title: Prevalence of IgE-mediated allergy and evaluation of Th1/Th2 cytokine profiles in patients with severe bronchial asthma.
abstract: BACKGROUND
  The pathogenesis of asthma remains unclear, especially in cases of the severe disease.
  
  
  OBJECTIVE
  To explore IgE-mediated inhalant sensitization in severe asthma compared with a group of patients with chronic mild disease and evaluate the Th1/Th2 cytokine profiles in asthma by different disease severities.
  
  
  METHODS
  One hundred and fifty-four patients (age range: 28-69) with severe chronic asthma (study group) and 141 patients with chronic mild disease (control group) diagnosed according to GINA criteria were included in the study. Seventy-eight severe asthmatics and 43 subjects with mild disease were randomly selected for serum Th1/Th2 cytokine level estimation. The groups were matched in terms of age and atopy features (skin prick tests, specific and total serum IgE).
  
  
  RESULTS
  Positive skin tests to at least one allergen were observed with comparable frequencies. Sensitization to Dermatophagoides pteronyssinus was the most prevalent positive result in both groups. An earlier onset of asthma together with a greater number of exacerbations was noted in severe asthmatics compared to patients with mild disease. Serum levels of interleukin 4 and 2 (IL-4 and IL-2) were detectable only in severe asthmatics irrespective of atopy features. The levels of interferon γ and tumour necrosis factor α were undetectable in both groups. IL-10 and IL-5 were detected in the serum of only 7 and 12 severe asthmatics, respectively.
  
  
  CONCLUSIONS
  The serum level of IL-2 and IL-4 could be perceived as a marker of severe asthma. Neither IL-2 nor IL-4 levels in the serum could differentiate allergic and non-allergic asthma.
authors.affiliation: Chair and Clinical Department of Internal Diseases, Allergology and Clinical Immunology, Medical University of Silesia, Katowice, Poland. Head of the Department: Prof. Barbara Rogala MD, PhD.
authors.forename: Barbara
authors.initials: B
authors.lastname: Rogala
authors.affiliation: Chair and Clinical Department of Internal Medicine, Dermatology and Allergology, Medical University of Silesia, Zabrze, Poland. Head of the Department: Prof. Jerzy Jarzab MD, PhD.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Bozek
authors.affiliation: Chair and Clinical Department of Internal Diseases, Allergology and Clinical Immunology, Medical University of Silesia, Katowice, Poland. Head of the Department: Prof. Barbara Rogala MD, PhD.
authors.forename: Joanna
authors.initials: J
authors.lastname: Gluck
authors.affiliation: Chair and Clinical Department of Internal Medicine, Dermatology and Allergology, Medical University of Silesia, Zabrze, Poland. Head of the Department: Prof. Jerzy Jarzab MD, PhD.
authors.forename: Jerzy
authors.initials: J
authors.lastname: Jarzab
keywords: Th1/Th2; immunoglobulin E; severe asthma