Mean IgE Levels Research Articles

Involvement of both HLA and Ig heavy chain haplotypes in human IgA deficiency.

Immunoglobulin-A deficiency (IgA-D) is the most common human Ig class deficiency with an estimated frequency of approximately 1 in 500 in the Swedish population. We investigated the immunoglobulin heavy chain constant region gene segments (IGHC) in 103 individuals with IgA-D and the immunoglobulin heavy chain variable region gene segments (IGHV) in 20 of these, in order to identify a possible molecular basis of the defect. No deletions of IGHV gene segments of the VH2, VH5, and VH6 families or the IGHG genes were observed. In the IGHC, there were, however, differences in the restriction fragment length polymorphism frequencies of IGHG genes where the Bam HI haplotype "H2" [IGHGP, 10 kilobases (kb), IGHG2, 25 kb; and IGHG4, 9.0 kb] was overrepresented. The mean serum levels of IgG4 and IgE were significantly lower in individuals (both IgA-D subjects and healthy controls) homozygous for the H2 haplotype than in individuals homozygous for the H1 haplotype (IGHGP, 8.8 kb, IGHG2, 13.5 kb, and IGHG4, 9.4 kb). IgA-D subjects homozygous for HLA DQB1*0201 (DQw2), a marker that has previously been reported to show a strong association with IgA deficiency, showed a similar reduction of serum levels of IgG4 and IgE as compared with DQB1*0201 negative IgA-D subjects. These findings suggest that the two loci found to be associated with IgA deficiency may act via a common pathway.

Combined Effect of Smoking Habits and Occupational Exposure to Hard Metal on Total IgE Antibodies

A survey was made within a population of workers (n = 706) exposed to hard metal dust (an alloy including cobalt), an agent known to cause occupational allergy. Twenty-seven (4 percent) of 733 workers were eliminated from consideration in this study because of atopic status identified prior to starting work in the plant. Using a Phadebas PRIST, the subjects' total IgE levels were determined and related to their smoking and exposure status. Nonexposed male smokers (n = 135) had a higher geometric mean IgE level (39.7 IU/ml) than did nonexposed subjects who had never smoked (33.1 IU/ml; n = 99); those with a higher Brinkman index (greater than 300), a smoking index obtained by multiplying the number of cigarettes per day by the duration of smoking in years, had significantly (p less than 0.05) decreased IgE levels. Although ex-smokers (n = 72) had a higher geometric mean IgE level (73.3 IU/ml) than did those who had never smoked, their serum IgE level declined with age since the time they quit smoking, regardless of their hard metal exposure status. Hard metal (cobalt) exposure may play a significant role as an adjuvant in the production of total IgE. A multivariate analysis demonstrated that hard metal exposure and a smoking habit together arithmetically (p less than 0.05) increased total IgE levels. These two factors may be preventable risk factors for occupational allergy in hard metal workers.

Cord serum IgE: an insensitive method for prediction of atopy

Cord total serum IgE has been advocated as a screening test to detect infants at high risk of allergy who would be suitable for preventive measures. In a population based prospective study to look at the predictive capacity of cord IgE and family history of atopy 1111 one-year-old infants were followed-up. Cord IgE was measured using the EIA ultra technique (Pharmacia, Uppsala, Sweden). Atopic symptoms developed in 255 (23%) at one year, 183 (16.5%) had probable atopy (clinical disorder but negative skin prick test (SPT)) and 72 (6.5%) had definite atopy (clinical disorder with positive SPT). There was no difference in the mean cord IgE levels in infants with or without atopic manifestations. The cut-off for IgE was taken at 0.6 ku/1. The specificity of the test was 92% but the sensitivity was only 8.5%. The positive and negative predictive values were 24% and 78% respectively. Family history of atopy is far more sensitive in detecting infants at risk of atopy and little is added by knowledge of cord IgE.

