Intrasubject Variability in Total IgE Levels in Patients with Moderate to Severe Persistent Allergic Asthma Over 1 Year

Hatipoğlu, Umur; Subramanian, Ahila; Campbell, Timothy J.; Rice, Richard; Mummadi, Srinivas R.; Hu, Bo; Lang, David M.

doi:10.1016/j.jaip.2016.02.007

Cited by 15 publications

(14 citation statements)

References 20 publications

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“…A decrease in sIgE tot by 3% with every year increase in age was observed in the present study. Not unexpectedly, allergen exposure score was associated with a rise of sIgE tot in sensitized subjects, supporting a role for allergen exposure in IgE synthesis in addition to its role in mast cell activation thereby confirming a recent study [9].…”

Section: Discussionsupporting

confidence: 85%

“…A retrospective chart review of severe asthmatics with two to four measurements of sIgE tot over an average period of 2 years showed some clinically significant variability in sIgE tot affecting candidacy and dosing of omalizumab [8]. A recent prospective study conducted with 17 moderate-to-severe asthma patients with 6 serial measurements confirmed this variability in sIgE tot over 1 year [9].…”

Section: Introductionmentioning

confidence: 99%

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Variability in total serum IgE over 1 year in severe asthmatics

Louis

Pilette

Michel

et al. 2019

Allergy Asthma Clin Immunol

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Background Immunoglobulin E (IgE) is the treatment target of omalizumab, a monoclonal antibody indicated in the treatment of severe allergic asthma. Long-term variability of serum total IgE (sIgE tot ) in asthmatics remains poorly documented. Methods In this prospective study, sIgE tot levels were measured over 1 year at 7 time points in 41 severe asthmatics treated with high-dose of inhaled corticosteroids and long-acting β 2 agonists. 33 patients were atopic based on at least one positive RAST to common aeroallergens. Patients were divided into three groups according to their baseline sIgE tot level: low (< 76 IU/mL; n = 10), intermediate (76–700 IU/mL; n = 20) or high (> 700 IU/mL; n = 11). Patients also completed the six-item Juniper Asthma Control Questionnaire (ACQ 6 ). The sIgE tot variability and factors predictive for this variability were studied, as well as ACQ 6 outcomes. Results The variation in sIgE tot level was mostly the consequence of between patient-variability, which represented 96%, 71% and 96% of the total variability in the low, intermediate and high sIgE tot subgroups, respectively. The residual within-patient variability was therefore limited. In 10/41 patients, sIgE tot levels increased or decreased, for at least one visit, beyond the predefined range of the subgroups to which they were assigned (< 76 IU/mL; 76–700 IU/mL; > 700 IU/mL). There was a significant but weak correlation between sIgE tot and ACQ 6 score over all time points (r = 0.15, p = 0.02), but sIgE tot failed to associate with severe exacerbation. sIgE tot decreased by 3% with any additional year of age for the whole group (p = 0.01) and increased by 5% per one unit of allergen exposure score in atopic patients (p = 0.002). Conclusion In severe asthmatics, limited within-patient variability of sIgE tot levels was observed over 1 year as opposed to marked between-subject variability. sIgE tot decreases with age. Variation in sIgE tot weakly associates with asthma control but not with exacerbation.

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Section: Discussionsupporting

confidence: 85%

Section: Introductionmentioning

confidence: 99%

Variability in total serum IgE over 1 year in severe asthmatics

Louis

Pilette

Michel

et al. 2019

Allergy Asthma Clin Immunol

View full text Add to dashboard Cite

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“…ACT scores strongly correlate with pulmonary function parameters and health-related quality of life, while lower scores are associated with GINA-defined “not-controlled asthma” ( 34 ). IgE is the predominant antibody in the pathogenesis of asthma; higher levels of IgE often occur in patients with asthma ( 35 ). Plasma SP-A is involved in surfactant homeostasis and pulmonary host defense increased plasma levels of SP-A are observed in COPD patients ( 36 ).…”

