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The prevalence of increased serum IgE and Aspergillus sensitization in patients with COPD and their association with symptoms and lung function.

Jin J, Liu X, Sun Y - Respir. Res. (2014)

Bottom Line: Compared with the normal T-IgE group, patients with elevated T-IgE had a longer history of dyspnea (p < 0.01), an earlier onset of dyspnea after chronic cough/expectoration (p < 0.01), and were more likely to wheeze (p < 0.01).Analysis of the clinical data in male patients with smoking as the risk factor showed the same results.Correlation analysis demonstrated that T-IgE was correlated positively with the time length of dyspnea (r = 0.401, p < 0.001), and the ratio of duration of dyspnea to that of chronic cough/expectoration (r = 0.59, p < 0.001), but negatively with FEV1/FVC% (r = -0.194, p = 0.001), and FEV1%predicted (r = -0.219, p < 0.001).

View Article: PubMed Central - PubMed

Affiliation: Department of Respiratory Medicine, Beijing Tongren Hospital, Capital Medical University, Beijing, China. suny@ccmu.edu.cn.

ABSTRACT

Background: Allergy and Aspergillus hypersensitivity (AH) were shown to be associated with severe symptoms or worse lung function in COPD patients. The prevalence of elevated total IgE (T-IgE) and its association with clinical symptoms and lung function in COPD have not been studied. The prevalence of AH and its correlation with clinical characteristics in a COPD cohort of larger sample size is also lacking.

Methods: 273 patients with COPD were evaluated by respiratory symptoms, blood test, chest HRCT, lung function, serum detection of T-IgE and Aspergillus specific IgE. Patients with T-IgE ≥ 1000 KU/L were further investigated for allergic bronchopulmonary aspergillosis (ABPA).

Results: The prevalence of elevated T-IgE and AH in patients with COPD was 47.3% and 15.0%, respectively. Eight patients (2.9%) met the diagnostic criteria for ABPA. Compared with the normal T-IgE group, patients with elevated T-IgE had a longer history of dyspnea (p < 0.01), an earlier onset of dyspnea after chronic cough/expectoration (p < 0.01), and were more likely to wheeze (p < 0.01). They also showed worse lung functions and more severe GOLD staging (p < 0.01). Analysis of the clinical data in male patients with smoking as the risk factor showed the same results. To evaluate the clinical characteristics of COPD with AH, patients with elevated T-IgE were further divided into subgroups with and without AH. When compared with the normal T-IgE group, both the two subgroups showed longer history of dyspnea (p < 0.01), an earlier onset of dyspnea (p < 0.01) and a worse status of lung function (p < 0.05). Correlation analysis demonstrated that T-IgE was correlated positively with the time length of dyspnea (r = 0.401, p < 0.001), and the ratio of duration of dyspnea to that of chronic cough/expectoration (r = 0.59, p < 0.001), but negatively with FEV1/FVC% (r = -0.194, p = 0.001), and FEV1%predicted (r = -0.219, p < 0.001).

Conclusions: There was a high prevalence of elevated serum T-IgE and AH in patients with COPD. Serum T-IgE level was correlated with symptoms such as dyspnea and impairment of lung function. Allergens other than Aspergillus may have similar effects on disease expression or progression of COPD.

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Related in: MedlinePlus

Prevalence of increased serum IgE,Aspergillushypersensitivity, and ABPA in patients with COPD. The prevalence of increased serum IgE, Aspergillus hypersensitivity, and allergic bronchopulmonary aspergillosis in patients with COPD was shown with a disproportional Venn diagram. Definition of abbreviations: IgE(+): increased serum IgE, IgE(−): normal serum IgE, AH: Aspergillus hypersensitivity, ABPA: allergic brochopulmonary aspergillosis.
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Fig2: Prevalence of increased serum IgE,Aspergillushypersensitivity, and ABPA in patients with COPD. The prevalence of increased serum IgE, Aspergillus hypersensitivity, and allergic bronchopulmonary aspergillosis in patients with COPD was shown with a disproportional Venn diagram. Definition of abbreviations: IgE(+): increased serum IgE, IgE(−): normal serum IgE, AH: Aspergillus hypersensitivity, ABPA: allergic brochopulmonary aspergillosis.

Mentions: The prevalence of increased serum T-IgE, A. Fumigatus hypersensitivity and ABPA was shown in Figure 2. Elevated serum T-IgE was found in 47.3% (129/273) of the COPD patients, and the average level of T-IgE was 401(916,2 ~ 7420) kU/L (see Table 1), both of which were significantly higher when compared with those of the control population (p < 0.001, and p < 0.001, respectively). A. Fumigatus hypersensitivity was confirmed in 15.0% (41/273) patients, all of whom had an increased level of serum T-IgE, i.e. 31.8% of the COPD patients with elevated serum T-IgE (41/129) were hypersensitive to A. Fumigatus (see Table 2). Eight patients (2.9%, 8/273) met the diagnostic criteria for combined COPD and ABPA, 5 (1.8%, 5/273) with ABPA-CB and 3 (1.0%, 3/273) with ABPA-S. Among COPD patients with elevated serum T-IgE, the occurrence of ABPA, ABPA-CB and ABPA-S was 6.2% (8/129), 3.9% (5/129) and 2.3% (3/129) respectively. Among COPD patients with A. Fumigatus hypersensitivity, the prevalence of ABPA, ABPA-CB and ABPA-S was 19.5% (8/41), 12.2% (5/41) and 7.3% (3/41) respectively. The clinical data of the 8 patients with combined COPD and ABPA were shown in Table 3.Figure 2


The prevalence of increased serum IgE and Aspergillus sensitization in patients with COPD and their association with symptoms and lung function.