Relation between Airway Responsiveness and Serum IgE in Children with Asthma and in Apparently Normal Children

Although asthma diagnosed by a physician is known to be related to serum IgE levels, it is not known whether there is a relation between the level of IgE and airway hyperresponsiveness to a methacholine challenge. The characteristics of asymptomatic persons that predispose them to airway hyperresponsiveness are also unknown. We studied the relation between the serum total IgE level and airway hyperresponsiveness in the presence or absence of asthma and other atopic diseases in a birth cohort of children. Data from a questionnaire regarding respiratory symptoms, plus measurements of the serum total IgE level and airway responsiveness to inhaled methacholine, were obtained for 562 11-year-olds in New Zealand. The boys had a higher prevalence than the girls of current diagnosed asthma (13 percent vs. 6 percent), current symptoms of wheezing (22 percent vs. 15 percent), and airflow obstruction at base line (6 percent vs. 1 percent) and had a wider distribution of IgE levels, although mean IgE levels (120.8 IU per milliliter in the boys and 98.1 IU per milliliter in the girls) did not differ significantly between the sexes. The prevalence of diagnosed asthma was strongly related to the serum IgE level (P for trend less than 0.0001). No asthma was reported in children with IgE levels less than 32 IU per milliliter, whereas 36 percent of those with IgE levels greater than or equal to 1000 IU per milliliter were reported to have asthma. This relation with the serum IgE level was not explained by a concomitant diagnosis of allergic rhinitis or eczema. Airway hyperresponsiveness to a methacholine challenge also correlated very highly (P less than 0.0001) with the serum IgE level. This relation remained significant even after the exclusion of children with diagnosed asthma (P less than 0.0001) and of all children with a history of wheezing, allergic rhinitis, or eczema (P less than 0.0001). Even in children who have been asymptomatic throughout their lives and have no history of atopic disease, airway hyperresponsiveness appears to be closely linked to an allergic diathesis, as reflected by the serum total IgE level.

Serum IgE and human immunodeficiency virus (HIV) infection

Human immunodeficiency virus infection is characterized by a progressive depletion of helper T-lymphocyes and, like allergic diseases, is associated with altered T cell regulation. Total serum IgE was measured in 67 infected male subjects, 27 uninfected heterosexual male subjects, and 18 uninfected homosexual male subjects. The mean IgE level (132 IU/ml) of infected subjects with a helper T-lymphocyte number ≤200/mm 3 was significantly greater than mean IgE levels of the uninfected heterosexual (38 IU/ml) and homosexual (35 IU/ml) groups. IgE levels were inversely related to both helper T cell and suppressor/cytotoxic T cell numbers but not to IgG or IgA levels. The increase in IgE was not a reflection of an increased prevalence of atopic disease (allergic asthma, allergic rhinitis, or atopic dermatitis) in the infected subjects. The elevation of IgE may be related to a difference among the groups in T cell production of IgE regulatory lymphokines.

Human immune responsiveness to Lolium Perenne pollen allergen Lol p III (Rye III) is associated with HLA-DR3 and DR5

A well-characterized allergen of Lolium perenne (perennial rye grass) pollen, Lol p III, has been used as a model antigen to study the genetic control of the human immune response. Associations between HLA type and IgE or IgG antibody (Ab) responsiveness to Lol p III were studied in two groups of skin-test-positive Caucasoid adults (N = 135 and 67). We found by nonparametric and parametric analyses that immune responsiveness to Lol p III was significantly associated with HLA-DR3 and DR5. No association was found between any DQ type and immune responsiveness to Lol p III. Geometric mean IgE or IgG Ab levels to Lol p III were not different between B8 +, DR3 + subjects and B8 −, DR3 + subjects, showing that HLA-B8 had no influence on the association. Lol p III IgG Ab data obtained on subjects after grass antigen immunotherapy showed that 100% of DR3 subjects and 100% of DR5 subjects were Ab +. A comparison of all the available protein sequences of DRB gene products showed that the first hypervariable region of DR3 and DR5 (and DRw6), and no other region, contains the sequence Glu 9TyrSerThrSer 13. Our observations are consistent with the possibility that immune responsiveness to the allergen Lol p III is associated with this amino acid sequence in the first hypervariable region of the DRβ 1 polypeptide chain.

