The clinical investigator

, Volume 70, Issue 3–4, pp 277–282 | Cite as

A role for IgE in extrinsic allergic alveolitis?

  • A. Pforte
  • U. Schild
  • G. Breyer
  • K. Häussinger
  • H. W. L. Ziegler-Heitbrock
Original Article


Receptors for the Fc portion of immunoglobulin E (IgE; CD23) can be detected on the surface of alveolar macrophages (AM) in extrinsic allergic alveolitis (FAA), using monoclonal antibodies in immunocytology. More than 50% of AM were positive in 16 of the 20 patients reported here, while the remaining 4 had 11–47% positive cells. Staining with anti-IgE antibody can, in addition, demonstrate endogeneous IgE bound to the AM. This suggests that IgE might be involved in the process. Since IgE-mediated asthma is associated with bronchoconstriction, we asked whether EAA patients do in fact exhibit an obstructive component. In 3 out of 10 patients we did indeed find clearly increased airway resistance (> 30 kPa × s × 1−1). These findings are consistent with the observation of immediate bronchoconstriction observed in some patients upon allergen challenge. Since only 1 of the 20 patients studied was a smoker, and since in the literature the majority of reported cases of FAA are in nonsmokers, we speculate that smoking may interfere with immunological processes leading to FAA.

Key words

IgE receptor Alveolar macrophages Exogenous allergic alveolitis 



alveolar macrophage


alkaline phosphatase anti-alkaline phosphatase technique


exogenous allergic alveolitis


Fe receptor


immunoglobulin E


interleukin 1


Interleukin 4


monoclonal antibody




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  1. 1.
    Baur X, Dorsch W, Becker T (1980) Levels of complement factors in human serum during immediate and late asthmatic reactions and during acute hypersensitivity pneumonitis. Allergy 35:383–390.CrossRefPubMedGoogle Scholar
  2. 2.
    Bieber T, Dannenberg B, Prinz JC, Rieber EP, Stolz W, Braun-Falco O, Ring J (1989) Occurrence of IgE bearing epidermal Langerhans cells in atopic eczema: a study of the time course of the lesions and with regard to the IgE serum level. J Invest Dermatol 93:215–219.CrossRefPubMedGoogle Scholar
  3. 3.
    Bjemer L, Frazén L, Littgrand B, Nilsson K, Angström T, Henriksson R (1990) Effect of smoking and irradiated volume on inflammatory response in the lung in irradiated breast cancer patients evaluated with bronchoalveolar lavage. Cancer Res 50:2027–2030.Google Scholar
  4. 4.
    Coffman RL, Ohara J, Bond MW, Carty J, Zlotnik A, Paul WE (1986) B cell stimulatory factor 1 enhances the IgE response of lipopolysaccharide-activated B cells. J Immunol 136:4538–4541.PubMedGoogle Scholar
  5. 5.
    Costabel U, Bross KJ, Marxen J, Matthys H (1984) T-lymphocytosis in bronchoalveolar lavage fluid hypersensitivity pneumonitis. Chest 35:514–518.CrossRefGoogle Scholar
  6. 6.
    Erber WN, Pinching AJ, Mason DJ (1984) Immunocytochemical detection of T- and B-cell populations in routine blood smears. Lancet 1: 1042–1046.CrossRefPubMedGoogle Scholar
  7. 7.
    Faux JA, Wide C, Hardgreave FE, Longbottom JL, Pepys J (1971) Immunological aspects of respiratory allergy in budgerigar (Melopsittacus undulatus) allergy. Clin Allergy 1:149–158.CrossRefPubMedGoogle Scholar
  8. 8.
    Fink JN (1984) Hypersensitivity pneumonitis. J Allergy Clin Immunol 74:1–9.CrossRefPubMedGoogle Scholar
  9. 9.
    Fournier E, Tonnel AB, Gosset PH, Wallaert B, Ameisen JC, Coisin C (1985) Early neutrophil alveolitis after antigen inhalation in hypersensitivity pneumonitis. Chest 88:563–566.CrossRefPubMedGoogle Scholar
  10. 10.
    Fuller RW, Morris PK, Richmond R, Sykes D, Varndell IM, Kemeny DM, Cole PJ, Dollery CT, MacDermot J (1986) Immunoglobulin E-dependent stimulation of human alveolar macrophages: significance in type 1 hypersensitivity. Clin Exp Immunol 65:416–426.PubMedPubMedCentralGoogle Scholar
  11. 11.
