Allergic bronchopulmonary aspergillosis: Diverse effects of acute phase illness and prednisone on total and specific serum immunoglobins

The changes in total serum IgE, specific IgE and specific IgG against Aspergillus fumigatus in patients with allergic bronchopulmonary aspergillosis were examined. Both total IgE and specific IgE declined with prednisone therapy and clinical remission but the decline in total IgE was significantly greater in 4 of 5 patients. The rise and fall in total IgE, specific IgE and specific IgG were examined during recurrences of allergic bronchopulmonary aspergillosis and repeat remissions. All three factors rose and also fell but there was a discordance between time of peak levels of IgE and specific IgE. We proposed that Aspergillus fumigatus may have a stimulatory effect of T helper cells for total IgE. The changes occurring from prednisone may be the result of greater suppression of subsets of T helper cells for total IgE as compared with T helper cells for specific IgE.