The relationship of respiratory allergy, skin test reactivity, and serum IgE in a community population sample

Abstract

The relationship between prick and intradermal skin test reactivity and serum levels of total and specific IgE was evaluated in 311 subjects selected from a general population. Test results were related to the historical allergy status of the subjects. Prick test reactivity to 14 common local allergens correlated with the presence of allergy symptoms. Similarly, mean total serum IgE (PRIST) levels were significantly higher (p < 0.02) in allergic (187.9 IU) than in nonallergic subjects (107 IU) and were found to be positively correlated with the degree of prick test reactivity. Conversely, intradermal reactions following a negative prick test for that allergen showed no correlation with either the clinical allergy status or the level of total serum IgE. Bermuda-specific IgE was found to correlate closely with prick reactivity to that allergen as an overall agreement of 89.2% was observed. In contrast, only 2 of 12 positive Bermuda intradermal tests ≥5 mm and none of 38 smaller reactions following a negative prick response were associated with positive RASTs. The results strongly suggest that prick test reactivity correlates with both total and specific IgE and allergic symptomatology, but intradermal reactions in the absence of prick reactivity do not correlate with either clinical or immunologic evidence of allergy.