Cusack Ruth P, Senavonge Anchalee, Whetstone Christiane E, Alsaji Nadia, Howie Karen J, Stevens Caitlin, Wattie Jennifer, Wiltshire Lesley, Sehmi Roma, O'Byrne Paul M, Lima Hermenio, Gauvreau Gail M
Division of Respirology, Department of Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.
Division of Allergy, Immunology and Rheumatology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
J Allergy Clin Immunol Glob. 2025 Apr 24;4(3):100489. doi: 10.1016/j.jacig.2025.100489. eCollection 2025 Aug.
There are overlapping physiologic mechanisms between atopic dermatitis (AD) and asthma. However, predictive factors in development of airway hyperresponsiveness (AHR) in patients with AD are lacking.
This study aimed to determine factors predictive of AHR in patients with AD without a history of asthma.
We performed a cross-sectional study measuring methacholine AHR in 12 participants with AD without a history of asthma. The clinical data measured included AD onset and severity. In addition, skin biopsy sample scores, sputum eosinophil counts, blood eosinophil counts, total IgE levels, and spirometry findings were obtained and compared between subjects with and without methacholine AHR.
Three of 12 participants with AD had a positive methacholine challenge result. Compared with the participants with AD without AHR, the participants with AD and AHR had significantly higher Eczema Area and Severity Index (EASI) scores (21.5 ± 13.6 vs 3.5 ± 2.9) and blood eosinophil counts (330/μL ± 50 vs 130/μL ± 60) (both < .05), as well as higher sputum eosinophil counts (3.92% ± 4.6% vs 0.38% ± 0.44%) and total IgE levels (832.3 IU/mL ± 922 vs 109.8 IU/mL ± 79). A lower ratio of FEV value to forced vital capacity (FVC) value (% predicted) (ie, FEV/FVC [% predicted]) (80 ± 0.04 vs 86 ± 0.03) was also demonstrated in participants with AHR, with a negative correlation between FEV/FVC (% predicted) and blood eosinophil count ( = -0.66 [ = .02]) and EASI score ( = -0.56 [ = .058]).
In this small group study, our data show that patients with AD without asthma but with AHR have higher EASI scores, elevated eosinophil counts, and circulating IgE levels, along with lower values of FEV/FVC (% predicted).
特应性皮炎（AD）和哮喘之间存在重叠的生理机制。然而，AD患者气道高反应性（AHR）发生发展的预测因素尚缺乏。
本研究旨在确定无哮喘病史的AD患者中AHR的预测因素。
我们进行了一项横断面研究，测量了12例无哮喘病史的AD患者的乙酰甲胆碱AHR。测量的临床数据包括AD的发病情况和严重程度。此外，获取皮肤活检样本评分、痰嗜酸性粒细胞计数、血嗜酸性粒细胞计数、总IgE水平和肺量计检查结果，并在有和无乙酰甲胆碱AHR的受试者之间进行比较。
12例AD患者中有3例乙酰甲胆碱激发试验结果为阳性。与无AHR的AD患者相比，有AHR的AD患者的湿疹面积和严重程度指数（EASI）评分（21.5±13.6对3.5±2.9）和血嗜酸性粒细胞计数（330/μL±50对130/μL±60）均显著更高（均P<0.05），痰嗜酸性粒细胞计数（3.92%±4.6%对0.38%±0.44%）和总IgE水平（832.3 IU/mL±922对109.8 IU/mL±79）也更高。有AHR的受试者还表现出较低的第一秒用力呼气容积（FEV）与用力肺活量（FVC）比值（%预计值）（即FEV/FVC [%预计值]）（80±0.04对86±0.03），且FEV/FVC（%预计值）与血嗜酸性粒细胞计数（r=-0.66，P=0.02）和EASI评分（r=-0.56，P=0.058）呈负相关。
在这项小样本研究中，我们的数据表明，无哮喘但有AHR的AD患者具有更高的EASI评分、升高的嗜酸性粒细胞计数和循环IgE水平，以及更低的FEV/FVC（%预计值）。
