Serum total IgE levels in a representative sample of a Greek population

The distribution of IgE in a large randomly stratified Greek population sample was determined in 1187 subjects (793 men and 394 women) aged between 20 and 60 years. Skin prick testing was performed and serum total IgE expressed in iu/ml was measured by Phadebas PRIST: the data are presented as the geometric mean. Subjects were classified as atopic (257 men, 118 women) and nonatopic (536 men, 276 women) according to the results of skin testing with various aeroallergens. At any age, atopic males (120.5 vs 38 iu/ml) and females (99.8 vs 29.3 iu/ml) had higher mean IgE levels, as compared to nonatopic subjects ( P <0.0001). In our adult nonatopic sample, IgE levels did not differ with age ( P >0.05). At any age, nonatopic males had higher (38 iu/ml) mean IgE levels than nonatopic females (29.3 iu/ml) ( P <0.05). The comparison of normal IgE values (nonatopic subjects) from this study with those reported by other investigators revealed that Greek adult males and females had higher IgE levels than populations from other nations. Our results represent the first report on reference values regarding serum total IgE in Greek adults.     

Allergy to complex salts of platinum in refinery workers: prospective evaluations of IgE and Phadiatop® status

BACKGROUND: Experience has shown some variation in the associations between IgE, atopy, and sensitization to platinum salts. Clarification of these associations, and the value of the parameters in predicting and diagnosing sensitization of workers at risk, required prospective investigation. OBJECTIVES: Evaluation of total IgE and Phadiatop(R) status to establish baseline values, and changes during employment, predictive or associated with subsequent platinum salt sensitization. METHODS: A 24-month prospective study, in a South African primary platinum refinery, of a cohort of 78 healthy recruits without evidence of atopy (tested negative to skin prick test with common allergens). Subsequently they were categorized as 22 sensitized (positive skin prick test to platinum salts), 46 not sensitized (negative skin prick test and symptom free), and 10 symptomatic subjects not included in either category. RESULTS: (1) Pre-employment: four (18%) of the subsequently sensitized subjects and eight (17%) not sensitized were Phadiatop(R) positive. Levels of total IgE > 100 kU/L, present in 16 subjects were associated with positive Phadiatop(R) status and race. (2) During employment: Phadiatop(R) status converted from negative to positive in more sensitized (12/18) than unsensitized (6/38) subjects (P 相似文献   

Are atopy and specific IgE to mites and molds important for adult asthma?

BACKGROUND: Atopy is known to be important for childhood asthma, but this is to our knowledge the first study on its relation with development of asthma in adulthood. OBJECTIVES: We addressed the role of atopy, measured as total IgE and Phadiatop, and of specific IgE antibodies to mites and molds in development of adult-onset asthma. METHODS: A population-based incident case-control study was conducted in the Pirkanmaa District in Southern Finland. All new clinically diagnosed cases of asthma 21-63 years of age were recruited 1997-2000 in the study district. A random sample of the source population formed the controls. A total of 485 cases and 665 controls provided a serum sample. Diagnosis of asthma was based on demonstration of reversibility in lung function investigations. Subjects with previous asthma were excluded. Phadiatop score and IgE antibodies were analyzed with the UniCAP system. RESULTS: The adjusted odds ratio of asthma increased with total IgE and Phadiatop score in a dose-dependent pattern. IgE antibodies to house dust mite and storage mite were significantly related to an increased risk of asthma. Among molds, increased risk of asthma was seen in relation to IgE antibodies to Aspergillus fumigatus and Cladosporium herbarum. Population attributable fraction due to sensitization to common aeroallergens was 30% (95% CI, 23-41). CONCLUSION: Atopy is a strong determinant of asthma in adulthood. Specific IgE antibodies to mites and some molds are significantly related to increased risk of adult-onset asthma. A considerable fraction of adult asthma could be prevented by measures to reduce atopy.     

