Basophil histamine release, IgE, eosinophil counts, ECP, and EPX are related to the severity of symptoms in seasonal allergic rhinitis


Lone Winther, MD, Allergy Unit, TTA 7511, RHIMA, National University Hospital, 20, Tagensvej, DK – 2200 Copenhagen N, Denmark


Background: Serum specific IgE, basophil histamine release, and blood eosinophil parameters are associated with allergic rhinitis, but investigations of the relationship to the severity of allergic symptoms are few and conflicting. Our study aimed to investigate the seasonal changes in the following laboratory tests: specific IgE, basophil histamine release, eosinophil counts, and serum and plasma eosinophil cationic protein (ECP) and eosinophil protein X (EPX), and to analyze, in detail, the relationship of each individual test to the severity of symptoms in rhinitis patients allergic to both birch and grass pollen.

Methods: The above tests were performed on blood samples obtained from 49 allergic rhinitis patients during the birch-pollen season, during the grass-pollen season, and after the seasons. Symptom-medication diaries were filled in during both pollen seasons. We used partial least square (PLS) analysis to establish an optimal statistical link between the symptom score and medication and the laboratory tests, in an investigator-independent way.

Results: Increases in specific IgE, basophil histamine release, eosinophil counts, serum ECP and EPX, and plasma EPX were observed from the birch-pollen season to the grass-pollen season, followed by a decrease from the grass-pollen season to after the pollen seasons, except for the specific IgE. No seasonal changes in plasma ECP and total IgE were seen. The PLS analysis found a relationship between symptom score and medication and the aggregate laboratory tests (F-test value 40.2, correlation 0.34 for the cumulative relation). However, the variation in laboratory tests could explain only half of the total variation in symptoms and less than a quarter of the total variation in medication. The symptom score and, to a minor degree, medication were especially correlated with the basophil histamine-release results, with a decreasing relevance of specific IgE, eosinophil counts, total IgE, serum and plasma EPX, and serum ECP. Plasma ECP was not related to the symptom score and medication.

Conclusions: A significant relationship between the severity of allergic rhinitis and various allergic inflammatory markers was found but could account for only a minor part of the variation in the patients' evaluation of their disease.

Abbreviations: ACRI: mean daily capsules of acrivastine; ANTA: mean daily antazoline-naphazoline eye-drops; CAP: specific IgE measured by Pharmacia CAP System; ECP: eosinophil cationic protein; EOS: eosinophil counts; EPX: eosinophil protein X; HR: histamine release; HR15: lowest concentration of extract giving ≥15 ng histamine/ml blood in histamine-release test; LEU: leukocyte counts; MAX: maximum histamine released (ng/ml) at any concentration of extract in histamine-release test; NAL: nasal lavage; PLS: partial least square analysis; PRED: mean daily mg of prednisolone; SYMP: mean daily value of total symptom score.