Plasma immunoglobulin E and risk of exacerbation and mortality in chronic obstructive pulmonary disease: A contemporary population- based cohort

摘要

Background: Novel biomarkers and targeted treatments are needed for patients with chronic obstructive pul-monary disease (COPD). Objective: To test the hypothesis that high plasma immunoglobulin (Ig)E concentrations associate with increased risk of exacerbation and mortality in individuals with COPD in the general population. Methods: Among 46,598 adults in the Copenhagen General Population Study, we included 1559 with COPD, defined as forced expiratory volume in 1 second/forced vital capacity = 40 years with chronic respiratory symptoms and smoking exposure >= 10 pack-years, and without asthma. We assessed risk of future severe exacerbation and all-cause mortality according to baseline plasma IgE >= 76 IU/mL, a clinical cutoff for omalizumab treatment in severe asthma.Results: During 14 years of follow-up (median, 6.9; interquartile range, 3.4), we recorded 224 severe exacerba-tions and 434 deaths in 1559 individuals with COPD. Individuals with COPD with IgE >= 76 IU/mL vs those with = 300 cells/mL, 1.62 (1.17-2.24) for IgE >= 76 IU/mL and blood eosinophils = 76 IU/mL and blood eosinophils >= 300 cells/ mL. Corresponding HRs for all-cause mortality were 1.27 (0.99-1.63), 1.47 (1.14-1.88), and 1.17 (0.83-1.64), respectively.Conclusion: High plasma IgE was associated with an increased risk of severe exacerbation and all-cause mortal-ity in individuals with COPD in the general population, independent of blood eosinophils. (c) 2022 American College of Allergy, Asthma Immunology. Published by Elsevier Inc. This is an open access arti-cle under the CC BY license (http://creativecommons.org/licenses/by/4.0/)