Relationship between serum IgA level and allergy/ asthma
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Background/Aims: Mucosal immunoglobulin A (IgA) may prevent the entrance of allergens. This study examined the relationship between serum IgA levels (within the normal range) and sensitization to house dust mites (HDM) or airway hyper-responsiveness (AHR). Methods: The clinical records of 1,136 adult patients with suspected asthma, for whom test data for serum IgA level and methacholine-AHR were available, were reviewed retrospectively. The AHR/allergy indices were compared among patient groups with low (<140 mg/dL, group I), intermediate (140 to 280 mg/dL, group II), or high (≥280 mg/dL, group III) IgA levels in serum. Results: The HDM skin sensitization rate progressively decreased from 30.0% in group I (n = 139) to 26.8% and 18.5% in groups II (n = 684) and III (n = 313), respectively (p = 0.003). Although both the HDM sensitization degree and the IgA level were significantly related to age, the adjusted odds ratio (OR) of association of a high IgA level (≥ 280 mg/dL) with HDM sensitization was significant (0.617; 95% confidence interval [CI], 0.415 to 0.916; p = 0.017). Among younger subjects (≤ 45 years of age) with AHR, the prevalence of moderate/severe AHR progressively decreased (70.6%, 52.3%, and 47.1% in groups I, II, and III [n = 34, 149, and 51]), respectively (p = 0.045). The IgA < 140 mg/dL was a significant risk factor for moderate/severe AHR (OR, 2.306; 95% CI, 1.049 to 5.071; p = 0.038). Conclusions: Sensitization to HDM and methacholine-AHR were significantly associated with serum IgA levels in suspected asthmatics, even when those levels were normal.
Abstract
Background/Aims: Mucosal immunoglobulin A (IgA) may prevent the entrance of allergens. This study examined the relationship between serum IgA levels (within the normal range) and sensitization to house dust mites (HDM) or airway hyper-responsiveness (AHR). Methods: The clinical records of 1,136 adult patients with suspected asthma, for whom test data for serum IgA level and methacholine-AHR were available, were reviewed retrospectively. The AHR/allergy indices were compared among patient groups with low (<140 mg/dL, group I), intermediate (140 to 280 mg/dL, group II), or high (≥280 mg/dL, group III) IgA levels in serum. Results: The HDM skin sensitization rate progressively decreased from 30.0% in group I (n = 139) to 26.8% and 18.5% in groups II (n = 684) and III (n = 313), respectively (p = 0.003). Although both the HDM sensitization degree and the IgA level were significantly related to age, the adjusted odds ratio (OR) of association of a high IgA level (≥ 280 mg/dL) with HDM sensitization was significant (0.617; 95% confidence interval [CI], 0.415 to 0.916; p = 0.017). Among younger subjects (≤ 45 years of age) with AHR, the prevalence of moderate/severe AHR progressively decreased (70.6%, 52.3%, and 47.1% in groups I, II, and III [n = 34, 149, and 51]), respectively (p = 0.045). The IgA < 140 mg/dL was a significant risk factor for moderate/severe AHR (OR, 2.306; 95% CI, 1.049 to 5.071; p = 0.038). Conclusions: Sensitization to HDM and methacholine-AHR were significantly associated with serum IgA levels in suspected asthmatics, even when those levels were normal.
