Background Previous epidemiologic studies have reported an association of serum immunoglobulin E (IgE) levels with reduced glioma risk, but the association between IgE and glioma prognosis has not been characterized. This study aimed to examine how sex, tumor subtype, and IgE class modulate the association of serum IgE levels with glioma risk and survival. Methods We conducted a case-control study using participants from the University of California, San Francisco Adult Glioma Study (1997-2010). Serum IgE levels for total, respiratory and food allergy were measured in adults diagnosed with glioma (n = 1319) and cancer-free controls (n = 1139) matched based on age, sex, and race and ethnicity. Logistic regression was adjusted for patient demographics to assess the association between IgE levels and glioma risk. Multivariable Cox regression adjusted for patient-specific and tumor-specific factors compared survival between the elevated and normal IgE groups. All statistical tests were 2-sided. Results Elevated total IgE was associated with reduced risk of IDH-wildtype (RR = 0.78, 95% CI: 0.71-0.86) and IDH-mutant glioma (RR = 0.73, 95% CI: 0.63-0.85). In multivariable Cox regression, positive respiratory IgE was associated with improved survival for IDH-wildtype glioma (RR = 0.79, 95% CI: 0.67-0.93). The reduction in mortality risk was significant in females only (RR = 0.75, 95% CI: 0.57-0.98) with an improvement in median survival of 6.9 months (P<.001). Conclusion Elevated serum IgE was associated with improved prognosis for IDH-wildtype glioma, with a more pronounced protective effect in females than males, which has implications for the future study of IgE-based immunotherapies for glioma.

中文翻译：

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免疫球蛋白 E 水平与神经胶质瘤风险和生存率的关系


背景 以前的流行病学研究报道了血清免疫球蛋白 E （IgE） 水平与神经胶质瘤风险降低的相关性，但 IgE 与神经胶质瘤预后之间的相关性尚未得到表征。本研究旨在检查性别、肿瘤亚型和 IgE 类别如何调节血清 IgE 水平与神经胶质瘤风险和生存率的关系。方法 我们使用加州大学旧金山分校成人胶质瘤研究 （1997-2010） 的参与者进行了一项病例对照研究。在诊断为神经胶质瘤的成人 （n = 1319） 和无癌对照 （n = 1139） 中测量总过敏、呼吸过敏和食物过敏的血清 IgE 水平，这些水平根据年龄、性别、种族和民族进行匹配。根据患者人口统计学调整 Logistic 回归，以评估 IgE 水平与神经胶质瘤风险之间的关联。针对患者特异性和肿瘤特异性因素调整的多变量 Cox 回归比较了 IgE 升高组和正常组之间的生存率。所有统计检验均为 2 面。结果 总 IgE 升高与 IDH 野生型 （RR = 0.78,95% CI： 0.71-0.86） 和 IDH 突变神经胶质瘤 （RR = 0.73， 95% CI： 0.63-0.85） 风险降低相关。在多变量 Cox 回归中，阳性呼吸 IgE 与 IDH 野生型神经胶质瘤生存率的提高相关 （RR = 0.79,95% CI： 0.67-0.93）。仅女性死亡风险显著降低 （RR = 0.75,95% CI： 0.57-0.98），中位生存期改善 6.9 个月 （P<.001）。结论 血清 IgE 升高与 IDH 野生型胶质瘤预后改善相关，女性的保护作用比男性更明显，这对未来基于 IgE 的神经胶质瘤免疫疗法的研究具有启示意义。