Serum immunoglobulin E and absolute eosinophil count as markers of severity in childhood asthma

Authors

  • Pinakin P. Trivedi Department of Pediatrics, GCS Medical College, Hospital and Research Centre, Ahmedabad, Gujarat, India
  • Ami H. Patel Department of Pediatrics, GCS Medical College, Hospital and Research Centre, Ahmedabad, Gujarat, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20200120

Keywords:

Absolute eosinophil count, Allergy, Asthma, Immunoglobulin E

Abstract

Background: Asthma is a chronic inflammatory condition of the airways resulting in increased airway reactivity to a variety of stimuli like allergens, irritants, viruses and exercise. There is a strong association between the exposure of allergens and development of asthmatic symptoms. A hypersensitivity reaction initiated by immunologic mechanisms mediated by Immunoglobulin E (IgE) antibodies occurs in allergic asthma. IgE and eosinophils play an important role in the inflammatory process resulting in bronchial hyperresponsiveness. The aim of this study was to evaluate serum total IgE levels and Absolute Eosinophil Count (AEC) as markers of disease activity and study their association with the severity of bronchial asthma in children.

Methods: A prospective study was conducted in the paediatric department of a tertiary care hospital in Ahmedabad, Gujarat, India from July 2017 to December 2018. Children between 4-14 years of age diagnosed as having bronchial asthma were included in the study. Serum total IgE levels and absolute eosinophil count were done in all the study participants and their correlation with the severity of asthma was assessed.

Results: Of the total 109 patients of asthma, 44(40.4%) had intermittent asthma, 30(27.5%) mild persistent, 25(22.9%) moderate persistent and 10(9.2%) severe persistent asthma. Serum total IgE levels were raised above the normal limits for age in 94(86.2%) patients and increased AEC was found in 61(56 %) patients. Both serum total IgE levels and AEC increased significantly (p<0.0001) with increasing severity of asthma.

Conclusions: Serum total IgE levels and AEC can be used to predict the severity of asthma in children.

References

Paramesh H. Epidemiology of asthma in India. Ind J Pediatr. 2002;69(4):309-12.

Gupta MK, Patodia J, Chaudhary P, Kakkar M. The rising trend of asthma prevalence in urban school children of Jaipur: A questionnaire-based study. Indian J Aller Asthma Immunol. 2018; 32:10-14.

Global initiative for asthma. Pocket guide for health professionals, 2015. Available at: http://www.ginasthma.org/wp-content/uploads/2016/01/GINA_pocket_2015.pdf. Accessed on 21 April 2017.

Froidure A, Mouthuy J, Durham SR, Chanez P, Sibille Y, Pilette C. Asthma phenotypes and tIgE responses. Eur Resp J. 2016;47:304-19.

Matucci A, Vultaggio A, Maggi E, Kasujee I. Is tIgE or eosinophils the key player in allergic asthma pathogenesis? Are we asking the right question? Resp Res. 2018;19:113-22.

Sánchez-García S, Habernau Mena A, Quirce S. Biomarkers in inflammometry pediatric asthma: utility in daily clinical practice. Eur Clin Resp J. 2017 Jan 1;4(1):1356160.

Liu AH, Covar RA, Spahn JD, Sicherer SH. Childhood asthma. In: Kliegman RM, editor. Nelson Textbook of Pediatrics. 20th ed. Philadelphia, PA: Elsevier; 2016: 1095-1115.

National Asthma Education and Prevention Program: Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma 2007. U.S. Department of Health and Human Services. Available at: https://www.nhlbi.nih.gov/sites/default/files/media/docs/asthgdln_1.pdf. Accessed on 2 May 2017.

Dati F, Ringel KP. Reference values for serum IgE in healthy non-atopic children and adult. Clin Chem. 1982;28(7):1556.

Vickery BP. Eosinophils. In: Kliegman RM, editor. Nelson Textbook of Pediatrics. 20th ed. Philadelphia, PA: Elsevier; 2016: 11038-11039.

Chandran CM, Kiran GS, Babu KR, Buchineni M. Serum IgE levels as a marker of disease activity in childhood asthma-A cross sectional study. IAIM. 2015;2(12):45-51.

Snehalatha G, Begum A, Raju N, Kumar R. A study on correlation of serum IgE levels with diagnosis and severity of asthma in children. Int J Contemp Pediatr. 2018 Nov;5(6):2240-3.

Gurjar R, Goyal D, Sareen D. To Study the Correlation of Serum tIgE and Absolute Eosinophil Count Levels with the Severity of Childhood Asthma. IOSR JDMS. 2018;17(3):14-8.

