[en] BACKGROUND: Atopy is known to play an important role in the asthmatic disease. The main objective of this study was to evaluate the frequency of sensitisation to common aeroallergens in a cohort of asthmatics with different inflammatory phenotypes and disease severity. METHODS: We have conducted a retrospective cross-sectional study including 772 asthmatics recruited between 2003 and 2014 in our Asthma Clinic. The patients were defined as asthmatics on the basis of respiratory symptoms together with a positive methacholine test (PC20M) < 16 mg/ml and/or a reversibility to short-acting beta2-agonists (salbutamol) >/= 12% and 200 ml. Sensitisation to house dust mites, grass and birch pollens, cats, dogs and moulds was assessed by RAST and a specific immunoglobulin E (IgE) > 0.35 kU/l was considered as significant. Inflammatory phenotypes were subdivided between pauci-granulocytic (n = 309) (40%), eosinophilic (n = 311) (40%), neutrophilic (N = 134) (17%) and mixed-granulocytic (N = 18) (3%) asthmatics. Severe asthmatics (n = 118) were defined according to the American Thoracic Society (ATS 2000) criteria and compared with mild-to-moderate asthmatics (N = 654). RESULTS: The eosinophilic phenotype was associated with higher levels of total serum IgE compared with neutrophilic and pauci-granulocytic asthma (p < 0.001 for both). Sensitisation rate to dogs and cats was higher in eosinophilic asthmatics (31% and 37%, respectively, p < 0.01 both) compared with neutrophilic (18% and 23% respectively) and pauci-granulocytic asthmatics (20% and 24%, respectively), while sensitisation rate to house dust mites and moulds were rather similar between the groups (ranging from 33% to 40% and from 10% to 16%, respectively). Severe asthmatics had slightly increased total serum IgE compared with mild-to-moderate asthmatics (p < 0.05) without any difference in the sensitisation rate to common aeroallergens. CONCLUSION: Eosinophilic asthma exhibits higher total serum IgE and sensitisation rate towards animal dander while clinical severity, though also associated with higher total IgE, did not preferentially relate to any type of common aeroallergens.
Disciplines :
Cardiovascular & respiratory systems
Author, co-author :
Manise, Maïté ; Université de Liège > Département des sciences cliniques > Pneumologie - Allergologie
Bakayoko, B.
SCHLEICH, FLorence ; Centre Hospitalier Universitaire de Liège - CHU > Service de pneumologie - allergologie
Corhay, Jean-Louis ; Université de Liège > Département des sciences cliniques > Département des sciences cliniques
Louis, Renaud ; Université de Liège > Département des sciences cliniques > Pneumologie - Allergologie
Language :
English
Title :
IgE mediated sensitisation to aeroallergens in an asthmatic cohort: relationship with inflammatory phenotypes and disease severity.
Publication date :
July 2016
Journal title :
International Journal of Clinical Practice
ISSN :
1368-5031
eISSN :
1742-1241
Publisher :
Wiley-Blackwell, United States
Volume :
70
Issue :
7
Pages :
596-605
Peer reviewed :
Peer Reviewed verified by ORBi
Commentary :
(c) 2016 The Authors. International Journal of Clinical Practice Published by John Wiley & Sons Ltd.
Owen CE. Immunoglobulin E: role in asthma and allergic disease: lessons from the clinic. Pharmacol Ther 2007; 113: 121–33.
Levetin E, de Van WP. Environmental contributions to allergic disease. Curr Allergy Asthma Rep 2001; 1: 506–14.
Sunyer J, Jarvis D, Pekkanen J et al. Geographic variations in the effect of atopy on asthma in the European Community Respiratory Health Study. J Allergy Clin Immunol 2004; 114: 1033–9.
Pearce N, Pekkanen J, Beasley R. How much asthma is really attributable to atopy? Thorax 1999; 54: 268–72.
Omenaas E, Bakke P, Elsayed S, Hanoa R, Gulsvik A. Total and specific serum IgE levels in adults: relationship to sex, age and environmental factors. Clin Exp Allergy 1994; 24: 530–9.
Zureik M, Neukirch C, Leynaert B, Liard R, Bousquet J, Neukirch F. Sensitisation to airborne moulds and severity of asthma: cross sectional study from European Community respiratory health survey. BMJ 2002; 325: 411–4.
Wenzel SE. Phenotypes in asthma: useful guides for therapy, distinct biological processes, or both? Am J Respir Crit Care Med 2004; 170: 579–80.
