IgE synthesis in man. II. Comparison of tetanus and diphtheria IgE antibody in allergic and nonallergic children.

Specific IgE and IgG antibodies were quantitated in 91 allergic and 80 nonallergic age- and sex-matched children between 4 and 17 yr of age. Statistically significant increased antidiphtheria and antitetanus IgE antibodies (p < 0.01) measured by the radioallergosorbent test (RAST) were noted in allergic compared with nonallergic subjects. Of the allergic children with total serum IgE >500 U/ml, 19 of 52 (37%) and 25 of 52 (48%) had elevations (>2 SD above nonallergic control mean) of serum antitetanus or antidiphtheria IgE antibody, respectively, whereas only 2 of 35 allergic children with serum IgE <500 U/ml had elevation (>2 SD) of these antibodies. Antitetanus and antidiphtheria IgG antibodies were measured by passive sheep red blood cell (SRBC) hemagglutination. Geometric mean antitetanus IgG antibodies were higher in allergic (4.9 AU/ml) as compared to nonallergic (1.7 AU/ml) children (p < 0.001). Geometric mean antidiphtheria IgG antibodies were higher (0.31 AU/ml) in nonallergic and lower in allergic (0.10 AU/ml) subjects (p < 0.01). These data suggest that allergic individuals with markedly elevated total serum IgE have unique antibody responses following routine immunization with tetanus-diphtheria (Td) toxoids and tetanus-pertussis-diphtheria (DPT) which are manifest by enhanced specific IgE synthesis.