摘要
血清免疫球蛋白(Ig)E升高是特应性的标志,有助于特应性个体的哮喘和支气管高反应性。相比之下,IgE在非过敏受试者中的意义尚不清楚。本研究的目的是澄清在没有临床过敏的情况下IgE和哮喘的潜在关联。为此目的,我们对1,219名连续进行肺部治疗的患者进行了评估。非过敏患者由皮肤点刺试验阴性、特应性和特异性IgE史确定,509例(42%)非过敏。其中80例患者(16%)总IgE水平升高(>150 U x mL(-1))。将IgE>150 U x mL(-1)的非过敏受试者的哮喘患病率和严重程度与正常IgE水平的受试者进行比较,所有非过敏受试者和哮喘患者的肺功能参数与血清IgE相关。哮喘在IgE水平升高的非过敏受试者中比在IgE正常的非过敏受试者中更为普遍(39%对14%;p < 0.001)。非变应性哮喘患者的肺功能值低于预测的1秒用力呼气量(FEV1)% (66+20% vs 83+/-17%; p<0.001), FEV1% forced vital capacity (FVC) (70+/-14% versus 81+/-8%; p<0.001) and forced mid expiratory flow (FEF25-75) (1.7+/-0.9 L x s(-1) versus 2.8+/-0.9 L x s(-1); p=0.002) in patients with high IgE compared to asthmatics with normal IgE, and were negatively correlated with log IgE levels in all nonallergic asthmatics. (FEVI % pred: r=-0.5, p<0.001; FEV1% FVC: r=-0.53, p<0.001; FEF25-75: r=-0.52, p<0.001). In the whole study population, multivariate analysis showed a greater than fivefold asthma risk for nonallergic individuals with serum IgE>150 U x mL(-1). These data support the role of IgE as risk factor for asthma independent of allergy, and they further challenge the definition of intrinsic asthma as "non-IgE mediated" entity.