AllergoOncology: ultra-low IgE, a potential novel biomarker in cancer-a Position Paper of the European Academy of Allergy and Clinical Immunology (EAACI).

Elevated serum IgE levels are associated with allergic disorders, parasitosis and specific immunologic abnormalities. In addition, epidemiological and mechanistic evidence indicates an association between IgE-mediated immune surveillance and protection from tumour growth. Intriguingly, recent studies reveal a correlation between IgE deficiency and increased malignancy risk. This is the first review discussing IgE levels and links to pathological conditions, with special focus on the potential clinical significance of ultra-low serum IgE levels and risk of malignancy. In this Position Paper we discuss: (a) the utility of measuring total IgE levels in the management of allergies, parasitosis, and immunodeficiencies, (b) factors that may influence serum IgE levels, (c) IgE as a marker of different disorders, and d) the relationship between ultra-low IgE levels and malignancy susceptibility. While elevated serum IgE is generally associated with allergic/atopic conditions, very low or absent IgE may hamper anti-tumour surveillance, indicating the importance of a balanced IgE-mediated immune function. Ultra-low IgE may prove to be an unexpected biomarker for cancer risk. Nevertheless, given the early stage of investigations conducted mostly in patients with diseases that influence IgE levels, in-depth mechanistic studies and stratification of malignancy risk based on associated demographic, immunological and clinical co-factors are warranted.

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© The Author(s) 2020.

Déclaration de conflit d'intérêts

Competing interestsAll authors have read and approved the Position Paper. Any potential conflicts of interests are listed here: EJJ: Erika Jensen-Jarolim declares inventorship in patents on allergen immunotherapy formulation with Biomedical International R + D, Vienna, Austria, of which she is shareholder. She received honoraria for presentations from Allergy Therapeutics, AllergoPharma, Bencard, Meda, Roxall, ThermoFisher, and consulted previously for MediGene, Germany, Novartis, for Allergy Therapeutics and Dr. Schär. VM: Vera Mahler indicates, that the views expressed in this Position Paper are the personal views of the author as an expert in the field of allergology and may not be understood or quoted as being made on behalf of or reflecting the position of the respective national competent authorities, the European Medicines Agency, or one of its committees or working parties. She reports having no COI within the last 3 years. FRW: Franziska Roth-Walter declares inventorship in patents on allergen immunotherapy formulation with Biomedical International R + D GmbH, Vienna, Austria. SNK: Sophia N. Karagiannis is founder and shareholder of Epsilogen Ltd. and has received funds from Espilogen Ltd. Sophia N. Karagiannis holds a patent on anti-tumour IgE antibodies. ESH: Esther Steveling declares honoraria as an expert in advisory board from Bencard and travel grant to attend the yearly European Academy of Allergy and Clinical Immunology congress from ALK and Bencard. HJB: Heather J Bax declares financial support from Epsilogen Ltd. MCT: Turner Michelle C is funded by a Ramón y Cajal fellowship (RYC-2017-01892) from the Spanish Ministry of Science, Innovation and Universities and co-funded by the European Social Fund. ISGlobal acknowledges support from the Spanish Ministry of Science, Innovation and Universities through the “Centro de Excelencia Severo Ochoa 2019-2023” Program (CEX2018-000806-S), and support from the Generalitat de Catalunya through the CERCA Program.