Total Serum IgE Levels Research Articles

Elevated MRGPRX2 Levels Related to Disease Severity in Patients With Chronic Spontaneous Urticaria.

Mas-related G-protein coupled receptor-X2 (MRGPRX2), a receptor on mast cells, basophils, and eosinophils associated with immunoglobulin E (IgE)-independent degranulation, has been reported to be highly expressed on cutaneous mast cells in patients with severe chronic spontaneous urticaria (CSU). We sought to investigate whether MRGPRX2 levels in the sera from CSU patients differ from those in healthy control subjects and to evaluate the clinical utility of MRGPRX2 levels in CSU patients. Severe CSU was defined as urticaria activity score over 7 days (UAS7) ≥ 28. Serum samples from 116 (73 severe and 43 non-severe) CSU patients and 50 healthy subjects were screened for MRGPRX2 using enzyme-linked immunosorbent assay. Serum MRGPRX2 levels were significantly higher in patients with severe CSU (median [interquartile range], 16.5 [10.8–24.8]) than in healthy controls (11.7 [6.5–21.2], P = 0.036) and in non-severe CSU patients (8.7 [4.5–18.8], P = 0.002), although they did not differ between healthy subjects and non-severe CSU patients. Serum MRGPRX2 levels in CSU patients showed positive correlations with UAS7 and specific IgE against Dermatophagoides farinae in CSU subjects, whereas no correlations were observed for age, sex, urticaria duration, atopy, combined angioedema, autologous serum skin test positivity, or total IgE levels. Logistic regression analysis identified serum MRGPRX2 ≥ 12 ng/mL (odds ratio, 6.421; P = 0.002) as an independent risk factor for severe CSU, along with increased serum total IgE levels, peripheral basophil percentage, and angioedema. In conclusion, we suggest that serum MRGPRX2 could help indicate severe CSU.

Elements of Immunoglobulin E Network Associate with Aortic valve Area in Patients with Acquired Aortic Stenosis.

Allergic mechanisms are likely involved in atherosclerosis and its clinical presentations, such as coronary artery disease (CAD). It has been previously reported that CAD severity associates with serum levels of immunoglobulin E (IgE), the molecule that, along with its high-affinity receptor (FcԑRI), plays a central role in allergic reactions. Considering multiple pathophysiological similarities between atherosclerosis and acquired aortic (valve) stenosis (AS), we speculated that allergic pathways could also contribute to the AS mechanisms and grading. To validate this hypothesis, we first checked whether total serum IgE levels associate with echocardiographic markers of AS severity. Having found a positive correlation between serum IgE and aortic valve area (AVA), we further speculated that also total IgE-determining genetic polymorphisms in FCER1A, a locus encoding an allergen-biding FcԑRI subunit, are related to acquired AS severity. Indeed, the major allele of rs2251746 polymorphism, known to associate with higher IgE levels, turned out to correlate with larger AVA, a marker of less severe AS. Our findings surprisingly suggest a protective role of IgE pathways against AS progression. IgE-mediated protective mechanisms in AS require further investigations.

Serum Levels of Total IgE and Interleukin-13 in a Sample of Allergic Asthma Patients in Baghdad

Allergic asthma is a type of asthma that provokes symptoms when an individual is exposed to certain triggers, such as pollen, animal sources of allergens, and other various types of allergens. These allergens cause an immune response that influences lungs and leads to difficulties in breathing. The current study is performed to estimate the concentrations of immunoglobulin E (IgE) and interleukin-13 (IL-13), tested by using the enzyme-linked immunosorbent assay (ELISA) and the numbers of eosinophils, calculated by using hematological analyzers, in the blood of patients with allergic asthma. A total of 150 patients and 50 healthy individuals were randomly selected for the study. The results revealed that IgE and IL-13 levels as well as eosinophil percentage were significantly increased (p<0.001) in the patients in comparison to the healthy individuals. These parameters deem to be a key element in allergic asthma pathogenesis. They also help in the diagnosis and management of the disease.

