Airway hyperresponsiveness is associated with total serum immunoglobulin E and sensitization to aeroallergens in Korean adolescents.
BACKGROUND
Allergen sensitization and airway hyperresponsiveness (AHR) are the most important characteristics of bronchial asthma and their correlation has been speculated.


OBJECTIVE
We attempted to investigate the relationship between sensitization to allergens and AHR to methacholine in Korean high school students.


METHODS
A questionnaire survey, methacholine bronchial provocation tests, and skin-prick tests for 16 major allergens were performed on 724 students. The mean age of participants was 15.79 ± 0.40 years old. Serum total immunoglobulin E (IgE) and the fraction of blood eosinophils were measured.


RESULTS
AHR (PC(20) < 16 mg/ml) was present in 12.3%. Log total IgE was higher in AHR-positive group than negative group (4.22 ± 1.55, 3.70 ± 1.33, P = 0.001). Three hundred eighty-four students (53.0%) were sensitized to more than one allergen, and among them Dermatophagoides pteronyssinus (Der p, 295 students, 40.7%) and Dermatophagoides farinae (Der f, 301 students, 41.6%) were most common. The risk of AHR development was high in the group who had sensitization to one allergen (adjusted odds ratio [aOR] = 1.97, 95% confidence interval [CI]: 1.13-3.44, P = 0.018) and to more than two allergens (aOR = 2.94, 95% CI: 1.32-6.57, P = 0.009). Among the specific allergens, AHR was developed in those who were sensitized to Der f (aOR = 1.73, 95% CI: 1.04-2.86, P = 0.033), dog dander (aOR = 3.97, 95% CI: 1.67-9.51, P = 0.002), and Alternaria (aOR = 3.19, 95% CI: 1.24-6.41, P = 0.016). In the groups with high IgE (>300 IU/ml) and high eosinophil fraction (>4%), AHR was more developed than groups who were low in each (aOR = 2.73, 95% CI: 1.15-6.51, P = 0.023; aOR = 10.82, 95% CI: 3.33-35.08, P = 0.001).


CONCLUSIONS
The risk of AHR development was closely linked with allergen sensitization itself, and the number or types of sensitized allergens such as indoor and fungal allergens in Korean young adolescents.
Kim
Bong-Seong
BS
Department of Pediatrics, Childhood Asthma Atopy Center, University of Ulsan College of Medicine, Seoul, Korea.
Jin
Hyun-Seung
HS
Kim
Hyo-Bin
HB
Lee
So-Yeon
SY
Kim
Ja-Hyung
JH
Kwon
Ji-Won
JW
Kim
Byoung-Ju
BJ
Yu
Jinho
J
Yoo
Sunmi
S
Hong
Soo-Jong
SJ
D000293:Adolescent; D000485:Allergens / Q000276:immunology*; D016535:Bronchial Hyperreactivity / Q000175:diagnosis*; D001985:Bronchial Provocation Tests; D016085:Bronchoconstrictor Agents; D002452:Cell Count; D004804:Eosinophils / Q000166:cytology; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood*; D008297:Male; D016210:Methacholine Chloride; D056910:Republic of Korea; D012882:Skin Tests; D011795:Surveys and Questionnaires
D000485:Allergens; D016085:Bronchoconstrictor Agents; D016210:Methacholine Chloride; D007073:Immunoglobulin E