Diagnosis and Management of Severe Asthma in Switzerland: Analysis of Survey Results Conducted with Specialists and General Practitioners

Respiration ◽  
2021 ◽  
pp. 1-12
Author(s):  
Peter Jandus ◽  
Mélanie Duc ◽  
Bianca Christine Fay
Keyword(s):  
General Practitioners ◽  
Severe Asthma ◽  
Immunoglobulin E ◽  
Therapeutic Strategies ◽  
Prescribing Patterns ◽  
Specific Immunoglobulin E ◽  
Specific Immunoglobulin ◽  
Background Therapy ◽  
Oral Corticosteroids ◽  
Survey Results

<b><i>Background:</i></b> Severe asthma commonly affects 5–10% of the asthmatic population and accounts for approximately 50% of the overall asthma costs. <b><i>Objective:</i></b> This analysis investigated how severe asthma is diagnosed, treated, and managed by specialists and general practitioners (GPs) in Switzerland. <b><i>Methods:</i></b> Two surveys, one each among specialists (<i>N</i> = 44) and GPs (<i>N</i> = 153), were conducted to understand their self-perception on diagnosis, treatment, and management of severe asthma. <b><i>Results:</i></b> Fifty-five percent of the specialists felt very confident and 43% confident in recognizing the symptoms of severe asthma and diagnosing severe asthma. In contrast, 9% of the GPs were very confident and 59% confident in diagnosing severe asthma. More specific diagnostic tests for severe asthma, like total and specific immunoglobulin E levels and measurement of the fraction of exhaled nitric oxide, were run by specialists (χ<sup>2</sup> = 171.4; df = 15, <i>p</i> &#x3c; 0.001). GPs and specialists were using different measurements to assess severe asthma (χ<sup>2</sup> = 385.2; df = 13, <i>p</i> &#x3c; 0.001) and their prescribing patterns differed significantly (χ<sup>2</sup> = 189.8; df = 10, <i>p</i> &#x3c; 0.001). GPs referred patients with severe asthma if the diagnosis was unclear (24%), if treatment failure occurred (26%), and if the patients were at high risk (41%). <b><i>Conclusions:</i></b> Oral corticosteroids (OCSs) are considered as background therapy for severe asthma by GPs and specialists. In order to reduce the OCS burden, there is a need to improve the awareness for other add-on therapies. A joint collaboration between GPs and specialists is the key to leverage therapeutic strategies together.

scholarly journals Prevalence of specific immunoglobulin E and G against Aspergillus fumigatus in patients with asthma

2019 ◽  
Author(s):  
Newsha Hedayati ◽  
Vida Mortezaee ◽  
Seyed Alireza Mahdaviani ◽  
Maryam Sadat Mirenayat ◽  
Maryam Hassanzad ◽  
...  
Keyword(s):  
Aspergillus Fumigatus ◽  
Severe Asthma ◽  
Immunoglobulin E ◽  
Clinical Symptoms ◽  
Specific Ige ◽  
Total Ige ◽  
Asthmatic Patients ◽  
Specific Immunoglobulin E ◽  
Specific Immunoglobulin ◽  
The Mean

Background and Purpose: Aspergillus fumigatus as a ubiquitous fungus can be found in the respiratory tract of the asthmatic and healthy people. The inhalation of Aspergillus spores leads to an immune response in individuals with asthma and results in the aggravation of the clinical symptoms. The present study aimed to investigate the prevalence of specific immunoglobulin E and G (IgE and IgG) against A.fumigatus in asthmatic patients.Materials and Methods: This study was conducted on 200 consecutive patients with moderate to severe asthma referring to Masih Daneshvari hospital Tehran, Iran, from January 2016 to February 2018. Skin prick test (SPT) was performed in all subjects with Aspergillus allergens. Moreover, all patients underwent specific IgE testing for Aspergillus using Hycor method. Enzyme immune assay was applied to measure total IgE and Aspergillus-specific IgG.Results: According to the results, the mean age of the patients was 45.8 years (age range: 18-78 years). The mean levels of total IgE and Aspergillus specific IgE in asthmatic patients were obtained as 316.3 (range: 6-1300 IU/ml) and 1.5 (range: 0.1-61.3 IU/ml), respectively. Out of 200 patients, 27 (13.5%), 65 (32.5%), 22 (11.0%), and 86 (43.0%) cases had positive Aspergillus SPT, total IgE of > 417 IU/ml, Aspergillus-specific IgE, and IgG, respectively. The level of these variables in patients with severe asthma were 16 (16.5%), 36 (37.1%), 15 (15.5%), and 46 (47.4%), respectively.Conclusion: As the findings indicated, reactivity to Aspergillus is a remarkable phenomenon in asthmatic patients. It is also emphasised that the climatic condition may affect the positive rate of hypersensitivity to Aspergillus.

