151
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De Amici M, Barocci F, Caimmi S, Nespoli L, Licari A, Giuliani G, Marseglia G. Clinical use of basophil activation test in drug, food and hymenoptera venom allergies. Minerva Pediatr 2019; 71:209-217. [DOI: 10.23736/s0026-4946.18.05144-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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152
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Torres MJ, Moreno E, Fernandez-Santamaría R, Doña I, Fernandez TD. Diagnostic Approximation to Delabeling Beta-Lactam Allergic Patients. CURRENT TREATMENT OPTIONS IN ALLERGY 2019. [DOI: 10.1007/s40521-019-0202-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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153
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Huang WY, Chou ST, Chen CH, Chou SY, Wu JH, Chen YC, Lee GB. An automatic integrated microfluidic system for allergy microarray chips. Analyst 2019; 143:2285-2292. [PMID: 29671851 DOI: 10.1039/c8an00247a] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Billions of people suffer from allergies, though in many cases, the source allergen is unknown. If one knows which allergens to avoid, this would result in an improved quality of life. Since a rapid, high-throughput, automatic allergen detection method is of great need, an integrated system combining microfluidic techniques and microarray chips has been developed herein to automate the allergen detection process. The developed microfluidic system could automatically carry out the entire procedure such as reagent incubation, hybridization, transport, and washing without any intermediate step. The microarray chip could be easily detached from the microfluidic chip afterwards, enabling it to be read under a fluorescence scanner. The experimental results indicated that the developed microfluidic system can automatically perform all the incubation processes, including hybridization, reagent transportation, and washing. It is worth noting that active mixing has been applied in the present study which is different from our previous study using micro-channels for passive incubation. Comparable results to a conventional benchtop approach were obtained in ∼30% less time with ∼25% less samples/reagents. Similar results were also demonstrated while detecting immunoglobulin E samples. The developed system could therefore provide a rapid, reliable, and automated approach for detecting allergen-specific antibodies in human serum.
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Affiliation(s)
- Wen-Yen Huang
- Department of Power Mechanical Engineering, National Tsing Hua University, Hsinchu, Taiwan 30013.
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Arai T, Sakurai D, Iinuma T, Nakagawa T, Yonekura S, Okamoto Y. Basophils from allergic rhinitis patients show allergen-specific upregulation of thymic stromal lymphopoietin receptor. Ann Allergy Asthma Immunol 2019; 120:155-163. [PMID: 29413340 DOI: 10.1016/j.anai.2017.12.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Revised: 11/24/2017] [Accepted: 12/11/2017] [Indexed: 11/26/2022]
Abstract
BACKGROUND An allergic rhinitis (AR) diagnosis is based on typical nasal symptoms and allergen sensitization testing. However, it is sometimes difficult to distinguish AR from non-AR, and it is especially difficult to identify the causal allergen for immunotherapy of patients with AR. OBJECTIVE To identify differences among patients with AR, subjects with asymptomatic sensitization (AS), and subjects without sensitization (NS) that could facilitate the diagnosis of AR. METHODS We used RNA sequencing to examine differential gene expression in unstimulated and allergen-stimulated peripheral basophils from participants with NS, AS, and AR. We selected genes that were upregulated after allergen stimulation and showed differences in expression in patients with AR compared with subjects with AS and NS. Basophil surface expression of 1 gene product was examined by flow cytometry. The usefulness of gene expression in the diagnosis of AR was examined with receiver operating characteristic curves. RESULTS Expression of cytokine receptor-like factor 2 and its product, thymic stromal lymphopoietin receptor (TSLPR), was significantly increased in basophils of patients with AR after allergen stimulation. A significantly larger percentage of TSLPR-positive cells was observed after allergen-specific stimulation of basophils from patients with AR compared with subjects with AS. Basophil TSLPR expression was as good as or better than CD203c expression in discriminating between patients with AR and subjects with AS, as judged by receiver operating characteristic curves. CONCLUSION Our data suggest that TSLPR expression on basophils was specifically upregulated by allergen stimulation and might be useful for the identification of the causative allergen in patients with AR.
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Affiliation(s)
- Tomoyuki Arai
- Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Medicine, Chiba University, Chuo-ku, Chiba, Japan
| | - Daiju Sakurai
- Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Medicine, Chiba University, Chuo-ku, Chiba, Japan
| | - Tomohisa Iinuma
- Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Medicine, Chiba University, Chuo-ku, Chiba, Japan
| | - Takuya Nakagawa
- Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Medicine, Chiba University, Chuo-ku, Chiba, Japan
| | - Syuji Yonekura
- Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Medicine, Chiba University, Chuo-ku, Chiba, Japan
| | - Yoshitaka Okamoto
- Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Medicine, Chiba University, Chuo-ku, Chiba, Japan.
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155
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156
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D'Auria E, De Amici M, Licari A, Caimmi S, Mantegazza C, Zuccotti G, Marseglia G. Basophil activation test in children with autoimmune chronic spontaneous urticaria: Is it ready for clinical practice? Immunobiology 2019; 224:30-33. [DOI: 10.1016/j.imbio.2018.11.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 11/04/2018] [Accepted: 11/04/2018] [Indexed: 01/18/2023]
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157
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Mayorga C, Ebo DG, Lang DM, Pichler WJ, Sabato V, Park MA, Makowska J, Atanaskovic-Markovic M, Bonadonna P, Jares E. Controversies in drug allergy: In vitro testing. J Allergy Clin Immunol 2019; 143:56-65. [DOI: 10.1016/j.jaci.2018.09.022] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 09/18/2018] [Accepted: 09/28/2018] [Indexed: 12/17/2022]
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158
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Ruinemans-Koerts J, Schmidt-Hieltjes Y, Jansen A, Savelkoul HF, Plaisier A, van Setten P. The Basophil Activation Test reduces the need for a food challenge test in children suspected of IgE-mediated cow's milk allergy. Clin Exp Allergy 2018; 49:350-356. [DOI: 10.1111/cea.13307] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 10/22/2018] [Accepted: 10/28/2018] [Indexed: 12/28/2022]
Affiliation(s)
| | - Yvonne Schmidt-Hieltjes
- Department of Clinical Chemistry and Haematology; Rijnstate Hospital; Arnhem The Netherlands
| | - Ad Jansen
- Department of Otorhinolaryngology; Radboud University Nijmegen Medical Centre; Nijmegen The Netherlands
| | - Huub F.J. Savelkoul
- Cell Biology and Immunology Group; Wageningen University& Research; Wageningen The Netherlands
| | - Annejet Plaisier
- Department of Paediatrics; Rijnstate Hospital; Arnhem The Netherlands
| | - Petra van Setten
- Department of Paediatrics; Rijnstate Hospital; Arnhem The Netherlands
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159
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Pfaar O, Lou H, Zhang Y, Klimek L, Zhang L. Recent developments and highlights in allergen immunotherapy. Allergy 2018; 73:2274-2289. [PMID: 30372537 DOI: 10.1111/all.13652] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 10/22/2018] [Accepted: 10/22/2018] [Indexed: 12/30/2022]
Abstract
Allergen immunotherapy (AIT) is the only disease-modifying treatment option for patients with IgE-mediated inhalant allergies. Though used in clinical practice for more than 100 years, most innovations in AIT efficacy and safety have been developed in the last two decades. This expert review aimed to highlight the recent progress in AIT for both application routes, the sublingual (SLIT) and subcutaneous (SCIT) forms. As such, it covers recent aspects regarding efficacy and safety in clinical trials and real-life data and outlines new concepts in consensus and position papers as well as in guidelines for AIT. Potential clinical and nonclinical biomarkers are discussed. This review also focuses on potential future perspectives in AIT, such as alternative application routes, immune-modulating adjuvants, and recombinant vaccines. In conclusion, this state of the art review provides a comprehensive overview of AIT and highlights unmet needs for the future.
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Affiliation(s)
- Oliver Pfaar
- Department of Otorhinolaryngology, Head and Neck Surgery; Section of Rhinology and Allergy; University Hospital Marburg; Philipps-Universität Marburg; Marburg Germany
| | - Hongfei Lou
- Department of Otolaryngology; Head and Neck Surgery; Beijing TongRen Hospital; Capital Medical University; Beijing China
- Beijing Key Laboratory of Nasal Diseases; Beijing Institute of Otolaryngology; Beijing China
- Department of Allergy; Beijing TongRen Hospital; Capital Medical University; Beijing China
| | - Yuan Zhang
- Department of Otolaryngology; Head and Neck Surgery; Beijing TongRen Hospital; Capital Medical University; Beijing China
- Beijing Key Laboratory of Nasal Diseases; Beijing Institute of Otolaryngology; Beijing China
- Department of Allergy; Beijing TongRen Hospital; Capital Medical University; Beijing China
| | - Ludger Klimek
- Center for Rhinology and Allergology; Wiesbaden Germany
| | - Luo Zhang
- Department of Otolaryngology; Head and Neck Surgery; Beijing TongRen Hospital; Capital Medical University; Beijing China
- Beijing Key Laboratory of Nasal Diseases; Beijing Institute of Otolaryngology; Beijing China
- Department of Allergy; Beijing TongRen Hospital; Capital Medical University; Beijing China
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160
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Hemmings O, Kwok M, McKendry R, Santos AF. Basophil Activation Test: Old and New Applications in Allergy. Curr Allergy Asthma Rep 2018; 18:77. [PMID: 30430289 PMCID: PMC6244909 DOI: 10.1007/s11882-018-0831-5] [Citation(s) in RCA: 98] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
PURPOSE OF REVIEW The basophil activation test (BAT) using flow cytometry has supplanted traditional methods of measuring basophil degranulation using histamine and other mediator release, and can be used for clinical applications as well as to explore the immune mechanisms of effector cell response to allergen. This review discusses the advancements made in clinical, diagnostic and laboratory research of allergy utilizing an ever-evolving BAT. RECENT FINDINGS Being an in vitro surrogate of the allergic reaction that happens in vivo in the sick patient, the BAT can be used to support the diagnosis of various allergic conditions, such as food, drug, respiratory and insect venom allergies, and the assessment of clinical response to allergen-specific immunotherapy and other immunomodulatory treatments. The BAT can also be used for research purposes to explore the mechanisms of allergy and tolerance at the level of the basophil, for instance by manipulating IgE and IgG and their receptors and by studying intracellular signalling cascade in response to allergen. This review covers the applications of the BAT to the clinical management of allergic patients and the increased understanding of the mechanisms of immune response to allergens as well as technological advancements made in recent years.
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Affiliation(s)
- Oliver Hemmings
- Department of Women and Children's Health (Paediatric 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.,MRC and Asthma UK Centre in Allergic Mechanisms of Asthma, London, UK
| | - Matthew Kwok
- Department of Women and Children's Health (Paediatric 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.,MRC and Asthma UK Centre in Allergic Mechanisms of Asthma, London, UK
| | - Richard McKendry
- Department of Women and Children's Health (Paediatric 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.,MRC and Asthma UK Centre in Allergic Mechanisms of Asthma, London, UK
| | - Alexandra F Santos
- Department of Women and Children's Health (Paediatric 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. .,MRC and Asthma UK Centre in Allergic Mechanisms of Asthma, London, UK. .,Children's Allergies Department, Guy's and St. Thomas' NHS Foundation Trust, St. Thomas' Hospital, Westminster Bridge Road, London, UK.
