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  • Title: Specific IgE serum concentration is associated with symptom severity in children with seasonal allergic rhinitis.
    Author: Rolinck-Werninghaus C, Keil T, Kopp M, Zielen S, Schauer U, von Berg A, Wahn U, Hamelmann E, Omalizumab Rhinitis Study Group.
    Journal: Allergy; 2008 Oct; 63(10):1339-44. PubMed ID: 18782113.
    Abstract:
    BACKGROUND: The impact of allergen-specific and total IgE serum levels before and during the pollen season on symptom severity as well as efficacy of treatment with anti-IgE requires further delineation. METHODS: Birch and grass pollen allergic patients aged 6-17 years with seasonal allergic rhinitis (SAR) were analyzed for the association of IgE serum concentration with symptom severity and rescue medication use (combination: symptom load, SL) during the grass pollen season. Reference group A (n = 53) received placebo, while group B (n = 54) received Omalizumab (anti-IgE) monotherapy before and during the grass pollen season. RESULTS: Patients on placebo with high baseline specific grass pollen IgE (>50 kU/l) had a significantly higher SL compared with those with low IgE levels (< or =50 kU/l): SL 1.28 vs 0.61, P = 0.015. This association was nonexistent in patients treated with anti-IgE. In contrast, baseline total IgE levels did not correlate with SL in any group. Patients with anti-IgE treatment and high free total IgE levels (>16.7 ng/ml) had a significantly higher SL compared with those with low free total IgE levels (< or =16.7 ng/ml): SL 0.63 vs 0.23, P = 0.031. CONCLUSIONS: Baseline specific IgE, but not total IgE, is associated with symptom severity during the pollen season in children with SAR. Likewise, the symptom load in SAR patients with anti-IgE correlates with free total IgE levels. Although further research in larger populations is needed to confirm our findings, our data suggest that specific IgE can be used as a parameter for patient selection for this kind of treatment.
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