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B-cell responses in allergen immunotherapy

Satitsuksanoa, Pattraporna,b; van de Veen, Willema,b; Akdis, Mübeccela,b

Current Opinion in Allergy and Clinical Immunology: December 2019 - Volume 19 - Issue 6 - p 632–639
doi: 10.1097/ACI.0000000000000580
IMMUNOTHERAPY AND NEW TREATMENTS: Edited by Giovanni Passalacqua and Robert Bush

Purpose of review The establishment of long-term clinical tolerance in AIT requires the involvement of basophils, mast cells, allergen-specific regulatory T and B cells, downregulation of effector type 2 responses, and increase in production of specific IgG, particularly immunglobulin G4 (IgG4) antibodies. This review aims to provide an overview of the role of B cells in AIT, their mechanism of action, and their potential for improving AIT.

Recent findings In-depth research of B cells has paved the way for improved diagnosis and research on allergic diseases. B cells play a central role in allergy and allergen tolerance through the production of immunglobulin E (IgE)-blocking antibodies. However, an increasing body of evidence has emerged supporting a role for B cells in regulating immune responses that extends beyond the production of antibodies. Regulatory B cells play an important role in immunosuppression, mediated by secretion of anti-inflammatory cytokines.

Summary Successful AIT establishes the reinstatement of immune tolerance toward allergens, reduces allergic symptoms, and improves clinical treatments in patients. B cells play a central role in this process through antibody-independent immune regulatory processes in addition to the production of IgE-blocking antibodies.

aSwiss Institute of Allergy and Asthma Research (SIAF), University of Zurich

bChristine Kühne-Center for Allergy Research and Education (CK-CARE), Davos, Switzerland

Correspondence to Mübeccel Akdis, MD, PhD, Swiss Institute of Allergy and Asthma Research (SIAF) Herman-Burchard-Strasse 9, CH- 7265 Davos, Switzerland. Tel: +41 81 4100848; fax: +41 81 4100840; e-mail:

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