Sensitization to major Dermatophagoides pteronyssinus allergens in house dust mite allergic patients from North Eastern Poland developing rhinitis or asthma.

PURPOSE: Recognition of individual allergens by IgE is crucial for triggering symptoms in allergic rhinitis (AR) or asthmatic (AA) patients. House dust mite (HDM) allergy is frequent around the world, the sensitization profile to individual HDM allergens varies in individual HDM-allergic patients (APs). The aim of this study was to evaluate the pattern of IgE sensitization to three major Dermatophagoides pteronyssinus (Dp) allergens among patients from North Eastern Poland suffering from HDM-AR and/or AA. PATIENTS AND METHODS: The study was performed on 323 HDM-AR and/or AA patients and 106 controls (CG) including 30 healthy non-atopic subjects, 32 AR patients not sensitized to Dp and 44 non-atopic asthmatics. IgE levels to natural (n)Der p 1, nDer p 2, recombinant (r)Der p 2.0101 and rDer p 23 allergens were measured by ELISA. RESULTS: The majority of HDM-APs were sensitized to nDer p 1 (72.1%), nDer p 2 (81.7%), rDer p 2.0101 (78.3%) and rDer p 23 (70.9%). The frequency of positive results to individual allergens depended on clinical manifestations and the level of IgE to the whole Dp extract. In HDM-AA patients, reactivity to nDer p 1 and rDer p 23 was detected more frequently than in HDM-AR patients. The whole Dp extract completely inhibited IgE binding to nDer p 1 and nDer p 2 but only partially to rDer p 23. CONCLUSIONS: HDM-APs from North-Eastern Poland display sensitization profile to major allergens which is similarly observed in western Europe. HDM-based diagnostic and therapeutic products should include all major allergens.

Serum immunoglobulin E reactivity to cross-reacting panallergen components in north-eastern Poland patients pollen sensitized.

Background: The presence of immunoglobulin E (IgE), which cross-reacts with allergen components, such as profilins, polcalcins, and cross-reacting carbohydrate determinants (CCD), creates a problem when selecting patients for allergen immunotherapy by using conventional methods. The aim of this study was to evaluate the prevalence of sensitization to profilins, polcalcins, and CCDs in patients with seasonal pollen allergic rhinitis. Methods: The study was performed on a group of 112 patients with seasonal pollen allergic rhinitis, ages 14 to 55 years, with sensitization to at least one seasonal allergen (IgE > 0.7 kUA/L). The presence of IgE sensitization to recombinant (r) Bet v 2, rPhl p 12, rBet v 4, rPhl p 7, and CCDs, in addition to rBet v 1, rPhl p 1, rPhl p 5, was evaluated by using a multiparameter immunoblot. Results: Among the studied patients, 64.3, 80.4, and 41.1% were sensitized to birch, timothy grass, and mugwort pollen, respectively. Sensitization to profilins rBet v 2/Phl p 12 was demonstrated in 28.6%, to polcalcins Bet v 4/Phl p 7 in 8.9%, and to CCDs in 25%. In 29.3%, serum IgE reactivity to any of the cross-reactive components could be demonstrated. Serum IgE reactivity to rBet v 2 was always accompanied by IgE reactivity to rPhl p 12, and IgE reactivity to rBet v 4 was always accompanied by IgE reactivity to rPhl p 7. Among the patients with pollinosis co-sensitized to at least two allergen sources according to extract-based diagnosis, possible false-positive results due to sensitization to cross-reactive components were detected in 17.9%. Conclusion: Evaluation of sensitization to cross-reacting components may be useful in evaluation of patients with pollen allergy who are being assessed for allergen immunotherapy to optimize the constitution of their immunotherapy vaccines.

Natural history of Hymenoptera venom allergy in children not treated with immunotherapy.

