Population-based study of multiplexed IgE sensitization in relation to asthma, exhaled nitric oxide, and bronchial responsiveness

Background: IgE sensitization is an important risk factor for the development of asthma. Objective: The aim of this study was to investigate the IgE antibody profile for a broad spectrum of allergen molecules in asthmatic patients. Methods: Participants from the European Community Respiratory Health Survey II (n = 467) were tested with ImmunoCAP ISAC against 103 allergen molecules. The presence of bronchial hyperresponsiveness was measured with a methacholine challenge test and bronchial inflammation with fraction of exhaled nitric oxide (FENO). Results: A total of 38% of the controls and 72% of the asthmatic patients were sensitized against at least 1 of the allergen components (P < .0001). Asthma was independently related to having IgE antibodies against pollen (odds ratio = 2.2) and perennial airway allergens (odds ratio = 5.6), increased FENO was independently related to having IgE antibodies against food allergens and perennial allergens, while bronchial responsiveness was independently associated with having IgE antibodies against only perennial allergens. Sensitization to food allergens was related to asthma and increased FENO if IgE antibody against pollen allergens was present. Simultaneous sensitization to perennial, pollen, and food allergens involves the highest risk of asthma (odds ratio = 18.3), bronchial inflammation, and responsiveness. Conclusions: FENO, bronchial responsiveness, and the risk of asthma increase with multiple sensitizations to different allergen groups. We show for the first time that the presence of IgE antibodies against food allergens is independently associated with increased FENO and increases the risk of asthma in subjects with simultaneous sensitization to pollen allergens. (J Allergy Clin Immunol 2012;130:397-402.)