Section: Discussionmentioning

confidence: 99%

Relationship between Fractional Exhaled Nitric Oxide Level and Efficacy of Inhaled Corticosteroid in Asthma-COPD Overlap Syndrome Patients with Different Disease Severity

Feng

Lin

et al. 2017

J Korean Med Sci

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This study explored the relationship between the fractional exhaled nitric oxide (FeNO) level and the efficacy of inhaled corticosteroid (ICS) in asthma-chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS) patients with different disease severity. A total of 127 ACOS patients with ACOS (case group) and 131 healthy people (control group) were enrolled in this study. Based on the severity of COPD, the ACOS patients were divided into: mild ACOS; moderate ACOS; severe ACOS; and extremely severe ACOS groups. We compared FeNO levels, pulmonary function parameters including percentage of forced expiratory volume in 1 second (FEV1) to predicted value (FEV1%pred), ratio of FEV1 to forced vital capacity (FEV1/FVC), inspiratory capacity to total lung capacity (IC/TLC) and residual volume to total lung capacity (RV/TLC), arterial blood gas parameters, including PH, arterial partial pressure of oxygen (PaO2) and arterial partial pressure of carbon dioxide (PaCO2), total serum immunoglobulin E (IgE), induced sputum eosinophil (EOS), plasma surfactant protein A (SP-A), plasma soluble receptor for advanced glycation end products (sRAGE), sputum myeloperoxidase (MPO), sputum neutrophil gelatinase-associated lipocalin (NGAL) and Asthma Control Test (ACT) scores, and COPD Assessment Test (CAT) scores. Compared with pre-treatment parameters, the FeNO levels, RV/TLC, PaCO2, total serum IgE, induced sputum EOS, plasma SP-A, sputum MPO, sputum NGAL, and CAT scores were significantly decreased after 6 months of ICS treatment, while FEV1%pred, FEV1/FVC, IC/TLC, PH, PaO2, plasma sRAGE, and ACT scores were significantly increased in ACOS patients with different disease severity after 6 months of ICS treatment. This finding suggests that the FeNO level may accurately predict the efficacy of ICS in the treatment of ACOS patients.

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“…The mechanism of action of omalizumab involves IgE binding followed by elimination of this antibody from circulation [ 6 ]. The patients subject to evaluation demonstrated high total IgE levels prior to enrolment ( Figure 1 ), except for one patient who had already been treated with omalizumab in phase III clinical trial (Novartis) in 2009.…”

Section: Discussionmentioning

confidence: 99%

Omalizumab improves forced expiratory volume in 1 second in patients with severe asthma

Pałgan

Żbikowska-Gotz

Lis

et al. 2018

pdia

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IntroductionAsthma is a multiphenotypic disease, and therapeutic managenment in patients with severe asthma is particulary difficult, with conventional treatment of severe asthma showing poor efficacy.AimTo analyse forced expiratory volume in 1 s (FEV1) following the adminstration of omalizumab.Material and methodsSix patinents (mean age: 50 ±12.6) with severe, uncontrolled asthma according to the GINA guidelines were enrolled in the study.ResultsTreatment with omalizumab increased in all subjects FEV1 by 17.28 ±13.4% after months and 18.57 ±13.4% after 12 months of treatment.ConclusionsThese results provides further evidence that therapy with omalizumab improves spiromtric parameters in severe asthma.

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Intrasubject Variability in Total IgE Levels in Patients with Moderate to Severe Persistent Allergic Asthma Over 1 Year

Cited by 15 publications

References 20 publications

Variability in total serum IgE over 1 year in severe asthmatics

Variability in total serum IgE over 1 year in severe asthmatics

Relationship between Fractional Exhaled Nitric Oxide Level and Efficacy of Inhaled Corticosteroid in Asthma-COPD Overlap Syndrome Patients with Different Disease Severity

Omalizumab improves forced expiratory volume in 1 second in patients with severe asthma

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