A mouse allergic asthma model induced by shrimp tropomyosin

Allergic asthma remains an important worldwide health issue. Animal models are valuable for understanding the pathophysiological mechanisms of asthma and the development of effective therapeutics. This study aims to develop an alternative murine model induced by shrimp tropomyosin (ST) instead of ovalbumin (OVA). To investigate responses to short-term exposure to antigens, mice were sensitized with intraperitoneal injections of ST or ST plus aluminum adjuvant on days 0, 7, 14 followed by an intranasal challenge with ST for seven consecutive days. We reveal that sensitization with ST alone or ST plus aluminum induces significant levels of serum total IgE and ST-specific IgE in mice. Challenge results show that ST causes severe eosinophilic airway inflammation. Histology analysis of the lung tissues demonstrates airway inflammation and mucus hypersecretion within the bronchi in mice exposed to ST. Analysis of the cell composition in bronchoalveolar lavage fluid (BALF) shows a significant increase in eosinophil count in ST alone and ST plus aluminum groups. We also detect increased CD4+ T lymphocytes in lung tissues and production of helper T cell type 2-associated cytokines (IL-4 and IL-5) in BALF. In addition, airway hyperresponsiveness to methacholine in ST alone and ST plus aluminum groups is much higher than that in control groups. For the chronic model, mice were sensitized by ST or ST plus aluminum adjuvant for 3weeks and challenged with ST for 6weeks. We find severe structural changes in animals upon prolonged exposure to ST, including goblet cell hyperplasia, collagen deposition, and smooth muscle thickening. In conclusion, ST-induced asthma is a simple murine model for studying pathogenesis of asthma and evaluating new therapeutic drugs.

Evaluation of Serum Total Immunoglobulin E, Interleukin-17 and Pentraxin-3 as Biomarkers for Chronic Rhinosinusitis With Nasal Polyposis.

Different biomarkers are detectable in cases of chronic rhinosinusitis with nasal polyposis (CRSwNP) with need for evaluation of their diagnostic and prognostic roles. To assess the serum levels of total IgE, interleukin-17 and Pentraxin-3 in patients with CRSwNP and correlate them with the clinical evaluation using Sino-Nasal Outcome Test (SNOT-22), radiological evaluation using Lund - Mackay (LM) computed tomography scan score, and polyposis recurrence. This cross-sectional comparative study was carried out on fifty patients with CRSwNP and twenty-five age and gender matched healthy volunteers as control group. Patients were assessed clinically by SNOT-22 and radiologically by LM score. Blood samples of patients and controls were analyzed for serum levels of total immunoglobulin E (IgE), Interleukin-17 (IL-17) and Pentraxin-3 (PTX-3). The correlation between the serum levels of every two markers of the study markers was assessed. The levels of the three biomarkers were correlated with SNOT-22 and LM scores and polyp recurrence with assessment of their sensitivity and specificity to diagnose CRSwNP. This study showed significantly higher values of the three biomarkers in patients group compared with control group (p < 0.001 for all). There were significant positive correlations between the levels of the three markers and SNOT 22 and LM scores (p < 0.001 for all) and with recurrence of polyposis (p < 0.001, p = 0.005 and p = 0.032 respectively). Agreement (sensitivity and specificity) for these markers to diagnose patient group was statistically significant (p < 0.001 for all). There was a significant positive correlation between every two markers of the study markers. Serum levels of total IgE, IL-17 and PTX-3 are important biological markers for diagnosis and follow up of cases of CRSwNP with high sensitivity and specificity in detection of such cases. They should be included in the routine laboratory workup for cases of CRSwNP.

