{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T23:14:17Z","timestamp":1785798857692,"version":"3.56.0"},"reference-count":63,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2021,5,20]],"date-time":"2021-05-20T00:00:00Z","timestamp":1621468800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Antibodies of the IgG4 isotype are strongly associated with allergic disease but have several properties such as not precipitating with allergens, not activating complement and poor binding to Fc\u03b3 receptors that argue against a pro-inflammatory role. In keeping with that, IgG4 antibodies are a striking feature of the response to immunotherapy. In two naturally occurring situations IgG4 antibodies are common with low or absent IgE antibodies. The first example is children raised in a house with a cat and the second is eosinophilic esophagitis (EoE). In many population-based cohorts, the ownership of a cat in early childhood is associated with a decreased prevalence of a cat allergy at age 10. The second example (i.e., EoE) is a novel form of food allergy that is not mediated by IgE and is related to consuming cow\u2019s milk or wheat. In EoE, patients have IgG4 to milk proteins in high &gt; 10 \u00b5g\/mL or very high &gt; 100 \u00b5g\/mL titers. Enigmatically these patients are found to have deposits of IgG4 in the wall of their inflamed esophagus. The factors that have given rise to EoE remain unclear; however, changes in food processing over the past 50 years, particularly ultra-heat treatment and the high pressure homogenization of milk, represent a logical hypothesis.<\/jats:p>","DOI":"10.3390\/children8050418","type":"journal-article","created":{"date-parts":[[2021,5,20]],"date-time":"2021-05-20T06:13:45Z","timestamp":1621491225000},"page":"418","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["An Overview of the Relevance of IgG4 Antibodies in Allergic Disease with a Focus on Food Allergens"],"prefix":"10.3390","volume":"8","author":[{"given":"Thomas A. E.","family":"Platts-Mills","sequence":"first","affiliation":[{"name":"Division of Allergy &amp; Clinical Immunology, Department of Medicine, University of Virginia, Charlottesville, VA 22908, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5121-6950","authenticated-orcid":false,"given":"Behnam","family":"Keshavarz","sequence":"additional","affiliation":[{"name":"Division of Allergy &amp; Clinical Immunology, Department of Medicine, University of Virginia, Charlottesville, VA 22908, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey M.","family":"Wilson","sequence":"additional","affiliation":[{"name":"Division of Allergy &amp; Clinical Immunology, Department of Medicine, University of Virginia, Charlottesville, VA 22908, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rung-chi","family":"Li","sequence":"additional","affiliation":[{"name":"Division of Allergy &amp; Clinical Immunology, Department of Medicine, University of Virginia, Charlottesville, VA 22908, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter W.","family":"Heymann","sequence":"additional","affiliation":[{"name":"Division of Allergy &amp; Clinical Immunology, Department of Medicine, University of Virginia, Charlottesville, VA 22908, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diane R.","family":"Gold","sequence":"additional","affiliation":[{"name":"Department of Environmental Health, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA 02115, USA"},{"name":"Channing Division of Network Medicine, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, MA 02115, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily C.","family":"McGowan","sequence":"additional","affiliation":[{"name":"Division of Allergy &amp; Clinical Immunology, Department of Medicine, University of Virginia, Charlottesville, VA 22908, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth A.","family":"Erwin","sequence":"additional","affiliation":[{"name":"Division of Allergy and Immunology, Nationwide Children\u2019s Hospital, Columbus, OH 43205, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,5,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1084\/jem.120.2.253","article-title":"H Chain Subgroups of Myeloma Proteins and Normal 7s Gamma-Globulin","volume":"120","author":"Grey","year":"1964","journal-title":"J. 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