Understanding IgE-mediated autoimmunity and autoallergy

Chronic inflammatory diseases affect millions of people and are associated with considerable clinical, human, and economic burden. Available treatments have limitations; some are toxic, or they may prevent disease symptoms without affecting pathogenic drivers and disease course. Recent progress in the understanding of chronic inflammation can facilitate the development of targeted and disease-modifying therapy. In particular, IgE autoantibodies against self-antigens are thought to be linked to the pathophysiology and course of chronic inflammatory diseases including atopic dermatitis, asthma, bullous pemphigoid, chronic spontaneous urticaria, and systemic lupus erythematosus. The European Network for IgE-Mediated Autoimmunity (ENIGMA) aims to unravel the role and relevance of IgE autoantibodies in chronic inflammatory diseases. In this review, the ENIGMA consortium presents the concept of IgE-dependent autoimmunity and autoallergy, summarizes current knowledge and its gaps, and focuses on ways to enhance our understanding of these complex processes.