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161
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Albert-Vega C, Tawfik DM, Trouillet-Assant S, Vachot L, Mallet F, Textoris J. Immune Functional Assays, From Custom to Standardized Tests for Precision Medicine. Front Immunol 2018; 9:2367. [PMID: 30386334 PMCID: PMC6198655 DOI: 10.3389/fimmu.2018.02367] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Accepted: 09/24/2018] [Indexed: 12/18/2022] Open
Abstract
The immune response is a dynamic system that maintains the integrity of the body, and more specifically fight against infections. However, an unbalanced host immune response is highlighted in many diseases. Exacerbated responses lead to autoimmune and allergic diseases, whereas, low or inefficient responses favor opportunistic infections and viral reactivations. Conflicting situations may also occur, such as in sepsis where inflammation and compensatory immunosuppression make it difficult to deploy the appropriate drug treatment. Until the current day, assessing the immune profile of patients remains a challenge. This is especially due to the inter-individual variability—a key feature of the immune system—which hinders precise diagnosis, prognosis, and therapeutic stratification. Our incapacity to practically interpret the host response may contribute to a high morbidity and mortality, such as the annual 6 million worldwide deaths in sepsis alone. Therefore, there is a high and increasing demand to assess patient immune function in routine clinical practice, currently met by Immune Functional Assays. Immune Functional Assays (IFA) hold a plethora of potentials that include the precise diagnosis of infections, as well as prediction of secondary and latent infections. Current available products are devoted to indirect pathogen detection such as Mycobacteria tuberculosis interferon gamma release assays (IGRA). In addition, identifying the status and the underlying factors of immune dysfunction (e.g., in septic patients) may guide immune targeted therapies. Tools to monitor and stratify the immune status are currently being studied but they still have many limitations such as technical standardization, biomarkers relevance, systematic interpretation and need to be simplified, in order to set the boundaries of “healthy,” “ill,” and “critically ill” responses. Thus, the design of new tools that give a comprehensive insight into the immune functionality, at the bedside, and in a timely manner represents a leap toward immunoprofiling of patients.
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Affiliation(s)
- Chloé Albert-Vega
- Joint Research Unit, Hospice Civils de Lyon, bioMerieux, Centre Hospitalier Lyon Sud, Pierre-Benite, France
| | - Dina M Tawfik
- Medical Diagnostic Discovery Department, bioMérieux S.A., Grenoble, France.,EA7426 Pathophysiology of Injury-Induced Immunosuppression, Université Claude Bernard Lyon 1-Hospices Civils de Lyon-bioMérieux, Lyon, France
| | - Sophie Trouillet-Assant
- Joint Research Unit, Hospice Civils de Lyon, bioMerieux, Centre Hospitalier Lyon Sud, Pierre-Benite, France.,Virologie et Pathologie Humaine - VirPath Team, Centre International de Recherche en Infectiologie (CIRI), INSERM U1111, CNRS UMR5308, ENS Lyon, Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France
| | - Laurence Vachot
- Medical Diagnostic Discovery Department, bioMérieux S.A., Grenoble, France
| | - François Mallet
- Joint Research Unit, Hospice Civils de Lyon, bioMerieux, Centre Hospitalier Lyon Sud, Pierre-Benite, France.,EA7426 Pathophysiology of Injury-Induced Immunosuppression, Université Claude Bernard Lyon 1-Hospices Civils de Lyon-bioMérieux, Lyon, France
| | - Julien Textoris
- EA7426 Pathophysiology of Injury-Induced Immunosuppression, Université Claude Bernard Lyon 1-Hospices Civils de Lyon-bioMérieux, Lyon, France.,Hospices Civils de Lyon, Department of Anaesthesiology and Critical Care Medicine, Groupement Hospitalier Edouard Herriot, Université Claude Bernard Lyon 1, Lyon, France
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162
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Wang X, Du K, She W, Ouyang Y, Sima Y, Liu C, Zhang L. Recent advances in the diagnosis of allergic rhinitis. Expert Rev Clin Immunol 2018; 14:957-964. [PMID: 30261765 DOI: 10.1080/1744666x.2018.1530113] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Allergic rhinitis (AR) is a disorder with high prevalence worldwide. Identification of clinically relevant allergens is the key step for the diagnosis, allergen avoidance and allergen specific immunotherapy for AR. Areas covered: With the new findings of mechanisms of AR and the development of technology, much progress has been achieved in the diagnosis of AR recently. We review the recent advances about local IgE, in vivo and in vitro tests, cytological diagnosis and nitric oxide (NO) in the diagnosis of AR. Expert commentary: AR is traditionally diagnosed with the combined evaluation of history and allergen sensitization by in vivo skin prick tests and in vitro allergen specific IgE in serum, to confirm the correlation between clinical history and potential allergens. Nasal provocation test and local IgE measurement can be used to diagnose local AR. Allergen microarray has the ability to detect more potential allergens. Basophil activation and mast cell activation tests can be used in allergen diagnosis and to modify the response to immunotherapy, while cytological diagnosis is useful in the differential diagnosis of AR and non-AR. Nasal NO has been confirmed to be an optimal biomarker to discriminate between AR and non-AR.
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Affiliation(s)
- Xiangdong Wang
- a Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital , Capital Medical University , Beijing PR China.,b Beijing Key Laboratory of Nasal Diseases , Beijing Institute of Otolaryngology , Beijing PR China
| | - Kun Du
- a Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital , Capital Medical University , Beijing PR China
| | - Wenyu She
- b Beijing Key Laboratory of Nasal Diseases , Beijing Institute of Otolaryngology , Beijing PR China
| | - Yuhui Ouyang
- b Beijing Key Laboratory of Nasal Diseases , Beijing Institute of Otolaryngology , Beijing PR China
| | - Yutong Sima
- a Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital , Capital Medical University , Beijing PR China
| | - Chengyao Liu
- a Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital , Capital Medical University , Beijing PR China
| | - Luo Zhang
- a Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital , Capital Medical University , Beijing PR China.,b Beijing Key Laboratory of Nasal Diseases , Beijing Institute of Otolaryngology , Beijing PR China
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163
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Yang Y, Hu MJ, Jin TC, Zhang YX, Liu GY, Li YB, Zhang ML, Cao MJ, Su WJ, Liu GM. A comprehensive analysis of the allergenicity and IgE epitopes of myosinogen allergens in Scylla paramamosain. Clin Exp Allergy 2018; 49:108-119. [PMID: 30187588 DOI: 10.1111/cea.13266] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 08/26/2018] [Accepted: 08/29/2018] [Indexed: 12/22/2022]
Abstract
BACKGROUND Scylla paramamosain is one of the most common and serious food allergens in Asia. Therefore, research on its prevalence, accurate diagnosis, and IgE-binding pattern of the allergens is crucial. OBJECTIVE To identify the IgE epitopes of the myosinogen allergens in S. paramamosain using phage peptide library. METHODS The prevalence of allergy to crabs (AC) and of sensitization was analysed using a questionnaire and a serological assay. BAT was performed by flow cytometry, and its diagnostic performance was evaluated in relation to allergens purified from crab myosinogen. IgE-binding epitopes were identified by phage display using the IgE from patients with AC. Sequence- and structure-based bioinformatics analyses were performed to identify allergenic epitopes. RESULTS Crab was the most common cause of food allergies in this study. Subjects with AC (n = 30) with clear clinical symptoms were identified by immunoblotting and BAT. All of the myosinogen allergens triggered basophil activation; surface expression of CD63 and CD203c was higher in patients allergic to AK and FLN c than in patients allergic to SCP and TIM. In addition to six conformational epitopes of SCP, six linear epitopes and eight conformational epitopes of AK were identified. Five linear epitopes and three conformational epitopes of TIM, nine linear and ten conformational epitopes of FLN c were also identified, and the sequence VH(I/T) L was appeared in epitopes of both TIM and FLN c. The number of epitopes showed consistency with the value of BAT. CONCLUSIONS AND CLINICAL RELEVANCE BAT can be used for accurate diagnosis of AC. Identification of particular allergenic motifs could be a valuable tool for prevention, diagnosis, and treatment of food allergies.
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Affiliation(s)
- Yang Yang
- College of Food and Biological Engineering, Fujian Collaborative Innovation Center for Exploitation and Utilization of Marine Biological Resources, Jimei University, Xiamen, China
| | - Meng Jun Hu
- College of Food and Biological Engineering, Fujian Collaborative Innovation Center for Exploitation and Utilization of Marine Biological Resources, Jimei University, Xiamen, China
| | - Teng Chuan Jin
- University of Science and Technology of China, Hefei, China
| | - Yong Xia Zhang
- College of Food and Biological Engineering, Fujian Collaborative Innovation Center for Exploitation and Utilization of Marine Biological Resources, Jimei University, Xiamen, China
| | - Guang Yu Liu
- College of Food and Biological Engineering, Fujian Collaborative Innovation Center for Exploitation and Utilization of Marine Biological Resources, Jimei University, Xiamen, China
| | - Yu Bao Li
- Medical center of Jimei University, Xiamen, China
| | | | - Min Jie Cao
- College of Food and Biological Engineering, Fujian Collaborative Innovation Center for Exploitation and Utilization of Marine Biological Resources, Jimei University, Xiamen, China
| | - Wen Jin Su
- College of Food and Biological Engineering, Fujian Collaborative Innovation Center for Exploitation and Utilization of Marine Biological Resources, Jimei University, Xiamen, China
| | - Guang Ming Liu
- College of Food and Biological Engineering, Fujian Collaborative Innovation Center for Exploitation and Utilization of Marine Biological Resources, Jimei University, Xiamen, China
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164
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Yasui K, Matsuyama N, Kimura T, Fujimura Y, Hirayama F. Immunoglobulin (Ig)G antibodies against IgE identified by basophil activation test as the putative causative agent of a serious allergic transfusion reaction: potential utility of the test as a new safety measure for allergic transfusion reactions. Transfusion 2018; 58:2572-2580. [PMID: 30264399 DOI: 10.1111/trf.14878] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2018] [Revised: 06/05/2018] [Accepted: 06/18/2018] [Indexed: 01/30/2023]
Abstract
BACKGROUND In most cases of allergic transfusion reactions (ATRs), the causative agents have not been identified and the mechanisms are largely unknown, with a few exceptions. The basophil activation test (BAT) was recently introduced in the field of transfusion to investigate the causal relationships between ATRs and transfusion, as well as the mechanisms behind them. STUDY DESIGN AND METHODS The BAT was used to screen the residual supernatants (SNs) of 43 blood components associated with serious ATRs for those that can activate basophils of many healthy volunteers. The SNs were then fractionated by centrifugal ultrafiltration and protein G column chromatography and each separated fraction was reexamined by the BAT. RESULTS Of the 43 such blood components, one activated basophils from 19 of 21 healthy volunteers. In the blood component, the IgG antibody against IgE was identified as a putative causative agent. CONCLUSION Blood donors who possessed the IgG antibody against IgE may be dangerous to transfusion recipients. The BAT would be useful in identifying such high-risk blood donors, when it is used to screen the blood components associated with serious ATRs for residual SNs that can activate the basophils of many healthy volunteers.
