DOI QR코드

DOI QR Code

Blood eosinophil counts as a biomarker for allergen sensitization in childhood allergic diseases in comparison with total IgE

  • Hye Jin Lee (Department of Pediatrics, College of Medicine, The Catholic University of Korea) ;
  • Eun-Ae Yang (Department of Pediatrics, College of Medicine, The Catholic University of Korea) ;
  • Yoon Hong Chun (Department of Pediatrics, College of Medicine, The Catholic University of Korea) ;
  • Hyun Hee Kim (Department of Pediatrics, College of Medicine, The Catholic University of Korea) ;
  • Hwan Soo Kim (Department of Pediatrics, College of Medicine, The Catholic University of Korea)
  • Received : 2023.06.30
  • Accepted : 2023.09.08
  • Published : 2024.01.30

Abstract

Purpose: Eosinophils and total immunoglobulin (IgE) have served as a histologic hallmark of allergic conditions. Many investigators have used total eosinophil count (TEC) and total IgE for evaluating allergic diseases. We examined differences in TEC and total IgE in allergic diseases and whether it differs according to sensitization. Methods: In this retrospective study, we enrolled 551 patients who visited Uijeongbu St. Mary's Hospital from January 1, 2009 through December 31, 2012 for allergic diseases. We included patients with a diagnosis of atopic dermatitis (AD), allergic rhinitis (AR), asthma (AS), or urticaria (UC). We compared the TEC and total IgE level according to sensitization patterns. Results: There were 235 cases of AD, 179 cases of AS, 112 cases of AR, and 82 cases of UC. Regarding sensitization, 106 were not sensitized to any allergens, 206 were sensitized to inhalants, 109 were sensitized to food allergens, and 49 were sensitized to both food and inhalant allergens. TEC was significantly higher in the AD and AR group than in the UC group. TEC was significantly higher in those sensitized to both inhalant and food than those not sensitized. The total IgE levels were significantly higher in those sensitized to both inhalant and food than those not sensitized or sensitized to food. Total IgE levels were significantly higher in those sensitized to inhalant than those not sensitized or sensitized to food. Conclusion: Eosinophils appear to play differential roles in the expression of different types of allergic diseases. Total IgE level may play a significant role in sensitization.

