嗜酸性粒细胞型COPD中的过敏性致敏和血清免疫球蛋白E
Allergic Sensitization and Serum Immunoglobulin E in Eosinophilic COPD.
文献信息
| PMID | 42734898 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Cailey M Denoncourt |
| 作者单位 | Division of Pulmonary, Critical Care and Sleep Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States. |
| 期刊 | Chronic obstructive pulmonary diseases (Miami, Fla.) |
| SCI 分区 | Q2 |
| IF | 2.8 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 鼻科 |
中文摘要
背景： 嗜酸性粒细胞型慢性阻塞性肺疾病（COPD）以2型炎症为特征，影响超过三分之一的COPD患者，并与急性加重风险和皮质类固醇反应性相关。该亚型中过敏性致敏和免疫球蛋白E（IgE）升高的患病率及临床意义尚不明确。
方法： 我们分析了纳入一项随机试验的174名嗜酸性粒细胞型COPD既往吸烟者的基线数据。参与者接受了14种区域气传过敏原的皮肤点刺试验和总血清IgE测量。过敏性致敏定义为≥1项皮肤试验阳性；总IgE升高定义为≥100 IU/mL。我们评估了致敏和IgE升高的患病率、其与哮喘和季节性过敏的重叠情况，以及与自我报告的过敏原暴露的关联。逻辑回归评估了特应性疾病、暴露与致敏之间的联系。我们还检查了与过去一年COPD相关住院的关联。
结果： 在参与者中（平均年龄71.5岁；FEV₁%预计值53.0%），47.1%有过敏性致敏，32.5%有IgE升高，55.7%有过敏性致敏或IgE升高。季节性过敏和哮喘的报告率分别为59.8%和43.7%。在没有合并哮喘的患者中，38.8%有过敏性致敏。养猫与猫过敏原敏感性相关（OR=3.1，95% CI 1.1-8.6）。哮喘和IgE与对多种过敏原的致敏相关。致敏和IgE与既往一年COPD住院无关。
结论： 过敏性致敏和IgE升高在嗜酸性粒细胞型COPD中很常见，即使没有合并哮喘。这些发现支持进一步研究环境过敏原在疾病进展和管理中的作用。
英文摘要
BACKGROUND: Eosinophilic chronic obstructive pulmonary disease (COPD), is marked by type 2 inflammation, affects more than one-third of people with COPD, and is linked to exacerbation risk and corticosteroid responsiveness. The prevalence and clinical significance of allergic sensitization and elevated immunoglobulin E (IgE) in this subtype are not well understood.
METHODS: We analyzed baseline data from 174 former smokers with eosinophilic COPD enrolled in a randomized trial. Participants underwent skin prick testing for 14 regional aeroallergens and total serum IgE measurement. Allergic sensitization was defined as ≥1 positive skin test; elevated total IgE as ≥100 IU/mL. We evaluated the prevalence of sensitization and elevated IgE, their overlap with asthma and seasonal allergies, and associations with self-reported allergen exposures. Logistic regression assessed links between atopic conditions, exposures, and sensitization. We also examined associations with COPD-related hospitalizations in the past year.
RESULTS: Among participants (mean age 71.5 years; FEV₁% predicted 53.0%), 47.1% had allergic sensitization, 32.5% had elevated IgE, and 55.7% had allergic sensitization or elevated IgE. Seasonal allergies and asthma were reported by 59.8% and 43.7%, respectively. Among those without concomitant asthma, 38.8% had allergic sensitization. Cat ownership was associated with cat allergen sensitivity (OR=3.1, 95%: CI 1.1-8.6). Asthma and IgE were associated with sensitization to multiple allergens. Sensitization and IgE were not associated with prior-year COPD hospitalization.
CONCLUSION: Allergic sensitization and elevated IgE are common in eosinophilic COPD, even without comorbid asthma. These findings support further research into the role of environmental allergens in disease progression and management.