Common immunoglobulin E (IgE) - what is this test and why is it done?

Total immunoglobulins E in human serum are gamma globulins that are produced by B lymphocytes. They take part in immediate reactions and provide antiparasitic protection. At the Yusupov Hospital, immunoglobulin E tests are prescribed by allergists, pulmonologists, gastroenterologists, internists, and hematologists.

The research is carried out by experienced laboratory technicians who use high-quality ingredients for the research to obtain accurate results. The Yusupov Hospital employs candidates and doctors of medical sciences, doctors of the highest category, who are leading immunologists. Complex cases are discussed at a meeting of the expert council. Doctors collectively decide how to reduce immunoglobulin.

Doctors at the therapy clinic use the results of the study to diagnose allergic diseases, helminthic infestations, and immunopathological diseases. With their help, the risk of developing allergic reactions in children is assessed. Class E immunoglobulins are involved in the development of atopic allergic reactions (rhinitis, bronchial asthma, urticaria, atopic dermatitis). They quickly attach to the surface of mast cells and basophils of the skin and mucous membranes. Upon repeated contact of reagin IgE with an allergen on the surface of these cells, vasoactive substances (histamine, heparin, serotonin) are released from them and the development of clinical manifestations of an allergic reaction.

Immunoglobulin E is elevated in 75% of children whose parents have allergic diseases. In healthy children, with an increase in immunoglobulin E, the risk of developing allergic diseases over the next 18 months increases 10 times compared to children whose level of total immunoglobulin E is not increased. If the total immunoglobulin is elevated, this means that the patient has an allergy. In order to determine the allergen that is the cause of the disease, it is necessary to identify immunoglobulins E. specific to it.

Immunoglobulins E play a significant role in the formation of antiparasitic immunity to Toxoplasma, roundworms, echinococci, nematodes, trichinella and other parasites. This is due to the ability of immunoglobulins E to interact with helminth antigens. If total immunoglobulin is elevated, it can be assumed that the patient has a parasitic infestation.

Method for determining immunoglobulins E

To determine the level of immunoglobulin E, laboratory assistants at the Yusupov Hospital use venous blood. The patient is advised to prepare for the study:

• before taking the test, do not eat for 2-3 hours (you can drink clean still water);
• exclude physical and emotional stress for 30 minutes before donating blood;
• do not smoke for three hours before the test.

Immunoglobulins E are determined by solid-phase chemiluminescent enzyme-linked immunosorbent assay, which is called the “sandwich” method. In people over 16 years of age, the normal level of immunoglobulin B ranges from 0 to 100 IU/ml.

Normal values

Immunoglobulins G penetrate through the placenta to the fetus, so their level in newborns is high, and during the first year it decreases, as maternal immunoglobulins are replaced with their own. The normal limits depend on the age and gender of the patient.

• in the first month of life – 3.97-17.65 g/l for boys, 3.91-17.37 g/l for girls
• from 1 month to one year – 2.05-9.48 g/l for boys, 2.03-9.34 g/l for girls
• from one year to 2 years – 4.75-12.10 g/l for boys, 4.83-12.26 g/l for girls
• from 2 to 80 years – 5.40-18.22 g/l for boys and men, 5.52-16.31 g/l for girls and women

Immunoglobulins A are unable to cross the placental barrier; in newborns, their concentration in the blood is very low. Self-synthesis of antibodies is fully established by the age of 5 years. The normal values ​​for immunoglobulin A are:

• in the first 3 months of life – 0.01-0.34 g/l
• from 3 months to a year – 0.08-0.91 g/l
• from one year to 12 years – 0.21-2.91 g/l for boys, 0.21-2.82 g/l for girls
• from 12 to 60 years – 0.63-4.84 g/l for boys and men, 0.65-4.21 g/l for girls and women
• after 60 years – 1.01-6.45 g/l for men, 0.69-5.17 g/l for women

Immunoglobulins M have a large molecular weight and do not cross the placenta during pregnancy. In children, the concentration of antibodies increases gradually, reaching adult values ​​by the age of 7-12 years:

• in the first 3 months of life – 0.06-0.21 hl
• from 3 months to one year – 0.17-1.43 g/l for boys, 0.17-1.50 g/l for girls
• from one year to 12 years – 0.41-1.83 g/l for boys, 0.47-2.40 g/l for girls
• after 12 years – 0.22-2.40 g/l for boys and men, 0.33-2.93 g/l for girls and women

A physiological decrease in the level of immunoglobulins can be detected during pregnancy, an increase - during intense physical activity or the experience of strong emotions.

Level up

Immunoglobulins are markers of an infectious process in the body; the most common reason for an increase in their level in the blood is respiratory and gastrointestinal infections. An increase in the concentration of IgG and IgA antibodies is characteristic of chronic processes; the number of IgM antibodies increases in both acute and chronic forms of diseases. Other reasons for increased levels of immunoglobulins include autoimmune pathologies, liver damage, as well as multiple myeloma and other monoclonal gammopathies.

Level reduction

The most common reason for a decrease in immunoglobulin levels is acquired deficiency. The concentration of antibodies decreases when their production is disrupted - with neoplasms of the lymphatic system, lymphoproliferative diseases. In addition, the level of immunoglobulins decreases with their increased breakdown and rapid elimination of protein - during irradiation, the use of drugs (for example, cytostatics), enteropathies, nephropathies and burns. Less commonly, the cause of a decrease in immunoglobulin levels is congenital deficiency. It develops with congenital agammaglobulinemia, ataxia-telangiectasia (IgA), Wiskott-Aldrich syndrome (IgG) and selective IgM deficiency.

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Immunoglobulin is elevated in an adult - reasons

If immunoglobulin E is elevated, what does this mean? Immunoglobulin E may be elevated in the presence of parasitic infestations - ascariasis, intestinal nematode, echinococcosis, hookworm disease, amoebiasis, helminth larval migration syndrome. Immunoglobulin levels are also elevated in patients suffering from allergic bronchopulmonary aspergillosis. Elevated immunoglobulin in the blood is detected in patients with allergic diseases caused by IgE antibodies:

• atopic bronchial asthma;
• allergic rhinitis and sinusitis;
• atopic dermatitis;
• drug and food allergies.

Total immunoglobulin ig E may be elevated due to anaphylaxis, urticaria, and angioedema. High immunoglobulin in patients suffering from immunopathological diseases:

• IgE myeloma;
• periarteritis nodosa;
• hypereosinophilia syndrome;
• hyper-IgE syndrome;
• recurrent pyoderma;
• pemphigus (Neumann's syndrome).

Immunoglobulin may also be exceeded in the case of graft-versus-host disease.

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Evaluation of patients with high immunoglobulin B levels

If a patient has a very high level of immunoglobulin E in the blood, this is not enough to diagnose an allergy. To search for the allergen that caused the disease, doctors at the Yusupov Hospital identify specific antibodies of the immunoglobulin E class. Currently, laboratory technicians determine allergen-specific immunoglobulin E in serum for six hundred allergens that most often cause allergic reactions in humans.

If specific immunoglobulin E to any antigen or allergen is detected in the blood serum, this is not conclusive evidence that this particular allergen is responsible for the clinical symptoms. Allergists at the Yusupov Hospital interpret research results only after comparing them with the clinical picture of the disease and a detailed allergological history. The absence of specific immunoglobulin E in the blood serum does not exclude the possibility that an IgE-dependent mechanism is involved in the development of the disease, since local production of immunoglobulin E and sensitization of mast cells can occur in the absence of specific immunoglobulin E in the blood. This happens with allergic rhinitis. Antibodies of other classes that are specific for a given allergen may cause false negative results.