诱导痰中的总免疫球蛋白E水平反映哮喘控制状态。
Total immunoglobulin E levels in induced sputum reflect asthma control status.
作者信息
Chen Wenhui, Liu Xiaofang, Yao Xiujuan, Hao Yanghe, Zhou Zhuo, Wang Chengshuo, Wang Ming, Zhang Luo
机构信息
Department of Otolaryngology, Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, China.
Beijing Key Laboratory of New Medicine and Diagnostic Technology Research for Nasal Diseases, Beijing Laboratory of Allergic Diseases, Beijing Institute of Otolaryngology, Beijing, China.
出版信息
Clin Transl Allergy. 2025 Jan;15(1):e70021. doi: 10.1002/clt2.70021.
BACKGROUND
Most patients with severe asthma are sensitized to at least one allergen. Whether local immunoglobulin E (IgE) in induced sputum reflects asthma control status has not been investigated.
METHODS
Patients with asthma were classified as well controlled, partly controlled, and uncontrolled asthma (UCA) according to Global Initiative for Asthma 2022 guidelines. Lung function and fractional exhaled nitric oxide (FeNO) were evaluated. Induced sputum was collected and total IgE and Phadiatop (IgE to common inhalant allergens) measurements were performed. General clinical characteristics and pulmonary inflammation indicators were analyzed between the three groups of asthmatic patients. Univariate and multifactor ordinal logistic regression were used to model the relationship between pulmonary inflammation indicators and asthma control status. The ability of sputum total IgE in identifying different levels of asthma control was assessed by receiver operating characteristic curve (ROC).
RESULTS
Patients with UCA had worse lung function and airway inflammation as indicated by lower levels of forced expiratory volume in 1s (FEV1)%pred, FEV1/FVC, MEF75%pred, MEF50%pred and MEF25%pred, and higher levels of FeNO and sputum eosinophil% compared with the WCA group. In addition, higher levels of total sputum IgE and Phadiatop were found in patients with UCA than in patients with WCA and PCA. Univariate and multifactor ordinal logistic regression analysis indicated that sputum total IgE was the unique significant risk factor for poor asthma control (adjusted odds ratio = 6.25; 95% CI, 1.07-36.55; p < 0.05) among pulmonary inflammation indicators including different indices of pulmonary function test, sputum IgE and FeNO. Sputum total IgE levels showed a significant correlation with asthma control scores (r = 0.53, p < 0.001). Moreover, ROC analysis showed that the predictive value of sputum total IgE for patients with UCA was 0.82 (95% CI, 0.74-0.9).
CONCLUSION
Sputum total IgE reflects levels of asthma control, and can be used as an indicator of UCA.
背景
大多数重度哮喘患者对至少一种变应原敏感。诱导痰中的局部免疫球蛋白E（IgE）是否反映哮喘控制状态尚未得到研究。
方法
根据《2022年全球哮喘防治创议》指南，将哮喘患者分为哮喘控制良好、部分控制和未控制（UCA）。评估肺功能和呼出一氧化氮分数（FeNO）。收集诱导痰并检测总IgE和Phadiatop（针对常见吸入性变应原的IgE）。分析三组哮喘患者的一般临床特征和肺部炎症指标。采用单因素和多因素有序逻辑回归分析肺部炎症指标与哮喘控制状态之间的关系。通过受试者工作特征曲线（ROC）评估痰总IgE识别不同哮喘控制水平的能力。
结果
与哮喘控制良好（WCA）组相比，UCA患者的肺功能和气道炎症更差，表现为第1秒用力呼气容积（FEV1）%预计值、FEV1/FVC、最大呼气流量75%预计值（MEF75%pred）、最大呼气流量50%预计值（MEF50%pred）和最大呼气流量25%预计值（MEF25%pred）水平较低，以及FeNO和痰嗜酸性粒细胞%水平较高。此外，UCA患者的痰总IgE和Phadiatop水平高于WCA和部分控制哮喘（PCA）患者。单因素和多因素有序逻辑回归分析表明，在包括不同肺功能测试指标、痰IgE和FeNO在内的肺部炎症指标中，痰总IgE是哮喘控制不佳的唯一显著危险因素（调整比值比=6.25；95%置信区间，1.07-36.55；p<0.05）。痰总IgE水平与哮喘控制评分显著相关（r=0.53，p<
0.001）。此外，ROC分析显示，痰总IgE对UCA患者的预测价值为0.82（95%置信区间，0.74-0.9）。
结论
痰总IgE反映哮喘控制水平，可作为UCA的一个指标。
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