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Parallel reductions of IgE and exhaled nitric oxide after optimized anti-inflammatory asthma treatment
Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden.;Karolinska Inst, Ctr Allergy Res, Stockholm, Sweden..
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Physiology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden..
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2016 (English)In: IMMUNITY INFLAMMATION AND DISEASE, ISSN 2050-4527, Vol. 4, no 2, 182-190 p.Article in journal (Refereed) Published
Abstract [en]

Immunoglobulin E (IgE) is crucial for the development of airway inflammation in atopic asthma, and inhibition of IgE using monoclonal antibodies is now part of asthma therapy. However, the impact of ordinary anti-inflammatory treatment on IgE is unclear. The aim of this study was to investigate if optimization of treatment with inhaled corticosteroid (ICS) and leukotriene-receptor antagonist (LTRA) according to symptoms or exhaled nitric oxide (FENO) levels over a one-year period affects IgE concentrations. Altogether, 158 relatively well-controlled but multi-sensitized asthmatics (age 18-65 years), with ongoing ICS treatment at baseline, were included in this post hoc analysis of data from a randomized, controlled trial on FENO-guided asthma therapy. Asthma control and quality of life (Juniper ACQ and mAQLQ), FENO, and serum IgE were measured at baseline and after one year. Concentrations of IgE antibodies to six common perennial aeroallergens were summed up (perennial IgE). We found that perennial and total IgE decreased by 10.2% and 16.0% (P<. 001 both comparisons). This was not related to allergen exposure, whereas the total use of ICS and LTRA during the year correlated with the reduction in perennial IgE (P = .030 and P = .013). The decrease in perennial and total IgE correlated significantly with the reduction in FENO (P<. 003 and P<. 001), and with improvements in ACQ and mAQLQ scores (P< 0.05, all comparisons). We conclude that one year of optimization of treatment with ICS and LTRA in patients with persistent atopic asthma resulted in significant decreases in total IgE and IgE antibodies; these decreases correlated with a reduction in FENO and improvements in asthma control and quality of life. Thus, IgE is reduced by ordinary asthma controller medications and the effect on IgE seems to be clinically important.

Place, publisher, year, edition, pages
2016. Vol. 4, no 2, 182-190 p.
Keyword [en]
Asthma, asthma control, atopy, breath test, corticosteroid, FENO, immunoglobulin E, leukotriene-receptor antagonist, quality of life
National Category
Medical and Health Sciences
URN: urn:nbn:se:uu:diva-304533DOI: 10.1002/iid3.103ISI: 000381570000006OAI: oai:DiVA.org:uu-304533DiVA: diva2:1034542
Available from: 2016-10-12 Created: 2016-10-06 Last updated: 2016-10-12Bibliographically approved

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Syk, JörgenMalinovschi, AndreiBorres, Magnus P.Alving, Kjell
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