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Population-based study of multiplexed IgE sensitization in relation to asthma, exhaled nitric oxide, and bronchial responsiveness
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Physiology.
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2012 (English)In: Journal of Allergy and Clinical Immunology, ISSN 0091-6749, E-ISSN 1097-6825, Vol. 130, no 2, 397-402 p.Article in journal (Refereed) Published
Abstract [en]

Background: IgE sensitization is an important risk factor for the development of asthma.

Objective: The aim of this study was to investigate the IgE antibody profile for a broad spectrum of allergen molecules in asthmatic patients.

Methods: Participants from the European Community Respiratory Health Survey II (n = 467) were tested with ImmunoCAP ISAC against 103 allergen molecules. The presence of bronchial hyperresponsiveness was measured with a methacholine challenge test and bronchial inflammation with fraction of exhaled nitric oxide (FENO).

Results: A total of 38% of the controls and 72% of the asthmatic patients were sensitized against at least 1 of the allergen components (P < .0001). Asthma was independently related to having IgE antibodies against pollen (odds ratio = 2.2) and perennial airway allergens (odds ratio = 5.6), increased FENO was independently related to having IgE antibodies against food allergens and perennial allergens, while bronchial responsiveness was independently associated with having IgE antibodies against only perennial allergens. Sensitization to food allergens was related to asthma and increased FENO if IgE antibody against pollen allergens was present. Simultaneous sensitization to perennial, pollen, and food allergens involves the highest risk of asthma (odds ratio = 18.3), bronchial inflammation, and responsiveness.

Conclusions: FENO, bronchial responsiveness, and the risk of asthma increase with multiple sensitizations to different allergen groups. We show for the first time that the presence of IgE antibodies against food allergens is independently associated with increased FENO and increases the risk of asthma in subjects with simultaneous sensitization to pollen allergens.

Place, publisher, year, edition, pages
2012. Vol. 130, no 2, 397-402 p.
Keyword [en]
Asthma, FENO, airway inflammation, methacholine test, bronchial responsiveness, ISAC, food allergy, multisensitization
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-181126DOI: 10.1016/j.jaci.2012.03.046ISI: 000307002200019OAI: oai:DiVA.org:uu-181126DiVA: diva2:553421
Available from: 2012-09-19 Created: 2012-09-17 Last updated: 2017-12-07Bibliographically approved
In thesis
1. IgE sensitization against food allergens: Natural history, relation to airway inflammation and asthma
Open this publication in new window or tab >>IgE sensitization against food allergens: Natural history, relation to airway inflammation and asthma
2015 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: According to recent studies in children, IgE sensitization not only against perennial allergens, but also against food allergens, is related to asthma risk and increased airway inflammation. During the last decade, a new technique for IgE determination based on allergen components has become available, but its use in epidemiological studies has been limited.

Aims: To investigate the relationship between the pattern of IgE sensitization to allergen components and the prevalence of asthma, airway inflammation and hyperresponsiveness in a population-based setting. To examine the relationship of IgE sensitization to allergen extract, and airway inflammation, airway hyperresponsiveness and blood eosinophilia in asthmatics. To examine the natural history of IgE sensitization to food allergens in adults. To compare extract-based and component-based IgE measurements in relation with new-onset respiratory disease and airway inflammation and hyperresponsiveness.

Methods: The present thesis is based on cross-sectional and longitudinal analyses of the adult, the population-based study ECRHS (European Community Health Survey) and a cross-sectional, observational study of young subjects with asthma. IgE sensitization was examined by means of both extract-based and component-based tests. Airway inflammation was assessed by exhaled NO and airway hyperresponsiveness with methacholine test.

Results: IgE sensitization to food allergens independently related to increased airway inflammation in both a population-based study and a study of asthmatics. Furthermore, a relation was found with increased blood eosinophils in asthmatics. The decrease in prevalence of IgE sensitization against food allergens during a 9-year follow-up was larger than the decrease of aeroallergens. Subjects with IgE sensitization to both cat extract and components showed more frequent airway inflammation, greater bronchial responsiveness and higher likelihood of developing asthma and rhinitis than subjects with IgE sensitization only to cat extract.

Conclusions: The presence of IgE antibodies against food allergens was independently associated with airway and systemic inflammation. Both aeroallergens and food allergens should be examined in order to understand the signaling of local and systemic inflammation in asthma. Prevalence of IgE sensitization to food decreased in adults to a larger extent than IgE sensitization against aeroallergens. Measurement of IgE sensitization to cat allergen components appears to have a higher clinical value than extract-based measurement

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2015. 66 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1107
Keyword
allergen components, extract-based, exhaled NO, airway hyperresponsiveness, blood eosinophil count, IgE sensitization, food hypersensitivity, food allergens, perennial allergens, natural history, markers of systemic inflammation, markers of local inflammation
National Category
Respiratory Medicine and Allergy
Research subject
Lung Medicine; Physiology; Immunology
Identifiers
urn:nbn:se:uu:diva-251396 (URN)978-91-554-9256-4 (ISBN)
Public defence
2015-06-02, Hedstrandssalen, Ing 70, Akademiska Sjukhuset, Uppsala, 13:15 (Swedish)
Opponent
Supervisors
Funder
Swedish Heart Lung FoundationVårdal FoundationSwedish Asthma and Allergy Association
Available from: 2015-05-12 Created: 2015-04-17 Last updated: 2015-07-07

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Patelis, AntoniosGunnbjörnsdottir, MariaMalinovschi, AndreiHögman, MarieannAlving, KjellJanson, Christer

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Patelis, AntoniosGunnbjörnsdottir, MariaMalinovschi, AndreiHögman, MarieannAlving, KjellJanson, Christer
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