Poor association between allergen-specific serum immunoglobulin E levels, skin sensitivity and basophil degranulation: a study with recombinant birch pollen allergen Bet v 1 and an immunoglobulin E detection system measuring immunoglobulin E capable of binding to Fc epsilon RI.
BACKGROUND
Results from several studies indicate that the magnitude of immediate symptoms of type I allergy caused by allergen-induced cross-linking of high-affinity Fc epsilon receptors on effector cells (mast cells and basophils) is not always associated with allergen-specific IgE levels.


OBJECTIVE
To investigate the association of results from intradermal skin testing, basophil histamine release and allergen-specific IgE, IgG1-4, IgA and IgM antibody levels in a clinical study performed in birch pollen-allergic patients (n = 18).


METHODS
rBet v 1-specific IgEs were measured by quantitative CAP measurements and by using purified Fc epsilon RI-derived alpha-chain to quantify IgE capable of binding to effector cells. Bet v 1-specific IgG subclasses, IgA and IgM levels were measured by ELISA, and basophil histamine release was determined in whole blood samples. Intradermal skin testing was performed with the end-point titration method.


RESULTS
Our study demonstrates on the molecular level that the concentrations of allergen-specific IgE antibodies capable of binding to Fc epsilon RI and biological sensitivities are not necessarily associated. A moderate association was found between cutaneous and basophil sensitivity.


CONCLUSIONS
Our results highlight the quantitative discrepancies and limitations of the present diagnostic tools in allergy, even when using a single allergenic molecule. The quantity of allergen-specific serum IgE is only one component of far more complex cellular systems (i.e. basophil-based tests, skin tests) used as indirect diagnostic tests for IgE-mediated allergic sensitivity.
Purohit
A
A
Department of Pneumology, Strasbourg University Hospitals, Strasbourg Cedex, France.
Laffer
S
S
Metz-Favre
C
C
Verot
A
A
Kricek
F
F
Valenta
R
R
Pauli
G
G
D000328:Adult; D000485:Allergens / Q000276:immunology*; D052179:Antigens, Plant; D001491:Basophils / Q000276:immunology*; D003429:Cross Reactions; D005260:Female; D006636:Histamine Release; D006801:Humans; D006967:Hypersensitivity / Q000276:immunology*; D007070:Immunoglobulin A / Q000097:blood; D007073:Immunoglobulin E / Q000097:blood* / Q000378:metabolism; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D008297:Male; D008407:Mast Cells / Q000276:immunology; D008875:Middle Aged; D011058:Pollen; D017455:Receptors, IgE / Q000378:metabolism; D012882:Skin Tests; D018709:Statistics, Nonparametric; D050378:T-Lymphocytes, Regulatory / Q000378:metabolism
D000485:Allergens; D052179:Antigens, Plant; D007070:Immunoglobulin A; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D017455:Receptors, IgE; D007073:Immunoglobulin E