Tobacco as an allergen in bronchial disease.
BACKGROUND
Skin testing and sera measurements have verified the existence of tobacco specific IgE. However, the few published studies on this matter report conflicting results concerning their clinical significance.


OBJECTIVE
To verify if a specific clinical allergenic response against tobacco might be possible in allergenic and nonallergenic bronchial diseases.


METHODS
We performed a cross-sectional observational case-control analysis on 180 patients with asthma, chronic obstructive pulmonary disease (COPD), and bronchial carcinoma and controls who were randomly chosen. Skin prick tests and serum specific IgE to tobacco and related allergens, bronchial challenge with cigarettes and tobacco extract, patch tests with tobacco and nicotine, sodium dodecyl sulfate-polyacrylamide gel electrophoresis immunoblotting, and Enzyme AllergoSorbent Test (EAST) inhibition were performed.


RESULTS
Twenty-eight patients had positive tobacco skin prick test results. The association among positive skin prick test results, IgE, and bronchial challenge was strong (P < .001). Tobacco sensitivity was higher in patients with pollen asthma than in patients with COPD and carcinoma and negative in patients with intrinsic asthma and controls. A positive bronchial challenge result was related to the length of habit (P < .001) and the tobacco index in patients who had stopped smoking (P < .001). Delayed bronchial and patch response was more common in patients with COPD (P < .001). Tobacco IgE response (EAST) was related to sensitivity to Lolium perenne (rye grass) pollen (P < .001) but not to other vegetables that belong to the Solanaceae family. EAST inhibition showed cross-reactivity between tobacco and Lolium pollen.


CONCLUSIONS
Tobacco may be responsible for a specific IgE response. Patients with pollen asthma were those with more positive responses to tobacco due to cross-reactivity between Lolium and tobacco allergens.
Armentia
Alicia
A
Sección de Alergia del Hospital Universitario Río Hortega, Valladolid, Spain. aliciaarmentia@terra.es
Bartolomé
Borja
B
Puyo
Miguel
M
Paredes
Carmen
C
Calderón
Silvia
S
Asensio
Teresa
T
del Villar
Valentín
V
D000293:Adolescent; D000328:Adult; D000485:Allergens; D001249:Asthma / Q000097:blood / Q000276:immunology*; D001984:Bronchial Neoplasms / Q000097:blood / Q000276:immunology*; D001985:Bronchial Provocation Tests; D016022:Case-Control Studies; D003429:Cross Reactions; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood / Q000276:immunology; D008297:Male; D008875:Middle Aged; D011058:Pollen; D029424:Pulmonary Disease, Chronic Obstructive / Q000097:blood / Q000276:immunology; D012882:Skin Tests; D014026:Nicotiana
D000485:Allergens; D007073:Immunoglobulin E