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Affiliation(s)
- Kazuta Yasui
- Japanese Red Cross Kinki Block Blood Center, Ibaraki, Osaka, Japan
| | - Nobuki Matsuyama
- Japanese Red Cross Kinki Block Blood Center, Ibaraki, Osaka, Japan
| | - Takafumi Kimura
- Japanese Red Cross Kinki Block Blood Center, Ibaraki, Osaka, Japan
| | | | - Fumiya Hirayama
- Japanese Red Cross Kinki Block Blood Center, Ibaraki, Osaka, Japan
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165
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Dewachter P, Chollet-Martin S, Mouton-Faivre C, de Chaisemartin L, Nicaise-Roland P. Comparison of Basophil Activation Test and Skin Testing Performances in NMBA Allergy. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2018; 6:1681-1689. [DOI: 10.1016/j.jaip.2017.12.037] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2017] [Revised: 11/28/2017] [Accepted: 12/27/2017] [Indexed: 12/31/2022]
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166
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Mehlich J, Fischer J, Hilger C, Swiontek K, Morisset M, Codreanu-Morel F, Schiener M, Blank S, Ollert M, Darsow U, Biedermann T, Eberlein B. The basophil activation test differentiates between patients with alpha-gal syndrome and asymptomatic alpha-gal sensitization. J Allergy Clin Immunol 2018; 143:182-189. [PMID: 30125663 DOI: 10.1016/j.jaci.2018.06.049] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 06/03/2018] [Accepted: 06/28/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Galactose-alpha-1,3-galactose (alpha-gal) syndrome is characterized by the presence of serum specific IgE antibodies to alpha-gal and delayed type I allergic reactions to the carbohydrate alpha-gal after consumption of mammalian (red) meat products and drugs of mammalian origin. Diagnostics currently rely on patient history, skin tests, determination of serum specific IgE antibodies, and oral food or drug challenges. OBJECTIVE We sought to assess the utility of different basophil parameters (basophil reactivity and sensitivity, the ratio of the percentage of CD63+ basophils induced by the alpha-gal-containing allergen to the percentage of CD63+ basophils after stimulation with anti-FcεRI antibody [%CD63+/anti-FcεRI], and area under the dose-response curve [AUC]) as biomarkers for the clinical outcome of patients with alpha-gal syndrome compared with subjects with asymptomatic alpha-gal sensitization. METHODS In addition to routine diagnostics, a basophil activation test (Flow CAST) with different concentrations of alpha-gal-containing allergens (eg, commercially available alpha-gal-carrying proteins and pork kidney extracts) was performed in 21 patients with alpha-gal syndrome, 12 alpha-gal-sensitized subjects, and 18 control subjects. RESULTS Alpha-gal-containing allergens induced strong basophil activation in a dose-dependent manner in patients. Basophil reactivity at distinct allergen concentrations, the %CD63+/anti-FcεRI ratio across most allergen concentrations, the AUC of dose-response curves, and basophil allergen threshold sensitivity (CD-sens) with pork kidney extract were significantly higher in patients with alpha-gal syndrome compared with those in sensitized subjects. All parameters were negative in control subjects. CONCLUSION The basophil activation test should be considered as an additional diagnostic test before performing time-consuming and potentially risky oral provocation tests. The %CD63+/anti-FcεRI ratio for all allergens and AUCs for pork kidney were the best parameters for distinguishing patients with alpha-gal syndrome from subjects with asymptomatic alpha-gal sensitization.
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Affiliation(s)
- Jana Mehlich
- Department of Dermatology and Allergy Biederstein, Technical University of Munich, Munich, Germany
| | - Jörg Fischer
- Department of Dermatology, Faculty of Medicine, Eberhard Karls University Tuebingen, Tuebingen, Germany
| | - Christiane Hilger
- Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg
| | - Kyra Swiontek
- Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg
| | - Martine Morisset
- Immunology-Allergology Department, Luxembourg Hospital, Luxembourg-Ville, Luxembourg
| | | | - Maximilian Schiener
- Center of Allergy and Environment (ZAUM), Technical University of Munich and Helmholtz Center Munich, Munich, Germany
| | - Simon Blank
- Center of Allergy and Environment (ZAUM), Technical University of Munich and Helmholtz Center Munich, Munich, Germany
| | - Markus Ollert
- Department of Infection and Immunity, Luxembourg Institute of Health, Esch-sur-Alzette, Luxembourg
| | - Ulf Darsow
- Department of Dermatology and Allergy Biederstein, Technical University of Munich, Munich, Germany
| | - Tilo Biedermann
- Department of Dermatology and Allergy Biederstein, Technical University of Munich, Munich, Germany
| | - Bernadette Eberlein
- Department of Dermatology and Allergy Biederstein, Technical University of Munich, Munich, Germany.
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167
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Bonadonna P, Scaffidi L. Hymenoptera Anaphylaxis as a Clonal Mast Cell Disorder. Immunol Allergy Clin North Am 2018; 38:455-468. [DOI: 10.1016/j.iac.2018.04.010] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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168
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Licari A, Castagnoli R, Brambilla I, Tosca MA, De Filippo M, Marseglia G, Ciprandi G. Biomarkers of immunotherapy response in patients with allergic rhinitis. Expert Rev Clin Immunol 2018; 14:657-663. [PMID: 30039714 DOI: 10.1080/1744666x.2018.1504679] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
INTRODUCTION Allergen immunotherapy represents the only disease-modifying therapy available for immunoglobulin E-mediated diseases such as allergic rhinitis and asthma. Allergen immunotherapy induces allergen tolerance by interfering with the immune-pathogenic mechanisms of the allergic response and is potentially able to provide long-term relief of symptoms of allergic rhinitis and asthma and alter the natural course of allergic diseases. Areas covered: Since allergen immunotherapy (AIT) is actually considered an individualized treatment on patient's clinical and immunological profile, the identification of specific biomarkers, which may guide diagnosis, management, and predict response to AIT treatment in allergic rhinitis (AR) patients, is essential and is currently an active field of research. Expert commentary: The identification and validation of biomarkers of successful AIT for AR is an urgent need to definitively establish the role of AIT as a therapeutic tool of personalized medicine.
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Affiliation(s)
- Amelia Licari
- a Department of Pediatrics , Foundation IRCCS Policlinico San Matteo, University of Pavia , Pavia , Italy
| | - Riccardo Castagnoli
- a Department of Pediatrics , Foundation IRCCS Policlinico San Matteo, University of Pavia , Pavia , Italy
| | - Ilaria Brambilla
- a Department of Pediatrics , Foundation IRCCS Policlinico San Matteo, University of Pavia , Pavia , Italy
| | | | - Maria De Filippo
- a Department of Pediatrics , Foundation IRCCS Policlinico San Matteo, University of Pavia , Pavia , Italy
| | - Gianluigi Marseglia
- a Department of Pediatrics , Foundation IRCCS Policlinico San Matteo, University of Pavia , Pavia , Italy
| | - Giorgio Ciprandi
- b Pediatric Allergy , IRCCS Istituto Giannina Gaslini , Genoa , Italy.,c Department of Medicine , IRCCS-A.O.U ., San Martino di Genova, Genoa , Italy
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169
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Ferrer M, Giménez-Arnau A, Saldana D, Janssens N, Balp MM, Khalil S, Risson V. Predicting Chronic Spontaneous Urticaria Symptom Return After Omalizumab Treatment Discontinuation: Exploratory Analysis. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2018; 6:1191-1197.e5. [DOI: 10.1016/j.jaip.2018.04.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Revised: 03/24/2018] [Accepted: 04/01/2018] [Indexed: 12/22/2022]
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170
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Sabogal-Cuadro P, Zakzuk J. Prueba de activación de basófilos: aspectos técnicos, metodológicos y su utilidad clínica. REVISTA DE LA FACULTAD DE MEDICINA 2018. [DOI: 10.15446/revfacmed.v66n3.61820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Introducción. La prueba de activación de basófilos (PAB) se considera una técnica confiable y segura para el diagnóstico de problemas alérgicos.Objetivo. Profundizar en el estado del arte de la PAB y su utilidad clínica.Materiales y métodos. Se realizó una revisión narrativa de la literatura mediante la búsqueda electrónica en las bases de datos y metabuscadores Ovid Medline, Google Scholar y PubMed, sin limitar la búsqueda por fecha, idioma o tipo de artículo. Se buscaron artículos sobre los detalles técnicos de la PAB y su utilidad clínica en el manejo de las enfermedades alérgicas.Resultados. De los marcadores de activación, CD63 ha sido el más estudiado y es el que mejor representa un evento de degranulación anafiláctica, mientras que CD203c es representativo de varias formas de degranulación. La superioridad de uno sobre otro como prueba diagnóstica depende del problema alérgico estudiado. En cuanto a los métodos de detección de basófilos, su selección con un único marcador, CCR3, se propone como una opción con buena relación de costo-efectividad.Conclusiones. La PAB es una herramienta prometedora para evaluar en clínica las reacciones alérgicas de forma segura. Es necesario una mayor estandarización de protocolos para obtener resultados más reproducibles.
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171
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Schulze J, Leberkuehne L, Salzmann-Manrique E, Schubert R, Zielen S, Rosewich M. Comparison of two different assays and the predictive value of allergen components in house dust mite allergy. Immunotherapy 2018; 9:1253-1262. [PMID: 29130795 DOI: 10.2217/imt-2017-0084] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
AIM In house dust mite (HDM) allergy diagnostics, the IMMULITE, ImmunoCAP and assays for allergen components (nDer p 1 and rDer p 2) are available. METHODS Serum sIgE levels were compared and the predictive values for the detection of an early asthmatic response (EAR) were calculated with receiver operating characteristics and a log-logistic regression model. RESULTS sIgE levels of IMMULITE and ImmunoCAP were similar (Dermatophagoides pteronyssinus [D. pter.] 47.3 ± 35.7 and 42.9 ± 34.4 kU.l-1; p = 0.23). ImmunoCAP slgEs exhibited similar accuracy in detecting an EAR, area under the curves (AUCs): D. pter. (0.76); Dermatophagoides farinae (0.79); nDer p 1 (0.69); and rDer p 2 (0.72). At low sIgE concentrations (3.5 kU.l-1), rDer p 2 was more specific and better predicted an EAR (probability rDer p 2: 62%; D. pter.: 19%).
