IgEdriven

IgEdriven (IgE-driven) refers to diseases and immune responses in which immunoglobulin E (IgE) plays the central role in initiating and propagating symptoms following exposure to allergens. It is a hallmark of Type 1 (immediate) hypersensitivity reactions and underpins many common allergic diseases, including allergic rhinitis, asthma, atopic dermatitis, and food allergy. In sensitization, allergens encountered by the mucosa or skin stimulate dendritic cells to present antigen to T cells, favoring a Th2 response. Interleukins IL-4 and IL-13 promote class-switching of B cells to produce IgE, which binds to high-affinity FcεRI receptors on mast cells and basophils, remaining ready for activation. On subsequent exposure, cross-linking of bound IgE by the allergen triggers rapid degranulation and release of mediators such as histamine, leukotrienes, and prostaglandins, causing itch, edema, vasodilation, and bronchoconstriction. A later phase involves eosinophils and cytokines that sustain inflammation.

Clinically, IgE-driven reactions range from localized symptoms (sneezing, rhinorrhea, urticaria, angioedema) to systemic anaphylaxis. Diagnosis combines clinical history with tests for allergen-specific IgE, including skin prick tests and serum specific IgE assays; component-resolved diagnostics and basophil activation tests may aid uncertain cases. Sensitization does not always equal clinical allergy; food challenges may be necessary to confirm food allergy in some situations.

Management emphasizes trigger avoidance, symptom control with antihistamines and corticosteroids, emergency treatment with epinephrine for anaphylaxis, and disease-modifying options such as allergen immunotherapy and anti-IgE therapy (e.g., omalizumab).