IgE Production in Allergic Asthmatic Patients with Different Asthma Control Status
Kittipong Maneechotesuwan MD, PhD*, Pimtira Sujaritwongsanon MD*, Tasneeya Suthamsmai MSc*
Affiliation : *Division of Respiratory Disease and Tuberculosis, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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 well-
controlled, 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 speci-
mens 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 develop-
ment of uncontrolled asthma.
Keywords : Allergic asthma; Asthma control; Immunoglobulin E