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Affiliation(s)
- Johannes Schulze
- Department of Allergy, Pulmonology & Cystic Fibrosis, Children's Hospital, Goethe University, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany
| | | | - Emilia Salzmann-Manrique
- Institute of Biostatistics & Mathematical Modeling, Department of Medicine, Goethe University, Frankfurt, Germany
| | - Ralf Schubert
- Department of Allergy, Pulmonology & Cystic Fibrosis, Children's Hospital, Goethe University, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany
| | - Stefan Zielen
- Department of Allergy, Pulmonology & Cystic Fibrosis, Children's Hospital, Goethe University, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany
| | - Martin Rosewich
- Department of Allergy, Pulmonology & Cystic Fibrosis, Children's Hospital, Goethe University, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany
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172
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Appel MY, Nachshon L, Elizur A, Levy MB, Katz Y, Goldberg MR. Evaluation of the basophil activation test and skin prick testing for the diagnosis of sesame food allergy. Clin Exp Allergy 2018; 48:1025-1034. [DOI: 10.1111/cea.13174] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Revised: 04/30/2018] [Accepted: 05/01/2018] [Indexed: 11/29/2022]
Affiliation(s)
- M. Y. Appel
- Institute of Allergy, Immunology and Pediatric Pulmonology Assaf‐Harofeh Medical Center Zerifin Israel
| | - L. Nachshon
- Institute of Allergy, Immunology and Pediatric Pulmonology Assaf‐Harofeh Medical Center Zerifin Israel
| | - A. Elizur
- Institute of Allergy, Immunology and Pediatric Pulmonology Assaf‐Harofeh Medical Center Zerifin Israel
- Department of Pediatrics Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel
| | - M. B. Levy
- Institute of Allergy, Immunology and Pediatric Pulmonology Assaf‐Harofeh Medical Center Zerifin Israel
| | - Y. Katz
- Department of Pediatrics Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel
| | - M. R. Goldberg
- Institute of Allergy, Immunology and Pediatric Pulmonology Assaf‐Harofeh Medical Center Zerifin Israel
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173
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Affiliation(s)
- F Schocker
- Division of Clinical and Molecular Allergology, Priority Research Area Asthma and Allergy, Research Center Borstel, Airway Research Center North (ARCN), Member of the German Center for Lung Research, Borstel, Germany
| | - A Recke
- Department of Dermatology, University of Lübeck, Lübeck, Germany
| | - S Kull
- Division of Clinical and Molecular Allergology, Priority Research Area Asthma and Allergy, Research Center Borstel, Airway Research Center North (ARCN), Member of the German Center for Lung Research, Borstel, Germany
| | - M Worm
- Department of Dermatology and Allergology, Allergy-Center- Charité, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - J Behrends
- Core Facility Fluorescence Cytometry at the Research Center Borstel, Borstel, Germany
| | - U Jappe
- Division of Clinical and Molecular Allergology, Priority Research Area Asthma and Allergy, Research Center Borstel, Airway Research Center North (ARCN), Member of the German Center for Lung Research, Borstel, Germany.,Interdisciplinary Allergy Outpatient Clinic, Department of Pneumology, University of Lübeck, Lübeck, Germany
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174
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Gutiérrez-Fernández D, Saldaña-Valderas M, de la Varga-Martínez R, Foncubierta-Fernández A, Fernández-Anguita MJ, Fernández-Valle MDC, Medina-Varo F. Hypersensitivity to alemtuzumab. A safe and effective desensitization protocol: A case report. J Oncol Pharm Pract 2018; 25:1016-1020. [PMID: 29792124 DOI: 10.1177/1078155218775473] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We describe a successful desensitization to alemtuzumab in one patient diagnosed with T-cell prolymphocytic leukaemia. Alemtuzumab treatment was initiated during infusion number 18, the patient showed cutaneous eruption with a miliary pattern, despite premedication with corticosteroids and antihistamines. The eruption returned with successive alemtuzumab infusions (infusions 19, 20 and 21), remained present for longer and was more severe with each infusion. The patient was referred to our Allergy Unit as it was necessary to maintain alemtuzumab treatment. Total immunoglobulin E level was 3 UI/ml and specific immunoglobulin E against more common pneumo-allergens, food, latex and hamster were inferior to 0.35 UI/ml. Prick test using the undiluted drug (30 mg/ml) and intradermal tests using serial dilutions (1/10, 1/100) were performed. The result of alemtuzumab skin prick test was 4 mm. The intradermal skin test result was positive at 1/100 dilution (papule: 8 mm; erythema: 12 mm). The basophil activation test with alemtuzumab was performed concluding that 10% of the basophils were activated by alemtuzumab. The patient underwent alemtuzumab desensitization according to a 12-step protocol that resolved to be safe and efficacious. Our experience may be helpful for similar clinical cases where the therapeutic options are very limited and a life-threatening condition such T-cell prolymphocytic leukaemia is present. In addition, a careful risk/benefit ratio should be considered and accurate informed consent is mandatory.
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Affiliation(s)
- Diego Gutiérrez-Fernández
- 1 Servicio de Alergología. UGC Neumología-Alergia, Hospital Universitario Puerta del Mar, Cádiz, Spain
| | | | | | | | | | - Maria Del C Fernández-Valle
- 6 Servicio de Hematología, UGC Hematología, Inmunología y Genética, Hospital Universitario Puerta del Mar, Cádiz, Spain
| | - Fermín Medina-Varo
- 7 Unidad de Reumatología. UGC Cirugía Ortopédica, Traumatología y Reumatología, Hospital Universitario Puerta del Mar, Cádiz, Spain
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175
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Berings M, Gevaert P, De Ruyck N, Derycke L, Holtappels G, Pilette C, Bachert C, Lambrecht BN, Dullaers M. FcεRI expression and IgE binding by dendritic cells and basophils in allergic rhinitis and upon allergen immunotherapy. Clin Exp Allergy 2018; 48:970-980. [PMID: 29682789 DOI: 10.1111/cea.13157] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Revised: 04/06/2018] [Accepted: 04/10/2018] [Indexed: 01/06/2023]
Abstract
BACKGROUND In humans, both basophils and dendritic cells (DCs) express the high-affinity IgE receptor (FcεRI). OBJECTIVE To gain more insight into the relation between serum IgE levels and FcεRI expression and IgE binding by DCs and basophils in house dust mite (HDM) allergy and during subcutaneous immunotherapy (SCIT). METHODS We measured FcεRI, IgE and HDM allergen on DCs (conventional type 2 DCs, cDC2s; plasmacytoid dendritic cells, pDCs) and basophils by flow cytometry in 22 non-allergic vs 52 allergic subjects and upon HDM SCIT in 28 allergic subjects. IgE levels were measured in serum. RESULTS Serum IgE correlated differentially with FcεRI expression and IgE binding depending on cell type and allergic status. In non-allergic subjects, FcεRI/IgE surface densities increased with serum IgE to a significantly stronger degree on basophils compared to cDC2s. By contrast, in allergic subjects FcεRI/IgE surface densities increased with serum IgE to a slightly stronger degree on cDC2s compared to basophils. In addition, the data set suggests sequential loading of IgE onto FcεRI expressed by these cells (basophils>cDC2s>pDCs). Finally, HDM SCIT induced a temporary increase in serum IgE, which was paralleled by a peak in FcεRI and IgE on DCs, but not on basophils. CONCLUSIONS & CLINICAL RELEVANCE This study provides a comprehensive insight into the relation between serum IgE and FcεRI/IgE on basophils and DC subsets. The novel finding that HDM SCIT induces a temporary increase in FcεRI expression on DCs, but not on basophils, can be an incentive for future research on the potential tolerogenic role of IgE/FcεRI signalling in DCs in the setting of allergen immunotherapy.
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Affiliation(s)
- M Berings
- Upper Airways Research Laboratory, Ghent University, Ghent, Belgium.,Laboratory of Immunoregulation, VIB Inflammation Research Center, Ghent, Belgium
| | - P Gevaert
- Upper Airways Research Laboratory, Ghent University, Ghent, Belgium
| | - N De Ruyck
- Upper Airways Research Laboratory, Ghent University, Ghent, Belgium
| | - L Derycke
- Upper Airways Research Laboratory, Ghent University, Ghent, Belgium
| | - G Holtappels
- Upper Airways Research Laboratory, Ghent University, Ghent, Belgium
| | - C Pilette
- Pole of Pneumology, ENT and Dermatology, Institute of Experimental and Clinical Research (IREC), Université catholique de Louvain, Brussels, Belgium
| | - C Bachert
- Upper Airways Research Laboratory, Ghent University, Ghent, Belgium
| | - B N Lambrecht
- Laboratory of Immunoregulation, VIB Inflammation Research Center, Ghent, Belgium.,Department of Internal Medicine, Ghent University, Ghent, Belgium
| | - M Dullaers
- Laboratory of Immunoregulation, VIB Inflammation Research Center, Ghent, Belgium.,Clinical Immunology Research Lab, Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium
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176
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Fernández TD, Mayorga C, Torres MJ. Reply. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2018; 6:1090-1091. [PMID: 29747974 DOI: 10.1016/j.jaip.2017.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Revised: 10/31/2017] [Accepted: 11/04/2017] [Indexed: 11/25/2022]
Affiliation(s)
- Tahia Diana Fernández
- Research Unit for Allergic Diseases, Biomedical Institut of Malaga (IBIMA)-Regional University Hospital of Malaga Universidad de Malaga (UMA), Malaga, Spain
| | - Cristobalina Mayorga
- Research Unit for Allergic Diseases, Biomedical Institut of Malaga (IBIMA)-Regional University Hospital of Malaga Universidad de Malaga (UMA), Malaga, Spain; Allergy Unit, IBIMA-Regional University Hospital of Malaga UMA, Malaga, Spain
| | - María José Torres
- Allergy Unit, IBIMA-Regional University Hospital of Malaga UMA, Malaga, Spain; Andalusian Center for Nanomedicine and Biotechnology - BIONAND, Malaga, Spain.
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177
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Santos AF, Couto-Francisco N, Bécares N, Kwok M, Bahnson HT, Lack G. A novel human mast cell activation test for peanut allergy. J Allergy Clin Immunol 2018; 142:689-691.e9. [PMID: 29731128 PMCID: PMC6080741 DOI: 10.1016/j.jaci.2018.03.011] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Revised: 03/20/2018] [Accepted: 03/23/2018] [Indexed: 11/25/2022]
Affiliation(s)
- Alexandra F Santos
- Department of Pediatric Allergy, School of Life Course Sciences, King's College London & Guy's and St Thomas' Hospital NHS Foundation Trust, London, United Kingdom; Peter Gorer Department of Immunobiology, School of Immunology & Microbial Sciences, King's College London, London, United Kingdom; MRC & Asthma UK Centre in Allergic Mechanisms of Asthma, London, United Kingdom.
| | - Natália Couto-Francisco
- Peter Gorer Department of Immunobiology, School of Immunology & Microbial Sciences, King's College London, London, United Kingdom; MRC & Asthma UK Centre in Allergic Mechanisms of Asthma, London, United Kingdom
| | - Natalia Bécares
- Peter Gorer Department of Immunobiology, School of Immunology & Microbial Sciences, King's College London, London, United Kingdom; MRC & Asthma UK Centre in Allergic Mechanisms of Asthma, London, United Kingdom
| | - Matthew Kwok
- Peter Gorer Department of Immunobiology, School of Immunology & Microbial Sciences, King's College London, London, United Kingdom; MRC & Asthma UK Centre in Allergic Mechanisms of Asthma, London, United Kingdom
| | - Henry T Bahnson
- Immune Tolerance Network, Benaroya Research Institute, Seattle, Wash
| | - Gideon Lack
- Department of Pediatric Allergy, School of Life Course Sciences, King's College London & Guy's and St Thomas' Hospital NHS Foundation Trust, London, United Kingdom; Peter Gorer Department of Immunobiology, School of Immunology & Microbial Sciences, King's College London, London, United Kingdom; MRC & Asthma UK Centre in Allergic Mechanisms of Asthma, London, United Kingdom
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178
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Renand A, Shamji MH, Harris KM, Qin T, Wambre E, Scadding GW, Wurtzen PA, Till SJ, Togias A, Nepom GT, Kwok WW, Durham SR. Synchronous immune alterations mirror clinical response during allergen immunotherapy. J Allergy Clin Immunol 2018; 141:1750-1760.e1. [PMID: 29128670 PMCID: PMC5938141 DOI: 10.1016/j.jaci.2017.09.041] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Revised: 08/25/2017] [Accepted: 09/18/2017] [Indexed: 12/23/2022]
Abstract
BACKGROUND Three years of treatment with either sublingual or subcutaneous allergen immunotherapy has been shown to be effective and to induce long-term tolerance. The Gauging Response in Allergic Rhinitis to Sublingual and Subcutaneous Immunotherapy (GRASS) trial demonstrated that 2 years of treatment through either route was effective in suppressing the response to nasal allergen challenge, although it was insufficient for inhibition 1 year after discontinuation. OBJECTIVE We sought to examine in the GRASS trial the time course of immunologic changes during 2 years of sublingual and subcutaneous immunotherapy and for 1 year after treatment discontinuation. METHODS We performed multimodal immunomonitoring to assess allergen-specific CD4 T-cell properties in parallel with analysis of local mucosal cytokine responses induced by nasal allergen exposure and humoral immune responses that included IgE-dependent basophil activation and measurement of serum inhibitory activity for allergen-IgE binding to B cells (IgE-facilitated allergen binding). RESULTS All 3 of these distinct arms of the immune response displayed significant and coordinate alterations during 2 years of allergen desensitization, followed by reversal at 3 years, reflecting a lack of a durable immunologic effect. Although frequencies of antigen-specific TH2 cells in peripheral blood determined by using HLA class II tetramer analysis most closely paralleled clinical outcomes, IgE antibody-dependent functional assays remained inhibited in part 1 year after discontinuation. CONCLUSION Two years of allergen immunotherapy were effective but insufficient for long-term tolerance. Allergen-specific TH2 cells most closely paralleled the transient clinical outcome, and it is likely that recurrence of the T-cell drivers of allergic immunity abrogated the potential for durable tolerance. On the other hand, the persistence of IgE blocking antibody 1 year after discontinuation might be an early indicator of a protolerogenic mechanism.
