Allergen‐specific immunotherapy boosts allergen‐specific IgD production in house dust mite‐sensitized asthmatic patients

Abstract

Whereas the biology of IgG, IgA, and IgE has been extensively studied in allergic diseases, the regulation and function of IgD remain poorly investigated. IgG4 is a blocking antibody, which prevents the cross-linking of receptor-bound IgE. IgD is unable to recruit complement protein which is similar to mucosal IgA. 1 IgD was shown to increase Th2 cell polarization in germinal centers, boosting Th2 cytokine production. 2 IgD-activated basophils also enhance IgG1 and IgE production by allergen-specific B cells. Interestingly, IgD could interfere with IgE-mediated basophil degranulation supporting its role in the development of allergen immune tolerance. 2 Of note, beekeepers with tolerance to bee venom developed higher serum IgDspecific phospholipase A2 (PLA2) levels and lower total IgD levels compared with healthy controls. 2 Moreover, milk-and egg-allergic children treated with oral immunotherapy showed increased serum allergen-specific IgD responses compared with placebo controls. 2 Allergen-specific immunotherapy (AIT) is the only treatment which induces long-term clinical tolerance.

Advances and recent developments in asthma in 2020

“…The longitudinal change in Der p 2‐specific IgE/IgD ratio was similar to that in Der p 2‐specific IgE/IgG4 ratio. Asthma symptoms were improving during the AIT process, which also correlated with allergen‐specific B‐cell responses 178 …”

“…The longitudinal change in Der p 2-specific IgE/IgD ratio was similar to that in Der p 2-specific IgE/IgG4 ratio. Asthma symptoms were improving during the AIT process, which also correlated with allergen-specific B-cell responses 178. Many retrospective AIT studies investigated the risk of new-onset asthma, the relative risk of medication dispensing for asthma and its potential progression among multimorbid allergic subjects.It was found that use of sublingual allergen immunotherapy tablets for pollen allergy for the treatment of AR could reduce the prevalence of asthma, decrease asthma medication usage, and also slow down progression of asthma in comparison with a group receiving only symptomatic AR medication [179][180][181].…”

Biology and dynamics of B cells in the context of IgE‐mediated food allergy

“…Interestingly, serum IgD antibodies against milk‐derived allergens alpha s1‐casein, beta‐lactoglobulin were increased in cow's milk allergic children after oral immunotherapy 73 . Similarly, in a cohort of HDM AIT‐treated patients, allergen‐specific IgD was significantly increased after 2 years of treatment 76 . Although the exact contribution of allergen‐specific IgD antibodies in the context of IgE‐mediated allergic inflammation remains incompletely understood, the currently available data suggest that IgD contributes to allergic sensitization through enhancing IgE production.…”

“…73 Similarly, in a cohort of HDM AIT-treated patients, allergen-specific IgD was significantly increased after 2 years of treatment. 76 Although the exact contribution of allergen-specific IgD antibodies in the context of IgE-mediated allergic inflammation remains incompletely understood, the currently available data suggest that IgD contributes to allergic sensitization through enhancing IgE production. On the other hand, IgD may also play a role in the induction of allergen tolerance by suppressing IgE-mediated basophil (and potentially also mast cell) degranulation.…”

Advances and Recent Developments in Asthma in 2020

“…Asthma symptoms were improving during the AIT process, which also correlated with allergen-specific B cell responses. 177 Many retrospective AIT studies investigated the risk of new-onset asthma, the relative risk of medication dispensing for asthma and its potential progression among multimorbid allergic subjects. It was found that use of sublingual allergen immunotherapy tablets for pollen allergy for the treatment of allergic rhinitis could reduce the prevalence of asthma, decrease asthma medication usage and also slow progression of asthma in comparison to a group receiving only symptomatic allergic rhinitis medication.…”