scholarly journals Allergic diseases attributable to atopy in a population sample of Asian children

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Chao-Yi Wu ◽  
Hsin-Yi Huang ◽  
Wen-Chi Pan ◽  
Sui-Ling Liao ◽  
Man-Chin Hua ◽  
...  
Keyword(s):  
Immunoglobulin E ◽  
Population Attributable Risk ◽  
Population Sample ◽  
International Study ◽  
Allergic Diseases ◽  
Population Based ◽  
School Age Children ◽  
Specific Immunoglobulin E ◽  
Asian Children ◽  
Specific Immunoglobulin

AbstractThe proportion of allergic diseases attributable to atopy remains a subject of controversy. This study aimed to estimate the population risk of physician-diagnosed asthma, rhinitis and eczema attributed to atopy among a population sample of Asian school-age children. Asian children aged 5–18 years (n = 1321) in the Prediction of Allergies in Taiwanese CHildren (PATCH) study were tested for serum allergen-specific immunoglobulin E. Physician-diagnosed asthma, rhinitis and eczema were assessed by a modified International Study of Asthma and Allergies in Childhood questionnaire. Atopy was defined as the presence of serum allergen-specific immunoglobulin E. In this population-based study, 50.4% of the subjects with asthma, 46.3% with rhinitis, and 46.7% with eczema were attributable to atopy. The population attributable risk (PAR) of atopy for three allergic diseases was higher in adolescents (asthma, 54.4%; rhinitis, 59.6%; eczema, 49.5%) than younger children aged less than 10 years (asthma, 46.9%; rhinitis, 39.5%; eczema, 41.9%). Among the seven allergen categories, sensitization to mites had the highest PARs for all three allergic diseases (51.3 to 64.1%), followed by sensitization to foods (asthma, 7.1%; rhinitis, 10.4%; eczema 27.7%). In conclusion, approximately half (46.3 to 50.4%) of Asian children in Taiwan with allergic diseases are attributable to atopy.

scholarly journals Effect of Specific Immunoglobulin E Response and Comorbidities on Effectiveness of MP-AzeFlu in a Real-Life Study

2020 ◽  
Vol 181 (10) ◽  
pp. 754-764
Author(s):  
Ludger Klimek ◽  
David Price ◽  
Gabriella Gálffy ◽  
Melanie Emmeluth ◽  
Arkady Koltun ◽  
...  
Keyword(s):  
Immunoglobulin E ◽  
Real Life ◽  
Life Study ◽  
Specific Immunoglobulin E ◽  
Specific Immunoglobulin ◽  
Real Life Study

scholarly journals Total and Specific Immunoglobulin E and Their Relationship to Respiratory Symptoms in Quebec Children and Adolescents

2005 ◽  
Vol 12 (8) ◽  
pp. 426-432 ◽  
Author(s):  
Benoît Levesque ◽  
Jean-François Duchesne ◽  
Suzanne Gingras ◽  
Pierre Allard ◽  
Edgar Delvin ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Respiratory Symptoms ◽  
Immunoglobulin E ◽  
Geometric Mean ◽  
Allergic Sensitization ◽  
Population Sample ◽  
Ethnic Origin ◽  
Total Ige ◽  
Specific Immunoglobulin E ◽  
Specific Immunoglobulin

BACKGROUND: Respiratory disease is a major cause of morbidity in young people. It is now recognized that atopy plays an important role in the development of chronic respiratory symptoms in children.OBJECTIVE: To examine the determinants and consequences of serum total and specific immunoglobulin E (IgE) in a general population sample of Québec children and adolescents.METHODS: In 1999, 2349 children and adolescents (nine, 13 or 16 years of age) who had participated in a respiratory symptom and disease questionnaire had their total IgE measured. Of these participants, a subsample of 451 children and adolescents was analyzed to detect antibodies to eight specific allergens (ie, allergens of dust mites [Dermatophagoides farinae and Dermatophagoides pteronyssinus], cat, dog, ragweed, Timothy grass, mould [alternaria] and cockroach).RESULTS: The geometric mean of the total IgE was 44.4 U/mL among all participants. Concentrations were higher in boys and increased with age. More than 41% of the participants were sensitized to at least one specific allergen. Such sensitization was strongly associated with the occurrence of respiratory conditions and symptoms, namely asthma, wheezing and rhinitis. Family history, school location and ethnic origin had an impact on the prevalence of atopy and total IgE levels.CONCLUSIONS: Allergic sensitization is a major determinant in the development of asthma, wheezing and rhinitis in children and adolescents in the province of Québec.