Froidure A, Mouthuy J, Durham SR, Chanez P, Sibille Y, Pilette C. Asthma phenotypes and IgE responses. Eur Respir J 2016; 47: 304–19.
Patelis A, Janson C, Borres MP, Nordvall L, Alving K, Malinovschi A. Aeroallergen and food IgE sensitization and local and systemic inflammation in asthma. Allergy 2014; 69: 380–7.
van Amsterdam JG, Janssen NA, de Meer G et al. The relationship between exhaled nitric oxide and allergic sensitization in a random sample of school children. Clin Exp Allergy 2003; 33: 187–91.
Simpson A, Custovic A, Pipis S, Adisesh A, Faragher B, Woodcock A. Exhaled nitric oxide, sensitization, and exposure to allergens in patients with asthma who are not taking inhaled steroids. Am J Respir Crit Care Med 1999; 160: 45–9.
Schleich F, Brusselle G, Louis R et al. Heterogeneity of phenotypes in severe asthmatics. The Belgian Severe Asthma Registry (BSAR). Respir Med 2014; 108: 1723–32.
Proceedings of the ATS workshop on refractory asthma: current understanding, recommendations, and unanswered questions. American Thoracic Society. Am J Respir Crit Care Med 2000; 162: 2341–51.
Delvaux M, Henket M, Lau L et al. Nebulised salbutamol administered during sputum induction improves bronchoprotection in patients with asthma. Thorax 2004; 59: 111–5.
Manise M, Holtappels G, Van Crombruggen K, Schleich F, Bachert C, Louis R. Sputum IgE and cytokines in asthma: relationship with sputum cellular profile. PLoS ONE 2013; 8: e58388.
Fahy JV, Liu J, Wong H, Boushey HA. Cellular and biochemical analysis of induced sputum from asthmatic and from healthy subjects. Am Rev Respir Dis 1993; 147: 1126–31.
Schleich FN, Manise M, Sele J, Henket M, Seidel L, Louis R. Distribution of sputum cellular phenotype in a large asthma cohort: predicting factors for eosinophilic vs neutrophilic inflammation. BMC Pulm Med 2013; 13: 11.
Jo EJ, Kim MY, Lee SE et al. Eosinophilic airway inflammation and airway hyperresponsiveness according to aeroallergen sensitization pattern in patients with lower airway symptoms. Allergy Asthma Immunol Res 2014; 6: 39–46.
Schleich FN, Seidel L, Sele J et al. Exhaled nitric oxide thresholds associated with a sputum eosinophil count ≥3% in a cohort of unselected patients with asthma. Thorax 2010; 65: 1039–44.
Burney P, Malmberg E, Chinn S, Jarvis D, Luczynska C, Lai E. The distribution of total and specific serum IgE in the European Community Respiratory Health Survey. J Allergy Clin Immunol 1997; 99: 314–22.
Droste JH, Kerhof M, de Monchy JG, Schouten JP, Rijcken B. Association of skin test reactivity, specific IgE, total IgE, and eosinophils with nasal symptoms in a community-based population study. The Dutch ECRHS Group. J Allergy Clin Immunol 1996; 97: 922–32.
Jarvis D, Luczynska C, Chinn S et al. Change in prevalence of IgE sensitization and mean total IgE with age and cohort. J. Allergy Clin Immunol 2005; 116: 675–82.
Kerkhof M, Droste JH, de Monchy JG, Schouten JP, Rijcken B. Distribution of total serum IgE and specific IgE to common aeroallergens by sex and age, and their relationship to each other in a random sample of the Dutch general population aged 20-70 years. Dutch ECRHS Group, European Community Respiratory Health Study. Allergy 1996; 51: 770–6.
Chen W, Mempel M, Schober W, Behrendt H, Ring J. Gender difference, sex hormones, and immediate type hypersensitivity reactions. Allergy 2008; 63: 1418–27.
Jarvis D, Chinn S, Luczynska C, Burney P. The association of smoking with sensitization to common environmental allergens: results from the European Community Respiratory Health Survey. J Allergy Clin Immunol 1999; 104: 934–40.
Holgate ST, Djukanovic R, Casale T, Bousquet J. Anti-immunoglobulin E treatment with omalizumab in allergic diseases: an update on anti-inflammatory activity and clinical efficacy. Clin Exp Allergy 2005; 35: 408–16.
Garcia G, Magnan A, Chiron R et al. A proof-of-concept, randomized, controlled trial of omalizumab in patients with severe, difficult-to-control, nonatopic asthma. Chest 2013; 144: 411–9.