Increasing evidence suggests that the low-affinity receptor for IgE, CD23, plays an important role in controlling the activity of allergen-specific Tcells through IgE-facilitated allergen presentation. We sought to determine the number of CD23 molecules on immune cells in allergic patients and to investigate whether the number of CD23 molecules on antigen-presenting cells is associated with IgE levels and influences allergen uptake and allergen-specific T-cell activation. Numbers of CD23 molecules on immune cells of allergic patients were quantified by using flow cytometry with QuantiBRITE beads and compared with total and allergen-specific IgE levels, as well as with allergen-induced immediate skin reactivity. Allergen uptake and allergen-specific T-cell activation in relation to CD23 surface density were determined by using flow cytometry in combination with confocal microscopy and Tcells transfected with the T-cell receptor specific for the birch pollen allergen Bet v 1, respectively. Defined IgE-allergen immune complexes were formed with human monoclonal allergen-specific IgE and Bet v 1. In allergic patients the vast majority of CD23 molecules were expressed on naive IgD+ Bcells. The density of CD23 molecules on Bcells but not the number of CD23+ cells correlated with total IgE levels (RS=0.53, P=.03) and allergen-induced skin reactions (RS=0.63, P=.008). Uptake ofallergen-IgE complexes into Bcells and activation of allergen-specific Tcells depended on IgE binding to CD23 and were associated with CD23 surface density. Addition of monoclonal IgE to cultured PBMCs significantly (P=.04) increased CD23 expression on Bcells. CD23 surface density on Bcells of allergic patients is correlated with allergen-specific IgE levels and determines allergen uptake and subsequent activation of Tcells.
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