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Blöndal V, Sundbom F, Zhou X, Movérare R, Borres MP, Högman M, Alving K, Malinovschi A, Janson C. Allergic sensitisation and type-2 inflammation is associated with new-onset and persistent allergic disease. Clin Transl Allergy 2023; 13:e12240. [PMID: 37186426 PMCID: PMC10080081 DOI: 10.1002/clt2.12240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 03/14/2023] [Accepted: 03/20/2023] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND Allergic disease is common. The aim of this study was to look at the change in asthma and rhinitis over time and to characterise factors contributing to remission and persistence of disease. METHODS This cohort study included 255 individuals with or without asthma and or rhinitis that participated in a population survey and a follow-up 10 years later. The participants were tested for allergic sensitisation, total IgE, multiplex allergen component analysis and type-2 inflammatory markers: exhaled nitric oxide (FE NO), eosinophil cationic protein (ECP) and eosinophil-derived neurotoxin (EDN). RESULTS Of the 132 healthy individuals, 112 remained healthy, 16 developed rhinitis, 4 asthma and rhinitis over the 10 years. Out of 82 subjects with rhinitis, 26 went into remission, 53 remained unchanged and 3 developed asthma in addition to rhinitis. None of the 41 participants with asthma and rhinitis went into remission. Subjects with persistent rhinitis and asthma had higher levels of total IgE (odds ratio [OR] 95% confidence interval [CI]: 6.16 [3.05-12.5]) at baseline and after 10 years, and FE NO and ECP at baseline (OR per log unit increase, 95% CI 5.21 [1.20-22.7] and 6.32 [1.52-26.4], respectively), compared with those that remained healthy. Subjects with persistent rhinitis were more likely to be sensitised to grass pollen and had higher total IgE levels than those that went into remission. Individuals with persistent asthma were more likely to be sensitised to tree pollen and furry animals than those with only persistent rhinitis (OR 95% CI: 3.50 [1.29-9.49] and 6.73 [2.00-22.6], respectively). CONCLUSION IgE sensitisation and total IgE levels are associated with the persistence of rhinitis and asthma. Participants with persistent allergic disease had higher levels of allergen sensitisation and type 2 inflammation markers at baseline than those who remained healthy.
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Affiliation(s)
- Viiu Blöndal
- Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
| | - Fredrik Sundbom
- Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
| | - Xingwu Zhou
- Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
- Department of Medical Sciences, Clinical Physiology, Uppsala University, Uppsala, Sweden
| | - Robert Movérare
- Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
- Thermo Fischer Scientific, Uppsala, Sweden
| | - Magnus P Borres
- Thermo Fischer Scientific, Uppsala, Sweden
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Marieann Högman
- Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
| | - Kjell Alving
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Andrei Malinovschi
- Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
- Department of Medical Sciences, Clinical Physiology, Uppsala University, Uppsala, Sweden
| | - Christer Janson
- Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
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Pascal M, Moreno C, Dávila I, Tabar AI, Bartra J, Labrador M, Luengo O. Integration of in vitro allergy test results and ratio analysis for the diagnosis and treatment of allergic patients (INTEGRA). Clin Transl Allergy 2021; 11:e12052. [PMID: 34582103 PMCID: PMC9082998 DOI: 10.1002/clt2.12052] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 07/05/2021] [Accepted: 07/30/2021] [Indexed: 01/09/2023] Open
Abstract
The introduction of molecular diagnosis into routine clinical practice has substantially improved the diagnosis and management of allergic patients by allowing clinicians to precisely identify the allergenic molecule responsible for immunoglobulin E (IgE)‐mediated allergies. However, it can be challenging to accurately interpret the results of molecular assays, partly due to the limited evidence base. In this context, a panel of experts with extensive experience in interpreting in vitro measures of total and serum specific IgE reviewed the available scientific evidence. After this review, the panel selected a series of representative case studies to demonstrate how determination of specific and total IgE values and the relationship between them (ratio analysis) can add value to the diagnostic process by more precisely defining the patient’s sensitization profile. Finally, the experts developed a series of recommendations on the clinical application of ratio analysis to optimize and complement the classical approach to allergy diagnosis.
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Affiliation(s)
- Mariona Pascal
- Immunology Department, Centre de Diagnòstic Biomèdic, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain.,ARADyAL Network, Health Institute Carlos III, Madrid, Spain
| | - Carmen Moreno
- ARADyAL Network, Health Institute Carlos III, Madrid, Spain.,Allergy Service, Hospital Universitario Reina Sofía, Maimonides Biomedical Research Institute of Córdoba (IMIBIC), Córdoba, Spain
| | - Ignacio Dávila
- ARADyAL Network, Health Institute Carlos III, Madrid, Spain.,Allergy Service, Department of Biomedical and Diagnostic Sciences and Institute for Biomedical Research of Salamanca (IBSAL), University Hospital of Salamanca, Salamanca, Spain
| | - Ana I Tabar
- ARADyAL Network, Health Institute Carlos III, Madrid, Spain.,Allergy Service, Hospital Complex of Navarra, Pamplona, Spain.,Navarra Institute for Health Research (IdiSNA), Cooperative Health Research Thematic Networks (RETICs) for Asthma, Madrid, Spain
| | - Joan Bartra
- ARADyAL Network, Health Institute Carlos III, Madrid, Spain.,Allergy Section, Pneumology Department, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
| | - Moisés Labrador
- ARADyAL Network, Health Institute Carlos III, Madrid, Spain.,Allergy Section, Internal Medicine Department, Hospital Universitari Vall d´Hebron, Institut de Recerca Vall d'Hebron (VHIR), Universitat Autònoma de Barcelona. Barcelona, Spain
| | - Olga Luengo
- ARADyAL Network, Health Institute Carlos III, Madrid, Spain.,Allergy Section, Internal Medicine Department, Hospital Universitari Vall d´Hebron, Institut de Recerca Vall d'Hebron (VHIR), Universitat Autònoma de Barcelona. Barcelona, Spain
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