Epidemiology of acute asthma: IgE antibodies to common inhalant allergens as a risk factor for emergency room visits (original) (raw)
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Clinical and Experimental Allergy, 1975
Cutaneous and bronchial immediate allergic reactivity and the serum level of IgE specific for each of four common inhalant allergens were determined for 153 asthmatic patients. Positive bronchial reactivity to an extract was not detected in any of the patients with a negative prick test reaction to that extract but did occur in 9% of the patients in whom the serum tests results for IgE specific to that allergen fell within the range regarded as negative. Highly significant correlation coefficients between the degree of bronchial and cutaneous allergic reactivity to the allergen extracts were found and these were slightly but significantly less than the correlation between the serum level of allergen specific IgE and the degree of bronchial allergic reactivity to the allergen extracts. These findings indicate that the results both of prick testing with appropriate extracts and estimation of the serum level of allergen specific IgE can be used to predict not only the presence of detectable bronchial reactivity to inhalant allergens but also the degree of this reactivity. However, for the routine investigation of asthmatic patients measurement of the serum level of allergen specific IgE would appear to have little advantage over properly performed prick tests.
Medical Principles and Practice, 2000
Background: Studies have shown that allergens are important sensitizing agents in asthma. The relationship between various allergy markers has not been documented in Kuwait, although asthma is common. This study was therefore designed to investigate this relationship. Method: One hundred and one adult asthmatics were recruited over a 1-year period for this study. After administering a skin prick test (SPT) for common allergens, blood was taken for measuring specific IgE concentrations. Results: Eighty-two percent of the patients had positive SPT reactions to at least one allergen. Chenopodium sensiti-zation was the most common, occurring in 47% of cases. Specific IgE was positive in fewer cases, which showed a positive reaction to SPT with the same allergen, the highest being observed with cockroach, occurring in 76% of the cases. There was a positive correlation between the wheal diameter of SPT and the concentration of specific IgE in three of the four allergens tested (r = 0.376, p ^ 0.001 for Bermuda grass; r = 0.255, p 0 .01 for cockroach, and r = 0.254, p ^ 0.01 for chenopodium). The sensitivity, specificity and diagnostic accuracy of SPT in the allergens tested were below the reported findings in studies from Western countries. Conclusion: This study revealed that SPT had a better predictive value than specific IgE, and there was evidence of increasing sensitization to the cockroach allergen in this environment.
Acta clinica Belgica
The aim of this study was to evaluate the relative frequencies of sensitisation to four common inhalant allergens in two atopic populations suffering from asthma and/or rhinitis. One had been studied in the period of 1975 till 1979, and a second population was evaluated between 1992 and 1995. At both time periods patients with inhalant allergy and visiting our outpatient clinic were included. Quantification of IgE to Dermatophagoides pteronyssinus, birch, timothy grass, and mugwort was performed via the Phadebas RAST technique (Pharmacia, Brussels, Belgium). In patients suffering from respiratory allergy the frequency of birch pollen sensitisation significantly increased from 13% in the period 1975-1979 to 34% in the period 1992-1995. In contrast, the frequency of house dust mite, timothy grass pollen, and mugwort pollen sensitisation remained almost unchanged. The increase was not associated with an increase in the birch pollen count. Birch pollen hypersensitivity has almost triple...
Serum IgE levels, atopy, and asthma in young adults: results from a longitudinal cohort study
Allergy, 1996
To explore the natural history of asthma and its relation to allergic responses, we examined the relation between total serum IgE in early adulthood and a history of respiratory symptoms, airway hyperresponsiveness (AHR), and atopy during childhood. We studied 180 subjects aged 18-20 years who had been studied since the age of 8-10 years. We measured wheeze in the previous year by questionnaire, AHR by histamine inhalation test, atopy by skin prick tests, and serum IgE levels by immunoassay. Subjects with AHR in early adulthood had higher IgE levels (mean 257.0 IU/ml) than subjects with past AHR (mean 93.3 IU/ml) or with lifelong normal responsiveness (mean 67.6 IU/ml) (P < 0.001). Subjects who had symptoms had higher IgE levels (mean 125.9 IU/ml) than those who were lifelong asymptomatic (mean 63.1 IU/ml) (P < 0.001). Recent wheeze, AHR, and allergic sensitization all had a positive relation to serum IgE, but IgE was not more predictive of AHR than skin prick tests. The finding that young adults who are sensitized to common allergens are highly likely to have AHR even in the absence of symptoms is further evidence of the fundamental role of IgE-mediated responses in the natural history of AHR throughout childhood and into adulthood.
