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Birch, alder, and hazel pollen–specific Immunoglobulin E (IgE) refers to the specialized antibodies produced by the immune system in response to allergens from trees in the Betulaceae family, such as the major allergen Bet v 1 (Valenta et al., 2019). These IgE molecules bind to high-affinity FcεRI receptors on the surface of effector cells, primarily mast cells and basophils, sensitizing them to the presence of these specific pollens (Crameri et al., 2014). Upon subsequent exposure, the allergens cross-link the bound IgE, triggering the immediate release of inflammatory mediators like histamine and leukotrienes, which results in the clinical symptoms of seasonal allergic rhinitis and conjunctivitis (Bousquet et al., 2020). This target is also central to pollen-food allergy syndrome, where cross-reactivity occurs between tree pollen IgE and homologous proteins in various fruits and nuts. Therapeutic strategies include the use of omalizumab, which neutralizes free IgE to prevent effector cell sensitization, and allergen-specific immunotherapy (AIT) like Itulazax, which induces immune tolerance (Biedermann et al., 2019). AIT works by promoting the production of blocking IgG4 antibodies and regulatory T cells, effectively dampening the allergic cascade.
Binding and neutralization of free serum IgE to prevent binding to FcεRI; induction of allergen-specific IgG4 blocking antibodies; downregulation of FcεRI receptors on effector cells; induction of regulatory T-cell responses.
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