Exploring the effect of presence and type of allergen sensitization on fractional exhaled nitric oxide, immunoglobulin E, and interleukins 4, 5, and 13 among asthmatics

摘要

Objective: Asthma is associated with airway inflammation. Allergen sensitization (atopy) is common in asthma. This study explored the effect of food and/or aeroallergen sensitization; on airway and systemic inflammation using fractional exhaled nitric oxide (FEsubNO/sub) and interleukins (ILs) 4, 5, and 13. Methods: The study enrolled asthmatics (diagnosed using Global Initiative for Asthma guidelines). Atopy was diagnosed using skin-prick testing (SPT). All subjects underwent testing for FEsubNO/sub, blood absolute eosinophil count (AEC), and serum levels of immunoglobulin E (IgE), and ILs 4, 5, and 13. Asthmatics (BA) were classified as atopic (BA-A) and nonatopic (BA-N). Atopic-asthmatics were subclassified as exclusively food allergen (AtAA) or aeroallergen (AtAA); or dually (AtFAA) sensitized. Results: The study enrolled 203 asthmatics (BA) and 50 controls. Among BA, 169 were BA-A and 34 were BA-N. Mean values of AEC, serum IgE and FEsubNO/sub, and ILs 4 and 13 were significantly higher in BA-A than BA-N (659 vs. 218/mmsup3/sup, 638 vs. 217 IU/ml, 39.2 vs. 20.0 ppb, 14.96 vs. 8.04 pg/ml, and 22.12 vs. 11.64 pg/ml, respectively). Meanwhile, mean IL-5 was higher in BA-A (11.01 vs. 8.76 pg/ml; P = 0.22), but not statistically significant. Subgroup analysis of atopic asthmatics (i.e., AtFA, AtAA, and AtFAA), revealed similar mean values for FEsubNO/sub (31.99 vs. 40.16 vs. 39.46 ppb), AEC (691.00 vs. 653.07 vs. 659.88/mmsup3/sup), IgE (635.60 vs. 630.32 vs. 646.39 IU/ml), IL-4 (12.63 vs. 14.74 vs. 15.44 pg/ml), and IL-13 (18.38 vs. 19.87 vs. 24.57 pg/ml). No difference was observed among subgroups of atopic-asthmatics. Conclusion: Subgroups of atopic-asthmatics did not show any consistent difference across all the studied parameters.