Abstract
The aim of this paper was to define, for the first time in Italy, normal levels of total serum IgE in a general population sample of North Italy. Total serum IgE in 1905 subjects, living in Po Delta area (near Venice), were measured by PRIST method. Normal values were derived from 558 subjects without asthma and/or asthmatic/rhinitic symptoms, noncurrent smokers, skin prick-test negatives (‘normals’). Cut-off values to differentiate ‘normals’ from the remaining part of the sample (‘others’), from asthmatic, and from rhinitic subjects, were established with the IgE value midway between the upper limit of the 95% confidence intervals (CI) of the geometric mean for ‘normals’ and the lower limit for ‘others’, asthmatics, and rhinitics, respectively. Geometric mean of normal children–adolescents was 45 kU/L (SD: 2.6; 95% CI: 38–63). In normal adults geometric mean was 29 kU/L (SD: 3.3; 95% CI: 25–40) in males and 19 kU/L (SD: 3.8; 95% CI: 16–22) in females. The diagnostic sensitivity of IgE test was low, while the specificity was very high. A good positive predictive value in discriminating ‘normals’ from ‘others’ was found, on the contrary, we found a good negative predictive value in discriminating ‘normals’ from asthmatics or from rhinitics. In conclusion, our results confirm that it is necessary to provide separate total serum IgE reference values for what concerns age in children–adolescents and in adults, and gender, in adults. Low level of total serum IgE are helpful to exclude allergic asthma or rhinitis.
Similar content being viewed by others
References
Merrett J, Merrett TG. Screening for IgE-mediated allergy. J Clin Immunoassay 1993; 16: 164–172.
Sunyer J, Anto JM, Tobias A, Burney P. Generational increase of self-reported attack of asthma in fifteen industrialized countries. European Community Respiratory Health Study. Eur Respir J 1999; 14: 885–891.
De Blay F, Zana H, Offner M, Verot A, Velten M, Pauli G. Receiver operating characteristic analysis: A useful method for a comparison of the clinical relevance of 2 in-vitro IgE tests. J Allergy Clin Immunol 1993; 92: 255–263.
Salkie ML. Role of clinical laboratory in allergic testing. Clin Biochem 1994; 27: 343–355.
Lindberg RE, Arroyave C. Levels of IgE in serum from normal children and allergic children as measured by an enzyme immunoassay. J Allergy Clin Immunol 1986; 78: 614–618.
Zetterström O, Johansson SGO. IgE concentration measured by PRIST in serum of healthy adults and in patients with respiratory allergy. A diagnostic approach. Allergy 1981; 36: 537–547.
Cline MG, Burrows B. Distribution of allergy in a population sample residing in Tucson, Arizona. Thorax 1989; 44: 425–431.
Jarvis D, Luczynska C, Chinn S, Burney P. The association of age, gender and smoking with total IgE and specific IgE. Clin Exp Allergy 1995; 25: 1083–1091.
Klink M, Cline MG, Halonen M, Burrows B. Problems in defining normal limits for serum IgE. J Allergy Clin Immunol 1990; 85: 440–444.
Zweig MH, Campbell G. Receiver-Operating Characteristic (ROC) plots: A fundamental evaluation tool in clinical medicine. Clin Chem 1993; 39: 561–577.
Bousquet J, Coulomb Y, Arrendal H, Robinet-Levy M, Michel FB. Total serum IgE concentrations in adolescents and adults using the Phadebas IgE PRIST technique. Allergy 1982; 37: 397–406.
Holford-Strevens V, Warren P, Wong C, Manfreda J. Serum total immunoglobulin E levels in Canadian adults. J Allergy Clin Immunol 1984; 73: 516–522.
Backer V, Ulrik CS, Wendelboe D, et al. Distribution of serum IgE in children and adolescents aged 7 to 16 yrs in Copenhagen, in relation to factors of importance. Allergy 1992; 47: 484–489.
Grigoreas C, Pappas D, Galatas ID, Kollias G, Papadimos S, Papadakis P. Serum total IgE levels in a representative sample of a Greek population. I. Correlation with age, sex, and skin reactivity to common aeroallergens. Allergy 1993; 48: 142–146.
Carrozzi L, Giuliano G, Viegi G, et al. The Po River Delta epidemiological study of obstructive lung disease: Sampling methods, environmental and population characteristics. Eur J Epidemiol 1990; 6: 191–200.
Baldacci S, Modena P, Carrozzi L, et al. Skin prick test reactivity to common aeroallergens in relation to total IgE, respiratory symptoms and smoking in a general population sample of Northern Italy. Allergy 1996; 51: 149–156.
Sapigni T, Biavati P, Simoni M, et al. The Po River Delta respiratory epidemiological survey: An analysis of factors related to level of total serum IgE. Eur Respir J 1998; 11: 278–283.
Bazaral M, Hamburger RN. Standardisation and Stability of Immunoglobulin E. J Allergy Clin Immunol 1972; 49:189–191.
Paoletti P, Carrozzi L, Viegi G, et al. Distribution of bronchial responsiveness in a general population: Effect of sex, age, smoking, and level of pulmonary function. Am J Respir Crit Care Med 1995; 151: 1770–1777.
Siest G, Petitclerc C. Selection of people for the production of population reference values. Ann Biol Clin 1978; 36: 149–334.
SPSS, Rel. 9.0, Spss Inc., Chicago, 1999.
Malvano R, Ferdeghini M, Chiecchio A, Coli A, Bo A. Valutazione delle prestazioni diagnostiche dei test di laboratorio: la determinazione di ormoni tiroidei. Gior It Chim Clin 1992; 17: 433–439.
Salvi SS, Babu KS, Holgate ST. Glucocorticoids enhance IgE synthesis, Are we heading towards new paradigms? Clin Exp Allergy 2000; 30: 1499–1505.
Dodge R, Cline MG, Lebowitz MD, Burrows B. Findings before the diagnosis of asthma in young adults. J Allergy Clin Immunol 1994; 94: 831–835.
Holberg CJ, Elston RC, Halonen M, et al. Segregation analysis of physician diagnosed asthma in hispanic and non-hispanic white families. Am J Respir Crit Care Med 1996; 154: 144–150.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Simoni, M., Biavati, P., Baldacci, S. et al. The Po River Delta epidemiological survey: Reference values of total serum IgE levels in a normal population sample of North Italy (8–78 yrs). Eur J Epidemiol 17, 231–239 (2001). https://doi.org/10.1023/A:1017929831911
Issue Date:
DOI: https://doi.org/10.1023/A:1017929831911