt;10years of age, food allergen sensitization was associated with hyper-IgE (p = 0.008). Conclusions: Hyper-IgE is independently associated with asthma, more severe atopy and more severe eczema during childhood and adolescence. IgE &gt; 2000 IU\/L may be a tool to aid prognostication of this chronic relapsing dermatologic disease and its progression to asthma.<\/jats:p>","DOI":"10.3390\/molecules21060753","type":"journal-article","created":{"date-parts":[[2016,6,10]],"date-time":"2016-06-10T07:37:41Z","timestamp":1465544261000},"page":"753","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Hyper IgE in Childhood Eczema and Risk of Asthma in Chinese Children"],"prefix":"10.3390","volume":"21","author":[{"given":"Chantel","family":"Ng","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6682-5529","authenticated-orcid":false,"given":"Kam","family":"Hon","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China"},{"name":"Institute of Chinese Medicine, The Chinese University of Hong Kong, Hong Kong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeng","family":"Kung","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nga","family":"Pong","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ting-Fan","family":"Leung","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chun","family":"Wong","sequence":"additional","affiliation":[{"name":"Institute of Chinese Medicine, The Chinese University of Hong Kong, Hong Kong, China"},{"name":"Department of Chemical Pathology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2016,6,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1111\/j.1525-1470.2005.22303.x","article-title":"The burden of atopic dermatitis: Impact on the patient, family, and society","volume":"22","author":"Carroll","year":"2005","journal-title":"Pediatr. Dermatol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1016\/j.yapd.2007.03.013","article-title":"Atopic dermatitis","volume":"54","author":"Leung","year":"2007","journal-title":"Adv. Pediatr."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1263","DOI":"10.1136\/bmj.39405.503773.AD","article-title":"Management of atopic eczema in children aged up to 12 years: Summary of NICE guidance","volume":"335","author":"Mugglestone","year":"2007","journal-title":"BMJ"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1007\/s12098-010-0042-0","article-title":"Atopy in children with eczema","volume":"77","author":"Hon","year":"2010","journal-title":"Indian J. Pediatr."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1016\/j.anai.2009.10.002","article-title":"From atopic dermatitis to asthma: The atopic march","volume":"105","author":"Spergel","year":"2010","journal-title":"Ann. Allergy Asthma Immunol."},{"key":"ref_6","first-page":"73","article-title":"The atopic march: From skin to the airways","volume":"11","author":"Hon","year":"2012","journal-title":"Iran. J. Allergy Asthma Immunol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1007\/s12519-012-0354-4","article-title":"Skin prick testing in atopic eczema: Atopic to what and at what age?","volume":"8","author":"Hon","year":"2012","journal-title":"World J. Pediatr."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1064","DOI":"10.1016\/j.jaci.2005.08.026","article-title":"Two types of eczema\u2014Or are there?","volume":"116","author":"Williams","year":"2005","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"813","DOI":"10.1034\/j.1398-9995.2001.t01-1-00001.x","article-title":"A revised nomenclature for allergy: An EAACI position statement from the EAACI nomenclature task force","volume":"56","author":"Johansson","year":"2001","journal-title":"Allergy"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1258","DOI":"10.1111\/j.1365-4632.2007.03407.x","article-title":"Are age-specific high serum IgE levels associated with worse symptomatology in children with atopic dermatitis?","volume":"46","author":"Hon","year":"2007","journal-title":"Int. J. Dermatol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"681","DOI":"10.1007\/s10875-015-0200-2","article-title":"Investigation of Skin Barrier Functions and Allergic Sensitization in Patients with Hyper-IgE Syndrome","volume":"35","author":"Dajnoki","year":"2015","journal-title":"J. Clin. Immunol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1111\/j.0105-2896.2005.00228.x","article-title":"Hyper-IgE syndromes","volume":"203","author":"Grimbacher","year":"2005","journal-title":"Immunol. Rev."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"23","DOI":"10.2500\/aap.2009.30.3193","article-title":"Elevated serum immunoglobulin E (IgE): When to suspect hyper-IgE syndrome-A 10-year pediatric tertiary care center experience","volume":"30","author":"Joshi","year":"2009","journal-title":"Allergy Asthma Proc."},{"key":"ref_14","first-page":"169","article-title":"Hyperimmunoglobulin E syndrome (Job\u2019s syndrome)","volume":"46","author":"Tamas","year":"2008","journal-title":"Rom. J. Intern. Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1013","DOI":"10.1016\/S0140-6736(66)90119-X","article-title":"Job\u2019s Syndrome. Recurrent, \u201ccold\u201d, staphylococcal abscesses","volume":"1","author":"Davis","year":"1966","journal-title":"Lancet"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1111\/j.1365-2133.1994.tb08532.x","article-title":"The U.K. Working Party\u2019s Diagnostic Criteria for Atopic Dermatitis. III. Independent hospital validation","volume":"131","author":"Williams","year":"1994","journal-title":"Br. J. Dermatol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1046\/j.1365-2133.2000.03300.x","article-title":"The Nottingham Eczema Severity Score: Preliminary refinement of the Rajka and Langeland grading","volume":"142","author":"Emerson","year":"2000","journal-title":"Br. J. Dermatol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1111\/j.1525-1470.2003.20601.x","article-title":"Validation of a Self-Administered Questionnaire in Chinese in the Assessment of Eczema Severity","volume":"20","author":"Hon","year":"2003","journal-title":"Pediatr. Dermatol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1551","DOI":"10.1007\/s11136-006-0019-7","article-title":"CDLQI, SCORAD and NESS: Are they Correlated?","volume":"15","author":"Hon","year":"2006","journal-title":"Qual. Life Res."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1046\/j.1365-2133.1998.02316.x","article-title":"Severity distribution of atopic dermatitis in the community and its relationship to secondary referral","volume":"139","author":"Emerson","year":"1998","journal-title":"Br. J. Dermatol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1046\/j.0905-6157.2003.00106.x","article-title":"Does the severity of atopic dermatitis correlate with serum IgE levels?","volume":"15","author":"Laske","year":"2004","journal-title":"Pediatr. Allergy Immunol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1159\/000189192","article-title":"Atopic dermatitis, dry skin and serum IgE in children in a community in japan","volume":"149","author":"Wakamori","year":"2009","journal-title":"Int. Arch. Allergy Immunol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1016\/S0022-3476(99)70203-9","article-title":"Serum IgE levels during the first 6 years of life","volume":"134","author":"Kulig","year":"1999","journal-title":"J. Pediatr."},{"key":"ref_24","first-page":"469","article-title":"Atopic dermatitis","volume":"69","author":"Sampson","year":"1992","journal-title":"Ann. Allergy"},{"key":"ref_25","first-page":"1","article-title":"The atopic eczema\/dermatitis syndrome. Epidemiology, natural course, and immunology of the IgE-associated (\u201cextrinsic\u201d) and the nonallergic (\u201cintrinsic\u201d) AEDS","volume":"13","author":"Wuthrich","year":"2003","journal-title":"J. Investig. Allergol. Clin. Immunol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1016\/j.jaci.2004.04.027","article-title":"How atopic is atopic dermatitis?","volume":"114","author":"Flohr","year":"2004","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1001\/archderm.1964.01590260047008","article-title":"The natural history of atopic dermatitis. A 20-year follow-up study","volume":"89","author":"Roth","year":"1964","journal-title":"Arch. Dermatol."},{"key":"ref_28","first-page":"117","article-title":"Long term follow-up in atopic dermatitis","volume":"114","author":"Rystedt","year":"1985","journal-title":"Acta Derm. Venereol. Suppl. (Stockh.)"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1016\/S1081-1206(10)62852-9","article-title":"Clinical aspects, epidemiology, and prognosis of atopic dermatitis","volume":"83","author":"Wuthrich","year":"1999","journal-title":"Ann. Allergy Asthma Immunol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"498","DOI":"10.1111\/all.12112","article-title":"Characterization of different courses of atopic dermatitis in adolescent and adult patients","volume":"68","author":"Garmhausen","year":"2013","journal-title":"Allergy"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1007\/s12519-015-0064-9","article-title":"Predicting eczema severity beyond childhood","volume":"12","author":"Hon","year":"2016","journal-title":"World J. Pediatr."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"S118","DOI":"10.1016\/j.jaci.2003.09.033","article-title":"Atopic dermatitis and the atopic march","volume":"112","author":"Spergel","year":"2003","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"763","DOI":"10.1001\/archderm.136.6.763","article-title":"Outcome measures of disease severity in atopic eczema","volume":"136","author":"Charman","year":"2000","journal-title":"Arch. Dermatol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1057","DOI":"10.1046\/j.1365-2133.2002.04644.x","article-title":"Reliability testing of the Six Area, Six Sign Atopic Dermatitis severity score","volume":"146","author":"Charman","year":"2002","journal-title":"Br. J. Dermatol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"932","DOI":"10.1046\/j.1523-1747.2003.12251.x","article-title":"Measuring Atopic Dermatitis Severity in Randomized Controlled Clinical Trials: What Exactly Are We Measuring?","volume":"120","author":"Charman","year":"2003","journal-title":"J. Investig. Dermatol."}],"container-title":["Molecules"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1420-3049\/21\/6\/753\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T19:25:18Z","timestamp":1760210718000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1420-3049\/21\/6\/753"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,6,10]]},"references-count":35,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2016,6]]}},"alternative-id":["molecules21060753"],"URL":"https:\/\/doi.org\/10.3390\/molecules21060753","relation":{},"ISSN":["1420-3049"],"issn-type":[{"value":"1420-3049","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,6,10]]}}}