Fc-Epsilon-Receptor-Bearing Lymphocytes in Patients with Clonorchiasis

Expression of Fc-epsilon-receptors (Fc epsilon R) on peripheral blood lymphocytes was examined in patients with clonorchiasis. Mean serum IgE levels in these patients was 2,518 IU/ml. Fc epsilon R was detected by flow cytometry analysis with monoclonal antibody. The frequency of Fc epsilon R+ lymphocytes and the density of Fc epsilon R on the cells in the patients were similar to those in normal subjects. Most of the Fc epsilon R+ lymphocytes were B cells. The number of Fc epsilon R+ cells decreased after incubation in serum-free medium at 37 degrees C for 3 h. The amount of regulatory molecules of IgE production, IgE binding factor, was not significantly different between the patients and normal subjects. The number of Fc gamma R bearing T or B cells in the patients was also similar to that of normal subjects. These results indicate that the mechanisms of elevated serum IgE in patients with clonorchiasis might be different from other diseases with hyperglobulinemia E.

Serum IgE in non-atopic adults and in dermatitis patients.

Total serum IgE was determined with the PRIST technique, and specific reaginic antibodies against 10 allergens were measured in 163 healthy adults with no personal or family history of symptoms indicative of atopy (Group A). 103 non-atopic adults with a family history of atopic diseases were similarly investigated (Group B). When all subjects who at the second interview presented with a history of atopic symptoms and those with positive RAST results were excluded, the geometric mean serum IgE value for Group A was 14.5 (SD = 2) - 94.4 U/ml and for Group B 14.4 (SD = 2) - 130.2 U/ml. There was no significant difference in the IgE values between men and women. Subjects under 40 years of age had significantly higher IgE values than subjects over 40 years. In the series of 276 dermatitis patients the geometric mean IgE value for the men was significantly higher (46.8) than for the women (28.8 U/ml). There was a highly significant difference in the mean serum IgE levels between the patients with a personal history of atopic diseases and the other patients. Patients with present atopic disease had significantly higher mean IgE values than those with past atopic disease while no significant difference was discernible in the mean IgE levels between the non-atopic patients from atopic families and those with no personal and family atopy. Three years later, total serum IgE was controlled in subjects with initial IgE levels greater than 100 U/ml. During this time, eight subjects had developed an atopic disease. In most cases, there were only slight variations in the IgE values.

A longitudinal study of serum IgE in a community cohort: Correlations with age, sex, smoking, and atopic status

A number of factors, including age, sex, smoking habits, and atopic status have been reported in cross-sectional studies to influence levels of serum IgE. We have examined the effects of these variables on serum IgE in a community population cohort of 1109 subjects during a longitudinal study in which two serum samples were obtained 8 years apart from each subject. For the entire cohort, mean serum IgE level changed little during the follow-up period (28.9 versus 26.0 IU/ml). Most of the decreases were observed in children and young adults. Subjects more than the age of 35 years demonstrated no systematic change in serum IgE levels. By the end of follow-up (when there were few subjects still less than 16 years of age), significant relationships of IgE to age could no longer be demonstrated in nonatopic subjects. Also, in the nonatopic subjects of this cohort, there were no significant differences in IgE levels between the sexes. Among atopic subjects, there was a clear tendency for IgE to decrease with age, with atopic women more than 35 years of age demonstrating greater declines in IgE levels during follow-up than men of comparable age. The IgE levels in atopic male subjects were significantly higher than in atopic female subjects after the age of 35 years. Smoking was associated with an elevation in serum IgE. In this cohort, the smoking effect appeared to be limited to male subjects. Among allergen skin test negative subjects at the start of the study, IgE levels >1 SD above the group mean were predictive of the subsequent development of allergic skin test reactivity. Although these findings confirm many findings from cross-sectional studies, they provide additional information concerning the epidemiology of IgE in the general population.

