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Yin Y, Li JM, Metcalfe DD, Olivera A, Frischmeyer-Guerrerio PA, Carter MC, Komarow H. Increased expression of formyl peptide receptor-1 by basophils from patients with mastocytosis. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. GLOBAL 2024; 3:100296. [PMID: 39148513 PMCID: PMC11325225 DOI: 10.1016/j.jacig.2024.100296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 03/29/2024] [Accepted: 04/05/2024] [Indexed: 08/17/2024]
Abstract
Background Symptoms in patients with systemic mastocytosis (SM) are associated with an increase in mast cell burden and release of mast cell-derived mediators. The most frequent presentation of SM is indolent SM (ISM), with moderate symptoms and prognosis. Basophil numbers in these patients are generally normal. However, when examining basophil activation in patients with ISM, we noted an abnormal response to N-formylmethione-leucyl-phenylalanine (fMLP). Objective Our aim was to compare basophil responsiveness to fMLP and anti-IgE in healthy volunteers and patients with ISM and relate the findings to fMLP receptor (FPR) expression. Methods Basophils isolated from peripheral blood of 15 patients with ISM and 14 healthy volunteers were stimulated with fMLP or anti-IgE. CD63 expression to assess basophil activation and expression of FPRs were assessed by flow cytometry. Results Baseline expression of CD63 on basophils was similar between the healthy volunteers and patients with ISM. fMLP induced higher expression of CD63 on basophils from patients with ISM, whereas responses to anti-IgE were similar between groups. Basophils from patients with ISM also had higher fMLP1 receptor (FPR1) expression, wheresas FPR2 and FPR3 were not detected. fMLP blocked the binding of anti-FPR1 antibody to FPR1, consistent with the conclusion that fMLP signals through FPR1. Conclusions Level of fMLP-induced basophil activation is higher in patients with ISM, which is associated with an increase in FPR1 expression. Further investigation is needed to determine why FPR1 expression is elevated, whether such expression might serve as an additional surrogate marker in the diagnosis of ISM, and whether enhanced responses of basophils to fMPL might have some relationship to unexplained episodes of mediator release.
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Affiliation(s)
- Yuzhi Yin
- Mast Cell Biology Section, Laboratory of Allergic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md
| | - Jenny Min Li
- Food Allergy Research Section, Laboratory of Allergic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md
| | - Dean D Metcalfe
- Mast Cell Biology Section, Laboratory of Allergic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md
| | - Ana Olivera
- Mast Cell Biology Section, Laboratory of Allergic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md
| | - Pamela A Frischmeyer-Guerrerio
- Food Allergy Research Section, Laboratory of Allergic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md
| | - Melody C Carter
- Mast Cell Biology Section, Laboratory of Allergic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md
| | - Hirsh Komarow
- Mast Cell Biology Section, Laboratory of Allergic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md
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Adamo G, Santonicola P, Picciotto S, Gargano P, Nicosia A, Longo V, Aloi N, Romancino DP, Paterna A, Rao E, Raccosta S, Noto R, Salamone M, Deidda I, Costa S, Di Sano C, Zampi G, Morsbach S, Landfester K, Colombo P, Wei M, Bergese P, Touzet N, Manno M, Di Schiavi E, Bongiovanni A. Extracellular vesicles from the microalga Tetraselmis chuii are biocompatible and exhibit unique bone tropism along with antioxidant and anti-inflammatory properties. Commun Biol 2024; 7:941. [PMID: 39097626 PMCID: PMC11297973 DOI: 10.1038/s42003-024-06612-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 07/22/2024] [Indexed: 08/05/2024] Open
Abstract
Extracellular vesicles (EVs) are membrane-enclosed bio-nanoparticles secreted by cells and naturally evolved to transport various bioactive molecules between cells and even organisms. These cellular objects are considered one of the most promising bio-nanovehicles for the delivery of native and exogenous molecular cargo. However, many challenges with state-of-the-art EV-based candidates as drug carriers still exist, including issues with scalability, batch-to-batch reproducibility, and cost-sustainability of the final therapeutic formulation. Microalgal extracellular vesicles, which we named nanoalgosomes, are naturally released by various microalgal species. Here, we evaluate the innate biological properties of nanoalgosomes derived from cultures of the marine microalgae Tetraselmis chuii, using an optimized manufacturing protocol. Our investigation of nanoalgosome biocompatibility in preclinical models includes toxicological analyses, using the invertebrate model organism Caenorhabditis elegans, hematological and immunological evaluations ex vivo and in mice. We evaluate nanoalgosome cellular uptake mechanisms in C. elegans at cellular and subcellular levels, and study their biodistribution in mice with accurate space-time resolution. Further examination highlights the antioxidant and anti-inflammatory bioactivities of nanoalgosomes. This holistic approach to nanoalgosome functional characterization demonstrates that they are biocompatible and innate bioactive effectors with unique bone tropism. These findings suggest that nanoalgosomes have significant potential for future therapeutic applications.
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Affiliation(s)
- Giorgia Adamo
- Cell-Tech HUB at Institute for Research and Biomedical Innovation, National Research Council of Italy (CNR), Palermo, Italy
| | - Pamela Santonicola
- Institute of Biosciences and BioResources, National Research Council (CNR), Naples, Italy
| | - Sabrina Picciotto
- Cell-Tech HUB at Institute for Research and Biomedical Innovation, National Research Council of Italy (CNR), Palermo, Italy
| | - Paola Gargano
- Cell-Tech HUB at Institute for Research and Biomedical Innovation, National Research Council of Italy (CNR), Palermo, Italy
| | - Aldo Nicosia
- Cell-Tech HUB at Institute for Research and Biomedical Innovation, National Research Council of Italy (CNR), Palermo, Italy
| | - Valeria Longo
- Institute for Research and Biomedical Innovation, National Research Council of Italy (CNR), Palermo, Italy
| | - Noemi Aloi
- Institute for Research and Biomedical Innovation, National Research Council of Italy (CNR), Palermo, Italy
| | - Daniele P Romancino
- Cell-Tech HUB at Institute for Research and Biomedical Innovation, National Research Council of Italy (CNR), Palermo, Italy
| | - Angela Paterna
- Cell-Tech HUB at Institute of Biophysics, National Research Council of Italy (CNR), Palermo, Italy
| | - Estella Rao
- Cell-Tech HUB at Institute of Biophysics, National Research Council of Italy (CNR), Palermo, Italy
| | - Samuele Raccosta
- Cell-Tech HUB at Institute of Biophysics, National Research Council of Italy (CNR), Palermo, Italy
| | - Rosina Noto
- Cell-Tech HUB at Institute of Biophysics, National Research Council of Italy (CNR), Palermo, Italy
| | - Monica Salamone
- Cell-Tech HUB at Institute for Research and Biomedical Innovation, National Research Council of Italy (CNR), Palermo, Italy
| | - Irene Deidda
- Institute for Research and Biomedical Innovation, National Research Council of Italy (CNR), Palermo, Italy
| | - Salvatore Costa
- Department of Biological, Chemical and Pharmaceutical Sciences and Technologies, University of Palermo, Palermo, Italy
| | - Caterina Di Sano
- Institute of Translational Pharmacology, National Research Council of Italy (CNR), Palermo, Italy
| | - Giuseppina Zampi
- Institute of Biosciences and BioResources, National Research Council (CNR), Naples, Italy
| | - Svenja Morsbach
- Max Planck Institute for Polymer Research (MPIP), Mainz, Germany
| | | | - Paolo Colombo
- Institute for Research and Biomedical Innovation, National Research Council of Italy (CNR), Palermo, Italy
| | - Mingxing Wei
- Cellvax SAS, Villejuif Bio Park, 1 Mail du Professeur Georges Mathé, Villejuif, France
| | - Paolo Bergese
- Cell-Tech HUB at Institute for Research and Biomedical Innovation, National Research Council of Italy (CNR), Palermo, Italy
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
- Center for Colloid and Surface Science (CSGI), Florence, Italy
| | - Nicolas Touzet
- Department of Environmental Science, School of Science, Centre for Environmental Research, Innovation and Sustainability, CERIS, Atlantic Technological University Sligo, Sligo, Ireland
| | - Mauro Manno
- Cell-Tech HUB at Institute of Biophysics, National Research Council of Italy (CNR), Palermo, Italy
| | - Elia Di Schiavi
- Institute of Biosciences and BioResources, National Research Council (CNR), Naples, Italy
| | - Antonella Bongiovanni
- Cell-Tech HUB at Institute for Research and Biomedical Innovation, National Research Council of Italy (CNR), Palermo, Italy.
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Gryak J, Georgievska A, Zhang J, Najarian K, Ravikumar R, Sanders G, Schuler CF. Prediction of pediatric peanut oral food challenge outcomes using machine learning. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. GLOBAL 2024; 3:100252. [PMID: 38745865 PMCID: PMC11090861 DOI: 10.1016/j.jacig.2024.100252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 01/04/2024] [Accepted: 02/15/2024] [Indexed: 05/16/2024]
Abstract
Background Clinical testing, including food-specific skin and serum IgE level tests, provides limited accuracy to predict food allergy. Confirmatory oral food challenges (OFCs) are often required, but the associated risks, cost, and logistic difficulties comprise a barrier to proper diagnosis. Objective We sought to utilize advanced machine learning methodologies to integrate clinical variables associated with peanut allergy to create a predictive model for OFCs to improve predictive performance over that of purely statistical methods. Methods Machine learning was applied to the Learning Early about Peanut Allergy (LEAP) study of 463 peanut OFCs and associated clinical variables. Patient-wise cross-validation was used to create ensemble models that were evaluated on holdout test sets. These models were further evaluated by using 2 additional peanut allergy OFC cohorts: the IMPACT study cohort and a local University of Michigan cohort. Results In the LEAP data set, the ensemble models achieved a maximum mean area under the curve of 0.997, with a sensitivity and specificity of 0.994 and 1.00, respectively. In the combined validation data sets, the top ensemble model achieved a maximum area under the curve of 0.871, with a sensitivity and specificity of 0.763 and 0.980, respectively. Conclusions Machine learning models for predicting peanut OFC results have the potential to accurately predict OFC outcomes, potentially minimizing the need for OFCs while increasing confidence in food allergy diagnoses.
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Affiliation(s)
- Jonathan Gryak
- Department of Computer Science, Queens College, City University of New York, New York, NY
| | - Aleksandra Georgievska
- Department of Computer Science, Queens College, City University of New York, New York, NY
| | - Justin Zhang
- Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, Mich
| | - Kayvan Najarian
- Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, Mich
- Department of Emergency Medicine, University of Michigan, Ann Arbor, Mich
- Department of Computer Science and Engineering, University of Michigan, Ann Arbor, Mich
- Michigan Institute for Data Science, University of Michigan, Ann Arbor, Mich
- Max Harry Weil Institute for Critical Care Research and Innovation, University of Michigan, Ann Arbor, Mich
| | - Rajan Ravikumar
- Division of Allergy and Immunology, Department of Internal Medicine, University of Michigan, Ann Arbor, Mich
| | - Georgiana Sanders
- Division of Allergy and Immunology, Department of Internal Medicine, University of Michigan, Ann Arbor, Mich
- Mary H. Weiser Food Allergy Center, University of Michigan, Ann Arbor, Mich
| | - Charles F. Schuler
- Division of Allergy and Immunology, Department of Internal Medicine, University of Michigan, Ann Arbor, Mich
- Mary H. Weiser Food Allergy Center, University of Michigan, Ann Arbor, Mich
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Barshow SM, Islam M, Commins S, Macauley MS, Paulson JC, Kulis MD. Targeting inhibitory Siglec-3 to suppress IgE-mediated human basophil degranulation. J Allergy Clin Immunol 2024; 154:492-497.e1. [PMID: 38593870 DOI: 10.1016/j.jaci.2024.03.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 01/12/2024] [Accepted: 03/08/2024] [Indexed: 04/11/2024]
Abstract
BACKGROUND Sialic acid-binding immunoglobulin-like lectin-3 (Siglec-3 [CD33]) is a major Siglec expressed on human mast cells and basophils; engagement of CD33 leads to inhibition of cellular signaling via immunoreceptor tyrosine-based inhibitory motifs. OBJECTIVE We sought to inhibit human basophil degranulation by simultaneously recruiting inhibitory CD33 to the IgE-FcεRI complex by using monoclonal anti-IgE directly conjugated to CD33 ligand (CD33L). METHODS Direct and indirect basophil activation tests (BATs) were used to assess both antigen-specific (peanut) and antigen-nonspecific (polyclonal anti-IgE) stimulation. Whole blood from donors with allergy was used for direct BAT, whereas blood from donors with nonfood allergy was passively sensitized with plasma from donors with peanut allergy in the indirect BAT. Blood was incubated with anti-IgE-CD33L or controls for 1 hour or overnight and then stimulated with peanut, polyclonal anti-IgE, or N-formylmethionyl-leucyl-phenylalanine for 30 minutes. Degranulation was determined by measuring CD63 expression on the basophil surface by flow cytometry. RESULTS Incubation for 1 hour with anti-IgE-CD33L significantly reduced basophil degranulation after both allergen-induced (peanut) and polyclonal anti-IgE stimulation, with further suppression after overnight incubation with anti-IgE-CD33L. As expected, anti-IgE-CD33L did not block basophil degranulation due to N-formylmethionyl-leucyl-phenylalanine, providing evidence that this inhibition is IgE pathway-specific. Finally, CD33L is necessary for this suppression, as monoclonal anti-IgE without CD33L was unable to reduce basophil degranulation. CONCLUSIONS Pretreating human basophils with anti-IgE-CD33L significantly suppressed basophil degranulation through the IgE-FcεRI complex. The ability to abrogate IgE-mediated basophil degranulation is of particular interest, as treatment with anti-IgE-CD33L before antigen exposure could have broad implications for the treatment of food, drug, and environmental allergies.
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Affiliation(s)
- Suzanne M Barshow
- Duke University School of Medicine, Durham, NC; University of North Carolina at Chapel Hill, Chapel Hill, NC
| | | | - Scott Commins
- University of North Carolina at Chapel Hill, Chapel Hill, NC
| | | | | | - Michael D Kulis
- University of North Carolina at Chapel Hill, Chapel Hill, NC.
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Hernández-Aguilar I, Vizuet-de-Rueda JC, Galván-Morales MÁ, Montero-Vargas JM, Teran LM. Rapid generation of an RBL cellular model to study proteins that cause allergenic reactions in vitro. Immunol Res 2024; 72:874-879. [PMID: 38334936 PMCID: PMC11347464 DOI: 10.1007/s12026-024-09461-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 01/26/2024] [Indexed: 02/10/2024]
Abstract
Allergic diseases affect nearly 30% of people worldwide. There is a wide range of allergen sources, such as animal dander, food, venom, dust mites, and pollen. The skin prick test is the predominant technique used to identify allergenic sensitivity in vivo; the main problem is that it can be imprecise as many of the allergen extracts are made of mixtures of allergic and nonallergic components, making it difficult to identify the disease-eliciting allergen. An alternative to solve this problem is employing cellular models in vitro that may allow allergen identification, allergy diagnosis, and testing of novel potential compounds that can be used in immunotherapeutics. For example, rat basophilic leukemia (RBL) cells are a well-suited model for studying allergies. Unfortunately, cells generated from RBL cells are not commercially available. Therefore, we developed an RBL model with a degranulation gene reporter capable of recognizing human IgE involved in allergenic sensitivity using commercial plasmids. Employing this model, we successfully evaluated the capacity of union between IgE from allergic patients to allergenic proteins from Oleaceae tree pollen. This RBL cell model can be used as a diagnostic method for sensitivity to any allergens from different sources in vitro.
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Affiliation(s)
- Israel Hernández-Aguilar
- Ciencias Básicas en Biología, Instituto Tecnológico del Valle de Oaxaca, Ex-Hda. de Nazareno, Santa Cruz Xoxocotlán, 10587, Oaxaca, México
| | - Juan Carlos Vizuet-de-Rueda
- Depto. de Inmunogenética y Alergia, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Calz. de Tlalpan 4502, Tlapan, 14080, Ciudad de Mexico, México
| | - Miguel Ángel Galván-Morales
- Depto. de Inmunogenética y Alergia, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Calz. de Tlalpan 4502, Tlapan, 14080, Ciudad de Mexico, México
| | - Josaphat Miguel Montero-Vargas
- Depto. de Inmunogenética y Alergia, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Calz. de Tlalpan 4502, Tlapan, 14080, Ciudad de Mexico, México
| | - Luis M Teran
- Depto. de Inmunogenética y Alergia, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Calz. de Tlalpan 4502, Tlapan, 14080, Ciudad de Mexico, México.
