The role of allergen-specific IgE, IgG and IgA in allergic disease

Mohamed H. Shamji, Rudolf Valenta, Theodore Jardetzky, Valerie Verhasselt, Stephen R. Durham, Peter A. Würtzen, Joost van Neerven*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

109 Citations (Scopus)


Immunoglobulin E (IgE)-mediated allergy is the most common hypersensitivity disease affecting more than 30% of the population. Exposure to even minute quantities of allergens can lead to the production of IgE antibodies in atopic individuals. This is termed allergic sensitization, which occurs mainly in early childhood. Allergen-specific IgE then binds to the high (FcεRI) and low-affinity receptors (FcεRII, also called CD23) for IgE on effector cells and antigen-presenting cells. Subsequent and repeated allergen exposure increases allergen-specific IgE levels and, by receptor cross-linking, triggers immediate release of inflammatory mediators from mast cells and basophils whereas IgE-facilitated allergen presentation perpetuates T cell–mediated allergic inflammation. Due to engagement of receptors which are highly selective for IgE, even tiny amounts of allergens can induce massive inflammation. Naturally occurring allergen-specific IgG and IgA antibodies usually recognize different epitopes on allergens compared with IgE and do not efficiently interfere with allergen-induced inflammation. However, IgG and IgA antibodies to these important IgE epitopes can be induced by allergen-specific immunotherapy or by passive immunization. These will lead to competition with IgE for binding with the allergen and prevent allergic responses. Similarly, anti-IgE treatment does the same by preventing IgE from binding to its receptor on mast cells and basophils. Here, we review the complex interplay of allergen-specific IgE, IgG and IgA and the corresponding cell receptors in allergic diseases and its relevance for diagnosis, treatment and prevention of allergy.

Original languageEnglish
Pages (from-to)3627-3641
JournalAllergy: European Journal of Allergy and Clinical Immunology
Issue number12
Early online date17 May 2021
Publication statusPublished - 2021


  • allergy treatment
  • basic mechanisms in allergy
  • biologics
  • biomarkers
  • IgE
  • immunotherapy
  • tolerance induction
  • vaccines and mechanisms


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