Effect of moderate malnutrition on immediate hypersensitivity and immunoglobulin E levels in asthmatic children

Dermal reactions and IgE levels were compared in 51 asthmatic Colombian children identified on the basis of anthropometric measurements as nutritionally normal (25) or mildly (16) or moderately (10) undernourished. Twenty-five nonatopic children served as controls. Total serum IgE concentrations were significantly elevated in the asthmatic group as a whole. Moderately malnourished (grade 11) asthmatic children had more than twice as much serum IgE as normal or mildly malnourished (grade I) asthmatic subjects and seven times more than nonatopic children. Intestinal parasitism did not appear to contribute to these differences in IgE levels. Serum levels of IgA and IgD were similarly elevated in grade II asthmatics. Concentrations of serum IgG, IgM, and C3 and C4 complement were unaffected by nutritional or allergic status. Eosinophilia in nasal mucus was significantly reduced in grade I and grade II malnourished asthmatic children. Among asthmatics, the most frequent dermal reactions were to mite antigens (96%), house dust (67%), and grass pollens (35%). Significant levels of specific IgE were detected by the RAST to two species of mites in nearly all atopic children. There was no apparent influence of nutritional status on the distribution of reactivity to a particular allergen by either dermal reactivity or specific IgE assay. The clinical significance of hyper immunoglobulin E in atopic, moderately malnourished children remains to be elucidated.