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6
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Pascal M, Bax HJ, Bergmann C, Bianchini R, Castells M, Chauhan J, De Las Vecillas L, Hartmann K, Álvarez EI, Jappe U, Jimenez-Rodriguez TW, Knol E, Levi-Schaffer F, Mayorga C, Poli A, Redegeld F, Santos AF, Jensen-Jarolim E, Karagiannis SN. Granulocytes and mast cells in AllergoOncology-Bridging allergy to cancer: An EAACI position paper. Allergy 2024. [PMID: 39036854 DOI: 10.1111/all.16246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Revised: 06/23/2024] [Accepted: 07/11/2024] [Indexed: 07/23/2024]
Abstract
Derived from the myeloid lineage, granulocytes, including basophils, eosinophils, and neutrophils, along with mast cells, play important, often disparate, roles across the allergic disease spectrum. While these cells and their mediators are commonly associated with allergic inflammation, they also exhibit several functions either promoting or restricting tumor growth. In this Position Paper we discuss common granulocyte and mast cell features relating to immunomodulatory functions in allergy and in cancer. We highlight key mechanisms which may inform cancer treatment and propose pertinent areas for future research. We suggest areas where understanding the communication between granulocytes, mast cells, and the tumor microenvironment, will be crucial for identifying immune mechanisms that may be harnessed to counteract tumor development. For example, a comprehensive understanding of allergic and immune factors driving distinct neutrophil states and those mechanisms that link mast cells with immunotherapy resistance, might enable targeted manipulation of specific subpopulations, leading to precision immunotherapy in cancer. We recommend specific areas of investigation in AllergoOncology and knowledge exchange across disease contexts to uncover pertinent reciprocal functions in allergy and cancer and allow therapeutic manipulation of these powerful cell populations. These will help address the unmet needs in stratifying and managing patients with allergic diseases and cancer.
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Affiliation(s)
- Mariona Pascal
- Immunology Department, CDB, Hospital Clínic de Barcelona; Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
- Department of Medicine, Universitat de Barcelona, Barcelona, Spain
- RETICS Asma, reacciones adversas y alérgicas (ARADYAL) and RICORS Red De Enfermedades Inflamatorias (REI), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Heather J Bax
- St. John's Institute of Dermatology, School of Basic & Medical Biosciences & KHP Centre for Translational Medicine, King's College London, London, UK
| | - Christoph Bergmann
- Department of Otorhinolaryngology, RKM740 Interdisciplinary Clinics, Düsseldorf, Germany
| | - Rodolfo Bianchini
- Institute of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University Vienna, Vienna, Austria
- The interuniversity Messerli Research Institute, University of Veterinary Medicine Vienna, Medical University Vienna, Vienna, Austria
| | - Mariana Castells
- Division of Allergy and Clinical Immunology, Drug Hypersensitivity and Desensitization Center, Mastocytosis Center, Brigham and Women's Hospital; Harvard Medical School, Boston, USA
| | - Jitesh Chauhan
- St. John's Institute of Dermatology, School of Basic & Medical Biosciences & KHP Centre for Translational Medicine, King's College London, London, UK
| | | | - Karin Hartmann
- Division of Allergy, Department of Dermatology, University Hospital Basel and University of Basel, Basel, Switzerland
- Department of Biomedicine, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Elena Izquierdo Álvarez
- Department of Basic Medical Sciences, Facultad de Medicina, Universidad San Pablo-CEU, CEU Universities, Urbanización Montepríncipe, Institute of Applied Molecular Medicine Instituto de Medicina Molecular Aplicada Nemesio Díez (IMMA), Madrid, Spain
| | - Uta Jappe
- Division of Clinical and Molecular Allergology, Priority Research Area Chronic Lung Diseases, Research Center Borstel, Leibniz Lung Center, German Center for Lung Research (DZL), Airway Research Center North (ARCN), Borstel, Germany
- Interdisciplinary Allergy Outpatient Clinic, Department of Pneumology, University of Luebeck, Luebeck, Germany
| | | | - Edward Knol
- Departments Center of Translational Immunology and Dermatology/Allergology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Francesca Levi-Schaffer
- Pharmacology and Experimental Therapeutics Unit, Institute for Drug Research, School of Pharmacy, Faculty of Medicine. The Hebrew University of Jerusalem, Ein Kerem Campus, Jerusalem, Israel
| | - Cristobalina Mayorga
- RETICS Asma, reacciones adversas y alérgicas (ARADYAL) and RICORS Red De Enfermedades Inflamatorias (REI), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Allergy Unit and Research Laboratory, Hospital Regional Universitario de Málaga-HRUM, Instituto de investigación Biomédica de Málaga -IBIMA-Plataforma BIONAND, Málaga, Spain
| | - Aurélie Poli
- Neuro-Immunology Group, Department of Cancer Research, Luxembourg Institute of Health, Luxembourg, Luxembourg
| | - Frank Redegeld
- Division of Pharmacology, Utrecht Institute of Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht, The Netherlands
| | - Alexandra F Santos
- Department of Women and Children's Health (Pediatric Allergy), School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
- Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, King's College London, London, UK
- Children's Allergy Service, Evelina London Children's Hospital, Guy's and St Thomas' Hospital, London, UK
| | - Erika Jensen-Jarolim
- Institute of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University Vienna, Vienna, Austria
- The interuniversity Messerli Research Institute, University of Veterinary Medicine Vienna, Medical University Vienna, Vienna, Austria
| | - Sophia N Karagiannis
- St. John's Institute of Dermatology, School of Basic & Medical Biosciences & KHP Centre for Translational Medicine, King's College London, London, UK
- Breast Cancer Now Research Unit, School of Cancer & Pharmaceutical Sciences, King's College London, Guy's Cancer Centre, London, UK
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7
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Wu J, Tontini C, Wang R, Bulfone-Paus S, Murray CS, Simpson A. Basophil Activating Factors in the Serum May Underlie the 'Nonreleaser' Basophil Status in the Basophil Activation Test. Clin Exp Allergy 2024. [PMID: 38991789 DOI: 10.1111/cea.14542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2024] [Revised: 06/27/2024] [Accepted: 06/29/2024] [Indexed: 07/13/2024]
Affiliation(s)
- Jiakai Wu
- Lydia Becker Institute of Immunology and Inflammation, University of Manchester, Manchester, UK
- Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, University of Manchester, Manchester, UK
- NIHR Manchester Biomedical Research Centre, Manchester Academic Health Science Centre, Manchester University NHS Foundation Trust, Manchester, UK
| | - Chiara Tontini
- Lydia Becker Institute of Immunology and Inflammation, University of Manchester, Manchester, UK
- Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, University of Manchester, Manchester, UK
| | - Ran Wang
- Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, University of Manchester, Manchester, UK
- NIHR Manchester Biomedical Research Centre, Manchester Academic Health Science Centre, Manchester University NHS Foundation Trust, Manchester, UK
| | - Silvia Bulfone-Paus
- Lydia Becker Institute of Immunology and Inflammation, University of Manchester, Manchester, UK
- Division of Musculoskeletal & Dermatological Sciences, School of Biological Sciences, University of Manchester, Manchester, UK
| | - Clare S Murray
- Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, University of Manchester, Manchester, UK
- NIHR Manchester Biomedical Research Centre, Manchester Academic Health Science Centre, Manchester University NHS Foundation Trust, Manchester, UK
| | - Angela Simpson
- Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, University of Manchester, Manchester, UK
- NIHR Manchester Biomedical Research Centre, Manchester Academic Health Science Centre, Manchester University NHS Foundation Trust, Manchester, UK
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8
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Nishida Y, Yagami A, Takada S, Muramatsu D, Nobuoka Y, Okayama Y. Clinical investigation for the mechanisms of anaphylactic symptoms in osteoarthritis patients after diclofenac etalhyaluronate administration. Mod Rheumatol 2024; 34:820-830. [PMID: 37862589 DOI: 10.1093/mr/road100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 09/26/2023] [Accepted: 10/05/2023] [Indexed: 10/22/2023]
Abstract
OBJECTIVE This study was conducted to investigate the mechanisms of anaphylaxis in patients with osteoarthritis of the knee and hip after diclofenac etalhyaluronate [product name: JOYCLU® (JCL)] intra-articular injection and to determine the utility of tests to investigate the mechanism involved. METHODS In this observational study in Japan, patients aged ≥20 years with knee or hip osteoarthritis who received JCL intra-articular injection experienced anaphylactic symptoms considered related to JCL ('experienced patients') or did not experience allergic symptoms considered related to JCL ('non-experienced patients'). Basophil activation tests (BATs), specific immunoglobulin E (IgE) antibody testing by enzyme-linked immunosorbent assays (ELISAs) or immunochromatographic kit, and genome-wide association studies (GWASs) were conducted using patient blood and saliva. RESULTS Thirteen experienced patients and 14 non-experienced patients were tested. Seven experienced patients tested positive by BAT using diclofenac etalhyaluronate-containing test substances. Diclofenac-specific IgE antibodies were detected in four of seven BAT-positive patients but not in the non-experienced patients. Specific IgE antibody testing by immunochromatographic kit and genome-wide association study showed no clear results. CONCLUSIONS These findings suggest that anaphylaxis occurs after JCL administration via an IgE-mediated mechanism and that diclofenac etalhyaluronate may be involved in this mechanism. BAT and diclofenac -specific IgE enzyme-linked immunosorbent assay may be useful tests for investigating the mechanisms of anaphylactic reactions after JCL administration.
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Affiliation(s)
- Yoshihiro Nishida
- Department of Rehabilitation Medicine, Rare Cancer Center, Nagoya University Hospital, Nagoya, Aichi, Japan
| | - Akiko Yagami
- Department of Allergology, Fujita Health University Bantane Hospital, Nagoya, Aichi, Japan
| | - Shuhei Takada
- Research and Development Division, Seikagaku Corporation, Higashiyamato, Tokyo, Japan
| | - Dai Muramatsu
- Research and Development Division, Seikagaku Corporation, Higashiyamato, Tokyo, Japan
| | - Yuji Nobuoka
- Research and Development Division, Seikagaku Corporation, Tokyo, Japan
| | - Yoshimichi Okayama
- Department of Internal Medicine, Division of Allergology, Misato Kenwa Hospital, Misato, Saitama, Japan
- Department of Medicine, Division of Respiratory Medicine and Allergology, Showa University, Tokyo, Japan
- Department of Internal Medicine, Division of Respiratory Medicine, Nihon University School of Medicine, Tokyo, Japan
- Advanced Medical Science Research Center, Gunma Paz University Graduate School of Health Sciences, Takasaki, Gunma, Japan
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9
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Mullins E, Bresson J, Dewhurst IC, Epstein MM, Firbank LG, Guerche P, Hejatko J, Moreno FJ, Naegeli H, Nogué F, Rostoks N, Sánchez Serrano JJ, Savoini G, Veromann E, Veronesi F, Cocconcelli PS, Glandorf D, Herman L, Jimenez Saiz R, Ruiz Garcia L, Aguilera Entrena J, Gennaro A, Schoonjans R, Kagkli DM, Dalmay T. New developments in biotechnology applied to microorganisms. EFSA J 2024; 22:e8895. [PMID: 39040572 PMCID: PMC11261303 DOI: 10.2903/j.efsa.2024.8895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/24/2024] Open
Abstract
EFSA was requested by the European Commission (in accordance with Article 29 of Regulation (EC) No 178/2002) to provide a scientific opinion on the application of new developments in biotechnology (new genomic techniques, NGTs) to viable microorganisms and products of category 4 to be released into the environment or placed on the market as or in food and feed, and to non-viable products of category 3 to be placed on the market as or in food and feed. A horizon scanning exercise identified a variety of products containing microorganisms obtained with NGTs (NGT-Ms), falling within the remit of EFSA, that are expected to be placed on the (EU) market in the next 10 years. No novel potential hazards/risks from NGT-Ms were identified as compared to those obtained by established genomic techniques (EGTs), or by conventional mutagenesis. Due to the higher efficiency, specificity and predictability of NGTs, the hazards related to the changes in the genome are likely to be less frequent in NGT-Ms than those modified by EGTs and conventional mutagenesis. It is concluded that EFSA guidances are 'partially applicable', therefore on a case-by-case basis for specific NGT-Ms, fewer requirements may be needed. Some of the EFSA guidances are 'not sufficient' and updates are recommended. Because possible hazards relate to genotypic and phenotypic changes introduced and not to the method used for the modification, it is recommended that any new guidance should take a consistent risk assessment approach for strains/products derived from or produced with microorganisms obtained with conventional mutagenesis, EGTs or NGTs.
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10
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Baig M, Nanjappa NC, Perkins GB, Di Lernia R, Thiruvenkatarajan V, Hissaria P. Basophil activation test in the diagnostic workup of perioperative anaphylaxis due to neuromuscular blocking agents: A case series and implications for practice. Anaesth Intensive Care 2024; 52:256-263. [PMID: 38649299 DOI: 10.1177/0310057x241232420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
In Australia, neuromuscular blocking agents are the leading cause of perioperative anaphylaxis. Current investigation of suspected anaphylaxis includes tryptase levels, serum immunoglobulin E (IgE) levels, and skin testing, including intradermal testing and skin prick testing. The gold standard for the diagnosis of a hypersensitivity reaction is a challenge test, but this poses a risk to patient safety. An alternative test, known as the basophil activation test (BAT) is a form of cellular in vitro testing using flow cytometry to measure the degree of basophil degranulation within a sample of blood following exposure to an allergen. This acts as a surrogate marker for mast cell and basophil activation, thereby identifying IgE-mediated allergy. It is most commonly used to supplement equivocal findings from initial in vitro testing to assist in confirming the diagnosis of a hypersensitivity reaction and identify the causative agent. We present a case series in which five patients with suspected anaphylaxis underwent a BAT, demonstrating its role and limitations in allergy testing within Australia.
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Affiliation(s)
- Mahanoor Baig
- Department of Anaesthesia, Queen Elizabeth Hospital, Adelaide, Australia
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Australia
| | - Nagesh C Nanjappa
- Department of Anaesthesia, Queen Elizabeth Hospital, Adelaide, Australia
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Australia
| | - Griffith B Perkins
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Australia
- SA Pathology, Adelaide, Australi
| | - Rachel Di Lernia
- Department of Anaesthesia, Queen Elizabeth Hospital, Adelaide, Australia
| | - Venkatesan Thiruvenkatarajan
- Department of Anaesthesia, Queen Elizabeth Hospital, Adelaide, Australia
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Australia
| | - Pravin Hissaria
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Australia
- SA Pathology, Adelaide, Australi
- Department of Allergy and Immunology, Royal Adelaide Hospital, Adelaide, Australia
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11
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Todoric K, Merrill S. Oral Immunotherapy: An Overview. Med Clin North Am 2024; 108:719-731. [PMID: 38816113 DOI: 10.1016/j.mcna.2023.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2024]
Abstract
Oral immunotherapy (OIT) is an alternative treatment of IgE-mediated food allergy that has been shown to increase tolerance threshold to many of the top food allergens, although this effect may be dependent on age, dose, frequency, and duration. OIT has been shown to be effective and safe in infants, and early initiation can improve rates of desensitization even for those foods whose natural history favors loss of allergy. Studies looking at protocol modification to improve OIT success are ongoing as is the evaluation of clinical tools to help monitor OIT effects.
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Affiliation(s)
- Krista Todoric
- Medical Arts Allergy, 220 Wilson Street Suite 200, Carlisle, PA 17013, USA.
| | - Sarah Merrill
- Family Medicine Department, UC San Diego Health, 402 Dickinson Street, San Diego, CA 92103, USA
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12
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Rosada T, Bartuzi Z, Grześk-Kaczyńska M, Rydzyńska M, Ukleja-Sokołowska N. Treatment of Allergies to Fur Animals. Int J Mol Sci 2024; 25:7218. [PMID: 39000328 PMCID: PMC11241144 DOI: 10.3390/ijms25137218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2024] [Revised: 06/27/2024] [Accepted: 06/28/2024] [Indexed: 07/16/2024] Open
Abstract
Allergy to fur animals is becoming an increasingly common clinical problem in everyday medical practice. Depending on the route of exposure to the allergen, patients present with many, often non-specific symptoms. The most common illnesses among people with allergies to the above-mentioned allergens are as follows: allergic rhinitis, allergic conjunctivitis, atopic bronchial asthma, food allergy, allergic contact dermatitis, and sometimes anaphylactic shock. In recent years, there has been a change in the holistic approach to the treatment of allergy patients. The method of treatment should be tailored to a specific patient, taking into account his or her predispositions, economic possibilities, and therapeutic goals. The article describes the main methods of treating allergies, focusing primarily on allergies to fur animals. Allergy treatment always requires great care, and qualification for specific types of therapy should be preceded by a thorough and accurate diagnosis.