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Affiliation(s)
- Amedee Renand
- Benaroya Research Institute at Virginia Mason, Seattle, Wash
| | - Mohamed H Shamji
- Immunomodulation and Tolerance Group, Allergy and Clinical Immunology, Section of Inflammation Repair and Development, National Heart and Lung Institute, Imperial College London, London, United Kingdom; MRC and Asthma UK, Centre in Allergic Mechanisms of Asthma, London, United Kingdom
| | | | | | - Erik Wambre
- Benaroya Research Institute at Virginia Mason, Seattle, Wash
| | - Guy W Scadding
- Immunomodulation and Tolerance Group, Allergy and Clinical Immunology, Section of Inflammation Repair and Development, National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | | | - Stephen J Till
- Asthma, Allergy and Lung Biology, School of Immunology & Microbial Sciences, King's College London, London, United Kingdom; MRC and Asthma UK, Centre in Allergic Mechanisms of Asthma, London, United Kingdom
| | - Alkis Togias
- National Institute of Allergy and Infectious Diseases, Bethesda, Md
| | - Gerald T Nepom
- Benaroya Research Institute at Virginia Mason, Seattle, Wash; Immune Tolerance Network, Bethesda, Md
| | - William W Kwok
- Benaroya Research Institute at Virginia Mason, Seattle, Wash
| | - Stephen R Durham
- Immunomodulation and Tolerance Group, Allergy and Clinical Immunology, Section of Inflammation Repair and Development, National Heart and Lung Institute, Imperial College London, London, United Kingdom; MRC and Asthma UK, Centre in Allergic Mechanisms of Asthma, London, United Kingdom.
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179
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Horiuchi T, Yokohama A, Orihara M, Tomita Y, Tomioka A, Yoshida N, Takahashi K, Saito S, Takazawa T. Usefulness of Basophil Activation Tests for Diagnosis of Sugammadex-Induced Anaphylaxis. Anesth Analg 2018. [DOI: 10.1213/ane.0000000000002879] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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180
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Caruso M, Cibella F, Emma R, Campagna D, Tringali G, Amaradio MD, Polosa R. Basophil biomarkers as useful predictors for sublingual immunotherapy in allergic rhinitis. Int Immunopharmacol 2018; 60:50-58. [PMID: 29702283 DOI: 10.1016/j.intimp.2018.04.034] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Revised: 02/21/2018] [Accepted: 04/18/2018] [Indexed: 01/08/2023]
Abstract
Prevalence of allergic diseases is increasing worldwide. Allergen-specific immunotherapy (ASIT) is potentially the only curative treatment for allergy, but there is a lack of reliable methods to monitor the immune responses to ASIT and to predict clinical efficacy. Recently, the definition of allergen sensitivity threshold (CD-Sens) by Basophil Activation Tests has been suggested as potential method in this context. The aim of this study was to compare trends of CD-Sens, measured by the markers CD63 and CD203c, and clinical symptoms in subjects with allergic rhinitis receiving Sublingual Immunotherapy (SLIT). 26 rhinitis patients allergic to Parietaria were selected and matched into two groups; a SLIT treated group (SG) and a reference group (RG) treated by traditional anti-allergic medications. Visual Analogue Scale (VAS) score for the four cardinal symptoms of rhinitis and peripheral blood was collected before the first dose of SLIT (T0) and after 12 months (T12) to define the severity of the symptoms and the sensitivity of basophils to Parietaria. The comparison between T0 and T12 in SG patients showed a significant decrease of symptom severity (VAS score) and an increased tolerability of basophils to Parietaria (CD-Sens) both by CD63 and CD203c. But, only CD203c seems to be correlated with the clinical symptoms. These data corroborate the hypothesis that SLIT could change the immunological course of allergic sensitization already in the first year, and that an immunological parameter as CD-Sens measured by CD63 and CD203c expression on stimulated basophils could be useful to monitor the changes in the immune system.
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Affiliation(s)
- Massimo Caruso
- Department of Clinical and Experimental Medicine, Azienda Ospedaliero-Universitaria "Policlinico-V. Emanuele", University of Catania, Via S. Sofia 78, 95123 Catania, Italy.
| | - Fabio Cibella
- National Research Council of Italy, Institute of Biomedicine and Molecular Immunology, via Ugo La Malfa 153, 90146 Palermo, Italy.
| | - Rosalia Emma
- Department of Clinical and Experimental Medicine, Azienda Ospedaliero-Universitaria "Policlinico-V. Emanuele", University of Catania, Via S. Sofia 78, 95123 Catania, Italy
| | - Davide Campagna
- Department of Clinical and Experimental Medicine, Azienda Ospedaliero-Universitaria "Policlinico-V. Emanuele", University of Catania, Via S. Sofia 78, 95123 Catania, Italy
| | - Giovanni Tringali
- Istituto Ricerca Medica ed Ambientale (I.R.M.A.) Srl, Via Paolo Vasta, 158/C, 95024 Acireale (CT), Italy
| | - Maria Domenica Amaradio
- Department of Clinical and Experimental Medicine, Azienda Ospedaliero-Universitaria "Policlinico-V. Emanuele", University of Catania, Via S. Sofia 78, 95123 Catania, Italy
| | - Riccardo Polosa
- Department of Clinical and Experimental Medicine, Azienda Ospedaliero-Universitaria "Policlinico-V. Emanuele", University of Catania, Via S. Sofia 78, 95123 Catania, Italy
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181
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Vizzardelli C, Gindl M, Roos S, Möbs C, Nagl B, Zimmann F, Sexl V, Kenner L, Neunkirchner A, Zlabinger GJ, Pickl WF, Pfützner W, Bohle B. Blocking antibodies induced by allergen-specific immunotherapy ameliorate allergic airway disease in a human/mouse chimeric model. Allergy 2018; 73:851-861. [PMID: 29159964 DOI: 10.1111/all.13363] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/15/2017] [Indexed: 12/19/2022]
Abstract
BACKGROUND Allergen-specific immunotherapy (AIT) induces specific blocking antibodies (Ab), which are claimed to prevent IgE-mediated reactions to allergens. Additionally, AIT modulates cellular responses to allergens, for example, by desensitizing effector cells, inducing regulatory T and B lymphocytes and immune deviation. It is still enigmatic which of these mechanisms mediate(s) clinical tolerance. We sought to address the role of AIT-induced blocking Ab separately from cellular responses in a chimeric human/mouse model of respiratory allergy. METHODS Nonobese diabetic severe combined immunodeficient γc-/- (NSG) mice received intraperitoneally allergen-reactive PBMC from birch pollen-allergic patients together with birch pollen extract and human IL-4. Engraftment was assessed by flow cytometry. Airway hyperresponsiveness (AHR) and bronchial inflammation were analyzed after intranasal challenges with allergen or PBS. Sera collected from patients before and during AIT with birch pollen were added to the allergen prior to intranasal challenge. The IgE-blocking activity of post-AIT sera was assessed in vitro. RESULTS Human cells were detected in cell suspensions of murine lungs and spleens indicating successful humanization. Humanized mice displayed a more pronounced AHR and bronchial inflammation when challenged with allergen compared to negative controls. Post-AIT sera exerted IgE-blocking activity. In contrast to pre-AIT sera, the presence of heterologous and autologous post-AIT sera significantly reduced the allergic airway inflammation and matched their IgE-blocking activity determined in vitro. CONCLUSION Our data demonstrate that post-AIT sera with IgE-blocking activity ameliorate allergic airway inflammation in a human/mouse chimeric model of respiratory allergy independently of AIT-induced cellular changes.
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Affiliation(s)
- C. Vizzardelli
- Institute of Pathophysiology and Allergy Research; Medical University of Vienna; Vienna Austria
| | - M. Gindl
- Institute of Pathophysiology and Allergy Research; Medical University of Vienna; Vienna Austria
| | - S. Roos
- Unit of Laboratory Animal Pathology; University of Veterinary Medicine Vienna; Vienna Austria
| | - C. Möbs
- Department of Dermatology and Allergology; Philipps University Marburg; Marburg Germany
| | - B. Nagl
- Institute of Pathophysiology and Allergy Research; Medical University of Vienna; Vienna Austria
| | - F. Zimmann
- Institute of Pathophysiology and Allergy Research; Medical University of Vienna; Vienna Austria
| | - V. Sexl
- Institute of Pharmacology and Toxicology; University of Veterinary Medicine Vienna; Vienna Austria
| | - L. Kenner
- Unit of Laboratory Animal Pathology; University of Veterinary Medicine Vienna; Vienna Austria
- Department of Experimental and Laboratory Animal Pathology; Medical University of Vienna; Vienna Austria
- Ludwig Boltzmann Institute for Cancer Research (LBI-CR); Vienna Austria
| | - A. Neunkirchner
- Institute of Immunology; Medical University of Vienna; Vienna Austria
| | - G. J. Zlabinger
- Institute of Immunology; Medical University of Vienna; Vienna Austria
| | - W. F. Pickl
- Institute of Immunology; Medical University of Vienna; Vienna Austria
| | - W. Pfützner
- Department of Dermatology and Allergology; Philipps University Marburg; Marburg Germany
| | - B. Bohle
- Institute of Pathophysiology and Allergy Research; Medical University of Vienna; Vienna Austria
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182
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Rolla G, Heffler E, Boita M, Doyen V, Mairesse M, Cvackova M, Debarbieux S, Kleine-Tebbe J, Ollert M, Raulf M, Bircher AJ, Hilger C. Pigeon tick bite: A neglected cause of idiopathic nocturnal anaphylaxis. Allergy 2018; 73:958-961. [PMID: 29083476 DOI: 10.1111/all.13344] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/25/2017] [Indexed: 11/28/2022]
Abstract
Anaphylaxis is a serious systemic allergic reaction with rapid onset and potentially life-threatening. We report in detail a case of severe nocturnal anaphylaxis due to pigeon tick bite showing the diagnostic value of the extract and the recombinant allergen in the diagnostic procedures (basophil activation test, IgE immunoblot, and experimental ImmunoCAP). Apart from the presented case, we describe that during the last 10 years, we have collected 28 cases of allergy to Argas reflexus from several European countries. We suspect that this allergy is underdiagnosed because of the lack of diagnostic reagents. Because of the growing number of pigeons in Middle and Southern Europe cities, some cases of idiopathic anaphylaxis could potentially be caused by A. reflexus in those countries. The identification of pigeon ticks as a trigger of anaphylaxis would greatly improve medical care and advice for these patients as the parasite can be exterminated by eradication measures to avoid further incidents.
