Saturation of Immunoglobulin E (IgE) Binding Sites by Polyclonal IgE Does Not Explain the Protective Effect of Helminth Infections against Atopy

Abstract

One hypothesis for the decreased rates of atopy observed among helminth-infected individuals is that parasite-induced polyclonal immunoglobulin E (IgE) outcompetes allergen-specific IgE for FcRI binding on basophils and mast cells. In experiments with fresh blood drawn from filaria-infected patients, we found no association between ratios of polyclonal to Brugia malayi antigen (BmAg)-specific IgE (range, 14:1 to 388:1) and basophil responses to BmAg as measured by histamine release. Using serum samples from a filaria-infected patient who also had dust mite (Dermatophagoides pteronyssinus)-specific IgE antibodies from time points with various ratios of polyclonal to D. pteronyssinus-specific IgE (16:1 to 86:1), we demonstrated that increased ratios of polyclonal to D. pteronyssinus-specific IgE did not attenuate basophil sensitization as measured by D. pteronyssinus-specific histamine release. Suppression of histamine release was likely not observed in either of these sets of experiments because polyclonal to antigen-specific IgE ratios were not sufficiently high, as concurrent passive sensitization of basophil experiments required ratios of polyclonal to antigen-specific IgE of greater than 500:1 to suppress basophil histamine release. Further, the intensity of IgE staining in basophil populations from 20 patients with active filaria infections correlated strongly with total serum IgE levels (rho ‫؍‬ 0.698; P ‫؍‬ 0.0024) with no plateau in intensity of IgE staining, even though some patients had total IgE levels of greater than 10,000 ng/ml. Our data therefore suggest that in helminth infections (and in filarial infections in particular), the ratios of polyclonal to allergen-specific IgE rarely reach those levels necessary to inhibit allergen-specific IgE-FcRI binding and to suppress allergen-induced degranulation of mast cells and basophils.

Helminth Infections and Host Immune Regulation

“…This observation parallels the situation in mice, in which unresponsiveness was further demonstrated to be dependent upon IL-10 (157). In contrast, little evidence has been found to support the concept that helminth-induced IgE blocks allergic reactivity, in part because IgE receptor expression is highly upregulated during infection (79,200).…”

T-Cell Regulation in Helminth Parasite Infections: Implications for Inflammatory Diseases

“…The proposition, in humans, that high polyclonal (or parasitespecific) IgE blocks allergen-specific IgE reactions is widely held, although not supported by evidence that cell FcR density is extremely plastic, so that blocking by parasite-specific IgE is unlikely to be effective [67].…”

IgE memory: Persistence of antigen-specific IgE responses years after treatment of human filarial infections

“…23 To determine frequencies of BmAg-specific and polyclonal IgE-producing cells, enzyme-linked immunospot assays (ELISPOTs) were performed by using PBMCs that had been cryopreserved and subsequently thawed. All pretreatment and posttreatment samples were run concurrently on the same plate.…”