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©2013 UpToDate ® Print Email Allergen-specific IgE production and dissemination Allergens (in this figure, aeroallergens) enter the tonsils, within which they are taken up and degraded by antigen presenting cells (APC). APCs then interact with T helper cells type 2 (TH2) cells and B cells in the lymph nodes, leading to allergen-specific IgE production. The IgE enters the blood stream, and then diffuses through tissues (especially the skin and mucosal tissues of the respiratory and gastrointestinal tracts). The IgE binds to high affinity Fc receptors (FcepsilonRI) on the surface of the tissue mast cells and circulating basophils. When these IgE-coated cells encounter that specific aeroallergen subsequently, they become activated, leading to the release of inflammatory mediators, which result in the signs and symptoms of IgE-mediated allergic reactions.