Changes in blood immunoglobulin E levels may affect management decisions in asthma

Published Online: March 30, 2016

Asthma is a highly prevalent inflammatory condition of the airways and continues to present a treatment challenge in some patients. Immunoglobulin E (IgE) is an antibody that mediates allergic reactions and plays a pivotal role in allergic asthma. Over the past decade, IgE targeted therapies have improved asthma outcomes in selected patients who have raised blood IgE concentrations. Patient selection and dosing for these treatments depend on concentrations of the antibody. There is, however, a paucity of studies that examine changes in IgE concentrations over time.

Hatipoğlu and colleagues from the Cleveland Clinic reported the change in serum IgE concentrations over one year in a group of patients with moderate to severe asthma in a recent issue of The Journal of Allergy and Clinical Immunology: In Practice.  17 patients with moderate to severe asthma were followed every 2 months with clinical visits and blood tests.

IgE concentrations showed an average variability of 23% over the course of one year among patients with moderate-severe persistent allergic asthma. Variability in IgE concentrations would have affected patient selection or dosing of anti-IgE therapy in 7 of the 17 patients followed in the study. The authors did not observe significant associations between variability and demographic data, lung function, exacerbations, allergy season, asthma control test scores, medication use and body mass index, possibly due to the small number of patients studied.

Although the impact on asthma outcomes is not known, variability in blood IgE concentrations may affect clinical management decisions and is relatively common. The factors that affect variability deserve further study. 

The Journal of Allergy and Clinical Immunology: In Practice is an official journal of the AAAAI, focusing on practical information for the practicing clinician.

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