by Lit Choi Wan. / Thesis (M.Sc.)--Chinese University of Hong Kong, 1996. / Includes bibliographical references (leaves 119-127). / ACKNOWLEDGEMENTS / SUMMARY / LIST OF TABLES / LIST OF FIGURES / Chapter CHAPTER 1 --- INTRODUCTION --- p.1 / Chapter 1.1 --- Terminology & Overview --- p.2 / Chapter 1.2 --- Gell & Coombs Classification of Hypersensitivity --- p.3 / Chapter 1.2.1 --- Type I - Immediate Hypersensitivity --- p.4 / Chapter 1.2.2 --- Type II - Antibody Dependent Cytotoxic Hypersensitivity --- p.4 / Chapter 1.2.3 --- Type III - Immune-Complex Mediated Hypersensitivity --- p.6 / Chapter 1.2.4 --- Type IV - Cell-Mediated (Delayed-Type) Hypersensitivity --- p.6 / Chapter 1.3 --- Historical Review of IgE-Mediated Hypersensitivity --- p.7 / Chapter 1.4 --- The Clinical Biochemistry of IgE --- p.8 / Chapter 1.4.1 --- Structure and Properties --- p.9 / Chapter 1.4.2 --- The Fcε Receptors --- p.11 / Chapter 1.4.3 --- Production and Tissue Localisation --- p.11 / Chapter 1.4.4 --- Turnover in Blood and on Mast Cells --- p.13 / Chapter 1.4.5 --- Control of Synthesis --- p.13 / Chapter 1.4.6 --- The Role of IgE in Health and Disease --- p.14 / Chapter 1.5 --- Pathophysiology of IgE-Mediated Hypersensitivity --- p.20 / Chapter 1.5.1 --- Cell Activation and IgE Synthesis --- p.20 / Chapter 1.5.2 --- Activation of Mast Cells and Basophils --- p.22 / Chapter 1.6 --- Allergens --- p.25 / Chapter 1.7 --- Factors Predisposing to Allergy --- p.30 / Chapter 1.7.1 --- Genetic Predisposition --- p.30 / Chapter 1.7.2 --- Environmental Exposure --- p.32 / Chapter 1.7.3 --- Underlying Infection and Immune Status --- p.32 / Chapter 1.8 --- Epidemiology --- p.33 / Chapter 1.8.1 --- Allergic Diseases Worldwide --- p.33 / Chapter 1.8.2 --- Allergic Diseases in Hong Kong --- p.34 / Chapter 1.9 --- Diagnosis of IgE-Mediated Allergy --- p.36 / Chapter 1.9.1 --- Medical History and Physical Examination --- p.36 / Chapter 1.9.2 --- Introduction to Diagnostic Tests --- p.36 / Chapter 1.9.3 --- Skin Tests --- p.37 / Chapter 1.9.4 --- In Vitro Tests --- p.38 / Chapter 1.9.5 --- Serum Total IgE Assay --- p.41 / Chapter (1) --- Test Principle --- p.41 / Chapter (2) --- Normal Values of Serum Total IgE Concentration --- p.42 / Chapter 1.9.6 --- Allergen Specific IgE Concentration --- p.44 / Chapter (1) --- Principle of RAST --- p.44 / Chapter (2) --- Clinical Usefulness of RAST --- p.44 / Chapter 1.9.7 --- The CAP System --- p.46 / Chapter 1.9.8 --- Mixed Aeroallergen Specific IgE Assay (Phadiatop´ёØ) --- p.46 / Chapter 1.10 --- Further Notes on Allergic Rhinitis --- p.48 / Chapter 1.10.1 --- A Prevalent and Costly Health Problem --- p.48 / Chapter 1.10.2 --- Epidemiology --- p.48 / Chapter 1.10.3 --- Symptoms of Allergic Rhinitis --- p.49 / Chapter 1.10.4 --- ENT Examination --- p.49 / Chapter 1.11 --- Aims of This Study --- p.51 / Chapter CHAPTER 2 --- MATERIALS AND METHOD I Evaluation of The Pharmacia CAP System --- p.52 / Chapter 2.1 --- Materials --- p.53 / Chapter 2.1.1 --- Pharmacia Reagents --- p.53 / Chapter 2.1.2 --- Abbott Reagents --- p.54 / Chapter 2.1.3 --- In-House Reagents --- p.54 / Chapter 2.2 --- Apparatus and Equipment --- p.55 / Chapter 2.2.1 --- Components and Accessories of the CAP System --- p.55 / Chapter 2.2.2 --- Abbott IMx Analyser --- p.55 / Chapter 2.3 --- Methods for Evaluation of the Pharmacia CAP System --- p.56 / Chapter 2.3.1 --- Principle of the Pharmacia CAP System RAST FEIA Fluorescence Enzyme Immunoassay --- p.56 / Chapter 2.3.2 --- Assay Preparation and Procedure --- p.58 / Chapter 2.3.3 --- Evaluation Experiments --- p.59 / Chapter (1) --- Elution Efficiency of Assay Washer96 --- p.59 / Chapter - --- Gross Assessment of Assay Washer96 --- p.59 / Chapter - --- Precision of Elution Volume in Each Well --- p.60 / Chapter - --- Overall Precision and Accuracy of Elution through ImmunoCAP --- p.60 / Chapter (2) --- Precision of RAST FEIA --- p.60 / Chapter (3) --- Accuracy --- p.61 / Chapter (4) --- Linearity and Detection Limits --- p.61 / Chapter (5) --- Recovery Study --- p.61 / Chapter CHAPTER 3 MATERIALS --- AND METHOD II Aetiology of Allergic Rhinitis in Hong Kong --- p.62 / Chapter 3.1 --- Patients and Controls --- p.63 / Chapter 3.2 --- Blood Samples --- p.63 / Chapter 3.3 --- Serum Total IgE Assay --- p.65 / Chapter 3.4 --- Mixed Aeroallergen Specific IgE (Phadiatop) --- p.67 / Chapter 3.5 --- Statistical Analysis --- p.67 / Chapter CHAPTER 4 --- RESULTS I Evaluation of The Pharmacia CAP System --- p.70 / Chapter 4.1 --- Elution Efficiency of Assay Washer96 --- p.71 / Chapter 4.1.1 --- Gross Assessment of Elution Volume --- p.71 / Chapter 4.1.2 --- Precision of Elution Volume in Each Well --- p.72 / Chapter 4.1.3 --- Overall Precision and Accuracy of Elution through ImmunoCAP --- p.75 / Chapter 4.2 --- Precision of RAST FEIA --- p.75 / Chapter 4.3 --- Accuracy --- p.75 / Chapter 4.4 --- Linearity and Detection Limit --- p.79 / Chapter 4.5 --- Recovery --- p.79 / Chapter CHAPTER 5 --- RESULTS II Aetiology of Allergic Rhinitis in Hong Kong --- p.83 / Chapter 5.1 --- Patients and Controls --- p.84 / Chapter 5.2 --- "Serum Total IgE, Mixed Aeroallergen IgE (Phadiatop) and Specific IgE Concentrations in Patients and Controls" --- p.84 / Chapter 5.2.1 --- Total IgE Concentration --- p.84 / Chapter 5.2.2 --- Phadiatop´ёØ --- p.84 / Chapter 5.2.3 --- Specific IgE Concentration --- p.93 / Chapter 5.2.4 --- Degree and Severity of Sensitization --- p.93 / Chapter 5.2.5 --- Single and Multiple Allergy --- p.94 / Chapter 5.2.6 --- Usefulness of Phadiatop´ёØ --- p.94 / Chapter CHAPTER 6 --- DISCUSSION I Evaluation of the Pharmacia CAP System --- p.95 / Chapter 6.1 --- Elution Efficiency of Assay Washer96 --- p.96 / Chapter 6.2 --- "Within-Batch and Between-Batch Precision, Accuracy, Linearity and Detection Limit, and Recovery of FEIA" --- p.97 / Chapter 6.3 --- Overall Evaluation --- p.98 / Chapter CHAPTER 7 --- DISCUSSION II Aetiology of Allergic Rhinitis in Hong Kong --- p.100 / Chapter 7.1 --- Patients and Controls --- p.101 / Chapter 7.2 --- Serum Total IgE Concentration --- p.102 / Chapter 7.3 --- Efficiency of Phadiatop´ёØ Screening Test --- p.103 / Chapter 7.4 --- Serum Specific IgE Assay and Aetiology of Allergic Rhinitis in Hong Kong --- p.107 / Chapter 7.4.1 --- Major Allergens in Allergic Rhinitis --- p.107 / Chapter 7.4.2 --- House Dust Mite --- p.108 / Chapter 7.4.3 --- Cockroach --- p.111 / Chapter 7.4.4 --- Cat and Dog --- p.111 / Chapter 7.4.5 --- Pollens --- p.112 / Chapter 7.4.6 --- Moulds --- p.113 / Chapter 7.4.7 --- Summary --- p.115 / REFERENCES --- p.118