Clinical, cosmetic and investigational dermatology · 2026
Elevated IgE Levels in Psoriasis: An Atypical Subtype with Th2 Dominance and Overlapping Features of Atopic Dermatitis.
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Shi Leyao, Dong Sitan, Li Dongmei, Xiong Huabao, Shi Dongmei
Аннотация
PURPOSE: This study aimed to investigate the potential impact of elevated IgE levels in psoriasis patients by exploring the responses of T cell subsets and B cell subsets, along with their associated cytokines.
PATIENTS AND METHODS: Cytokine levels were measured using ELISA, and total IgE levels were measured using ELISPOT assay, along with PBMCs were collected for flow cytometry analysis to assess CD4+ T cell subsets (Th1, Th2, Th17) using their signature cytokines (IFN-γ, IL-4, IL-17A, respectively). Additionally, the expression of CD23 and CD19 on peripheral blood lymphocytes was measured to evaluate B cell responses.
RESULTS: Despite similar psoriasis area severity index (PASI) scores between the high-IgE psoriasis (H-PSO) and psoriasis vulgaris (PSO) groups, patients in the H-PSO group exhibited significantly higher peak pruritus numerical rating scale (NRS) scores. The elevated peripheral blood IgE levels in H-PSO patients were positively correlated with PASI scores, but not necessarily with peak pruritus NRS scores. Consistent with the elevation in IgE levels, Th2 cells and IL-4 cytokine levels were increased, along with the CD19+CD23+ cell population in H-PSO patients. Conversely, Th17 cells and associated IL-17A cytokine levels were more pronounced in H-PSO Conversely, the percentage of Th17 cells was significantly higher in H-PSO patients than in those with atopic dermatitis (AD), whereas IL-17A levels showed a similar trend that did not reach statistical significance; no significant differences were observed between H-PSO and PSO patients. The levels of Th1 cells and associated IFN-γ cytokines remained comparable not only between the two types of psoriasis but also between each psoriasis group and the AD group.
CONCLUSION: These findings suggest distinct immune profiles in psoriasis patients with elevated IgE levels, characterized by heightened Th2 responses and CD23+ B cell populations, as well as a prominent Th17 response, underscoring the complexity of immune dysregulation in psoriasis.
PATIENTS AND METHODS: Cytokine levels were measured using ELISA, and total IgE levels were measured using ELISPOT assay, along with PBMCs were collected for flow cytometry analysis to assess CD4+ T cell subsets (Th1, Th2, Th17) using their signature cytokines (IFN-γ, IL-4, IL-17A, respectively). Additionally, the expression of CD23 and CD19 on peripheral blood lymphocytes was measured to evaluate B cell responses.
RESULTS: Despite similar psoriasis area severity index (PASI) scores between the high-IgE psoriasis (H-PSO) and psoriasis vulgaris (PSO) groups, patients in the H-PSO group exhibited significantly higher peak pruritus numerical rating scale (NRS) scores. The elevated peripheral blood IgE levels in H-PSO patients were positively correlated with PASI scores, but not necessarily with peak pruritus NRS scores. Consistent with the elevation in IgE levels, Th2 cells and IL-4 cytokine levels were increased, along with the CD19+CD23+ cell population in H-PSO patients. Conversely, Th17 cells and associated IL-17A cytokine levels were more pronounced in H-PSO Conversely, the percentage of Th17 cells was significantly higher in H-PSO patients than in those with atopic dermatitis (AD), whereas IL-17A levels showed a similar trend that did not reach statistical significance; no significant differences were observed between H-PSO and PSO patients. The levels of Th1 cells and associated IFN-γ cytokines remained comparable not only between the two types of psoriasis but also between each psoriasis group and the AD group.
CONCLUSION: These findings suggest distinct immune profiles in psoriasis patients with elevated IgE levels, characterized by heightened Th2 responses and CD23+ B cell populations, as well as a prominent Th17 response, underscoring the complexity of immune dysregulation in psoriasis.