BACKGROUND: Differences in treatment approach still exist for children after systemic sting reactions. In addition, there are still some doubts about when systemic reactors should be treated with venom immunotherapy (VIT). OBJECTIVE: To determine the rate of sting recurrence and natural history of Hymenoptera venom allergy (HVA) in children not treated with VIT. METHODS: A total of 219 children diagnosed as having HVA who were not treated with VIT were identified in 3 pediatric allergology centers. Survey by telephone or mail with the use of a standardized questionnaire was conducted. The number of field re-stings, subsequent symptoms, and provided treatment were analyzed. RESULTS: A total of 130 of the 219 patients responded to the survey, for a response rate of 59.4%. During the median follow-up period of 72 months (interquartile range, 52-85 months), 44 children (77% boys) were stung 62 times. Normal reactions were most common, occurring in 27 patients (62%). Severe systemic reactions (SSRs) occurred in 8 (18%) of those who were re-stung. The subsequent reaction was significantly milder (P < 0.001), especially in the case of patients re-stung by the same insect (P < .001). None of the children with prediagnostic large local reactions and negative test results for venom specific IgE developed SSRs after re-sting by the culprit insect (P = .03). In children with SSRs, median time from diagnosis to re-sting was 2 times longer than that in those with large local reactions and normal reactions (P = .007). CONCLUSIONS: Most children with HVA not treated with VIT reported milder reactions after a re-sting. Probability of SSR to re-sting increases along with the severity of initial reaction.

Long-term intense exposure to grass pollen can mask positive effects of allergenic immunotherapy on non-specific bronchial hyperresponsiveness.

INTRODUCTION: There are many potential factors that can modulate bronchial reactivity, including exposure to allergens, viral infections, and medications. The aim of this study was to analyze the effect of grass pollination intensity on the bronchial reactivity in seasonal allergic rhinitis (SAR) patients subjected to subcutaneous allergenic immunotherapy (SCIT). MATERIAL AND METHODS: This study, performed between 2005 and 2008, included 41 patients with confirmed sensitivity to grass pollens and predominating symptoms of SAR, randomly assigned to desensitization by pre-seasonal or maintenance SCIT. Bronchial provocation challenge with histamine was performed before the onset of immunotherapy, and repeated three times after each pollen season covered by this study. Bronchial reactivity was analyzed with regard to grass pollination intensity in 2005-2008 (air concentration of grass pollen grains, seasonal number of days when air concentration of grass pollen reached at least 20 or 50 grains per 1 m(3)). RESULTS: After 3 years of SCIT, a significant decrease in bronchial responsiveness was observed in the analyzed group as confirmed by an increase in PC20 FEV1 histamine values (p = 0.001). An inverse tendency was observed after 2 years of SCIT, however. This second year of SCIT corresponded to the 2007 season, when a significantly higher number of days with at least 50 grains of pollen per 1 m(3) of air was recorded. CONCLUSIONS: FLUCTUATIONS IN POLLINATION INTENSITY OBSERVED DURING CONSECUTIVE YEARS OF IMMUNOTHERAPY CAN INFLUENCE BRONCHIAL REACTIVITY IN PATIENTS SUBJECTED TO SCIT (ISRCTN REGISTER: ISRCTN 86562422).

Mannitol challenge does not confirm bronchial hyperreactivity in some histamine-responsive asthmatic children.

OBJECTIVE: The aim of this study was to compare the usefulness of mannitol provocation test to that of classical histamine challenge in children with PC(20)FEV(1) histamine lower than 4 mg/ml. METHODS: Twenty-two adolescent patients (mean age of 15.4 ± 4.1 years) with established asthma (PC(20)FEV(1) histamine below 4 mg/ml) were included in this study. Bronchial challenge with mannitol was performed 1-2 days after the test with histamine. RESULTS: The fraction of positive results of mannitol test was markedly lower when compared with the histamine challenge (72.7% vs. 100%, p = .015). The test was discontinued in one case due to severe coughing after inhalation of 315 mg of mannitol. Coughing during inhalation of dry mannitol powder occurred in most patients, although drinking water after subsequent doses alleviated this symptom in nearly all of them. Of note, triboelectrification of the inhaler and capsules was observed during the administration of consecutive mannitol doses, markedly hindering the delivery of this provoking agent. The relative decrease in FEV(1) resulting from bronchial provocation was significantly lower following mannitol delivery when compared with the histamine test (70.3% vs. 81.6% of resting value, p < .001). Significant correlation was not observed between the values of PC(20)FEV(1) histamine and PD(15)FEV(1) mannitol levels. CONCLUSIONS: Bronchial challenge with mannitol can be used as a screening test in everyday practice, but one cannot exclude bronchial hyperresponsiveness based on its negative results. Moreover, its usefulness is limited by the influence of static on the delivery of sequential mannitol doses and coughing which can be often associated with mannitol inhalation.

Allergenic immunotherapy and seasonal changes in nitric oxide concentration in exhaled air in seasonal rhinitis patients.

