BACTERIAL ALLERGY IN NASAL POLYPOSIS - A NEW METHOD FOR QUANTIFYING SPECIFIC IGE

Objectives.-To determine (1) if bacteria-specific serum IgE levels can be more effectively measured by first absorbing competing IgG antibod ies from serum and (2) if patients with chronic paranasal sinus diseas e exhibit a high positive prevalence of bacteria-specific serum IgE. D esign.-A modified radioallergosorbent test method was employed wherein each serum sample was absorbed with recProtein A to remove competing non-IgE antibodies, and purified proteins extracted from 16 individual bacteria were used as potential allergens. Participants.-Twenty-four patients with nasal polyposis and 14 with chronic sinusitis, all refra ctory to conventional medical therapy and requiring endoscopic sinusot omies, were tested. Tested as controls were 10 subjects with chronic a llergic rhinitis, without a history of chronic sinus disease, and poss essing total serum IgE and inhalant-specific IgE levels equal to or hi gher than the patient group. Results.-(1) Pretreatment of serum sample s with recProtein A resulted in an increase of bacteria-specific radio allergosorbent test sensitivity. (2) Seventeen of 24 patients with pol yps, eight of 14 with chronic sinusitis, and one of 10 with chronic al lergic rhinitis were determined to be IgE positive when tested with th is assay. Conclusions.-(1) Bacteria-specific serum IgE can be quantifi ed; (2) most patients with nasal polyposis and/or chronic sinusitis po ssess bacteria-specific IgE in their serum, while subjects with only a llergic rhinitis do not; and (3) multiple bacterial species isolated f rom chronically infected sinuses are capable of inducing IgE-mediated sensitization.