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Affiliation(s)
- Tomasz Rosada
- Chair and Clinic of Allergology, Clinical Immunology and Internal Diseases, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 87-100 Toruń, Poland
| | - Zbigniew Bartuzi
- Chair and Clinic of Allergology, Clinical Immunology and Internal Diseases, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 87-100 Toruń, Poland
| | - Magdalena Grześk-Kaczyńska
- Clinic of Allergology, Clinical Immunology and Internal Diseases, Jan Biziel University Hospital No. 2 in Bydgoszcz, Ujejskiego 75, 85-168 Bydgoszcz, Poland
| | - Magdalena Rydzyńska
- Clinic of Allergology, Clinical Immunology and Internal Diseases, Jan Biziel University Hospital No. 2 in Bydgoszcz, Ujejskiego 75, 85-168 Bydgoszcz, Poland
| | - Natalia Ukleja-Sokołowska
- Chair and Clinic of Allergology, Clinical Immunology and Internal Diseases, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 87-100 Toruń, Poland
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13
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Wang JC, Nikpoor AR, Crosson T, Kaufmann E, Rafei M, Talbot S. BASOPHILS ACTIVATE PRURICEPTOR-LIKE VAGAL SENSORY NEURONS. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.06.11.598517. [PMID: 38915548 PMCID: PMC11195257 DOI: 10.1101/2024.06.11.598517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/26/2024]
Abstract
Vagal sensory neurons convey sensations from internal organs along the vagus nerve to the brainstem. Pruriceptors are a subtype of neurons that transmit itch and induce pruritus. Despite extensive research on the molecular mechanisms of itch, studies focusing on pruriceptors in the vagal ganglia still need to be explored. In this study, we characterized vagal pruriceptor neurons by their responsiveness to pruritogens such as lysophosphatidic acid, β-alanine, chloroquine, and the cytokine oncostatin M. We discovered that lung-resident basophils produce oncostatin M and that its release can be induced by engagement of FcεRIα. Oncostatin M then sensitizes multiple populations of vagal sensory neurons, including Tac1+ and MrgprA3+ neurons in the jugular ganglia. Finally, we observed an increase in oncostatin M release in mice sensitized to the house dust mite Dermatophagoides pteronyssinus or to the fungal allergen Alternaria alternata, highlighting a novel mechanism through which basophils and vagal sensory neurons may communicate during type I hypersensitivity diseases such as allergic asthma.
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Affiliation(s)
- Jo-Chiao Wang
- Department of Pharmacology and Physiology, Université de Montréal, Canada
| | - Amin Reza Nikpoor
- Department of Biomedical and Molecular Sciences, Queen’s University, Canada
- Department of Physiology and Pharmacology, Karolinska Institutet, Sweden
| | - Théo Crosson
- Department of Pharmacology and Physiology, Université de Montréal, Canada
| | - Eva Kaufmann
- Department of Biomedical and Molecular Sciences, Queen’s University, Canada
| | - Moutih Rafei
- Department of Pharmacology and Physiology, Université de Montréal, Canada
| | - Sébastien Talbot
- Department of Biomedical and Molecular Sciences, Queen’s University, Canada
- Department of Physiology and Pharmacology, Karolinska Institutet, Sweden
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14
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Conway AE, Golden DBK, Brough HA, Santos AF, Shaker MS. Serologic measurements for peanut allergy: Predicting clinical severity is complex. Ann Allergy Asthma Immunol 2024; 132:686-693. [PMID: 38272114 DOI: 10.1016/j.anai.2024.01.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 01/14/2024] [Accepted: 01/15/2024] [Indexed: 01/27/2024]
Abstract
Allergist-immunologists use serologic peanut allergy testing to maximize test sensitivity and specificity while minimizing cost and inconvenience. Recent advances toward this goal include a better understanding of specific IgE (sIgE) and component testing, epitope-sIgE assays, and basophil activation testing. Predicting reaction severity with serologic testing is challenged by a range of co-factors that influence reaction severity, such as the amount and form of any allergen consumed and comorbid disease. In 2020, the Allergy Immunology Joint Task Force on Practice Parameters recommended Ara h 2-sIgE as the most cost-effective diagnostic test for peanut allergy because of its superior performance, when compared with skin prick testing and serum IgE. Basophil activation testing, a functional test of allergic response not evaluated in the Joint Task Force on Practice Parameters guideline, is a promising option for both allergy diagnosis and prognosis. Similarly, epitope-sIgE testing may improve prediction of reaction thresholds, but further validation is needed. Despite advances in food allergy testing, many of these tools remain limited by cost, accessibility, and feasibility. In addition, there is a need for further research on how atopic dermatitis may be modifying serologic food allergy severity assessments. Given these limitations, allergy test selection requires a shared decision-making approach so that a patient's values and preferences regarding financial impact, inconvenience, and psychological effects are considered in the context of clinician expertise on the timing and use of optimized testing.
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Affiliation(s)
| | - David B K Golden
- Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Helen A Brough
- Department of Women and Children's Health (Pediatric Allergy), School of Life Courses Sciences, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom; Children's Allergy Service and Children's Allergy Service, Evelina Children's Hospital, Guy's and St. Thomas's NHS Foundation Trust, London, United Kingdom
| | - Alexandra F Santos
- Department of Women and Children's Health (Pediatric Allergy), School of Life Courses Sciences, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom; Children's Allergy Service and Children's Allergy Service, Evelina Children's Hospital, Guy's and St. Thomas's NHS Foundation Trust, London, United Kingdom; Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom
| | - Marcus S Shaker
- Dartmouth Geisel School of Medicine, Hanover, New Hampshire; Section of Allergy and Immunology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire.
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15
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Ishibashi S, Yanagida N, Sato S, Ebisawa M. Management of food allergy based on oral food challenge. Curr Opin Allergy Clin Immunol 2024; 24:153-159. [PMID: 38538146 DOI: 10.1097/aci.0000000000000980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
PURPOSE OF REVIEW Food allergy is a growing health problem that affects both patients and society in multiple ways. Despite the emergence of novel diagnostic tools, such as component-resolved diagnostics (CRD) and basophil activation tests (BAT), oral food challenge (OFC) still plays an indispensable role in the management of food allergies. This review aimed to highlight the indications and safety concerns of conducting an OFC and to provide insights into post-OFC management based on recent findings. RECENT FINDINGS Standardized OFC protocols have regional diversification, especially in Japan and Western countries. Recent studies suggested that the interval between doses should be at least more than an hour. Furthermore, applying a stepwise method tailored to the patient's specific immunoglobulin E level and history of anaphylaxis seems to mitigate these risks. Recent surveys have shown that, following a positive OFC, options other than strict avoidance are also selected. SUMMARY OFC serves diverse purposes, yet the risks it carries warrant caution. The stepwise protocol appears promising for its safety. Subthreshold consumption following OFC shows potential; however, further research on its efficacy and safety is required. Management following OFC should be tailored and well discussed between clinicians and patients.
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Affiliation(s)
- Seijiro Ishibashi
- Department of Allergy, Clinical Research Center for Allergy and Rheumatology, NHO Sagamihara National Hospital, Kanagawa, Japan
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16
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Rosada T, Lis K, Bartuzi Z, Grześk-Kaczyńska M, Ukleja-Sokołowska N. Diagnostics of Allergy to Furry Animals-Possibilities in 2024. J Clin Med 2024; 13:3239. [PMID: 38892951 PMCID: PMC11172995 DOI: 10.3390/jcm13113239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2024] [Revised: 05/21/2024] [Accepted: 05/28/2024] [Indexed: 06/21/2024] Open
Abstract
Diagnosing allergies is not always easy. Sometimes the symptoms reported by the patient do not match the results of diagnostic tests. Diagnostics of IgE-dependent allergy, including allergy to furry animals, can be based on two basic strategies, "BOTTOM-UP" and "TOP-DOWN", and almost all available allergy tests can be used ranging from skin tests, through specific IgE, to molecular panels and challenge tests. Currently, most information regarding the diagnosis and incidence of allergies to furry animals focuses almost exclusively on the two most common pets-dogs and cats. This is certainly due to the fact that allergy to cats and/or dogs is a common phenomenon, has a huge impact on quality of life, and is a challenge for doctors of many specialties. However, the growing number of owners of other pet species means that diagnostic methods must keep up with the changing needs of patients. Further research in these groups will certainly provide new facts and facilitate clinical decision-making when working with allergic patients.
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Affiliation(s)
- Tomasz Rosada
- Department and Clinic of Allergology, Clinical Immunology and Internal Diseases, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 87-100 Toruń, Poland; (K.L.); (Z.B.); (N.U.-S.)
| | - Kinga Lis
- Department and Clinic of Allergology, Clinical Immunology and Internal Diseases, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 87-100 Toruń, Poland; (K.L.); (Z.B.); (N.U.-S.)
| | - Zbigniew Bartuzi
- Department and Clinic of Allergology, Clinical Immunology and Internal Diseases, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 87-100 Toruń, Poland; (K.L.); (Z.B.); (N.U.-S.)
| | - Magdalena Grześk-Kaczyńska
- Clinic of Allergology, Clinical Immunology and Internal Diseases, Jan Biziel University Hospital No. 2 in Bydgoszcz, 75 Ujejskiego St., 85-168 Bydgoszcz, Poland;
| | - Natalia Ukleja-Sokołowska
- Department and Clinic of Allergology, Clinical Immunology and Internal Diseases, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, 87-100 Toruń, Poland; (K.L.); (Z.B.); (N.U.-S.)
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17
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Goldberg MR, Appel MY, Tobi K, Levy MB, Epstein-Rigbi N, Holmqvist M, Östling J, Nachshon L, Lidholm J, Elizur A. Validation of the NUT CRACKER Diagnostic Algorithm and Prediction for Cashew and Pistachio Co-Allergy. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2024; 12:1273-1282.e5. [PMID: 38382880 DOI: 10.1016/j.jaip.2024.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 02/07/2024] [Accepted: 02/08/2024] [Indexed: 02/23/2024]
Abstract
BACKGROUND Because of the high cross-sensitization among tree nuts, the NUT CRACKER (Nut Co-reactivity-Acquiring Knowledge for Elimination Recommendations) study proposed a diagnostic algorithm to minimize the number of required oral food challenges (OFCs). OBJECTIVE To validate the algorithm for cashew and pistachio allergy and determine markers for allergic severity. METHODS Patients (n = 125) with a median age of 7.8 (interquartile range, 5.9-11.2) years with suspected tree nut allergy were evaluated prospectively with decision tree points on the basis of skin prick test (SPT), basophil activation test (BAT), and knowledge of the coincidence of allergies. Validation of allergic status was determined by OFC. Markers of clinical severity were evaluated using the combined original and prospective cohort (n = 187) in relationship to SPT, BAT, and Ana o 3-sIgE. RESULTS Reactivity to cashew in SPT, BAT, and Ana o 3-sIgE and the incidence of abdominal pain on challenge were significantly higher in dual-allergic cashew/pistachio patients (n = 82) versus single cashew allergic patients (n = 18) (P = .001). All 3 diagnostic tests showed significant inverse correlation with log10 reaction doses for positive cashew OFC. The algorithm reduced overall the total number of OFCs by 72.0%, with a positive predictive value and negative predictive value of 93.0% and 99.0%, respectively. Cashew false-positives were observed primarily in hazelnut-allergic patients (P = .026). In this population, Ana o 3-specific IgE could diagnose cashew allergy with a sensitivity of more than 90% and a specificity of more than 95%. CONCLUSIONS The NUT CRACKER diagnostic algorithm was validated and reduced the number of diagnostic OFCs required. Markers for severity phenotypes may guide oral immunotherapy protocols, improving the risk/benefit ratio for patients.
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Affiliation(s)
- Michael R Goldberg
- Institute of Allergy, Immunology and Pediatric Pulmonology, Shamir (Assaf-Harofeh) Medical Center, Zerifin, Israel; Department of Pediatrics, Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
| | - Michael Y Appel
- Institute of Allergy, Immunology and Pediatric Pulmonology, Shamir (Assaf-Harofeh) Medical Center, Zerifin, Israel
| | - Katz Tobi
- Institute of Allergy, Immunology and Pediatric Pulmonology, Shamir (Assaf-Harofeh) Medical Center, Zerifin, Israel
| | - Michael B Levy
- Institute of Allergy, Immunology and Pediatric Pulmonology, Shamir (Assaf-Harofeh) Medical Center, Zerifin, Israel
| | - Naama Epstein-Rigbi
- Institute of Allergy, Immunology and Pediatric Pulmonology, Shamir (Assaf-Harofeh) Medical Center, Zerifin, Israel; Department of Pediatrics, Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | | | | | - Liat Nachshon
- Institute of Allergy, Immunology and Pediatric Pulmonology, Shamir (Assaf-Harofeh) Medical Center, Zerifin, Israel; Department of Medicine, Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | | | - Arnon Elizur
- Institute of Allergy, Immunology and Pediatric Pulmonology, Shamir (Assaf-Harofeh) Medical Center, Zerifin, Israel; Department of Pediatrics, Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
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18
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Song LB, Zhang L, Zhu Y, Yang YS, Xu ZQ, Sun JL, Wei JF. Identification of fructose-bisphosphate aldolase as new pollen allergens. Allergy 2024; 79:1368-1372. [PMID: 38375932 DOI: 10.1111/all.16058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 01/18/2024] [Accepted: 02/05/2024] [Indexed: 02/21/2024]
Affiliation(s)
- Le-Bin Song
- Department of Pharmacy, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China
- Department of Dermatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Li Zhang
- Division of Respiratory and Critical Care Medicine, Respiratory Infection and Intervention Laboratory of Frontiers Science Center for Disease-related Molecular Network, State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China
| | - Ying Zhu
- Department of Blood Transfusion, First Affiliated Hospital of Gannan Medical University, Ganzhou, China
| | - Yong-Shi Yang
- Department of Allergy, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Zhi-Qiang Xu
- Department of Pharmacy, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Jin-Lyu Sun
- Department of Allergy, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Ji-Fu Wei
- Department of Pharmacy, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China
- Department of Pharmacy, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
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19
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Hsin L, Varese N, Aui PM, Wines BD, von Borstel A, Mascarell L, Hogarth PM, Hew M, O'Hehir RE, van Zelm MC. Accurate determination of house dust mite sensitization in asthma and allergic rhinitis through cytometric detection of Der p 1 and Der p 2 binding on basophils (CytoBas). J Allergy Clin Immunol 2024; 153:1282-1291.e10. [PMID: 38360181 DOI: 10.1016/j.jaci.2024.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 01/10/2024] [Accepted: 02/06/2024] [Indexed: 02/17/2024]
Abstract
BACKGROUND House dust mite (HDM) is the most common allergen trigger globally for allergic rhinitis and atopic asthma. OBJECTIVES To expedite accurate confirmation of allergen sensitization, we designed fluorescent allergen tetramers to directly stain specific IgE on basophils to detect specific allergen sensitization using the flow cytometric CytoBas assay. METHODS Recombinant proteins of major HDM allergens (component), Der f 1, Der p 1, and Der p 2 were biotinylated and conjugated with fluorochrome streptavidins as tetramers. Blood samples from 64 patients who are HDM-allergic and 26 controls that are non-HDM-sensitized were incubated with allergen tetramers for evaluation of basophil binding (CytoBas) and activation (BAT) with flow cytometry. RESULTS The tetramers effectively bound and activated basophils from patients who are allergic but not from controls who are nonsensitized. CytoBas with Der p 1 as a single allergen had comparable sensitivity and specificity (92% and 100%) to BAT (91% and 100%) in detecting allergen sensitization, as did CytoBas with Der p 2 (95% and 96%) to BAT (95% and 87%). A positive staining for Der p 1 and/or Der p 2 in CytoBas was 100% sensitive and 96% specific for HDM allergy. CONCLUSIONS CytoBas has diagnostic accuracy for group 1 and group 2 HDM allergens that is comparable to BAT, but with additional advantages of multiple allergen components in a single tube and no requirement for in vitro basophil activation. These findings endorse a single, multiplex CytoBas assay for accurate and component-resolved diagnosis of aeroallergen sensitization in patients with allergic asthma and/or rhinitis.