Jin J, Liu X, Sun Y - Respir. Res. (2014)

Prevalence of increased serum IgE,Aspergillushypersensitivity, and ABPA in patients with COPD. The prevalence of increased serum IgE, Aspergillus hypersensitivity, and allergic bronchopulmonary aspergillosis in patients with COPD was shown with a disproportional Venn diagram. Definition of abbreviations: IgE(+): increased serum IgE, IgE(−): normal serum IgE, AH: Aspergillus hypersensitivity, ABPA: allergic brochopulmonary aspergillosis.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4216660&req=5

Fig2: Prevalence of increased serum IgE,Aspergillushypersensitivity, and ABPA in patients with COPD. The prevalence of increased serum IgE, Aspergillus hypersensitivity, and allergic bronchopulmonary aspergillosis in patients with COPD was shown with a disproportional Venn diagram. Definition of abbreviations: IgE(+): increased serum IgE, IgE(−): normal serum IgE, AH: Aspergillus hypersensitivity, ABPA: allergic brochopulmonary aspergillosis.
Mentions: The prevalence of increased serum T-IgE, A. Fumigatus hypersensitivity and ABPA was shown in Figure 2. Elevated serum T-IgE was found in 47.3% (129/273) of the COPD patients, and the average level of T-IgE was 401(916,2 ~ 7420) kU/L (see Table 1), both of which were significantly higher when compared with those of the control population (p < 0.001, and p < 0.001, respectively). A. Fumigatus hypersensitivity was confirmed in 15.0% (41/273) patients, all of whom had an increased level of serum T-IgE, i.e. 31.8% of the COPD patients with elevated serum T-IgE (41/129) were hypersensitive to A. Fumigatus (see Table 2). Eight patients (2.9%, 8/273) met the diagnostic criteria for combined COPD and ABPA, 5 (1.8%, 5/273) with ABPA-CB and 3 (1.0%, 3/273) with ABPA-S. Among COPD patients with elevated serum T-IgE, the occurrence of ABPA, ABPA-CB and ABPA-S was 6.2% (8/129), 3.9% (5/129) and 2.3% (3/129) respectively. Among COPD patients with A. Fumigatus hypersensitivity, the prevalence of ABPA, ABPA-CB and ABPA-S was 19.5% (8/41), 12.2% (5/41) and 7.3% (3/41) respectively. The clinical data of the 8 patients with combined COPD and ABPA were shown in Table 3.Figure 2

Bottom Line: Compared with the normal T-IgE group, patients with elevated T-IgE had a longer history of dyspnea (p < 0.01), an earlier onset of dyspnea after chronic cough/expectoration (p < 0.01), and were more likely to wheeze (p < 0.01).Analysis of the clinical data in male patients with smoking as the risk factor showed the same results.Correlation analysis demonstrated that T-IgE was correlated positively with the time length of dyspnea (r = 0.401, p < 0.001), and the ratio of duration of dyspnea to that of chronic cough/expectoration (r = 0.59, p < 0.001), but negatively with FEV1/FVC% (r = -0.194, p = 0.001), and FEV1%predicted (r = -0.219, p < 0.001).

View Article: PubMed Central - PubMed

Affiliation: Department of Respiratory Medicine, Beijing Tongren Hospital, Capital Medical University, Beijing, China. suny@ccmu.edu.cn.

ABSTRACT

Background: Allergy and Aspergillus hypersensitivity (AH) were shown to be associated with severe symptoms or worse lung function in COPD patients. The prevalence of elevated total IgE (T-IgE) and its association with clinical symptoms and lung function in COPD have not been studied. The prevalence of AH and its correlation with clinical characteristics in a COPD cohort of larger sample size is also lacking.

Methods: 273 patients with COPD were evaluated by respiratory symptoms, blood test, chest HRCT, lung function, serum detection of T-IgE and Aspergillus specific IgE. Patients with T-IgE ≥ 1000 KU/L were further investigated for allergic bronchopulmonary aspergillosis (ABPA).

Results: The prevalence of elevated T-IgE and AH in patients with COPD was 47.3% and 15.0%, respectively. Eight patients (2.9%) met the diagnostic criteria for ABPA. Compared with the normal T-IgE group, patients with elevated T-IgE had a longer history of dyspnea (p < 0.01), an earlier onset of dyspnea after chronic cough/expectoration (p < 0.01), and were more likely to wheeze (p < 0.01). They also showed worse lung functions and more severe GOLD staging (p < 0.01). Analysis of the clinical data in male patients with smoking as the risk factor showed the same results. To evaluate the clinical characteristics of COPD with AH, patients with elevated T-IgE were further divided into subgroups with and without AH. When compared with the normal T-IgE group, both the two subgroups showed longer history of dyspnea (p < 0.01), an earlier onset of dyspnea (p < 0.01) and a worse status of lung function (p < 0.05). Correlation analysis demonstrated that T-IgE was correlated positively with the time length of dyspnea (r = 0.401, p < 0.001), and the ratio of duration of dyspnea to that of chronic cough/expectoration (r = 0.59, p < 0.001), but negatively with FEV1/FVC% (r = -0.194, p = 0.001), and FEV1%predicted (r = -0.219, p < 0.001).

Conclusions: There was a high prevalence of elevated serum T-IgE and AH in patients with COPD. Serum T-IgE level was correlated with symptoms such as dyspnea and impairment of lung function. Allergens other than Aspergillus may have similar effects on disease expression or progression of COPD.

Show MeSH
Related in: MedlinePlus