    Hargreave FE, Pepys J, Longbottom JL (1966) Bird breeder's (fancier's) lung. Lancet 1:7435–7449.Google Scholar
  12. 12.
    Haslam PL, Dewar A, Butchers P, Primett ZS, Newman-Taylor A, Turner Warwick M (1987) Mast cells, atypical lymphocytes, and neutrophils in bronchoalveolar lavage in extrinsic allergic alveolitis. Am Rev Respir Dis 135:35–47.PubMedGoogle Scholar
  13. 13.
    Ishizaka K (1988) IgE binding factors and regulation of the IgE antibody response. Annu Rev Immunol 6:513–534.CrossRefPubMedGoogle Scholar
  14. 14.
    Joseph M, Tonnel A, Capron A, Voisin C (1980) Enzyme release and superoxide anion production by human alveolar macrophages stimulated with immunoglobulin E. Clin Exp Immunol 40:416–422.PubMedPubMedCentralGoogle Scholar
  15. 15.
    Melewicz FM, Spiegelberg HL (1980) Fc receptors for IgE on a subpopulation of human peripheral blood monocytes. J Immunol 125:1026–1031.PubMedGoogle Scholar
  16. 16.
    Pepys J, Jenkins PA (1965) Precipitin (FLH) test in farmer's lung. Thorax 20:21–35.CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Pforte A, Breyer G, Prinz J, Gais P, Burger G, Häussinger K, Rieber EP, Held E, Ziegler-Heitbrock HWL (1990) Expression of the Fc receptor for IgE (FcɛRII, CD23) on alveolar macrophages in extrinsic allergic alveolitis. J Exp Med 171:1163–1169.CrossRefPubMedGoogle Scholar
  18. 18.
    Platts-Mills TAE (1979) Local production of IgG, IgA, and IgE antibodies in grass pollen hay fever. J Immunol 122:2218–2225.PubMedGoogle Scholar
  19. 19.
    Prinz JC, Rieber EP (1987) Fc-receptors for IgE in human lymphocytes. Detection with a rosetting assay using a recombinant human/mouse IgE-antibody and characterization with monoclonal antibodies. Hybridoma 6:1–16.CrossRefPubMedGoogle Scholar
  20. 20.
    Reynolds HY, Fulmer JD, Kazmierowski JA, Roberts WC, Frank MM, Crystal RG (1977) Analysis of cellular and protein content of broncho-alveolar lavage fluid from patients with idiopathic pulmonary fibrosis and chronic hypersensitivity pneumonitis. J Clin Invest 59:165–175.CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    Rosenthal AS, Shevach EM (1973) Function of macrophages in antigen recognition by guinea pig T lymphocytes. J Exp Med 138:1194–1212.CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Rouzer CA, Scott WA, Hamill AL, Fu-Tong L, Katz DH, Cohn ZA (1982) Secretion of leukotriene C and other arachidonic acid metabolites by macrophages challenged with immunoglobulin E immune complexes. J Exp Med 156:1077–1086.CrossRefPubMedGoogle Scholar
  23. 23.
    Sarfati M, Delespesse G (1988) Possible role of human lymphocyte receptor for IgE (CD23) or its soluble fragments in the in vitro synthesis of human IgE. J Immunol 141:2195–2199.PubMedGoogle Scholar
  24. 24.
    Vercelli D, Jabara HH, Bee-Wah L, Woodland N, Geha RS, Leung DYM (1988) Human recombinant interleukin 4 induces Fcɛ R2/CD23 on normal human monocytes. J Exp Med 167:1406–1416.CrossRefPubMedGoogle Scholar
  25. 25.
    Vitetta ES, Brooks K, Chen Y-W, Isakson P, Jones S, Layton J, Mishra GC, Pure E, Weiss E, Word C, Yuan D, Tucker P, Uhr JW, Krammer PH (1984) T cell derived lymphokines that induce IgM and IgG secretion in activated murine B cells. Immunol Rev 78:137–157.CrossRefPubMedGoogle Scholar
  26. 26.
    Warren CPW (1977) Extrinsic allergic alveolitis: a disease commoner in non-smokers. Thorax 32:567–569.CrossRefPubMedPubMedCentralGoogle Scholar
  27. 27.
    Wenzel FJ, Emanuel DA, Gray RL (1971) Immunofluorescent studies in patients with farmer's lung. J Allergy Clin Immunol 48:224–229.CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 1992

Authors and Affiliations

  • A. Pforte
    • 1
  • U. Schild
    • 1
  • G. Breyer
    • 3
  • K. Häussinger
    • 3
  • H. W. L. Ziegler-Heitbrock
    • 2
  1. 1.Medizinische Klinik, Klinikum InnenstadtGermany
  2. 2.Institut für ImmunologicUniversität MünchenGermany
  3. 3.Zentralkrankenhaus GautingGermany

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