IgE and mast cells: The endogenous adjuvant

Adv Immunol. 2020:148:93-153. doi: 10.1016/bs.ai.2020.10.003. Epub 2020 Nov 5.


Mast cells and IgE are most familiar as the effectors of type I hypersensitivity reactions including anaphylaxis. It is becoming clear however that this pair has important immunomodulatory effects on innate and adaptive cells of the immune system. In this purview, they act as endogenous adjuvants to ignite evolving immune responses, promote the transition of allergic disease into chronic illness and disrupt the development of active mechanisms of tolerance to ingested foods. Suppression of IgE-mediated mast cell activation can be exerted by molecules targeting IgE, FcɛRI or signaling kinases including Syk, or by IgG antibodies acting via inhibitory Fcγ receptors. In 2015 we reviewed the evidence for the adjuvant functions of mast cells. This update includes the original text, incorporates some important developments in the field over the past five years and discusses how interventions targeting these pathways might have promise in the development of strategies to treat allergic disease.

Keywords: FcɛRI; FcγRIIb; Food allergy; IgE; Immune modulation; Mast cell; OIT; Oral tolerance; Th2; Treg.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Desensitization, Immunologic / methods*
  • Food Hypersensitivity / immunology*
  • Humans
  • Immune Tolerance
  • Immunoglobulin E / metabolism*
  • Immunomodulation
  • Mast Cells / immunology*
  • Receptors, IgG / metabolism*
  • T-Lymphocytes, Regulatory / immunology*
  • Th2 Cells / immunology*


  • FCGR1A protein, human
  • FCGR2B protein, human
  • Receptors, IgG
  • Immunoglobulin E