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Affiliation(s)
- G. Rolla
- Allergy and Clinical Immunology; Department Medical Sciences; University of Torino; Torino Italy
| | - E. Heffler
- Department of Biomedical Sciences; Humanitas University; Milan Italy
| | - M. Boita
- Allergy and Clinical Immunology; Department Medical Sciences; University of Torino; Torino Italy
| | - V. Doyen
- Clinic of Immuno-Allergology; CHU Brugmann; Université Libre de Bruxelles (ULB); Brussels Belgium
| | - M. Mairesse
- Clinic of Immuno-Allergology; CHU Brugmann; Université Libre de Bruxelles (ULB); Brussels Belgium
| | - M. Cvackova
- Department of Allergy and Clinical Immunology; Faculty Hospital Kralovske Vinohrady; Prague Czech Republic
| | - S. Debarbieux
- Service de Dermatologie; Centre Hospitalier Lyon Sud; Pierre Bénite France
| | | | - M. Ollert
- Department of Dermatology and Allergy Center; Odense Research Center for Anaphylaxis; University of Southern Denmark; Odense Denmark
- Department of Infection and Immunity; Luxembourg Institute of Health; Esch-sur-Alzette Luxembourg
| | - M. Raulf
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance (IPA); Institute of the Ruhr-Universität Bochum; Bochum Germany
| | - A. J. Bircher
- Allergology; Department of Dermatology; University Hospital Basel; Basel Switzerland
| | - C. Hilger
- Department of Infection and Immunity; Luxembourg Institute of Health; Esch-sur-Alzette Luxembourg
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183
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Korošec P, Gibbs BF, Rijavec M, Custovic A, Turner PJ. Important and specific role for basophils in acute allergic reactions. Clin Exp Allergy 2018; 48:502-512. [PMID: 29431885 PMCID: PMC5947573 DOI: 10.1111/cea.13117] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
IgE‐mediated allergic reactions involve the activation of effector cells, predominantly through the high‐affinity IgE receptor (FcεRI) on mast cells and basophils. Although the mast cell is considered the major effector cell during acute allergic reactions, more recent studies indicate a potentially important and specific role for basophils and their migration which occurs rapidly upon allergen challenge in humans undergoing anaphylaxis. We review the evidence for a role of basophils in contributing to clinical symptoms of anaphylaxis and discuss the possibility that basophil trafficking during anaphylaxis might be a pathogenic (to target organs) or protective (preventing degranulation in circulation) response. Finally, we examine the potential role of basophils in asthma exacerbations. Understanding the factors that regulate basophil trafficking and activation might lead to new diagnostic and therapeutic strategies in anaphylaxis and asthma.
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Affiliation(s)
- P Korošec
- University Clinic of Respiratory and Allergic Diseases Golnik, Golnik, Slovenia
| | - B F Gibbs
- Department of Dermatology and Allergology, Carl von Ossietzky University of Oldenburg, Oldenburg, Germany
| | - M Rijavec
- University Clinic of Respiratory and Allergic Diseases Golnik, Golnik, Slovenia
| | - A Custovic
- Section of Paediatrics and MRC and Asthma UK Centre in Allergic Mechanisms of Asthma, Imperial College London, London, UK
| | - P J Turner
- Section of Paediatrics and MRC and Asthma UK Centre in Allergic Mechanisms of Asthma, Imperial College London, London, UK
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184
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Thinnes A, Merk HF, Wurpts G, Röseler S, Lehmann S, Tenbrock K, Baron JM, Balakirski G. Individual risk assessment in the diagnosis of immediate type drug hypersensitivity reactions to betalactam and non-betalactam antibiotics using basophil activation test: a single center experience. Cutan Ocul Toxicol 2018; 37:309-318. [PMID: 29508626 DOI: 10.1080/15569527.2018.1448990] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
BACKGROUND Drug hypersensitivity reactions of immediate type pose a challenging problem, especially, if standard diagnostic procedures do not lead to conclusive results. The aim of this investigation is to identify, whether basophil activation test (BAT) is able to provide additional benefit in the diagnostic evaluation of immediate type drug hypersensitivity reactions to antibiotics in comparison with the routine allergological diagnostic methods. MATERIALS AND METHODS We investigated patients, who presented to the Department of Dermatology and Allergology of the University Hospital of RWTH Aachen in Germany for diagnostic workup of type I allergic reactions to antibiotics during the period from 2009 to 2012. The analysis was performed retrospectively based on patient records. The inclusion criteria were performed standard allergological in vivo diagnostic and a BAT as a part of diagnostic workup. RESULTS Eighty-two diagnostic investigations were performed in 52 patients. BAT was positive in 9 of 12 cases with a positive clinical history but negative skin test results. Furthermore, all patients who reported severe drug hypersensitivity reactions (anaphylactic reaction grade 2 and above) showed positive BAT (5/5), while only three of these five cases demonstrated a positive skin testing that led to the conclusion of possible immediate type drug hypersensitivity. CONCLUSIONS Although skin tests remain the most important part of the primary diagnostic investigation, BAT is an additional valuable and sensitive in vitro test in the diagnostic procedure of immediate type allergic reactions to antibiotics. However, further standardized investigations are needed in order to calculate exact sensitivity and specificity of this diagnostic tool in both, adult and pediatric populations.
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Affiliation(s)
- Antonia Thinnes
- a Department of Ophthalmology , University Hospital of RWTH Aachen , Aachen , Germany
| | - Hans F Merk
- b Department of Dermatology and Allergology , University Hospital of RWTH Aachen , Aachen , Germany
| | - Gerda Wurpts
- b Department of Dermatology and Allergology , University Hospital of RWTH Aachen , Aachen , Germany
| | - Stefani Röseler
- b Department of Dermatology and Allergology , University Hospital of RWTH Aachen , Aachen , Germany
| | - Sylvia Lehmann
- c Department of Pediatrics and Adolescent Medicine , University Hospital of RWTH Aachen , Aachen , Germany
| | - Klaus Tenbrock
- c Department of Pediatrics and Adolescent Medicine , University Hospital of RWTH Aachen , Aachen , Germany
| | - Jens Malte Baron
- b Department of Dermatology and Allergology , University Hospital of RWTH Aachen , Aachen , Germany
| | - Galina Balakirski
- b Department of Dermatology and Allergology , University Hospital of RWTH Aachen , Aachen , Germany
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185
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Bahri R, Custovic A, Korosec P, Tsoumani M, Barron M, Wu J, Sayers R, Weimann A, Ruiz-Garcia M, Patel N, Robb A, Shamji MH, Fontanella S, Silar M, Mills ENC, Simpson A, Turner PJ, Bulfone-Paus S. Mast cell activation test in the diagnosis of allergic disease and anaphylaxis. J Allergy Clin Immunol 2018. [PMID: 29518421 PMCID: PMC6075471 DOI: 10.1016/j.jaci.2018.01.043] [Citation(s) in RCA: 109] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Background Food allergy is an increasing public health issue and the most common cause of life-threatening anaphylactic reactions. Conventional allergy tests assess for the presence of allergen-specific IgE, significantly overestimating the rate of true clinical allergy and resulting in overdiagnosis and adverse effect on health-related quality of life. Objective To undertake initial validation and assessment of a novel diagnostic tool, we used the mast cell activation test (MAT). Methods Primary human blood-derived mast cells (MCs) were generated from peripheral blood precursors, sensitized with patients' sera, and then incubated with allergen. MC degranulation was assessed by means of flow cytometry and mediator release. We compared the diagnostic performance of MATs with that of existing diagnostic tools to assess in a cohort of peanut-sensitized subjects undergoing double-blind, placebo-controlled challenge. Results Human blood-derived MCs sensitized with sera from patients with peanut, grass pollen, and Hymenoptera (wasp venom) allergy demonstrated allergen-specific and dose-dependent degranulation, as determined based on both expression of surface activation markers (CD63 and CD107a) and functional assays (prostaglandin D2 and β-hexosaminidase release). In this cohort of peanut-sensitized subjects, the MAT was found to have superior discrimination performance compared with other testing modalities, including component-resolved diagnostics and basophil activation tests. Using functional principle component analysis, we identified 5 clusters or patterns of reactivity in the resulting dose-response curves, which at preliminary analysis corresponded to the reaction phenotypes seen at challenge. Conclusion The MAT is a robust tool that can confer superior diagnostic performance compared with existing allergy diagnostics and might be useful to explore differences in effector cell function between basophils and MCs during allergic reactions.
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Affiliation(s)
- Rajia Bahri
- Division of Musculoskeletal and Dermatological Sciences & Manchester Collaborative Centre for Inflammation Research (MCCIR), School of Biological Sciences, University of Manchester, Manchester, United Kingdom
| | - Adnan Custovic
- Section of Paediatrics, Department of Medicine, Imperial College London, London, United Kingdom
| | - Peter Korosec
- Laboratory for Clinical Immunology & Molecular Genetics, University Hospital for Respiratory and Allergic Diseases, Golnik, Slovenia
| | - Marina Tsoumani
- Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, University of Manchester, and NIHR Manchester Biomedical Research Centre, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom
| | - Martin Barron
- Division of Musculoskeletal and Dermatological Sciences & Manchester Collaborative Centre for Inflammation Research (MCCIR), School of Biological Sciences, University of Manchester, Manchester, United Kingdom
| | - Jiakai Wu
- Division of Musculoskeletal and Dermatological Sciences & Manchester Collaborative Centre for Inflammation Research (MCCIR), School of Biological Sciences, University of Manchester, Manchester, United Kingdom
| | - Rebekah Sayers
- Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, University of Manchester, and NIHR Manchester Biomedical Research Centre, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom
| | | | - Monica Ruiz-Garcia
- Section of Paediatrics, Department of Medicine, Imperial College London, London, United Kingdom
| | - Nandinee Patel
- Section of Paediatrics, Department of Medicine, Imperial College London, London, United Kingdom
| | - Abigail Robb
- Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, University of Manchester, and NIHR Manchester Biomedical Research Centre, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom
| | - Mohamed H Shamji
- Section of Allergy and Clinical Immunology, National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Sara Fontanella
- Section of Paediatrics, Department of Medicine, Imperial College London, London, United Kingdom
| | - Mira Silar
- Laboratory for Clinical Immunology & Molecular Genetics, University Hospital for Respiratory and Allergic Diseases, Golnik, Slovenia
| | - E N Clare Mills
- Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, University of Manchester, and NIHR Manchester Biomedical Research Centre, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom
| | - Angela Simpson
- Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, University of Manchester, and NIHR Manchester Biomedical Research Centre, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom
| | - Paul J Turner
- Section of Paediatrics, Department of Medicine, Imperial College London, London, United Kingdom.
| | - Silvia Bulfone-Paus
- Division of Musculoskeletal and Dermatological Sciences & Manchester Collaborative Centre for Inflammation Research (MCCIR), School of Biological Sciences, University of Manchester, Manchester, United Kingdom.
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186
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The usefulness of the basophil activation test in monitoring specific immunotherapy with house dust mite allergens. Postepy Dermatol Alergol 2018; 35:93-98. [PMID: 29599678 PMCID: PMC5872250 DOI: 10.5114/ada.2018.73169] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Accepted: 12/01/2016] [Indexed: 02/04/2023] Open
Abstract
Introduction In clinical practice, reliable tools for monitoring specific immunotherapy (SIT) are of utmost importance. Aim To assess the usefulness of the basophil activation test (BAT) in monitoring SIT in paediatric patients with allergy to house dust mites (HDM). Material and methods Thirty-one children qualified for SIT with HDM, of whom 21 completed the SIT during the observation period. The BAT was carried out prior to commencing the SIT (time point BAT1) and upon finishing the initial pack of allergy vaccine (cumulative dose of allergen 12487.5 PNU; BAT2), as well as after the second vaccine pack (cumulative dose of allergen 23750.0 PNU; BAT3). Peripheral blood of the patients was stimulated with allergen solutions in five concentrations from 0.00225 ng/ml to 22.5 ng/ml. Basophil activation was measured by CD63 expression in flow cytometry. Results For the allergen concentration of 0.225 ng/ml, a statistically significant decrease in median basophil activation was observed, from 51.29% at BAT1 to 8.48% at BAT2 (p = 0.004) and 4.21% at BAT3 (p < 0.001). For the allergen concentration of 0.0225 ng/ml, a statistically significant decrease was seen between BAT1 (1.72%) and BAT3 (0.21%, p = 0.01). Median CD-sens index decreased significantly from 1099.02 at BAT1 to 179.31 at BAT2 (p < 0.002) and 168.04 at BAT3 (p < 0.001). Conclusions There is a significant decrease in BAT results in the course of specific immunotherapy with HDM allergens in children, with the optimum allergen concentration for monitoring basophil response at 0.225 ng/ml. The CD-sens index seems to be a better monitoring parameter than the plain percentage of CD63-expressing basophils.
