Wafaa Ali Hassan^*, Ibrahiem Shalan, Mohammed Khalifa

Show more
Chest Department, Assiut University, Assiut, Egypt.
Chest Department, Al-Azhar University, Assiut, Egypt.
Show less

Abstract: Introduction: Although an increased prevalence of airway obstruction, bronchial hyperreactivity and allergic diseases such as asthma has been associated with bronchiectasis, studies investigating role of atopy in bronchiectasis are few and controversial. We have therefore studied IgE level and reversible airways obstruction in bronchiectasis which have not previously been evaluated in bronchiectasis. Patients and Methods: This study was conducted at Department of Chest Diseases of Al-Azhar University, Assiut, Egypt from January 2012 to December 2013, all consecutive patients with bronchiectasis admitted to the department were enrolled to the study. Serum IgE, pulmonary function tests (PFT) and high resolution computerized tomography (HRCT) were done to all cases. Results: Patients with high IgE (32/50) had longer disease duration and frequent history of allergic diseases. They also had significantly worse FEV1 (49.38 ± 12.65; p = 0.041) and FEV1/FVC (60.89 ± 13.52, p = 0.015) values. Mean HRCT score was significantly higher in patients with high IgE than in patients with normal (18/50) IgE (23.6 ± 10.1 and 7.83 ± 2.43 respectively). IgE showed positive correlation (r = 0.266, p = 0.015) with HRCT scores. Furthermore, the mean increase in FEV1 after inhalation of salbutamol was significantly greater (p = 0.002) in high IgE patients. Conclusions: In conclusion, IgE level is significantly high in bronchiectasis and it may lead to worse pulmonary function and more HRCT extent. Appreciable reversible airways obstruction should be sought in all cases of bronchiectasis and treated appropriately.

Keywords: Atopy, Bronchiectasis, IgE

Cite this paper: Hassan, W. , Shalan, I. and Khalifa, M. (2014) Impact of Immunoglobulin E and Airway Obstruction on Bronchiectasis. Open Journal of Respiratory Diseases, 4, 34-40. doi: 10.4236/ojrd.2014.42006.

References

[1]   Barker, A.F. and Bardana Jr., E.J. (1988) Bronchiectasis: Update of an Orphan Disease. American Review of Respiratory Disease, 137, 969-978.
http://dx.doi.org/10.1164/ajrccm/137.4.969

[2]   Hilton, A.M. and Doyle, L. (1978) Immunological Abnormalities in Bronchiectasis with Chronic Bronchial Suppuration. British Journal of Diseases of the Chest, 72, 207-216.
http://dx.doi.org/10.1016/0007-0971(78)90043-8

[3]   Varpela, E., Laitinen, L.A., Keskinen, H. and Korhola, O. (1978) Asthma, Allery and Bronchial Hyperreactivity to Histamine in Patients with Bronchiectasis. Clinical & Experimental Allergy, 8, 273-280.
http://dx.doi.org/10.1111/j.1365-2222.1978.tb03224.x

[4]   Tobin, M.J., Maguire, O., Reen, D., Tempany, E. and Fitzgerald, M.X. (1980) Atopy and Bronchial Reactivity in Older Patients with Cystic Fibrosis. Thorax, 36, 807-813.
http://dx.doi.org/10.1136/thx.35.11.807

[5]   Al-Mousawi, M.S.H., Lovel, H., Behbehani, N., Arifhodzic, N., Woodcock, A. and Custovic, A. (2004) Asthma and Sensitization in a Community with Low Indoor Allergen Levels and Low Pet-Keeping Frequency. The Journal of Allergy and Clinical Immunology, 114, 1389-1394.
http://dx.doi.org/10.1016/j.jaci.2004.09.005

[6]   Nogrady, S.G., Evans, W. and Davies, B.H. (1978) Reversibility of Airways Obstruction in Bronchiectasis. Thorax, 33, 635-637.
http://dx.doi.org/10.1136/thx.33.5.635