BACKGROUND: Concentration of nitric oxide in exhaled air (FeNO) was revealed to decrease as a result of immunotherapy. However, individuals who are exposed to environmental allergens are characterized by elevated values of FeNO. The aim of this study was to analyze the effects of subcutaneous immunotherapy (SCIT) on the dynamics of FeNO determined during consecutive pollination seasons. METHODS: This study, performed between 2005 and 2008, included 41 patients with confirmed sensitivity to grass pollens and predominating symptoms of seasonal allergic rhinitis, randomly assigned to desensitization by preseasonal or maintenance SCIT. FeNO was measured prior to and during each pollen season (November-January and May-July, respectively). The results were conferred to data on grass pollination intensity in 2006-2008 (air concentration of grass pollen grains, seasonal number of days when air concentration of grass pollen reached at least 50 grains per 1 m(3)). RESULTS: Median content of FeNO in exhaled air was significantly higher in 2007 compared to 2006 and 2008 pollen seasons. During 2007 and 2008 pollen seasons, significant increase in FeNO was observed compared to the respective preseasonal values. Median number of days with air concentration of grass pollen ≥ 50 grains per 1 m(3) of air during 4 weeks preceding seasonal FeNO measurement was significantly higher in 2007, corresponding to higher FeNO value recorded during this pollen season. However, no significant correlation was observed between seasonal number of days with ≥ 50 grass pollen grains per 1 m(3) of air and FeNO in exhaled air (r=0.09, p=0.362). CONCLUSIONS: Most seasonal allergic rhinitis patients show physiological levels of FeNO prior to the pollen seasons and a marked increase in this parameter, probably proportional to pollination intensity, is observed within the seasons. ISRCTN Registry: ISRCTN86562422.

Health-related quality of life in Polish adolescents with Hymenoptera venom allergy treated with venom immunotherapy.

INTRODUCTION: Venom allergy, though rare, may seriously influence health-related quality of life (HRQoL). There is a paucity of research on HRQoL of adolescents and young adults with Hymenoptera venom allergy. The aim was to assess the level of HRQoL and to evaluate its independent predictors in Polish adolescents and young adults treated with venom immunotherapy. MATERIAL AND METHODS: A multicenter cross-sectional study based on the Vespid Allergy Quality of Life Questionnaire (VQLQ) adapted for Polish adolescents was used. The study sample included 87 patients (14-21 years) studied at different stages of venom immunotherapy (VIT). Statistical analysis was done with multivariate linear regression. RESULTS: Anxiety level was higher in patients with 4(th) grade of Mueller's classification (anaphylactic shock) than in those with 3(rd) grade (B = 0.84, 95% CI = 0.07-1.61, p = 0.03). Caution increased along with an increase of anxiety of adolescents treated with VIT (B = 0.54, 95% CI = 0.39-0.68, p < 0.01). Level of limitations increased with increasing caution of adolescents (B = 0.63, 95% CI = 0.35-0.91, p < 0.01). Discomfort increased along with a rise of caution of patients (B = 0.38, 95% CI = 0.22-0.55, p < 0.01). Similarly, it increased with an increase of their feeling of limitations (B = 0.37, 95% CI = 0.23-0.51, p < 0.01). The level of discomfort in adolescents treated with VIT was lower in those who were treated with conventional protocol in comparison to those treated with rush or ultra-rush ones (B = -0.47, 95% CI = -0.90 - -0.03, p = 0.04). CONCLUSIONS: Severity of anaphylactic reaction is an independent determinant of anxiety level in adolescents treated with VIT. The VIT protocol affects HRQoL of treated patients.

Oral corticosteroid sparing with omalizumab in severe allergic (IgE-mediated) asthma patients.