CLINICAL-IMMUNOLOGICAL EFFECTIVENESS OF RIBOMUNYL IN CHILDREN WITH VIRUS-INDUCED BRONCHIAL ASTHMA

The aim of the study is to research the effects of immunostimulant Ribomunyl in virus-induced bronchial asthma (VBA) children.Materials and methods. 14 virus-induced bronchial asthma (VBA) children were agministrated with immunostimulant Ribomunyl as a part of complex therapy in a 18-month trial (3 cycles of treatment). The comparison group consisted of 16 patients who received only standard therapy for bronchial asthma. At the end of the study, against the background of basic BA therapy, the following parameters were estimated: the frequency of acute respiratory viral infections (ARVI), the need for antibacterial therapy, the frequency of IgG to respiratory-syncytial virus (RSV) prevalence, the serum level dynamics of total IgE, IFN-γ, interleukin-4 (IL-4), interferon gamma (IFN-γ).Results. The inclusion of Ribomunyl into the basic therapy complex in virus-induced bronchial asthma (VBA) children, made it possible to reduce the need for the VBA basic therapy complex by 50% and by 12,5% (р=0,0279). At the same time, as for the frequency of acute respiratory viral infections (ARVI), there was a comparable decrease in both groups, but in the main group the number of cases requiring antibiotic therapy decreased from 78.6% to 42.9% (p=0.0199). The inclusion of Ribomunyl into the basic therapy complex resulted in the decrease of the total IgE serum level; in the patients with the initial presence of IgG to the respiratory syncytial virus (RSV), the IL-4 level decreased and the IFN-γ level increased.Conclusion. Ribomunyl improves the treatment of virus-induced bronchial asthma (VBA) children, herewith the dynamics of immunological indicators is more in RSV-seropositive patients.

IgE antibody in serum-detection and diagnostic significance as a biomarker in patients with uncontrolled asthma

Background: The presence of atopy increases the probability that a patient with respiratory symptoms has allergic asthma but this is not specific for asthma nor is it present in all asthma phenotypes. Atopic status can be identified by skin prick testing or level of serum IgE. Ig E is a tissue bound molecule found in serum in equilibrium with that bound to mast cells and basophils. The aim of this study was to evaluate the levels of serum total IgE in patients with uncontrolled asthma and test the significance of serum IgE as a biomarker/predictor of severity for uncontrolled asthma. Materials and Methods: A simple random sampling of 55 patients in the age group of 5 to 63 years with 19 males and 36 females over two groups of 45 cases with uncontrolled asthma and 10 controls of controlled asthma were included in the study. Clinical examination, spirometry and serum IgE levels were measured. Results: The level of serum IgE was high in 80 % of the total study population with as high as 88.8% in the uncontrolled asthma group and 40 % in the controlled group. The mean serum IgE level in uncontrolled asthma patients were 2222 IU/L, while in the control group it was 1224 IU/L. Conclusions: The high levels of serum IgE in uncontrolled asthma patients clearly indicates the definite correlation between higher IgE levels and uncontrolled asthma and demonstrates an inverse relationship with serum IgE levels and FEV1 %. Keywords: Allergy; Asthma; Atopy; Gina; Serum IgE.

Glycan-specific IgG anti-IgE autoantibodies are protective against allergic anaphylaxis in a murine model

IgE causes anaphylaxis in type I hypersensitivity diseases by activating degranulation of effector cells such as mast cells and basophils. The mechanisms that control IgE activity and prevent anaphylaxis under normal conditions are still enigmatic. We aimed to unravel how anti-IgE autoantibodies are induced and we aimed to understand their role in regulating serum IgE level and allergic anaphylaxis. We immunized mice with different forms of IgE and tested anti-IgE autoantibody responses and their specificities. We then analyzed the effect of those antibodies on serum kinetics and their invitro and invivo impact on anaphylaxis. Finally, we investigated anti-IgE autoantibodies in human sera. Immunization of mice with IgE-immune complexes induced glycan-specific anti-IgE autoantibodies. The anti-IgE autoantibodies prevented effector cell sensitization, reduced total IgE serum levels, protected mice from passive and active IgE sensitization, and resulted in cross-protection against different allergens. Furthermore, glycan-specific anti-IgE autoantibodies were present in sera from subjects with allergy and subjects without allergy. In conclusion, this study provided the first evidence that in the murine model, the serum level and anaphylactic activity of IgE may be downregulated by glycan-specific IgG anti-IgE autoantibodies.

Investigation of Serum Total IgE and Eosinophil Levels in Different Allergic Diseases Together with the Study of Their Correlations with Various Possible Allergens in Mosul City

