Abstract
BackgroundAlthough the relationship between allergic sensitization and increased respiratory symptoms of chronic obstructive pulmonary disease (COPD) has been suggested, which allergen has a significant effect on COPD pathology is unclear. This study aimed to identify the specific IgE related to clinical features of COPD and the diagnosis of asthma-COPD overlap (ACO).MethodsWe recruited 76 patients with COPD and analyzed 39 IgE using panel IgE test (View Allergy 39®). ACO was diagnosed according to the Japanese Respiratory Society Guidelines.ResultsAs for perennial aeroallergens, the positivity for moth (31.5%), Candida (23.7%), Dermatophagoides pteronyssinus (22.4%) and house dust (22.4%), and concerning pollen, Japanese cedar (35.5%) and Japanese cypress (22.2%) exceeded 20%. Only the positivity of IgE for Dermatophagoides pteronyssinus and house dust was significantly higher in ACO compared with that in non-ACO COPD. Moreover, it contributed to the diagnosis of ACO in an IgE class-dependent manner. Patients with cockroach IgE exhibited higher residual volume, whereas those with Japanese cedar IgE exhibited better diffusion capacity than negative patients. The contribution for ACO diagnosis by the receiver operating characteristic curve analysis was comparable among total IgE (cutoff value: 158 IU/mL), blood eosinophil count (234/μL), and fraction of exhaled nitric oxide (31.0 ppb).ConclusionsThe prominent role of mite-specific IgE in the diagnosis and pathology of ACO and the potentially detrimental effect of cockroach sensitization on air trapping in COPD were suggested. The finding highlights the future development of a treatment targeting IgE as a treatable trait in COPD.
Highlights
The relationship between allergic sensitization and increased respiratory symptoms of chronic obstructive pulmonary disease (COPD) has been suggested, which allergen has a significant effect on COPD pathology is unclear
Allergic sensitization may not be routinely assessed in patients with chronic obstructive pulmonary disease (COPD), Toyota et al Allergy Asthma Clin Immunol (2021) 17:13 and the diagnosis of allergy is not recommended by the Global Initiative for Chronic Obstructive Lung Disease (GOLD) [2]
We analyzed the positivity of 39 allergen-specific immunoglobulin E (IgE) in all COPD patients
Summary
The relationship between allergic sensitization and increased respiratory symptoms of chronic obstructive pulmonary disease (COPD) has been suggested, which allergen has a significant effect on COPD pathology is unclear. This study aimed to identify the specific IgE related to clinical features of COPD and the diagnosis of asthma-COPD overlap (ACO). Allergic sensitization has been reported to be related to increased respiratory symptoms and risk of exacerbations in patients with COPD [3] and may be a potential treatable trait by avoidance of allergen or by anti-immunoglobulin E (IgE) treatment [4]. Some recent guidelines introduced elevated levels of IgE into the diagnostic criteria [8, 9], the cutoff level of IgE was not stated in the guidelines, including the Japanese Respiratory Society (JRS) published in 2018 [10, 11]. Recent evidence suggests the interactions between food allergy and asthma [12], the relationship between food allergy and ACO or COPD is largely unknown
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