Predicting Outcomes of Oral Food Challenges by Using the Allergen-Specific IgE-Total IgE Ratio

Objective: In this study, we: (1) evaluated the correlation between total IgE and the presence of specific IgE; (2) compared the characteristics of patients with positive specific IgE to those with negative specific IgE; and, (3) analyzed the allergic testing results of patients on omalizumab and reported the effect of omalizumab on forced expiratory volume (FEV1) and asthma control test (ACT) results. Methods: Data from patients diagnosed with allergic asthma and seen at Florida Lung, Asthma & Sleep Specialists (FLASS) between January 2016 and June 2019 were analyzed. Parameters evaluated were total IgE, and levels of specific IgE to antigens in the ImmunoCAP test and skin prick test (SPT). Additional parameters for patients on omalizumab therapy for at least 6 months were FEV1, % predicted FEV1 and ACT results. Results: A total of 475 patients (114 males, 361 females) met the inclusion criteria. The mean age was 53 years (range: 17 to 89 years). Of these, 36 patients were not included in the analysis due to incomplete data. Mean total IgE was higher in patients with positive ImmunoCAP results compared to those with negative results (396 KU/L vs. 81.3 KU/L). There was a significant positive correlation between total IgE and levels of positive specific IgE in the ImmunoCAP test (p<0.0001, r=0.36, n=213 patients). The correlation between total IgE and levels of positive allergens in SPT was not significant (p=0.15, n=44 patients) Two positive reactions to allergens were seen in 22% of ImmunoCAP tests and 13% of SPT tests. There was no statistically significant improvement in FEV1 (p=0.097, CI -0.17 to 0.02) and % predicted FEV1 (p=0.109, CI -6.63 to 0.70) in patients who used omalizumab for at least 6 months. There was a statistically significant improvement in ACT scores (p=0.031, CI -4.21 to -0.21) in patients who used omalizumab for at least 6 months. Conclusion: Allergic asthma could be seen in patients who had an absence of specific IgE in ImmunoCAP and a negative reaction to SPT. The benefit of omalizumab therapy is not limited to allergic asthma patients with positive specific IgE.

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Specific IgE and IgG4 antibodies to Japanese cedar pollen and total IgE antibody in lumbermen

Aerobiologia ◽

10.1007/bf02694300 ◽

1998 ◽

Vol 14 (4) ◽

pp. 321-324 ◽

Cited By ~ 2

Author(s):

Kensei Naito ◽

G. Ishii ◽

T. Ogawa ◽

N. Yokoyama ◽

S. Iwata

Keyword(s):

Japanese Cedar ◽

Specific Ige ◽

Total Ige ◽

Ige Antibody ◽

Japanese Cedar Pollen ◽

Cedar Pollen

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Preparation of rabbit anti-IgE for use in radioimmunoassays of total IgE and specific IgE antibodies

Journal of Immunological Methods ◽

10.1016/0022-1759(78)90255-7 ◽

1978 ◽

Vol 20 ◽

pp. 185-200 ◽

Cited By ~ 11

Author(s):

Wai Ying Lee ◽

Douglas C. Heiner

Keyword(s):

Specific Ige ◽

Ige Antibodies ◽

Total Ige ◽

Specific Ige Antibodies

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Increase of regulatory T cells and the ratio of specific IgE to total IgE are candidates for response monitoring or prognostic biomarkers in 2-year sublingual immunotherapy (SLIT) for Japanese cedar pollinosis

Clinical Immunology ◽

10.1016/j.clim.2010.12.022 ◽

2011 ◽

Vol 139 (1) ◽

pp. 65-74 ◽

Cited By ~ 57

Author(s):

Takashi Fujimura ◽

Syuji Yonekura ◽

Shigetoshi Horiguchi ◽

Yuriko Taniguchi ◽

Akemi Saito ◽

...

Keyword(s):

T Cells ◽

Regulatory T Cells ◽

Sublingual Immunotherapy ◽

Japanese Cedar ◽

Specific Ige ◽

Prognostic Biomarkers ◽

Response Monitoring ◽

Total Ige ◽

Japanese Cedar Pollinosis

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Relationship between food-specific IgE concentrations and the risk of positive food challenges in children and adolescents☆☆☆★

Journal of Allergy and Clinical Immunology ◽

10.1016/s0091-6749(97)70133-7 ◽

1997 ◽

Vol 100 (4) ◽

pp. 444-451 ◽

Cited By ~ 728

Author(s):

Hugh A. Sampson ◽

Deborah G. Ho

Keyword(s):

Children And Adolescents ◽

Specific Ige ◽

Food Challenges ◽

Food Specific Ige

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BASOPHILE ACTIVATION TEST FOR THE DIAGNOSTICS OF FUNGAL SENSITIZATION IN THE PATIENTS WITH CYSTIC FIBROSIS

Medical Immunology (Russia) ◽

10.15789/1563-0625-2019-5-919-928 ◽

2019 ◽

Vol 21 (5) ◽

pp. 919-928

Author(s):

Ya. I. Kozlova ◽

E. V. Frolova ◽

A. E. Uchevatkina ◽

L. V. Filippova ◽

O. V. Aak ◽

...

Keyword(s):

Cystic Fibrosis ◽

Stimulation Index ◽

Allergic Bronchopulmonary Aspergillosis ◽

Basophil Activation Test ◽

Specific Ige ◽

Basophil Activation ◽

Total Ige ◽

Activation Test ◽

Fungal Allergens ◽

Fungal Sensitization

Aspergillus fumigatus colonization in the patients with cystic fibrosis (CF) may cause sensitization against A. fumigatus and/or allergic bronchopulmonary aspergillosis (ABPA), which significantly worsens the course of underlying disease. At the present time, new diagnostic tests are searched for detection of fungal sensitization in these patients. The aim of this work was to evaluate an opportunity of application of basophile activation test with A. fumigatus allergen in vitro using flow cytometry, aiming for identification of fungal sensitization in the CF patients. The study included 190 patients with CF aged 1 to 37 years. All the patients underwent common allergy screening (skin tests with fungal allergens, determination of serum levels of total IgE and specific IgE for the fungal allergens), and mycological examination (microscopy and culture of respiratory substrates). Computed tomography of the chest was performed upon clinical indications. The basophil activation test with the A. fumigatus allergen was performed in 10 CF patients with ABPA, and 10 CF patients without ABPA, in addition to the standard allergological examination. Frequency of sensitization to A. fumigatus in the patients with cystic fibrosis was 27%, the incidence of allergic bronchopulmonary aspergillosis was 5.7%. The number of eosinophils, total IgE and specific IgE levels in CF patients with ABPA were significantly higher than in CF patients without ABPA. In blood of the ABPA patients we have identified 68.5 (52.5-81.5%) of basophilic leukocytes activated by A. fumigatus allergen, with a stimulation index of 17.07 (10.30-27.70). In appropriate comparison group, the stimulation index did not exceed 1.5 (p = 0.000). Direct positive correlation between the levels of specific IgE to A. fumigatus and the number of basophils activated by A. fumigatus allergens was revealed (r = 0.77; р < 0.05). FVC values and the body mass index in CF patients with ABPA were significantly lower when compared with the patients without fungal sensitization. Introduction of the basophil activation test, along with standard techniques, may enable a more differentiated assessment of ABPA development in CF patients. Timely detection of associations between A. fumigatus sensitization and clinical status of CF patients will facilitate early and effective administration of specific therapy.

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