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and background Regulatory cells are important for maintaining immunological homeostasis and tolerance to antigens, including self-antigens. Even though in the majority of autoimmune diseases and inflammatory processes, B cells generally play an important role due to their capacity to secrete antibodies, it has emerged that different B cell subsets may be able to down regulate immune responses, especially in experimental autoimmune disease models. Moreover, it has been demonstrated that B cells are able to drive T cell differentiation in favor of a regulatory phenotype (regulatory T cells, Treg) both in mice and humans [1]. In several studies the presence of Breg cells is often related to the development of chronic inflammation or autoimmune disease, but their pathogenic involvement is not completely understood. Researchers have described many B cell subsets with regulatory functions in mice, which are characterized by different surface markers, such as CD5B-1a cells, CD19CD1dCD5 B cells, or marginal zone (MZ) B cells [1]. Some studies have also suggested that human IL-10-producing B10 cells include CD24CD38 and CD24CD27 B cells, which have been identified by their capacity to produce IL10 after appropriate stimulation [2]. However, Breg cells represent an heterogeneous group of immunosuppressive cells subset with distinct phenotypic and functional properties, that could play a role also in the induction of immune tolerance to allergens. Breg-derived IL10 is involved not only in inhibition of Th1 polarization, but also in preventing Th2 responses and its expression in mucosal environment is important for the generation of immunological tolerance. Moreover, allergic disorders are characterized by an imbalance of immune response, typically defined by type 2 response and by a functional defect of Treg (3). In particular, allergic inflammation is mediated and regulated by allergen-specific Th2 cells that induce B cells to produce IgG1 and IgE by secreting IL-4. Moreover, Th2 cells also recruit eosinophils via IL-5 production and directly act on epithelial cells and smooth muscle cells through IL13 production. The development of the allergic environment, for example in asthma, could increase germinal center B cell numbers and MHC II and CD23 expression on follicular mature B cells in lung, bronchial lymph nodes (bLN) and spleen and affect the maturation of regulatory B cell subsets [3]. It is not clear if the alteration in Bregs differentiation in germinal centers is a consequence of the establishment of an allergic environment or vice versa contributes to allergic pathogenesis. Anyway, there is evidence that Breg cells are involved in allergic diseases [4]. A recent review by Palomares and colleagues highlights the importance of IL10and TFGβproducing Breg cells because of their immunosuppressive properties during allergic reaction. These cell subsets are increased both in mice and humans in response to highdose allergen exposure [4]. Bregs are able to promote * Correspondence: chiara.valsecchi@unipv.it Department of Clinical Surgical Diagnostic and Pediatric Sciences, University of Pavia and Fondazione IRCCS Policlinico San Matteo, P.le Golgi 19, 27100 Pavia, Italy Department of Clinical Surgical Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy Full list of author information is available at the end of the article

Detection of IL10-producing B cell (B10) in adenoids of atopic children with adenoidal hypertrophy