Type 2 Inflammation Linked With Persistent Allergic Disease

Levels of allergen sensitization and type 2 inflammation markers were higher in people with persistent allergic disease compared with healthy individuals, according to a study published in Clinical and Translational Allergy.

“Identifying individuals at risk for continued rhinitis and asthma allows clinicians to better plan follow-up appointments and improve the selection of patients who might benefit from allergen immunotherapy or treatments targeting type 2 inflammation,” wrote corresponding author Viiu Blöndal, a PhD student at Uppsala University in Sweden, and study coauthors.

The study looked at changes in asthma and rhinitis over a decade in 255 people. Among participants, 132 were healthy, 82 had rhinitis, and 41 had asthma and rhinitis at baseline.

At follow-up 10 years later, 16 of the healthy individuals had developed rhinitis, and 4 developed asthma and rhinitis. Among the 82 people with rhinitis at baseline, 26 went into remission, and 3 developed asthma in addition to rhinitis. All 41 participants with both asthma and rhinitis still had the conditions at follow-up.

To investigate factors associated with remission and persistence of disease, patients were tested for allergens and type 2 inflammatory markers at both time points. Individuals with persistent rhinitis and asthma had higher total immunoglobulin E (IgE) levels at baseline and follow-up, and higher exhaled nitric oxide and eosinophil cationic protein levels at baseline, compared with those who remained healthy, according to the study.

Individuals with persistent rhinitis were more likely to be sensitized to grass pollen and had higher total IgE levels at baseline and follow-up than individuals who went into remission. Meanwhile, individuals with persistent asthma were more likely to be sensitized to tree pollen and furry animals than individuals with persistent rhinitis alone.

“IgE sensitisation and total IgE levels are associated with the persistence of rhinitis and asthma,” researchers concluded.

Reference:
Blöndal V, Sundbom F, Zhou X, et al. Allergic sensitisation and type-2 inflammation is associated with new-onset and persistent allergic disease. Clin Transl Allergy. 2023;13(4):e12240. doi:10.1002/clt2.12240