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Higher IgE Levels May Explain High Asthma Prevalence And Severity In African-American Children DEARBORN, MI -- May 16, 2000 -- African-American children are more likely to have higher levels of an antibody called IgE which may be one biological explanation for their increased asthma prevalence and severity. This was one of the findings of a new study reported in the May issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians (ACCP). Asthma, the most common chronic disease of children, is greater among African-American children than other racial groups. Asthma-related emergency department visits, hospitalizations, and deaths are also higher in this population. Researchers at the Henry Ford Health System in Detroit carried out a study to explore racial differences in physiologic factors associated with pediatric asthma severity. In previous studies, they noted, it has been difficult to separate racial effects from the effects of poverty. Their data were drawn from two study groups in suburban Detroit - the Childhood Allergy Study and the Southfield Childhood Allergy Study. In an attempt to reduce the confounding factors of socio- economic status (SES) on racial differences, the 569 children involved in the study were drawn from similar SES populations. Seventy-nine were African-American. Four hundred and ninety were described as European-American. They were all between the ages of six and eight years. Investigators took medical histories and gave physical examinations. They employed allergen skin testing and spirometry, as well as the methacholine challenge, a method of measuring airway activity by an inhalation challenge test, often used to confirm the diagnosis of asthma when symptoms are present. They measured total and allergen-specific IgE, which is the antiboy that causes all allergic reactions. People with allergic diseases, including asthma, produce large amounts of IgE antibodies in response to any number of environmental factors. The results of the study showed a significant difference in the geometric mean serum IgE in African-American children (60.63 IU/mL) versus that in European-American children (27.48 IU/mL). The racial differences were even greater when compared with those children with serum IgE levels of greater than 100 IU/mL, 40.6 percent for African-Americans and 16.2 percent for European- Americans. In looking at just African-American children, the difference in serum IgE levels between those with asthma (74.44 IU/mL) and those without (59.15 IU/mL) was not significant. The differences among European-American children, on the other hand, was quite significant: 67.36 IU/mL for those with asthma and 24.78 for those without asthma. The researchers did not ind racial differences when testing for sensitization to major indoor allergens, including cockroaches. They did find that African-American children were more likely to be sensitized to ragweed and grass. Investigators acknowledged that it has been established in previous studies that African- American children have smaller lung capacities than European-American children. But, they noted, even after correction for racial differences, pulmonary function levels were still lower in African-Americans. "This racial difference in lung volumes, they said, "is demonstrated by the finding that only 75.9 percent of African-American children had FEV 1 scores of more than 70 percent of what was predicted as compared to 99.2 percent of European-American children. "In summary," the researchers reported, "we found a significant racial difference in the relationship between total serum IgE and airway responsiveness, and between serum IgE and asthma status. To our knowledge," they added, "this finding has not been reported in the literature. These differences," they said, "are consistent with the hypothesis that African- American children may be predisposed to more severe asthma." CHEST is published by the American College of Chest Physicians which represent 15,000 members who provide clinical, respiratory, and cardiothoracic patient care in the U.S. and throughout the world. E-mail this page to a friend or colleague! To print, use this version