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187
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An Updated Review of the Molecular Mechanisms in Drug Hypersensitivity. J Immunol Res 2018; 2018:6431694. [PMID: 29651444 PMCID: PMC5830968 DOI: 10.1155/2018/6431694] [Citation(s) in RCA: 96] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Accepted: 11/09/2017] [Indexed: 02/07/2023] Open
Abstract
Drug hypersensitivity may manifest ranging from milder skin reactions (e.g., maculopapular exanthema and urticaria) to severe systemic reactions, such as anaphylaxis, drug reactions with eosinophilia and systemic symptoms (DRESS)/drug-induced hypersensitivity syndrome (DIHS), or Stevens–Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN). Current pharmacogenomic studies have made important strides in the prevention of some drug hypersensitivity through the identification of relevant genetic variants, particularly for genes encoding drug-metabolizing enzymes and human leukocyte antigens (HLAs). The associations identified by these studies are usually drug, phenotype, and ethnic specific. The drug presentation models that explain how small drug antigens might interact with HLA and T cell receptor (TCR) molecules in drug hypersensitivity include the hapten theory, the p-i concept, the altered peptide repertoire model, and the altered TCR repertoire model. The broad spectrum of clinical manifestations of drug hypersensitivity involving different drugs, as well as the various pathomechanisms involved, makes the diagnosis and management of it more challenging. This review highlights recent advances in our understanding of the predisposing factors, immune mechanisms, pathogenesis, diagnostic tools, and therapeutic approaches for drug hypersensitivity.
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188
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Falcone FH, Wan D, Barwary N, Sagi-Eisenberg R. RBL cells as models for in vitro studies of mast cells and basophils. Immunol Rev 2018; 282:47-57. [DOI: 10.1111/imr.12628] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- Franco H. Falcone
- Division of Molecular Therapeutics and Formulation; School of Pharmacy; University of Nottingham; Nottingham UK
| | - Daniel Wan
- Division of Molecular Therapeutics and Formulation; School of Pharmacy; University of Nottingham; Nottingham UK
| | - Nafal Barwary
- Division of Molecular Therapeutics and Formulation; School of Pharmacy; University of Nottingham; Nottingham UK
| | - Ronit Sagi-Eisenberg
- Department of Cell and Developmental Biology; Sackler Faculty of Medicine; Tel Aviv University; Tel Aviv Israel
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189
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Cardona V, Demoly P, Dreborg S, Kalpaklioglu AF, Klimek L, Muraro A, Pfaar O, Popov TA, Hoffmann HJ. Current practice of allergy diagnosis and the potential impact of regulation in Europe. Allergy 2018; 73:323-327. [PMID: 28905404 DOI: 10.1111/all.13306] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2017] [Indexed: 01/16/2023]
Abstract
In the European Union (EU), the regulatory framework regarding diagnostic allergen extracts is currently in the process of being implemented at the national level. Due to these regulations, the initial and periodic renewal expenses for the registration of diagnostic allergen extracts may render extract production unprofitable. Consequently, many extracts may be at risk of removal from the market. The current survey, which was conducted by a task force of the European Academy of Allergy and Clinical Immunology, aimed to assess the current practice of allergy diagnosis in Europe. This survey revealed that skin tests continue to be the main diagnostic procedure and are used as the first option in almost two-third of all types of allergic diseases and in 90% of individuals suffering from respiratory allergies. Therefore, there is a need to ensure the availability of high-quality allergen extracts to maintain the common diagnostic procedures used by EU professionals. To reach this goal, it is necessary to align efforts and establish active partnerships between manufacturers, relevant scientific societies, consumer organizations and authorities to maintain the availability of these diagnostic tools.
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Affiliation(s)
- V. Cardona
- Allergy Section; Department of Internal Medicine; Hospital Universitari Vall d'Hebron; Barcelona Spain
| | - P. Demoly
- UPMC Paris 06, UMR-S 1136, IPLESP, Equipe EPAR; Département de Pneumologie et Addictologie; Hôpital Arnaud de Villeneuve; CHRU de Montpellier and Sorbonnes Universités; Paris France
| | - S. Dreborg
- Section on Child and Adolescent Allergology; Women's and Children's Health; Academic Hospital; University of Uppsala; Uppsala Sweden
| | - A. F. Kalpaklioglu
- Department of Immunology and Allergic Diseases; Kirikkale University Hospital; Kirikkale Turkey
| | - L. Klimek
- Centre for Rhinology and Allergology; Wiesbaden Germany
| | - A. Muraro
- Food Allergy Referral Centre Veneto Region; Department of Women and Child Health; Padua General University Hospital; Padua Italy
| | - O. Pfaar
- Centre for Rhinology and Allergology; Wiesbaden Germany
- Department of Otorhinolaryngology; Head and Neck Surgery; Universitätsmedizin Mannheim; Medical Faculty Mannheim; Heidelberg University; Mannheim Germany
| | - T. A. Popov
- Clinic of Allergy and Asthma; Medical University; Sofia Bulgaria
| | - H. J. Hoffmann
- Department of Respiratory Diseases and Allergy; Department of Clinical Medicine; Aarhus University; Aarhus C Denmark
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190
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Wise SK, Lin SY, Toskala E, Orlandi RR, Akdis CA, Alt JA, Azar A, Baroody FM, Bachert C, Canonica GW, Chacko T, Cingi C, Ciprandi G, Corey J, Cox LS, Creticos PS, Custovic A, Damask C, DeConde A, DelGaudio JM, Ebert CS, Eloy JA, Flanagan CE, Fokkens WJ, Franzese C, Gosepath J, Halderman A, Hamilton RG, Hoffman HJ, Hohlfeld JM, Houser SM, Hwang PH, Incorvaia C, Jarvis D, Khalid AN, Kilpeläinen M, Kingdom TT, Krouse H, Larenas-Linnemann D, Laury AM, Lee SE, Levy JM, Luong AU, Marple BF, McCoul ED, McMains KC, Melén E, Mims JW, Moscato G, Mullol J, Nelson HS, Patadia M, Pawankar R, Pfaar O, Platt MP, Reisacher W, Rondón C, Rudmik L, Ryan M, Sastre J, Schlosser RJ, Settipane RA, Sharma HP, Sheikh A, Smith TL, Tantilipikorn P, Tversky JR, Veling MC, Wang DY, Westman M, Wickman M, Zacharek M. International Consensus Statement on Allergy and Rhinology: Allergic Rhinitis. Int Forum Allergy Rhinol 2018; 8:108-352. [PMID: 29438602 PMCID: PMC7286723 DOI: 10.1002/alr.22073] [Citation(s) in RCA: 217] [Impact Index Per Article: 36.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Revised: 12/01/2017] [Accepted: 12/01/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND Critical examination of the quality and validity of available allergic rhinitis (AR) literature is necessary to improve understanding and to appropriately translate this knowledge to clinical care of the AR patient. To evaluate the existing AR literature, international multidisciplinary experts with an interest in AR have produced the International Consensus statement on Allergy and Rhinology: Allergic Rhinitis (ICAR:AR). METHODS Using previously described methodology, specific topics were developed relating to AR. Each topic was assigned a literature review, evidence-based review (EBR), or evidence-based review with recommendations (EBRR) format as dictated by available evidence and purpose within the ICAR:AR document. Following iterative reviews of each topic, the ICAR:AR document was synthesized and reviewed by all authors for consensus. RESULTS The ICAR:AR document addresses over 100 individual topics related to AR, including diagnosis, pathophysiology, epidemiology, disease burden, risk factors for the development of AR, allergy testing modalities, treatment, and other conditions/comorbidities associated with AR. CONCLUSION This critical review of the AR literature has identified several strengths; providers can be confident that treatment decisions are supported by rigorous studies. However, there are also substantial gaps in the AR literature. These knowledge gaps should be viewed as opportunities for improvement, as often the things that we teach and the medicine that we practice are not based on the best quality evidence. This document aims to highlight the strengths and weaknesses of the AR literature to identify areas for future AR research and improved understanding.
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Affiliation(s)
| | | | | | | | - Cezmi A. Akdis
- Allergy/Asthma, Swiss Institute of Allergy and Asthma Research, Switzerland
| | | | - Antoine Azar
- Allergy/Immunology, Johns Hopkins University, USA
| | | | | | | | | | - Cemal Cingi
- Otolaryngology, Eskisehir Osmangazi University, Turkey
| | | | | | | | | | | | | | - Adam DeConde
- Otolaryngology, University of California San Diego, USA
| | | | | | | | | | | | | | - Jan Gosepath
- Otorhinolaryngology, Helios Kliniken Wiesbaden, Germany
| | | | | | | | - Jens M. Hohlfeld
- Respiratory Medicine, Hannover Medical School, Airway Research Fraunhofer Institute for Toxicology and Experimental Medicine, German Center for Lung Research, Germany
| | | | | | | | | | | | | | | | | | | | | | | | | | - Amber U. Luong
- Otolaryngology, McGovern Medical School at the University of Texas Health Science Center Houston, USA
| | | | | | | | - Erik Melén
- Pediatric Allergy, Karolinska Institutet, Sweden
| | | | | | - Joaquim Mullol
- Otolaryngology, Universitat de Barcelona, Hospital Clinic, IDIBAPS, Spain
| | | | | | | | - Oliver Pfaar
- Rhinology/Allergy, Medical Faculty Mannheim, Heidelberg University, Center for Rhinology and Allergology, Wiesbaden, Germany
| | | | | | - Carmen Rondón
- Allergy, Regional University Hospital of Málaga, Spain
| | - Luke Rudmik
- Otolaryngology, University of Calgary, Canada
| | - Matthew Ryan
- Otolaryngology, University of Texas Southwestern, USA
| | - Joaquin Sastre
- Allergology, Hospital Universitario Fundacion Jiminez Diaz, Spain
| | | | | | - Hemant P. Sharma
- Allergy/Immunology, Children's National Health System, George Washington University School of Medicine, USA
| | | | | | | | | | | | - De Yun Wang
- Otolaryngology, National University of Singapore, Singapore
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191
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Kim SH, Kim SH, Chung SJ, Kim JH, Lee SY, Kim BK, Lim KW, Chang YS. Changes in basophil activation during immunotherapy with house dust mite and mugwort in patients with allergic rhinitis. Asia Pac Allergy 2018; 8:e6. [PMID: 29423373 PMCID: PMC5796966 DOI: 10.5415/apallergy.2018.8.e6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 01/23/2018] [Indexed: 01/23/2023] Open
Abstract
Background The basophil activation test (BAT) is a promising tool for monitoring allergen-specific immunotherapy responses. Objective We aimed to investigate the changes in basophil activation in response to the inhalant allergens of house dust mite (HDM) and mugwort pollen during immunotherapy in patients with allergic rhinitis. Methods We enrolled patients with allergic rhinitis who were to receive subcutaneous immunotherapy for the inhalant allergens HDM or mugwort. A BAT was performed to assess CD63 upregulation in response to allergen stimulation using peripheral blood collected from the patients prior to immunotherapy and at 3, 6, 12, and 24 months after beginning immunotherapy. Rhinitis symptoms were evaluated using the rhinitis quality of life questionnaire (RQLQ) at 1-year intervals. Results Seventeen patients (10 with HDM sensitivity, 3 with mugwort sensitivity, and 4 with sensitivity to both HDM and mugwort) were enrolled in the study. Basophil reactivity to HDM did not change significantly during 24 months of immunotherapy. However, a significant reduction in basophil reactivity to mugwort was observed at 24-month follow-up. There was no significant association between the change in clinical symptoms by RQLQ and the change in basophil reactivity to either allergen. The change in allergen-specific basophil reactivity to HDM was well correlated with the change in nonspecific basophil activation induced by anti-FcεRI antibody, although basophil reactivity to anti-FcεRI antibody was not significantly reduced during immunotherapy. Conclusion Suppression of CD63 upregulation in the BAT was only observed with mugwort at 2-year follow-up. However, the basophil response did not reflect the clinical response to immunotherapy.