Isotopic and enzymatic IgE assays in non-allergic subjects

In order to establish normal values in an adult population for serum IgE concentration, sera were obtained from 446 ambulatory Canadian caucasian subjects with negative allergy histories. A standard isotopic procedure, the Phadebas paper radioimmunosorbent test (PRIST), was compared with the new enzymatic counterpart, the Phadezyme PRIST. By the isotopic method, serum IgE concentrations in women and men were comparable from one age group to another with no age-related trend in the seven age groups examined (15-20, 21-30, 31-40, 41-50, 51-60, 61-70, above 70). The median and 95th percentile units (U)/ml respectively were 17.5 and 145 for 224 women and 25.5 and 275 for 222 men. Mean values +/- 1 SD for women were 43 +/- 102 and for men, 58 +/- 137. Levels were significantly higher in men as a group. Sera with IgE concentrations above 100 U and a sampling of additional sera were tested for specific IgE antibodies to 13 common allergens by the radioallergosorbent test (RAST). After exclusion of RAST-positive sera, the mean U/ml values +/- 1 SD were 22 +/- 29 for 204 women and 37 +/- 54 for 196 men. Geometric mean U/ml values for these sera were 14.6 for women and 22.3 for men and the median and 95th percentile U/ml respectively for the women were 15 and 66, for the men, 24 and 135. These 95th percentile values are considered the upper limits of normal in this population. The RAST identification of antibodies to allergens to which sensitization was demonstrated provided a potential explanation for serum IgE concentrations above 100 U/ml in less than 30% of the sera in this population with negative allergy histories. The isotopic method and the counterpart enzymatic method (Phadezyme PRIST) were highly comparable; the correlation coefficient (r) for all the sera was +0.93 (P less than 0.001). IgE levels were significantly higher in male smokers than non-smokers by both methods but these differences were not significant in women.     

A longitudinal study of serum IgE in a community cohort: Correlations with age, sex, smoking, and atopic status

A number of factors, including age, sex, smoking habits, and atopic status have been reported in cross-sectional studies to influence levels of serum IgE. We have examined the effects of these variables on serum IgE in a community population cohort of 1109 subjects during a longitudinal study in which two serum samples were obtained 8 years apart from each subject. For the entire cohort, mean serum IgE level changed little during the follow-up period (28.9 versus 26.0 IU/ml). Most of the decreases were observed in children and young adults. Subjects more than the age of 35 years demonstrated no systematic change in serum IgE levels. By the end of follow-up (when there were few subjects still less than 16 years of age), significant relationships of IgE to age could no longer be demonstrated in nonatopic subjects. Also, in the nonatopic subjects of this cohort, there were no significant differences in IgE levels between the sexes. Among atopic subjects, there was a clear tendency for IgE to decrease with age, with atopic women more than 35 years of age demonstrating greater declines in IgE levels during follow-up than men of comparable age. The IgE levels in atopic male subjects were significantly higher than in atopic female subjects after the age of 35 years. Smoking was associated with an elevation in serum IgE. In this cohort, the smoking effect appeared to be limited to male subjects.(ABSTRACT TRUNCATED AT 250 WORDS)     

Role of gender and hormone-related events on IgE, atopy, and eosinophils in the Epidemiological Study on the Genetics and Environment of Asthma, bronchial hyperresponsiveness and atopy

BACKGROUND: The pattern of asthma over the lifespan is different in male and female patients, but etiologic differences according to gender are only partially understood. In women, information regarding factors explaining perimenstrual asthma and the role of hormone-related aspects on asthma-related phenotypes is scanty. OBJECTIVE: To assess the relationships of eosinophils, IgE, and atopy with (1) asthma according to gender and age of onset and (2) hormone-related events. METHODS: Using data from the Epidemiological study on the Genetics and Environment of Asthma, Bronchial Hyperresponsiveness and Atopy, adults and children with asthma recruited in chest clinics (n=313) and first-degree relatives of patients with asthma (n=214) were compared with nonasthmatic controls (n=334) and first-degree relatives without asthma (n=595). RESULTS: Among asthmatic women, eosinophilia was significantly associated with perimenstrual asthma independently from age, smoking, and asthma severity (eosinophils/mm(3) 330 vs 194; P=.01). In nonasthmatic women, IgE level was significantly decreased (by half) and atopy decreased with menopause, and IgE increased with oral contraceptive use, independently from age and smoking. Considering both genders, the increase of eosinophil counts with asthma was significantly greater in women with childhood-onset asthma than in women with adulthood-onset or in men in general. No interaction between gender and asthma was observed for eosinophils in children and for IgE level and atopy in children and adults. CONCLUSION: Results suggest a role of hormone-related events on asthma-related traits and support the hypothesis of the role of eosinophils in the persistence and severity of asthma.     

