Human IgE - What We Can Learn from Repertoire Studies and How We Can Use Them as Tools

Antibodies of the IgE isotype play a key role as the allergen recognizer in allergic disease, which today affects as much as a third of the population in the industrialized parts of the world. Despite this crucial role of IgE, our knowledge of IgE repertoires and how we can utilize the information hidden in monoclonal IgE to improve the quality of life of allergic patients, is limited. This thesis aims at describing our current understanding of human IgE repertoires and how we can use human monoclonal allergen-specific IgE as multitools in attempts to design improved diagnostic tools and novel therapeutic candidates.
The first part of the thesis, based on five original papers, discusses some fundamental features of human IgE repertoires and how such repertoires evolve in response to allergen, either via natural exposure or in the course of allergen-specific immunotherapy. Further, the involvement of IgE repertoires developed at local tissue sites, and how such repertoires may complicate diagnosis, is discussed.
In the second part, the focus is turned to human monoclonal IgE, and how we can learn useful lessons from studying the interactions between such antibodies and allergen. This part also describes the interaction between isolated allergen-specific monoclonal IgE and major allergens. Further, it discusses a range of potential applications for human monoclonal IgE, such as how we can use the information gained to design novel hypoallergenic variants to be used in allergen-specific immunotherapy.
In conclusion, this thesis outlines what we may learn from studies of human IgE and how we can use the information gained from such studies to improve the quality of life of allergic patients.