Nevertheless, this view of the IgA response as a pathogenic mechanism in AR acting along with IgE, is contested by several observations: first, SIgAD or delayed serum IgA production in childhood is a well-known risk factor for atopy (97, 98) and patients with sIgAD suffer more frequently from AR compared to the general population (71, 72). Here, IGHE is linked to selective IgA deficiency disease.