BACKGROUND: Long-term oral corticosteroid (OCS) therapy and related adverse events are associated with a significant burden on patients and healthcare resources. METHODS: This subgroup analysis of a randomized, open-label, parallel-group study evaluated the OCS-sparing effect of omalizumab (OMA) added to optimized asthma therapy (OAT), compared with OAT alone. Patients (12-75 years) with severe allergic asthma, uncontrolled despite GINA 2004 Step 4 therapy, received OMA or OAT for 32 weeks. The change from baseline in OCS use by Week 32 in patients requiring maintenance OCS at baseline was assessed in terms of percent OCS dose change and numbers of patients with reduced/stopped or maintained/increased OCS. RESULTS: Eighty-two patients were receiving maintenance OCS at baseline (OMA/OAT n = 59, OAT n = 23). Change from baseline in mean maintenance OCS dose at Week 32 was significantly greater in the OMA/OAT group compared with the OAT group (-45% vs. + 18.3%, p = 0.002). In the OMA/OAT group, 37 patients (62.7%) reduced/stopped OCS use at Week 32, compared with seven patients (30.4%) receiving OAT (p = 0.013). Improvements in other efficacy outcomes were seen at Week 32 in the OMA/OAT group, irrespective of OCS use. An investigator global evaluation of treatment effectiveness at Week 16 was an effective predictor of persistent treatment response at 32 weeks for the majority of OMA/OAT patients (93%), also irrespective of OCS use. CONCLUSION: In this open-label study of patients with severe allergic asthma, OMA/OAT therapy reduced maintenance OCS use, compared with OAT alone. Improvements in efficacy measures were observed in the OMA/OAT group, irrespective of OCS change. CLINICALTRIALS.GOV IDENTIFIER: NCT00264849.

Antiasthmatic versus surgical treatment-how important is the precise analysis of spirometry?

OBJECTIVE: Carcinoids are low-grade, slow growing malignant tumors in the bronchi usually producing symptoms secondary to bronchial obstruction. We describe a case of 25-year-old woman who was initially diagnosed with asthma. METHOD: Case report. RESULTS: Because of exacerbation and unresponsiveness to proper asthma treatment she was referred to spirometry, which showed low values of forced expiratory volume in 1 second. The shape of inspiratory limb of flow volume curve suggested an obstruction in the main bronchus or in the trachea. Further bronchoscopy revealed a tumor of the right main bronchus with characteristic histological features for carcinoid. CONCLUSIONS: Both the inspiratory curve and the expiratory part of the flow-volume loop should be evaluated in patients being evaluated for asthma. If there are changes in the shape of the inspiratory limb suggesting an obstruction, CT and/or bronchoscopy should be considered.

Bronchial allergen challenge in allergic children: continuous increase of nitric oxide in exhaled air 72 hours after allergen inhalation independent of bronchial obstruction.

BACKGROUND: Changes in fractional exhaled nitric oxide (FeNO) occurring after bronchial allergen challenges (BAC) are still not understood, neither are any possible associations between FeNO and forced expiratory volume in 1 sec (FEV(1)). The aim of the study was to compare the fluctuations of FeNO and FEV(1), which occur within 72 h of BAC in children sensitive to grass pollen. METHODS: Seventy-four children were divided into two groups based on their medical histories and the results of skin prick tests with 10 common allergens. Individuals in whom the test yielded a positive result to at least grass pollen (Group A, n = 57), and those with negative test results against all of the allergens applied (Group B, n = 17) were subjected to BAC. FeNO was measured at a baseline and at 1, 8, 21, and 72 h after the last dose of the allergen inhalation, whereas FEV(1) was measured at a baseline, hourly for 8 h after the challenge and at 21 and 72 h thereafter. RESULTS: Baseline FeNO in sensitive subjects (Group A) was significantly higher than in controls of Group B. In all grass pollen-sensitive subjects, even those that were free of a bronchial response, FeNO was markedly elevated compared to its baseline values, starting from the eighth hour onward, and still increased 72 h post-BAC, whereas FEV(1) returned to a baseline at the 72nd h post-BAC. The highest increase in FeNO was registered in individuals with a dual asthmatic response. CONCLUSIONS: An increase in FeNO in sensitive subjects starts a few hours later than the decrease in FEV(1). Consequently, measurements of FeNO seem to be useful in long-term monitoring of the allergic reaction triggered by a specific allergen.

[Diagnosis and venom specific immunotherapy (VIT) in allergic children in Poland--how much the current practice follows the international guidelines?]. / Diagnostyka i immunoterapia u dzieci z alergia na jad owadów blonkoskrzydlych (VIT) w Polsce--jak wyglda w praktyce zgodnosc z miedzynarodowymi wytycznymi?

