PIPE-cloned human IgE, IgG1 and IgG4 antibodies: New tools for investigating cow’s milk allergy and tolerance

Abstract

Cow's milk (CM) allergy (CMA) is defined as an immune-mediated adverse response to CM proteins. 2% to 3% of children are suffering from CMA, but many develop natural tolerance after 3-4 years.1,S01 Food allergen immunotherapy (FA-AIT) applying increasing antigen doses (oral immunotherapy, OIT) can contribute to improvement of CMA,S02 with variable clinical efficacy,2,S03 but immunologically often resulting in decreased specific IgE levels and increased specific IgG4 levelsS04,S05. IgG4 is (a) anti-inflammatory as it does not activate the complement system; (b) bi-specific due to fab-arm exchange and, thus, has less crosslinking capacity than IgE, but has (c) blocking capacity.3 The interplay of IgE and IgG4 may hence be decisive for the immune balance in CMA.