The impact of sensitization patterns on COPD severity and exacerbations: Insights from a case-control and longitudinal study.

Abstract

Total Immunoglobulin E (tIgE) and allergen-specific IgE (sIgE) have been linked to asthma in numerous studies, with emerging evidence suggesting IgE sensitization influences chronic obstructive pulmonary disease (COPD) onset and severity. This study explores whether (a) serum tIgE and sIgE profiles differ among COPD, asthma, and controls (case-control substudy) and (b) tIgE and 300 individual sIgE levels correlate with disease severity and outcomes in 343 COPD patients (longitudinal substudy). The case-control substudy measured tIgE and sIgE in 122 participants (76 COPD, 19 asthma, 27 controls). The longitudinal substudy analyzed tIgE and 300 sIgE in 343 COPD patients, examining links to disease severity and outcomes. Atopy was defined as tIgE>20 kUA/L, while skin-sensitization was determined by skin prick test positivity. No significant tIgE differences were observed among asthma, COPD, and controls, however asthma and COPD patients showed distinct sIgE patterns for various allergens. Atopic men reported fewer urgent visits for acute exacerbations of COPD (ECOPD) than non-atopic men (79.07 % vs.91.33 %, p = 0.007), while skin-sensitized women experienced more severe ECOPD than non-skin-sensitized women (46.43 % vs. 24.36 %, p = 0.028). Exacerbation etiology was not associated with atopic or skin-sensitization profiles. Fungal sensitization correlated with older age (p = 0.032), worse 6-minute walking test outcomes (p = 0.007), and reduced diffusion capacity (DLCO/VA %, p = 0.006). While atopic profiles are similar across groups, asthma features higher aeroallergen sIgE. Skin-sensitization and atopy may influence lung function and symptom severity in COPD but are differently associated with ECOPD between sexes and are not linked to the etiology of ECOPD.