\documentclass[10pt]{article}

\usepackage{fullpage}
\usepackage{setspace}
\usepackage{parskip}
\usepackage{titlesec}
\usepackage[section]{placeins}
\usepackage{xcolor}
\usepackage{breakcites}
\usepackage{lineno}
\usepackage{hyphenat}





\PassOptionsToPackage{hyphens}{url}
\usepackage[colorlinks = true,
            linkcolor = blue,
            urlcolor  = blue,
            citecolor = blue,
            anchorcolor = blue]{hyperref}
\usepackage{etoolbox}
\makeatletter
\patchcmd\@combinedblfloats{\box\@outputbox}{\unvbox\@outputbox}{}{%
  \errmessage{\noexpand\@combinedblfloats could not be patched}%
}%
\makeatother


\usepackage{natbib}




\renewenvironment{abstract}
  {{\bfseries\noindent{\abstractname}\par\nobreak}\footnotesize}
  {\bigskip}

\titlespacing{\section}{0pt}{*3}{*1}
\titlespacing{\subsection}{0pt}{*2}{*0.5}
\titlespacing{\subsubsection}{0pt}{*1.5}{0pt}


\usepackage{authblk}


\usepackage{graphicx}
\usepackage[space]{grffile}
\usepackage{latexsym}
\usepackage{textcomp}
\usepackage{longtable}
\usepackage{tabulary}
\usepackage{booktabs,array,multirow}
\usepackage{amsfonts,amsmath,amssymb}
\providecommand\citet{\cite}
\providecommand\citep{\cite}
\providecommand\citealt{\cite}
% You can conditionalize code for latexml or normal latex using this.
\newif\iflatexml\latexmlfalse
\providecommand{\tightlist}{\setlength{\itemsep}{0pt}\setlength{\parskip}{0pt}}%

\AtBeginDocument{\DeclareGraphicsExtensions{.pdf,.PDF,.eps,.EPS,.png,.PNG,.tif,.TIF,.jpg,.JPG,.jpeg,.JPEG}}

\usepackage[utf8]{inputenc}
\usepackage[english]{babel}



\usepackage{float}








\begin{document}

\title{High prevalence of IgE sensitization to inactivated influenza vaccines,
yet robust IgG4 responses, in a healthy pediatric population}



\author[1]{Takao Fujisawa}%
\author[1]{Prince Baffour Tonto}%
\author[1]{Mizuho Nagao}%
\author[1]{Shigeru Suga}%
\author[1]{Kiyosu Taniguchi}%
\author[2]{Masahiro Hirayama}%
\author[3]{Tetsuo Nakayama}%
\author[4]{Takuji Kumagai}%
\affil[1]{Kokuritsu Byoin Kiko Mie Byoin}%
\affil[2]{Mie Daigaku}%
\affil[3]{Kitasato Daigaku Kansen Seigyo Kenkyu Kiko}%
\affil[4]{Kumagai Naika Shonika Iin}%


\vspace{-1em}



  
  \date{June 10, 2024}


\begingroup
\let\center\flushleft
\let\endcenter\endflushleft
\maketitle
\endgroup





\selectlanguage{english}
\begin{abstract}
\textbf{Background:} Anaphylaxis following influenza vaccination is a
rare but serious problem. The underlying immune responses are not well
understood. \textbf{Objective:} To elucidate IgE and IgG antibody
responses in healthy children and adolescents following inactivated
influenza vaccines (IIVs). \textbf{Methods:} The efficacy and safety of
quadrivalent IIV (QIV) and trivalent IIV (TIV) were compared in healthy
subjects aged 0-18 years. Serum IIV-specific IgE, IgG and IgG4 levels
(sIgE, sIgG, sIgG4) were measured with ImmunoCAP. Hemagglutinin
inhibition (HI) assay was performed for each influenza virus subtype.
Sera from earlier patients who developed anaphylaxis to different IIVs
were similarly tested. \textbf{Results}: A total of 393 subjects were
enrolled: 96 were 6 months -2 years old, 100 were 3-5 years old, 100
were 6-12 years old, and 97 were 13-18 years old \emph{.} No anaphylaxis
was observed. Generally, QIV and TIV induced similar antibody responses.
IIV-sIgE levels rose significantly after vaccination in the 6m-2y and
3-5y groups, did not change in the 6-12y group, and decreased in the
13-18y group. In contrast, the IIV-sIgG4/sIgE ratio increased
significantly after vaccination in all age groups. Sensitized subjects
had significantly higher HI titers and IIV-sIgG levels in the youngest
age group and higher IIV-sIgG4 levels in all age groups compared with
the non-sensitized. The IIV-sIgG4/sIgE ratio in 5 patients with
anaphylaxis was significantly lower than in age-matched healthy
subjects. \textbf{Conclusion:} IIVs induce IgE sensitization in healthy
children, but also robust IgG4 responses that may protect them from
anaphylaxis. (239 words)%
\end{abstract}%



\sloppy


\textbf{Hosted file}

\verb`IV-IgE_Manucsript_Allergy_cleanCopy.docx`  available at \url{https://authorea.com/users/382919/articles/565205-high-prevalence-of-ige-sensitization-to-inactivated-influenza-vaccines-yet-robust-igg4-responses-in-a-healthy-pediatric-population}\selectlanguage{english}
\begin{figure}[H]
\begin{center}
\includegraphics[width=0.70\columnwidth]{figures/Fig1/Fig1}

\end{center}
\end{figure}\selectlanguage{english}
\begin{figure}[H]
\begin{center}
\includegraphics[width=0.70\columnwidth]{figures/Fig2/Fig2}

\end{center}
\end{figure}\selectlanguage{english}
\begin{figure}[H]
\begin{center}
\includegraphics[width=0.70\columnwidth]{figures/Fig3/Fig3}

\end{center}
\end{figure}\selectlanguage{english}
\begin{figure}[H]
\begin{center}
\includegraphics[width=0.70\columnwidth]{figures/Fig4/Fig4}

\end{center}
\end{figure}\selectlanguage{english}
\begin{figure}[H]
\begin{center}
\includegraphics[width=0.70\columnwidth]{figures/Fig5/Fig5}

\end{center}
\end{figure}

\selectlanguage{english}
\FloatBarrier
\end{document}

