IgE plasma level in asthmatics with nasal polyps is independent of atopy

INTRODUCTION. Rhinitis and Chronic Rhinosinusitis (CRS) are associated to asthma. IgE plasma levels are associated to atopy/allergy in these patients but also in asthmatics with nasal polyps.

OBJECTIVE. To investigate plasma levels of IgE in a cohort of asthmatic patients according to associated nasosinusal disease, rhinitis or CRS and atopy.

METHODS. A prospective study carried out by pneumonologists and ENT specialists, recluted 492 asthmatics, 45(±15) yo, 70.5% female, by GINA: 17.3% intermittent and 82.7% persistent (24.6% mild, 31.4% moderate, and 26.7% severe).The presence of allergic (AR) and non-allergic (NAR) rhinitis and chronic rhinosinusitis with (CRSwNP) and without (CRSsNP) nasal polyps were evaluated (ARIA and EPOS) , by nasal symptoms, prick test, nasal endoscopy and sinus CT scan. Atopy was defined by a positive prick test to aeroallergens. A determination of total IgE in plasma was performed.

RESULTS. Half (49,6%) of asthmatics associated rhinitis (37.0% AR; 12.6% NAR) and 36.2% CRS (16.7% CRSsNP; 19.5% CRSwNP) while 14.2% had no sinonasal symptoms. IgE levels in asthmatics with rhinitis or CRS were similar (132 [45-352] vs. 176 [73-483]; p= 0.097). In asthmatics with AR, levels of IgE were higher (161 [73-416] vs.; p: 0.001) than in those with NAR (53 [16-151]). In asthmatics with CRSsNP total IgE was superior in patients with atopy (257 [130-710] vs. 51 [22-83]; p= 0.001) while in those with CRswNP, total IgE was similar in atopic and non-atopic patients (161 [100-468] vs. 169 [67-628]; p: 0.779).

CONCLUSIONS. In asthmatic patients with rhinitis and CRSsNP, IgE plasma levels are elevated according to atopy while in those with CRSwNP, IgE plasma levels were independent of atopy.