Gondo A, Saeki N, Tokuda Y
Department of Dermatology, Tokyo Medical College, Japan.
Br J Dermatol. 1987 Sep;117(3):301-10. doi: 10.1111/j.1365-2133.1987.tb04136.x.
The role of IgG4 in atopic dermatitis was investigated by determining the total amounts of IgG4 and of IgG4 specific for ovalbumin (a food allergen), Dermatophagoides farinae mite antigen and house dust (inhalant allergens) and Candida. These were related to the amounts of total and antigen specific IgE in patients with atopic dermatitis and normal healthy controls. Most patients with atopic dermatitis had greater amounts of total IgG4 and of antigen-specific IgG4 than did normal control individuals. Patients who had received hyposensitization treatment injections had greater amounts of IgG4 than the atopic dermatitis patients not so treated. In patients treated by hyposensitization there was a large increase in the amount of blocking antibody detected by incubating the antigen with the serum overnight before injecting the mixture into the skin of a patient sensitive to the antigen. Blocking activity was also examined by partial inhibition by the serum of IgE-mediated mast cell degranulation and by injection of serum into the skin of sensitive patients before challenge with antigens. In all tests the blocking activity of the serum was related to the amount of antigen-specific IgG4 but not related to total IgG4. In patients with atopic dermatitis who were sensitive to mite antigen, severe cases had small amounts of specific IgG4 and large amounts of specific IgE but in mild cases there was an opposite trend with relatively large amounts of specific IgG4. Large amounts of IgG4 ovalbumin specific antibody were found in children and adults with atopic dermatitis and egg allergy but small amounts of IgE. In infants most of the anti-ovalbumin antibody was IgE with little or no IgG4. The work of others has confirmed that increased amounts of total and antigen-specific IgG4 occur in atopic dermatitis, and it is concluded that IgG4 is a blocking antibody for anaphylactic sensitization responses.
通过测定IgG4总量以及针对卵清蛋白（一种食物过敏原）、粉尘螨抗原、屋尘（吸入性过敏原）和念珠菌的特异性IgG4，研究了IgG4在特应性皮炎中的作用。将这些结果与特应性皮炎患者和正常健康对照者体内的总IgE及抗原特异性IgE量进行关联分析。大多数特应性皮炎患者的总IgG4和抗原特异性IgG4含量高于正常对照个体。接受过脱敏治疗注射的患者比未接受该治疗的特应性皮炎患者有更高的IgG4含量。在脱敏治疗的患者中，将抗原与血清孵育过夜后再注射到对抗原敏感的患者皮肤中，检测到的封闭抗体量大幅增加。还通过血清对IgE介导的肥大细胞脱颗粒的部分抑制作用以及在抗原激发前将血清注射到敏感患者皮肤中，来检测封闭活性。在所有测试中，血清的封闭活性与抗原特异性IgG4量相关，而与总IgG4无关。在对螨抗原敏感的特应性皮炎患者中，重症患者的特异性IgG4量少而特异性IgE量多，但轻症患者则呈现相反趋势，特异性IgG4量相对较多。在患有特应性皮炎且对鸡蛋过敏的儿童和成人中发现了大量的卵清蛋白特异性IgG4抗体，但IgE量少。在婴儿中，大多数抗卵清蛋白抗体是IgE，IgG4很少或没有。其他人的研究证实，特应性皮炎患者体内总IgG4和抗原特异性IgG4含量增加，得出的结论是IgG4是过敏致敏反应的封闭抗体。
