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Aeroallergen and food IgE sensitization and local and systemic inflammation in asthma
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 Women's and Children's Health, Pediatrics.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics.
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2014 (English)In: Allergy. European Journal of Allergy and Clinical Immunology, ISSN 0105-4538, E-ISSN 1398-9995, Vol. 69, no 3, 380-387 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: We recently reported an independent association between IgE sensitization to food allergens and increased airway inflammation, assessed by fraction of exhaled nitric oxide (FeNO), in a population-based study (J Allergy Clin Immunol, 130, 2012, 397). Similar studies have not been performed in populations with asthma. The aim of the present study was to investigate the allergic sensitization profile in asthmatics and examine FeNO, airway responsiveness and blood eosinophilia in relation to type and degree of IgE sensitization.

METHOD: FeNO, airway responsiveness, blood eosinophil count (B-Eos) and IgE sensitization to food allergens and aeroallergens were determined in 408 subjects with asthma, aged 10-34 years.

RESULTS: Asthmatics had higher prevalence of IgE sensitization against all allergens than controls (P < 0.001). Mite, pollen, furry animal, mould and food sensitizations were each associated with increased FeNO, airway responsiveness and B-Eos in asthmatics. IgE sensitization to mould, furry animals and food allergens was independently related to FeNO (all P < 0.05) after adjustment for age, sex, height, smoking history and medication. IgE sensitization to mould (P < 0.001) and furry animals (P = 0.02) was related to airway responsiveness in a similar model. Finally, IgE sensitization to mould (P = 0.001), furry animals (P < 0.001) and food allergens (P < 0.001) was independently related to B-Eos.

CONCLUSION: Independent effects of IgE sensitization to aeroallergens (furry animals and mould) and food allergens were found on both local and systemic markers of inflammation in asthma. The finding regarding food IgE sensitization is novel, and a clinical implication might be that even food sensitization must be assessed to fully understand inflammation patterns in asthma.

Place, publisher, year, edition, pages
2014. Vol. 69, no 3, 380-387 p.
National Category
Respiratory Medicine and Allergy
Identifiers
URN: urn:nbn:se:uu:diva-215165DOI: 10.1111/all.12345ISI: 000331358400012PubMedID: 24397423OAI: oai:DiVA.org:uu-215165DiVA: diva2:686397
Note

De sista två författarna delar sista författarskapet.

Available from: 2014-01-12 Created: 2014-01-12 Last updated: 2017-12-06Bibliographically 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, AntoniosJanson, ChristerBorres, Magnus PNordvall, LennartAlving, KjellMalinovschi, Andrei

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