1
|
Schistosomicidal efficacy of bee venom-loaded pluronic F127 nanomicelles in S. mansoni infected CD1 mice. J Drug Deliv Sci Technol 2022. [DOI: 10.1016/j.jddst.2022.103344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
|
2
|
Rattanamanee T, Lumjiaktase P, Kemawichanura N, Kiewnga P, Jotikasthira W, Manuyakorn W. Immunologic changes after house dust mite modified rush subcutaneous immunotherapy in allergic rhinitis children. Asia Pac Allergy 2022; 12:e4. [PMID: 35174055 PMCID: PMC8819415 DOI: 10.5415/apallergy.2022.12.e4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Accepted: 01/13/2022] [Indexed: 11/19/2022] Open
Abstract
Background House dust mites (HDM) are the major causative allergen for allergic rhinitis. The sole disease-modifying therapy for allergic rhinitis is allergen immunotherapy (AIT). Rush immunotherapy is the accelerated build-up schedules to reach the target maintenance dose. Objective To evaluate the kinetic changes of peripheral blood CD4+CD25+FOXP3+ regulatory T cells (Treg) and serum cytokines in children undergoing 2-day modified rush HDM AIT. Methods Children aged 5–15 years with allergic rhinitis were enrolled for a 2-day modified rush HDM AIT. Peripheral blood CD4+CD25+FOXP3+ Treg, serum interleukin (IL)-4, IL-13, interferon-γ, and IL-10 were measured at baseline, finishing rush, achieving maintenance dose, 6 months, and 12 months after reaching maintenance dose. Specific IgE (sIgE) to HDM was evaluated at baseline and 12 months after getting the maintenance dose. Rhinitis symptoms were assessed daily using a daily card. Results A total of 12 children with a mean age of 13 years were enrolled. Rhinitis symptom-free days per month increased significantly after reaching the maintenance dose compared to baseline (from 9.5 days to 19.5 days, p = 0.002), and the maximum improvement was seen at 1 year. The levels of Treg were significantly increased at 6 months after maintenance dose compared to baseline level (6.27%±1.63% vs. 3.83%±1.80%, p < 0.001). After treatment, there were significantly decreased serum IL-13 at 1 year after maintenance but no significant changes in sIgE to HDM. The systemic reaction during AIT occurred 7 episodes from 119 shots (5.9%). Conclusion Two-day modified rush HDM AIT provides acceptable systemic reactions and increases the number of CD4+CD25+FOXP3+ Treg in children.
Collapse
Affiliation(s)
- Tipyapa Rattanamanee
- Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Putthapoom Lumjiaktase
- Department of Pathology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Nanthisa Kemawichanura
- Department of Pathology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Potjanee Kiewnga
- Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Wanlapa Jotikasthira
- Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Wiparat Manuyakorn
- Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| |
Collapse
|
3
|
Ishida W, Kishimoto T, Takaiwa F, Fukuda K. Prophylactic and Therapeutic Effects of Oral Immunotherapy on Birch Pollen-Induced Allergic Conjunctivitis in Mice with a Rice-Based Edible Vaccine Expressing a Hypoallergenic Birch Pollen Allergen. Cells 2021; 10:cells10123361. [PMID: 34943868 PMCID: PMC8699710 DOI: 10.3390/cells10123361] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 11/26/2021] [Accepted: 11/28/2021] [Indexed: 11/16/2022] Open
Abstract
We investigated the prophylactic and therapeutic effects of the oral administration of transgenic rice seeds expressing a hypoallergenic Bet v 1 derivative of allergic birch pollen conjunctivitis in mice. Transgenic rice seed depositing a chimeric molecule called TPC7 (tree pollen chimera 7) created by DNA shuffling of Bet v 1 family sequences from birch, alder and hazel in protein bodies of endosperm was generated. BALB/c mice were sensitized to birch pollen in alum and challenged with pollen in eyedrops. They were fed TPC7 transgenic or non-transgenic (control) rice seeds for 14 d before sensitization (prophylactic protocol) or 17 d after sensitization (therapeutic protocol). The clinical score and number of conjunctival eosinophils were significantly lower in TPC7-fed mice than in the control mice based on both the prophylactic and therapeutic protocols. Serum concentration of allergen-specific IgE did not differ between TPC7-fed and control groups in either protocol. Prophylactic administration of TPC7 downregulated the production of IL-4 and IFN-γ, whereas therapeutic administration of TPC7 upregulated the production of IFN-γ by allergen-stimulated splenocytes. Prophylactic or therapeutic oral administration of transgenic rice expressing TPC7 suppressed birch pollen-induced allergic conjunctivitis in mice. Feeding transgenic rice is a potentially effective approach as an allergen-specific immunotherapy for allergic conjunctivitis.
