The Association of Atopy, Total IgE, and Pulmonary Function in Bronchiectasis

過敏體質、免疫球蛋白E總量與肺功能在支氣管擴張症中的關聯性

林玠模(Chieh-Mo Lin) ； 林鴻銓(Horng-Chyuan Lin) ； 陳冠元(Guan-Yuan Chen) ； 謝孟亨(Meng-Heng Hsieh) ； 鍾福財(Fu-Tsai Chung) ； 枋岳甫(Yueh-Fu Fang) ； 余志騰(Chih-Teng Yu) ； 郭漢彬(Han-Pin Kuo)

《胸腔醫學》 26卷5期 (2011/10) Pp. 240-251

https://doi.org/10.29806/TM.201110.0001

摘要

Background: Bronchiectasis is characterized by irreversible airway dilation and destruction, but its clinical features relative to atopy and sensitized allergens remain unclear. Therefore, this study aimed to investigate the relationship between atopy, serum IgE level, and lung function in bronchiectasis patients.Method: The study included 114 adult patients with a clinical diagnosis of bronchiectasis between January 2001 and December 2009. They were all evaluated for allergen specific-IgE levels, serum total IgE and eosinophilic cationic protein (ECP) levels, spirometry values of the pulmonary function test, and high-sensitivity C-reactive protein (hs-CRP) levels. Atopy was defined as the presence of a specific IgE to 1 or more allergens.Results: Of the 114 adult bronchiectasis patients, 33 (28.9%) showed positive specific immunoglobulin E (IgE) levels to 1 or more allergens and were assessed as atopic. Atopic patients with bronchiectasis had worse pulmonary function parameters, in terms of forced expiratory volume in 1 second (FEV1) and FEV1/FVC (forced vital capacity) ratio, and higher levels of total serum IgE. There was a significant decrease in the pulmonary function test of atopic subjects with a positive specific-IgE response to more than 2 allergens, but not in those with only 1 or 2 positive allergens. There were higher serum total IgE levels in patients with more positive allergen-specific IgE tests. Bronchiectatic patients with a high total IgE level (≥100 kU/L) had significantly worse lung function (FEV1% predicted and FEV1/FVC ratio) and more sensitized allergens than those with a normal IgE level (＜100 kU/L).Conclusion: The existence of atopy with more sensitized allergens or higher total serum IgE levels may lead to a worse pulmonary function in patients with bronchiectasis. This may be due to IgE-mediated local and systemic inflammation.

關鍵字

過敏體質 ； 異位性體質 ； 免疫球蛋白E總量 ； 肺功能 ； 支氣管擴張症

並列摘要

Background: Bronchiectasis is characterized by irreversible airway dilation and destruction, but its clinical features relative to atopy and sensitized allergens remain unclear. Therefore, this study aimed to investigate the relationship between atopy, serum IgE level, and lung function in bronchiectasis patients.Method: The study included 114 adult patients with a clinical diagnosis of bronchiectasis between January 2001 and December 2009. They were all evaluated for allergen specific-IgE levels, serum total IgE and eosinophilic cationic protein (ECP) levels, spirometry values of the pulmonary function test, and high-sensitivity C-reactive protein (hs-CRP) levels. Atopy was defined as the presence of a specific IgE to 1 or more allergens.Results: Of the 114 adult bronchiectasis patients, 33 (28.9%) showed positive specific immunoglobulin E (IgE) levels to 1 or more allergens and were assessed as atopic. Atopic patients with bronchiectasis had worse pulmonary function parameters, in terms of forced expiratory volume in 1 second (FEV1) and FEV1/FVC (forced vital capacity) ratio, and higher levels of total serum IgE. There was a significant decrease in the pulmonary function test of atopic subjects with a positive specific-IgE response to more than 2 allergens, but not in those with only 1 or 2 positive allergens. There were higher serum total IgE levels in patients with more positive allergen-specific IgE tests. Bronchiectatic patients with a high total IgE level (≥100 kU/L) had significantly worse lung function (FEV1% predicted and FEV1/FVC ratio) and more sensitized allergens than those with a normal IgE level (＜100 kU/L).Conclusion: The existence of atopy with more sensitized allergens or higher total serum IgE levels may lead to a worse pulmonary function in patients with bronchiectasis. This may be due to IgE-mediated local and systemic inflammation.

並列關鍵字

atopy ； total IgE ； pulmonary function ； bronchiectasis