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Affiliation(s)
- Sae-Hoon Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul 03080, Korea.,Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul 03080, Korea.,Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam 13620, Korea
| | - Soon-Hee Kim
- Biomedical Research Institute, Seoul National University Bundang Hospital, Seongnam 13620, Korea
| | - Soo-Jie Chung
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul 03080, Korea.,Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul 03080, Korea
| | - Jung-Hyun Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul 03080, Korea.,Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul 03080, Korea.,Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam 13620, Korea
| | - Suh-Young Lee
- Department of Internal Medicine, Kangdong Sacred Heart Hospital, Seoul 05355, Korea
| | - Byung-Keun Kim
- Department of Internal Medicine, Korea University Medical Center Anam Hospital, Seoul 02841, Korea
| | - Kyung-Whan Lim
- Department of Internal Medicine, The Armed Forces Capital Hospital, Seongnam 13574, Korea
| | - Yoon-Seok Chang
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul 03080, Korea.,Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul 03080, Korea.,Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam 13620, Korea
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192
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Lind C, Skaarup SH, Lorentz A, Hoffmann HJ. Basophil testing with CD63 in pollen-sensitized patients is independent of the circadian clock. J Allergy Clin Immunol 2018; 141:1906-1908. [PMID: 29330012 DOI: 10.1016/j.jaci.2017.10.048] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Revised: 09/07/2017] [Accepted: 10/17/2017] [Indexed: 11/25/2022]
Affiliation(s)
- Cecilie Lind
- Department of Respiratory Diseases and Allergy, Aarhus University Hospital, Aarhus, Denmark
| | - Søren Helbo Skaarup
- Department of Respiratory Diseases and Allergy, Aarhus University Hospital, Aarhus, Denmark
| | - Axel Lorentz
- Department of Nutritional Medicine, University of Hohenheim, Stuttgart, Germany
| | - Hans Jürgen Hoffmann
- Department of Respiratory Diseases and Allergy, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Aarhus University, Aarhus University Hospital, Aarhus, Denmark.
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193
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Abstract
Food allergies manifest in a variety of clinical conditions within the gastrointestinal tract, skin and lungs, with the most dramatic and sometimes fatal manifestation being anaphylactic shock. Major progress has been made in basic, translational and clinical research, leading to a better understanding of the underlying immunological mechanisms that lead to the breakdown of clinical and immunological tolerance against food antigens, which can result in either immunoglobulin E (IgE)-mediated reactions or non-IgE-mediated reactions. Lifestyle factors, dietary habits and maternal-neonatal interactions play a pivotal part in triggering the onset of food allergies, including qualitative and quantitative composition of the microbiota. These factors seem to have the greatest influence early in life, an observation that has led to the generation of hypotheses to explain the food allergy epidemic, including the dual-allergen exposure hypothesis. These hypotheses have fuelled research in preventive strategies that seek to establish desensitization to allergens and/or tolerance to allergens in affected individuals. Allergen-nonspecific therapeutic strategies have also been investigated in a number of clinical trials, which will eventually improve the treatment options for patients with food allergy.
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194
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Possible Utility of the Basophil Activation Test for the Analysis of Mechanisms Involved in Allergic Transfusion Reactions. Transfus Med Rev 2018; 32:43-51. [DOI: 10.1016/j.tmrv.2017.09.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 08/18/2017] [Accepted: 09/07/2017] [Indexed: 12/13/2022]
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195
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Affiliation(s)
- Jung-Won Park
- Department of Internal Medicine and Allergy Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Kyoung Yong Jeong
- Department of Internal Medicine and Allergy Institute, Yonsei University College of Medicine, Seoul, Korea
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196
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Larsen LF, Juel‐Berg N, Hansen KS, Clare Mills EN, Ree R, Poulsen LK, Jensen BM. A comparative study on basophil activation test, histamine release assay, and passive sensitization histamine release assay in the diagnosis of peanut allergy. Allergy 2018; 73:137-144. [PMID: 28686296 DOI: 10.1111/all.13243] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/04/2017] [Indexed: 01/04/2023]
Abstract
BACKGROUND Allergy can be diagnosed using basophil tests. Several methods measuring basophil activation are available. This study aimed at comparing basophil activation test (BAT), histamine release assay (HR), and passive sensitization histamine release assay (passive HR) in the diagnosis of peanut allergy. METHODS BAT, HR, and passive HR were performed on 11 peanut-allergic and 14 nonallergic subjects. Blood was incubated with peanut extract or anti-IgE and tests were performed as follows: BAT-CD63 upregulation was assessed by flow cytometry; HR-released histamine was quantified by a glass fiber-based fluorometric method; passive HR-IgE-stripped donor basophils were incubated with participants' serum and histamine release was quantified as HR. RESULTS CDsens, a measure of basophil allergen sensitivity, was significantly higher for BAT (80.1±17.4) compared to HR (23.4±10.31) and passive HR (11.1±2.0). BAT, HR, and passive HR had a clinical sensitivity of 100%, 100%, and 82% and specificity of 100%, 100%, and 100%, respectively, when excluding inconclusive results. BAT identified 11 of 11 allergic patients, HR 10, and passive HR 9. Likewise, BAT recognized 12 of 14 nonallergic subjects, HR 10, and passive HR 13. However, the tests' diagnostic performances were not statistically different. Interestingly, nonreleasers in HR but not in BAT had lower basophil count compared to releasers (249 vs 630 counts/min). CONCLUSION BAT displayed a significantly higher CDsens compared to HR and passive HR. The basophil tests' diagnostic performances were not significantly different. Still, BAT could diagnose subjects with low basophil number in contrast to HR.
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Affiliation(s)
- L. F. Larsen
- Allergy Clinic Copenhagen University Hospital Gentofte Copenhagen Denmark
| | - N. Juel‐Berg
- Allergy Clinic Copenhagen University Hospital Gentofte Copenhagen Denmark
| | - K. S. Hansen
- Allergy Clinic Copenhagen University Hospital Gentofte Copenhagen Denmark
| | - E. N. Clare Mills
- Division of Infection, Immunity and Respiratory School of Biological Sciences Manchester Institute of Biotechnology Manchester Academic Health Sciences Centre The University of Manchester Manchester UK
| | - R. Ree
- Departments of Experimental Immunology and of Otorhinolaryngology Academic Medical Center University of Amsterdam Amsterdam The Netherlands
| | - L. K. Poulsen
- Allergy Clinic Copenhagen University Hospital Gentofte Copenhagen Denmark
| | - B. M. Jensen
- Allergy Clinic Copenhagen University Hospital Gentofte Copenhagen Denmark
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197
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de la Varga Martínez R, Gutiérrez Fernández D, Áñez GA, Foncubierta Fernández A, Andrés García JA, Medina Varo F. Use of the basophil activation test in monitoring clinical tolerance after desensitization to brentuximab vedotin. Ann Allergy Asthma Immunol 2017; 118:745-747. [PMID: 28583265 DOI: 10.1016/j.anai.2017.04.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Revised: 04/16/2017] [Accepted: 04/18/2017] [Indexed: 11/26/2022]
Affiliation(s)
- Raquel de la Varga Martínez
- Unidad de Investigación, Área de investigación clínica en Inmunología y Reumatología, Hospital Universitario Puerta del Mar, Cádiz, Spain.
| | | | - Gustavo A Áñez
- UGC de Cirugía Ortopédica, Traumatología y Reumatología, Hospital Universitario Puerta del Mar, Cádiz, Spain
| | | | - José A Andrés García
- UGC de Cirugía Ortopédica, Traumatología y Reumatología, Hospital Universitario Puerta del Mar, Cádiz, Spain
| | - Fermín Medina Varo
- UGC de Cirugía Ortopédica, Traumatología y Reumatología, Hospital Universitario Puerta del Mar, Cádiz, Spain
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198
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Lasa EM, González C, García-Lirio E, Martínez S, Arroabarren E, Gamboa PM. Anaphylaxis caused by immediate hypersensitivity to topical chlorhexidine in children. Ann Allergy Asthma Immunol 2017; 118:118-119. [PMID: 28007083 DOI: 10.1016/j.anai.2016.10.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2016] [Revised: 09/28/2016] [Accepted: 10/13/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Eva María Lasa
- Servicio de Alergología, Hospital Universitario Donostia, San Sebastián, España.
| | - Carlos González
- Servicio de Alergología, Hospital Universitario de Basurto, Bilbao, España
| | | | - Sara Martínez
- Servicio de Alergología, Hospital Universitario Donostia, San Sebastián, España
| | - Esozia Arroabarren
- Servicio de Alergología, Complejo Hospitalario de Navarra, Pamplona, España
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199
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Usefulness of basophil activation test for the diagnosis of IgE mediated hypersensitivity to tetanus toxoid vaccine. J Immunol Methods 2017; 454:86-88. [PMID: 29162425 DOI: 10.1016/j.jim.2017.11.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Revised: 10/02/2017] [Accepted: 11/17/2017] [Indexed: 01/14/2023]
Abstract
A great number of vaccinated patients develop specific anti-tetanus toxoid IgE, but usually do not undergo any adverse effect. Most of the allergic reactions to tetanus toxoid vaccine usually present with unspecific symptoms of local inflammation. In the presence of severe reactions, and in a special way if the vaccine is provided together with other drugs, it is difficult to establish which is the harmful drug responsible for IgE-mediated adverse reaction. A patient with an anaphylactic reaction after the administration of Toxoid Tetanic (TT) along with several drugs is described. All skin test were negative. The basophils activation test (BAT) in a clear way, identified TT as the allergen that triggered anaphylaxis. The results achieved demonstrates the usefulness of BAT to clarify patients with hypersensibility to tetanus toxoide when the clinic is severe and the vaccine has been administered together with other drugs.
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200
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Abstract
Food allergy diagnosis remains challenging. Most standard methods are unable to differentiate sensitization from clinical allergy. Recognizing food allergy is of utmost importance to prevent life-threatening reactions. On the other hand, faulty interpretation of tests leads to overdiagnosis and unnecessary food avoidances. Highly predictive models have been established for major food allergens based on skin prick testing and food-specific immunoglobulin E but are lacking for most other foods. Although many newer diagnostic techniques are improving the accuracy of food allergy diagnostics, an oral food challenge remains the only definitive method of confirming a food allergy.
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Affiliation(s)
- Malika Gupta
- Division of Allergy & Immunology, Department of Internal Medicine, University of Michigan, 24 Frank Lloyd Wright Drive, Suite H-2100, Ann Arbor, MI 48106, USA
| | - Amanda Cox
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, Jaffe Food Allergy Institute, One Gustave Levy Place, Box 1198, New York, NY 10029, USA
| | - Anna Nowak-Węgrzyn
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, Jaffe Food Allergy Institute, One Gustave Levy Place, Box 1198, New York, NY 10029, USA
| | - Julie Wang
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, Jaffe Food Allergy Institute, One Gustave Levy Place, Box 1198, New York, NY 10029, USA.
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