title: The risk of respiratory symptoms on allergen exposure increases with increasing specific IgE levels.
abstract: The relation between IgE sensitization and allergic respiratory symptoms has usually been evaluated by dichotomizing specific IgE levels. The aim of this study was to evaluate the association between specific IgE levels and risk of symptoms on allergen-related exposure, with special reference to allergen-related asthma-rhinitis comorbidity.
  
  
  
  We considered 6391 subjects enrolled within the European Community Respiratory Health Survey 2, having information on cat/grass/D. pteronyssinus IgE levels and symptoms on exposure to animals/pollen/dust. The risk of oculonasal/asthmalike/both symptoms was evaluated by a multinomial logistic model.
  
  
  
  A clear positive association was observed between specific IgE levels to cat/grass/mite and the risk of symptoms on each allergen-related exposure (test for trend with P < 0.001). This trend was particularly pronounced when considering the coexistence of asthmalike and oculonasal symptoms. Compared to non-sensitized subjects, subjects with specific IgE to cat >= 3.5 kU/l presented relative risk ratios of 11.4 (95% CI 6.7-19.2), 18.8 (8.2-42.8), and 55.3 (30.5-100.2) when considering, respectively, only oculonasal symptoms, only asthmalike symptoms, or both. A similar pattern was observed when considering specific IgE to grass/mite and symptoms on exposure to pollen/dust. Also the proportion of people using inhaled medicines or visiting a general practitioner for breathing problems in the previous year increased with increasing sum of specific IgE to cat/grass/mite.
  
  
  
  Specific IgE level is the most important predictor of allergen-related symptoms. The risk of both oculonasal/asthmalike symptoms increases with specific IgE levels, suggesting that specific IgE contributes to the 'united airways disease'.
authors.affiliation: Unit of Occupational Medicine, University Hospital of Verona, Verona, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Olivieri
authors.affiliation: Helmholtz Zentrum München - German Research Center for Environmental Health, Institute of Epidemiology I, Neuherberg, Germany.|Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital Munich, Ludwig Maximilians University Munich, Munich, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Heinrich
authors.affiliation: Department of Public Health, Section of Environment, Occupation and Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark.
authors.forename: V
authors.initials: V
authors.lastname: Schlünssen
authors.affiliation: Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.|IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.|Universitat Pompeu Fabra (UPF), Barcelona, Spain.|CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.
authors.forename: J M
authors.initials: JM
authors.lastname: Antó
authors.affiliation: Department of Public Health and Clinical Medicine, Division of Occupational and Environmental Medicine, Umea University, Umea, Sweden.
authors.forename: B
authors.initials: B
authors.lastname: Forsberg
authors.affiliation: Department of Medical Sciences/Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden.
authors.forename: C
authors.initials: C
authors.lastname: Janson
authors.affiliation: Inserm, UMR 1152, Pathophysiology and Epidemiology of Respiratory Diseases, Paris, France.|University Paris Diderot Paris 7, UMR 1152, Paris, France.
authors.forename: B
authors.initials: B
authors.lastname: Leynaert
authors.affiliation: Department of Medical Science/Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden.
authors.forename: D
authors.initials: D
authors.lastname: Norback
authors.affiliation: Department of Public Health, Section of Environment, Occupation and Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark.
authors.forename: T
authors.initials: T
authors.lastname: Sigsgaard
authors.affiliation: Centre for International Health, University of Bergen, Bergen, Norway.|Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway.
authors.forename: C
authors.initials: C
authors.lastname: Svanes
authors.affiliation: Helmholtz Zentrum München - German Research Center for Environmental Health, Institute of Epidemiology I, Neuherberg, Germany.|Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.|Universitat Pompeu Fabra (UPF), Barcelona, Spain.|CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Tischer
authors.affiliation: Unit of Biostatistics and Clinical Epidemiology, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Villani
authors.affiliation: Respiratory Epidemiology and Public Health Group, Imperial College London, London, United Kingdom.|MRC-PHE Centre for Environment and Health, Imperial College, London, United Kingdom.
authors.forename: D
authors.initials: D
authors.lastname: Jarvis
authors.affiliation: Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Verlato
mesh_terms: D000328:Adult; D000485:Allergens / Q000276:immunology*; D000818:Animals; D000918:Antibody Specificity / Q000276:immunology; D004781:Environmental Exposure; D005260:Female; D006801:Humans; D007114:Immunization; D007073:Immunoglobulin E / Q000097:blood / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011159:Population Surveillance; D012130:Respiratory Hypersensitivity / Q000175:diagnosis* / Q000276:immunology*; D018570:Risk Assessment; D012307:Risk Factors; D063189:Symptom Assessment; D055815:Young Adult
chemical_list: D000485:Allergens; D007073:Immunoglobulin E
keywords: allergen exposure; allergic respiratory symptoms; specific IgE levels; united airways disease