Epidemiology of immunoglobulin E levels in a defined population

Age-adjusted geometric mean IgE levels in 621 older subjects were higher in men (26.3 kU/L) than in women (19.1 kU/L), and decreased with age. The higher levels in men were largely a result of a strong positive association with cigarette smoking. Among allergic conditions, a personal history of asthma was associated with the highest IgE levels. In multiple linear regression models in men, cigarette smoking was the single strongest correlate of IgE levels, while a personal history of allergy was the strongest correlate in women. Our results suggest important nonallergic as well as allergic determinants of IgE levels in populations.     

Association between IgE levels and asthma severity among African American, Mexican, and Puerto Rican patients with asthma

BACKGROUND: High levels of IgE are associated with asthma. Whether higher levels of IgE are associated with more severe asthma is still unclear. OBJECTIVE: To determine whether IgE is associated with asthma severity among Latino and African American subjects with asthma. METHODS: We assessed lung function and asthma severity among African American, Mexican, and Puerto Rican patients with asthma with high IgE levels (> or =100 IU/mL; n = 492) and compared these values to those of patients with asthma with low IgE levels (<100 IU/mL; n = 247). We also examined IgE as a continuous variable among these groups. RESULTS: Patients with asthma with high IgE had a lower mean FEV(1) (87.6 +/- 17.1, percent of predicted) than patients with asthma with low IgE (91.5 +/- 17.0; P = .031). Regardless of race and ethnicity, baseline FEV(1), forced expiratory flow, and FEV(1)/forced vital capacity were lower among subjects with high IgE than among subjects with low IgE (P = .031, P < .0001, P = .0001, respectively). In addition, 54.7% of patients with asthma with high IgE had been previously hospitalized, compared with 44.1% of patients with asthma with low IgE (odds ratio, 1.33; 95% CI, 1.04-1.71). CONCLUSION: Higher IgE is associated with lower baseline lung function and more severe asthma among these populations. CLINICAL IMPLICATIONS: Among patients with asthma from 3 ethnically distinct groups, total IgE levels are inversely correlated with baseline lung function and asthma severity.     

The use of Phadiatop® in mass-screening programmes of inhalant allergies: advantages and limitations

The validity of Phadiatop as a tool in the mass screening for inhalant allergies was investigated. Seventy-nine out of 600 recruits (13.2%) were classified as allergic to inhalant allergens (68 oculorhinitis; 11 asthma) on the basis of positive history, confirmed by skin testing and/or RAST for the seven most common aero-allergens in Italy. Another 74 subjects had positive RAST and/or skin tests, yet had never experienced allergic symptoms. Phadiatop was positive in 145/600: in 78 out of 79 allergics and in 67 RAST-positive non-allergics. Correlation between Phadiatop and RAST was statistically significant, though higher for grass pollens (r = 0.85, P less than 0.001) than for Dermatophagoides pteronyssinus (r = 0.68, P less than 0.01). PRIST (cut-off 220 IU/ml) identified 36/79 allergics (45.6% sensitivity, whereas that of Phadiatop was 98.7%). As the high percentage of cases in the unselected population had specific serum IgE against inhalant allergens and no allergic symptomatology, the Phadiatop-positive predictive value falls to 53.7%, thus creating the need for Phadiatop-positive subjects to undergo further investigation for an appropriate diagnosis. Given this limitation, Phadiatop appears to be an important step forward in the field of mass-screening programmes for inhalant allergies.     

