IgE production in allergic asthmatic patients with different asthma control status.

Background: Although much is known about the fact that IgE-mediated allergic inflammatory response contributes to airway inflammation, bronchial hyperresponsiveness, and asthma severity, little is known about the degree of IgE response in allergic asthmatics during treatment.

Objective: To determine the amount of total serum IgE among allergic asthmatic patients with various asthma controls.

Material And Method: A total of 190 non-smoking patients with allergic asthma were divided into three groups by using the asthma control definition according to the GINA 2006 criteria. There were 64 well-controlled, 88 partly-controlled, and 38 uncontrolled. After study entry, patients underwent lung function test, methacholine challenge and skin prick test to establish allergic status. Peripheral venous blood specimens were collected to measure total IgE and absolute eosinophil numbers. The data are expressed as mean +/- SD.

Results: The logarithm of total serum IgE was significantly higher in subjects with uncontrolled allergic asthma than in those with well-controlled disease (p < .0001). IgE response in uncontrolled asthmatics was still high despite having been treated with ICS at a dose which was significantly high when compared with well-controlled subjects (1075.4 +/- 420 vs. 703.5 +/- 355, p < .0001). The logarithm of total serum IgE was associated with increased blood eosinophil counts (r = 0.25, p .0007) among three asthmatic groups and with decreased prebronchodilator FEV1 (r = -0.42, p = .0075) and PC20 (r = -0.36, p = .04) only in uncontrolled group.

Conclusion: In allergic asthmatic patients with various disease control stages, there are differences in IgE immune response. Both high and non-suppressible total serum IgE response may be involved in the development of uncontrolled asthma.