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Affiliation(s)
- Lin Hsin
- Department of Immunology, Central Clinical School, Monash University, Melbourne, Australia
| | - Nirupama Varese
- Department of Immunology, Central Clinical School, Monash University, Melbourne, Australia; Allergy, Asthma and Clinical Immunology, Alfred Health, Melbourne, Australia; Immune Therapies Group, Burnet Institute, Melbourne, Australia
| | - Pei Mun Aui
- Department of Immunology, Central Clinical School, Monash University, Melbourne, Australia
| | - Bruce D Wines
- Department of Immunology, Central Clinical School, Monash University, Melbourne, Australia; Immune Therapies Group, Burnet Institute, Melbourne, Australia; Department of Pathology, The University of Melbourne, Parkville, Australia
| | - Anouk von Borstel
- Department of Immunology, Central Clinical School, Monash University, Melbourne, Australia
| | - Laurent Mascarell
- Innovation and Science Department, Stallergenes Greer, Antony, France
| | - P Mark Hogarth
- Department of Immunology, Central Clinical School, Monash University, Melbourne, Australia; Immune Therapies Group, Burnet Institute, Melbourne, Australia; Department of Pathology, The University of Melbourne, Parkville, Australia
| | - Mark Hew
- Allergy, Asthma and Clinical Immunology, Alfred Health, Melbourne, Australia; Department of Pathology, The University of Melbourne, Parkville, Australia
| | - Robyn E O'Hehir
- Department of Immunology, Central Clinical School, Monash University, Melbourne, Australia; Allergy, Asthma and Clinical Immunology, Alfred Health, Melbourne, Australia
| | - Menno C van Zelm
- Department of Immunology, Central Clinical School, Monash University, Melbourne, Australia; Allergy, Asthma and Clinical Immunology, Alfred Health, Melbourne, Australia; Department of Immunology, Erasmus Medical Center, University Medical Center, Rotterdam, The Netherlands.
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20
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Santos AF, Antoneria G, Jama Z, Ilangovan J, Houghton V. Reply to the correspondence on "Basophil activation test as predictor of severity and threshold of allergic reactions to egg". Allergy 2024; 79:1389-1391. [PMID: 38462821 DOI: 10.1111/all.16101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Revised: 02/10/2024] [Accepted: 03/05/2024] [Indexed: 03/12/2024]
Affiliation(s)
- Alexandra F Santos
- Department of Women and Children's Health (Pediatric Allergy), School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
- Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, King's College London, London, UK
- Children's Allergy Service, Evelina London Children's Hospital, Guy's and St Thomas' Hospital, London, UK
| | - Grammatiki Antoneria
- Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, King's College London, London, UK
| | - Zainab Jama
- Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, King's College London, London, UK
| | - Jana Ilangovan
- Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, King's College London, London, UK
- Centre for Host Microbiome interactions, King's College London, London, UK
| | - Vikki Houghton
- Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, King's College London, London, UK
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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21
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Alvarez-Arango S, Kumar M, Chow TG, Sabato V. Non-IgE-Mediated Immediate Drug-Induced Hypersensitivity Reactions. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2024; 12:1109-1119. [PMID: 38423288 PMCID: PMC11081849 DOI: 10.1016/j.jaip.2024.02.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 02/04/2024] [Accepted: 02/15/2024] [Indexed: 03/02/2024]
Abstract
Immediate drug-induced hypersensitivity reactions (IDHSRs) have conventionally been attributed to an immunoglobulin E (IgE)-mediated mechanism. Nevertheless, it has now been acknowledged that IDHSRs can also occur independently of IgE involvement. Non-IgE-mediated IDHSRs encompass the activation of effector cells, both mast cell-dependent and -independent and the initiation of inflammatory pathways through immunogenic and nonimmunogenic mechanisms. The IDHSRs involve inflammatory mediators beyond histamine, including the platelet-activating factor, which activates multiple cell types, including smooth muscle, endothelium, and MC, and evidence supports its importance in IgE-mediated reactions in humans. Clinically, distinguishing IgE from non-IgE mechanisms is crucial for future treatment strategies, including drug(s) restriction, readministration approaches, and pretreatment considerations. However, this presents significant challenges because certain drugs can trigger both mechanisms, and their presentations can appear similarly, ranging from mild to life-threatening symptoms. Thus, history alone is often inadequate for differentiation, and skin tests lack a standardized approach. Moreover, drug-specific IgE immunoassays have favorable specificity but low sensitivity, and the usefulness of the basophil activation test remains debatable. Lastly, no biomarker reliably differentiates between both mechanisms. Whereas non-IgE-mediated mechanisms likely predominate in IDHSRs, reclassifying most drug-related IDHSRs as non-IgE-mediated, with suggested prevention through dose administration adjustments, is premature and risky. Therefore, continued research and validated diagnostic tests are crucial to improving our capacity to distinguish between these mechanisms, ultimately enhancing patient care.
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Affiliation(s)
- Santiago Alvarez-Arango
- Division of Clinical Pharmacology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Md; Division of Allergy and Clinical Immunology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Md; Department of Pharmacology and Molecular Science, Johns Hopkins University School of Medicine, Baltimore, Md.
| | - Mukesh Kumar
- School of Biological Sciences, University of Hong Kong, Hong Kong, SAR
| | - Timothy G Chow
- Division of Allergy and Immunology, Department of Pediatrics and Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Vito Sabato
- Department of Immunology, Allergology and Rheumatology, Antwerp University Hospital, University Antwerp, Antwerp, Belgium
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22
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Bergmann MM, Santos AF. Basophil activation test in the food allergy clinic: its current use and future applications. Expert Rev Clin Immunol 2024:1-8. [PMID: 38591129 DOI: 10.1080/1744666x.2024.2336568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Accepted: 03/26/2024] [Indexed: 04/10/2024]
Abstract
INTRODUCTION The basophil activation test (BAT) has shown evidence of high sensitivity and high specificity to support the diagnosis of IgE-mediated allergy. It is a functional test that uses live cells analyzed by flow cytometry and thus needs to be performed within 24h of blood collection. BAT has shown to be reproducible and reliable when tested in a clinical diagnostic laboratory with standardized protocols and flow cytometry settings. AREAS COVERED In this review, we summarize the evidence to support clinical use of BAT and the next steps required for clinical implementation for an improve clinical care for patients with suspected IgE-mediated food allergy. EXPERT OPINION BAT has recently been included in Clinical Guidelines of Food Allergy Diagnosis and its implementation in clinical practice depends largely on availability. Proposed clinical applications of the BAT include: distinction between food allergy and asymptomatic IgE sensitization; determination of food allergic status to peanut, tree nuts and seeds in polysensitized children; evaluation of tolerance to baked egg and baked milk in egg and milk allergic children; identification of patients at high-risk of severe allergic reactions; monitoring for spontaneous resolution of food allergy; confirmation of eligibility for specific treatments of food allergy; prediction and monitoring of response to immunomodulatory treatments.
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Affiliation(s)
- Marcel M Bergmann
- Pediatric allergy unit, Department of Women, Children and Adolescents, University Hospitals of Geneva, Geneva, Switzerland
- Pediatrics, Centro Pediatrico del Mendrisiotto, Mendrisio, Switzerland
- Faculty of Biomedical Science, Università della Svizzera Italiana (USI), Lugano, Switzerland
| | - Alexandra F Santos
- Department of Women and Children's Health (Pediatric Allergy), School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
- Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, King's College London, London, UK
- Children's Allergy Service, Evelina London Children's Hospital, Guy's and St Thomas' Hospital, London, UK
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23
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Dwivedi V, Kopanja S, Schmidthaler K, Sieber J, Bannert C, Szépfalusi Z. Preventive allergen immunotherapy with inhalant allergens in children. Allergy 2024. [PMID: 38588176 DOI: 10.1111/all.16115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 02/09/2024] [Accepted: 03/20/2024] [Indexed: 04/10/2024]
Abstract
The efficacy and safety of preventive allergen immunotherapy (pAIT) in children are currently under investigation. Here, we provide an overview of pAIT with respiratory allergens concerning the prevention of new sensitizations, allergic disease onset and progression as well as further immunomodulatory effects. Three databases were searched for clinical pAIT studies in children. Selected publications were reviewed for preventive outcomes according to prevention level (primary, secondary, and tertiary), allergen type, administration route, dose, and treatment duration. The primary prevention approach appears safe but showed no allergen-specific effect on new sensitizations. Secondary prevention seems feasible and may induce regulatory T cell-mediated immunotolerance. The number of studies at these prevention levels is limited. Tertiary prevention with grass and/or tree pollen-based pAIT has shown efficacy in preventing disease progression from allergic rhinitis/conjunctivitis to asthma. Data on tertiary pAIT with house dust mites and other allergen types are inconclusive. Subcutaneous and sublingual routes appear similarly effective, but head-to-head comparative paediatric studies are scarce. Additionally, there are fewer placebo-controlled studies. Nevertheless, immunomodulatory outcomes of pAIT are encouraging. Currently, limited but favourably suggestive evidence is available for preventing respiratory allergic diseases in children by pAIT. Primary and secondary prevention have potential and warrant further investigation through well-designed studies.
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Affiliation(s)
- Varsha Dwivedi
- Division of Paediatric Pulmonology, Allergy and Endocrinology, Department of Paediatrics and Adolescent Medicine, Comprehensive Centre of Paediatrics, Medical University of Vienna, Vienna, Austria
| | - Sonja Kopanja
- Division of Paediatric Pulmonology, Allergy and Endocrinology, Department of Paediatrics and Adolescent Medicine, Comprehensive Centre of Paediatrics, Medical University of Vienna, Vienna, Austria
| | - Klara Schmidthaler
- Division of Paediatric Pulmonology, Allergy and Endocrinology, Department of Paediatrics and Adolescent Medicine, Comprehensive Centre of Paediatrics, Medical University of Vienna, Vienna, Austria
| | - Justyna Sieber
- Division of Paediatric Pulmonology, Allergy and Endocrinology, Department of Paediatrics and Adolescent Medicine, Comprehensive Centre of Paediatrics, Medical University of Vienna, Vienna, Austria
| | - Christina Bannert
- Division of Paediatric Pulmonology, Allergy and Endocrinology, Department of Paediatrics and Adolescent Medicine, Comprehensive Centre of Paediatrics, Medical University of Vienna, Vienna, Austria
| | - Zsolt Szépfalusi
- Division of Paediatric Pulmonology, Allergy and Endocrinology, Department of Paediatrics and Adolescent Medicine, Comprehensive Centre of Paediatrics, Medical University of Vienna, Vienna, Austria
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24
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Barrett TF, Roland LT. Promising New Diagnostic and Treatment Modalities for Allergic Rhinitis: What's Coming Next? Otolaryngol Clin North Am 2024; 57:243-251. [PMID: 37722952 DOI: 10.1016/j.otc.2023.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/20/2023]
Abstract
Novel diagnostic tests may help diagnose patients with local allergic rhinitis (AR) when systemic testing is negative or inconclusive. Surgical approaches including septoplasty, inferior turbinate reduction, nasal swell body reduction, and posterior nasal nerve ablation may improve symptoms in patients whose symptoms are refractory to medical therapy, though high-quality evidence is lacking in the AR population. Intralymphatic and epicutaneous immunotherapy have the potential to improve adherence to allergen immunotherapy, though comparisons with current gold standard treatments are lacking and studies reporting long-term outcomes are needed. Immunomodulatory agents in combination with subcutaneous immunotherapy (SCIT) may improve tolerance of SCIT but reports to date do not demonstrate a clear benefit in symptom alleviation. Future work in these areas may support these options as beneficial for testing and treatment of AR.
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Affiliation(s)
- Thomas F Barrett
- Division of Rhinology & Anterior Skull Base Surgery, Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, 660 South Euclid Avenue, St Louis, MO 63110, USA
| | - Lauren T Roland
- Division of Rhinology & Anterior Skull Base Surgery, Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, 660 South Euclid Avenue, St Louis, MO 63110, USA.
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25
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Fernández-Lozano C, Rita CG, Barra-Castro A, de la Hoz Caballer B, Roldán E, Pueyo López C, Martinez-Botas J, Berges-Gimeno MP. Specific IgE and Basophil Activation Test by Microarray: A Promising Tool for Diagnosis of Platinum Compound Hypersensitivity Reactions. Int J Mol Sci 2024; 25:3890. [PMID: 38612700 PMCID: PMC11011729 DOI: 10.3390/ijms25073890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 03/26/2024] [Accepted: 03/26/2024] [Indexed: 04/14/2024] Open
Abstract
Drug hypersensitivity reactions (DHRs) to platinum-based compounds (PCs) are on the rise, and their personalized and safe management is essential to enable first-line treatment for these cancer patients. This study aimed to evaluate the usefulness of the basophil activation test by flow cytometry (BAT-FC) and the newly developed sIgE-microarray and BAT-microarray in diagnosing IgE-mediated hypersensitivity reactions to PCs. A total of 24 patients with DHRs to PCs (20 oxaliplatin and four carboplatin) were evaluated: thirteen patients were diagnosed as allergic with positive skin tests (STs) or drug provocation tests (DPTs), six patients were diagnosed as non-allergic with negative STs and DPTs, and five patients were classified as suspected allergic because DPTs could not be performed. In addition, four carboplatin-tolerant patients were included as controls. The BAT-FC was positive in 2 of 13 allergic patients, with a sensitivity of 15.4% and specificity of 100%. However, the sIgE- and BAT-microarray were positive in 11 of 13 DHR patients, giving a sensitivity of over 84.6% and a specificity of 90%. Except for one patient, all samples from the non-allergic and control groups were negative for sIgE- and BAT-microarray. Our experience indicated that the sIgE- and BAT-microarray could be helpful in the endophenotyping of IgE-mediated hypersensitivity reactions to PCs and may provide an advance in decision making for drug provocation testing.
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Affiliation(s)
- Carlos Fernández-Lozano
- Biochemistry-Research Department, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria, Carretera de Colmenar Km 9, 28034 Madrid, Spain;
- Allergology Department, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria, Carretera de Colmenar Km 9, 28034 Madrid, Spain; (A.B.-C.); (B.d.l.H.C.)
| | - Claudia Geraldine Rita
- Immunology Service, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria, Carretera de Colmenar Km 9, 28034 Madrid, Spain; (C.G.R.); (E.R.)
- Department of Medicine and Health Sciences, Alcalá University, 28801 Madrid, Spain
| | - Alicia Barra-Castro
- Allergology Department, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria, Carretera de Colmenar Km 9, 28034 Madrid, Spain; (A.B.-C.); (B.d.l.H.C.)
| | - Belén de la Hoz Caballer
- Allergology Department, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria, Carretera de Colmenar Km 9, 28034 Madrid, Spain; (A.B.-C.); (B.d.l.H.C.)
- Department of Medicine and Health Sciences, Alcalá University, 28801 Madrid, Spain
| | - Ernesto Roldán
- Immunology Service, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria, Carretera de Colmenar Km 9, 28034 Madrid, Spain; (C.G.R.); (E.R.)
| | - Cristina Pueyo López
- Pharmacy Department, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria, Carretera de Colmenar Km 9, 28034 Madrid, Spain;
| | - Javier Martinez-Botas
- Biochemistry-Research Department, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria, Carretera de Colmenar Km 9, 28034 Madrid, Spain;
| | - María Pilar Berges-Gimeno
- Allergology Department, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria, Carretera de Colmenar Km 9, 28034 Madrid, Spain; (A.B.-C.); (B.d.l.H.C.)
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26
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Faihs V, Schmalhofer V, Kugler C, Bent RK, Scherf KA, Lexhaller B, Mortz CG, Bindslev-Jensen C, Biedermann T, Skov PS, Eberlein B, Brockow K. Detection of Sensitization Profiles with Cellular In Vitro Tests in Wheat Allergy Dependent on Augmentation Factors (WALDA). Int J Mol Sci 2024; 25:3574. [PMID: 38612386 PMCID: PMC11012217 DOI: 10.3390/ijms25073574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Revised: 03/13/2024] [Accepted: 03/16/2024] [Indexed: 04/14/2024] Open
Abstract
Wheat allergy dependent on augmentation factors (WALDA) is the most common gluten allergy in adults. IgE-mediated sensitizations are directed towards ω5-gliadin but also to other wheat allergens. The value of the different in vitro cellular tests, namely the basophil activation test (BAT) and the active (aBHRA) and passive basophil histamine-release assays (pBHRA), in the detection of sensitization profiles beyond ω5-gliadin has not been compared. Therefore, 13 patients with challenge-confirmed, ω5-gliadin-positive WALDA and 11 healthy controls were enrolled. Specific IgE (sIgE), skin prick tests, BATs, aBHRA, and pBHRA were performed with allergen test solutions derived from wheat and other cereals, and results were analyzed and compared. This study reveals a distinct and highly individual reactivity of ω5-gliadin-positive WALDA patients to a range of wheat allergens beyond ω5-gliadin in cellular in vitro tests and SPT. In the BAT, for all tested allergens (gluten, high-molecular-weight glutenin subunits, α-amylase/trypsin inhibitors (ATIs), alcohol-free wheat beer, hydrolyzed wheat proteins (HWPs), rye gluten and secalins), basophil activation in patients was significantly higher than in controls (p = 0.004-p < 0.001). Similarly, significant histamine release was detected in the aBHRA for all test substances, exceeding the cut-off of 10 ng/mL in all tested allergens in 50% of patients. The dependency of tests on sIgE levels against ω5-gliadin differed; in the pBHRA, histamine release to any test substances could only be detected in patients with sIgE against ω5-gliadin ≥ 7.7 kU/L, whereas aBHRA also showed high reactivity in less sensitized patients. In most patients, reactivity to HWPs, ATIs, and rye allergens was observed. Additionally, alcohol-free wheat beer was first described as a promising test substance in ω5-gliadin-positive WALDA. Thus, BAT and aBHRA are valuable tools for the identification of sensitization profiles in WALDA.
