Local Immunoglobulin E in the Nasal Mucosa: Clinical Implications.
10.4168/aair.2015.7.4.321
- Author:
Els DE SCHRYVER
1
;
Lien DEVUYST
;
Lara DERYCKE
;
Melissa DULLAERS
;
Thibaut VAN ZELE
;
Claus BACHERT
;
Philippe GEVAERT
Author Information
1. Upper Airways Research Laboratory, Department of Otorhinolaryngology, Ghent University Hospital, Ghent, Belgium. Philippe.gevaert@ugent.be
- Publication Type:Review
- Keywords:
local IgE;
allergic rhinitis;
local allergic rhinitis;
chronic rhinosinusitis with nasal polyps;
diagnostics;
treatment
- MeSH:
B-Lymphocytes;
Humans;
Immunoglobulin E*;
Immunoglobulins*;
Inflammation;
Mucous Membrane;
Nasal Mucosa*;
Nasal Polyps;
Recombination, Genetic;
Rhinitis
- From:Allergy, Asthma & Immunology Research
2015;7(4):321-331
- CountryRepublic of Korea
- Language:English
-
Abstract:
Immunoglobulin E (IgE) can be highly elevated in the airway mucosa independently of IgE serum levels and atopic status. Mostly, systemic markers are assessed to investigate inflammation in airway disease for research or clinical practice. A more accurate but more cumbersome approach to determine inflammation at the target organ would be to evaluate markers locally. We review evidence for local production of IgE in allergic rhinitis (AR) and chronic rhinosinusitis with nasal polyps (CRSwNP). Diagnostic and therapeutic consequences in clinical practice are discussed. We describe that the airway mucosa has the intrinsic capability to produce IgE. Moreover, not only do IgE-positive B cells reside within the mucosa, but all tools are present locally for affinity maturation by somatic hypermutation (SHM), clonal expansion, and class switch recombination to IgE. Recognizing local IgE in the absence of systemic IgE has diagnostic and therapeutic consequences. Therefore, we emphasize the importance of local IgE in patients with a history of AR or CRSwNP.