참고문헌 (28)
- Weber-Mzell D, "Gender, age and seasonal effects on IgA deficiency: a study of 7293Caucasians", Eur J Clin Invest, 34, pp.224~228 (2004)
- Burgio GR, "Selective IgA deficiency: clinical and immunological evaluation of 50 pediatric patients", Eur J Pediatr, 133, pp.101~106 (1980)
- Kanoh T, "Selective IgA deficiency in Japanese blood donors: frequency and statistical analysis", Vox Sang, 50, pp.81~86 (1986)
- Ludviksson BR, "Correlation between serum immunoglobulin A concentrations and allergic manifestations in infants", J Pediatr, 121, pp.23~27 (1992)
- van Asperen PP, "The relationship between atopy and salivary IgA deficiency in infancy", Clin Exp Immunol, 62, pp.753~757 (1985)
- Ludviksson BR, "Allergic diseases and asthma in relation to serum immunoglobulins and salivary immunoglobulin A in pre-school children: a follow-up community-based study", Clin Exp Allergy, 35, pp.64~69 (2005)
- Gloudemans AK, "Potential of immunoglobulin A to prevent allergic asthma", Clin Dev Immunol, 2013, pp.542091~ (2013)
- Morell A, "Susceptibility to infections in children with selective IgA- and IgA-IgG subclass deficiency", Eur J Pediatr, 145, pp.199~203 (1986)
- Schwarze J, "Antigen-specific immunoglobulin-A prevents increased airway responsiveness and lung eosinophilia after airway challenge in sensitized mice", Am J Respir Crit Care Med, 158, pp.519~525 (1998)
- Balzar S, "Subtle immunodeficiency in severe asthma: IgA and IgG2 correlate with lung function and symptoms", Int Arch Allergy Immunol, 140, pp.96~102 (2006)
- Sears MR, "The relative risks of sensitivity to grass pollen, house dust mite and cat dander in the development of childhood asthma", Clin Exp Allergy, 19, pp.419~424 (1989)
- Papadopoulou A, "Bronchial hyper-responsiveness in selective IgA deficiency", Pediatr Allergy Immunol, 16, pp.495~500 (2005)
- Conley ME, "Diagnostic criteria for primary immunodeficiencies: representing PAGID (Pan-American Group for Immunodeficiency) and ESID (European Society for Immunodeficiencies)", Clin Immunol, 93, pp.190~197 (1999)
- Morris AH, "Clinical Pulmonary Function Testing: A Manual of Uniform Laboratory Procedures" (1984), Intermountain Thoracic Society
- Crapo RO, "Reference spirometric values using techniques and equipment that meet ATS recommendations", Am Rev Respir Dis, 123, pp.659~664 (1981)
- Hargreave FE, "Bronchial responsiveness to histamine or methacholine in asthma:measurement and clinical significance", J Allergy Clin Immunol, 68, pp.347~355 (1981)
- Woolcock AJ, "Assessment of bronchial responsiveness as a guide to prognosis and therapy in asthma", Med Clin North Am, 74, pp.753~765 (1990)
- Klion AD, "Middleton’s Allergy: Principles & Practice", pp.1205~1223 (2014), Elsevier Saunders
- Fageras M, "Slow salivary secretory IgA maturation may relate to low microbial pressure and allergic symptoms in sensitized children", Pediatr Res, 70, pp.572~577 (2011)
- Pilette C, "Grass pollen immunotherapy induces an allergen-specific IgA2 antibody response associated with mucosal TGF-beta expression", J Immunol, 178, pp.4658~4666 (2007)
- Scadding GW, "Sublingual grass pollen immunotherapy is associated with increases in sublingual Foxp3-expressing cells and elevated allergen-specific immunoglobulin G4, immunoglobulin A and serum inhibitory activity for immunoglobulin E-facilitated allergen binding to B cells", Clin Exp Allergy, 40, pp.598~606 (2010)
- Yu HQ, "Sublingual immunotherapy efficacy of Dermatophagoides farinae vaccine in a murine asthma model", Int Arch Allergy Immunol, 152, pp.41~48 (2010)
- Cockcroft DW, "Mechanisms of airway hyperresponsiveness", J Allergy Clin Immunol, 118, pp.551~559 (2006)
- 최인선, "Personal Factors Affecting Therapeutic Responses to BCG Vaccination in Asthmatics", Allergy, Asthma & Immunology Research, 3(3), pp.178~185 (2011), 대한천식알레르기학회
- Wuthrich B, "IgE levels, atopy markers and hay fever in relation to age, sex and smoking status in a normal adult Swiss population: SAPALDIA (Swiss Study on Air Pollution and Lung Diseases in Adults) Team", Int Arch Allergy Immunol, 111, pp.396~402 (1996)
- Sears MR, "Atopy in childhood. I. Gender and allergen related risks for development of hay fever and asthma", Clin Exp Allergy, 23, pp.941~948 (1993)
- 최인선, "Gender-Specific Asthma Treatment", Allergy, Asthma & Immunology Research, 3(2), pp.74~80 (2011), 대한천식알레르기학회
- Stiehm ER., "The four most common pediatric immunodeficiencies", J Immunotoxicol, 5, pp.227~234 (2008)