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Affiliation(s)
- Valentina Faihs
- Department of Dermatology and Allergy Biederstein, School of Medicine and Health, Technical University of Munich, 80802 Munich, Germany
| | - Viktoria Schmalhofer
- Department of Dermatology and Allergy Biederstein, School of Medicine and Health, Technical University of Munich, 80802 Munich, Germany
| | - Claudia Kugler
- Department of Dermatology and Allergy Biederstein, School of Medicine and Health, Technical University of Munich, 80802 Munich, Germany
| | - Rebekka K. Bent
- Department of Dermatology and Allergy Biederstein, School of Medicine and Health, Technical University of Munich, 80802 Munich, Germany
| | - Katharina A. Scherf
- Department of Bioactive and Functional Food Chemistry, Institute of Applied Biosciences, Karlsruhe Institute of Technology (KIT), 76131 Karlsruhe, Germany
| | - Barbara Lexhaller
- Department of Bioactive and Functional Food Chemistry, Institute of Applied Biosciences, Karlsruhe Institute of Technology (KIT), 76131 Karlsruhe, Germany
| | - Charlotte G. Mortz
- Odense Research Center for Anaphylaxis (ORCA), Department of Dermatology and Allergy Centre, Odense University Hospital, 5000 Odense, Denmark
| | - Carsten Bindslev-Jensen
- Odense Research Center for Anaphylaxis (ORCA), Department of Dermatology and Allergy Centre, Odense University Hospital, 5000 Odense, Denmark
| | - Tilo Biedermann
- Department of Dermatology and Allergy Biederstein, School of Medicine and Health, Technical University of Munich, 80802 Munich, Germany
| | - Per S. Skov
- Odense Research Center for Anaphylaxis (ORCA), Department of Dermatology and Allergy Centre, Odense University Hospital, 5000 Odense, Denmark
- RefLab ApS, 2200 Copenhagen, Denmark
| | - Bernadette Eberlein
- Department of Dermatology and Allergy Biederstein, School of Medicine and Health, Technical University of Munich, 80802 Munich, Germany
| | - Knut Brockow
- Department of Dermatology and Allergy Biederstein, School of Medicine and Health, Technical University of Munich, 80802 Munich, Germany
- Odense Research Center for Anaphylaxis (ORCA), Department of Dermatology and Allergy Centre, Odense University Hospital, 5000 Odense, Denmark
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27
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Mayorga C, Çelik GE, Pascal M, Hoffmann HJ, Eberlein B, Torres MJ, Brockow K, Garvey LH, Barbaud A, Madrigal-Burgaleta R, Caubet JC, Ebo DG. Flow-based basophil activation test in immediate drug hypersensitivity. An EAACI task force position paper. Allergy 2024; 79:580-600. [PMID: 38084472 DOI: 10.1111/all.15957] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 11/06/2023] [Accepted: 11/13/2023] [Indexed: 12/22/2023]
Abstract
Diagnosing immediate drug hypersensitivity reactions (IDHRs) can pose a significant challenge and there is an urgent need for safe and reliable tests. Evidence has emerged that the basophil activation test (BAT), an in vitro assay that mirrors the in vivo response, can be a complementary test for many drugs. In this position paper, members of Task Force (TF) "Basophil activation test in the evaluation of Drug Hypersensitivity Reactions" from the European Academy of Allergy and Clinical Immunology (EAACI) present the data from a survey about the use and utility of BAT in IDHRs in Europe. The survey results indicate that there is a great interest for using BAT especially for diagnosing IDHRs. However, there are still main needs, mainly in the standardization of the protocols. Subsequently consensus-based recommendations were formulated for: (i) Technical aspects of BAT in IDHRs including type of sample, management of drugs, flow cytometry protocols, interpretation of the results; and (ii) Drug-specific aspects that should be taken into account when performing BAT in relation to betalactams, neuromuscular blocking agents, fluoroquinolones, chlorhexidine, opioids, radio contrast media, chemotherapeutics, biological agents, nonsteroidal anti-inflammatory drugs, COVID vaccine, and excipients. Moreover, aspects in the evaluation of pediatric population have also been considered. All this indicates that BAT offers the clinician and laboratory a complementary tool for a safe diagnostic for IDHRs, although its place in the diagnostic algorithm depends on the drug class and patient population (phenotype, geography, and age). The standardization of BAT is important for generalizing this method beyond the individual laboratory.
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Affiliation(s)
- C Mayorga
- Allergy Unit, Hospital Regional Universitario de Málaga and Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, Málaga, Spain
- RETICS Asma reacciones adversas y alérgicas (ARADYAL) and RICORS Red De Enfermedades Inflamatorias (REI), Madrid, Spain
| | - G E Çelik
- Department of chest disease, Division of Allergy & Immunology, Ankara University School of Medicine, Ankara, Turkey
| | - M Pascal
- RETICS Asma reacciones adversas y alérgicas (ARADYAL) and RICORS Red De Enfermedades Inflamatorias (REI), Madrid, Spain
- Immunology Department, Centre de Diagnòstic Biomèdic, Hospital Clínic de Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
| | - H J Hoffmann
- Department of Clinical Medicine and Department of Clinical Immunology, Aarhus University and Aarhus University Hospital, Aarhus N, Denmark
| | - B Eberlein
- Department of Dermatology and Allergy Biederstein, School of Medicine, Technical University Munich, Munich, Germany
| | - M J Torres
- Allergy Unit, Hospital Regional Universitario de Málaga and Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, Málaga, Spain
- RETICS Asma reacciones adversas y alérgicas (ARADYAL) and RICORS Red De Enfermedades Inflamatorias (REI), Madrid, Spain
- Medicine Department, Malaga University, Málaga, Spain
| | - K Brockow
- Department of Dermatology and Allergy Biederstein, School of Medicine, Technical University Munich, Munich, Germany
| | - L H Garvey
- Allergy Clinic, Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen and Department of Clinical Medicine, University of Copenhagen, Kobenhavn, Denmark
| | - A Barbaud
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP.Sorbonne Université, Hôpital Tenon, Département de dermatologie et allergologie, Paris, France
| | - R Madrigal-Burgaleta
- Allergy & Severe Asthma Service, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK
| | - J C Caubet
- Department of Women-Children-Teenagers, University Hospital of Geneva, Geneva, Switzerland
| | - D G Ebo
- Faculty of Medicine and Health Sciences, Department of Immunology, Allergology, Rheumatology and the Infla-Med Centre of Excellence, Antwerp (Belgium) and Immunology, Allergology, Rheumatology, Antwerp University Hospital, University of Antwerp, Antwerp, Belgium
- Department of Immunology and Allergology, AZ Jan Palfijn Gent, Ghent, Belgium
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28
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Zhao J, Camus-Ela M, Zhang L, Wang Y, Rennie GH, Wang J, Raghavan V. A comprehensive review on mango allergy: Clinical relevance, causative allergens, cross-reactivity, influence of processing techniques, and management strategies. Compr Rev Food Sci Food Saf 2024; 23:e13304. [PMID: 38343296 DOI: 10.1111/1541-4337.13304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 01/08/2024] [Accepted: 01/11/2024] [Indexed: 02/15/2024]
Abstract
Mangoes (Mangifera indica) are widely prized for their abundant nutritional content and variety of beneficial bioactive compounds and are popularly utilized in various foods, pharmaceuticals, and cosmetics industries. However, it is important to note that certain proteins present in mango can trigger various allergic reactions, ranging from mild oral allergy syndrome to severe life-threatening anaphylaxis. The immunoglobulin E-mediated hypersensitivity of mango is mainly associated with three major allergenic proteins: Man i 1 (class IV chitinase), Man i 2 (pathogenesis-related-10 protein; Bet v 1-related protein), and Man i 4 (profilin). Food processing techniques can significantly affect the structure of mango allergens, reducing their potential to cause allergies. However, it is worth mentioning that complete elimination of mango allergen immunoreactivity has not been achieved. The protection of individuals sensitized to mango should be carefully managed through an avoidance diet, immediate medical care, and long-term oral immunotherapy. This review covers various aspects related to mango allergy, including prevalence, pathogenesis, symptoms, and diagnosis. Furthermore, the characterization of mango allergens and their potential cross-reactivity with other fruits, vegetables, plant pollen, and seeds were discussed. The review also highlights the effects of food processing on mango and emphasizes the available strategies for managing mango allergy.
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Affiliation(s)
- Jinlong Zhao
- Key Laboratory of Environmental Medicine and Engineering, Ministry of Education, and Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing, China
- School of Food Engineering, Anhui Science and Technology University, Fengyang, China
| | - Mukeshimana Camus-Ela
- Key Laboratory of Environmental Medicine and Engineering, Ministry of Education, and Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing, China
| | - Lili Zhang
- Key Laboratory of Environmental Medicine and Engineering, Ministry of Education, and Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing, China
| | - Yuxin Wang
- Key Laboratory of Environmental Medicine and Engineering, Ministry of Education, and Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing, China
| | - Gardiner Henric Rennie
- Key Laboratory of Environmental Medicine and Engineering, Ministry of Education, and Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing, China
| | - Jin Wang
- Key Laboratory of Environmental Medicine and Engineering, Ministry of Education, and Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing, China
| | - Vijaya Raghavan
- Department of Bioresource Engineering, Faculty of Agricultural and Environmental Sciences, McGill University, Montreal, Quebec, Canada
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29
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Bennett MR, Mathioudakis AG, Wu J, Chu MMH, Tontini C, Thomas I, Simpson A. Performance Characteristics of Basophil Activation Tests for Diagnosing Penicillin Allergy: A Meta-Analysis. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2024; 12:714-723.e5. [PMID: 37940090 DOI: 10.1016/j.jaip.2023.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Revised: 09/22/2023] [Accepted: 11/01/2023] [Indexed: 11/10/2023]
Abstract
BACKGROUND Approximately 10% of the global population identify themselves as penicillin allergic, yet 90% are not truly allergic and could safely tolerate penicillin. There is no simple way to identify these people. Current in vitro diagnostics include specific immunoglobulin E (with a sensitivity of 19% and specificity of 97%) and a basophil activation test (BAT) with undefined sensitivity and specificity. OBJECTIVE To define the sensitivity and specificity of BAT in the diagnosis of penicillin allergy METHODS: We searched PubMed and EMBASE from inception to April 2, 2023, for original studies evaluating the performance characteristics of BAT for penicillin allergy in adults. Study selection, data extraction, risk of bias, assessment with QUADAS-2 tool, certainty assessment with Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology were performed independently, in duplicate. Meta-analysis was performed using Reitsma methodology. RESULTS Twenty-two studies fulfilled the inclusion criteria. Twelve used the same positive threshold giving a summary point sensitivity 51% (95% confidence interval [95% CI]46%-56%) and specificity 89% (95% CI 85%-93%). Significant risk of bias was identified owing to patient selection. GRADE certainty of evidence rated sensitivity very low due to imprecision and specificity as low. There was great heterogeneity in methods used. Use of 1,000 basophils per test did not improve performance above 500 basophils. CONCLUSIONS BAT sensitivity is highly variable across studies and remains too low to be considered as a routine element of clinical practice. BAT specificity is not as good as specific immunoglobulin E in penicillin allergy diagnosis. Significant further work is required in this field before clinical application of BAT in routine practice.
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Affiliation(s)
- Miriam R Bennett
- Division of Immunology, Immunity to Infection and Respiratory Medicine, University of Manchester, Manchester, UK.
| | - Alexander G Mathioudakis
- Division of Immunology, Immunity to Infection and Respiratory Medicine, University of Manchester, Manchester, UK; Manchester University NHS Foundation Trust, Respiratory and Allergy, Manchester, UK
| | - Jiakai Wu
- Division of Immunology, Immunity to Infection and Respiratory Medicine, University of Manchester, Manchester, UK
| | - Michael M H Chu
- Manchester University NHS Foundation Trust, Otolaryngology, Manchester, UK
| | - Chiara Tontini
- Division of Immunology, Immunity to Infection and Respiratory Medicine, University of Manchester, Manchester, UK
| | - Iason Thomas
- Division of Immunology, Immunity to Infection and Respiratory Medicine, University of Manchester, Manchester, UK; Manchester University NHS Foundation Trust, Respiratory and Allergy, Manchester, UK
| | - Angela Simpson
- Division of Immunology, Immunity to Infection and Respiratory Medicine, University of Manchester, Manchester, UK; Manchester University NHS Foundation Trust, Respiratory and Allergy, Manchester, UK
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Kedar O, Golberg A, Obolski U, Confino-Cohen R. Allergic to bureaucracy? Regulatory allergenicity assessments of novel food: Motivations, challenges, compromises, and possibilities. Compr Rev Food Sci Food Saf 2024; 23:e13300. [PMID: 38477215 DOI: 10.1111/1541-4337.13300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 12/12/2023] [Accepted: 12/12/2023] [Indexed: 03/14/2024]
Abstract
New sources of proteins are essential to meet the demands of the growing world population and evolving food trends. Assessing the allergenicity of proteins in novel food (NF) poses a significant food safety regulatory challenge. The Codex Alimentarius Commission presented an allergenicity assessment protocol for genetically modified (GM) foods, which can also be adapted for NF. Since no single laboratory test can adequately predict the allergenic potential of NF, the protocol follows a weight-of-evidence approach, evaluated by experts, as part of a risk management process. Regulatory bodies worldwide have adopted this safety protocol, which, among other things, promotes global harmonization. This review unravels the reliability and various motivations, terms, concepts, and approaches of allergenicity assessments, aiming to enhance understanding among manufacturers and the public. Health Canada, Food Safety Commission JAPAN, and Food Standards Australia New Zealand were surveyed, focusing on the European Food Safety Authority and the US Food Safety Administration for examples of scientific opinions regarding allergenicity assessments for novel and GM foods, from 2019 to 2023. According to our findings, current regulatory allergenicity assessments for NF approval primarily rely on literature reviews. Only a few of the NF assessments proactively presented additional tests. We recommend conducting bioinformatic analyses on NF when a panel of experts deems that there is insufficient prior scientific research.
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Affiliation(s)
- Odeya Kedar
- Faculty of Exact Sciences, Department of Environmental Studies, The Porter School of Environment and Earth Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Alexander Golberg
- Faculty of Exact Sciences, Department of Environmental Studies, The Porter School of Environment and Earth Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Uri Obolski
- Faculty of Exact Sciences, Department of Environmental Studies, The Porter School of Environment and Earth Sciences, Tel Aviv University, Tel Aviv, Israel
- Faculty of Medicine, School of Public Health, Department of Epidemiology and Preventive Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ronit Confino-Cohen
- Allergy and Clinical Immunology Unit, Meir Medical Center, Kfar Saba, Israel
- School of Medicine, Tel Aviv University, Tel Aviv, Israel
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Müller S, Kröger C, Schultze JL, Aschenbrenner AC. Whole blood stimulation as a tool for studying the human immune system. Eur J Immunol 2024; 54:e2350519. [PMID: 38103010 DOI: 10.1002/eji.202350519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 12/05/2023] [Accepted: 12/07/2023] [Indexed: 12/17/2023]
Abstract
The human immune system is best accessible via tissues and organs not requiring major surgical intervention, such as blood. In many circumstances, circulating immune cells correlate with an individual's health state and give insight into physiological and pathophysiological processes. Stimulating whole blood ex vivo is a powerful tool to investigate immune responses. In the context of clinical research, the applications of whole blood stimulation include host immunity, disease characterization, diagnosis, treatment, and drug development. Here, we summarize different setups and readouts of whole blood assays and discuss applications for preclinical research and clinical practice. Finally, we propose combining whole blood stimulation with high-throughput technologies, such as single-cell RNA-sequencing, to comprehensively analyze the human immune system for the identification of biomarkers, therapeutic interventions as well as companion diagnostics.
