Department of Epidemiology and Biostatistics, School of Public Health, Faculty of Medicine, Imperial College London, London, UK.
J Natl Cancer Inst. 2011 Nov 2;103(21):1588-95. doi: 10.1093/jnci/djr361. Epub 2011 Oct 18.
Increased levels of serum immunoglobulin E (IgE) because of allergies have been inversely associated with risk of glioma in observational studies. Despite consistency across studies examining history of allergies and glioma, questions remain as to whether those are causal associations. An inverse association between serum IgE and risk of glioma was reported in a large case-control study, but reverse causality and treatment effects remain potential explanations for those findings.
We combined data from four prospective cohort studies and used a nested case-control design to examine the association between allergy and glioma. We included glioma case subjects who were confirmed from medical or pathology records or from death certificates, and with prediagnostic blood available. We matched three control subjects per case subject, and the final numbers for analyses were 169 case subjects and 520 control subjects. Total IgE, food allergen-specific IgE, and respiratory allergen-specific IgE levels were measured using a highly sensitive fluorescent assay. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using conditional logistic regression analysis. Stratified analyses were conducted by age and birth cohorts.
Borderline elevated total IgE levels (25-100 kU/L) showed a statistically significant inverse association with glioma (OR = 0.63, 95% CI = 0.42 to 0.93), but no association was noted between elevated IgE (>100 kU/L) and glioma (OR = 0.98, 95% CI = 0.61 to 1.56) compared with clinically normal IgE levels (<25 kU/L). The association between glioma and total IgE was consistent for both men and women. Non-statistically significant inverse associations were noted for elevated IgE levels among individuals born before year 1930 (OR = 0.67, 95% CI = 0.34 to 1.34) and when restricting analyses to highly fatal (deceased within 2 years of diagnosis) glioma case subjects (OR = 0.64, 95% CI = 0.34 to 1.19) compared with individuals with clinically normal IgE levels. No associations were observed for either food allergen-specific or respiratory allergen-specific IgE levels.
Overall, our prospective findings are consistent with recent retrospective studies and support an association between total IgE levels and glioma. However, this association requires further elucidation.
过敏导致的血清免疫球蛋白 E（IgE）水平升高与观察性研究中的胶质瘤风险呈负相关。尽管研究检查过敏史和胶质瘤之间的一致性，但仍存在疑问，即这些是否是因果关系。一项大型病例对照研究报告称，血清 IgE 与胶质瘤风险之间存在负相关，但反向因果关系和治疗效果仍然是这些发现的潜在解释。
我们结合了四项前瞻性队列研究的数据，并使用嵌套病例对照设计来研究过敏与胶质瘤之间的关系。我们纳入了从医疗或病理记录或死亡证明中确诊的胶质瘤病例患者，并且有预诊断血液可供使用。我们为每个病例患者匹配了三个对照患者，最终分析的病例患者数量为 169 例，对照患者数量为 520 例。使用高度敏感的荧光测定法测量总 IgE、食物过敏原特异性 IgE 和呼吸道过敏原特异性 IgE 水平。使用条件逻辑回归分析计算比值比（OR）和 95%置信区间（CI）。按年龄和出生队列进行分层分析。
边缘升高的总 IgE 水平（25-100 kU/L）与胶质瘤呈统计学显著负相关（OR=0.63，95%CI=0.42 至 0.93），但与临床正常 IgE 水平（<25 kU/L）相比，升高的 IgE（>100 kU/L）与胶质瘤之间没有关联（OR=0.98，95%CI=0.61 至 1.56）。这种与胶质瘤的关联在男性和女性中均一致。在出生于 1930 年以前的个体中（OR=0.67，95%CI=0.34 至 1.34）和当将分析仅限于高度致命性（诊断后 2 年内死亡）的胶质瘤病例患者时（OR=0.64，95%CI=0.34 至 1.19），升高的 IgE 水平与临床正常 IgE 水平的个体相比，非统计学显著的负相关。对于食物过敏原特异性或呼吸道过敏原特异性 IgE 水平，均未观察到关联。
总体而言，我们的前瞻性发现与最近的回顾性研究一致，支持总 IgE 水平与胶质瘤之间的关联。然而，这种关联需要进一步阐明。
