Takahashi Daisuke, Hizawa Nobuyuki, Maeda Yukiko, Fukui Yoshinobu, Nishimura Masaharu
First Department of Medicine, School of Medicine, Hokkaido University.
Arerugi. 2004 Oct;53(10):1071-8.
An increase in the prevalence of asthma does not seem to be comparable to the dramatic increase of atopy for the last two decades in Japan. Atopy is considered an important risk factor for asthma. It is, however, suggested that asthma itself may be responsible for the increased overall IgE responsiveness. We examined the significance of IgE responsiveness in asthma.
We studied 265 healthy controls and 275 patients with asthma. Total serum IgE levels and levels of antigen-specific IgE antibody to mite (D. farinae), cat, dog, timothy, and Candida spp. were determined. We defined atopy by positive RAST (>0.35UA/ml) or MAST scores (>1.0 lumicount) to at least one inhaled allergen. Frequencies of atopic subjects and frequencies of subjects sensitized to each allergen in atopic subjects were compared between the asthmatics and controls. All comparisons were made in younger (<41 yrs) and older (> = 41 yrs) groups, separately.
In younger non-asthmatics, 76.5% (104/136) were atopic. The frequency of atopy was significantly higher in asthmatic subjects compared to non-asthmatics in both younger and older groups. In atopic subjects, older asthmatics were sensitized to animals more frequently than older controls. Although the frequency of subjects sensitized to mite did not differ between asthmatics and controls both in younger and older atopic subjects, asthmatics sensitized to mite had higher titers of specific IgE antibody to mite compared to those of controls sensitized to mite. Even non-atopic asthmatics had higher levels of total IgE compared to non-atopic controls.
Our data may indicate that sensitization to animals and severer sensitizations to mite are risk factors for asthma. However, given the high prevalence of atopy in younger healthy controls, and increased levels of total serum IgE even in non-atopic asthmatics, our findings may reflect the increased overall IgE responsiveness that is inherent in asthma.
在日本，过去二十年中哮喘患病率的增加似乎与特应性疾病的急剧增加不具有可比性。特应性被认为是哮喘的一个重要危险因素。然而，有研究表明哮喘本身可能是导致总体IgE反应性增加的原因。我们研究了IgE反应性在哮喘中的意义。
我们研究了265名健康对照者和275名哮喘患者。测定了血清总IgE水平以及针对螨（粉尘螨）、猫、狗、梯牧草和念珠菌属的抗原特异性IgE抗体水平。我们将对至少一种吸入性过敏原的RAST阳性（>0.35UA/ml）或MAST评分（>1.0 lumicount）定义为特应性。比较了哮喘患者和对照者中特应性受试者的频率以及特应性受试者中对每种过敏原致敏的受试者频率。所有比较均分别在较年轻（<41岁）和较年长（>=41岁）的组中进行。
在较年轻的非哮喘患者中，76.5%（104/136）为特应性。在较年轻和较年长的组中，哮喘患者的特应性频率均显著高于非哮喘患者。在特应性受试者中，年长的哮喘患者对动物致敏的频率高于年长的对照者。尽管在较年轻和较年长的特应性受试者中，哮喘患者和对照者对螨致敏的频率没有差异，但与对螨致敏的对照者相比，对螨致敏的哮喘患者具有更高滴度的螨特异性IgE抗体。即使是非特应性哮喘患者，其总IgE水平也高于非特应性对照者。
我们的数据可能表明对动物致敏和对螨的更严重致敏是哮喘的危险因素。然而，鉴于较年轻健康对照者中特应性的高患病率，以及即使是非特应性哮喘患者血清总IgE水平也升高，我们的发现可能反映了哮喘固有的总体IgE反应性增加。
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