Clinical significance of specific IgE determination on nasal secretion

The clinical use of RAST on the nasal secretions was investigated in seventeen atopic patients, with asthma or rhinitis, who had shown at a first diagnostic screening, some difficulties in the identification of the responsible allergen(s). The results of the skin tests, of the RAST on the serum and on the nasal secretions and of the specific provocation test (bronchial or nasal) were compared. In some cases the basophil degranulation test was performed. The results of the RAST on the nasal secretions were in perfect agreement with the provocation test. The skin tests and the RAST on the serum showed many discrepancies, particularly for Dermatophagoides, epidermal derivatives of cat and dog and moulds, and less frequently for Graminaceae and other pollens. It is concluded that RAST analysis on nasal secretions is useful in clinical diagnosis of allergy especially for Dermatophagoides, epidermal derivatives and moulds. Most false positive results were observed with the RAST on serum; in fifteen cases it was positive, while all the other tests, basophil degranulation test included, were negative. The data suggest that IgE may have a low affinity for basophil receptors.