Strait Richard T, Morris Suzanne C, Finkelman Fred D
Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
J Clin Invest. 2006 Mar;116(3):833-41. doi: 10.1172/JCI25575. Epub 2006 Feb 23.
Although it has long been hypothesized that allergen immunotherapy inhibits allergy, in part, by inducing production of IgG Abs that intercept allergens before they can cross-link mast cell Fc epsilonRI-associated IgE, this blocking Ab hypothesis has never been tested in vivo. In addition, evidence that IgG-allergen interactions can induce anaphylaxis by activating macrophages through Fc gammaRIII suggested that IgG Ab might not be able to inhibit IgE-mediated anaphylaxis without inducing anaphylaxis through this alternative pathway. We have studied active and passive immunization models in mice to approach these issues and to determine whether any inhibition of anaphylaxis observed was a direct effect of allergen neutralization by IgG Ab or an indirect effect of cross-linking of Fc epsilonRI to the inhibitory IgG receptor Fc gammaRIIb. We demonstrate that IgG Ab produced during the course of an immune response or administered passively can completely suppress IgE-mediated anaphylaxis; that these IgG blocking Abs inhibit IgE-mediated anaphylaxis without inducing Fc gammaRIII-mediated anaphylaxis only when IgG Ab concentration is high and challenge allergen dose is low; that allergen epitope density correlates inversely with the allergen dose required to induce both IgE- and Fc gammaRIII-mediated anaphylaxis; and that both allergen interception and Fc gammaRIIb-dependent inhibition contribute to in vivo blocking Ab activity.
尽管长期以来一直有人提出假设,即变应原免疫疗法部分地通过诱导产生IgG抗体来抑制过敏,这些IgG抗体在变应原能够交联肥大细胞FcεRI相关IgE之前就拦截变应原,但这种阻断性抗体假说从未在体内得到验证。此外,有证据表明IgG-变应原相互作用可通过FcγRIII激活巨噬细胞从而诱导过敏反应,这表明IgG抗体若不通过此替代途径诱导过敏反应,可能无法抑制IgE介导的过敏反应。我们研究了小鼠的主动免疫和被动免疫模型以探讨这些问题,并确定所观察到的对过敏反应的任何抑制作用是IgG抗体中和变应原的直接效应,还是FcεRI与抑制性IgG受体FcγRIIb交联的间接效应。我们证明,在免疫反应过程中产生或被动给予的IgG抗体可完全抑制IgE介导的过敏反应;只有当IgG抗体浓度高且激发变应原剂量低时,这些IgG阻断性抗体才会抑制IgE介导的过敏反应而不诱导FcγRIII介导的过敏反应;变应原表位密度与诱导IgE和FcγRIII介导的过敏反应所需的变应原剂量呈负相关;变应原拦截和FcγRIIb依赖性抑制均有助于体内阻断性抗体的活性。