Relationship between smoking habits and low-density lipoprotein-cholesterol,high-density lipoprotein-cholesterol,and triglycerides in a hypercholesterolemic adult cohort,in relation to gender and age

Elevated total cholesterol, the related low-density lipoprotein-cholesterol, high-density lipoprotein-cholesterol, triglycerides, and smoking habits are risk factors for cardiovascular disease. The objective of this study was to investigate the influence of habitual smoking on these parameters in 492 hypercholesterolemic men and women, aged between 26 and 66 years. Relative differences between smokers and non-smokers in the mean values of total cholesterol, low-density and high-density lipoprotein-cholesterol, and triglycerides were 2.2%, 5.5%, −8.1%, and 13.7%, respectively. These differences were statistically significant (P<0.04). Over the entire cohort, including men and women, age did not affect the mean values significantly, except for total cholesterol and triglyceride values in smoking women, which were significantly higher in women over 50 years than in the younger women (P=0.011 and P=0.004). In both men and women, regardless of smoking habits, 43%–59% of subjects exceeded the upper reference range value for low-density lipoprotein-cholesterol (4.9 mmol/l), while 38%–59% exceeded the upper reference range value for triglycerides (2.0 mmol/l) and 82%–91% had values below the lower reference range value for high-density lipoprotein-cholesterol (0.9 mmol/l for men, 1.2 mmol/l for women). Smoking habits hardly influenced the extent to which reference values were exceeded, except for low-density lipoprotein-cholesterol in all subjects (higher percentage for smokers, P=0.041). Similar results were obtained for age, except for triglycerides in smoking women, which showed high values in 26% of women <50 years versus 50% of women ≥50 years (P=0.026). In conclusion, smoking has an adverse effect on low-density and high-density lipoprotein-cholesterol, and triglycerides in a hypercholesterolemic population of men and women, regardless of age. Received: 9 November 2001 / Accepted: 4 May 2002     

The alpha-chain of high-affinity receptor for IgE (FcepsilonRIalpha) gene polymorphisms and serum IgE levels

BACKGROUND: The high-affinity receptor for immunoglobulin-E (IgE) (FcepsilonRI) plays a major role in the pathogenesis of allergy, but there are only two published studies on its alpha subunit (FcepsilonRIalpha) genetic variability in allergic diseases. AIMS OF THE STUDY: Mutational screening in the region of the FcepsilonRIalpha gene promoter and the first exon with subsequent genetic variability assessment in allergic patients and a random population sample. METHODS: Allergic subjects were individuals with asthma or urticaria. Age- and sex-matched controls were randomly selected from a large population sample. Mutational screening was performed using a single-stranded conformational polymorphism and subsequent sequencing. Detected polymorphisms were genotyped by restriction fragment length polymorphism. Total serum IgE was measured in allergic subjects and controls. Skin prick tests, blood eosinophil count and aspirin challenge test were performed only in the subjects. A subgroup of the subjects was further characterized by autologous serum skin test, histamine release test, Phadiatop and IgE antibodies against staphylococcal enterotoxins. RESULTS: Two linked polymorphisms -344 C>T and -95 T>C were found within the FcepsilonRIalpha gene. The allele -344 T frequency was 0.45 vs 0.37 (P = 0.33), and the allele -95 C frequency was 0.26 in subjects vs 0.30 in controls (P = 0.62). Serum IgE was significantly higher in subjects homozygous for the -344T allele (TT genotype) than in those carrying the -344 C allele (CT or CC genotype; P = 0.003), but this association was not detectable in controls. CONCLUSIONS: Our findings of genotype-related differences in IgE levels in allergic patients suggest an impact of -344 C>T but not -95 T>C gene polymorphism of FcepsilonRIalpha on total levels of IgE. The genetic variability in FcepsilonRIalpha at the -344 nucleotide of its regulatory sequence, though not related to atopy, predicts higher levels of the immunoglobulin.     

Total serum IgE and FEV1 by respiratory symptoms and obstructive lung disease in adults of a Norwegian community

