Probability of Hospital Admission with Acute Asthma Exacerbation Increases with Increasing Specific IgE Antibody Levels

摘要

Background: Asthma exacerbation is a common cause of hospital admission in children. We aimed to investigate whether the level of IgE antibodies to inhalant allergens is associated with an increased risk of asthma hospitalization in childhood. Methods: Children (n = 84; age 3-17 years) hospitalized with an acute asthma exacerbation (AA) were matched (age, sex) with 2 controls: stable asthmatics (SA) and children hospitalized with nonrespiratory conditions (IC). Subjects underwent measurement of specific IgE (mite, cat, dog; immunoCAP? and nasal lavage for common respiratory pathogens (PCR). Results: A significantly higher proportion of A A had a respiratory pathogen detected (44%) compared to SA (18%) and IC (17%; p < .001). Sensitization (IgE > 0.35 kU_A/l) was significantly more common amongst AA than SA and IC groups (90% vs. 65% vs. 33% respectively; p < .001). Further analysis of risk factors for hospital admission was carried out within the two groups of asthmatic patients (AA, SA) using logistic regression. The risk of admission increased significantly with increasing IgE to mite (OR 1.18, 95% CI 1.05-1.34, p = .005). When specific IgE levels to mite, cat and dog were summed, the probability of hospitalization increased 1.3-fold (95% CI 1.1-1.4, p < .001) per logarithmic unit increase in IgE. In the multivariate analysis, the sum of mite, cat and dog specific IgE remained a significant, independent associate of hospital admission (OR 1.33, 1.12-1.57, p = .001). In addition, there was a significant interaction between the sum of IgEs and virus infection in increasing the risk of admission (OR 1.45, 1.03-2.06, p = .035). Conclusions: Increasing specific IgE antibody levels interact with natural virus infection in increasing the probability of hospitalization amongst childhood asthmatics.