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The importance of serum IgE for level and longitudinal change in airways hyperresponsiveness in COPD
Author(s) -
Tej Renkema,
Huib A. M. Kerstjens,
Jan P. Schouten,
Judith M. Vonk,
Gh Koeter,
Dirkje S. Postma
Publication year - 1998
Publication title -
clinical and experimental allergy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.462
H-Index - 154
eISSN - 1365-2222
pISSN - 0954-7894
DOI - 10.1046/j.1365-2222.1998.00382.x
Subject(s) - medicine , copd , bronchial hyperresponsiveness , immunoglobulin e , placebo , histamine , prednisolone , asthma , budesonide , immunology , pulmonary function testing , corticosteroid , gastroenterology , respiratory disease , lung , antibody , pathology , alternative medicine
Background Airways hyperresponsiveness (AHR) is an important feature of patients with chronic obstructive pulmonary disease (COPD). Little is known about factors that modulate AHR in COPD. Objective To study these factors, we performed a long‐term, double‐blind, parallel intervention study in 58 male, non‐allergic patients with COPD. Methods During a period of 2 years, patients were treated with inhaled budesonide (1600 μg/day), inhaled budesonide (1600 μg/day) plus oral prednisolone (5 mg/day), or placebo. PC 20 histamine was measured at 4‐monthly intervals. The influence of treatment, smoking, age, level of lung function, initial serum IgE level and peripheral blood eosinophils on level and longitudinal change of PC 20 histamine was analysed. Results During follow‐up, PC 20 decreased in our group, and this decrease was not influenced by treatment. PC 20 tended to decrease faster in current smokers than in ex‐smokers. PC 20 was significantly associated with pre‐challenge FEV 1 at each time point. Level nor decline of PC 20 were significantly related to age. A higher initial serum IgE level was independently associated with a lower PC 20 . Moreover, a higher initial serum IgE level was associated with a slower annual decline of PC 20 , regardless of treatment, pre‐challenge FEV 1 , and other modulating factors. No significant associations were found between initial blood eosinophils and level or decline of PC 20 . Conclusion We conclude that AHR increases over time in non‐allergic patients with COPD. Treatment with an inhaled corticosteroid alone or in combination with oral prednisolone does not change this increase. Our study suggests an important role for IgE in the course of the disease, since a higher initial serum IgE level predicts a more favourable course with regard to annual decline of PC 20 histamine.