INTRODUCTION: Insect venom allergy requires a high level approach adequate to allergy intensity. In case of severe IgE-mediated sting reactions, in children older than five years, venom immunotherapy is a treatment of choice. AIM: Identification of current practices applied to venom allergic children in Poland and their adherence to the international guidelines. METHOD: Questionnaire survey concerning diagnostic and treatment rules was carried out in 8 centres of pediatric allergology, based on a similar audit conducted in the United Kingdom [Diwakar L. et al. Clin Exp Allergy 2008, 38: 1651]. RESULTS: In 5 centres both RAST and SPT tests were used as the first line of investigation. Subsequently 6 centres performed IDT. In three centres baseline serum tryptase levels were estimated. In case of sensitization to both bee and wasp venom in a child with the history of severe systemic reaction, but uncertain culprit insect, specific venom immunotherapy with both venoms was practised by 2 centres. In systemic reaction and not-detectable IgE in 6 centres child was followed-up in 6-12 months. Antihistamine premedication concerned all children in 7 centres. Six-week interval between booster doses was applied in half of centres. A target dose equal 100 mcg was used in 7 centres. Similarly all centres practiced 3-5 five year period of VIT. CONCLUSIONS: In Poland current practice with venom allergic children was conducted in congruence with most of the recommendations.

[Adaptation of Vespide Allergy Quality of Life Questionnaire for Polish children with venom allergy and for their parents]. / Adaptacja kwestionariuszy jakosci zycia dla dzieci z alergia na jad owadów oraz dla ich rodziców.

Aim of the study was to assess validity and reliability of adaptations of VQLQ for Polish children with Hymenoptera venom allergy and their parents. Sample under study consisted of 73 children aged up to 14 years, who were treated with specific venom immunotherapy (VIT) in 2008 in centres conducting this procedure in Poland, and their parents. Theoretical validity of the scales was assessed with exploratory factor analysis using principal component analysis method. Reliability of the scales was assessed in terms of internal consistency with Cronbach alpha coefficient. Results of analysis showed that both scales measure 4 dimension of quality of life and reliability of scales measuring particular dimensions is at least acceptable in case of scale for children, and high in case of scale for parents. Both adapted scales are valid and reliable tools measuring quality of life in children with Hymenoptera venom allergy and their parents' quality of life in the face of child's allergy.

[Health-related quality of life in children with Hymenoptera venom allergy treated with VIT and quality of life of their parents]. / Jakosc zycia warunkowana stanem zdrowia dzieci z alergia na jad owadów blonkoskrzydlych leczonych VIT oraz jakosc zycia ich rodziców.

UNLABELLED: Hymenoptera venom allergy, although rare in children, by its potential fatalities, leads to many psychosocial consequences, influencing quality of life of children and their parents. Aim of this paper is the estimation of health-related quality of life of venom allergic children treated with specific immunotherapy, and their parents. Assessment of factors influencing health-related quality of life levels was also performed. MATERIAL AND METHODS: Sample under study consisted of 73 children: mean age 10.6, SD 2, 4, treated because of Hymenoptera venom allergy in 5 clinical allergy centers in Poland. Data was collected using VQLQ questionnaire adapted for children and their parents. Determinants of quality of life were assessed with multivariate linear and logistic regression models. Analysis were done with SPSS 15 for Windows package. RESULTS: Girls reported higher level of anxiety than boys (B = 0.47; 95% CI = (0.01; 0.94)). Level of caution in children increased along with increase of their anxiety against re-sting (B = 0.49; 95% CI = (0.27; 0.71)). Level of anxiety of children who were under treatment from 6 months to 2 years was lower than level of anxiety of parents of children treated shorter than 6 months (B = -1.21; 95% CI = (-2.16; -0.25)). The lowest level of caution was reported by parents of children aged 10 year or less (B = -0.86; 95% CI = (-1.67; -0.05)), while the highest was reported by parents of children aged 11 years (B = 0.86; 95% CI = (0.20; 1.53)) in comparison to parents of children aged 12 years or more. Parents' caution increased along with increase of their anxiety (B = 0.61; 95% CI = (0.40; 0.83)). Higher level of limitations was imposed by parents of children treated with rush or ultra rush method, in comparison to parents of children treated with conventional method (B = 1.27; 95% CI = (0.21; 2.33)). Levels of quality of life in children and their parents were strongly dependent in the same dimensions. CONCLUSIONS: 1. Levels of quality of life in particular dimension in children is related to level of the same dimension in parents. 2. Age of children influenced level of caution of their parents. 3. Treatment duration influenced level of anxiety of parents. 4. Safety feeling acquired by parents at the beginning of treatment improves their quality of life in all dimensions.

