Previously we reported that patients with severe forms of atopy (e.g. atopic dermatitis, AD) frequently display IgE reactivity against autoantigens. Here we investigated the effects of periodate treatment and reducing versus nonreducing conditions on IgE recognition of nitrocellulose-blotted human cell extracts. IgE and IgG subclass reactivities of AD patients to blotted human cellular extracts as well as to ELISA plate-bound purified endogenous (myosin, histones) antigens and an environmental allergen (timothy grass pollen allergen, Phl p 5) were compared. Serum samples were collected over a period of 12 months from 3 autoreactive AD patients with pollen allergy and tested for IgE reactivity to nitrocellulose-blotted human epithelial and endothelial cell extracts as well as to birch and timothy grass pollen allergens. Results obtained indicate that (1) IgE autoantibodies may be directed primarily against protein and not carbohydrate epitopes, (2) reducing conditions seem to expose or better extract epitopes recognized by IgE autoantibodies, (3) IgE and IgG1-4 autoantibody responses were poorly associated and (4) IgE responses to autoallergens may reflect skin manifestations and may be boosted by seasonal exposure to pollen allergens. Our results thus indicate that IgE autoreactivity may represent a true form of autoimmunity directed against partly denatured peptide epitopes which may be boosted by exogenous allergen contact.