Serum levels of total IgE in non-allergic children. Influence of genetic and environmental factors.

The purpose of this study was to establish the range of total serum IgE in a healthy population lacking personal and family history of allergy, as well as the influence of genetic factors (family history of allergy), environmental factors (degree of air pollution), age, and sex on the serum IgE levels. Using a commercial enzyme immunoassay (Phadezym IgE Prist) the mean serum level of IgE was determined in 363 non-atopic children from 0 to 12 years of age. The geometric mean of serum IgE increased according to age, indicating a positive correlation between both. Higher mean values of serum IgE were found for children with a family history of allergy, than for children without (27.82 and 14.49 U/ml respectively). The percentage of variation due to age was about 94.5% in children with no family history of allergy. The mean value of serum IgE increased with the degree of air pollution in the living area (15.49 U/ml in non-polluted areas, 20.78 U/ml in very polluted areas). However, the influence of air pollution was smaller than the influence of family history on the mean values of serum IgE. The mean value of serum IgE was not modified by sex.

Levels of immunoglobulin G, M, A, and E at various ages in allergic and nonallergic black and white individuals

Studies were conducted to detect major differences in immunoglobulin levels between allergic and nonallergic individuals. Immunoglobulins G, M, A, and E were quantitated in members of 63 families selected for the presence of children with asthma or allergic rhinitis and compared with a larger group of healthy individuals and families. Mean IgE levels were significantly higher in healthy black than in white individuals. No significant difference was found in IgE levels between healthy parents with and without allergic children. Mean IgE levels were significantly higher in asthmatic children than in healthy children and also much higher in asthmatic children than in their healthy siblings. Asthma occurred more frequently in boys than in girls. IgE levels in healthy children increased rapidly early in childhood, reached a peak before 10 yr of age, and decreased during the teens. This decrease in IgE during the teens may provide the immunologic mechanism by which some children can “outgrow” certain childhood allergies. IgA levels were very low in young children and not significantly different between allergic and healthy individuals. The low IgA level in young children may be of importance in the development of childhood allergies.

Sensitization via IgE-mediated mechanism in patients with chronic periapical lesions

