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We found a fourfold increased production of I\u03b5 RNA in both patient groups as compared to control donors. The increased expression of germ\u2010line transcripts correlates with higher serum IgE levels. Nested primer polymerase chain reaction was used to generate S\u03bc\/S\u03b5 fragments from DNA of patient peripheral blood mononuclear cells. Twenty\u2010nine out of fourty sequenced switch fragments had undergone direct joining from S\u03bc to \u03b5 whereas seven fragments showed mono sequential switching from S\u03bc via either S\u03bc, S\u03b32, S\u03b34 or S\u03b5 to S\u03b5 and four fragments demonstrated double sequential switch: S\u03bc\/S\u03bc\/S\u03b31\/S\u03b5, S\u03bc\/S\u03b32\/S\u03b5\/S\u03b5 or S\u03bc\/S\u03b31\/S\u03b32\/S\u03b5. The sequential switching had occurred either via deletions or inversions. Mapping of the breakpoints showed hot spots for recombination within S\u03bc, S\u03b31 and S\u03b5. To our knowledge, this is the first <jats:italic>in vivo<\/jats:italic> study in humans demonstrating that switching to IgE can occur from sequential rearrangements via \u03b31, \u03b32 or \u03b34.<\/jats:p>","DOI":"10.1002\/eji.1830270120","type":"journal-article","created":{"date-parts":[[2007,3,2]],"date-time":"2007-03-02T03:31:13Z","timestamp":1172806273000},"page":"130-135","source":"Crossref","is-referenced-by-count":18,"title":["Direct and sequential switching from \u03bc to \u03b5 in patients with <i>Schistosoma mansoni<\/i> infection and atopic dermatitis"],"prefix":"10.1002","volume":"27","author":[{"given":"Berivan","family":"Baskin","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Khalid B.","family":"Islam","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Birgitta","family":"Eveng\u00e5rd","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lennart","family":"Emtestam","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C. 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