Abstract
IgG4 and its role in immune tolerance has been investigated widely. Symptom reduction and improved clinical outcomes in immunotherapy trials are associated with significant increases in allergen-specific IgG4 antibodies. Natural immune tolerance observed in beekeepers and cat owners has also been associated with elevated levels of bee venom and cat allergen-specific IgG4, respectively. Functionally, allergen-specific IgG4 has been shown to reduce the binding of IgE-allergen complexes to B cells, a key step in the initiation of the type 1 hypersensitivity allergic response. In laboratory animal allergy, IgG4 has been described as a "protective/blocking" antibody. However, a consensus on the exact relationship between exposure, IgG4, and tolerance has yet to be reached. In this chapter, we review the factors that require consideration when developing an ELISA for the quantification of allergen-specific IgG4.
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