IgE sensitization to food allergens and airborne allergens in relation to biomarkers of type 2 inflammation in asthma

• BACKGROUND: We have recently reported that sensitisation to food allergens and sensitisation to airborne allergens had independent associations with increased fraction of exhaled nitric oxide (FeNO) and blood eosinophils in middle-aged adults and in young subjects with asthma.OBJECTIVE: To investigate the relation between IgE sensitisation and several type 2 inflammation biomarkers in adult asthmatics.METHODS: FeNO, urinary eosinophil-derived neurotoxin (U-EDN), serum eosinophil cationic protein (S-ECP) and periostin were measured in 396 asthmatics, aged 17-76 years, from the Swedish GA2LEN study. Sensitisation to airborne allergens was examined with skin prick tests (≥3 mm wheal) and sensitisation to food allergens with measurement of specific IgE (≥0.35kU/L).RESULTS: Asthmatics sensitised to food allergens had higher FeNO, 22.3 ppb (18.6, 26.7) vs. 16.1 ppb (14.2, 18.2) (p=0.005), S-ECP, 17.7 mg/L (14.8, 21.1) vs. 12.8 mg/L (10.9, 14.9) (p=0.01), and periostin, 73.7 (67.5, 80.3) ng/mL vs. 59.9 (55.8, 64.2) ng/mL (p=0.003), than non-sensitised subjects. Periostin levels in this group were also significantly higher than in the group sensitised only to airborne allergens (p=0.01). Sensitisation to food allergens related independently to FeNO (p=0.02), S-ECP (p=0.006) and periostin (p=0.004), whereas sensitisation only to airborne allergens related only to FeNO (p=0.02) after adjustments for age, sex, height, weight and smoking history. FeNO correlated weakly with S-ECP (r=0.17, p<0.001), periostin (r=0.19, p<0.001) and U-EDN (0.16, p<0.001). S-ECP also correlated weakly with U-EDN (r=0.12, p=0.02). None of the correlations between the remaining pairs of markers of type 2 inflammation were significant.CONCLUSIONS & CLINICAL RELEVANCE: Sensitisation to food allergens related to several local and systemic type 2 inflammation markers, such as FeNO, S-ECP and periostin. Assessing the profile of allergic sensitisation, including to food allergens, might improve the understanding and interpretation of inflammatory markers and potentially improve asthma management. 

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Lungmedicin och allergi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Respiratory Medicine and Allergy (hsv//eng)

Nyckelord

IgE sensitisation

airborne allergens

asthma

food allergens

type 2 inflammation

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