An old clinical classification distinguished between atopic (IgE-mediated) and non-atopic forms of bronchial asthma. Leaving aside the allergen triggers of extrinsic asthma, the triggers for intrinsic asthma and extrinsic asthma are the same, e.g. exercise, cold air and inhaled irritants. Recently, scientific evidence has challenged the dualistic concept of extrinsic and intrinsic asthma. Biopsies obtained from non-atopic asthmatics showed enhanced expression of high-affinity IgE receptor (FcɛRI), probably due to IgE synthesis occurring at least locally in the airways of these patients, despite their having negative skin prick tests and low serum IgE levels.
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