ABSTRACT Serum total IgE (tIgE) is frequently used in the diagnosis of allergic diseases in Mosul city and Iraq. However, neither normal nor elevated levels can exclude or confirm the diagnosis of these diseases. Here, we tried to evaluate the validity of tIgE in the diagnosis of allergic asthma(AS), allergic rhinitis(AR) and atopic dermatitis(AD) in a sample of Mosul population, to set up an optimum cut-off value for diagnosis of these diseases and to study its correlation with different parameters that might affect its level. 38 patients with AS, 27 with AR, 46 with AD and 45 healthy controls were included in this study. tIgE were determined by ELISA and compared between allergic diseases and controls. Blood eosinophilia was ascertained and correlated with tIgE levels. The geometric means of tIgE were 316.87 IU/ml (95% CI: 234.69 to 427.82) in AS, 262.07 IU/ml (95% CI:174.24 to 394.18) in AR and 270.48 IU/ml (95% CI:202.57 to 361.16) in AD compared to 16.90 IU/ml (95% CI:12.32 to 23.18) in healthy controls. tIgE in allergic diseases was significantly increased in comparison to healthy controls (P <.0001). Female gender influenced tIgE in AS, but not in AR or AD. tIgE predominated in younger age groups; however, no significant difference was found between younger and older groups. Optimum values for tIgE with best discriminative accuracy were 77 IU/ml for AS and 81 IU/ml for AR and AD. Eosinophils count appeared to be a useful adjunct, and correlate well with tIgE in the diagnosis of allergic diseases.

A Nomogram Combing Peripheral Parameters for Estimation of CRSwNP Recurrence

The preoperative prediction of the recurrence of chronic rhinosinusitis with nasal polyps (CRSwNP) remains difficult in clinical practice. We aimed to develop a nomogram that combined peripheral risk factors to clinically predict the recurrence of CRSwNP. Data from 158 CRSwNP patients who underwent endoscopic sinus surgery (ESS) from January 2012 to December 2016 were collected, and the patients were followed up for 3 years. Of these, 96 patients who underwent ESS in an earlier period formed the training cohort for nomogram development, and 62 patients who underwent ESS thereafter formed the validation cohort to confirm the model's performance. Risk factors for recurrence identified by univariate and multivariate logistic regression were used to create a nomogram. The recurrence rate was 29.2% (28/96) for the training cohort and 35.5% (22/62) for the validation cohort. Univariate analysis identified blood eosinophils (Eos), serum IgE level, asthma comorbidity, and the number of previous ESSs as risk factors for recurrence. Among those four parameters, serum IgE level and a previous ESS surgery were identified as two independent risk factors. A nomogram consisting of blood Eos, total serum IgE level, asthma comorbidity, and the number of previous ESSs was constructed, demonstrating a C index of 0.81 (95% CI, 0.79-0.83) and 0.80 (95% CI, 0.77-0.83) for predicting recurrence in the training and validation cohorts, respectively. The nomogram had well-fitted calibration curves. The nomogram might be able to preoperatively predict the recurrence of CRSwNP by using currently available and objective parameters. Further studies are required to validate its reliability and effectiveness.

Role of gut microbiota in children with allergic rhinitis with high serum total IgE level

Objective:To study the role of gut microbiota in children with allergic rhinitis with high serum total IgE level. Method:A total of 17 cases of children in Shanghai Children's Medical Center of Shanghai Jiao Tong University School of Medicine, who suffered from perennial allergic rhinitis of grade 5-6, were enrolled in this study. Baseline information were collected from all participants. Peripheral blood was collected to test the level of serum total IgE and specific IgE. Fecal samples were collected for bacterial DNA extraction and sequenced by 16S rDNA high-throughput sequencing. R, Mother and LEfSe softwares were used for diversity analysis, relative abundance calculation and differential species detection. Result:Twenty-three fecal samples were collected in total, including thirteen in attack period（attack group） and ten in control period（control group）. In the attack group, six cases were serum total IgE positive（positive group） and seven were negative（negative group）. Compared with the control group, there was no significant difference in either Alpha diversity or Beta diversity of Weighted Unifrac in the attack group（P>0.05）. The relative abundance of odoribacteraceae and odoribacter were significantly increased in the attack group（LDA score>2）. The relative abundance of Porphyromonadaceae in positive group were significantly lower than that in negative group, while family Dethiosulfovibrionaceae genus Pyramidobacter was definitely higher on the contrast（LDA score>2）. Conclusion:Children with allergic rhinitis have different characteristics of intestinal flora during the attack and control period. Gut microbiota is associated with high serum total IgE level in children with allergic rhinitis. Specific microbial alterations play a potential role in disease pathophysiology.

