title: IgG Sensitization to Extracellular Vesicles in Indoor Dust Is Closely Associated With the Prevalence of Non-Eosinophilic Asthma, COPD, and Lung Cancer.
abstract: OBJECTIVE
  Recent experimental evidence shows that extracellular vesicles (EVs) in indoor dust induce neurtrophilic pulmonary inflammation, which is a characteristic pathology in patients with severe asthma and chronic obstructive pulmonary disease (COPD). In addition, COPD is known to be an important risk factor for lung cancer, irrespective of cigarette smoking. Here, we evaluated whether sensitization to indoor dust EVs is a risk for the development of asthma, COPD, or lung cancer.
  
  
  METHODS
  Serum IgG antibodies against dust EVs were measured in 90 healthy control subjects, 294 asthmatics, 242 COPD patients, and 325 lung cancer patients. Serum anti-dust EV IgG titers were considered high if they exceeded a 95 percentile value of the control subjects. Age-, gender-, and cigarette smoke-adjusted multiple logistic regression analyses were performed to determine odds ratios (ORs) for asthma, COPD, and lung cancer patients vs the control subjects.
  
  
  RESULTS
  In total, 4.4%, 13.6%, 29.3%, and 54.9% of the control, asthma, COPD, and lung cancer groups, respectively, had high serum anti-dust EV IgG titers. Adjusted multiple logistic regression revealed that sensitization to dust EVs (high serum anti-dust EV IgG titer) was an independent risk factor for asthma (adjusted OR, 3.3; 95% confidence interval [CI], 1.1-10.0), COPD (adjusted OR, 8.0; 95% CI, 2.0-32.5) and lung cancer (adjusted OR, 38.7; 95% CI, 10.4-144.3).
  
  
  CONCLUSIONS
  IgG sensitization to indoor dust EVs appears to be a major risk for the development of asthma, COPD, and lung cancer.
authors.affiliation: Asan Institute for Life Science and University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: You Sun
authors.initials: YS
authors.lastname: Kim
authors.affiliation: Institute of Convergence Medicine, Ewha Womans University Medical Center and Ewha Womans University School of Medicine, Seoul, Korea.
authors.forename: Jun Pyo
authors.initials: JP
authors.lastname: Choi
authors.affiliation: Institute of Convergence Medicine, Ewha Womans University Medical Center and Ewha Womans University School of Medicine, Seoul, Korea.
authors.forename: Min Hye
authors.initials: MH
authors.lastname: Kim
authors.affiliation: Institute of Convergence Medicine, Ewha Womans University Medical Center and Ewha Womans University School of Medicine, Seoul, Korea.
authors.forename: Han Ki
authors.initials: HK
authors.lastname: Park
authors.affiliation: Institute of Convergence Medicine, Ewha Womans University Medical Center and Ewha Womans University School of Medicine, Seoul, Korea.
authors.forename: Sejung
authors.initials: S
authors.lastname: Yang
authors.affiliation: Department of Internal Medicine, Dankook University College of Medicine, Cheonan, Korea.
authors.forename: Youn Seup
authors.initials: YS
authors.lastname: Kim
authors.affiliation: Department of Allergy and Clinical Immunology, Asan Medical Center, Seoul, Korea.
authors.forename: Tae Bum
authors.initials: TB
authors.lastname: Kim
authors.affiliation: Department of Allergy and Clinical Immunology, Asan Medical Center, Seoul, Korea.
authors.forename: You Sook
authors.initials: YS
authors.lastname: Cho
authors.affiliation: Department of Pulmonary and Critical Care Medicine, and Clinical Research Center for Chronic Obstructive Airway Disease, Asan Medical Center, Seoul, Korea. ymoh55@amc.seoul.kr.
authors.forename: Yeon Mok
authors.initials: YM
authors.lastname: Oh
authors.affiliation: Department of Internal Medicine, Dankook University College of Medicine, Cheonan, Korea. ykjee@dku,edu.
authors.forename: Young Koo
authors.initials: YK
authors.lastname: Jee
authors.affiliation: Department of Pulmonary and Critical Care Medicine, and Clinical Research Center for Chronic Obstructive Airway Disease, Asan Medical Center, Seoul, Korea.
authors.forename: Sang Do
authors.initials: SD
authors.lastname: Lee
authors.affiliation: Institute of Convergence Medicine, Ewha Womans University Medical Center and Ewha Womans University School of Medicine, Seoul, Korea. juinea@ewha.ac.kr.
authors.forename: Yoon Keun
authors.initials: YK
authors.lastname: Kim
keywords: COPD; Extracellular vesicles; IgG sensitization; asthma; indoor dust; lung cancer