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The role of IgG subclass antibodies in the clinical response to immunotherapy in allergic disease

Introduction Allergen-specific immunotherapy, formerly also known as desensitization or hyposensitization, was introduced in 1911 by Noon [1] and Freemand [2] for the treatment of allergie disorders, and has been applied clinically to patients with IgE-mediated allergy to inhaled allergens such as house dust mites and pollens and to insect venoms. Its efficacy has been established by a number of studies [3-6], although some side effects have been reported [7]. Clinical improvements associated with immunotherapy have been attributed to a variety of immunological mechanisms including suppression of IgE antibody synthesis and production of TgG blocking antibodies. Thus, the recognition of four distinct subclasses of IgG bas prompted attempts to identify the subclass distribution of such IgG blocking antibodies [8]. The aim of this article is to review and summarize the present 'state of the art' on the role of IgG subclass antibodies in the clinical response to immunotherapy and, furthermore, in the type I allergic reactions, on the basis of experimental data obtained by determining each immunoglobulin isotype antibody level in various allergic conditions.