成年哮喘患者总IgE水平的纵向升高：与哮喘控制不佳相关。
Longitudinal increase in total IgE levels in patients with adult asthma: an association with poor asthma control.
作者信息
Tanaka Akihiko, Jinno Megumi, Hirai Kuniaki, Miyata Yoshito, Mizuma Hiroko, Yamaguchi Munehiro, Ohta Shin, Watanabe Yoshio, Yamamoto Mayumi, Suzuki Shintaro, Yokoe Takuya, Adachi Mitsuru, Sagara Hironori
机构信息
Department of Internal Medicine, Division of Allergy and Respiratory Medicine, Showa University, School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8666, Japan.
Department of Allergy, Sanno Hospital, Clinical Research Centers for Medicine, International University of Health and Welfare, Tokyo, Japan.
出版信息
Respir Res. 2014 Nov 20;15(1):144. doi: 10.1186/s12931-014-0144-8.
BACKGROUND
Immunoglobulin (Ig) E is well-known to play a critical role in allergic diseases. We investigated the association between longitudinal change in total IgE level and the asthma control in patients with adult asthma.
METHODS
For this retrospective study, 154 patients with asthma aged 21-82 years were recruited from the allergy and pulmonary units of the Showa University Hospital. Data on longitudinal changes in IgE over the preceding 10 years were collected and logarithmically transformed. Associations between longitudinal change in IgE and clinical characteristics including asthma control test (ACT) score, asthma control, pulmonary function test, and antigen specific IgE, were assessed.
RESULTS
Patients with increased IgE tended to have significantly higher mean age, more episodes of acute exacerbation within a year, lower ACT scores, and used oral corticosteroids more frequently than those with decreased or unchanged IgE. The prevalence of uncontrolled asthma was higher in patients with increased IgE than in those with decreased or unchanged IgE. Mean %FEV1 and FEV1% were lower in patients with increased IgE than in those with decreased or unchanged IgE. Moreover, the prevalence of Aspergillus-specific IgE was higher in patients with increased IgE than in those with decreased or unchanged IgE.
CONCLUSIONS
These data suggest that a longitudinal increase in total IgE is associated with both poor asthma control and Aspergillus-specific IgE in patients with adult asthma.
背景
免疫球蛋白（Ig）E在过敏性疾病中起着关键作用，这是众所周知的。我们研究了成年哮喘患者总IgE水平的纵向变化与哮喘控制之间的关联。
方法
在这项回顾性研究中，从昭和大学医院的过敏科和肺病科招募了154名年龄在21至82岁之间的哮喘患者。收集了过去10年中IgE纵向变化的数据，并进行对数转换。评估了IgE纵向变化与包括哮喘控制测试（ACT）评分、哮喘控制、肺功能测试和抗原特异性IgE在内的临床特征之间的关联。
结果
与IgE降低或不变的患者相比，IgE升高的患者往往平均年龄显著更高，一年内急性加重发作次数更多，ACT评分更低，且更频繁地使用口服糖皮质激素。IgE升高的患者中未控制哮喘的患病率高于IgE降低或不变的患者。IgE升高的患者的平均FEV1%和FEV1占预计值百分比低于IgE降低或不变的患者。此外，IgE升高的患者中曲霉菌特异性IgE的患病率高于IgE降低或不变的患者。
结论
这些数据表明，成年哮喘患者总IgE的纵向升高与哮喘控制不佳和曲霉菌特异性IgE均相关。
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