Longitudinal analysis of total serum IgE levels with allergen sensitization and atopic diseases in early childhood

There are few studies addressing the longitudinal analysis of serum IgE levels and its impact to the development of atopic diseases in early childhood. We investigated 170 children who regularly followed up at our clinic for 4 years in a birth cohort study with at least 3 time-points of serum samples. The pattern of total serum IgE levels from 6 months to 4 years of age was clustered using K-means method in R software. Specific immunoglobulin E antibodies against food (egg white and milk) and inhalant allergens (D. pteronyssinus and D. farinae) were measured at 0.5, 1, 1.5, 2, 3 and 4 years of age. By using K-means clustering, the dynamic changes in serum IgE levels was significantly stratified into 3 clusters (cluster A, < 100 kU/L, n = 106; cluster B, 100–200 kU/L, n = 35; cluster C, ≥ 200 kU/L, n = 29). A persistent total IgE levels higher than 100 kU/L appeared to be associated with higher prevalence of sensitization to food but not mite. However, a persistent IgE levels higher than 200 kU/L was not only remarkably related to increased prevalence of mite sensitization, but also risk of eczema at age 1 and allergic rhinitis and asthma at age 2, 3 and 4. In conclusion, a persistent total serum IgE level ≥ 200 kU/L since infancy is strongly associated with the presence of food and mite sensitization, as well as the development of eczema in infants, and rhinitis and asthma later in early childhood.

Clinical, functional and laboratory characteristics of patients with asthma-COPD overlap

Objective: to access some clinical, functional and laboratory features of patients with asthma-COPD overlap (ACO).Material and methods. Our study involved 120 patients and two ACO groups were created: asthmatic smokers - Group I and COPD patients with high degree of reversibility of airflow limitation and eosinophilic COPD (eosinophil blood count ≥2% and 200 cell/ml) - Group II. All the other COPD subjects – Group III. The spirometry testing were performed using computer spirograph «BTL-08SpiroPro» (Great Britain). Weight and body composition variables were measured with a body composition monitor (BC-601 Tanita, Japan). Blood eosinophils and total IgE levels were estimated. «Microsoft Excel», «Statistica» were used for mathematical and statistical analysis.Results. There were 28,3% of participants classified as ACO. The combination of long-acting beta-agonist and inhaled corticosteroids usage rate was higher among asthmatic smokers (2,3 and 1,8 times higher than in Group II and Group III respectively), as well as short acting beta-agonist and oral corticosteroid usage rates (1,7 and 2,3 times higher in Group I compared to Group II). The peripheral blood eosinophil and serum IgE levels were 1,8 and 3,3 times higher (p&lt;0,05) in Group II than in Group I and III. FEVI was higher in Group I by 7,6% and in Group II by 11,8% than in COPD. It has been demonstrated that among Group II subjects there was higher BMI( by 28,8% and 22,2% (p&lt;0,05)), the body fat percentage ( by 19,7% and 41,3% (р&lt;0,05)), the visceral fat level (by 16,7% and 20,3%(р&lt;0,05)) and the muscle mass(by 10,8% and 15,5%(р&lt;0,05)) than in asthmatic smokers and COPD patients respectively.Conclusion. The prevalence of ACO (asthmatic smokers, eosinophilic COPD and COPD with high degree of reversibility) among the examined subjects was 28,3%. COPD patients with high degree of reversibility and eosinophilic inflammation are characterized by higher blood eosinophil and total serum IgE levels, higher FEV1, amount of visceral fat, body fat percentage and especially muscle muss.

Acute and Subacute Oral Toxicity of Deoxynivalenol Exposure in a Dermatophagoides farinae-Induced Murine Asthma Model.