[7]   Büyükoztürk, S., Gelincik, A.A., Genc, S., Kocak, H., Oneriyidogan, Y., Erden, S., Dal, M. and Colakoglu, B. (2004) Acute Phase Reactants in Allergic Airway Disease. The Tohoku Journal of Experimental Medicine, 204, 209-213.
http://dx.doi.org/10.1620/tjem.204.209

[8]   Pifferi, M., Caramella D., Bulleri, A., Baldi, S., Peroni, D., Pietrobelli A. and Boner, A.L. (2004) Bronchiectasis: Correlation of HRCT, Ventilation and Perfusion Scintigraphy, and Pulmonary Function Testing. Pediatric Pulmonology, 38, 298-303.
http://dx.doi.org/10.1002/ppul.20110

[9]   Bhalla, M., Turcois, N., Aponte, V., Jenkins, M., Leitman, B.S., McCauley, D.I. and Naidich, D.P. (1991) Cystic Fibrosis: Scoring System with Thin Section CT. Radiology, 179, 783-788.

[10]   Pellegrion, R., Viegi, G., Enright, P., et al. (2005) Interpretation of Lung Function Test. European Respiratory Journal, 26, 948-968.
http://dx.doi.org/10.1183/09031936.05.00035205

[11]   Tsang, K.W. and Tipoe, G.L. (2004) Bronchiectasis: Not an Orphan Disease in the East. The International Journal of Tuberculosis and Lung Disease, 8, 691-702.

[12]   Twiss, J., Metcalfe, R., Edwards, E. and Byrnes, C. (2005) New Zealand National Incidence of Bronchiectasis “Too High” for a Developed Country. Archives of Disease in Childhood, 90, 737-740. http://dx.doi.org/10.1136/adc.2004.066472

[13]   Pang, J., Chan, H.S. and Sung, J.Y. (1989) Prevalence of Asthma, Atopy, and Bronchial Hyperreactivity in Bronchiectasis: A Controlled Study. Thorax, 44, 948-951.
http://dx.doi.org/10.1136/thx.44.11.948

[14]   Ip, M., Lam, M.W., So, S.Y., Liong, E., Chan, C.Y. and Tse, K.M. (1991) Analysis of Factors Associated with Bronchial Hyperreactivity to Methacholine in Bronchiectasis. Lung, 169, 43-51. http://dx.doi.org/10.1007/BF02714140

[15]   Bodner, C., Godden, G. and Seaton, A. (1998) Family Size, Childhood Infections and Atopic Diseases. Thorax, 53, 28-32. http://dx.doi.org/10.1136/thx.53.1.28

[16]   Ip, M.S.M., So, S.Y., Lam, W.K. and Liong, E. (1992) High Prevalence of Asthma in Patients with Bronchiectasis in Hong Kong. European Respiratory Journal, 5, 418-423.

[17]   Bager, P., Westergaard, T., Rostgaard, K., Hjalgrim, H. and Melbye, M. (2002) Age at Childhood Infections and Risk of Atopy. Thorax, 57, 379-382.
http://dx.doi.org/10.1136/thorax.57.5.379

[18]   Von Mutius, E. (2001) Infection: Friend or Foe in the Development of Atopy and Asthma? The Epidemiological Evidence. European Respiratory Journal, 18, 872-881.
http://dx.doi.org/10.1183/09031936.01.00268401

[19]   Paunio, M., Heinonen, O.P., Virtanen, M., Leinikki, P., Patja, A. and Peltola, H. (2000) Measles History and Atopic Diseases: A Population-Based Cross-Sectional Study. JAMA, 283, 343-346. http://dx.doi.org/10.1001/jama.283.3.343

[20]   Farooqi, I.S. and Hopkin, J.M. (1998) Early Childhood Infection and Atopic Disorder. Thorax, 53, 927-932. http://dx.doi.org/10.1136/thx.53.11.927

[21]   Corne, J.M., Lau, L., Scott, S.J., Davies, R., Johnston, S.L. and Howart, P.H. (2001) The Relationship between Atopic Status and IL-10 Nasal Lavage Levels in the Acute and Persistent Inflammatory Response to Upper Respiratory Tract Infection. American Journal of Respiratory and Critical Care Medicine, 163, 1101-1107. http://dx.doi.org/10.1164/ajrccm.163.5.9902047