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Affiliation(s)
- Sophie Müller
- Systems Medicine, Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE) e.V., Bonn, Germany
- Department of Microbiology and Immunology, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
- Genomics & Immunoregulation, Life and Medical Sciences (LIMES) Institute, University of Bonn, Bonn, Germany
| | - Charlotte Kröger
- Systems Medicine, Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE) e.V., Bonn, Germany
- Genomics & Immunoregulation, Life and Medical Sciences (LIMES) Institute, University of Bonn, Bonn, Germany
| | - Joachim L Schultze
- Systems Medicine, Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE) e.V., Bonn, Germany
- Genomics & Immunoregulation, Life and Medical Sciences (LIMES) Institute, University of Bonn, Bonn, Germany
- PRECISE Platform for Single Cell Genomics and Epigenomics, DZNE and University of Bonn, Bonn, Germany
| | - Anna C Aschenbrenner
- Systems Medicine, Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE) e.V., Bonn, Germany
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Pascal M, Edelman SM, Nopp A, Möbs C, Geilenkeuser WJ, Knol EF, Ebo DG, Mertens C, Shamji MH, Santos AF, Patil S, Eberlein B, Mayorga C, Hoffmann HJ. EAACI task force report: A consensus protocol for the basophil activation test for collaboration and external quality assurance. Allergy 2024; 79:290-293. [PMID: 37795777 PMCID: PMC10843141 DOI: 10.1111/all.15907] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 09/18/2023] [Accepted: 09/25/2023] [Indexed: 10/06/2023]
Affiliation(s)
- M Pascal
- Immunology Department, Centre de Diagnòstic Biomèdic, Hospital Clínic de Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
- RETICS Asma reacciones adversas y alérgicas (ARADYAL) and RICORS Red De Enfermedades Inflamatorias (REI), Madrid, Spain
| | - S M Edelman
- Skin and Allergy Hospital, Helsinki University Central Hospital, Helsinki, Finland
| | - A Nopp
- Department of Clinical Science and Education, Karolinska Institutet, Södersjukhuset, and Sachs´ Children and Youth Hospital, Stockholm, Sweden
| | - C Möbs
- Department of Dermatology and Allergology, Philipps-Universität Marburg, Marburg, Germany
| | | | - E F Knol
- Center of Translational Immunology and Dermatology/Allergology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - D G Ebo
- Faculty of Medicine and Health Sciences, Department of Immunology-Allergology- Rheumatology, University of Antwerp, Antwerp, Belgium
| | - C Mertens
- Faculty of Medicine and Health Sciences, Department of Immunology-Allergology- Rheumatology, University of Antwerp, Antwerp, Belgium
| | - M H Shamji
- National Heart and Lung Institute, Imperial College London, London, UK
- NIHR Imperial Biomedical Research Centre, London, UK
| | - A F Santos
- Department of Women and Children's Health (Pediatric Allergy) & Peter Gorer Department of Immunobiology, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom
- Children's Allergy Service, Evelina London Children's Hospital, Guy's and St Thomas' Hospital, London, United Kingdom
| | - S Patil
- Division of Allergy and Immunology, Departments of Medicine and Pediatrics, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United States
| | - B Eberlein
- Department of Dermatology and Allergy Biederstein, School of Medicine, Technical University Munich, Munich, Germany
| | - C Mayorga
- RETICS Asma reacciones adversas y alérgicas (ARADYAL) and RICORS Red De Enfermedades Inflamatorias (REI), Madrid, Spain
- Allergy Clinical Unit, Hospital Regional Universitario de Málaga and Allergy Research Group, Instituto de Investigación Biomédica de Málaga-IBIMA-BIONAND, Málaga, Spain
| | - H J Hoffmann
- Department of Clinical Medicine, Aarhus University, Department of Respiratory Diseases and Allergy, Aarhus University Hospital, Aarhus, Denmark
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Castaño N, Chua K, Kaushik A, Kim S, Cordts SC, Nafarzadegan CD, Hofmann GH, Seastedt H, Schuetz JP, Dunham D, Parsons ES, Tsai M, Cao S, Desai M, Sindher SB, Chinthrajah RS, Galli SJ, Nadeau KC, Tang SK. Combining avidin with CD63 improves basophil activation test accuracy in classifying peanut allergy. Allergy 2024; 79:445-455. [PMID: 37916710 PMCID: PMC10842984 DOI: 10.1111/all.15930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 10/11/2023] [Accepted: 10/12/2023] [Indexed: 11/03/2023]
Abstract
BACKGROUND Conventional basophil activation tests (BATs) measure basophil activation by the increased expression of CD63. Previously, fluorophore-labeled avidin, a positively-charged molecule, was found to bind to activated basophils, which tend to expose negatively charged granule constituents during degranulation. This study further compares avidin versus CD63 as basophil activation biomarkers in classifying peanut allergy. METHODS Seventy subjects with either a peanut allergy (N = 47), a food allergy other than peanut (N = 6), or no food allergy (N = 17) were evaluated. We conducted BATs in response to seven peanut extract (PE) concentrations (0.01-10,000 ng/mL) and four control conditions (no stimulant, anti-IgE, fMLP (N-formylmethionine-leucyl-phenylalanine), and anti-FcεRI). We measured avidin binding and CD63 expression on basophils with flow cytometry. We evaluated logistic regression and XGBoost models for peanut allergy classification and feature identification. RESULTS Avidin binding was correlated with CD63 expression. Both markers discriminated between subjects with and without a peanut allergy. Although small by percentage, an avidin+ /CD63- cell subset was found in all allergic subjects tested, indicating that the combination of avidin and CD63 could allow a more comprehensive identification of activated basophils. Indeed, we obtained the best classification accuracy (97.8% sensitivity, 96.7% specificity) by combining avidin and CD63 across seven PE doses. Similar accuracy was obtained by combining PE dose of 10,000 ng/mL for avidin and PE doses of 10 and 100 ng/mL for CD63. CONCLUSIONS Avidin and CD63 are reliable BAT activation markers associated with degranulation. Their combination enhances the identification of activated basophils and improves the classification accuracy of peanut allergy.
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Affiliation(s)
| | - Kaiser Chua
- Department of Mechanical Engineering, Stanford University
| | - Abhinav Kaushik
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University
- Department of Environmental Health, T. H. Chan School of Public Health, Harvard University
| | - Sungu Kim
- Department of Mechanical Engineering, Stanford University
| | - Seth C. Cordts
- Department of Mechanical Engineering, Stanford University
| | - Ceena D. Nafarzadegan
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University
- Department of Microbiology and Immunology, Stanford University
| | | | - Hana Seastedt
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University
| | - Jackson P. Schuetz
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University
| | - Diane Dunham
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University
| | - Ella S. Parsons
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University
| | - Mindy Tsai
- Department of Pathology, Stanford University
| | - Shu Cao
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University
| | - Manisha Desai
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University
- Department of Medicine, Biomedical Informatics Research, Stanford University
| | - Sayantani B. Sindher
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University
- Department of Medicine, Division of Pulmonary, Allergy and Critical Care, Stanford University
| | - R. Sharon Chinthrajah
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University
- Department of Medicine, Division of Pulmonary, Allergy and Critical Care, Stanford University
| | - Stephen J. Galli
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University
- Department of Microbiology and Immunology, Stanford University
- Department of Pathology, Stanford University
| | - Kari C. Nadeau
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University
- Department of Environmental Health, T. H. Chan School of Public Health, Harvard University
| | - Sindy K.Y. Tang
- Department of Mechanical Engineering, Stanford University
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University
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Acevedo N, Llinás-Caballero K. Mass Cytometry in Food Allergy Research. Methods Mol Biol 2024; 2717:207-219. [PMID: 37737986 DOI: 10.1007/978-1-0716-3453-0_13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/23/2023]
Abstract
Mechanisms underlying food allergy are not well understood. Mass cytometry is a technique that allows the multiple analysis of cell surface markers and intracellular proteins by using the spectrum of rare metal isotopes of different atomic masses without channel overlap. Bioinformatic approaches are implemented to combine and reduce the information of more than 60 parameters to define immune cell subpopulations. To date, mass cytometry has revealed a great heterogeneity in human response to food antigens and that subpopulations of basophils and mononuclear cells might be mechanistically implicated in food allergy. This chapter reviews some fundamentals of mass cytometry and the contributions of this technique in elucidating the immune basis of food allergy, oral tolerance, food desensitization, phenotypes, and the cellular events occurring upon allergen-specific immunotherapy.
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Affiliation(s)
- Nathalie Acevedo
- Institute for Immunological Research, University of Cartagena, Cartagena, Colombia.
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La Sorda M, Fossati M, Graffeo R, Ferraironi M, De Rosa MC, Buzzonetti A, Righino B, Zampetti N, Fattorossi A, Nucera E, Aruanno A, Ferrandina G, Apostol AI, Buonomo A, Scambia G, Sanguinetti M, Battaglia A. A Modified Basophil Activation Test for the Clinical Management of Immediate Hypersensitivity Reactions to Paclitaxel: A Proof-of-Concept Study. Cancers (Basel) 2023; 15:5818. [PMID: 38136365 PMCID: PMC10741873 DOI: 10.3390/cancers15245818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 12/01/2023] [Accepted: 12/08/2023] [Indexed: 12/24/2023] Open
Abstract
Immediate hypersensitivity reactions (iHSRs) to taxanes are observed in 6% and 4% of gynecologic and breast cancer patients, respectively. Drug desensitization is the only option, as no comparable alternative therapy is available. Surfactants in the taxane formulation have been implicated in the immunopathogenesis of iHSRs, although sporadic skin test (ST) positivity and iHSRs to nab-paclitaxel have suggested the involvement of the taxane moiety and/or IgE-mediated pathomechanisms. In vitro diagnostic tests might offer insights into mechanisms underlying iHSRs to taxanes. The aim of the present study was to address this unmet need by developing a novel basophil activation test (BAT). The study included patients (n = 31) undergoing paclitaxel/carboplatin therapy. Seventeen patients presented with iHSRs to paclitaxel (iHSR-Taxpos), and eleven were tolerant (iHSR-Taxneg). Fourteen patients presented with iHSRs to carboplatin (iHSR-Plpos), and fourteen were tolerant (iHSR-Plneg). The BAT median stimulation index (SI) values were 1.563 (range, 0.02-4.11; n = 11) and -0.28 (range -4.88-0.07, n = 11) in iHSR-Taxpos and iHSR-Taxneg, respectively. The BAT median SI values were 4.45 (range, 0.1-26.7; n = 14) and 0 (range, -0.51-1.65; n = 12) in iHSR-Plpos and iHSR-Plneg, respectively. SI levels were not associated with iHSR severity grading. Comparing BAT results in iHSR-Taxpos and iHSR-Taxneg showed the area under the receiver operator characteristic (ROC) curve to be 0.9752 (p = 0.0002). The cutoff calculated by the maximized likelihood ratio identified 90.91% of iHSR-Taxpos patients and 90.91% of iHSR-Taxneg patients. Comparing BAT results for iHSR-Plpos and iHSR-Plneg showed the area under the ROC curve to be 0.9286 (p = 0.0002). The cutoff calculated by the maximized likelihood ratio identified 78.57% of iHSR-Plpos patients and 91.67% of iHSR-Plneg patients. Most iHSR-Taxpos patients for which ST was available (10/11) scored ST-negative and BAT-positive, whereas most iHSR-Plpos patients for which ST was available (14/14) scored both BAT- and ST-positive. This suggested the intervention of non-IgE-mediated mechanisms in iHSR-Taxpos patients. Consistent with this view, an in silico molecular docking analysis predicted the high affinity of paclitaxel to the degranulation-competent MRGPRX2 receptor. This hypothesis warrants further in vitro investigations. In conclusion, the present study provides preliminary proof-of-concept evidence that this novel BAT has potential utility in understanding mechanisms underlying iHSRs to taxanes.
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Affiliation(s)
- Marilena La Sorda
- Microbiology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (M.L.S.); (R.G.); (M.S.)
| | - Marco Fossati
- Cytometry Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (M.F.); (A.B.); (N.Z.); (A.F.)
| | - Rosalia Graffeo
- Microbiology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (M.L.S.); (R.G.); (M.S.)
| | - Manuela Ferraironi
- Microbiology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (M.L.S.); (R.G.); (M.S.)
| | - Maria Cristina De Rosa
- Institute of Chemical Sciences and Technologies ‘‘Giulio Natta’’ (SCITEC)-CNR, 00168 Rome, Italy; (M.C.D.R.); (B.R.)
| | - Alexia Buzzonetti
- Cytometry Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (M.F.); (A.B.); (N.Z.); (A.F.)
| | - Benedetta Righino
- Institute of Chemical Sciences and Technologies ‘‘Giulio Natta’’ (SCITEC)-CNR, 00168 Rome, Italy; (M.C.D.R.); (B.R.)
| | - Nicole Zampetti
- Cytometry Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (M.F.); (A.B.); (N.Z.); (A.F.)
| | - Andrea Fattorossi
- Cytometry Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (M.F.); (A.B.); (N.Z.); (A.F.)
| | - Eleonora Nucera
- Allergy Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (E.N.); (A.A.); (A.B.)
| | - Arianna Aruanno
- Allergy Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (E.N.); (A.A.); (A.B.)
| | - Gabriella Ferrandina
- Gynecology Oncology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (G.F.); (G.S.)
| | - Adriana Ionelia Apostol
- Department of Woman, Child and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy;
| | - Alessandro Buonomo
- Allergy Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (E.N.); (A.A.); (A.B.)
| | - Giovanni Scambia
- Gynecology Oncology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (G.F.); (G.S.)
| | - Maurizio Sanguinetti
- Microbiology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (M.L.S.); (R.G.); (M.S.)
| | - Alessandra Battaglia
- Department of Life Science and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
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Santos AF, Riggioni C, Halken S, Muraro A, Akdis CA, Roberts G, Du Toit G, Skypala I. Executive summary of the EAACI guidelines on diagnosis of IgE-mediated food allergy. Allergy 2023; 78:3053-3056. [PMID: 37815198 DOI: 10.1111/all.15906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 09/12/2023] [Accepted: 09/23/2023] [Indexed: 10/11/2023]
Affiliation(s)
- Alexandra F Santos
- Department of Women and Children's Health (Pediatric Allergy), School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
- Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
- Children's Allergy Service, Evelina London Children's Hospital, Guy's and St Thomas' Hospital, London, UK
| | - Carmen Riggioni
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, National University Health System, Singapore, Singapore
| | - Susanne Halken
- Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark
| | - Antonella Muraro
- Food Allergy Referral Centre, Padua University Hospital, Padua, Italy
| | - Cezmi A Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University Zurich, Davos, Switzerland
| | - Graham Roberts
- Paediatric Allergy and Respiratory Medicine, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, Southampton, UK
- David Hide Asthma and Allergy Centre, St Mary Hospital, Isle of Wight, UK
| | - George Du Toit
- Department of Women and Children's Health (Pediatric Allergy), School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
- Peter Gorer Department of Immunobiology, School of Immunology and Microbial Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
- Children's Allergy Service, Evelina London Children's Hospital, Guy's and St Thomas' Hospital, London, UK
| | - Isabel Skypala
- Royal Brompton & Harefield Hospitals, Part of Guys & St Thomas NHS Foundation Trust, London, UK
- Department of Inflammation and Repair, Imperial College, London, UK
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Charles N, Kortekaas-Krohn I, Kocaturk E, Scheffel J, Altrichter S, Steinert C, Xiang YK, Gutermuth J, Reber LL, Maurer M. Autoreactive IgE: Pathogenic role and therapeutic target in autoimmune diseases. Allergy 2023; 78:3118-3135. [PMID: 37555488 DOI: 10.1111/all.15843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 07/08/2023] [Accepted: 07/27/2023] [Indexed: 08/10/2023]
Abstract
Autoimmunity is the break of tolerance to self-antigens that leads to organ-specific or systemic diseases often characterized by the presence of pathogenic autoreactive antibodies (AAb) produced by plasmablast and/or plasma cells. AAb are prevalent in the general population and not systematically associated with clinical symptoms. In contrast, in some individuals, these AAb are pathogenic and drive the development of signs and symptoms of antibody-mediated autoimmune diseases (AbAID). AAb production, isotype profiles, and glycosylations are promoted by pro-inflammatory triggers linked to genetic, environmental, and hormonal parameters. Recent evidence supports a role for pathogenic AAb of the IgE isotype in a number of AbAID. Autoreactive IgE can drive the activation of mast cells, basophils, and other types of FcεRI-bearing cells and may play a role in promoting autoantibody production and other pro-inflammatory pathways. In this review, we discuss the current knowledge on the pathogenicity of autoreactive IgE in AbAID and their status as therapeutic targets. We also highlight unresolved issues including the need for assays that reproducibly quantify IgE AAbs, to validate their diagnostic and prognostic value, and to further study their pathophysiological contributions to AbAID.
