IGHE and allergic disease: Due to the close interactions between allergen, T, B and basophil or mast cell effector cells, the optimal allergy vaccine should be depleted of IgE-binding epitopes to evade cross-linking of high affinity receptors on effector cells and IgE-facilitated allergen presentation, and show a moderate T cell activation profile to avoid LPR and bronchial hypersensitivity.