Correlation of the specific IgE in serum and nasal secretions with clinical symptoms in atopies

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Abstract
In an unselected population of 133 young adults studied by prick testing to common allergens, 3 groups were identified: 11 subjects with positive skin test responses and clinical symptoms of allergy; 10 subjects only with positive skin tests and the remainder with negative skin tests. All subjects with positive skin tests (with and without symptoms) were studied by RAST [radioallergosorbent test] on the serum and nasal secretions. Specific and non-specific bronchial provocation tests (BPT) were carried out. The serum RAST was positive in all subjects with positive skin tests and there was good correlation between high levels of circulating specific IgE and the presence of clinical symptoms. The RAST of nasal secretions was negative in most symptom-free subjects and as a diagnostic test it was slightly better than the serum RAST. BPT with extracts of the relevant allergens caused bronchospasm in every subject with a positive nasal secretion RAST. Only 2 subjects of 15 with a positive response were clinical asthmatics. The results cast doubt on the clinical relevance of the BTP as it is usually conducted.