The Association of Skin Test Reactivity, Total Serum IgE Levels, and Peripheral Blood Eosinophilia with Asthma in Kuwait

Abstract

There is evidence that elevated serum immunoglobulin E (IgE) and eosinophilia correlate well with allergic skin test reactivity. These parameters have been used as alternative methods to characterize atopic subjects. Skin test reactivity is the only measure used routinely in clinical practice in Kuwait to reflect atopy in asthma patients. This study examines the usefulness of the two other parameters of atopy in patients with asthma, and to determine the most common allergens involved in Kuwait. Between 1998 and 1999, 101 asthma patients and 33 healthy controls were recruited for this study. Skin sensitivity test, serum total and specific IgE, total blood eosinophil count (B-EOS), and eosinophil cationic protein (ECP) tests were performed in patients and controls. Nine allergens known to be prevalent in this environment were selected for the skin test and specific IgE test. Spirometry was also measured. These parameters were repeated after 4 weeks of therapy in the patients only. Skin test reaction was positive in 81% of the patients, while total IgE above 200 kU/L was obtained in 63% of cases. B-EOS above 300 x 10(3)/L was found in 75% of cases. House dust mite reactivity (positivity) was the most frequently encountered skin allergy, occurring in 28% of the patients. IgE correlated positively with B-EOS and ECP. B-EOS similarly correlated positively with ECP. There was a negative correlation between ECP and forced expiratory volume in 1 sec (FEV1) (% predicted) as expected. At least one positive parameter of atopy was found in 95% of the patients. In 48% of the patients, all three parameters of atopy were found to be positive. Skin test reactivity and elevated IgE were found together in 62% of the cases. This study reveals a significant degree of allergy among patients with asthma in this environment. Skin testing was found to be the most effective measure of atopy in this environment, and correlates well with the other more sensitive newer tests.

Correlation of total serum immunoglobulin E level, sputum, and peripheral eosinophil count in assessing the clinical severity in bronchial asthma

“…Khadadah et al . [42] in their study reported positive correlation between total blood eosinophil counts, serum total IgE levels, and eosinophilic cationic protein.…”

Asthma and sensitization in a community with low indoor allergen levels and low pet-keeping frequency

“…37 Previous studies among children with asthma in Kuwait have also shown a broadly similar sensitization rate to dust mite compared with the current study. 22,38 Interestingly, a study conducted in Kuwait 2 decades ago reported a much lower rate of sensitization to dust mite (1.5%). 39 Thus, comparing our data with those available from Kuwait 20 to 25 years ago, it would appear that the prevalence of both asthma and sensitization rates have increased dramatically.…”

Serum total IgE levels and total eosinophil counts: relationship with treatment response in patients with acute asthma

“…In a study, a positive correlation between serum total IgE levels, total blood eosinophil counts and eosinophil cationic protein (ECP) was reported. (25) Eosinophils play an important role in the pathogenesis of asthma. Airway inflammation, involving infiltration of the bronchial wall by activated eosinophils, mast cells and T lymphocytes, is an established feature of asthma.…”