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Peer-reviewedCC BY 4.0Frontiers in Immunology

Ultra-low values of total serum immunoglobulin E and cancer risk: a systematic review and exploratory analysis of the Swedish AMORIS cohort

  • Maria J. Monroy-Iglesias1
  • Gincy George1
  • Isolt Reardon1
  • Jitesh Chauhan2
  • Heather J. Bax2
  • Alexandra McCraw2
  • Michelle C. Turner3,4,5
  • Aurélie Poli6
  • Niklas Hammar7
  • Maria Feychting7
  • Mats Talbäck7
  • Denisa E. Ferastraoaru8
3 more authors
  • Aida Santaolalla1
  • Sophia N. Karagiannis2,9
  • Mieke Van Hemelrijck1
9 affiliations
  1. 1Transforming Cancer OUtcomes through Research (TOUR), School of Cancer and Pharmaceutical Sciences, King’s College London
  2. 2St. John’s Institute of Dermatology, School of Basic and Medical Biosciences and King's Health Partners (KHP) Centre for Translational Medicine, Guy’s Hospital, King’s College London
  3. 3Barcelona Institute for Global Health (ISGlobal)
  4. 4Universitat Pompeu Fabra (UPF)
  5. 5Centro de Investigación Biomédica en Red (CIBER) Epidemiología y Salud Pública (CIBERESP)
  6. 6Neuro-Immunology Group, Department of Cancer Research, Luxembourg Institute of Health
  7. 7Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet
  8. 8Department of Internal Medicine/Allergy and Immunology, Albert Einstein College of Medicine, Montefiore Medical Center
  9. 9Breast Cancer Now Research Unit, School of Cancer and Pharmaceutical Sciences, King’s College London, Innovation Hub, Guy’s Cancer Centre
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Abstract

Background: Immunoglobulin E (IgE) is increasingly recognized as a component of immune surveillance with potential relevance to cancer biology. While elevated IgE has been studied in relation to cancer risk, the implications of ultra-low or deficient total serum IgE remain unclear.

Methods: We conducted a systematic review of observational studies examining ultra-low or deficient total serum IgE and cancer risk, searching PubMed/MEDLINE and Embase through September 2026. We additionally conducted exploratory analyses among 26,676 adults in the Swedish Apolipoprotein-related Mortality RISk (AMORIS) cohort with baseline total serum IgE measurements. Cancer risk was assessed using Cox proportional hazards models adjusted for age, sex, and education. IgE was analyzed using clinically defined categories (<2, 2–10, 10–20, 20–100, 100–<1,000, ≥1,000kU/L).

Results: Seven observational studies met inclusion criteria. Several studies reported higher cancer prevalence or risk among individuals with ultra-low or deficient IgE, although studies were heterogeneous and largely retrospective or unadjusted. In exploratory AMORIS analyses, there was no evidence of an increased overall cancer risk among individuals with IgE deficiency (<2kU/L).

Conclusion: Existing studies suggest a possible association between ultra-low total serum IgE and cancer risk, but current evidence is limited. In exploratory AMORIS cohort analyses, there was no evidence of an increased overall cancer risk among individuals with IgE deficiency. Further prospective studies with repeated IgE measurements and comprehensive covariate data are needed to clarify this understudied association.

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Cite

BibTeXRIS
BibTeX
@article{monroyiglesias2026ultralow,
  title = {{Ultra-low values of total serum immunoglobulin E and cancer risk: a systematic review and exploratory analysis of the Swedish AMORIS cohort}},
  author = {Maria J. Monroy-Iglesias and Gincy George and Isolt Reardon and Jitesh Chauhan and Heather J. Bax and Alexandra McCraw and Michelle C. Turner and Aurélie Poli and Niklas Hammar and Maria Feychting and Mats Talbäck and Denisa E. Ferastraoaru and Aida Santaolalla and Sophia N. Karagiannis and Mieke Van Hemelrijck},
  journal = {Frontiers in Immunology},
  year = {2026},
  month = oct,
  doi = {10.3389/fimmu.2026.1812536},
  url = {https://www.frontiersin.org/articles/10.3389/fimmu.2026.1812536/full},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Ultra-low values of total serum immunoglobulin E and cancer risk: a systematic review and exploratory analysis of the Swedish AMORIS cohort
AU  - Maria J. Monroy-Iglesias
AU  - Gincy George
AU  - Isolt Reardon
AU  - Jitesh Chauhan
AU  - Heather J. Bax
AU  - Alexandra McCraw
AU  - Michelle C. Turner
AU  - Aurélie Poli
AU  - Niklas Hammar
AU  - Maria Feychting
AU  - Mats Talbäck
AU  - Denisa E. Ferastraoaru
AU  - Aida Santaolalla
AU  - Sophia N. Karagiannis
AU  - Mieke Van Hemelrijck
PY  - 2026
DA  - 2026/10/22
JO  - Frontiers in Immunology
DO  - 10.3389/fimmu.2026.1812536
UR  - https://www.frontiersin.org/articles/10.3389/fimmu.2026.1812536/full
AB  - Background: Immunoglobulin E (IgE) is increasingly recognized as a component of immune surveillance with potential relevance to cancer biology. While elevated IgE has been studied in relation to cancer risk, the implications of ultra-low or deficient total serum IgE remain unclear.  Methods: We conducted a systematic review of observational studies examining ultra-low or deficient total serum IgE and cancer risk, searching PubMed/MEDLINE and Embase through September 2026. We additionally conducted exploratory analyses among 26,676 adults in the Swedish Apolipoprotein-related Mortality RISk (AMORIS) cohort with baseline total serum IgE measurements. Cancer risk was assessed using Cox proportional hazards models adjusted for age, sex, and education. IgE was analyzed using clinically defined categories (<2, 2–10, 10–20, 20–100, 100–<1,000, ≥1,000kU/L).  Results: Seven observational studies met inclusion criteria. Several studies reported higher cancer prevalence or risk among individuals with ultra-low or deficient IgE, although studies were heterogeneous and largely retrospective or unadjusted. In exploratory AMORIS analyses, there was no evidence of an increased overall cancer risk among individuals with IgE deficiency (<2kU/L).  Conclusion: Existing studies suggest a possible association between ultra-low total serum IgE and cancer risk, but current evidence is limited. In exploratory AMORIS cohort analyses, there was no evidence of an increased overall cancer risk among individuals with IgE deficiency. Further prospective studies with repeated IgE measurements and comprehensive covariate data are needed to clarify this understudied association.
SN  - 1664-3224
ER  -