Coordinated IgG2 and IgE responses as a marker of allergen immunotherapy efficacy

Véronique Bordas-Le Floch, Nathalie Berjont, Thierry Batard, Nirupama Varese, Robyn E. O’Hehir, Walter G. Canonica, Menno C. van Zelm, Laurent Mascarell

Research output: Contribution to journalArticleResearchpeer-review

17 Citations (Scopus)


Background: IgG2 responses are associated with repeated antigen exposure and display highly mutated variable domains. A recent study highlighted a role of IgG2+ memory B cells and allergen-specific IgG2 levels after a 3rd consecutive pre-seasonal sublingual allergen immunotherapy (AIT) with grass pollen tablet. Herein, we aim to explore changes in allergen-specific IgG2 in individuals undergoing house dust mite immunotherapy (HDM-AIT) and explore whether the interrelationship with other humoral responses (i.e., IgG4 and IgE) may discriminate between high and low responders. Methods: Levels of serum Dermatophagoides pteronyssinus and Dermatophagoides farinae-specific IgG2, IgG4, and IgE antibodies were measured by ELISA or ImmunoCap in a sub-group of individuals enrolled in a randomized, double-blind, placebo-controlled, sublingual AIT study evaluating the safety and efficacy of a 300 IR HDM tablet. Results: After 1-year sublingual AIT, HDM-specific serum IgG2 responses increase mostly in high versus low responders and are distinctive according to the clinical benefit. Higher correlation between HDM-specific IgG2, IgE, and/or IgG4 responses is seen in subjects benefiting the most from HDM-AIT as indicated by changes in Average Total Combined Scores. More strikingly, statistically significant correlation between HDM-specific IgG2 and IgE responses is only observed in individuals stratified as high responders. Conclusions: We provide evidence for coordinated serum immune responses upon AIT in HDM-allergic subjects exhibiting high clinical benefit when compared with low responders. Assessing HDM-specific IgE, IgG2, and IgG4 in serum could be used as follow-up combined markers to support decision as to AIT continuation and/or adaptation.

Original languageEnglish
Pages (from-to)1263-1273
Number of pages11
Issue number4
Publication statusPublished - Apr 2022


  • allergen immunotherapy efficacy
  • house dust mite
  • humoral responses
  • IgG2
  • sublingual immunotherapy

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