Increased peripheral blood monocytes with Fc receptors for IgE in patients with severe allergic disorders.

Peripheral blood monocytes, defined as latex bead-ingesting mononuclear cells, from 15 healthy nonallergic donors and 22 patients with allergic disorders were analyzed for Fc receptors for IgE (Fc epsilon) by a rosette assay employing ox erythrocytes coated with IgE. The patients were divided into 3 groups. Group I: 12 patients with mild to moderate atopic disease and serum IgE levels up to 2300 IU/ml. Group II: 6 patients with severe generalized atopic dermatitis, allergic rhinitis, and asthma, of which 5 had IgE serum levels of 8000 to 77,500 IU/ml. Group III: 4 severely atopic patients with IgE levels greater than 10,000 IU/ml and receiving oral corticosteroids. The numbers of monocytes were similar in healthy donors and patients. In contrast, severely atopic patients (Group II) had significantly more (p less than 0.01) Fc epsilon + monocytes (107 +/- 42/mm3) than healthy donors (20 +/- 14/mm3) or patients of Group I (31 +/- 14/mm3). Patients of Group III had significantly fewer (p less than 0.05) Fc epsilon + monocytes (12 +/- 16/mm3) than controls and patients of Groups I and II. We conclude that patients with severe allergic disorders have a significant increase of peripheral blood monocytes with Fc receptors for IgE, which suggests that these cells may participate in the pathophysiology of atopic disease.