2021
DOI: 10.3389/fimmu.2021.693192
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Allergic Aspects of IgG4-Related Disease: Implications for Pathogenesis and Therapy

Abstract: IgG4-related disease (IgG4-RD) is a rare systemic fibroinflammatory disease frequently associated with allergy. The pathogenesis of IgG4-RD is poorly understood, and effective therapies are limited. However, IgG4-RD appears to involve some of the same pathogenic mechanisms observed in allergic disease, such as T helper 2 (Th2) and regulatory T cell (Treg) activation, IgG4 and IgE hypersecretion, and blood/tissue eosinophilia. In addition, IgG4-RD tissue fibrosis appears to involve activation of basophils and m… Show more

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Cited by 29 publications
(13 citation statements)
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“… 1 The activated Th2 cells produce an inflammatory cytokine milieu that promotes the maturation from B cells into plasma cells and the isotype switch towards IgG4. 4 Among the Th2-secreted cytokines, interleukin-13 (IL-13) plays a crucial role in the progression of allergic diseases and has been found to be significantly elevated in the serum and affected tissues of the patients suffering from many autoimmune diseases, such as Sjögren’s syndrome, rheumatoid arthritis, and systemic sclerosis. 5 Notably, the number of IL-13-positive cells in the submandibular glands (SMGs) of IgG4-RS patients is much higher than that of submandibular sialolithiasis and normal controls.…”
Section: Introductionmentioning
confidence: 99%
“… 1 The activated Th2 cells produce an inflammatory cytokine milieu that promotes the maturation from B cells into plasma cells and the isotype switch towards IgG4. 4 Among the Th2-secreted cytokines, interleukin-13 (IL-13) plays a crucial role in the progression of allergic diseases and has been found to be significantly elevated in the serum and affected tissues of the patients suffering from many autoimmune diseases, such as Sjögren’s syndrome, rheumatoid arthritis, and systemic sclerosis. 5 Notably, the number of IL-13-positive cells in the submandibular glands (SMGs) of IgG4-RS patients is much higher than that of submandibular sialolithiasis and normal controls.…”
Section: Introductionmentioning
confidence: 99%
“…Recently, patterns of RF reactivity to Fc epitopes have been associated with particular diseases [26]. In addition, elevated levels of IgG4 have been associated a rare fibroinflammatory illness [38]. However, although the pre-existing responses in one study population bound to an epitope on human IgG4, the autoantibodies were not themselves IgG4.…”
Section: Discussionmentioning
confidence: 97%
“…The relationship between IgG4-RD and allergy is both intriguing and controversial. As IgG4-RD and allergy both engage similar Type2 immune pathways and share certain immunopathological features, it is thought that allergy plays a significant role in the pathogenesis of IgG4 ( 20 ). However, eosinophilia and elevated IgE concentrations have also been observed in IgG4-RD patients without allergic diseases ( 21 23 ), indicating that Th2 immune activation is not necessarily allergy-mediated and may be driven by immune processes inherent to IgG4-RD itself.…”
Section: Discussionmentioning
confidence: 99%