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*
ALK-Abelló, Hørsholm, Denmark; and
Lung and Allergy Clinic, Copenhagen, Denmark
Allergen-specific CD4+ T lymphocytes are activated at
extremely low allergen concentrations in vivo as a result of
serum-facilitated allergen presentation (S-FAP). It is not clear at
present if specific allergy vaccination (SAV) has an effect on this
mechanism. Here we show that birch allergen-specific serum-IgE
facilitates the presentation of Bet v 1, the major birch pollen
allergen, to Bet v 1-specific CD4+ T lymphocytes by a
factor of >100. This process is CD23 mediated, could be detected in
sera from the majority of birch-allergic patients, and was clearly dose
dependent. S-FAP of Bet v 1 was inhibited in patients undergoing
long-term birch SAV, but not by sera from patients undergoing grass
SAV, indicating that birch-specific Abs are involved. This resulted in
decreased proliferation and IL-4, IL-5, IL-10, and IFN-
production
of Bet v 1-specific T cells. The inhibition was already noted after
3–9 mo of SAV and could not be solely explained by increased serum
levels of birch-specific IgG4. When IgG- and IgA/IgM-containing
fractions of long-term SAV sera were used to inhibit S-FAP, only
IgG-containing fractions were shown to inhibit S-FAP. These results
indicate that blocking IgG Abs induced by SAV inhibits the occurrence
of S-FAP at very low allergen concentrations, resulting in
significantly higher allergen threshold levels to obtain T cell
proliferation and cytokine production and thus allergen-induced
late-phase responses.
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