A role for IgE in extrinsic allergic alveolitis?
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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 wordsIgE receptor Alveolar macrophages Exogenous allergic alveolitis
alkaline phosphatase anti-alkaline phosphatase technique
exogenous allergic alveolitis
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