Serum IgE
Blood Tests

Author: Gianpiero Pescarmona
Date: 02/05/2012

Description

DEFINITION

A short yet comprehensive description

External links

DatabaseLink
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ANALYTICAL METHOD

ANALYTICAL TRICKS AND TIPS

THE BIOLOGICAL CONTEXT

Mechanisms of IgE Inflammation. 2011

  • The prevalence of diseases such as allergic asthma and rhinitis continues to increase in the United States, affecting millions of people. It is well-established that allergy contributes to the pathogenesis of most asthma, especially in children and young adults. Despite current therapy (eg, inhaled corticosteroids, anti-leukotrienes, and bronchodilators), patients with moderate to severe asthma remain symptomatic and experience frequent exacerbations of disease requiring oral corticosteroids, emergency department treatments, and hospitalizations. Allergic diseases are traditionally referred to as immediate or type 1 hypersensitivity reactions, with IgE as a critical factor. IgE is involved in allergic inflammation, especially in early-phase response, but it may also be involved in the late-phase allergic response. A direct correlation between serum IgE levels and asthma exists. As logarithm IgE values increase, asthma prevalence increases linearly, even in patients who are categorized as having nonallergic asthma. In addition, there is a significant, although low association in allergic rhinitis with IgE levels and positive skin test reactivity to pollens. Recent advances in our understanding of the role of IgE in allergic inflammation have led to the development of a monoclonal antibody to IgE that reduces IgE levels, thereby reducing allergic inflammation. This review aims to provide an overview of the basic science of the IgE molecule and the clinical efficacy of anti-IgE therapy in allergic and asthmatic diseases.

Genetic

Evidence for a Locus Regulating Total Serum IgE Levels Mapping to Chromosome 5, 1994

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Immunoglobulin E (IgE) occupies a key role in the pathogenesis of allergy . Like other immunoglobulins, IgE is produced by B-lymphocytes following exposure of a dendritic cell to a foreign antigen under the control of T-helper lymphocytes (TH). T-helper lymphocytes have been found to produce two distinct profiles of signaling proteins or cytokines and have been divided into two subsets on this basis. TH2 lymphocytes are characterized by secretion of Interleukin 4 (IL-4), Interleukin 5 (IL-5), and Interleukin 13 (IL-13) as opposed to production of interferon gamma (IFN-) and Interleukin 2 by TH1 lymphocytes. It is theTH2 subset of lymphocytes that are thought to mediate the production of IgE by B-lymphocytes and it is hypothesized that an imbalance between TH2 and TH1 subtypes of lymphocytes underlies the pathogenesis of allergic diseases.

Much of the IgE produced by B-lymphocytes is removed from the circulation and bound to the surface of either mast cells, which reside in the tissue or basophils, which can be found in low numbers of the circulation. For this reason, circulating IgE levels often correlate poorly with the total amount of IgE present within the body. When two or more molecules of IgE bound to the surface of a cell are simultaneously linked to its specific allergen, the cell will immediately release preformed inflammatory mediators including histamine, which induce the immediate affects or early phase of allergy. The cells will also synthesize newly formed inflammatory molecules including leukotriene D4, prostaglandins and cytokines such as tumor necrosis factor alpha (TNF-), IL-4 and IL-5. These cytokines recruit eosinophils, macrophages and more basophils to the area. These newly synthesized substances and the cells they recruit are key players in the late phase of the allergic response.

Gene: ... of the human high- affinity receptor for IgE, one of the potent IgE- binding molecules, was tested for its ability to regulate IL- 4- induced IgE synthesis by human lymphocytes. Utilizing a IFN... binding and interleukin- 4- induced IgE and IgG4 production by human B cells. Regulatory relationships...
Homo sapiens
IL6 - interleukin 6 (interferon, beta 2)
Gene: ... , addition of IL- 5 or IL- 6 did not reverse IL- 8- induced inhibition of IgE production. These results indicate that histamine enhanced IgE and IgG4 production by increasing endogenous IL- 6 and IL- 10...
Homo sapiens
IL4 - interleukin 4
Gene: ... of inducing isotype class- switching of B- cells to produce IgE after allergen exposure. Further associations.... These results show that the induction of IgE synthesis by recombinant IL4 is T cell dependent and optimal... was studied. Prostaglandin E2 potently enhanced IgE production stimulated with IL4 alone but was inhibitory...

DIAGNOSTIC USE

Issues

Immunoglobulin E in health and disease, 2011 PDF

Specificity, sensitivity etc.

Diagnostic Algorithms

PROs and CONTROs

Open Questions

Working Hypothesis

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