The serum IgE levels of four patients with allergic bronchopulmonary aspergillosis ranged from 201 to 16,800 I.U./ml. The corresponding mean level for control subjects was 205±68 I.U./ml. A considerable proportion of the patients' serum IgE was found to be specific reagin directed against extracts of Aspergillus fumigatus. Notwithstanding the high levels of reagin, the circulating basophils were relatively insensitive to histamine release with allergen or antiserum to I gE. The effects of steroid therapy may have contributed in part towards this lack of reactivity of the basophiis. Two of the patients showed in vitro evidence of Type IV in addition to in vitro Type I hypersensitivity but did not demonstrate the presence of precipitins to A. fumigatus in their serum, one of these previously having a positive precipitin test. Precipitins were present in the sera of the two other patients, both of whom demonstrated in vivo Type I hypersensitivity. One of these was tested in vitro for Type IV hypersensitivity but was adjudged negative. The sputum of one patient (L.P.) contained fungal mycelia which was conjugated with both IgA and IgE antibodies.
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