Past studies have identified several classes of tissue immunoglobulins within human periapical granulomas. It has recently been determined that elevated serum IgE levels occur in conjunction with acute orofacial swellings related to pulpally involved teeth. We theorized that pulpally involved teeth could elicit a sensitization reflected in elevated blood serum IgE values. To test this hypothesis, this study quantitated blood serum IgE levels of patients exhibiting asymptomatic necrotic teeth and compared these with values obtained from an equal number of volunteer controls. Although the IgE levels varied considerably within both groups, Student's t test showed a significant difference (p≤0.01) between mean IgE levels of experimental (190.5±216.9) and control (46.5±44.5) patients. These results might have clinical implications, with increased IgE formation representing an aberrant immunological response enhancing the potential for an immediate hypersensitivity reaction. Past studies have identified several classes of tissue immunoglobulins within human periapical granulomas. It has recently been determined that elevated serum IgE levels occur in conjunction with acute orofacial swellings related to pulpally involved teeth. We theorized that pulpally involved teeth could elicit a sensitization reflected in elevated blood serum IgE values. To test this hypothesis, this study quantitated blood serum IgE levels of patients exhibiting asymptomatic necrotic teeth and compared these with values obtained from an equal number of volunteer controls. Although the IgE levels varied considerably within both groups, Student's t test showed a significant difference (p≤0.01) between mean IgE levels of experimental (190.5±216.9) and control (46.5±44.5) patients. These results might have clinical implications, with increased IgE formation representing an aberrant immunological response enhancing the potential for an immediate hypersensitivity reaction. Estudios anteriores han identificado varias clases de inmunoglobulinas tisulares dentro de granulomas periapicales humanos. Recientemente se ha determinado que hay niveles séricos elevados de IgE en conjunción con edemas oro-faciales agudos referidos a dientes no vitales. Nuestra hipótesis es que los dientes no vitales pueden desencadenar una sensibilización que se ve reflejada en los niveles séricos de IgE. Para probar esta hipótesis, este estudio determinó los niveles séricos de IgE de los pacientes con dientes necróticos asintomáticos y los comparo con los valores obtenidos en un número igual de-controles voluntarios. A pesar que los niveles de IgE variaron considerablemente dentro de ambos grupos, las diferencias de acuerdo a la prueba t de Student fueron estadísticamente significativas (p≤0.01) entre la media de IgE para el grupo experimental (190.5±216.9) y para el grupo control (46.5±44.5). Estos resultados pueden tener implicancias clinicas y la producción incrementada de IgE puede representar una respuesta inmunológica aberrante que puede a su vez reforzar el potencial para las reacciones de hypersensibilidad inmediata. Estudios anteriores han identificado varias clases de inmunoglobulinas tisulares dentro de granulomas periapicales humanos. Recientemente se ha determinado que hay niveles séricos elevados de IgE en conjunción con edemas oro-faciales agudos referidos a dientes no vitales. Nuestra hipótesis es que los dientes no vitales pueden desencadenar una sensibilización que se ve reflejada en los niveles séricos de IgE. Para probar esta hipótesis, este estudio determinó los niveles séricos de IgE de los pacientes con dientes necróticos asintomáticos y los comparo con los valores obtenidos en un número igual de-controles voluntarios. A pesar que los niveles de IgE variaron considerablemente dentro de ambos grupos, las diferencias de acuerdo a la prueba t de Student fueron estadísticamente significativas (p≤0.01) entre la media de IgE para el grupo experimental (190.5±216.9) y para el grupo control (46.5±44.5). Estos resultados pueden tener implicancias clinicas y la producción incrementada de IgE puede representar una respuesta inmunológica aberrante que puede a su vez reforzar el potencial para las reacciones de hypersensibilidad inmediata.

A clinical study of Laotian refugees infected with Clonorchis sinensis or Opisthorchis viverrini.

Twenty-six Laotian refugees infected with Clonorchis or Opisthorchis liver flukes, and 15 uninfected controls, were assessed clinically by history, physical examination, serum 5'nucleotidase level, and serum immunoglobulin E level. Ultrasound studies of the biliary tract were also done on a subset of six infected subjects. The results showed no differences between subjects and controls with respect to clinical symptoms, physical findings, 5'nucleotidase, or biliary ultrasound. Mean serum IgE levels were four times higher in fluke-infected individuals than uninfected controls (P less than 0.002). Even when those infected with other parasites in addition to Clonorchis were excluded from the analysis, serum IgE levels remained three times higher in fluke infected individuals (P = 0.06). This study provides some evidence that the fluke provokes a mild immune response in the asymptomatic human host but may not require eradication.

Increased total serum IgE in alcoholics.

Total serum IgE concentrations were measured in 106 male alcoholics with current alcohol abstinence of varying duration. The influence of smoking habits and clinical atopy on IgE levels was considered. The majority (91%) of the alcoholics were smokers and 26% suffered from possible clinical atopy. The geometric mean IgE in non-atopic, smoking alcoholics was 42 kU/l and significantly higher than the mean IgE level, 19 kU/l, in age-matched, smoking, non-atopic male participants in a general health survey (p less than 0.001). The IgE levels declined with the length of the alcohol abstinence period. Alcoholics, serially followed after a heavy drinking spree, showed a uniform pattern of declining IgE levels during a fortnight of abstinence (p less than 0.001). No link was noted between total IgE levels and the extent of liver affection as estimated by various serum variables (bilirubin, aminotransferases, gamma-GT, IgG, IgA and IgM) or galactose tolerance test. The increased IgE levels in alcoholics are suggested to reflect an influence of ethanol on T lymphocytes regulating the IgE synthesis. Such a proposed effect of ethanol on cellular immunity may contribute to certain organic alcohol diseases, but does not appear to influence the frequency of clinical atopy, being similar in our patient group and in the general population of the same geographic area.

