The Development of Respiratory Syncytial Virus-Specific IgE and the Release of Histamine in Nasopharyngeal Secretions after Infection

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Abstract
We studied the development of respiratory syncytial virus (RSV)-specific IgE and the release of histamine in nasopharyngeal secretions from 79 infants with various forms of respiratory illness due to RSV. RSV-IgE was measured by an enzyme-linked immunosorbent assay; specificity was confirmed by appropriate blocking experiments. Histamine content in the secretions was determined by fluorimetric methods. RSV-IgE was detectable in only one of 19 patients with RSV infection without wheezing, but was detectable in the majority of 60 patients with wheezing (P<0.01). Titers of RSV-IgE were significantly higher in patients with wheezing (P<0.05). Histamine was detectable in secretions of some patients with all forms of illness but was detected significantly more often (P = 0.05) and in higher concentrations in patients with wheezing. Peak titers of RSV-IgE and concentrations of histamine correlated significantly with the degree of hypoxia (P<0.001). Formation of RSV-specific IgE and release of histamine may adversely affect the outcome of RSV infection. (N Engl J Med. 1981; 305:841–6.)