Different Asthma Phenotypes in Adult Asthma: Comparison of Allergic Asthma and Nonallergic Asthma

不同表型的成人氣喘：過敏性氣喘與非過敏性氣喘的比較

張志豪(Chih-Hao Chang) ； 林鴻銓(Horng-Chyuan Lin) ； 謝孟亨(Meng-Heng Hsieh) ； 陳冠元(Guan-Yuan Chen) ； 鍾福財(Fu-Tsai Chung) ； 余志騰(Chih-Teng Yu) ； 郭漢彬(Han-Pin Kuo)

《胸腔醫學》 27卷1期 (2012/02) Pp. 1-12

https://doi.org/10.29806/TM.201202.0001

摘要

Background: Allergen sensitization is a risk factor for the development of bronchial asthma in adults. However, the relationship between allergen sensitization and lung function in asthma patients is not well understood. This study was conducted to evaluate the relationship between sensitized allergens, total serum immunoglobulin E (IgE) level, and lung function in adult asthmatic patients in northern Taiwan.Methods: A total of 266 adult Taiwanese patients diagnosed with asthma between January 2003 and December 2004 were enrolled. Age, sex, duration of asthma, pulmonary function tests, total IgE, eosinophilic cationic protein, and specific IgE of ImmunoCAP were recorded. Allergic was defined as the presence of a specific IgE to 1 or more allergens.Results: There were 161 (60.5%) male and 105 (39.5%) female patients, with a mean age of 60.46 ± 15.40 years. The mean duration of asthma was 13.64 ± 7.35 years. Mite allergens, Dermatophagoides pteronyssinus (48.46%) and Dermatophagoides farina (49.23%), were the most common indoor allergens. We divided the patients into allergic and nonallergic asthma groups: 164 (61.7%) patients had allergic asthma and 102 (38.3%), nonallergic asthma. Patients with allergic asthma were younger, and had a higher total IgE level and better lung function than the nonallergic asthmatics (p＜0.05, respectively). Total serum IgE was correlated to peak expiratory flow (PEF) variability (r=0.3395, p＜0.0001) in asthmatic patients. Among allergic asthmatics, the serum total IgE and PEF variability were higher as the number of positive allergen-specific IgE tests increased.Conclusions: Defining asthma phenotypes as allergic or nonallergic is essential. This study supports the difference between allergic and nonallergic asthma. Patients with allergic asthma were younger and had higher total IgE and better lung function than patients with nonallergic asthma.

關鍵字

過敏原 ； 氣喘 ； 異位性體質 ； ImmunoCAP ； 尖端呼氣流量

並列摘要

Background: Allergen sensitization is a risk factor for the development of bronchial asthma in adults. However, the relationship between allergen sensitization and lung function in asthma patients is not well understood. This study was conducted to evaluate the relationship between sensitized allergens, total serum immunoglobulin E (IgE) level, and lung function in adult asthmatic patients in northern Taiwan.Methods: A total of 266 adult Taiwanese patients diagnosed with asthma between January 2003 and December 2004 were enrolled. Age, sex, duration of asthma, pulmonary function tests, total IgE, eosinophilic cationic protein, and specific IgE of ImmunoCAP were recorded. Allergic was defined as the presence of a specific IgE to 1 or more allergens.Results: There were 161 (60.5%) male and 105 (39.5%) female patients, with a mean age of 60.46 ± 15.40 years. The mean duration of asthma was 13.64 ± 7.35 years. Mite allergens, Dermatophagoides pteronyssinus (48.46%) and Dermatophagoides farina (49.23%), were the most common indoor allergens. We divided the patients into allergic and nonallergic asthma groups: 164 (61.7%) patients had allergic asthma and 102 (38.3%), nonallergic asthma. Patients with allergic asthma were younger, and had a higher total IgE level and better lung function than the nonallergic asthmatics (p＜0.05, respectively). Total serum IgE was correlated to peak expiratory flow (PEF) variability (r=0.3395, p＜0.0001) in asthmatic patients. Among allergic asthmatics, the serum total IgE and PEF variability were higher as the number of positive allergen-specific IgE tests increased.Conclusions: Defining asthma phenotypes as allergic or nonallergic is essential. This study supports the difference between allergic and nonallergic asthma. Patients with allergic asthma were younger and had higher total IgE and better lung function than patients with nonallergic asthma.

並列關鍵字

allergens ； asthma ； atopy ； ImmunoCAP ； peak expiratory flow