[22]   Heaton, T., Mallon, D., Venaille, T. and Holt, P. (2003) Staphylococcal Enterotoxin Induced IL-5 Stimulation as a Cofactor in the Pathogenesis of Atopic Disease: The Hygiene Hypothesis in Reverse? Allergy, 58, 252-256. http://dx.doi.org/10.1034/j.1398-9995.2003.00088.x

[23]   Mucha, S.M. and Baroody, F.M. (2003) Relationships between Atopy and Bacterial Infections. Current Allergy and Asthma Reports, 3, 232-237. http://dx.doi.org/10.1007/s11882-003-0045-2

[24]   Kocabas, C.N. (2001) Do Hepatitis B Virus Carriers Develop Atopic Diseases? Allergy, 56, 1100-1101. http://dx.doi.org/10.1034/j.1398-9995.2001.00377.x

[25]   Ji, W., Wang, H.F. and Feng, C.Q. (2001) Activation-Induced Cell Death in Peripheral Blood Mononuclear Cells (PBMCs) from Patients with Chronic Hepatitis B May Be Related to Abnormal Production of Interleukin 12 and 10. Journal of Viral Hepatitis, 8, 30-33.
http://dx.doi.org/10.1046/j.1365-2893.2001.00251.x

[26]   Naumov, N.V. and Rossol, S. (1997) Studies of Interleukin-12 in Chronic Hepatitis B Virus Infection. Journal of Viral Hepatitis, 4, 87-91.
http://dx.doi.org/10.1111/j.1365-2893.1997.tb00185.x

[27]   Pasteur, M.C., Helliwell, S.M., Houghton, S.J., Webb, S.C., Foweraker, J.E., Coulden, R.A., Flower, C.D., Bilton, D. and Keogan, M.T. (2000) An Investigation into Causative Factors in Patients with Bronchiectasis. American Journal of Respiratory and Critical Care Medicine, 162, 1277-1284.
http://dx.doi.org/10.1164/ajrccm.162.4.9906120

[28]   Murphy, M.B., Reen, D.J. and Fitzgerald, M.X. (1984) Atopy, Immunological Changes, and Respiratory Function in Bronchiectasis. Thorax, 39, 179-184.
http://dx.doi.org/10.1136/thx.39.3.179

[29]   Cohen, M. and Sahn, S.A. (1999) Bronchiectasis in Systemic Diseases. Chest, 116, 1063-1074. http://dx.doi.org/10.1378/chest.116.4.1063

[30]   Roberts, H.R., Wells, A.U., Milne, D.G., Rubens, M.B., Kolbe, J., Cole, P.J. and Hansell, D.M. (2000) Airflow Obstruction in Bronchiectasis: Correlation between Computed Tomography Features and Pulmonary Function Tests. Thorax, 55, 198-204.
http://dx.doi.org/10.1136/thorax.55.3.198

[31]   Varpela, E., Laitinen, L.A., Keskinen, H. and Korhola, O. (1978) Asthma, Allergy and Bronchial Hyper-Reactivity to Histamine in Patients with Bronchiectasis. Clinical Experimental Allergy, 8, 273-280.
http://dx.doi.org/10.1111/j.1365-2222.1978.tb03224.x

[32]   Hassan, J.A., Saadiah, S., Roslan, H. and Zainudin, B.M.Z. (1999) Bronchodilator Response to Inhaled Beta-2 Agonist and Anticholinergic Drugs in Patients with Bronchiectasis. Respirology, 4, 423-426. http://dx.doi.org/10.1046/j.1440-1843.1999.00215.x

[33]   Cherniak, N.S. and Carton, R.W. (1966) Factors Associated with Respiratory Insufficiency in Bronchiectasis. American Journal of Medicine, 41, 562-571.
http://dx.doi.org/10.1016/0002-9343(66)90218-X

[34]   Pande, J.N., Jain, B.P., Gupta, R.G. and Guleria, J.S. (1971) Pulmonary Ventilation and Gas Exchange in Bronchiectasis. Thorax, 26, 727-733.
http://dx.doi.org/10.1136/thx.26.6.727