Does SARS-CoV-2 Possess “Allergen-Like” Epitopes?

An increase in IgG4 levels is typically associated with immunological tolerance states and develops after prolonged exposure to antigens. Accordingly, IgG4 is considered an anti-inflammatory antibody with a limited ability to trigger efficient immune responses. Additionally, IgG4 reduces allergic reactions by blocking immunoglobulin E (IgE) activity. In the case of COVID-19, it has been reported that the repeated administration of some vaccines induces high IgG4 levels. The latest research data has revealed a surprising IgE anti-receptor binding domain response after both natural infection and several SARS-CoV-2 vaccines. The presence of IgG4 and IgE in COVID-19 disease suggests that the virus may induce an “allergic-like” response to evade immune surveillance, leading to a shift from Th1 to Th2, which promotes tolerance to the virus and potentially contributes to chronic infection. The spike protein from vaccines could also induce such a response. Interestingly, "allergen-like" epitopes and IgE responses have been reported for other viruses, such as HIV and respiratory syncytial virus (RSV). The impact of this viral-induced tolerance will be discussed, concerning the protective efficacy of vaccines.