Total and Specific Immunoglobulin E in Different Phenotypes of Childhood Asthma

Abstract BACKGROUND: Asthma is a heterogeneous disease with varying immunological profiles in children. Understanding differences in total and specific immunoglobulin E (IgE) levels across asthma phenotypes is critical for precise diagnosis and management. This study aimed to assess and compare these IgE levels among school-aged children with different asthma phenotypes. METHODS: A cross-sectional study was conducted on 80 children aged ≥6 years diagnosed with asthma at a pediatric pulmonology center between October 2023 and July 2024. Participants were classified into allergic, eosinophilic, mixed allergic and eosinophilic (MAAE), and nonallergic noneosinophilic (NANE) phenotypes. Total and specific IgE levels were measured using the enzyme-linked immunosorbent assay. RESULTS: Total IgE levels differed significantly among phenotypes ( P < 0.001), with MAAE children showing the highest mean IgE and NANE the lowest. Sensitization to aeroallergens was prevalent in 91%, mainly to Goosefoot, Russian thistle, Horse, and Rough pigweed. Polysensitization was observed in 83.8%. CONCLUSION: The study highlights the immunological heterogeneity among pediatric asthma phenotypes, with MAAE phenotypes showing elevated IgE sensitization. This knowledge benefits clinical practice by emphasizing phenotype-specific diagnostic and therapeutic strategies, enabling personalized asthma management to improve the outcomes through targeted allergen identification and immunotherapies.