Immunoglobulin E pattern in cigarette smokers.

Serum IgE levels in healthy blood donors who had no history of atopy were measured by a paper-disc RIA and analyzed according to the donors' smoking habits. The IgE geometric mean for regular smokers was 41.7 IU/ml, which was significantly higher than that for nonsmokers (19.3 IU/ml) or rare smokers (22.7 IU/ml). Whereas 28% of smokers had IgE levels greater than 200 IU/ml, none of the rare smokers or nonsmokers did. IgE levels in smokers showed a moderate inverse correlation with the degree of smoking. The mean IgE level was 189.8 IU/ml in those who smoked 1-9 cigarettes/day but only 32.8 IU/ml in those who smoked 10-19 cigarettes per day and 11.1 IU/ml in those who smoked 20 or more cigarettes/day. The number of years a person smoked did not seem to significantly influence the IgE level. The mean IgE level in ex-smokers (50.5 IU/ml) was much lower than in current light smokers but was still higher than in nonsmokers. There was a moderate inverse correlation between IgE levels and duration of cessation of smoking. Our data suggest a characteristic pattern for the influence of cigarette smoking on serum IgE level, namely, a striking rise associated with light smoking and a remarkable drop in heavy smokers, and such changes seemed reversible after the habit was stopped. Smoking status, therefore, appears to be an important consideration in interpreting serum IgE levels and in revising the "norms" of IgE levels.

Total serum IgE concentrations in adolescents and adults using the phadebas IgE PRIST technique.

Total serum IgE measured with the Phadebas PRIST technique was titrated in 117 normal non-allergic subjects, 237 allergic adolescents or adults and 89 non-allergic patients who suffered from asthma, rhinitis, or conjunctivitis. All subjects were of Caucasian origin. In normal subjects, mean total serum IgE was 38 +/- 43 kU/l. This value is exactly the same as that found in a study of Caucasian New Zealanders and very similar to the values found in most U.S. studies. This suggests that the mean total serum IgE concentration is remarkably constant in normal non-allergic Caucasians. The upper limit of the normal range is considered to be 150 kU/l. 38% of allergic patients have total IgE concentrations within the normal range. Some pollen or hymenoptera venom-sensitive patients have a total serum IgE concentration below 20 kU/l. The non-allergic patients had a mean IgE concentration of 94 +/- 93 kU/l, and 25% of them had a total serum IgE above the normal range. Asthmatic patients had higher mean IgE levels than those who were suffering from either rhinitis or conjunctivitis.

Age-related serum immunoglobulin E levels in healthy subjects and in patients with allergic disease

Serum IgE levels were measured by a paper-disc radioimmunoassay technique (PRIST) in 425 nonallergic subjects and in 570 patients with asthma, 244 with allergic rhinitis, 48 with asthma and eczema (atopic dermatitis), 49 with eczema but without asthma, and 57 with chronic urticaria. The data are presented for age groups in geometric means and standard deviations and by modal distribution. Normal mean IgE levels for the total sample were 32 IU/ml with highest levels (mean of 51 IU/ml) in school-age children. The highest IgE levels were found in patients with both asthma and eczema (mean of 985 IU/ ml), followed by asthma alone (305 IU/ml), eczema alone (273 IU/ml), and allergic rhinitis (171 IU/ml). The values for our United States population were higher than those reported from Scandinavian countries but lower than those reported from Canada. The geometric mean plus 1 SD (64 IU/ml for infants, 150 IU/ml for schoolchildren, and 100 to 120 IU/ml for all other age groups) appears to be the most useful limit of normalcy. Overlaps with normal values are largest for urticaria, eczema, and allergic rhinitis and least for patients with allergic asthma.

