J Med Assoc Thai 2010; 93 (1):71

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IgE Production in Allergic Asthmatic Patients with Different Asthma Control Status
Maneechotesuwan K Mail, Sujaritwongsanon P , Suthamsmai T

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 wellcontrolled,
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.

Keywords: Allergic asthma; Asthma control; Immunoglobulin E

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