A Simple and Rapid Light-Initiated Chemiluminescence Assay for Quantitation of Artemisia-Specific Immunoglobulin E

2021 ◽  
pp. 1-8
Author(s):  
Dandan Liu ◽  
Bei Zhang ◽  
Lina Zhu ◽  
Lisheng Zheng ◽  
Shaoshen Li ◽  
...  
Keyword(s):  
Food Allergen ◽  
Clinical Guideline ◽  
Immunoglobulin E ◽  
Limit Of Detection ◽  
Enzyme Linked Immunosorbent Assay ◽  
Serum Samples ◽  
Chemiluminescence Assay ◽  
Limit Of Quantitation ◽  
Specific Immunoglobulin E ◽  
Specific Immunoglobulin

<b><i>Background:</i></b> Light-initiated chemiluminescence assay (LICA) is a homogeneous assay that has been successfully used for the quantitation of food allergen-specific immunoglobulin E (sIgE), but not inhaled allergen-sIgE. Simultaneously, current assays used to detect allergen-sIgE are serum consuming and/or time consuming. Hence, we established a method for the quantitation of <i>Artemisia</i>-sIgE based on LICA and verified its performance according to the clinical guideline documents, laying a foundation for the quantitation of inhaled and food allergen-sIgE in parallel on LICA. <b><i>Methods:</i></b> The assay was established after optimizing the first incubation time and the dilutions of <i>Artemisia</i>-coated chemibeads, biotinylated goat anti-human IgE, and serum. In order to quantitate <i>Artemisia</i>-sIgE, the calibration curve was established with a high positive serum of known concentration. The assay performance was confirmed per the clinical guideline documents. In addition, the correlation between the results of LICA and capture enzyme-linked immunosorbent assay was evaluated. <b><i>Results:</i></b> The developed LICA’s coefficients of variation of repeatability and intermediate precision were 3.20%, 2.14%, and 3.85% and 4.30%, 4.00%, and 4.40%, respectively. The limit of detection was 0.10 kU<sub>A</sub>/L, and the limit of quantitation was 0.11 kU<sub>A</sub>/L. The range of linearity was from 0.27 kU<sub>A</sub>/L to 97.53 kU<sub>A</sub>/L (<i>r</i> = 0.9968). The correlation coefficient (<i>r</i>) for the correlation analysis between results of LICA and capture ELISA was 0.9087. This assay was successfully applied in 64 human serum samples, showing good sensitivity (82.20%) and specificity (100%). <b><i>Conclusion:</i></b> An <i>Artemisia</i>-sIgE quantitation assay based on LICA was successfully established. Its performance satisfied the clinical requirements and could be widely used in clinical laboratories.

Lidocaine anaphylaxis and lidocaine-specific immunoglobulin E measurement

2013 ◽  
Vol 1 (1) ◽  
pp. 98 ◽  
Author(s):  
Jin Yeop Yeo ◽  
Gyung Eun Kim ◽  
Ju Young Han ◽  
Jae Hyoung Im ◽  
Sung Wook Park ◽  
...  
Keyword(s):  
Immunoglobulin E ◽  
Specific Immunoglobulin E ◽  
Specific Immunoglobulin

Challenge-confirmed peanut allergy in older patients: Performance of skin tests, specific immunoglobulin E, and ara h 2

2018 ◽  
Vol 120 (3) ◽  
pp. 334-335
Author(s):  
Philip H. Li ◽  
Krzysztof Rutkowski ◽  
Lucinda Kennard ◽  
Priya Sellaturay ◽  
Timothy J. Watts ◽  
...  
Keyword(s):  
Older Patients ◽  
Peanut Allergy ◽  
Immunoglobulin E ◽  
Skin Tests ◽  
Ara H 2 ◽  
Specific Immunoglobulin E ◽  
Specific Immunoglobulin
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