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Affiliation(s)
- Nicolas Charles
- Faculté de Médecine site Bichat, Centre de Recherche sur l'Inflammation, INSERM UMR1149, CNRS EMR8252, Université Paris Cité, Paris, France
- Laboratoire d'Excellence Inflamex, Université Paris Cité, Paris, France
| | - Inge Kortekaas-Krohn
- Vrije Universiteit Brussel (VUB), Skin Immunology & Immune Tolerance (SKIN) Research Group, Brussels, Belgium
- Department of Dermatology, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium
| | - Emek Kocaturk
- Department of Dermatology, Koç University School of Medicine, Istanbul, Turkey
- Institute of Allergology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, Germany
| | - Jörg Scheffel
- Institute of Allergology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, Germany
| | - Sabine Altrichter
- Institute of Allergology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, Germany
- Departement of Dermatology and Venerology, Kepler University Hospital, Linz, Austria
| | - Carolin Steinert
- Institute of Allergology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, Germany
- Freie Universität Berlin, Department of Biology, Chemistry and Pharmacy, Berlin, Germany
| | - Yi-Kui Xiang
- Institute of Allergology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, Germany
| | - Jan Gutermuth
- Vrije Universiteit Brussel (VUB), Skin Immunology & Immune Tolerance (SKIN) Research Group, Brussels, Belgium
- Department of Dermatology, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium
| | - Laurent L Reber
- Toulouse Institute for Infectious and Inflammatory Diseases (Infinity), UMR 1291, University of Toulouse, INSERM, CNRS, Toulouse, France
| | - Marcus Maurer
- Institute of Allergology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, Germany
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Wang J. Food challenges: Patient selection, predictors, component testing, and decision points. JOURNAL OF FOOD ALLERGY 2023; 5:38-42. [PMID: 39022753 PMCID: PMC11250189 DOI: 10.2500/jfa.2023.5.230010] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 07/20/2024]
Abstract
Background Oral food challenges are commonly used when there is uncertainty based on a clinical history as to whether a food allergy exists and to assess whether a food allergy has been outgrown. Methods A narrative review was performed, synthesizing available evidence in the literature. Results Because food challenges are generally multi-hour procedures that carry the risk for potentially severe allergic reactions, careful patient selection is important. Allergy tests can provide additional supportive information to guide decision-making but do not have sufficient diagnostic accuracy to replace food challenges in most circumstances. Conclusion Clinical history provides important clues with regard to the likelihood that a reaction may occur and should be combined with patient and family preferences and allergy test results when making decisions about pursuing food challenges.
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Affiliation(s)
- Julie Wang
- From the Division of Allergy and Immunology, Department of Pediatrics, Jaffe Food Allergy Institute, Icahn School of Medicine at Mount Sinai, New York, New York
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Chan HH, Burrows AK, Hosgood G, Ghubash R. Sensitivity of a Hymenoptera serological immunoglobulin (Ig)E assay for the diagnosis of venom hypersensitivity in dogs. Vet Dermatol 2023; 34:543-553. [PMID: 37485613 DOI: 10.1111/vde.13194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 05/15/2023] [Accepted: 07/10/2023] [Indexed: 07/25/2023]
Abstract
BACKGROUND Hymenoptera envenomation with honey bee (Apis mellifera) and paper wasp (Polistes spp.) may cause life-threatening anaphylaxis in dogs. In human patients, clinical history, intradermal testing (IDT) and measurement of allergen-specific serological immunoglobulin (Ig)E (sIgE) are used to support a diagnosis of Hymenoptera venom hypersensitivity. The utility of venom allergen-specific sIgE has not yet been evaluated for this purpose in dogs. OBJECTIVES The objective of the study was to investigate the sensitivity (sn), specificity (sp) and positive predictive value (PPV) of honey bee and paper wasp serological titres using a commercially available sIgE assay [VARL (Veterinary Allergen Reference Laboratory) Liquid Gold] against clinical history for a diagnosis of Hymenoptera hypersensitivity in dogs. MATERIALS AND METHODS Honeybee and paper wasp IgE serum titres were measured in 15 client-owned dogs with a diagnosis of Hymenoptera venom hypersensitivity based on a history of anaphylaxis, owner observation of Hymenoptera, and positive IDT to bee and/or wasp; and in 10 client-owned dogs with no known history of anaphylaxis or Hymenoptera exposure and a negative IDT to bee and wasp. RESULTS Analysis of receiver operating characteristic (ROC) curves demonstrate that a VARL score cut-off of one of six for honeybee yields Sn, Sp and PPV of 40%, 60% and 60%, respectively, and two of six for wasp yields Sn, Sp and PPV of 25%, 78% and 60%, respectively. CONCLUSIONS AND CLINICAL RELEVANCE Owing to the poor sensitivity and PPV of sIgE assays for both bee and wasp hypersensitivity in dogs with known envenomation and anaphylaxis, the use of sIgE cannot be recommended as a tool for venom identification.
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Affiliation(s)
- Hilary H Chan
- Animal Dermatology Clinic Perth, The Animal Hospital Murdoch University, Murdoch, Western Australia, Australia
| | - Amanda K Burrows
- Animal Dermatology Clinic Perth, The Animal Hospital Murdoch University, Murdoch, Western Australia, Australia
| | - Giselle Hosgood
- College of Veterinary Medicine, The Animal Hospital Murdoch University, Murdoch, Western Australia, Australia
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Koumaki D, Gregoriou S, Evangelou G, Katoulis A, Papadakis M, Krueger-Krasagakis SE, Doxastaki A, Mylonakis D, Krasagakis K. Real-Life Utility of Basophil Activation Test in the Diagnosis of Immediate Hypersensitivity Drug Reactions. Dermatol Ther (Heidelb) 2023; 13:3229-3239. [PMID: 38015412 PMCID: PMC10689598 DOI: 10.1007/s13555-023-01069-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Accepted: 11/03/2023] [Indexed: 11/29/2023] Open
Abstract
INTRODUCTION The basophil activation test (BAT) is a flow cytometry laboratory technique that assesses the level of activation indicators expressed on the surface of basophils. We conducted a real-life study in a prospective cohort of patients with reported drug hypersensitivity reactions to determine the true relevance of BAT as a diagnostic tool for assessing immediate hypersensitivity reactions to medicines. METHODS We prospectively assessed individuals with clinical suspicion of immediate hypersensitivity reactions to drugs over a 2-year period. The allergological evaluation was carried out in accordance with European Academy of Allergy and Clinical Immunology (EAACI) guidance. All patients underwent BAT using the activation marker CD63. RESULTS In total 13 patients with 54 reported immediate drug hypersensitivity reactions to medications were included in this study. Twelve were female (92.3%) and one was male (7.70%). The mean ± SD age of the patients was 47.31 ± 19.94 years. Antibiotics were tested in 35.2% (19/54) of patients, corticosteroids in 24.1% (13/54), iodinated contrast medium in 14.8% (8/54), and NSAIDs in 5.6% (3/54). There was no correlation between the BAT results and the age of patients, gender, type of medication, or time interval between the allergic reaction and BAT procedure. The sensitivity of BAT 5% CD63+ basophils to drugs was 97.6%, specificity was 96% for drug allergies, positive predictive value (PPV) was 94.3%, and negative predictive value (NPV) was 95.2%. CONCLUSIONS The sensitivity of BAT for drug allergies is limited, but it can nevertheless be very helpful before contemplating provocation testing in cases of life-threatening drug allergies where patients cannot be rechallenged or in cases of medications for which no other tests are available or their results are ambiguous.
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Affiliation(s)
- Dimitra Koumaki
- Dermatology Department, University Hospital of Heraklion, 71110, Heraklion, Crete, Greece.
| | - Stamatios Gregoriou
- Department of Dermatology and Venereology, Medical School of Athens, Andreas Sygros Hospital, National and Kapodistrian University of Athens, I. Dragoumi 5, 161 21, Athens, Greece
| | - Georgios Evangelou
- Dermatology Department, University Hospital of Heraklion, 71110, Heraklion, Crete, Greece
| | - Alexander Katoulis
- 2nd Department of Dermatology and Venereology, Medical School, National and Kapodistrian University of Athens, "Attikon" General University Hospital, Rimini 1, Haidari, 124 62, Athens, Greece
| | - Marios Papadakis
- Department of Surgery II, Witten/Herdecke University, Heusnerstrasse 40, 42283, Witten, Germany
| | | | - Aikaterini Doxastaki
- Dermatology Department, University Hospital of Heraklion, 71110, Heraklion, Crete, Greece
| | - Dimitrios Mylonakis
- Dermatology Department, University Hospital of Heraklion, 71110, Heraklion, Crete, Greece
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Koga Y, Ishii S, Yokooji T, Yamamoto K, Ogino R, Taogoshi T, Matsuo H. A novel test for type-I allergy based on crosslink formation of immunoglobulin-E receptors by allergen-specific immunoglobulin-E antibodies and an allergen. Sci Rep 2023; 13:19676. [PMID: 37951988 PMCID: PMC10640595 DOI: 10.1038/s41598-023-46730-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 11/04/2023] [Indexed: 11/14/2023] Open
Abstract
Detection of allergen-specific immunoglobulin E (IgE) antibodies (Abs) in serum would allow for screening of the causative allergen in patients with type-I allergy. In this study, we developed a new assay method to detect allergen-specific IgE Abs, which involved crosslinking the plural FcεRIα molecules with an allergen and detection using an amplified luminescence proximity homogeneous assay (AlphaCL). First, the allergen concentration, bead concentrations, and incubation time were optimized for the detection of anti-2,4-dinitrophenyl (DNP) IgE Abs in buffer. Under optimal conditions, AlphaCL was able to detect DNP-specific IgE Abs in simulated human serum at levels comparable to those in serum from type-I allergic patients. When AlphaCL was used to detect anti-DNP IgE Abs, no signal counts were obtained with the monovalent allergen 2,4-dinitrophenylated poly-γ-glutamic acid, whereas high signal counts were obtained with the multivalent allergen DNP-BSA. This confirmed that AlphaCL could specifically detect allergen-specific IgE Abs with the ability to crosslink a multivalent allergen. In summary, we have established a new assay model using AlphaCL to detect allergen-specific IgE Abs with FcεRIα crosslinking ability in human serum. This simple and practical assay model may be applied as a new diagnostic tool for patients with type-I allergy.
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Affiliation(s)
- Yuki Koga
- Department of Pharmaceutical Services, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8553, Japan
| | - Soichiro Ishii
- Department of Pharmaceutical Services, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8553, Japan
| | - Tomoharu Yokooji
- Department of Pharmaceutical Services, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8553, Japan
- Department of Frontier Science for Pharmacotherapy, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Konomi Yamamoto
- Department of Frontier Science for Pharmacotherapy, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Ryohei Ogino
- Department of Frontier Science for Pharmacotherapy, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Takanori Taogoshi
- Department of Pharmaceutical Services, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8553, Japan
| | - Hiroaki Matsuo
- Department of Pharmaceutical Services, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8553, Japan.
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Ishii T, Miyoshi H, Kubo T, Tsutsumi YM, Horikawa YT, Tanaka H. Delayed Nonimmune Anaphylaxis Caused by Ropivacaine for Preoperative Nerve Blocks: A Case Report. A A Pract 2023; 17:e01727. [PMID: 37948548 DOI: 10.1213/xaa.0000000000001727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2023]
Abstract
Ropivacaine is an amide local anesthetic with rare reports of anaphylaxis. To our knowledge, this is the first report of delayed nonimmune anaphylaxis induced by ropivacaine. A 70-year-old man underwent general anesthesia with a nerve block for a total knee arthroplasty. The patient developed symptoms of anaphylaxis 3.5 hours after receiving ropivacaine for femoral and tibial nerve blocks. A basophil activation test (BAT) revealed ropivacaine as the causative agent. Notably, anaphylaxis can be caused by medications even hours after their administration, and all administered drugs should be suspected of potentially causing anaphylaxis.
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Affiliation(s)
- Tomomi Ishii
- From the Department of Anesthesiology and Critical Care, Hiroshima University, Hiroshima, Japan
| | - Hirotsugu Miyoshi
- From the Department of Anesthesiology and Critical Care, Hiroshima University, Hiroshima, Japan
| | - Takashi Kubo
- Department of Anesthesiology, Hiroshima City North Medical Center Asa Citizens Hospital, Hiroshima, Japan
| | - Yasuo M Tsutsumi
- From the Department of Anesthesiology and Critical Care, Hiroshima University, Hiroshima, Japan
| | - Yousuke T Horikawa
- Department of Pediatrics, Sharp Rees-Stealy Medical Group, San Diego, California
| | - Hiroyuki Tanaka
- Department of Anesthesiology, Hiroshima City North Medical Center Asa Citizens Hospital, Hiroshima, Japan
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Peng X, Ge Y, Li W, Lin X, Song H, Lin L, Zhao J, Gao Y, Wang J, Li J, Huang Y, Li Y, Li L. Targeting Lewis X oligosaccharide-modified liposomes encapsulated with house dust mite allergen Der f 2 to dendritic cells inhibits Th2 immune response. Eur J Pharm Sci 2023; 190:106570. [PMID: 37634600 DOI: 10.1016/j.ejps.2023.106570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Revised: 08/01/2023] [Accepted: 08/25/2023] [Indexed: 08/29/2023]
Abstract
Allergen-specific immunotherapy (AIT) is the only curative treatment for allergic diseases. However, the long desensitization phase and potentially dangerous allergic side effects limit its broad application. Therefore, safer and more effective vaccines are required. Targeting dendritic cells (DCs) with novel allergen conjugates is a promising strategy for AIT. In this study, a novel vaccine with a DC-targeting effect for AIT was constructed. Liposomes were used as vehicles, and a targeted nanovaccine (Lex-lip-Der f 2) was constructed by loading the recombinant group 2 allergen of Dermatophagoides farinae (Der f 2) and conjugating with the DC-SIGN ligand Lewis X. The effect of the vaccine on DCs and T cell responses and the safety of the vaccine were investigated in vitro. The results showed that the Lex-lip-Der f 2 vaccine was spherical, with size of approximately 128 nm. The protein-loading capacity of the vaccine was 0.106 ± 0.001 mg per mg liposome and protein was gradually released from the liposomes during the first 12 h. Lex-lip-Der f 2 was taken up more efficiently by DCs than non-targeted liposomes or free Der f 2. Besides, Lex-lip-Der f 2 significantly inhibited the release of IL-4, IL-6, and TNF-a from DCs. Accordingly, Der f 2-lip loaded DCs significantly decreased IL-4 levels in autologous naïve CD4+T cells. Moreover, Lex-lip-Der f 2-treated basophils showed lower activation levels. These results suggest that DC-SIGN targeting mediated by Lewis X could inhibit the Th2 cell response and improve vaccine safety, and may be a novel vaccination strategy.
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Affiliation(s)
- Xia Peng
- Department of Laboratory Medicine, Shanghai General Hospital, Shanghai Jiaotong University School of medicine, China
| | - Yiqin Ge
- Department of Laboratory Medicine, Shanghai General Hospital, Shanghai Jiaotong University School of medicine, China; Department of Laboratory Medicine, Shanghai Chest Hospital Affiliated Shanghai Jiao Tong University, China
| | - Weize Li
- Department of Laboratory Medicine, Shanghai General Hospital, Shanghai Jiaotong University School of medicine, China
| | - Xiuke Lin
- Fujian Provincial Key Laboratory of Innovative Drug Target Research, School of Pharmaceutical Sciences, Xiamen University
| | - Hua Song
- Fujian Provincial Key Laboratory of Innovative Drug Target Research, School of Pharmaceutical Sciences, Xiamen University
| | - Lihui Lin
- Department of Laboratory Medicine, Shanghai General Hospital, Shanghai Jiaotong University School of medicine, China
| | - Jinyan Zhao
- Department of Laboratory Medicine, Shanghai General Hospital, Shanghai Jiaotong University School of medicine, China
| | - Yanting Gao
- Department of Laboratory Medicine, Shanghai General Hospital, Shanghai Jiaotong University School of medicine, China
| | - Juan Wang
- Department of Laboratory Medicine, Shanghai General Hospital, Shanghai Jiaotong University School of medicine, China
| | - Jia Li
- Department of Laboratory Medicine, Shanghai General Hospital, Shanghai Jiaotong University School of medicine, China
| | - Yuji Huang
- Department of Laboratory Medicine, Shanghai General Hospital, Shanghai Jiaotong University School of medicine, China
| | - Yanning Li
- Department of Laboratory Medicine, Shanghai General Hospital, Shanghai Jiaotong University School of medicine, China
| | - Li Li
- Department of Laboratory Medicine, Shanghai General Hospital, Shanghai Jiaotong University School of medicine, China.
