title: Identification of alpha-enolase as an autoantigen associated with severe asthma.
abstract: BACKGROUND
  Approximately 5% to 10% of patients with asthma have severe disease that is not effectively controlled by typical therapies. The existence of an autoantigen associated with severe asthma has been previously reported.
  
  
  OBJECTIVE
  We attempted to identify the autoantigen.
  
  
  METHODS
  Severe asthma was defined as patients having at least 1 severe asthmatic exacerbation requiring an emergency department visit or admission in the last year despite continuous typical therapies. Autoantibodies to airway epithelial cells (A549) were examined in sera from patients with severe asthma by immunoblot analysis.
  
  
  RESULTS
  IgG autoantibodies to the 52-kd airway epithelial cell antigen were detected in sera from 32 of 78 patients with severe asthma (41%), 9 of 83 patients with mild-to-moderate asthma (11%), and 2 of 58 healthy controls (3%; P < .001). The 52-kd autoantigen was identified as alpha-enolase by mass spectrometry analysis and confirmed by using recombinant human alpha-enolase protein. The detection of IgG autoantibodies to alpha-enolase was the most significant indicator for distinguishing severe asthma from mild-to-moderate asthma, even after adjusting for the effects of other clinical variables, including age, sex, atopy, and FEV(1) (adjusted odds ratio, 5.2; 95% CI, 2.1-12.9; P < .001).
  
  
  CONCLUSIONS
  The alpha-enolase was identified as an autoantigen associated with severe asthma. Further studies are needed to determine the significance of this autoantigen in severe asthma.
  
  
  CONCLUSIONS
  IgG autoantibodies to alpha-enolase could be a biological marker for severe asthma.
authors.affiliation: Department of Allergy and Rheumatology, Ajou University Hospital, Suwon 443-721, Korea. donghonahm@yahoo.co.kr
authors.forename: Dong-Ho
authors.initials: DH
authors.lastname: Nahm
authors.forename: Kwang-Hoon
authors.initials: KH
authors.lastname: Lee
authors.forename: Jee-Young
authors.initials: JY
authors.lastname: Shin
authors.forename: Young-Min
authors.initials: YM
authors.lastname: Ye
authors.forename: Yup
authors.initials: Y
authors.lastname: Kang
authors.forename: Hae-Sim
authors.initials: HS
authors.lastname: Park
mesh_terms: D000328:Adult; D001249:Asthma / Q000276:immunology*; D001323:Autoantibodies / Q000097:blood / Q000276:immunology; D001324:Autoantigens / Q000276:immunology*; D015415:Biomarkers / Q000097:blood; D002460:Cell Line; D004847:Epithelial Cells / Q000276:immunology; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood / Q000276:immunology*; D008297:Male; D010751:Phosphopyruvate Hydratase / Q000276:immunology*; D020545:Respiratory Mucosa / Q000276:immunology
chemical_list: D001323:Autoantibodies; D001324:Autoantigens; D015415:Biomarkers; D007074:Immunoglobulin G; D010751:Phosphopyruvate Hydratase