Relationship between longitudinal changes in type-2 inflammation, immunoglobulin E sensitization, and clinical outcomes in young asthmatics

• Type: Article in International Scientific Journal
• Date: 2021

Authors

Tsolakis, N (Author) Other; Jacinto T (Author) FMUP; Janson, C (Author) Other; Borres, M (Author) Other; Malinovschi, A (Author) Other; Alving, K (Author) Other

Journal

Title: Clinical and Translational Allergy

Vol. 11

Publisher: Wiley-Blackwell

Indexing

ISI Web of Knowledge - 0 Citations

Scopus - 0 Citations

Other information

Authenticus ID: P-00V-FGD

DOI: 10.1002/clt2.12066

Abstract (EN): Background Asthma is a heterogeneous condition where biomarkers may be of considerable advantage in diagnosis and therapy monitoring. However, the changes in asthma biomarkers and immunoglobulin E (IgE) over the course of life has not been extensively investigated. Objective To study longitudinal changes in type-2 inflammatory biomarkers, IgE, and clinical outcomes, and the association between these changes, in young asthmatics. Methods Asthmatics (age 10-35 years, n = 253) were examined at baseline and at a follow-up visit, 43 [23-65] (median [range]) months later. Subjects were analyzed using the multi-allergen tests Phadiatop and fx5 (ImmunoCAP) and grouped based on the baseline allergen-specific IgE antibody (sIgE) concentration: <0.10, 0.10-0.34, and >= 0.35 kU(A)/L. The relationship between changes (Delta values) in type-2 biomarkers (individualized fraction of exhaled nitric oxide [FeNO%], blood eosinophil [B-Eos] count, total IgE [tIgE] and sIgE, lung function [% predicted forced expiratory volume in 1 second (FEV1) and FEV1/forced vital capacity (FVC)], and Asthma Control Test [ACT]) score were determined. Results At follow up, FEV1 and FEV1/FVC had decreased (93.6% vs. 95.8%, and 93.4% vs. 94.7% of predicted, respectively [p < 0.001 both]), whereas ACT score had increased (21.6 vs. 20.6, p = 0.001). A significant decline in lung function was seen in subjects with sIgE >= 0.10 kUA/L, but not in those with undetectable sIgE (<0.10 kU(A)/L). Furthermore, tIgE and sIgE declined over time (p < 0.001 all) whereas FeNO% and B-Eos count were not significantly changed. In univariate analysis, significant negative correlations between increment B-Eos count and increment FeNO%, on one hand, and changes in lung function, on the other hand, were seen, and multivariate analysis showed an independent relationship between Delta FeNO%, and Delta FEV1 (p < 0.05) and Delta FEV1/FVC% (p < 0.01). Sex-specific analysis showed that the independent association between Delta FeNO%, and Delta FEV1 remained only in females (p = 0.005), and there was a significant interaction with sex (p = 0.02). Conclusion In young asthmatics, IgE levels declined over 43 months, whereas FeNO and B-Eos remained unchanged. In spite of improved asthma control, an accelerated lung function decline was seen in patients with detectable sIgE at baseline, and the decline correlated with changes in type-2 biomarkers. Particularly, the increase in individualized FeNO associated independently with decline in FEV1 in females.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 10