High Serum IgE is Associated with Risk of Severe Exacerbations Among Non-Eosinophilic Bronchiectasis

PURPOSE: Bronchiectasis has traditionally been characterized as a neutrophil-driven disease, yet emerging evidence suggested inflammatory heterogeneities. The prognostic significance of elevated serum immunoglobulin E (IgE) in patients without peripheral eosinophilia remains unclear. METHODS: We conducted a multicenter prospective cohort study between 2017 and 2020 across 16 institutions in Taiwan. Individuals with bronchiectasis but without allergic bronchopulmonary aspergillosis were included. Patients were stratified by baseline absolute eosinophil count (cutoff 300 /uL) and serum IgE level (≤ 100, 100-500, > 500 IU/mL). The primary endpoint was severe exacerbations resulting in hospitalization at one year. Secondary endpoints included all-cause mortality, distribution of sputum pathogen, imaging pattern, and lung function. RESULTS: A total of 579 individuals were enrolled. Nontuberculous mycobacteria (10.7%) and Pseudomonas aeruginosa (9.0%) were the most commonly isolated microorganisms in sputum. 493 patients (85.1%) were categorized as low-eosinophil bronchiectasis, and 41 (7.1%) presented serum IgE levels exceeding 500 IU/mL. The rate of hospitalization for acute exacerbation in such group was pronouncedly higher than in patients with lower IgE levels (9.8% vs. 0.9% and 2.3%; P = 0.009). In multivariate analysis, IgE exceeding 500 IU/mL was the strongest independent predictor of hospitalization (adjusted odds ratio, 7.38; 95% confidence interval, 2.40-22.7; P < 0.001). The association was particularly pronounced in female and patients with coexisting asthma. All-cause mortality did not differ significantly among IgE strata. CONCLUSION: Markedly elevated serum IgE independently predicted severe exacerbations resulting in hospitalization in patients with non-eosinophilic bronchiectasis, identifying a high-risk subgroup that may benefit from targeted immunomodulatory therapies.

Authors

Institutions

Publication Details

Journal
Lung
Published
2026-04-27
DOI
https://doi.org/10.1007/s00408-026-00874-2
Primary Topic
Cystic Fibrosis Research Advances
Type
article
Field-Weighted Citation Impact
0.00

Funders

Controls
|||
ALL TIME
JAN
FEB
MAR
APR
MAY
JUN
JUL
AUG
SEP
OCT
article

High Serum IgE is Associated with Risk of Severe Exacerbations Among Non-Eosinophilic Bronchiectasis

Ming‐Tsung Chen, Ping-Huai Wang, Hao‐Chien Wang, Chung‐Kan Peng et al.
Lung
Cystic Fibrosis Research Advances
article

High Serum IgE is Associated with Risk of Severe Exacerbations Among Non-Eosinophilic Bronchiectasis

Ming‐Tsung Chen, Ping-Huai Wang, Hao‐Chien Wang, Chung‐Kan Peng, Lun-Yu Jao, Ting‐Wei Kao, Chi-Jui Chen, Yao‐Tung Wang, Wei-Fan Ou, Shih‐Pin Chen, Jung‐Yien Chien, Chih‐Bin Lin, Chia-Ling Chang, Chau-Chyun Sheu, Chou-Chin Lan, Ming-Shian Lin, Ya-Hui Wang, Yu-Feng Wei, Wen-Chien Cheng, Yi-Hsuan Tsai, Shih-Feng Liu, Meng-Heng Hsieh, Yen-Fu Chen, Ching-Hsiung Lin, Ming-Cheng Chan, Tsung-Ming Yang, Meng-Hsuan Cheng, Cheng-Yi Wang, Shih-Lung Cheng, Horng-Chyuan Lin, Ching-Yi Chen, Wu-Huei Hsu
article en

Abstract

PURPOSE: Bronchiectasis has traditionally been characterized as a neutrophil-driven disease, yet emerging evidence suggested inflammatory heterogeneities. The prognostic significance of elevated serum immunoglobulin E (IgE) in patients without peripheral eosinophilia remains unclear. METHODS: We conducted a multicenter prospective cohort study between 2017 and 2020 across 16 institutions in Taiwan. Individuals with bronchiectasis but without allergic bronchopulmonary aspergillosis were included. Patients were stratified by baseline absolute eosinophil count (cutoff 300 /uL) and serum IgE level (≤ 100, 100-500, > 500 IU/mL). The primary endpoint was severe exacerbations resulting in hospitalization at one year. Secondary endpoints included all-cause mortality, distribution of sputum pathogen, imaging pattern, and lung function. RESULTS: A total of 579 individuals were enrolled. Nontuberculous mycobacteria (10.7%) and Pseudomonas aeruginosa (9.0%) were the most commonly isolated microorganisms in sputum. 493 patients (85.1%) were categorized as low-eosinophil bronchiectasis, and 41 (7.1%) presented serum IgE levels exceeding 500 IU/mL. The rate of hospitalization for acute exacerbation in such group was pronouncedly higher than in patients with lower IgE levels (9.8% vs. 0.9% and 2.3%; P = 0.009). In multivariate analysis, IgE exceeding 500 IU/mL was the strongest independent predictor of hospitalization (adjusted odds ratio, 7.38; 95% confidence interval, 2.40-22.7; P < 0.001). The association was particularly pronounced in female and patients with coexisting asthma. All-cause mortality did not differ significantly among IgE strata. CONCLUSION: Markedly elevated serum IgE independently predicted severe exacerbations resulting in hospitalization in patients with non-eosinophilic bronchiectasis, identifying a high-risk subgroup that may benefit from targeted immunomodulatory therapies.

LungVol. 204(1)
Fu Jen Catholic University (TW), Kaohsiung Medical University (TW), National Chung Hsing University (TW), National Taiwan University (TW), Chang Gung University (TW), National Chiayi University (TW), China Medical University (TW), Tzu Chi University (TW), Tzu Chi Foundation (TW), Kaohsiung Medical University Chung-Ho Memorial Hospital (TW), Chang Gung Memorial Hospital (TW), E-Da Hospital (TW), Taichung Veterans General Hospital (TW), Hualien Armed Forces General Hospital (TW), Kaohsiung Chang Gung Memorial Hospital (TW), Taipei Tzu Chi Hospital (TW), Far Eastern Memorial Hospital (TW), Chung Shan Medical University Hospital (TW), Chia-Yi Christian Hospital (TW), Linkou Chang Gung Memorial Hospital (TW), China Medical University Hospital (TW), National Taiwan University Hospital (TW), Pingtung Hospital (TW), Cardinal Tien Hospital (TW), Chiayi Chang Gung Memorial Hospital (TW), Changhua Christian Hospital (TW), National Defense Medical Center (TW), National Yunlin University of Science and Technology (TW), Chung Shan Medical University (TW), I-Shou University (TW)
National Defense Medical College, National Taiwan University Hospital, National Taiwan University, Cardinal Tien Hospital, Fu Jen Catholic University
Good health and well-being
Openalex Percentile: Top 12%
Cystic Fibrosis Research Advances
DOIOpen Access PDFOpenAlex
AI Navigator

Ask Laika to Summarize, Analyze, and Connect papers live on the map.

Summarize Papers & Methodologies

Extract key findings, datasets, and comparative methods across publications.

Benchmark Rankings & Visual Analytics

Rank top research institutions, authors, funders, topics, and journals by Field-Weighted Citation Impact (FWCI) and paper volume with instant charts.

Connect Distant Disciplines

Bridge topological clusters on the map to find hidden collaborative intersections.