Background: The importance of total serum IgE level on lung function impairment has not been established in a general population. Objective: The aim of this cross-sectional community study was to examine the relationship between total serum IgE and level of lung function in adults, and whether this relationship differed by sex, age, smoking habits or by respiratory symptom and disease status. Methods: A stratified random sample of 18–73 year old adults from the general population were invited to spirometry and serum analyses of total and specific IgE. Of 1512 subjects invited, 82% met and performed complete examinations. Results: Increasing level of total serum IgE was related to reduced lung function (P<0.01) given as sex, age, and height standardized residuals of one second forced expiratory volume (SFEV₁). Subjects with total serum IgE in the highest vs the lowest tertile had a mean SFEV₁ of -0.58 vs -0.28, corresponding to age and height adjusted FEV₁ differences of 120 and 150mL in women and men, respectively. The relationship between IgE and lung function impairment did not differ significantly by sex, age or smoking habits. In subjects with obstructive’lung disease increasing level of total serum IgE was more negatively associated with lung function level than in subjects with respiratory symptoms alone. No relationship was observed in a symptomatic subjects. This was confirmed in a multiple linear regression analysis adjusting for sex, age, smoking habits and lifetime smoking consumption showing that SFEV₁ was predicted by an interaction between total serum IgE level and symptom and disease status (P < 0.01). This interaction remained after excluding subjects (n= 105) having specific IgE antibodies. Conclusion: Increasing total serum IgE level was associated with progressively lower lung function in a general adult population after taking other predictors of impaired Spiro metric lung function into account, though dependent on the subjects’respiratory symptom and disease status. Variation in prevalences of respiratory symptoms and obstructive lung disease in previous examined populations may thus explain conflicting observations of the association between total IgE and airflow impairment.     

Inhaled steroids are associated with reduced lung function decline in subjects with asthma with elevated total IgE

BACKGROUND: Few studies have investigated the long-term association between inhaled corticosteroids (ICSs) and lung function decline in asthma. OBJECTIVE: To evaluate whether prolonged treatment with ICSs is associated with FEV(1) decline in adults with asthma. METHODS: An international cohort of 667 subjects with asthma (20-44 years old) was identified in the European Community Respiratory Health Survey (1991-1993) and followed up from 1999 to 2002. Spirometry was performed on both occasions. FEV(1) decline was analyzed according to age, sex, height, body mass index, total IgE, time of ICS use, and smoking, while adjusting for potential confounders. RESULTS: As ICS use increased, the decline in FEV(1) was lower (P trend = .025): on average, decline passed from 34 mL/y in nonusers (half of the sample) to 20 mL/y in subjects treated for 48 months or more (18%). When adjusting for all covariates, there was an interaction (P = .02) between ICS use and total IgE: in subjects with high (>100 kU/L) IgE, ICS use for 4 years or more was associated with a lower FEV(1) decline (23 mL/y; 95% CI, 8-38 compared with nonusers). This association was not seen in those with lower IgE. CONCLUSION: Although confirming a beneficial long-term association between ICSs and lung function in asthma, our study suggests that subjects with high IgE could maximally benefit from a prolonged ICS treatment. CLINICAL IMPLICATIONS: This study adds further evidence to the beneficial effect of inhaled steroids on lung function in asthma; future studies will clarify whether calibrating the corticosteroid dose according to the level of total IgE is a feasible approach in asthma management.     

ImmunoCAP Phadiatop Infant--a new blood test for detecting IgE sensitisation in children at 2 years of age

BACKGROUND: Correct diagnosis of immunoglobulin E (IgE)-mediated disease is the prerequisite for secondary allergy prevention during early childhood. OBJECTIVE: To evaluate the diagnostic efficacy of a new blood test, Phadiatop Infant, in detecting IgE sensitisation to food and inhalant allergens among children at 2 years of age. METHODS: Children (n = 239) were followed prospectively from birth to 2 years of age for the presence of IgE sensitisation and the development of atopic manifestations. Immunoglobulin E sensitisation was evaluated by skin prick test (SPT) and analysis of allergen-specific IgE antibodies in plasma to food and inhalant allergens. The children were classified into three groups: IgE-sensitised, non-IgE sensitised and inconclusive, depending on SPT and allergen-specific IgE results. RESULTS: Twenty-six (11%) of the children were classified as IgE-sensitised, 182 (76%) as non-IgE sensitised and 31 (13%) as inconclusive. Phadiatop Infant was positive in 50 (21%) of the children. Ten children (4%) with identified IgE antibodies against the selected food and inhalant allergens showed negative Phadiatop Infant. Three children showed positive Phadiatop Infant but were negative in the other tests performed. These results correspond to positive and negative predictive values for Phadiatop Infant of 89 and 99%, respectively. Children with clinical symptoms of atopic diseases had significantly increased levels for Phadiatop Infant (P < 0.01). CONCLUSION: Phadiatop Infant appears to be a reliable alternative to SPT and the measurement of allergen-specific IgE antibodies in plasma for detecting clinically important IgE sensitisation among children at 2 years of age.     