Total serum IgE levels among adults patients with intermittent and persistent allergic asthmas
Medical Journal of Indonesia
Background: Allergic asthma is a chronic inflammatory airway disease mediated by immunologic mechanisms. Based on the degree of severity, allergic asthma is divided into intermittent asthma and persistent asthma. IgE plays an important role in mediating allergic response in asthma; however, there are no studies on total IgE levels in adult asthmatic patients in Indonesia based on disease severity. This study aimed to determine the difference of serum total IgE levels between adult patients with intermittent and persistent allergic asthmas. Methods: This was a cross-sectional study of allergic asthma patients treated at the Allergy-Immunology Division Polyclinic, Cipto Mangunkusumo Hospital, Jakarta from January to August 2017. The data obtained included the demographic information of the patients, the level of severity of asthma, and the total serum IgE level. The severity level was the independent variable, while the total serum IgE level was the dependent variable. Median difference was analyzed using a Mann-Whitney U test. Results: There were 60 patients included in this study. Based on the degree of severity, 11 patients (18.3%) had intermittent asthma and 49 patients (81.67%) had persistent asthma. The mean (standard deviation) total serum IgE level in all subjects was 42.35 (32.7) IU/ml. Median total serum IgE level was significantly higher in persistent asthma than in intermittent asthma (37 vs. 16 IU/ml; p=0.004). Conclusion: Serum total IgE levels in persistent allergic asthma patients were significantly higher than in intermittent allergic asthma patients. This finding is consistent with a more severe degree of airway inflammation.
International Archives of Allergy and Immunology, 2007
specificity for atopy were assessed on the other 50% of nonatopic and on all atopic subjects. The 95th percentile of IgEt reference values in non-smokers was 148 kU/l in women and 169 kU/l in men, while it was 194 and 220 kU/l in female and male smokers, respectively: serum IgE-t above the 95th percentile identifies ! 32% and above the 99th percentile ! 20% of atopic adults (low sensitivity), but a serum IgE-t below the 95th percentile identifies 1 90% and below the 99th percentile identifies 1 95% of non-atopic adults (good specificity). Due to the adequate specificity, IgE-t values exceeding the normal limits confirm a suspected atopic status; however, because of the low sensitivity, values below the cutoff seem not to exclude an atopic status with sufficient accuracy.
Journal of Allergy and Clinical Immunology, 1995
Background: The detection of specific IgE antibodies to environmental allergens does not always coincide with a diagnosis of clinical[y evident allergic disease, because some patients with positive skin and/or in vitro test results have no symptoms related to the allergen or allergens that induced the antibodies. Objective: In a multicenter study the optimal cutoff values for specific 1gE antibody levels and skin test results that could discriminate between patients with symptomatic and those with asymptomatic allergy were determined. Methods: 1gE antibodies specific for a panel of common aeroallergens were assayed with the Pharrnacia CAP System (Pharmacia, Uppsala, Sweden) in two groups of patients, a group of 267 patients with symptomatic allergy and a group of 232 patients with asymptomatic allergy-both ~vith positive skin prick test results and in a group of 243 healthy, nonallergic control subjects. The cuto]f values were established by receiver operating characteristic analysis. Results: A significantly higher mean specific IgE antibody value was found in patients with symptomatic allergy compared with patients with asymptomatic allergy (p < 0.001) and in patients with symptomatic allergy compared with healthy control subjects (p < 0.001). The optimal CAP System cutoff value between patients with symptomatic and those with asymptomatic allergy was 11.7 kU/L, and when seasonal allergens were compared with perennial allergens, the cutoffs were 10.7 kU/L and 8.4 kU/L, respectively. The optimal cutoff value for the skin prick test was a wheal area of 32 mm 2 for seasonal allergens and 31 mm 2 for perennial allergens. The skin test had a lower diagnostic value (sum of sensitivity and specificity) than the CAP System. Conclusions: Cutoff values for specific serum IgE antibody levels are likely to be useful in clinical practice to distinguish symptomatic from asymptomatic allergy in patients with positive skin test results.
Allergy, 2010
Relationships among allergen-specific IgE levels, allergen exposure and asthma severity are poorly understood since sensitization has previously been evaluated as a dichotomous, rather than continuous characteristic. Five hundred and forty-six inner-city adolescents enrolled in the Asthma Control Evaluation study underwent exhaled nitric oxide (FE(NO)) measurement, lung function testing, and completion of a questionnaire. Allergen-specific IgE levels and blood eosinophils were quantified. Dust samples were collected from the participants' bedrooms for quantification of allergen concentrations. Participants were followed for 12 months and clinical outcomes were tracked. Among sensitized participants, allergen-specific IgE levels were correlated with the corresponding settled dust allergen levels for cockroach, dust mite, and mouse (r = 0.38, 0.34, 0.19, respectively; P < 0.0001 for cockroach and dust mite and P = 0.03 for mouse), but not cat (r = -0.02, P = 0.71). Higher cockroach-, mite-, mouse-, and cat-specific IgE levels were associated with higher FE(NO) concentrations, poorer lung function, and higher blood eosinophils. Higher cat, dust mite, and mouse allergen-specific IgE levels were also associated with an increasing risk of exacerbations or hospitalization. Allergen-specific IgE levels were correlated with allergen exposure among sensitized participants, except for cat. Allergen-specific IgE levels were also associated with more severe asthma across a range of clinical and biologic markers. Adjusting for exposure did not provide additional predictive value, suggesting that higher allergen-specific IgE levels may be indicative of both higher exposure and a greater degree of sensitization, which in turn may result in greater asthma severity.