Original articleSystemic allergic disorderRelationships between total and allergen-specific serum IgE concentrations and lung function in young adults
Introduction
Previous studies have shown that increasing serum concentrations of total immunoglobulin E (IgE) are strongly related to an increasing risk of a person having asthma.[1], [2], [3] Sears et al.2 also showed that serum IgE concentrations were significantly correlated with responsiveness to inhaled methacholine. In the study of Burrows et al.,1 the positive correlation between total serum IgE and asthma was stronger than correlations between indicators of allergen-specific IgE and asthma, suggesting that a mechanism other than sensitivity to inhalant allergens links IgE to asthma.1
Studies by Grunstein et al4 have shown that, in mice, airway smooth muscle cells have both high- (FcϵR1) and low- (FcϵR2) affinity IgE receptors on their surfaces.4 These are functional IgE receptors, as shown by upregulation of cytokine production, especially interleukin (IL)-5 and IL-13.5 Furthermore, IgE activation of airway smooth muscle cells increases smooth muscle reactivity.4 Human studies have also shown associations between IgE and airway responsiveness,6 illustrated by studies in which reducing serum IgE concentration with omalizumab improved asthma symptoms.[7], [8]
Important gender differences are seen in asthma. During childhood, boys are more likely to have asthma than girls, whereas in adolescence, prevalence equalizes, followed by a greater prevalence in women during adulthood.9 Likely the hormonal changes occurring during puberty contribute to this pattern.[10], [11] These known gender differences prompted us to look for gender differences in correlations between IgE and lung function.
Based on the described relationships of IgE to asthma, we evaluated whether total or allergen-specific serum IgE concentrations were associated with decreased lung function in a population-based birth cohort of otherwise healthy young adults after considering their individual histories of asthma. We hypothesized that increasing levels of serum IgE would be associated with reduced lung function, primarily seen as reduced airflow measured by percent predicted forced expiratory volume in 1 second (FEV1) and ratio of FEV1 to forced vital capacity (FVC) or (FEV1/FVC). We posited that inverse relationships between IgE and lung function would be found in individuals with current asthma, those with a history of asthma, and perhaps also those that had never had a diagnosis of asthma.
Section snippets
Methods
The initial selection of the cohort has been previously described.[12], [13], [14] Briefly, the Childhood Allergy Study is a population-based birth cohort conducted among members of a health maintenance organization in the northern suburbs of Detroit, Michigan, to study environmental influences on the development of allergic diseases and asthma. All pregnant women enrolled in the health maintenance organization who were at least 18 years of age, living in a predefined geographic area, and due
Results
Table 1 shows the characteristics of the study participants and compares the gender and racial distributions of those included and excluded from analysis. The gender and racial proportions did not differ significantly for those included and excluded. Males were more likely to be atopic than females, but this difference did not reach statistical significance (92.9% vs 67.6%, respectively; P = .08). Total serum IgE concentrations were strongly correlated with the sum of the allergen-specific IgE
Discussion
Although our results are consistent with our initial hypothesis that increasing serum IgE concentrations would be negatively correlated with lung function, we believe our observation of gender differences between IgE and lung function are unique. Increasing total IgE was associated with lower FVC% in males, but the association was in the opposite direction for females. The reverse was true for FEV1/FVC. The same pattern of relationships was observed when the sum of allergen-specific IgE values
References (27)
- et al.
Relationship between serum IgE and cross-sectional and longitudinal FEV1 in two cohort studies
Chest
(1986) - et al.
Relationship between serum IgE and airway responsiveness in adults with asthma
J Allergy Clin Immunol
(1995) Gender differences in asthma development and progression
Gend Med
(2007)- et al.
The relationship of serum immunoglobulin E, allergy skin tests and smoking to respiratory disorders
J Allergy Clin Immunol
(1982) - et al.
Sex differences in the presentation and course of asthma hospitalizations
Chest
(2006) - et al.
Asthma from childhood to adulthood: course and outcome of lung function
Respir Med
(2000) - et al.
Physiology of the small airways: a gender difference?
Respir Med
(2008) - et al.
Association of asthma with serum IgE levels and skin-test reactivity to allergens
N Engl J Med
(1989) - et al.
Relation between airway responsiveness and serum IgE in children with asthma and in apparently normal children
N Engl J Med
(1991) - et al.
IL-13-dependent autocrine signaling mediates altered responsiveness of IgE-sensitized airway smooth muscle
Am J Physiol Lung Cell Mol Physiol
(2002)
Functional expression of IgG-Fc receptors in human airway smooth muscle cells
Am J Respir Cell Mol Biol
Treatment of allergic asthma with monoclonal anti-IgE antibody
N Engl J Med
The size of the disease relevant IgE antibody fraction in relation to ‘total-IgE’ predicts the efficacy of anti-IgE (Xolair) treatment
Allergy
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Disclosures: Authors have nothing to disclose.
Funding Sources: This work was supported by the National Institutes of Health [Grants R01 AI051598 and R01 AI59415].