Distinct “Immunoallertypes” of Disease and High Frequencies of Sensitization in Non–Cystic Fibrosis Bronchiectasis

• DOI: 10.1164/rccm.201807-1355oc
• Publication Date: 2018-09-28T21:17:21Z
• Authors: Micheál Mac Aogáin; Pei Yee Tiew; Albert Yick Hou Lim; Teck Boon Low; Gan Liang Tan; Tidi Hassan; Thun How Ong; Sze Lei Pang; Zi Yang Lee; Xiao Wei Gwee; Christopher Martinus; Yang Yie Sio; Sri Anusha Matta; Tan Ching Ong; Yuen Seng Tiong; Kang Ning Wong; Sriram Narayanan; Veonice Bijin Au; Damien Marlier; Holly R. Keir; Augustine Tee; John Arputhan Abi...; Mariko Siyue Koh; De Yun Wang; John E. Connolly; Fook Tim Chew; James D. Chalmers; Sanjay H. Chotirmall
• Keywords: Adult; Aged, 80 and over; Male; Allergy; House dust-mite; Pyroglyphidae; 610; Allergens; Middle Aged; Sensitization; Asthma; Bronchiectasis; 3. Good health; Cohort Studies; 03 medical and health sciences; Aspergillus; 0302 clinical medicine; Hypersensitivity; Animals; Humans; :Medicine [Science]; Female; Immunization; Aged

Allergic sensitization is associated with poor clinical outcomes in asthma, chronic obstructive pulmonary disease, and cystic fibrosis; however, its presence, frequency, significance non-cystic fibrosis bronchiectasis remain unclear.To determine the frequency geographic variability that exists a pattern to common specific allergens, including house dust mite fungi, correlate such patterns airway immune-inflammatory status bronchiectasis.Patients were recruited Asia (Singapore Malaysia) United Kingdom (Scotland) (n = 238), forming Cohort of Asian Matched European Bronchiectasis, which matched patients on age, sex, severity. Specific IgE response against range allergens was determined, combined correlated outcomes. Clinically relevant patient clusters, based immune profiles ("immunoallertypes"), determined.A high multiple detected bronchiectasis, exceeding comparator cohort allergic rhinitis 149). Sensitization outcomes, decreased function more severe disease. "Sensitized bronchiectasis" classified into two immunoallertypes: one fungal driven proinflammatory, other chemokine dominant, former demonstrating poorer outcome.Allergic occurs at from different global centers. Improving endophenotyping sensitized clinically significant state, "treatable trait" permits therapeutic intervention appropriate patients, may allow improved stratification future research trials.