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Pellefigues C, Karasuyama H. Editorial: The fundamental biology of basophils in health and disease. Front Immunol 2023; 14:1292279. [PMID: 37928516 PMCID: PMC10622782 DOI: 10.3389/fimmu.2023.1292279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 10/06/2023] [Indexed: 11/07/2023] Open
Affiliation(s)
- Christophe Pellefigues
- Université Paris Cité, Centre de Recherche sur l’Inflammation, Institut National de la santé et de la recherche médicale (INSERM) UMR1149, Centre national de la recherche scientifique (CNRS) EMR8252, Faculté de Médecine site Bichat, Paris, France
- Université Paris Cité, Laboratoire d’Excellence Inflamex, Paris, France
| | - Hajime Karasuyama
- Inflammation, Infection and Immunity Laboratory, TMDU Advanced Research Institute, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
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45
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Smith BRE, Reid Black K, Bermingham M, Agah S, Glesner J, Versteeg SA, van Ree R, Pena-Amelunxen G, Aglas L, Smith SA, Pomés A, Chapman MD. Unique allergen-specific human IgE monoclonal antibodies derived from patients with allergic disease. FRONTIERS IN ALLERGY 2023; 4:1270326. [PMID: 37901762 PMCID: PMC10602672 DOI: 10.3389/falgy.2023.1270326] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 09/25/2023] [Indexed: 10/31/2023] Open
Abstract
Introduction Allergic reactions are mediated by human IgE antibodies that bind to and cross-link allergen molecules. The sites on allergens that are recognized by IgE antibodies have been difficult to investigate because of the paucity of IgE antibodies in a human serum. Here, we report the production of unique human IgE monoclonal antibodies to major inhaled allergens and food allergens that can be produced at scale in perpetuity. Materials and methods The IgE antibodies were derived from peripheral blood mononuclear cells of symptomatic allergic patients, mostly children aged 3-18 years, using hybridoma fusion technology. Total IgE and allergen-specific IgE was measured by ImmunoCAP. Their specificity was confirmed through ELISA and immunoblotting. Allergenic potency measurements were determined by ImmunoCAP inhibition. Biological activity was determined in vitro by comparing β-hexosaminidase release from a humanized rat basophilic cell line. Results Human IgE monoclonal antibodies (n = 33) were derived from 17 allergic patients with symptoms of allergic rhinitis, asthma, atopic dermatitis, food allergy, eosinophilic esophagitis, or red meat allergy. The antibodies were specific for five inhaled allergens, nine food allergens, and alpha-gal and had high levels of IgE (53,450-1,702,500 kU/L) with ratios of specific IgE to total IgE ranging from <0.01 to 1.39. Sigmoidal allergen binding curves were obtained through ELISA, with low limits of detection (<1 kU/L). Allergen specificity was confirmed through immunoblotting. Pairs of IgE monoclonal antibodies to Ara h 6 were identified that cross-linked after allergen stimulation and induced release of significant levels of β-hexosaminidase (35%-80%) from a humanized rat basophilic cell line. Conclusions Human IgE monoclonal antibodies are unique antibody molecules with potential applications in allergy diagnosis, allergen standardization, and identification of allergenic epitopes for the development of allergy therapeutics. The IgE antibody probes will enable the unequivocal localization and validation of allergenic epitopes.
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Affiliation(s)
| | | | | | - Sayeh Agah
- InBio, Charlottesville, VA, United States
| | | | - Serge A. Versteeg
- Department of Experimental Immunology, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Ronald van Ree
- Department of Experimental Immunology, Amsterdam University Medical Center, Amsterdam, Netherlands
| | | | - Lorenz Aglas
- Department of Biosciences and Medical Biology, University of Salzburg, Salzburg, Austria
| | - Scott A. Smith
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Anna Pomés
- InBio, Charlottesville, VA, United States
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Gilstad CW, Conry-Cantilena K, Zarpak R, Eder AF. An outbreak of anaphylactic transfusion reactions to group B plasma and platelets and its possible relationship to Alpha-Gal syndrome. Transfusion 2023; 63:1997-2000. [PMID: 37642435 DOI: 10.1111/trf.17521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 06/12/2023] [Accepted: 07/18/2023] [Indexed: 08/31/2023]
Abstract
BACKGROUND Alpha-gal syndrome (AGS) is a potentially life-threatening acquired meat allergy associated with tick bites. The allergen Galactose-α-1,3-Galactose is antigenically similar to the B blood group antigen. B blood group status offers some protection against development of the allergy. Although not preferred practice, transfusion of plasma and platelets from group B donors is believed to be safe for group O recipients. STUDY DESIGN AND METHODS Anaphylactic transfusion reactions were reported for three patients in two Washington DC hospitals from Nov 2022 to February 2023. A chart review was performed for all three patients. Patients or family members were interviewed, and IgE levels to alpha-gal were measured in two of the three patients. RESULTS One reaction was acutely fatal. All reactions were to blood group B Plasma or Platelets in blood group O recipients. One patient had two prior anaphylactic reactions to group O RBCs and group B Plasma in a previous admission. All patients came from southern Maryland where AGS is an emerging problem. Two patients had histories of tick bites, previously unexplained gastrointestinal complaints, and abnormal elevated levels of IgE to alpha gal. Two patients had cat allergies. DISCUSSION AGS is an emerging problem which may have implications for blood transfusion practice. Avoidance of blood group B antigen containing components may be prudent in non-blood group B patients with established AGS. Investigation for AGS should be considered in the evaluation of anaphylactic transfusion reactions.
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Affiliation(s)
| | | | - Roya Zarpak
- Medstar Georgetown University Hospital, Washington, DC, USA
| | - Anne F Eder
- U.S. Food and Drug Administration, Silver Spring, Maryland, USA
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Charpy J, Barbier O, Le Mauff B, Sarrat A, Roland-Nicaise P, Goret J. Basophil activation test: Feedback and lessons from routine practice in French clinical laboratories. Clin Exp Allergy 2023; 53:1055-1058. [PMID: 37366346 DOI: 10.1111/cea.14363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 05/04/2023] [Accepted: 05/30/2023] [Indexed: 06/28/2023]
Affiliation(s)
- Juliette Charpy
- Department of Immunology and Immunogenetics, Bordeaux University Hospital, Bordeaux, France
- AllergoBioNet network, Angers, France
| | - Ophélie Barbier
- Allergoly Unit, Bordeaux University Hospital, Bordeaux, France
| | - Brigitte Le Mauff
- AllergoBioNet network, Angers, France
- Department of Immunology, Caen University Hospital, Caen, France
| | - Anne Sarrat
- Department of Immunology and Immunogenetics, Bordeaux University Hospital, Bordeaux, France
- AllergoBioNet network, Angers, France
| | - Pascale Roland-Nicaise
- AllergoBioNet network, Angers, France
- Department of Immunology, Paris Nord Val de Seine University Hospital, Bichat Hospital, Paris, France
| | - Julien Goret
- Department of Immunology and Immunogenetics, Bordeaux University Hospital, Bordeaux, France
- AllergoBioNet network, Angers, France
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Bourgoin P, Busnel JM. Promises and Remaining Challenges for Further Integration of Basophil Activation Test in Allergy-Related Research and Clinical Practice. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2023; 11:3000-3007. [PMID: 37634807 DOI: 10.1016/j.jaip.2023.08.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 08/21/2023] [Accepted: 08/21/2023] [Indexed: 08/29/2023]
Abstract
More than 20 years after having been initially proposed, the relevance and usefulness of basophil activation test (BAT) for the field of allergy research and testing were demonstrated on many occasions. Leveraging the fully open format of a flexible, whole blood-based functional assay, BAT has been shown to be equally important for fundamental research, clinical research, and diagnosis. Regardless of whether the focus of a study is on the characterization of the allergenic moiety, on the patient side, or on the study of the fundamental processes involved in the allergic disease or its treatment, BAT enables the gathering of very important insights. In spite of this, its full capabilities have yet to be leveraged. Various bottlenecks, including but not limited to assay logistics, robustness, flow cytometry access, and/or expertise, have indeed been limiting its development beyond experts and long-term users. Now, various initiatives, aiming at resolving these bottlenecks, have been launched. If successful, a broader use of BAT could then be contemplated. In such a situation, its more thorough integration in clinical practice has the potential to significantly change the allergic patient's journey.
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Affiliation(s)
- Pénélope Bourgoin
- Global Research Organization, Beckman Coulter Life Sciences, Marseille, France
| | - Jean-Marc Busnel
- Global Research Organization, Beckman Coulter Life Sciences, Marseille, France.
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Wang J, Golden DBK, Khan DA. The Value of Current Laboratory Tests in Diagnosing Food, Venom, and Drug Allergies. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2023; 11:2973-2981. [PMID: 37343922 DOI: 10.1016/j.jaip.2023.06.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 05/19/2023] [Accepted: 06/08/2023] [Indexed: 06/23/2023]
Abstract
An accurate diagnosis of IgE-mediated allergies is necessary to inform risk management for severe allergic reactions including anaphylaxis for food, venom, and drug allergies. The most widely available laboratory test for allergy is serum-specific IgE testing, which is routinely used for food allergy and insect sting allergy. Testing for specific IgE is limited by high sensitivity and low specificity, resulting in concern regarding overdiagnosis. Testing of allergen components has led to improved diagnosis for some food and venom allergens. Additional options for laboratory tests, such as epitope analysis, basophil activation, and mast cell activation, are being investigated for their potential to optimize diagnosis and provide predictors for reaction severity and treatment response. In contrast, laboratory testing for drug allergy is more limited because to date, there are no well-validated commercial assays in the United States. Furthermore, it is important to diagnose delayed reactions to medications, because these also significantly affect decision-making regarding therapeutic options for infectious disorders. Reliable tests for both immediate and delayed drug hypersensitivity are much needed, because drug allergy labels can significantly limit treatment options for patients. Research in this area is emerging.
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Affiliation(s)
- Julie Wang
- Division of Allergy and Immunology, Department of Pediatrics, Jaffe Food Allergy Institute, Icahn School of Medicine at Mount Sinai, New York, NY.
| | - David B K Golden
- Division of Allergy and Immunology, Department of Pediatrics, Jaffe Food Allergy Institute, Icahn School of Medicine at Mount Sinai, New York, NY; Division of Allergy and Clinical Immunology, Johns Hopkins University School of Medicine, Baltimore, Md
| | - David A Khan
- Department of Internal Medicine, Division of Allergy and Immunology, University of Texas Southwestern Medical Center, Dallas, Texas
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Ieven T, Coorevits L, Vandebotermet M, Tuyls S, Vanneste H, Santy L, Wets D, Proost P, Frans G, Devolder D, Breynaert C, Bullens DMA, Schrijvers R. Endotyping of IgE-Mediated Polyethylene Glycol and/or Polysorbate 80 Allergy. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2023; 11:3146-3160. [PMID: 37380070 PMCID: PMC10291891 DOI: 10.1016/j.jaip.2023.06.031] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 06/07/2023] [Accepted: 06/13/2023] [Indexed: 06/30/2023]
Abstract
BACKGROUND Polyethylene glycol (PEG) and polysorbate 80 (PS80) allergy preclude from SARS-CoV-2 vaccination. The mechanism(s) governing cross-reactivity and PEG molecular weight dependence remain unclear. OBJECTIVES To evaluate PEGylated lipid nanoparticle (LNP) vaccine (BNT162b2) tolerance and explore the mechanism of reactivity in PEG and/or PS80 allergic patients. METHODS PEG/PS80 dual- (n = 3), PEG mono- (n = 7), and PS80 mono-allergic patients (n = 2) were included. Tolerability of graded vaccine challenges was assessed. Basophil activation testing on whole blood (wb-BAT) or passively sensitized donor basophils (allo-BAT) was performed using PEG, PS80, BNT162b2, and PEGylated lipids (ALC-0159). Serum PEG-specific IgE was measured in patients (n = 10) and controls (n = 15). RESULTS Graded BNT162b2 challenge in dual- and PEG mono-allergic patients (n = 3/group) was well tolerated and induced anti-spike IgG seroconversion. PS80 mono-allergic patients (n = 2/2) tolerated single-dose BNT162b2 vaccination. Wb-BAT reactivity to PEG-containing antigens was observed in dual- (n = 3/3) and PEG mono- (n = 2/3), but absent in PS80 mono-allergic patients (n = 0/2). BNT162b2 elicited the highest in vitro reactivity. BNT162b2 reactivity was IgE mediated, complement independent, and inhibited in allo-BAT by preincubation with short PEG motifs, or detergent-induced LNP degradation. PEG-specific IgE was only detectable in dual-allergic (n = 3/3) and PEG mono-allergic (n = 1/6) serum. CONCLUSION PEG and PS80 cross-reactivity is determined by IgE recognizing short PEG motifs, whereas PS80 mono-allergy is PEG-independent. PS80 skin test positivity in PEG allergics was associated with a severe and persistent phenotype, higher serum PEG-specific IgE levels, and enhanced BAT reactivity. Spherical PEG exposure via LNP enhances BAT sensitivity through increased avidity. All PEG and/or PS80 excipient allergic patients can safely receive SARS-CoV-2 vaccines.
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Affiliation(s)
- Toon Ieven
- KU Leuven Department of Microbiology, Immunology and Transplantation, Allergy and Clinical Immunology Research Group, KU Leuven, Leuven, Belgium; Department of General Internal Medicine, Division of Allergy and Clinical Immunology, University Hospitals Leuven, Leuven, Belgium
| | - Lieve Coorevits
- KU Leuven Department of Microbiology, Immunology and Transplantation, Allergy and Clinical Immunology Research Group, KU Leuven, Leuven, Belgium; Department of General Internal Medicine, Division of Allergy and Clinical Immunology, University Hospitals Leuven, Leuven, Belgium
| | - Martijn Vandebotermet
- Department of General Internal Medicine, Division of Allergy and Clinical Immunology, University Hospitals Leuven, Leuven, Belgium; Department of Pulmonology, AZ Groeninge Hospital, Kortrijk, Belgium
| | - Sebastiaan Tuyls
- Department of General Internal Medicine, Division of Allergy and Clinical Immunology, University Hospitals Leuven, Leuven, Belgium; Department of Pulmonology, GZA St-Augustinus Hospital, Wilrijk, Belgium
| | - Hélène Vanneste
- Department of General Internal Medicine, Division of Allergy and Clinical Immunology, University Hospitals Leuven, Leuven, Belgium; Department of Pulmonology, AZ Vesalius, Tongeren, Belgium
| | - Lisa Santy
- Department of General Internal Medicine, Division of Allergy and Clinical Immunology, University Hospitals Leuven, Leuven, Belgium; Department of Internal Medicine, Division of Pulmonology, St-Jozefskliniek, Izegem, Belgium
| | - Dries Wets
- Department of General Internal Medicine, Division of Allergy and Clinical Immunology, University Hospitals Leuven, Leuven, Belgium
| | - Paul Proost
- KU Leuven Department of Microbiology, Immunology and Transplantation, Laboratory of Molecular Immunology, Rega Institute for Medical Research, KU Leuven, Leuven, Belgium
| | - Glynis Frans
- Clinical Department of Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium
| | - David Devolder
- Pharmacy Department, University Hospitals Leuven, Leuven, Belgium
| | - Christine Breynaert
- KU Leuven Department of Microbiology, Immunology and Transplantation, Allergy and Clinical Immunology Research Group, KU Leuven, Leuven, Belgium; Department of General Internal Medicine, Division of Allergy and Clinical Immunology, University Hospitals Leuven, Leuven, Belgium
| | - Dominique M A Bullens
- KU Leuven Department of Microbiology, Immunology and Transplantation, Allergy and Clinical Immunology Research Group, KU Leuven, Leuven, Belgium; Department of Pediatrics, University Hospitals Leuven, Leuven, Belgium
| | - Rik Schrijvers
- KU Leuven Department of Microbiology, Immunology and Transplantation, Allergy and Clinical Immunology Research Group, KU Leuven, Leuven, Belgium; Department of General Internal Medicine, Division of Allergy and Clinical Immunology, University Hospitals Leuven, Leuven, Belgium.
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