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Can Immunoglobulin E-measurement replace challenge tests in allergic rhinoconjunctivits to grass pollen?

Authors

  • J. Huss-Marp,

    1. ZAUM-Center for Allergy and Environment, Division of Environmental Dermatology and Allergy, Helmholtz Center Munich, Technische Universität München, Munich, Germany
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  • U. Darsow,

    1. ZAUM-Center for Allergy and Environment, Division of Environmental Dermatology and Allergy, Helmholtz Center Munich, Technische Universität München, Munich, Germany
    2. Department of Dermatology, Technische Universität München, Munich, Germany
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  • K. Brockow,

    1. ZAUM-Center for Allergy and Environment, Division of Environmental Dermatology and Allergy, Helmholtz Center Munich, Technische Universität München, Munich, Germany
    2. Department of Dermatology, Technische Universität München, Munich, Germany
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  • F. Pfab,

    1. ZAUM-Center for Allergy and Environment, Division of Environmental Dermatology and Allergy, Helmholtz Center Munich, Technische Universität München, Munich, Germany
    2. Department of Dermatology, Technische Universität München, Munich, Germany
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  • I. Weichenmeier,

    1. ZAUM-Center for Allergy and Environment, Division of Environmental Dermatology and Allergy, Helmholtz Center Munich, Technische Universität München, Munich, Germany
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  • W. Schober,

    1. ZAUM-Center for Allergy and Environment, Division of Environmental Dermatology and Allergy, Helmholtz Center Munich, Technische Universität München, Munich, Germany
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  • C. J. Petersson,

    1. Phadia AB, Uppsala, Sweden
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  • M. P. Borres,

    1. Phadia AB, Uppsala, Sweden
    2. Department of Paediatrics, Sahlgrenska Academy of Göteborg University, Göteborg, Sweden
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  • J. Ring,

    1. Department of Dermatology, Technische Universität München, Munich, Germany
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  • H. Behrendt

    1. ZAUM-Center for Allergy and Environment, Division of Environmental Dermatology and Allergy, Helmholtz Center Munich, Technische Universität München, Munich, Germany
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Correspondence:
Dr Johannes Huss-Marp, ZAUM-Center for Allergy and Environment, Division of Environmental Dermatology and Allergy, Technische Universität München, Biedersteiner Str. 29, 80802 Munich, Germany.
E-mail: huss-marp@lrz.tum.de

Summary

Background There is minimal data available concerning the dose–response relationship between allergen exposure and clinical reactivity for outdoor aeroallergens, such as timothy grass pollen. Timothy pollen-specific IgE (sIgE) determinations might assist in predicting the clinical reactivity in patients with allergic rhinoconjunctivitis (ARC).

Methods Allergen-sIgE antibody levels of timothy grass pollen were correlated with individual threshold doses eliciting allergic reactions in skin prick test (SPT), conjunctival (CPT) and nasal (NPT) provocation tests in patients suffering from pollen-induced rhinoconjunctivitis and healthy controls.

Results One hundred and four patients with ARC (median age: 27 years; range: 18–64; females: 58%) and 36 controls (25 years (22–77); females: 70%) were included in the study. Ninety-six percent of the patients showed a positive reaction in the nasal and 57% showed a positive reaction in the conjunctival provocation. With regarding to titrated SPT, 98% of the patients showed a positive skin test reaction; correlating with the level of sIgE for timothy (P<0.001). For both provocation protocols, there was no correlation between the provocation concentration at the reaction and the level of sIgE for timothy. The ratio of sIgE/total IgE correlated with the dilution level of SPT (P<0.002) and CPT (P<0.01), respectively.

Conclusion and Clinical Relevance A dose–response relationship between the levels of sIgE and clinical outcome of timothy allergen exposure could not be established. Although IgE-determination remains an important key element in allergy diagnosis, provocation tests are procedures of choice if the clinical relevance of an allergen has to be confirmed.

Cite this as: J. Huss-Marp, U. Darsow, K. Brockow, F. Pfab, I. Weichenmeier, W. Schober, C. J. Petersson, M. P. Borres, J. Ring and H. Behrendt, Clinical & Experimental Allergy, 2011 (41) 1116–1124.

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