IGHE and asthma: In addition, cigarette smoke increases total IgE levels and the risk of sensitization to aeroallergens, thus enhancing a combined Th1/Th2 inflammatory response developing a more severe asthma phenotype and a putative link between asthma and chronic obstructive pulmonary disease (COPD) in subjects with a relevant smoking history, airflow obstruction, and overlapping features of asthma, termed asthma–COPD overlap syndrome (ACO) [53,68,69].