Please use this identifier to cite or link to this item: https://hdl.handle.net/10356/145453
Title: Distinct "immunoallertypes" of disease and high frequencies of sensitization in non-cystic fibrosis bronchiectasis
Authors: Mac Aogáin, Micheál
Tiew, Pei Yee
Lim, Albert Yick Hou
Low, Teck Boon
Tan, Gan Liang
Hassan, Tidi
Ong, Thun How
Pang, Sze Lei
Lee, Zi Yang
Gwee, Xiao Wei
Martinus, Christopher
Sio, Yang Yie
Matta, Sri Anusha
Ong, Tan Ching
Tiong, Yuen Seng
Wong, Kang Ning
Narayanan, Sriram
Au, Veonice Bijin
Marlier, Damien
Keir, Holly R.
Tee, Augustine
Abisheganaden, John Arputhan
Koh, Mariko Siyue
Wang, De Yun
Connolly, John E.
Chew, Fook Tim
Chalmers, James D.
Chotirmall, Sanjay Haresh
Keywords: Science::Medicine
Issue Date: 2019
Source: Mac Aogáin, M., Tiew, P. Y., Lim, A. Y. H., Low, T. B., Tan, G. L., Hassan, T., . . . Chotirmall, S. H. (2019). Distinct "immunoallertypes" of disease and high frequencies of sensitization in non-cystic fibrosis bronchiectasis. American Journal of Respiratory and Critical Care Medicine, 199(7), 842-853. doi:10.1164/rccm.201807-1355OC
Project: NMRC/TA/0048/2016 (S.H.C.)
N-154-000-038-001
R-154-000-404-112
R-154-000-553-112
R-154-000-565-112
R-154-000-630-112
R-154-000-A08-592
R-154-000-A27-597
SIgN-06-006
SIgN-08-020
NMRC/1150/2008 (F.T.C.)
Journal: American Journal of Respiratory and Critical Care Medicine
Abstract: Rationale: Allergic sensitization is associated with poor clinical outcomes in asthma, chronic obstructive pulmonary disease, and cystic fibrosis; however, its presence, frequency, and clinical significance in non–cystic fibrosis bronchiectasis remain unclear. Objectives: To determine the frequency and geographic variability that exists in a sensitization pattern to common and specific allergens, including house dust mite and fungi, and to correlate such patterns to airway immune-inflammatory status and clinical outcomes in bronchiectasis. Methods: Patients with bronchiectasis were recruited in Asia (Singapore and Malaysia) and the United Kingdom (Scotland) (n = 238), forming the Cohort of Asian and Matched European Bronchiectasis, which matched recruited patients on age, sex, and bronchiectasis severity. Specific IgE response against a range of common allergens was determined, combined with airway immune-inflammatory status and correlated to clinical outcomes. Clinically relevant patient clusters, based on sensitization pattern and airway immune profiles (“immunoallertypes”), were determined. Measurements and Main Results: A high frequency of sensitization to multiple allergens was detected in bronchiectasis, exceeding that in a comparator cohort with allergic rhinitis (n = 149). Sensitization was associated with poor clinical outcomes, including decreased pulmonary function and more severe disease. “Sensitized bronchiectasis” was classified into two immunoallertypes: one fungal driven and proinflammatory, the other house dust mite driven and chemokine dominant, with the former demonstrating poorer clinical outcome. Conclusions: Allergic sensitization occurs at high frequency in patients with bronchiectasis recruited from different global centers. Improving endophenotyping of sensitized bronchiectasis, a clinically significant state, and a “treatable trait” permits therapeutic intervention in appropriate patients, and may allow improved stratification in future bronchiectasis research and clinical trials.
URI: https://hdl.handle.net/10356/145453
ISSN: 1073-449X
DOI: 10.1164/rccm.201807-1355OC
Rights: © 2019 American Thoracic Society. This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial License 4.0 (http://creativecommons.org/licenses/by-nc/4.0/). For commercial usage and reprints, please contact Diane Gern (dgern@thoracic.org).
Fulltext Permission: open
Fulltext Availability: With Fulltext
Appears in Collections:LKCMedicine Journal Articles

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