Allergy Asthma Immunol Res.  2016 May;8(3):198-205. 10.4168/aair.2016.8.3.198.

IgG Sensitization to Extracellular Vesicles in Indoor Dust Is Closely Associated With the Prevalence of Non-Eosinophilic Asthma, COPD, and Lung Cancer

• Kim YS
• Choi JP
• Kim MH
• Park HK
• Yang S
• Kim YS
• Kim TB
• Cho YS
• Oh YM
• Jee YK
• Lee SD
• Kim YK

• KMID: 2391039
• DOI: http://doi.org/10.4168/aair.2016.8.3.198

Abstract

PURPOSE
Recent experimental evidence shows that extracellular vesicles (EVs) in indoor dust induce neurtrophilic pulmonary inflammation, which is a characteristic pathology in patients with severe asthma and chronic obstructive pulmonary disease (COPD). In addition, COPD is known to be an important risk factor for lung cancer, irrespective of cigarette smoking. Here, we evaluated whether sensitization to indoor dust EVs is a risk for the development of asthma, COPD, or lung cancer.
METHODS
Serum IgG antibodies against dust EVs were measured in 90 healthy control subjects, 294 asthmatics, 242 COPD patients, and 325 lung cancer patients. Serum anti-dust EV IgG titers were considered high if they exceeded a 95 percentile value of the control subjects. Age-, gender-, and cigarette smoke-adjusted multiple logistic regression analyses were performed to determine odds ratios (ORs) for asthma, COPD, and lung cancer patients vs the control subjects.
RESULTS
In total, 4.4%, 13.6%, 29.3%, and 54.9% of the control, asthma, COPD, and lung cancer groups, respectively, had high serum anti-dust EV IgG titers. Adjusted multiple logistic regression revealed that sensitization to dust EVs (high serum anti-dust EV IgG titer) was an independent risk factor for asthma (adjusted OR, 3.3; 95% confidence interval [CI], 1.1-10.0), COPD (adjusted OR, 8.0; 95% CI, 2.0-32.5) and lung cancer (adjusted OR, 38.7; 95% CI, 10.4-144.3).
CONCLUSIONS
IgG sensitization to indoor dust EVs appears to be a major risk for the development of asthma, COPD, and lung cancer.

Keyword

Extracellular vesicles; IgG sensitization; indoor dust; asthma; COPD; lung cancer

MeSH Terms

Antibodies
Asthma*
Dust*
Humans
Immunoglobulin G*
Logistic Models
Lung Neoplasms*
Lung*
Odds Ratio
Pathology
Pneumonia
Prevalence*
Pulmonary Disease, Chronic Obstructive*
Risk Factors
Smoking
Tobacco Products
Antibodies
Dust
Immunoglobulin G

Figure

• 

  Fig. 1 The distribution of serum anti-dust EV IgG concentrations in the healthy control, asthma, COPD, and lung cancer groups. The dashed vertical line indicates the cutoff value that represents high serum anti-dust EV IgG levels. This cutoff value was defined as the 95 percentile value of the control subjects. The histograms are presented with normal distribution curves. Serum anti-EV: the concentration of serum IgG reactive to EVs in indoor dust.

• 

  Fig. 2 Adjusted odds ratios showing the relationship between high serum anti-dust EV IgG levels and the risk of asthma subtypes/COPD severity/lung cancer subtypes. Multiple linear logistic regression analyses after adjustment for age, gender, and cigarette smoking history were performed on 294 asthma, 242 COPD, and 325 lung cancer patients vs 90 control subjects. Asthma was divided into non-atopic and atopic asthma according to positive skin prick test responses to common inhalant allergens, and into non-eosinophilic and eosinophilic asthma according to sputum eosinophil percentage (3%). COPD were divided into into tertile subgroups according to lung function. Lung cancer was classified as main cellular subtypes, namely, squamous cell carinoma, adenocarcinoma, and small cell lung cancer. Serum anti-dust EV IgG levels were deemed to be high when they exceeded the 95 percentile value of the control subjects. *P<0.05 vs the control group.

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