Distribution of total serum IgE and specific IgE to common aeroallergens by sex and age,and their relationship to each other in a random sample of the Dutch general population aged 20–70 years*

To describe the distribution of serum total IgE and specific IgE. to common aeroallergens by sex and age and to study their relationship to each other, we measured serum total IgE and specific IgE (CAP) to house-dust mite, timothy grass, cat, birch, and Cladosporium in a random sample of 2496 subjects, aged 20–70 years from the Dutch general population. We found that total IgE was higher in men, independently of smoking, and that total IgE had no relationship with age after adjustment for specific IgE and smoking in linear regression analysis. At least one positive specific IgE test was found in 32% in both sexes. Men had higher prevalences of specific IgE to house-dust mite and lower prevalences of specific IgE to birch than women. The proportion with positive specific IgE decreased with age. The mean total IgE increased with the number of positive specific IgE tests. Thus, total IgE is higher in men and has no relationship with age if specific IgE is taken into account. The prevalences of specific IgE to aeroallergens are high and decrease with increasing age. We suggest that sex differences in total IgE should be considered when using total IgE.     

The relationship between smoking and total immunoglobulin E levels

Results of skin testing to common allergens, total serum IgE levels, and the responses to a respiratory questionnaire were obtained for 1768 individuals participating in a survey of a rural population. The geometric mean total IgE levels in a group of subjects without skin-test reactions and with no histories of asthma or hay fever was 14.8 U/ml for men and 11.9 U/ml for women. When individuals were classified according to skin reactivity and smoking history there was a significant difference in IgE levels among nonsmokers, exsmokers, and smokers, with smokers having the highest levels. The percentage of subjects with elevated total IgE levels was higher in smokers than in nonsmokers regardless of skin reactivity to common allergens. Among smokers there was no relationship between intensity and duration of smoking and IgE levels. Among exsmokers IgE levels tended to be lower in those who had stopped smoking earlier.     

The IL-1beta genotype carries asthma susceptibility only in men

One proinflammatory cytokine possibly implicated in the pathogenesis of asthma is IL-1beta. We analyzed the polymorphism of the IL-1beta gene (single nucleotide exchange at position -511) in a cohort of 245 patients with asthma (mean age, 58 years; age range, 31-84 years) and 405 controls. There were no differences in the allele frequencies. However, in men the genotype distribution differed significantly between asthmatic and control subjects (P =.03). The number of 1.2 heterozygotes was decreased in the patient group (P =.01). In subgroup analysis, the genotype distributions between cases and controls proved significantly different only in men with lower serum IgE (<100 IU/mL; P =.009). The odds ratio of the 1.2 heterozygote men was 0.37 (95% CI, 0.19-0.71). Thus in the case of men the effect of the IL-1beta locus is clear, whereas in women there is no effect. In men this might make a significant contribution to the total asthma prevalence because of the high number of functional genotypes (ie, 50/50 IL-1beta homozygote/heterozygote ratio).     

Associations of the IL12B promoter polymorphism in longitudinal data from asthmatic patients 7 to 42 years of age