Collapse
Affiliation(s)
- Waka Ishida
- Department of Ophthalmology and Visual Science, Kochi Medical School, Kochi University, Kochi 783-8505, Japan; (W.I.); (T.K.)
| | - Tatsuma Kishimoto
- Department of Ophthalmology and Visual Science, Kochi Medical School, Kochi University, Kochi 783-8505, Japan; (W.I.); (T.K.)
| | - Fumio Takaiwa
- Institute of Agrobiological Sciences, National Agriculture and Food Research Organization, Ibaraki 305-8602, Japan;
| | - Ken Fukuda
- Department of Ophthalmology and Visual Science, Kochi Medical School, Kochi University, Kochi 783-8505, Japan; (W.I.); (T.K.)
- Correspondence: ; Tel.: +81-88880-2391
| |
Collapse
|
4
|
Ramchandani R, Hossenbaccus L, Ellis AK. Immunoregulatory T cell epitope peptides for the treatment of allergic disease. Immunotherapy 2021; 13:1283-1291. [PMID: 34558985 DOI: 10.2217/imt-2021-0133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Allergic diseases are type 2 inflammatory reactions with an increasing worldwide prevalence, making the search for new therapeutic options pertinent. Allergen immunotherapy is the only disease-modifying approach for allergic rhinitis, though it can result in systemic reactions. Recently, peptide immunotherapy (PIT), involving T-cell epitope peptides that bind to major histocompatibility complexes, have been developed. It is speculated that they can induce T helper cell type 2 anergy, Treg cell upregulation or immune deviation. Promising results in cat dander, honeybee venom, Japanese cedar pollen, grass pollens, ragweed and house dust mite clinical trials have shown safety, efficacy and tolerability to PIT. Hence, PIT may hold the potential to change the treatment algorithm for allergic rhinitis.
Collapse
Affiliation(s)
- Rashi Ramchandani
- Department of Medicine, Queen's University, Kingston, ON, K7L 3N6, Canada.,Allergy Research Unit, Kingston Health Sciences Center - KGH Site, Kingston, on, K7L 2V7, Canada
| | - Lubnaa Hossenbaccus
- Department of Biomedical & Molecular Sciences, Queen's University, Kingston, ON, K7L 3N6, Canada.,Allergy Research Unit, Kingston Health Sciences Center - KGH Site, Kingston, on, K7L 2V7, Canada
| | - Anne K Ellis
- Department of Medicine, Queen's University, Kingston, ON, K7L 3N6, Canada.,Department of Biomedical & Molecular Sciences, Queen's University, Kingston, ON, K7L 3N6, Canada.,Allergy Research Unit, Kingston Health Sciences Center - KGH Site, Kingston, on, K7L 2V7, Canada
| |
Collapse
|
5
|
Garcovich S, Maurelli M, Gisondi P, Peris K, Yosipovitch G, Girolomoni G. Pruritus as a Distinctive Feature of Type 2 Inflammation. Vaccines (Basel) 2021; 9:vaccines9030303. [PMID: 33807098 PMCID: PMC8005108 DOI: 10.3390/vaccines9030303] [Citation(s) in RCA: 65] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 03/17/2021] [Accepted: 03/19/2021] [Indexed: 12/13/2022] Open
Abstract
Pruritus is a common symptom of several skin diseases, both inflammatory and neoplastic. Pruritus might have a tremendous impact on patients’ quality of life and strongly interfere with sleep, social, and work activities. We review the role of type-2 inflammation and immunity in the pathogenesis of chronic pruritic conditions of the skin. Type 2 cytokines, including IL-4, IL-13, thymic stromal lymphopoietin, periostin, IL-31, IL-25, and IL-33 are released by mast cells, innate lymphoid cells 2, keratinocytes, and type 2 T lymphocytes, and are master regulators of chronic itch. These cytokines might act as direct pruritogen on primary sensory neurons (pruriceptors) or alter the sensitivity to other itch mediators Type 2 inflammation- and immunity-dominated skin diseases, including atopic dermatitis, prurigo nodularis, bullous pemphigoid, scabies, parasitic diseases, urticaria, and Sézary syndrome are indeed conditions associated with most severe pruritus. In contrast, in other skin diseases, such as scleroderma, lupus erythematosus, hidradenitis suppurativa, and acne, type 2 inflammation is less represented, and pruritus is milder or variable. Th2 inflammation and immunity evolved to protect against parasites, and thus, the scratching response evoked by pruritus might have developed to alert about the presence and to remove parasites from the skin surface.
