title: The association between serum lead and total immunoglobulin E levels according to allergic sensitization.
abstract: BACKGROUND
  Results of several studies showed that blood lead concentration is positively associated with total immunoglobulin E (IgE) value. However, no study has investigated whether allergic sensitization could be responsible for the association between lead exposure and total IgE value.
  
  
  OBJECTIVE
  We investigated whether there was difference in the association between lead exposure and the total IgE value, depending on the presence or absence of Dermatophagoides farinae sensitization.
  
  
  METHODS
  We used data obtained from the Korea National Health and Nutrition Examination Survey. Serum levels of heavy metals, such as mercury, cadmium, and lead, were measured. Total and D. farinae specific IgE levels were measured, and the urinary cotinine level was investigated. Information about sex, age, body mass index, and household income were also obtained. We analyzed the association between serum lead and total IgE levels, after adjusting other variables.
  
  
  RESULTS
  In an multivariate linear regression analysis, only the serum concentration of lead among the three heavy metals was positively associated with logarithmic transformed total IgE (coefficient [B], 0.026 [95% confidence interval {CI}], 0.008-0.044). When we performed the same analysis on groups divided by allergic D. farinae sensitization status, we found a significant positive association between serum lead and logarithmic transformed total IgE values in subjects with D. farinae sensitization (B, 0.043 [95% CI, 0.014-0.071]) but not in subjects without D. farinae sensitization (B, 0.015 [95% CI, -0.008 to 0.039]).
  
  
  CONCLUSIONS
  A positive association between the serum lead and total IgE levels was statistically significant in subjects with D. farinae sensitization, which indicated that the immunologic effects of lead exposure may be greater in people with allergic sensitization.
authors.affiliation: 1Department of Otorhinolaryngology, Jeju National University School of Medicine, Jeju, Korea.
authors.forename: Jeong Hong
authors.initials: JH
authors.lastname: Kim
authors.forename: Jung Hyun
authors.initials: JH
authors.lastname: Chang
authors.forename: Hyun Seung
authors.initials: HS
authors.lastname: Choi
authors.forename: Hyun Jik
authors.initials: HJ
authors.lastname: Kim
authors.forename: Ju Wan
authors.initials: JW
authors.lastname: Kang
mesh_terms: D000328:Adult; D000818:Animals; D039741:Antigens, Dermatophagoides / Q000276:immunology; D003367:Cotinine / Q000652:urine; D040001:Dermatophagoides farinae; D004781:Environmental Exposure / Q000009:adverse effects; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000276:immunology*; D007114:Immunization; D007073:Immunoglobulin E / Q000097:blood / Q000276:immunology*; D007854:Lead / Q000009:adverse effects / Q000097:blood / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D056910:Republic of Korea
chemical_list: D039741:Antigens, Dermatophagoides; D007854:Lead; D007073:Immunoglobulin E; D003367:Cotinine