Total IgE level in respiratory allergy: study of patients at high risk for helminthic infection

Abstract

Objective: Eosinophilia and increased serum IgE levels are indicators of atopy; however, other factors can also play a key role, such as intestinal parasitic infections. This study assesses the relationship between total serum IgE, eosinophil count, and anti-Ascaris IgE in individuals with asthma and/or allergic rhinitis. Methods:A cross-sectional study was carried out in adolescents with asthma and/or allergic rhinitis. The patients had their total serum IgE, anti-Ascaris IgE and eosinophil count measured.Results: A total of 101 patients aged 12 to 21 years were assessed. Median IgE level was 660 IU/mL (P 25-75 243.5-1500), and the eosinophil count corresponded to 510 cells/mm 3 (P 25-75 284-811). Anti-Ascaris IgE was positive in 73% (74/101) of the individuals, but parasitological stool examination yielded positive results in only 33.7% (34/101). The correlation coefficients were the following: 0.34 (p = 0.001) between total IgE level and eosinophil count, 0.52 (p < 0.001) between total IgE level and anti-Ascaris IgE, and 0.26 (p = 0.01) between eosinophil count and anti-Ascaris IgE. The final multiple linear regression model pointed out that anti-Ascaris IgE contributed to a total serum IgE level with a coefficient of determination (adjusted R 2 ) of 0.25 (F = 12.35; p < 0.001). This effect occurred regardless of eosinophil count and of the presence of intestinal helminthic infection. Conclusion:In patients with respiratory allergy and increased total serum IgE levels living in areas where there is a high risk for helminthic infections, the quantification of anti-Ascaris IgE can be more useful and more insightful than the parasitological stool examination.J Pediatr (Rio J). 2006;82(4):255-9: IgE, eosinophils, allergy, helminthic infection, ascariasis. ResumoObjetivo: Eosinofilia e elevação de IgE sérica são expressões de atopia, contudo há fatores intervenientes como, por exemplo, as parasitoses intestinais. Esta pesquisa verifica a relação entre IgE sérica total, eosinófilos e IgE específica anti-áscaris em indivíduos portadores de asma e/ou rinite alérgica.Métodos: Estudo do tipo transversal em adolescentes portadores de asma e/ou rinite alérgica que foram examinados quanto ao nível sérico de IgE total, de IgE anti-áscaris e de contagem dos eosinófilos sangüíneos.Resultados: Foram analisados 101 pacientes com idade entre 12 e 21 anos. A mediana da IgE foi 660 UI/mL (P 25-75 243,5-1500), e a dos eosinófilos foi 510 células/mm 3 (P 25-75 284-811). A IgE anti-áscaris foi positiva em 73% (74/101) da amostra, mas houve apenas 33,7% (34/ 101) de positividade ao parasitológico de fezes. Os coeficientes de correlação encontrados foram: 0,34 (p = 0,001) entre IgE total e eosinófilos, 0,52 (p < 0,001) entre IgE total e IgE anti-áscaris e 0,26 (p = 0,01) entre eosinófilos e IgE anti-áscaris. O modelo de regressão linear múltipla final encontrou que IgE anti-áscaris foi fator contribuinte para IgE sérica total com coeficiente de determinação (r 2 ajustado) de 0,25 (F = 12,35; p < 0,001), e esse efeito foi indep...

<i>Giardia lamblia</i> and respiratory allergies: a study of children from an urban area with a high incidence of protozoan infections

“…O teste cutâneo de leitura imediata foi categorizado em positivo quando a pápula tinha diâmetro igual ou maior a 3 mm em relação ao controle negativo. Em relação aos níveis séricos de IgE total, essa variável foi categorizada em acima e abaixo de 400 UI, nível que foi associado com atopia em indivíduos sem helmintíase concomitante detectada em nosso meio 23 . A IgE específica foi categorizada em negativa ou positiva, sendo esta última considerada positiva quando acima de classe 1, segundo o padrão de ImmunoCAP System da Phadia Diagnóstico.…”

Atopy Is Associated with Asthma in Adults Living in Rural and Urban Southwestern Nigeria

“…The modulatory effect of helminthic infection on asthma represents a likely explanation to the hygiene hypothesis, which supports the low prevalence of asthma and atopy in developing countries. One possible mechanism for this is the production of high levels of interleukin (IL)-10 (an anti-inflammatory cytokine) during parasitic infections, which modulate allergic responses and inhibit skin test responses to environmental allergens (30,31).…”

A Study of Allergic Sensitization to Anisakis Species in Experimental Mice

“…Epidemiological and immunological studies indicate contribution of helminthes infection to the development of asthmatic conditions, depending on a direct relation which was present between the degree of helminthes infection and an increase in peak expiratory flow by the bronchodilator [29]. On the other hand, some authors suggest that the production of the nonspecific IgE by helminthes infections can suppress the allergic response to environmental and parasite allergens via protection from mast cell or basophil degranulation by saturating IgE binding sites [30,31]. However, in our study the Anisakis antigen was prepared from dead Anisakis larvae.…”