Total IgE Variability Is Associated with Future Asthma Exacerbations: A 1-Year Prospective Cohort Study

Area of Science:

• Allergy and Immunology
• Respiratory Medicine
• Clinical Research

Background:

• Prospective studies on immunoglobulin E (IgE) variability and asthma exacerbations (AEs) are limited.
• Understanding IgE variability's role in asthma is crucial for risk stratification.

Purpose of the Study:

• To investigate the association between IgE variability and the risk of asthma exacerbations.
• To determine if IgE variability can serve as a predictive marker for AEs.

Main Methods:

• Collected serum total IgE levels from stable asthma patients at baseline and 1 month to calculate IgE coefficient of variation (CV).
• Categorized patients into IgE CV-high and IgE CV-low groups based on the median CV.
• Utilized negative binomial regression to analyze the association between IgE variability and AEs over a 12-month follow-up period.

Main Results:

• Patients with high IgE CV (n=170) showed poorer asthma control, reduced lung function, increased airway inflammation, and higher medication use compared to the low IgE CV group (n=170).
• High IgE CV was significantly associated with increased rates of moderate-to-severe (adjusted rate ratio = 2.88) and severe (adjusted rate ratio = 2.16) asthma exacerbations.
• Sputum IL-6 levels partially mediated the relationship between IgE CV and exacerbation risk.

Conclusions:

• Variability in total serum IgE is a practical and easily measurable predictor of asthma exacerbations.
• Further research is warranted to explore the utility of IgE variability in guiding personalized asthma treatment strategies.