New onset wheezing in an older male population: evidence of allergen sensitization in a longitudinal study. Results of the normative aging study.
BACKGROUND
Thirty-nine male subjects, with new-onset wheezing, were selected from participants in the Department of Veterans Affairs Normative Aging Study and compared with 74 age-matched controls. Wheezing was defined by responses to a standardized and regularly administered questionnaire. The subjects with wheezing had a reduced FEV1 compared with controls (p = 0.005), but most had values above 80% predicted. Current smoking was more common in subjects with wheezing (36.8% vs 8.11% in controls, p < 0.001). The mean age of both subjects and controls was 64 years.


METHODS
Allergen-specific IgE antibodies were measured, starting with sera at the time of the most recent questionnaire, and on the average 3.1, 7.6, and 12.3 years before that, with use of stored serum samples.


RESULTS
Total IgE did not differ significantly between the groups. IgE binding to dust mite antigen was detected in 13% to 15% of the subjects with wheezing compared with fewer than 7% of the controls over four time intervals (p = 0.014). IgE binding to cat and ragweed antigens did not differ significantly between groups. If current nonsmokers were analyzed separately, IgE binding to cat allergen was also slightly greater in subjects with wheezing compared with controls (p = 0.054). Sequential analysis of IgE antibody levels to mite antigen, over time, indicated that IgE antibody antedated the onset of wheezing.


CONCLUSIONS
New-onset wheezing in an older adult male population is significantly associated with allergic sensitization to dust mite. There was a borderline association with sensitization to cat in noncurrent smokers only. This supports the hypothesis that a subgroup may have allergic triggers to their symptoms.
Ohman
J L
JL
New England Medical Center, Tufts University, School of Medicine, Boston, MA 02111.
Sparrow
D
D
MacDonald
M R
MR
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000276:immunology*; D000485:Allergens / Q000276:immunology*; D000818:Animals; D006801:Humans; D007073:Immunoglobulin E / Q000032:analysis; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D008925:Mites / Q000276:immunology; D015656:Respiratory Mechanics; D012135:Respiratory Sounds / Q000276:immunology* / Q000503:physiopathology; D012907:Smoking; D011795:Surveys and Questionnaires
D000485:Allergens; D007073:Immunoglobulin E