Population-based study of multiplexed IgE sensitization in relation to asthma, exhaled nitric oxide, and bronchial responsiveness.
BACKGROUND
IgE sensitization is an important risk factor for the development of asthma.


OBJECTIVE
The aim of this study was to investigate the IgE antibody profile for a broad spectrum of allergen molecules in asthmatic patients.


METHODS
Participants from the European Community Respiratory Health Survey II (n=467) were tested with ImmunoCAP ISAC against 103 allergen molecules. The presence of bronchial hyperresponsiveness was measured with a methacholine challenge test and bronchial inflammation with fraction of exhaled nitric oxide (Feno).


RESULTS
A total of 38% of the controls and 72% of the asthmatic patients were sensitized against at least 1 of the allergen components (P<.0001). Asthma was independently related to having IgE antibodies against pollen (odds ratio=2.2) and perennial airway allergens (odds ratio=5.6), increased Feno was independently related to having IgE antibodies against food allergens and perennial allergens, while bronchial responsiveness was independently associated with having IgE antibodies against only perennial allergens. Sensitization to food allergens was related to asthma and increased Feno if IgE antibody against pollen allergens was present. Simultaneous sensitization to perennial, pollen, and food allergens involves the highest risk of asthma (odds ratio=18.3), bronchial inflammation, and responsiveness.


CONCLUSIONS
Feno, bronchial responsiveness, and the risk of asthma increase with multiple sensitizations to different allergen groups. We show for the first time that the presence of IgE antibodies against food allergens is independently associated with increased Feno and increases the risk of asthma in subjects with simultaneous sensitization to pollen allergens.
Department of Medical Sciences, Respiratory Medicine and Allergology, Uppsala University, Uppsala, Sweden. antonios.patelis@medsci.uu.se
Antonios
A
Patelis
Maria
M
Gunnbjörnsdottir
Andrei
A
Malinovschi
Per
P
Matsson
Annica
A
Onell
Marieann
M
Högman
Kjell
K
Alving
Christer
C
Janson
D000328:Adult; D000485:Allergens / Q000276:immunology; D001249:Asthma / Q000453:epidemiology / Q000276:immunology* / Q000503:physiopathology; D015415:Biomarkers / Q000378:metabolism; D016535:Bronchial Hyperreactivity / Q000453:epidemiology / Q000276:immunology* / Q000503:physiopathology; D001985:Bronchial Provocation Tests; D004777:Environment; D045853:Exhalation; D005260:Female; D005512:Food Hypersensitivity / Q000453:epidemiology / Q000276:immunology* / Q000503:physiopathology; D006306:Health Surveys; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000453:epidemiology / Q000276:immunology* / Q000503:physiopathology; D007073:Immunoglobulin E / Q000097:blood / Q000276:immunology*; D008297:Male; D016210:Methacholine Chloride / Q000276:immunology; D008875:Middle Aged; D009569:Nitric Oxide / Q000032:analysis; D011058:Pollen / Q000276:immunology; D012129:Respiratory Function Tests; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology
D000485:Allergens; D015415:Biomarkers; D016210:Methacholine Chloride; D009569:Nitric Oxide; D007073:Immunoglobulin E