Previously, researchers have demonstrated that mycotoxin deoxynivalenol (DON) significantly enhances immunocyte activation. However, the interaction between DON exposure and immune disorders remains unclear. In this study, we aimed to investigate whether acute and subacute oral exposure to DON exacerbates the development of respiratory allergy using a mite allergen (Dermatophagoides farina, Derf)-induced mouse model of asthma. The direct relationship between DON exposure and asthma development was examined following acute oral DON administration (0, 0.1, or 0.3 mg/kg body weight), immediately before the final mite allergen challenge. Simultaneously, the influence of subacute oral exposure via low dose DON contaminated wheat (0.33 ppm) was evaluated using the same settings. To detect the proinflammatory effects of DON exposure, we examined the total and Derf-specific serum IgE levels, histology, number of immunocytes, and cytokine and chemokine secretion. Acute oral DON significantly enhanced the inflammatory responses, including cellular infiltration into bronchoalveolar lavage fluid, infiltration of immunocytes and cytokine production in local lymph nodes, and cytokine levels in lung tissues. Corresponding proinflammatory responses were observed in a mouse group exposed to subacute oral DON. In vivo results were validated by in vitro experiments using the human bronchial epithelial (BEAS-2B) and human eosinophilic leukemia (EOL-1) cell lines. Following exposure to DON, the secretion of interleukin (IL)-1β, IL-6, IL-8, and/or tumor necrosis factor-α in BEAS-2B cells, as well as EoL-1 cells, increased significantly. Our findings indicate that DON exposure is significantly involved in the proinflammatory response observed in respiratory allergy.

Association of Cotinine-Verified Cigarette Exposure with Chronic Rhinosinusitis in Korean Adults.

Chronic rhinosinusitis is known to be influenced by cigarette exposure; however, this relationship is based on the presence of nasal polyps, and objective measurements of cigarette exposure in chronic rhinosinusitis are not well established. This study aimed to estimate the association between chronic rhinosinusitis and smoking status based on self-reported questionnaires and urinary cotinine levels according to the presence of nasal polyps. We analyzed a total of 23,621 participants who participated from the fifth Korea National Health and Nutrition Examination Survey (2010–2012). Serum total and specific IgE level were measured. Higher prevalence of chronic rhinosinusitis with nasal polyps was associated with current smoking status (OR = 1.43, 95% CI = 1.00–2.03). This association was prevalent in participants aged ≤ 50 years (OR = 1.76, 95% CI = 1.01–3.05), and higher urinary cotinine level showed correlation with higher prevalence of chronic rhinosinusitis with nasal polyps in this age group (OR = 1.04, 95% CI = 1.00–1.08). In addition, positive correlation between serum total IgE and urinary cotinine levels was greater in patients with chronic rhinosinusitis (β = 0.493, 95% CI = 0.071–0.916) than in controls (β = 0.062, 95% CI = 0.021–0.103). Aggressive smoking interventions should be performed in patients with chronic rhinosinusitis with nasal polyp, especially in cases of young adults or high serum IgE levels.

English

Uncaria guianensis (Aubl.) J. F. Gmel. (&ldquo;cat&rsquo;s claw&rdquo;, Rubiaceae) is a plant with potential to treat asthma because of its anti-inflammatory and antioxidant activities. The aim of this study was to evaluate the effects of two extracts of U. guianensis in an animal model of allergic asthma. Balb/c mice were sensitized twice with ovalbumin intraperitoneally one week apart, then challenged with intranasal ovalbumin for three days. Animals were treated with aqueous or hydroethanolic extracts (100 mg/kg) for three days, simultaneously with ovalbumin challenges. Control mice received saline solution on the same days. In vivo bronchial hyper responsiveness, airway and lung inflammation, IgE levels, and total antioxidant capacity were measured. Treatment with the hydroethanolic extract significantly reduced total cell and eosinophil counts in bronchoalveolar lavage, and in vivo bronchial hyper responsiveness. Moreover, U. guianensis hydroethanolic extract significantly reduced interleukin 13 levels in lung homogenate. Total antioxidant capacity and IgE serum levels were not affected with the extract administration. Of note, treatment with the aqueous extract did not elicit significant effects on asthma-like characteristics. Only the hydroethanolic extract of U. guianensis reduced lung inflammation and bronchial hyper responsiveness in asthmatic mice. Key words: Anti-inflammatory agents, asthma, oxindolics, phenols, respiratory hypersensitivity, Uncaria guianensis, Rubiaceae. &nbsp

Biomarkers of airways inflammation in patients with severe asthma in a real clinical practice