Bapna A, Mathur US, Saigal R, Arya A. The Relationship of Allergic Bronchial Asthma, Cutaneous Sensitivity Reaction and Serum Total IgE. Lung Ind. 1990 May 1;8(2):76-78.

Raj D, Lodha R, Pandey A, Mukherjee A, Agrawal A, Kabra SK, New Delhi Childhood Asthma Study Group. Aeroallergen sensitization in childhood asthmatics in northern India. Ind Pediatr. 2013 Dec 1;50(12):1113-8.

Chaudhary GS, Kumar A, Shashtri M. Comparison of total serum immunoglobulin E and absolute eosinophil count levels among asthmatic and non-asthmatic children. Ind J Child Health. 2017;4(3):345-7.

Rathoria E, Bansal U, Gupta A, Gupta NB, Ahuja R, Rathoria R. Study of serum tIgE levels in childhood asthma in Barabanki region, India. Int J Contemp Pediatr. 2018;5:1755-8.

Lama M, Chatterjee M, Chaudhuri TK. Total serum immunoglobulin E in children with asthma. Ind J Clin Biochem. 2013 Apr 1;28(2):197-200.

Al eterie S, Al Khouatli K. Serum Levels of IL-4 and tIgE in bronchial asthma in Syrian children. JCPS. 2017;10(2):879-83.

Sears MR, Burrows B, Flannery EM, Herbison GP, Hewitt CJ, Holdaway MD. Relation between airway responsiveness and serum IgE in children with asthma and in apparently normal children. New Eng J Med. 1991 Oct 10;325(15):1067-71.

Devi CG, Sabapathy S, Pabiyasree J. Correlation of serum tIgE and absolute eosinophil count levels with the severity of childhood asthma. Int J Gen Med Pharm. 2014;4(1):79-82.

Ahmed MA, Chohan MN, Abbas K. Correlation of serum immunoglobulin E levels with asthma severity in children (2-12 years) presenting to a tertiary care hospital. Khyber Med Uni J. 2018 Dec 31;10(4)212-6.

Ching MW, Yap JM, Santos KC, Ong CM, Ramos JD. Correlation of total IgE, house-dust mite specific IgE and absolute eosinophils in an asthmatic pediatric population. Philipp Sci Lett. 2013;6:241-8.

Carroll WD, Lenney W, Child F, Strange RC, Jones PW, Whyte MK, et al. Asthma severity and atopy: how clear is the relationship?. Archiv Dis Childhood. 2006 May 1;91(5):405-9.

Kovač K, Dodig S, Tješić-Drinković D, Raos M. Correlation between asthma severity and serum IgE in asthmatic children sensitized to Dermatophagoides pteronyssinus. Archiv Med Res. 2007 Jan 1;38(1):99-105.

Sciuca S. Prognostic importance of IgE for the evolution of recurrent wheezing into the bronchial asthma in children. World Allerg Organizat J. 2007;11:119-20.

Tu Y-L, Chang S-W, Tsai H-J, Chen L-C, Lee W-I, Hua MC, et al. Total Serum IgE in a Population-Based Study of Asian Children in Taiwan: Reference Value and Significance in the Diagnosis of Allergy. PLoS One. 2013;8(11):e80996.

Vora A. Anti IgE therapy in allergic asthma and allergic rhinitis. Med Upda. 2012;22:370-6.

Tran TN, Khatry DB, Ke X, Ward CK, Gossage D. High blood eosinophil count is associated with more frequent asthma attacks in asthma patients. Annal Allerg, Asthma Immunol. 2014 Jul 1;113(1):19-24.

Carr TF, Berdnikovs S, Simon HU, Bochner BS, Rosenwasser LJ. Eosinophilic bioactivities in severe asthma. World Allerg Organ J. 2016 Dec;9(1):21.

Rodríguez-Martínez CE, Sossa-Briceño MP, Castro-Rodriguez JA. Factors predicting persistence of early wheezing through childhood and adolescence: a systematic review of the literature. J Asthma Allerg. 2017; 10:83-98.

Castro-Rodríguez JA, Holberg CJ, Wright AL. A clinical index to define risk of asthma in young children with recurrent wheezing. Am J Respir Crit Care Med. 2000;162:1403-6.

Abrams EM, Becker AB, Szefler SJ. Current state and future of biologic therapies in the treatment of asthma in children. Pediatr Allerg, Immunol, Pulmonol. 2018 Sep 1;31(3):119-31.

Satwani H, Rehman A, Ashraf S, Hassan A. Is serum total IgE levels a good predictor of allergies in children. J Pak Med Assoc. 2009 Oct;59(10):698-702.

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Published

2020-01-23

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Original Research Articles