The relationship of IgE, skin-test, eosinophilia, eosinophil cationic protein and tumor necrosis factor production in allergic rhinitis.

One hundred and twelve patients with allergic rhinitis (AR) were selected for this study. Sixty-one percent of the patients had elevated levels of total serum IgE (> 210 IU/ml) whereas 55% of them had eosinophilia. Skin-test reactivities to house dust mite and fungi allergens were positive in 86% of the patients, but this was correlated neither to levels of eosinophils and specific IgE to Dermatophagoides ptronyssinus (Dpt) and D. farinae (Df), nor with the levels of total IgE except in the skin-test highest-reactive group; they had significantly higher IgE level than the normal controls. Radioallergosorbent test (RAST) was 66% in those patients with high IgE levels and the major allergens were further identified by Quidel Allergen Screen assay as Dpt and Df. Serum ECP level was correlated with high, but not low, blood eosinophil numbers in patients with AR. Tumor necrosis factor (TNF) production from peripheral blood mononuclear cells culture by phytohemagglutinin (PHA) stimulation was suppressed in patients with AR with eosinophilia when compared with that of the normal controls. The symptom-triggering factors in patients with AR were primarily cold air, temperature change and the common cold. This suggests that factors other than the specific IgE response to house dust mite, skin-test reactivity and eosinophilia may also be important in the development of AR.