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Allergen extract vs component sensitisation and airway inflammation, responsiveness and new-onset respiratory disease
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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(English)In: Clinical and Experimental Allergy, ISSN 0954-7894, E-ISSN 1365-2222Article in journal (Other academic) Submitted
Abstract [en]

Background: The absence of IgE sensitization to allergen components in the presence of sensitization to the corresponding extract has been reported, but its clinical importance has not been studied.

Objective: To evaluate the clinical significance of IgE sensitization to three  aeroallergen extracts and the corresponding components in relation to the development of respiratory disease.

Methods: A total of 467 adults participated in the European Community Respiratory Health Survey (ECRHS) II and 302 in ECRHS III, 12 years later. IgE sensitization to allergen extract and components, exhaled nitric oxide (FeNO) and bronchial responsiveness to methacholine were measured in ECRHS II. Rhinitis and asthma symptoms were questionnaire-assessed in both ECRHS II and III.

Results: A good overall correlation was found between IgE sensitization to extract and components for cat (r=0.83), timothy (r=0.96) and birch (r=0.95). However, a substantial proportion of subjects tested IgE-positive for cat and timothy allergen extracts but negative for the corresponding components (48% and 21%, respectively). Subjects sensitized to both cat extract and components had higher FeNO (p=0.008) and more bronchial responsiveness (p=0.002) than subjects sensitized only to the extract. Further, subjects sensitized to cat components were more likely to develop asthma (p=0.005) and rhinitis (p=0.007) than subjects sensitized only to cat extract.

Conclusion: Measurement of IgE sensitization to cat allergen components would seem to have a higher clinical value than extract-based measurement, as it related better to airway inflammation and responsiveness and had a higher prognostic value for the development of asthma and rhinitis over a 12-year period.

National Category
Respiratory Medicine and Allergy
Identifiers
URN: urn:nbn:se:uu:diva-251581OAI: oai:DiVA.org:uu-251581DiVA: diva2:806652
Available from: 2015-04-21 Created: 2015-04-21 Last updated: 2017-12-04Bibliographically 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, MariaAlving, KjellBorres, Magnus P.Högman, MarieannJanson, ChristerMalinovschi, Andrei

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Patelis, AntoniosGunnbjörnsdottir, MariaAlving, KjellBorres, Magnus P.Högman, MarieannJanson, ChristerMalinovschi, Andrei
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