Wu Yudan, Wu Hanxi, Yao Li, Zhu Jiayi, Tao Ailin, Li Linmei
The Second Affiliated Hospital, Guangdong Provincial Key Laboratory of Allergy & Immunology, The State Key Laboratory of Respiratory Disease, Guangzhou Medical University, Guangzhou, China.
Asia Pac Allergy. 2025 Sep;15(3):140-144. doi: 10.5415/apallergy.0000000000000193. Epub 2025 Mar 17.
Patients with allergic rhinitis (AR) and bronchial hyperreactivity (BHR) may be at higher risk of developing asthma.
The study was to investigate whether reactivity to house dust mites (HDM) and serum IgE level can be used to predict BHR.
A total of 75 asthmatic patients were included in the study. All patients performed spirometry and underwent a bronchial challenge with histamine.
Seventy-five patients with HDM-positive skin prick tests who underwent airway provocation tests were included in this study. Small airway dysfunction was found in 19 patients. After the histamine challenge, the change of forced expiratory volume in the first second (FEV1) was more than 15% in 48 patients and more than 20% in 42 patients. There were positive associations between serum IgE levels and FEV1 fall value. The following cutoff values showed the best combination of sensitivity and specificity for AR with BHR: Serum total IgE 104.2 IU/mL (area under the curve [AUC]: 0.711, = 0.0019), -specific IgE 13.7 IU/mL (AUC: 0.799, < 0.0001), -specific IgE 27.8 IU/mL (AUC: 0.743, = 0.0009).
AR patients with HDM allergy have small airway dysfunction and airway hyperresponsiveness, and airway hyperresponsiveness is related to the degree of allergy. Simple measurement of allergen-specific IgE may be the best predictor of HDM-induced asthma in patients with AR.
过敏性鼻炎（AR）和支气管高反应性（BHR）患者发生哮喘的风险可能更高。
本研究旨在探讨对屋尘螨（HDM）的反应性和血清IgE水平是否可用于预测BHR。
本研究共纳入75例哮喘患者。所有患者均进行了肺功能测定，并接受了组胺支气管激发试验。
本研究纳入了75例HDM皮肤点刺试验阳性且接受气道激发试验的患者。19例患者存在小气道功能障碍。组胺激发试验后，48例患者第一秒用力呼气容积（FEV1）变化超过15%，42例患者超过20%。血清IgE水平与FEV1下降值之间存在正相关。以下截断值显示了AR合并BHR时敏感性和特异性的最佳组合：血清总IgE 104.2 IU/mL（曲线下面积[AUC]：0.711，P = 0.0019），HDM特异性IgE 13.7 IU/mL（AUC：0.799，P < 0.0001），尘螨特异性IgE 27.8 IU/mL（AUC：0.743，P = 0.0009）。
HDM过敏的AR患者存在小气道功能障碍和气道高反应性，且气道高反应性与过敏程度相关。简单测量过敏原特异性IgE可能是AR患者HDM诱发哮喘的最佳预测指标。