Collapse
Affiliation(s)
- Simone Garcovich
- Dermatology, Università Cattolica del Sacro Cuore, 00168 Rome, Italy;
- Dermatology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
- Correspondence:
| | - Martina Maurelli
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, 37126 Verona, Italy; (M.M.); (P.G.); (G.G.)
| | - Paolo Gisondi
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, 37126 Verona, Italy; (M.M.); (P.G.); (G.G.)
| | - Ketty Peris
- Dermatology, Università Cattolica del Sacro Cuore, 00168 Rome, Italy;
- Dermatology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Gil Yosipovitch
- Miami Itch Center, Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, Miller School of Medicine, University of Miami, Miami, FL 33136, USA;
| | - Giampiero Girolomoni
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, 37126 Verona, Italy; (M.M.); (P.G.); (G.G.)
| |
Collapse
|
6
|
Kasozi KI, Niedbała G, Alqarni M, Zirintunda G, Ssempijja F, Musinguzi SP, Usman IM, Matama K, Hetta HF, Mbiydzenyuy NE, Batiha GES, Beshbishy AM, Welburn SC. Bee Venom-A Potential Complementary Medicine Candidate for SARS-CoV-2 Infections. Front Public Health 2020; 8:594458. [PMID: 33363088 PMCID: PMC7758230 DOI: 10.3389/fpubh.2020.594458] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 10/19/2020] [Indexed: 12/15/2022] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is characterized by severe cytokine storm syndrome following inflammation. SARS-CoV-2 directly interacts with angiotensin-converting enzyme 2 (ACE-2) receptors in the human body. Complementary therapies that impact on expression of IgE and IgG antibodies, including administration of bee venom (BV), have efficacy in the management of arthritis, and Parkinson's disease. A recent epidemiological study in China showed that local beekeepers have a level of immunity against SARS-CoV-2 with and without previous exposure to virus. BV anti-inflammatory properties are associated with melittin and phospholipase A2 (PLA2), both of which show activity against enveloped and non-enveloped viruses, including H1N1 and HIV, with activity mediated through antagonist activity against interleukin-6 (IL-6), IL-8, interferon-γ (IFN-γ), and tumor necrosis factor-α (TNF-α). Melittin is associated with the underexpression of proinflammatory cytokines, including nuclear factor-kappa B (NF-κB), extracellular signal-regulated kinases (ERK1/2), and protein kinase Akt. BV therapy also involves group III secretory phospholipase A2 in the management of respiratory and neurological diseases. BV activation of the cellular and humoral immune systems should be explored for the application of complementary medicine for the management of SARS-CoV-2 infections. BV "vaccination" is used to immunize against cytomegalovirus and can suppress metastases through the PLA2 and phosphatidylinositol-(3,4)-bisphosphate pathways. That BV shows efficacy for HIV and H1NI offers opportunity as a candidate for complementary therapy for protection against SARS-CoV-2.
Collapse
Affiliation(s)
- Keneth Iceland Kasozi
- Infection Medicine, Deanery of Biomedical Sciences, College of Medicine and Veterinary Medicine, The University of Edinburgh, Edinburgh, United Kingdom.,School of Medicine, Kabale University, Kabale, Uganda
| | - Gniewko Niedbała
- Department of Biosystems Engineering, Faculty of Environmental Engineering and Mechanical Engineering, Poznan University of Life Sciences, Poznan, Poland
| | - Mohammed Alqarni
- Department of Pharmaceutical Chemistry, College of Pharmacy, Taif University, Taif, Saudi Arabia
| | - Gerald Zirintunda
- Faculty of Agriculture and Animal Sciences, Busitema University Arapai Campus, Soroti, Uganda
| | - Fred Ssempijja
- Faculty of Biomedical Sciences, Kampala International University Western Campus, Bushenyi, Uganda
| | | | - Ibe Michael Usman
- Faculty of Biomedical Sciences, Kampala International University Western Campus, Bushenyi, Uganda
| | - Kevin Matama
- Department of Clinical Pharmacy and Pharmacy Practice, School of Pharmacy, Kampala International University Western Campus, Bushenyi, Uganda
| | - Helal F Hetta
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Ngala Elvis Mbiydzenyuy
- Department of Basic Medical Sciences, Michael Chilufya Sata School of Medicine, Copperbelt University, Ndola, Zambia
| | - Gaber El-Saber Batiha
- Department of Pharmacology and Therapeutics, Faculty of Veterinary Medicine, Damanhour University, Damanhour, Egypt
| | - Amany Magdy Beshbishy
