Women's and Children's Health, Uppsala University, Uppsala, Sweden.
Medical Sciences, Uppsala University, Uppsala, Sweden.
Clin Exp Allergy. 2018 Jun;48(6):722-730. doi: 10.1111/cea.13103. Epub 2018 Feb 27.
Atopic asthma is associated with elevated type-2 biomarkers such as fraction of exhaled nitric oxide (FeNO) and blood eosinophil (B-Eos) count. However, increased type 2 markers have also been reported in traditionally defined non-atopic asthma.
To determine a clinically useful level of IgE sensitization for ruling out type 2 asthma.
Asthmatics (N = 408; age 10-35 years) were analysed using the multi-allergen tests Phadiatop and fx5 (ImmunoCAP). Subjects were grouped based on IgE-antibody concentrations: ≥0.35 kU /L for at least one test (n = 326) or <0.35 kU /L for both tests (n = 82). Τhe latter group was subsequently divided into 2 groups: IgE 0.10-0.34 kU /L (n = 34) and IgE < 0.10 kU /L (n = 48). The relationships between type 2 biomarkers, and inadequate asthma control (ACT < 20), reduced lung function (FEV < 80%), recent asthma attacks and airway hyperresponsiveness (AHR) to methacholine were determined.
In univariate analyses, at least one type 2 marker related to each asthma outcome in subjects with IgE ≥0.35 kU /L. In subjects with IgE 0.10-0.34 kU /L, elevated FeNO related to reduced lung function (P = .008) and B-Eos to AHR (P = .03). No associations were found in subjects with IgE < 0.10 kU /L. In multivariate analysis, a relationship between FeNO and reduced lung function remained in subjects with IgE < 0.35 kU /L (P = .03).
Clinically relevant elevation of type 2 biomarkers was seen in young asthmatics with IgE antibodies <0.35 kU /L, but not those with IgE < 0.10 kU /L. It seems possible to define non-type 2 asthma through sensitive IgE-antibody measurement.
特应性哮喘与 2 型生物标志物（如呼出气一氧化氮分数[FeNO]和血嗜酸性粒细胞计数[B-Eos]）升高有关。然而，在传统定义的非特应性哮喘中也有报道称 2 型标志物增加。
确定 IgE 致敏的临床有用水平，以排除 2 型哮喘。
对 408 名（年龄 10-35 岁）哮喘患者进行多过敏原测试 Phadiatop 和 fx5（ImmunoCAP）分析。根据 IgE 抗体浓度将受试者分为两组：至少一种检测≥0.35 kU / L（n = 326）或两种检测均<0.35 kU / L（n = 82）。后者进一步分为两组：IgE 0.10-0.34 kU / L（n = 34）和 IgE<0.10 kU / L（n = 48）。确定 2 型生物标志物与哮喘控制不足（ACT<20）、肺功能降低（FEV<80%）、近期哮喘发作和乙酰甲胆碱气道高反应性（AHR）之间的关系。
在单变量分析中，在 IgE≥0.35 kU / L 的受试者中，至少有一种 2 型标志物与每种哮喘结局相关。在 IgE 0.10-0.34 kU / L 的受试者中，FeNO 升高与肺功能降低（P=0.008）和 B-Eos 与 AHR（P=0.03）相关。在 IgE<0.10 kU / L 的受试者中未发现相关性。在多变量分析中，在 IgE<0.35 kU / L 的受试者中，FeNO 与肺功能降低之间仍存在相关性（P=0.03）。
在 IgE 抗体<0.35 kU / L 的年轻哮喘患者中观察到与 2 型生物标志物相关的临床显著升高，但在 IgE<0.10 kU / L 的患者中未观察到。通过敏感的 IgE 抗体测量来定义非 2 型哮喘似乎是可行的。
