title: The prevalence of increased serum IgE and Aspergillus sensitization in patients with COPD and their association with symptoms and lung function.
abstract: BACKGROUND
  Allergy and Aspergillus hypersensitivity (AH) were shown to be associated with severe symptoms or worse lung function in COPD patients. The prevalence of elevated total IgE (T-IgE) and its association with clinical symptoms and lung function in COPD have not been studied. The prevalence of AH and its correlation with clinical characteristics in a COPD cohort of larger sample size is also lacking.
  
  
  METHODS
  273 patients with COPD were evaluated by respiratory symptoms, blood test, chest HRCT, lung function, serum detection of T-IgE and Aspergillus specific IgE. Patients with T-IgE ≥ 1000 KU/L were further investigated for allergic bronchopulmonary aspergillosis (ABPA).
  
  
  RESULTS
  The prevalence of elevated T-IgE and AH in patients with COPD was 47.3% and 15.0%, respectively. Eight patients (2.9%) met the diagnostic criteria for ABPA. Compared with the normal T-IgE group, patients with elevated T-IgE had a longer history of dyspnea (p < 0.01), an earlier onset of dyspnea after chronic cough/expectoration (p < 0.01), and were more likely to wheeze (p < 0.01). They also showed worse lung functions and more severe GOLD staging (p < 0.01). Analysis of the clinical data in male patients with smoking as the risk factor showed the same results. To evaluate the clinical characteristics of COPD with AH, patients with elevated T-IgE were further divided into subgroups with and without AH. When compared with the normal T-IgE group, both the two subgroups showed longer history of dyspnea (p < 0.01), an earlier onset of dyspnea (p < 0.01) and a worse status of lung function (p < 0.05). Correlation analysis demonstrated that T-IgE was correlated positively with the time length of dyspnea (r = 0.401, p < 0.001), and the ratio of duration of dyspnea to that of chronic cough/expectoration (r = 0.59, p < 0.001), but negatively with FEV1/FVC% (r = -0.194, p = 0.001), and FEV1%predicted (r = -0.219, p < 0.001).
  
  
  CONCLUSIONS
  There was a high prevalence of elevated serum T-IgE and AH in patients with COPD. Serum T-IgE level was correlated with symptoms such as dyspnea and impairment of lung function. Allergens other than Aspergillus may have similar effects on disease expression or progression of COPD.
authors.forename: Jianmin
authors.initials: J
authors.lastname: Jin
authors.forename: Xiaofang
authors.initials: X
authors.lastname: Liu
authors.affiliation: Department of Respiratory Medicine, Beijing Tongren Hospital, Capital Medical University, Beijing, China. suny@ccmu.edu.cn.
authors.forename: Yongchang
authors.initials: Y
authors.lastname: Sun
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001230:Aspergillus; D015415:Biomarkers / Q000097:blood; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000097:blood / Q000453:epidemiology / Q000382:microbiology; D007073:Immunoglobulin E / Q000097:blood*; D008168:Lung / Q000378:metabolism / Q000382:microbiology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D029424:Pulmonary Disease, Chronic Obstructive / Q000097:blood* / Q000453:epidemiology / Q000382:microbiology*
chemical_list: D015415:Biomarkers; D007073:Immunoglobulin E