Work

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

Year: 2025

Type: article

Abstract: BACKGROUND: Atopic diseases-including atopic dermatitis (AD), asthma (AA), and allergic rhinitis (AR)-are driven by Th2 inflammation and often occur together (atopic multimorbidity), along with non-atopic comorbidities. Chronic spontaneous urticaria (CSU) is an autoimmune mast cell-driven disease, but its relationship to classic atopic diseases remains unclear. This study investigated the association of CSU with classical atopic diseases as well as sensitization patterns and T cell activation in atopic multimorbidity. METHODS: We conducted a prospective, single-center study involving 123 participants who completed structured questionnaires regarding physician-diagnosed AD, AA, AR, and/or CSU, as well as non-atopic comorbidities and a history of type I sensitizations. AD patients (n = 22, with or without AR/AA, but not CSU) and healthy controls (n = 20) underwent additional immunophenotyping. Peripheral blood T cell subsets and T cell activation status were measured by flow cytometry and compared across groups. RESULTS: Individuals with atopic multimorbidity exhibited more frequent type I sensitizations, sleep disorders, and elevated serum IgE levels. CSU differed from classical atopic diseases regarding age of onset and duration and was therefore excluded from immunophenotyping. T cell subsets and activation in AD did not differ by presence of atopic multimorbidity but correlated with disease activity scores. CONCLUSION: Our findings highlight the burden associated with atopic multimorbidity, demonstrated by increased serum IgE and sensitization rates in individuals with multiple atopic diseases. Importantly, T cell activation appeared to be more closely related to AD disease activity rather than the presence of classic atopic comorbidities.

Source: Clinical and Translational Allergy

DOI: 10.1002/clt2.70129