- National Research Center for Protozoan Diseases, Obihiro University of Agriculture and Veterinary Medicine, Obihiro, Japan
| | - Susan Christina Welburn
- Infection Medicine, Deanery of Biomedical Sciences, College of Medicine and Veterinary Medicine, The University of Edinburgh, Edinburgh, United Kingdom.,Zhejiang University-University of Edinburgh Institute, Zhejiang University School of Medicine, Zhejiang University, Haining, China
| |
Collapse
|
7
|
Zahirović A, Luzar J, Molek P, Kruljec N, Lunder M. Bee Venom Immunotherapy: Current Status and Future Directions. Clin Rev Allergy Immunol 2020; 58:326-341. [PMID: 31240545 DOI: 10.1007/s12016-019-08752-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Bee venom immunotherapy is the main treatment option for bee sting allergy. Its major limitations are the high percentage of allergic side effects and long duration, which are driving the development of novel therapeutic modalities. Three general approaches have been evaluated including the use of hypoallergenic allergen derivatives, adjunctive therapy, and alternative delivery routes. This article reviews preclinical and clinical evidence on the therapeutic potential of these new therapies. Among hypoallergenic derivatives, hybrid allergens showed a markedly reduced IgE reactivity in mouse models. Whether they will offer therapeutic benefit over extract, it is still not known since clinical trials have not been carried out yet. T cell epitope peptides have proven effective in small clinical trials. Major histocompatibility complex class II restriction was circumvented by using long overlapping or promiscuous T cell epitope peptides. However, the T cell-mediated late-phase adverse events have been reported with both short and longer peptides. Application of mimotopes could potentially overcome both T cell- and IgE-mediated adverse events. During this evolution of vaccine, there has been a gain in safety. The efficacy was further improved with the use of Toll-like receptor-activating adjuvants and delivery systems. In murine models, the association of allergen Api m 1 with cytosine-guanosine rich oligonucleotides stimulated strong T-helper type-1 response, whereas its encapsulation into microbubbles protected mice against allergen challenge. An intralymphatic administration of low-dose vaccine has shown the potential to decrease treatment from 5 years to only 12 weeks. Bigger clinical trials are needed to follow up on these results.
Collapse
Affiliation(s)
- Abida Zahirović
- Faculty of Pharmacy, Department of Pharmaceutical Biology, University of Ljubljana, Aškerčeva 7, SI-1000, Ljubljana, Slovenia.
| | - Jernej Luzar
- Faculty of Pharmacy, Department of Pharmaceutical Biology, University of Ljubljana, Aškerčeva 7, SI-1000, Ljubljana, Slovenia
| | - Peter Molek
- Faculty of Pharmacy, Department of Pharmaceutical Biology, University of Ljubljana, Aškerčeva 7, SI-1000, Ljubljana, Slovenia
| | - Nika Kruljec
- Faculty of Pharmacy, Department of Pharmaceutical Biology, University of Ljubljana, Aškerčeva 7, SI-1000, Ljubljana, Slovenia
| | - Mojca Lunder
- Faculty of Pharmacy, Department of Pharmaceutical Biology, University of Ljubljana, Aškerčeva 7, SI-1000, Ljubljana, Slovenia
| |
Collapse
|
8
|
Matsuda M, Terada T, Tsujimoto N, Morie Y, Ishida T, Takahashi H, Hamaguchi J, Tabuchi Y, Doi K, Noro K, Kikuoka Y, Omura S, Yoshida T, Ayani Y, Suzuki M, Ichihara T, Inaka Y, Inui T, Kawata R, Nabe T. Regulatory T and B cells in peripheral blood of subcutaneous immunotherapy-treated Japanese cedar pollinosis patients. Immunotherapy 2020; 11:473-482. [PMID: 30860439 DOI: 10.2217/imt-2018-0170] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
AIM The aim of this study was to clarify whether there are more regulatory T (Treg) and regulatory B (Breg) cells, and higher levels of IL-10-related transcription factors in subcutaneous immunotherapy (SCIT)-treated pollinosis patients than in non-SCIT-treated patients. METHODS Japanese cedar pollinosis patients undergoing SCIT had received treatment for at least 2.8 years. Peripheral blood mononuclear cells were used for flow cytometer analyses and mRNA measurement. RESULTS The numbers of type 1 regulatory T (Tr1)-like cells and Breg cells, and expression of E4BP4 mRNA by peripheral blood mononuclear cells in SCIT-treated patients were higher than those in non-SCIT-treated patients. CONCLUSION Tr1-like cells, Breg cells and E4BP4 may be involved in the effectiveness of SCIT.
