Obstructive Lung Diseases: COPD I |

The Prevalence of Increased Serum IgE and Aspergillus Sensitization in Patients With COPD and Their Association With Symptoms and Lung Function FREE TO VIEW

Jianmin Jin, MD; Xiaofang Liu, MD; Yongchang Sun, MD
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Beijing Tongren Hospital, Beijing, China

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;149(4_S):A374. doi:10.1016/j.chest.2016.02.389
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SESSION TYPE: Original Investigation Poster

PRESENTED ON: Saturday, April 16, 2016 at 11:45 AM - 12:45 PM

PURPOSE: To investigate the prevalence of increased serum total IgE (T-IgE), A. fumigatus sensitization and ABPA in a COPD cohort of larger sample size. To analyze the clinical characteristics of COPD patients with increased serum T-IgE, A. fumigatus sensitization, or combined with ABPA.

METHODS: 273 patients with COPD were evaluated by respiratory symptoms, blood test, chest HRCT, lung function, serum detection of T-IgE and Aspergillus specific IgE. Patients with T-IgE more than 1000KU/L were further investigated for allergic bronchopulmonary aspergillosis (ABPA).

RESULTS: The prevalence of elevated serum T-IgE and AH in patients with COPD was 47.3% and 15.0%, respectively. Eight patients (2.9%) met the diagnostic criteria for ABPA. Compared with the normal T-IgE group, patients with elevated T-IgE had a longer history of dyspnea (p<0.01), an earlier onset of dyspnea after chronic cough/expectation (p<0.01), and were more likely to wheeze (p<0.01). They also showed worse lung functions and more severe GOLD staging (p<0.01). Analysis of the clinical data in male patients with smoking as the risk factor showed the same results. To evaluate the clinical characteristics of COPD with AH, patients with elevated T-IgE were further divided into subgroups with and without AH. When compared with the normal T-IgE group, both the two subgroups showed longer history of dyspnea (p<0.01), an earlier onset of dyspnea (p<0.01) and a worse status of lung function (p<0.05). Correlation analysis demonstrated that serum T-IgE was correlated positively with the time length of dyspnea (r=0.401, p<0.001), and the ratio of duration of dyspnea to that of chronic cough/expectation (r=0.59, p<0.001), but negatively with FEV1/FVC% (r=−0.194, p=0.001), and FEV1% predicted (r=−0.219, p<0.001).

CONCLUSIONS: There was a high prevalence of elevated serum T-IgE and AH in patients with COPD. Serum T-IgE level was correlated with symptoms such as dyspnea and impairment of lung function. Allergens other than Aspergillus may have similar effects on disease expression or progression of COPD.

CLINICAL IMPLICATIONS: It can be helpful to demonstrate the role of allergy in disease expression or progression of COPD, and then may be beneficial to provide an individual diagnosis and treatment for the patients.

DISCLOSURE: The following authors have nothing to disclose: Jianmin Jin, Xiaofang Liu, Yongchang Sun

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