Variability in total serum IgE over 1 year in severe asthmatics

Renaud Louis, Charles Pilette, Olivier Michel, Alain Michils, Guy Brusselle, Antoine Poskin, Jan Van Schoor, Kris Denhaerynck, Stefaan Vancayzeele, Ivo L Abraham, Sandra Gurdain

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3 Scopus citations

Abstract

Background: Immunoglobulin E (IgE) is the treatment target of omalizumab, a monoclonal antibody indicated in the treatment of severe allergic asthma. Long-term variability of serum total IgE (sIgE tot ) in asthmatics remains poorly documented. Methods: In this prospective study, sIgE tot levels were measured over 1 year at 7 time points in 41 severe asthmatics treated with high-dose of inhaled corticosteroids and long-acting β 2 agonists. 33 patients were atopic based on at least one positive RAST to common aeroallergens. Patients were divided into three groups according to their baseline sIgE tot level: low (< 76 IU/mL; n = 10), intermediate (76-700 IU/mL; n = 20) or high (> 700 IU/mL; n = 11). Patients also completed the six-item Juniper Asthma Control Questionnaire (ACQ 6 ). The sIgE tot variability and factors predictive for this variability were studied, as well as ACQ 6 outcomes. Results: The variation in sIgE tot level was mostly the consequence of between patient-variability, which represented 96%, 71% and 96% of the total variability in the low, intermediate and high sIgE tot subgroups, respectively. The residual within-patient variability was therefore limited. In 10/41 patients, sIgE tot levels increased or decreased, for at least one visit, beyond the predefined range of the subgroups to which they were assigned (< 76 IU/mL; 76-700 IU/mL; > 700 IU/mL). There was a significant but weak correlation between sIgE tot and ACQ 6 score over all time points (r = 0.15, p = 0.02), but sIgE tot failed to associate with severe exacerbation. sIgE tot decreased by 3% with any additional year of age for the whole group (p = 0.01) and increased by 5% per one unit of allergen exposure score in atopic patients (p = 0.002). Conclusion: In severe asthmatics, limited within-patient variability of sIgE tot levels was observed over 1 year as opposed to marked between-subject variability. sIgE tot decreases with age. Variation in sIgE tot weakly associates with asthma control but not with exacerbation.

Original languageEnglish (US)
Article number20
JournalAllergy, Asthma and Clinical Immunology
Volume15
Issue number1
DOIs
StatePublished - Mar 29 2019
Externally publishedYes

Keywords

  • Asthma
  • IgE
  • Variability

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Pulmonary and Respiratory Medicine

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    Louis, R., Pilette, C., Michel, O., Michils, A., Brusselle, G., Poskin, A., Van Schoor, J., Denhaerynck, K., Vancayzeele, S., Abraham, I. L., & Gurdain, S. (2019). Variability in total serum IgE over 1 year in severe asthmatics. Allergy, Asthma and Clinical Immunology, 15(1), [20]. https://doi.org/10.1186/s13223-019-0331-8