Local and systemic IgE in the evaluation and treatment of allergy

Abstract

Traditional descriptions of type I hypersensitivity and its manifestations center on systemic immunoglobulin E (IgE)-mediated reactions to inciting antigens. Hence, many current diagnostic and therapeutic measures are based on systemic skin testing for allergy, systemic pharmacotherapy, and immunotherapy. Recent developments in rhinology and pulmonology, particularly in defining the phenomenon of local IgE production in various airway inflammatory conditions, have an impact on both medical and surgical diagnosis and management of these conditions. This review includes a discussion of allergy as a systemic disease, current systemic diagnostic and management strategies for allergy, and local IgE presence and synthesis in the upper and lower airways.