‘Entopy’: localized mucosal allergic disease in the absence of systemic responses for atopy
Open accessAbstract
Summary: Background The Th2 immune response in the nasal mucosa of subjects with allergic rhinitis is mediated by allergen‐specific IgE. Moreover, these subjects show positive responses for markers of systemic atopy, including allergen‐specific skin sensitivity and raised serum IgE titres. In contrast, idiopathic rhinitis (IR) subjects with similar histological nasal mucosal features differ in being defined as non‐allergic because they have negative atopic responses. Objective We hypothesized that it is possible to have an allergic Th2 disease pathway localized in the nasal mucosa of ‘non‐allergic’ rhinitis subjects despite an absence of atopic responses. Methods The presence of house dust mite and grass pollen‐specific IgE antibodies was investigated in non‐atopic (n=10) and atopic (n=11) subjects with persistent rhinitis and compared to normal (n=12) control subjects. Biotin‐labelled allergen was used to localize specific allergen‐binding antibodies in situ in sections of nasal mucosa. Results Grass pollen allergen binding was detected in the nasal mucosa of 3/10 non‐atopic IR subjects but, in contrast, dust mite‐specific antibodies were not detected. Specific antibodies were present in a total of 8/11 mucosal samples from the allergic group, but none was detected in normal control tissues. Conclusion These findings support the concept of localized nasal allergy in ‘non‐atopic’ rhinitis subjects. We propose the term ‘entopy’ to define this phenomenon and believe that this concept has a wider implication for localized allergic responses in other mucosal sites.
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Locally produced IgE plays a key role in ongoing inflammation by up-regulating FcεRI expression in mast cells.
“The locally produced IgE plays a key role in ongoing inflammation by up-regulating FcεRI expression in mast cells.283-285”
From International Consensus Statement on Allergy and Rhinology: Allergic Rhinitis (2018) · cites this paper as [284]
The Discussion (page unavailable) links localized nasal IgE production with mucosal allergic inflammation and reports allergen co-localization with mast cells. It does not say that locally produced IgE sustains inflammation by up-regulating FcεRI expression in mast cells; the paper instead suggests that inflammatory cells may help maintain IgE production. (LLM, conf=0.85)
Experimental — accuracy not yet measuredSeveral in vivo and in vitro studies have confirmed production of local IgE in the nasal mucosa of AR patients.
“Several studies, both in vivo and in vitro have confirmed the production of local IgE in the nasal mucosa of patients with AR.282-284”
From International Consensus Statement on Allergy and Rhinology: Allergic Rhinitis (2018) · cites this paper as [284]
The Discussion (page unavailable) describes nasal B cells locally producing IgE and reports mucosal allergen binding in allergic rhinitis subjects; the References also identify studies of local IgE production. Our copy does not establish the claim’s distinction that both in vivo and in vitro studies confirmed this finding. (LLM, conf=0.83)
Experimental — accuracy not yet measuredLAR is a regional inflammatory condition defined by local symptoms and sIgE-mediated inflammation without evidence of systemic hypersensitivity.
“LAR is a regional inflammatory condition defined by local symptoms and sIgE-mediated inflammation without evidence of systemic hypersensitivity.107,194,284,288”
From International Consensus Statement on Allergy and Rhinology: Allergic Rhinitis (2018) · cites this paper as [284]
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References 31 · Cited by 200
Research works printed but not linked: 3
- Bobrow M, Harris T, Shaughnessy K, Litt G. Catalyzed reporter deposition, a novel method of signal amplification. J Immunol Methods 1989; 125:279-85.
- Powe DG, Huskisson RS, Carney AS et al. Is idiopathic rhinitis a highly-localised form of allergic rhinitis, confined to the nasal mucosa? J Allergy Clin Immunol 2001; 107:784.
- Varney V, Jacobson M, Sudderick R et al. Immunohistology of the nasal mucosa following allergen-induced rhinitis. Am Rev Respir Dis 1992; 146:170-6.
- Authors
- Powe, D. G., Jagger, C., Kleinjan, A., Carney, A. S., Jenkins, D., & Jones, N. S.
- Affiliations
- Erasmus University Rotterdam (NL)
- Flinders Medical Centre (AU)
- Queen's Medical Centre (GB)
- Corresponding author
- Powe, D. G.
- Venue
- Clinical & Experimental Allergy
- Publisher
- Wiley
- Published
- 2003-10
- Volume
- 33
- Issue
- 10
- Pages
- 1374-1379
- ISSN
- 0954-7894 (ISSN-L)
- 1365-2222
- OpenAlex
- W2140517434
- Cited by
- 200
- References
- 31
- Citations by year
- 2026: 1 · 2025: 9 · 2024: 8 · 2023: 3 · 2022: 9 · 2021: 9 · 2020: 8 · 2019: 6 · 2018: 10 · 2017: 10 · 2016: 18 · 2015: 7 · 2014: 13 · 2013: 13 · 2012: 12
- FWCI
- 1.76
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Clinical & Experimental Allergy (publishedVersion)
- PubMed (publishedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (publishedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (submittedVersion)
- Flinders Academic Commons (Flinders University) (submittedVersion)
- Topics
- Health Sciences › Medicine › Immunology and Allergy › Allergic Rhinitis and Sensitization
- Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
- Health Sciences › Medicine › Immunology and Allergy › Food Allergy and Anaphylaxis Research
- Keywords
- vasomotor rhinitis, allergic rhinitis, house dust mite allergens, grass pollen allergens, specific IgE, Th2 immune response, nasal mucosa, atopy
- MeSH terms
- Adolescent, Adult, Allergens, Animals, B-Lymphocytes, Female, Humans, Immunoglobulin E, Male, Mast Cells, Middle Aged, Mites, Nasal Mucosa, Plasma Cells, Pollen, Rhinitis, Rhinitis, Allergic, Perennial
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