Serum concentrations of immunoglobulins E and G and α2-macroglobulin in childhood renal disease

Serum concentrations of IgE, IgG, and α 2-macroglobulin ( α 2M) were determined in 67 children with renal disease and in appropriate controls. IgE concentrations were significantly elevated in patients with renal disease and proteinuria, including those with minimal change nephrotic syndrome (MCNS). IgG concentrations were lower and α 2M concentrations higher in patients with proteinuria than in patients without proteinuria. In 16 patients with nephrotic syndrome who had a decrease in proteinuria with therapy, there was a concomitant decrease in mean serum IgE level. All nine with MCNS had a decrease in serum IgE following therapy whereas eight of the nine had a concomitant increase in serum IgG. The findings suggest the possibility that IgE may play an etiologic role in the proteinuria of childhood nephrotic syndrome, and that both elevated serum IgE and proteinuria may represent unusual responses to antigens that are seldom identified. Elevations of IgE secondary to lowered IgG or to entirely nonspecific alterations in IgE metabolism in proteinuric renal disease are other possibilities. Further studies to elucidate the role of IgE in renal disease, including the nature of the altered metabolism of this immunoglobulin, are warranted.

A modified sandwich technique for the measurment of IgE

The paper radioimmunosorbent test (PRIST) has been described as the method of choice for determining low serum IgE levels; the radioimmunosorbent test (RIST) as the method of choice for determining normal and elevated serum IgE levels. By replacing the 125I-labelled anti-IgE antibody used in the paper radioimmunosorbent test by the 125I-labelled anti-IgE reagent used in radioallergosorbent test (RAST) and by changing the serum dilution and the incubation time, this modified sandwich technique (MST) became comparable to the RIST in the normal and elevated IgE-region and showed results similar to the PRIST in the very low IgE-region. The affinity of the 125I-labelled anti-IgE of the RAST proved to be about 2.6 times higher than the antibody used in the PRIST, which explains the improved results in the normal and the good results in the very low IgE-region. The lowest serum IgE level measurable by this method was as low as 0.05 I.U./ml, as determined in 20 cord sera. The mean IgE level in cord sera was 0.45 I.U./ml (range 0.05–2.63 I.U./ml). The results of this study suggest replacement of the antiserum used in PRIST by the one available for RAST.

Nasal PolyposisRelationships to Allergy and Acetylsalicylic Acid Intolerance

Allergological, clinical and histological findings in 109 unselected patients, treated for nasal polyps during the period Feb. 1977 to Feb. 1978 are reported. The material was divided into three groups according to clinical findings: 1) Atopy Group; 18 patients with positive history and skin test; 2) ASA Intolerance Group; 25 patients with a definite history of acetylsalicylic acid intolerance; and 3) Intrinsic Disease Group; 66 patients in whom specific etiological factors were not found. On skin testing, positive reactions were obtained in 42 patients. In 23 of the patients, the skin test result agreed with the history. Secretion and tissue eosinophilia, noted in 97 and 102 patients, respectively, correlated in 88% of the patients, whereas correlation with blood eosinophilia was poor (30%). The mean IgE level was 140 in the serum and 731 in the polyp fluid, serum values above 150 occurring in 28 out of 105 patients and fluid values above 150 in 58 out of 84 patients. The predominant histological finding in the polyp biopsies was tissue eosinophilia, which was most abundant in the ASA intolerance group. Squamous metaplasia was seen in 30% but it was marked only in 5 cases. In 10 patients ASA intolerance was confirmed by oral provocation.