Epidemiology and pathophysiology of immunoglobulin E-mediated asthma.

Asthma is one of the most common chronic conditions affecting mankind. The development of asthma may at least in part result from genetic or host susceptibility to asthma, allergy or atopy, and bronchial hyperresponsiveness. The interaction between the at risk host and environmental exposures to allergens, air pollutants, and viral infections may lead to the development of asthma. Much is mentioned about the hygiene hypothesis as a possible reason for the increased in atopy conditions such as asthma in developed countries throughout the world. With the discovery of immunoglobulin E (IgE), the medical community has learned the importance of this immunoglobulin in all atopic conditions, especially asthma. Recent literature in peer-reviewed journals on serum IgE and asthma was examined. Numerous studies clearly show the relationship of asthma to specific allergens, but only recently has there been documentation of the association of total serum IgE level with airways hyperreactivity and asthma. Data on patients with severe or difficult-to-treat asthma showed serum IgE levels higher in asthmatic patients than in nonasthmatic patients and the more severe the asthma, the higher the serum IgE. Our increasing knowledge of the underlying role of IgE in the asthmatic patient should pave the way for better treatments for this population of sufferers.