Severe asthma is a heterogeneous disease consisting of several endotypes and phenotypes diagnosed due to different biomarkers. Frequency of different endotypes and phenotypes in real clinical practice needs further investigation.The aim of this study was to assess biomarkers of T2-inflammation in patients with severe asthma in a single secondary care center.Methods. We examined 96 adult outpatients (34% male) with severe asthma. Data collected included demographics, smoking history, asthma exacerbations during previous 12 months, medication use, comorbidities. Lung function tests were assessed by using the Spirograph 2120 (Vitalograph, Great Britain). Blood eosinophils (Eos) were measured by automatic haemoanalyser. Atopic status was determined by positive skin prick-test (&gt; 3 mm) and/or serum specific IgE to common inhalant allergens. Serum total IgE levels were assessed by immunofluorescence assay. FeNO was measured by a chemiluminescence analyzer (Model LR4000; Logan Research, Rochester, UK). Presence of allergy, need for regular oral steroid use, blood Eos ≥ 150 cell/μl and FeNO ≥ 20 ppb were considered as markers of T2-driven inflammation. Asthma control and quality of life were assessed by using Russian versions of ACQ-5 and St. George's Respiratory Questionnaire (SGRQ). Statistical analyses were performed with Statistica Ver. 10.0 (StatSoft, Inc., USA).Results. The majority of patients with severe asthma (93%) have at least one or more elevated markers (presence of allergy, need for regular oral steroid use, Eos ≥ 150 cell/μl or FeNO ≥ 20 ppb) of T2-inflammation. Biomarkers levels did not differ in non-steroid-dependent and steroid-dependent patients. The most frequent markers were allergy and blood Eos ≥ 150 cell/μl. Two or more elevated biomarkers were revealed in 72% of patients.Conclusion. The majority of patients with severe asthma in real clinical practice have signs of T2-inflammation. It seems that many severe asthmatics have indications for prescription of biological and can be treated by more than one of monoclonal antibodies against major cytokines of T2-inflammation.

Total serum IgE level in COPD exacerbations

COPD exacerbations were diagnosed based on the clinical parameters only. Till now we were unable to find out a reliable blood based biomarker. Serum IgE is one of the measurements of airway inflammation which is well established in asthma, it’s role in COPD not studied adequately. This is a cross sectional study conducted in a tertiary care center. This study included 75 COPD patients who were admitted in our hospital for exacerbations. Exacerbations defined by the GOLD report 2018. Complete history &amp; Total serum IgE levels were obtained from all patients during admission, pulmonary function test has been done at the time of discharge and results were analyzed. In our study the mean value of serum IgE is 416.75 IU/L. Patients who had elevated serum IgE (&amp;#62;100 IU/L) levels were 55 (73.3%). FEV/FVC ratio significantly high in elevated IgE group (0.58±0.09 in elevated IgE vs 0.49±0.10 in IgE not elevated, p&amp;#60;0.001). Post BD change in FEV was significantly more in elevated IgE group (13.7%+185ml in elevated IgE vs 6.4%+73ml in IgE not elevated, p=0.001). IgE elevated patients have seasonal variation history, Biomass exposure history. They had more Asthma COPD Overlap features than IgE not elevated group (p=0.001). COPD patients can have elevated serum IgE levels during exacerbations. IgE may play an important role in pathogenesis of COPD and can be used as a biomarker for COPD Exacerbations. Serum total IgE can be used as a biomarker in COPD exacerbations. This can be used as a new therapeutic target for the same.

Assessing prevalence and clinical and allergological characteristics of fungal sensitization in Samara City

Molds Alternaria spp., Cladosporium spp., Aspergillus spp., and Penicillium spp. play a major role in populational sensitization. Fungal spores may become a predisposing factor in developing bronchial asthma (BA), allergic rhinitis (AR) and atopic dermatitis (AD). The aim of our study was to investigate prevalence and clinical manifestation of fungal sensitization in the City of Samara. 2016 – 2019 general clinical and allergological examination of 855 patients of different age suspected for respiratory allergy was performed. All patients were tested for measuring serum level of total IgE and IgE specific to most common respiratory and food allergens, including fungal allergens derived from Alternaria spp., Cladosporium spp., Aspergillus spp., Penicillium spp., (RIDA Allergyscreen, R-Biopharm, Germany). 26 patients previously diagnosed positive to native Alternaria extracts and 50 patients with symptoms of exacerbated allergic rhinitis during summer and autumn were tested for serum level of IgE specific to recombinant molecular Alternaria component (rAlt a l, Phadia ImmunoCAP). It was found that 28.4% pediatric and 18.2 % adult patients (р = 0.0322). 25% of patients appeared to be sensitized to fungal allergens. Sensitization to various mold-derived allergens was distributed as follows: Alternaria allergens – in 23% all patients examined, (27% children and 14% adults); Cladosporium – in 11% patients (10% children and 8% adults); Aspergillus – in 5% patients (6% children and 2% adults); Penicillum – in 2% patients (1% children and 3% adults). Moreover, sensitization to Alternaria allergens prevailed in more than 90% patients with fungal sensitization that was more common in young individuals (up to 18% in 7-17-year-old group), but profoundly declined in subjects over 50 years of age (p = 0.00001, χ2 = 61.31). True sensitization to Alternaria (Alt a 1) was detected in more than half (63%) of patients with confirmed sensitization to native Alternaria extracts, whereas 66% and 25% patients with fungal sensitization suffered from allergic rhinitis and asthma, respectively. Sensitization to Alternaria is a risk factor of developing asthma in childhood (OR = 2.415). The data obtained evidence about prevalence of fungal sensitization and associated allergic diseases in the Samara region.