Keywords

References

  1. Breiteneder H, Peng YQ, Agache I, Diamant Z, Eiwegger T, Fokkens WJ, et al. Biomarkers for diagnosis and prediction of therapy responses in allergic diseases and asthma. Allergy 2020;75:3039-68.
  2. Basu MN, Mortz CG, Jensen TK, Barington T, Lambertsen KL, Halken S. Biomarkers in asthma in the context of atopic dermatitis in young children. Pediatr Allergy Immunol 2022;33:e13823.
  3. O'Sullivan JA, Bochner BS. Eosinophils and eosinophil-associated diseases: an update. J Allergy Clin Immunol 2018;141:505-17.
  4. Robinson DS, Assoufi B, Durham SR, Kay AB. Eosinophil cationic protein (ECP) and eosinophil protein X (EPX) concentrations in serum and bronchial lavage fluid in asthma. Effect of prednisolone treatment. Clin Exp Allergy 1995;25:1118-27.
  5. Stelmach I, Majak P, Grzelewski T, Jerzynska J, Juralowicz D, Stelmach W, et al. The ECP/Eo count ratio in children with asthma. J Asthma 2004;41:539-46.
  6. Kolkhir P, Akdis CA, Akdis M, Bachert C, Bieber T, Canonica GW, et al. Type 2 chronic inflammatory diseases: targets, therapies and unmet needs. Nat Rev Drug Discov 2023;22:743-67.
  7. Tu YL, Chang SW, Tsai HJ, Chen LC, Lee WI, 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:e80996.
  8. Benson VS, Hartl S, Barnes N, Galwey N, Van Dyke MK, Kwon N. Blood eosinophil counts in the general population and airways disease: a comprehensive review and meta-analysis. Eur Respir J 2022;59:2004590.
  9. Halken S. Prevention of allergic disease in childhood: clinical and epidemiological aspects of primary and secondary allergy prevention. Pediatr Allergy Immunol 2004;15 Suppl 16:4-5, 9-32.
  10. Koh HS, Lee KS, Han DH, Rha YH, Choi SH. Relationship between serum total IgE, specific IgE, and peripheral blood eosinophil count according to specific allergic diseases. Allergy Asthma Respir Dis 2013;1:123-8.
  11. Li Y, Wu R, Tian Y, Bao T, Tian Z. The correlation of serum eosinophil cationic protein level with eosinophil count, and total IgE level in Korean adult allergic rhinitis patients. Asian Pac J Allergy Immunol 2016;34:33-7.
  12. Small P, Keith PK, Kim H. Allergic rhinitis. Allergy Asthma Clin Immunol 2018;14(Suppl 2):51.
  13. Muraro A, Dreborg S, Halken S, Host A, Niggemann B, Aalberse R, et al. Dietary prevention of allergic diseases in infants and small children. Part II. Evaluation of methods in allergy prevention studies and sensitization markers. Definitions and diagnostic criteria of allergic diseases. Pediatr Allergy Immunol 2004;15:196-205.
  14. Crapo RO, Casaburi R, Coates AL, Enright PL, Hankinson JL, Irvin CG, et al. Guidelines for methacholine and exercise challenge testing-1999. This official statement of the American Thoracic Society was adopted by the ATS Board of Directors, July 1999. Am J Respir Crit Care Med 2000;161:309-29.
  15. Zuberbier T, Abdul Latiff AH, Abuzakouk M, Aquilina S, Asero R, Baker D, et al. The international EAACI/GA2LEN/EuroGuiDerm/APAAACI guideline for the definition, classification, diagnosis, and management of urticaria. Allergy 2022;77:734-66.
  16. Sastre B, Rodrigo-Munoz JM, Garcia-Sanchez DA, Canas JA, Del Pozo V. Eosinophils: old players in a new game. J Investig Allergol Clin Immunol 2018;28:289-304.
  17. Kita H, Bochner BS. Biology of eosinophils. Middleton's Allergy Principles and Practice 2013;8:265-79.
  18. Nair P, Hargreave FE. Measuring bronchitis in airway diseases: clinical implementation and application: airway hyperresponsiveness in asthma: its measurement and clinical significance. Chest 2010;138(2 Suppl):38S-43S.
  19. Kim KW, Lee KE, Kim ES, Song TW, Sohn MH, Kim KE. Serum eosinophil-derived neurotoxin (EDN) in diagnosis and evaluation of severity and bronchial hyperresponsiveness in childhood asthma. Lung 2007;185:97-103.
  20. Zhang XY, Simpson JL, Powell H, Yang IA, Upham JW, Reynolds PN, et al. Full blood count parameters for the detection of asthma inflammatory phenotypes. Clin Exp Allergy 2014;44:1137-45.
  21. Chang KL, Yang YH, Yu HH, Lee JH, Wang LC, Chiang BL. Analysis of serum total IgE, specific IgE and eosinophils in children with acute and chronic urticaria. J Microbiol Immunol Infect 2013;46:53-8.
  22. Takebuchi Y, Minatogawa A, Naito Y, Sano C, Ohta R. Acute exacerbation of hypereosinophilic syndrome complicated with dermatitis, enteritis, and myositis: a case report. Cureus 2023;15:e34090.
  23. Baldwa VS, Goyal RK, Singh J, Varandani N, Chopra YM. Blood histamine levels and eosinophil, basophil counts in urticaria. Ann Allergy 1975;34:351-5.
  24. Kolkhir P, Church MK, Altrichter S, Skov PS, Hawro T, Frischbutter S, et al. Eosinopenia, in chronic spontaneous urticaria, is associated with high disease activity, autoimmunity, and poor response to treatment. J Allergy Clin Immunol Pract 2020;8:318-25.e5.
  25. Olbrich CL, Bivas-Benita M, Xenakis JJ, Maldonado S, Cornwell E, Fink J, et al. Remote allergen exposure elicits eosinophil infiltration into allergen nonexposed mucosal organs and primes for allergic inflammation. Mucosal Immunol 2020;13:777-87.
  26. Guthier HE, Zimmermann N. Targeting eosinophils in mouse models of asthma. Methods Mol Biol 2022;2506:211-22.
  27. Kool M, Soullie T, van Nimwegen M, Willart MA, Muskens F, Jung S, et al. Alum adjuvant boosts adaptive immunity by inducing uric acid and activating inflammatory dendritic cells. J Exp Med 2008;205:869-82.
  28. Daniluk U, Alifier M, Kaczmarski M, Stasiak-Barmuta A, Lebensztejn D. Longitudinal observation of children with enhanced total serum IgE. Ann Allergy Asthma Immunol 2015;114:404-10.e4.
  29. Wu G, Hu H, Zhang T, Zhang XD, Sun B. Profiles of sensitization and comorbidity in asthma patients with markedly increased serum total IgE (>1000kU/L). Allergy Asthma Proc 2022;43:124-32.
  30. Hu Y, Liu S, Liu P, Mu Z, Zhang J. Clinical relevance of eosinophils, basophils, serum total IgE level, allergen-specific IgE, and clinical features in atopic dermatitis. J Clin Lab Anal 2020;34:e23214.
  31. Kim EJ, Kwon JW, Lim YM, Yoon D, Seo JH, Chang WS, et al. Assessment of total/specific IgE levels against 7 inhalant allergens in children aged 3 to 6 years in Seoul, Korea. Allergy Asthma Immunol Res 2013;5:162-9.
  32. Kim JH, Chang JH, Choi HS, Kim HJ, Kang JW. The association between serum lead and total immunoglobulin E levels according to allergic sensitization. Am J Rhinol Allergy 2016;30:e48-52.