IgE-mediated and age-related bronchial hyperresponsiveness in patients with asthma. Relationship to family history of the disease

Objective: to uncover any differences in the age-related and IgE-mediated p athophysiology of the airways in asthmatics. Methods: we examined the relationship of both IgE-mediated bronchial hyperr esponsiveness and the cell content of bronchoalveolar lavage fluid with a f amily history of asthma in 263 patients with asthma classified according to age at onset. Results: bronchial hyperresponsiveness decreased significantly as age at on set increased in those without a family history. Responsiveness was signifi cantly higher in patients who were greater than or equal to 60 years of age at onset who had a family history than in those who did not (P < 0.05). Th e proportion of lymphocytes in bronchoalveolar lavage fluid was significant ly higher in patients between 50 and 59 years old at onset who had a family history than those who did not (P < 0.05). These results suggest that bron chial hyperresponsiveness and the proportion of bronchoalveolar lavage lymp hocytes differ according to the presence or absence of a family history, a finding which is closely related to IgE-mediated allergy in elderly patient s at onset. Conclusions: our findings suggest (i) the possibility of asthma induced by non-IgE-mediated allergy in elderly patients and (ii) that bronchial respon siveness is also influenced by IgE-mediated allergy and age at onset.