BACKGROUND: The IL12B gene encodes the p40 chain of IL-12, a proinflammatory cytokine that antagonizes TH2 expression and hence may play a critical role in the pathogenesis of airway inflammation observed in asthma. A promoter polymorphism of the gene was recently shown to be associated with asthma severity in children but only in heterozygotes. OBJECTIVE: The aim of the present study was to test the hypothesis that the IL12B promoter polymorphism is associated with asthma susceptibility, severity, and related phenotypes in a cohort with longitudinal phenotypic data, from childhood to adulthood. METHODS: Four hundred one 7-year-old children (106 control children, 295 asthmatic children) and 83 10-year-old children with severe asthma were recruited from a 1957 birth cohort. Atopic status and respiratory functions were determined at ages 7, 10, 14, 21, 28, 35, and 42 years. At age 42 years, blood samples were taken from 244 individuals for genotyping and the determination of plasma IgE levels and PHA- and house dust mite-induced IFN-gamma responses. Genotyping was done by the PCR restriction fragment length polymorphism method, using Alu I, and confirmed in 10% of the samples by direct sequencing. RESULTS: The IL12B genotypes were not associated with asthma susceptibility, severity, or atopy at ages 7 and 42 years. Total serum IgE levels at age 42 of men with at least one CTCTAA allele were higher than those homozygous for the GC allele (P = .042), whereas no difference was observed for women. At all ages, female subjects with at least 1 copy of the CTCTAA allele had lower mean percent predicted levels of FEV1 and FVC compared with those without this allele; these differences were significant at ages 10 and 14 years (P < .05) and in the asthmatic subgroup at age 7 years (P = .001). CONCLUSIONS: In this long-term study of asthmatic subjects with comprehensive data on asthma severity, we found no evidence to support the presence of a heterozygote effect of the IL12B promoter polymorphism on the level of asthma in early childhood or adulthood. The polymorphism was also not associated with asthma susceptibility, but the CTCTAA allele may have been associated with elevated serum IgE levels in male subjects and reduced pulmonary function in female subjects in early childhood.     

Atopy in Norwegian and Russian adults: a population-based study from the common border area

Background: Several studies have concluded that atopy is more common in Western than in Eastern Europe. We aimed to study whether a similar difference exists between Norwegian and Russian adults living in geographically adjacent areas. Methods: A cross‐sectional population‐based study was performed in Sør‐ Varanger municipality (Norway) and in the cities of Nikel and Zapolyarny (Russia). The Russian cities are heavily polluted by sulfur dioxide from local nickel industry. In addition to questionnaire information, results on IgE sensitization (S‐Phadiatop, Pharmacia & Upjohn, Uppsala, Sweden) were obtained from 3134 Norwegian and 709 Russian participants. Results: A positive Phadiatop was found in 20.7% of the Norwegians (men 21.9%, women 19.7%) and in 27.5% of the Russians (men 35.7%, women 23.0%); the sex‐ and age‐adjusted relative risk of testing positive in Russia being 1.49 (95% CI 1.23–1.81). The Norwegian participants reported more atopic dermatitis and hay fever, although this difference was statistically significant only for atopic dermatitis in women. Conclusion: IgE sensitization was more common in Russia than in Norway, unlike findings from other east–west European studies. The Russians did not, however, report more atopic diseases. This discrepancy might reflect different awareness of allergies in the two countries and demonstrates the need for objective markers of atopy when comparing prevalence in different populations.     

Atopic disease and exhaled nitric oxide in an unselected population of young adults.

BACKGROUND: Several studies have reported elevated levels of fractional exhaled nitric oxide (FeNO) in atopic patients, particularly in asthmatic patients, suggesting that FeNO is a marker of bronchial inflammation. However, the independent influence of different atopic entities (eczema, allergic rhinitis, and asthma) on FeNO has never been studied in the general population. OBJECTIVE: To study the influence of a questionnaire-based diagnosis of atopic diseases and IgE and lung function measurements on FeNO levels. METHODS: This study was part of a follow-up on otitis media of a birth cohort of 1,328 children born in Nijmegen, the Netherlands, between September 1, 1982, and August 31, 1983. Within the birth cohort, the incidence of asthma, allergic rhinitis, and eczema was determined, and off-line FeNO, spirometry, and IgE measurements were performed at the age of 21 years. RESULTS: FeNO measurements were successfully performed in 361 participants. Median FeNO levels were significantly higher in those with vs without eczema (23.6 vs 18.0 ppb; P < .0001), those with vs without allergic rhinitis (20.7 vs 17.8 ppb; P = .0001), and those with vs without atopic asthma (23.3 vs 18.1 ppb; P = .02) but not in those with vs without asthma (20.8 vs 18.3 ppb; P = .24). Eczema, allergic rhinitis, smoking, sex, and atopic sensitization appeared to be independently associated with log FeNO in this population sample, whereas (atopic) asthma was not. No effect on FeNO levels was observed for lung function parameters. CONCLUSION: Eczema, allergic rhinitis, and atopic status were all independently associated with elevated FeNO levels, whereas (atopic) asthma was not. This finding implies that future studies into the role of FeNO in asthma should consider the influence of atopic disease outside the lungs.