ASTIM HASTASI ÇOCUKLARIN DEMOGRAFİK, KLİNİK VE LABORATUVAR BULGULARININ DEĞERLENDİRİLMESİ

AMAÇ: Astım çocukluk çağının en sık kronik hastalıklarından biridir. Çalışmamızın amacı polikliniğimizde astım tanısı ile iz-lenen hastalarımızın demografik, klinik, laboratuvar özelliklerini incelemek, verilen tedavileri, hastaların ilaç kullanım tekniği doğruluğu ve ilaç uyumunu değerlendirmektir. GEREÇ VE YÖNTEM: Polikliniğimizde astım tanısı alan 188 hastanın dosyalarından yaş, cinsiyet, ailesel atopi, pasif sigara maruziyeti verileri kaydedildi. Kan mutlak eozinofil sayısı, serum total IgE, alerjen spesifik IgE, cilt delme testi, besin yükleme testi sonuçları incelendi. Hastalar Global Initiative for Asthma (GINA 2018) ve Allergic Rhinitis and its Impact on Asthma (ARIA 2016) kılavuzlarına göre hastalık kontrol/ağırlık gruplarına ayrıldı. Astım kontrol testi, çocukluk çağı astım kontrol testi ve çocuklar için solunum ve astım kontrol testi sonuçları kaydedildi. Hastaların başvuruda almakta olduğu ve tarafımızca başlanan tedaviler incelendi. Başvuru ve ilk kontrol muayenelerinde inhaler tekniklerin doğru uygulanması ve ilaç uyumu değerlendirildi. Bu değerlendirmeler için tanımlayıcı istatistiksel analizler kullanıldı. BULGULAR: Hastaların yaş ortalaması 8,41±3,52 yaş (1,5-16,5) ve 107 (%56,9) hasta erkek idi. 52 hastada ailesel atopi, 60 has-tada sigara maruziyeti vardı. Hastalar astım açısından en çok iyi kontrollü, alerjik rinit açısından en çok orta-ağır grupların-daydı. 82 hastada solunumsal alerjen duyarlılığı, iki hastada da besin alerjisi saptanmıştı. Hastaların %39,89’una dış merkezde, %31,91’ine tarafımızca kontrol edici tedavi başlanmıştı. İlaç uyu-mu bilgisine ulaşılabilen hastaların %33,59’unun ilaç uyumsuz hasta olduğu görüldü. Hastaların %39,28’inin başvuruda, en az bir kez kontrole gelenlerin %24,48’inin kontrol muayenesinde inhaler tekniği doğru uygulamadığı görüldü.SONUÇ: Çalışmamızda ilimizdeki astımlı çocuk hastaların demografik, klinik, laboratuvar bulguları, tedavileri ve tedavi uyumları değerlendirilmiştir. Ailede astım varlığı ve alerjik rinit eşlik etme sıklıkları literatürle uyumludur. Tedavide ağırlık/kont-rol düzeyinin dikkate alınması tekrar hatırlanmalıdır. İlaç uyumsuzluğu ve yanlış teknikle kullanım hastalarımızda da yüksek oranda olup tedavi başarısı için akılda tutulmalıdır. Ülkemizdeki astımlı çocukların değerlendirildiği literatürdeki az sayıdaki çalışmaya katkıda bulunulmuştur.