[Fifty percent of pollinosis patients sensitive to birch pollen demonstrate bronchoconstriction during bronchial provocation test with the allergen]. / Polowa chorych na pylkowice, uczulonych na pylek brzozy, reaguje skurczem oskrzeli w trakcie oskrzelowego testu prowokacyjnego z alergenem.

UNLABELLED: Birch pollens are known as seasonal asthma precipitants. Our earlier studies evidenced a very high frequency of positive results bronchial allergen challenges in pollinosis patients sensitive to grass pollen. The aim of the study was to evaluate how often the bronchial challenge with birch pollen allergen causes bronchoconstriction. MATERIAL AND METHODS: Studies were performed outside of pollen season on 30 patients sensitive to birch pollen allergen. Before the allergen challenges bronchial provocation tests with methacholine were performed in all subjects. RESULTS: About 13% of examined group had bronchial hyperreactivity (PC20FEV1Mch < 8 mg/ml) and 50% demonstrated bronchoconstriction after birch pollen allergen inhalation. CONCLUSIONS: About 13 percent of patients sensitive to birch pollen demonstrated nonspecific hyperrectivity out of pollen season. Bronchial birch allergen challenge tests are positive in about half of birch sensitive patients with pollinosis.

[The estimation of treatment of Hymenoptera venoms allergy in children]. / Ocena sposobów immunoterapil dzieci uczulonych na jady owadów blonkoskrzydlych.

Specific immunotherapy in patients hypersensitive to Hymenoptera venom is effective method of preventing from severe adverse events after wasp or honey bee sting. In children very often the conventional method was used. In this method injections of vaccines in rising doses was repeated in intervals of 7 days during 3 or 4 months. After obtaining the dose of 100 microg/ml the maintenance therapy is continued during 3-5 years with prolongation of time between vaccine injection to 4-5 weeks. In this paper the "rush" method of immunotherapy was described. Using this method the maintenance dose of vaccine can obtained after 5 days therapy using 3 to 5 concentrations of vaccines during one day. The preliminary effects in 10 children showed that it is safe method and except one children who have the local manifestation of oedema did not observed adverse effects. The efficacy of sting immunotherapy was documented by presentation the 31 cases of children treated by conventional method. The immunotherapy in a short time after "rush" method in our opinion make progress in this treatment.

[Seasonal changes in serum level of eosinophil-derived neurotoxin, interleukin-18, and interferon-gamma in pollinosis patients]. / Sezonowe zmiany stezenia neurotoksyny eozynofilowej, interleukiny 18 i interferonu gamma w surowicy chorych na pylkowice.

UNLABELLED: Pollinosis is the most common disease in the world in people touched by atopy. The aim of the study was to evaluate seasonal changes in serum levels of EDN, IL-18, and IFN-gamma. MATERIAL AND METHODS: Studies were carried out on a group of 30 patients suffering from pollinosis, sensitive to pollen of Ryegrass engl. Twenty healthy subject were considered as a control group. Blood samples were collected in June and December. The concentrations of above mentioned substances were evaluated using ELISA method. RESULT AND CONCLUSION: In pollen season the significant increase in concentration of EDN, and IL-18, and no changes in serum concentration of IFN-gamma were found.

[Seasonal changes in bronchial reactivity in pollinosis patients]. / Sezonowe zmiany reaktywnosci oskrzeli u chorych na pylkowice.

THE AIM OF THE STUDY: To evaluate seasonal changes in bronchial hyperreactivity (BHR) in patients suffering from pollinosis, sensitive to Ryegrass engl. MATERIAL AND METHODS: The studies were carried out on 26 patients and 20 healthy subjects. All the patients had a history of seasonal allergic rhinitis. The following measurements were performed outside and during the pollen season: bronchial provocation test (BPT) with metacholine and 4.5% NaCl, serum concentration of specific and total IgE. RESULTS: Outside the pollen season additionally the BPT with Ryegrass engl. allergen was performed and 88% of the pollinosis patients had positive result of the test. After 4.5% NaCl bronchial challenge positive results had 2 out of 26 patients outside the season, and 3 during the season. Bronchial hyperreactivity to metacholine (PC20 < 8 mg/ml) were observed in 4/26 (15.4%) persons outside the season and in 7 (26.9) during the season. The healthy subjects had no bronchoconstriction neither after metacholine or 4.5% NaCl. During the pollen season the increase in serum concentration of tIgE and sIgE was observed only in pollinosis patient. CONCLUSIONS: There was not found a correlation between BHR to the allergen and serum total IgE nor specific IgE concentration.