Source: Annual Congress 2002 - Epidemiology of asthma, rhinitis and allergy
Disease area: Airway diseases

Abstract

IgG4 antibodies responses to aeroallergens have been suggested to protect, as 'blocking antibodies', against IgE-mediated allergic disease; supporting evidence from population studies is however very limited. Occupational exposure to high allergen levels is often associated with strong specific IgG4 responses, but their role in work-related airway disease is not well known. We have analysed the relations between IgG4 responses to work-related aeroallergens and respiratory health parameters in two populations of Dutch (n=191) and Danish (n=90) pig farmers. Exposure measurements showed that the major allergen at their workplace are pig urinary proteins (PUP), with very high exposure levels of 10-100 μg/m3. Specific EIAs for IgG4 anti-PUP revealed a wide range of titres, from <1 (non-detectable) to more than 10,000.
Remarkably strong negative associations were found between these IgG4 anti-PUP titres and the presence of self-reported common or work-related respiratory symptoms and of non-specific bronchial hyperresponsiveness assessed by histamine provocation. For the combined presence of symptoms and BHR, Odds Ratios (ORs) adjusted for age, smoking and common atopy were eg. 0.16 (95% cfi: 0.04-0.66) and 0.03 (0.00-0.66) for high (>50) vs. low (<5) titres, in the Dutch and Danish population, respectively, and 0.33 (0.11-0.98) for intermediate (6-50) versus low titres.
IgG4 responses to occupational aeroallergens thus indeed seem to protect against respiratory illness and BHR. The combination with very high allergen exposure levels suggests that 'high dose tolerance' might play a role in the prevention of allergic sensitization and symptomatic allergy, via IgG4 responses or possibly other anti-inflammatory or anti-allergic mechanisms.

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Citations should be made in the following way:
G. Doekes, L. Preller, R. Snippe, M. Iversen, D. J. J. Heederik (Utrecht, Zeist, The Netherlands; Aarhus, Denmark). IgG4 response to high occupational aeroallergen exposure: a protective mechanism against allergic and inflammatory airway disease?. Eur Respir J 2002; 20: Suppl. 38, 806

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