RELATION BETWEEN AIRWAY RESPONSIVENESS AND SERUM IGE IN CHILDREN WITH ASTHMA AND IN APPARENTLY NORMAL-CHILDREN
RELATION BETWEEN AIRWAY RESPONSIVENESS AND SERUM IGE IN CHILDREN WITH ASTHMA AND IN APPARENTLY NORMAL-CHILDREN
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DOI：
10.1056/nejm199110103251504
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发表时间：
1991-10-10
影响因子：
158.5
通讯作者：
HOLDAWAY, MD
中科院分区：
文献类型：
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作者：
SEARS, MR;BURROWS, B;HOLDAWAY, MD
背景 虽然已知由医生诊断的哮喘与血清IgE水平有关，但尚不清楚IgE水平与乙酰甲胆碱激发的气道高反应性之间是否存在关系。 无症状者易患气道高反应性的特征也是未知的。 我们研究了一个出生队列中有无哮喘和其他特应性疾病的儿童血清总IgE水平与气道高反应性之间的关系。 从新西兰562名11岁儿童的呼吸道症状问卷调查中获得数据，并测量血清总IgE水平和气道对吸入乙酰甲胆碱的反应性。 目前诊断的哮喘男孩患病率高于女孩（13% vs. 6%），当前喘息症状（22% vs. 15%），以及基线气流阻塞（6%对1%），并且IgE水平分布更广，尽管平均IgE水平（男孩为每毫升120.8 IU，女孩为每毫升98.1 IU）在性别之间没有显著差异。 哮喘患病率与血清IgE水平密切相关（P < 0.0001）。 在IgE水平< 32 IU/ml的儿童中没有哮喘报告，而IgE水平大于或等于1000 IU/ml的儿童中有36%报告患有哮喘。 过敏性鼻炎或湿疹的伴随诊断不能解释与血清IgE水平的这种关系。 对乙酰甲胆碱激发的气道高反应性也与血清IgE水平高度相关（P < 0.0001）。 即使排除了诊断为哮喘的儿童（P < 0.0001）和所有有喘息、过敏性鼻炎或湿疹病史的儿童（P < 0.0001），这种关系仍然显著。 即使在儿童谁一直是无症状的整个生活，并没有过敏性疾病的历史，气道高反应性似乎是密切相关的过敏素质，反映了血清总IgE水平。
Background. Although asthma diagnosed by a physician is known to be related to serum IgE levels, it is not known whether there is a relation between the level of IgE and airway hyperresponsiveness to a methacholine challenge. The characteristics of asymptomatic persons that predispose them to airway hyperresponsiveness are also unknown.Methods. We studied the relation between the serum total IgE level and airway hyperresponsiveness in the presence or absence of asthma and other atopic diseases in a birth cohort of children. Data from a questionnaire regarding respiratory symptoms, plus measurements of the serum total IgE level and airway responsiveness to inhaled methacholine, were obtained for 562 11-year-olds in New Zealand.Results. The boys had a higher prevalence than the girls of current diagnosed asthma (13 percent vs. 6 percent), current symptoms of wheezing (22 percent vs. 15 percent), and airflow obstruction at base line (6 percent vs. 1 percent) and had a wider distribution of IgE levels, although mean IgE levels (120.8 IU per milliliter in the boys and 98.1 IU per milliliter in the girls) did not differ significantly between the sexes. The prevalence of diagnosed asthma was strongly related to the serum IgE level (P for trend < 0.0001). No asthma was reported in children with IgE levels < 32 IU per milliliter, whereas 36 percent of those with IgE levels greater-than-or-equal-to 1000 IU per milliliter were reported to have asthma. This relation with the serum IgE level was not explained by a concomitant diagnosis of allergic rhinitis or eczema. Airway hyperresponsiveness to a methacholine challenge also correlated very highly (P < 0.0001) with the serum IgE level. This relation remained significant even after the exclusion of children with diagnosed asthma (P < 0.0001) and of all children with a history of wheezing, allergic rhinitis, or eczema (P < 0.0001).Conclusions. Even in children who have been asymptomatic throughout their lives and have no history of atopic disease, airway hyperresponsiveness appears to be closely linked to an allergic diathesis, as reflected by the serum total IgE level.