Allergy. 1998 Jul;53(7):673-81. doi: 10.1111/j.1398-9995.1998.tb03953.x.
The aim of the analysis was to test whether total serum IgE levels, specific serum IgE levels, and asthma symptoms are independent predictors of bronchial hyperresponsiveness (BHR), after controlling for known risk factors or potential confounders. The study was carried out on a sample of 875 young adults, 20-44 years old, who took part in the European Community Respiratory Health Survey in Italy. The subjects underwent a dose-response methacholine challenge test. We also measured airway caliber as the baseline FEV1 in absolute terms and as percentage of forced vital capacity (FVC); skin wheal response to 11 common environmental allergens; and total and specific serum IgE levels to mites, molds, pets, and respiratory symptoms by means of a standardized questionnaire. Atopy (positive skin prick test and/or positive specific IgE assay), total IgE, asthma symptoms, airway caliber, and age appeared to be independent predictors of BHR. When all the other risk factors were taken into account, atopy and total IgE were associated with a threefold increase in BHR risk and thus emerged as the main determinants of BHR. The importance of symptom status as a determinant of BHR decreased remarkably after controlling for atopy and IgE: the odds ratio of current asthmatics to asymptomatic subjects decreased from 15.3 to 8.8. When controlling for symptoms and atopy, a family history of allergic diseases and early respiratory infections was not found to be associated with BHR. Both FEV1 and FEV1/FVC were strongly and inversely associated with BHR. When airway caliber was taken into account, older age was associated with decreased responsiveness, and the level of responsiveness did not differ significantly between males and females and between smokers and nonsmokers. The results from this analysis indicate that at any given age, irrespective of sex and smoking habits, total serum IgE, specific IgE, airway caliber, and asthma symptoms are the main independent factors influencing the occurrence of BHR in a young adult sample.
该分析的目的是在控制已知风险因素或潜在混杂因素后，检验血清总IgE水平、特异性血清IgE水平和哮喘症状是否为支气管高反应性（BHR）的独立预测因素。该研究以875名年龄在20至44岁之间的年轻成年人作为样本，他们参与了意大利的欧洲共同体呼吸健康调查。受试者接受了剂量反应性乙酰甲胆碱激发试验。我们还测量了气道口径，以绝对值表示的基线第一秒用力呼气容积（FEV1）以及作为用力肺活量（FVC）百分比的FEV1；对11种常见环境过敏原的皮肤风团反应；以及通过标准化问卷测量的针对螨虫、霉菌、宠物的血清总IgE和特异性IgE水平以及呼吸道症状。特应性（阳性皮肤点刺试验和/或阳性特异性IgE检测）、总IgE、哮喘症状、气道口径和年龄似乎是BHR的独立预测因素。当考虑所有其他风险因素时，特应性和总IgE与BHR风险增加三倍相关，因此成为BHR的主要决定因素。在控制特应性和IgE后，症状状态作为BHR决定因素的重要性显著降低：当前哮喘患者与无症状受试者的比值比从15.3降至8.8。在控制症状和特应性时，未发现过敏性疾病家族史和早期呼吸道感染与BHR相关。FEV1和FEV1/FVC均与BHR呈强烈负相关。当考虑气道口径时，年龄较大与反应性降低相关，并且男性与女性之间以及吸烟者与非吸烟者之间的反应性水平无显著差异。该分析结果表明，在任何给定年龄，无论性别和吸烟习惯如何，血清总IgE、特异性IgE、气道口径和哮喘症状是影响年轻成年人样本中BHR发生的主要独立因素。