Collapse
Affiliation(s)
- Masaya Matsuda
- Laboratory of Immunopharmacology, Faculty of Pharmaceutical Sciences, Setsunan University, Hirakata, Osaka, Japan
| | - Tetsuya Terada
- Department of Otolaryngology, Head & Neck Surgery, Osaka Medical College, Takatsuki, Osaka, Japan
| | - Nau Tsujimoto
- Laboratory of Immunopharmacology, Faculty of Pharmaceutical Sciences, Setsunan University, Hirakata, Osaka, Japan
| | - Yuki Morie
- Laboratory of Immunopharmacology, Faculty of Pharmaceutical Sciences, Setsunan University, Hirakata, Osaka, Japan
| | - Tomoki Ishida
- Laboratory of Immunopharmacology, Faculty of Pharmaceutical Sciences, Setsunan University, Hirakata, Osaka, Japan
| | - Hiromu Takahashi
- Laboratory of Immunopharmacology, Faculty of Pharmaceutical Sciences, Setsunan University, Hirakata, Osaka, Japan
| | - Junpei Hamaguchi
- Laboratory of Immunopharmacology, Faculty of Pharmaceutical Sciences, Setsunan University, Hirakata, Osaka, Japan
| | - Yuki Tabuchi
- Laboratory of Immunopharmacology, Faculty of Pharmaceutical Sciences, Setsunan University, Hirakata, Osaka, Japan
| | - Kana Doi
- Laboratory of Immunopharmacology, Faculty of Pharmaceutical Sciences, Setsunan University, Hirakata, Osaka, Japan
| | - Keiki Noro
- Department of Otolaryngology, Head & Neck Surgery, Osaka Medical College, Takatsuki, Osaka, Japan
| | - Yusuke Kikuoka
- Department of Otolaryngology, Head & Neck Surgery, Osaka Medical College, Takatsuki, Osaka, Japan
| | - Shuji Omura
- Department of Otolaryngology, Head & Neck Surgery, Osaka Medical College, Takatsuki, Osaka, Japan
| | - Takuya Yoshida
- Department of Otolaryngology, Head & Neck Surgery, Osaka Medical College, Takatsuki, Osaka, Japan
| | - Yusuke Ayani
- Department of Otolaryngology, Head & Neck Surgery, Osaka Medical College, Takatsuki, Osaka, Japan
| | - Manabu Suzuki
- Department of Otolaryngology, Head & Neck Surgery, Osaka Medical College, Takatsuki, Osaka, Japan
| | - Takahiro Ichihara
- Department of Otolaryngology, Head & Neck Surgery, Osaka Medical College, Takatsuki, Osaka, Japan
| | - Yuko Inaka
- Department of Otolaryngology, Head & Neck Surgery, Osaka Medical College, Takatsuki, Osaka, Japan
| | - Takaki Inui
- Department of Otolaryngology, Head & Neck Surgery, Osaka Medical College, Takatsuki, Osaka, Japan
| | - Ryo Kawata
- Department of Otolaryngology, Head & Neck Surgery, Osaka Medical College, Takatsuki, Osaka, Japan
| | - Takeshi Nabe
- Laboratory of Immunopharmacology, Faculty of Pharmaceutical Sciences, Setsunan University, Hirakata, Osaka, Japan
| |
Collapse
|
9
|
Jonsdottir S, Cvitas I, Svansson V, Fettelschloss-Gabriel A, Torsteinsdottir S, Marti E. New Strategies for Prevention and Treatment of Insect Bite Hypersensitivity in Horses. CURRENT DERMATOLOGY REPORTS 2019. [DOI: 10.1007/s13671-019-00279-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Abstract
Purpose of Review
Treatment of equine insect bite hypersensitivity (IBH) needs to be improved. Allergen-specific immunotherapy (ASIT), the only curative treatment of allergy, currently has only a limited efficacy for treatment of IBH. This review highlights the latest findings in prophylactic and therapeutic strategies.
Recent Findings
Prophylactic vaccination against IBH using recombinant Culicoides allergen has been developed in unexposed Icelandic horses and is ready to be tested. Therapeutic virus-like particle (VLP)–based vaccines targeting equine interleukin- (IL-) 5 or IL-31 improved clinical signs of IBH by induction of anti-cytokine antibodies thus reducing eosinophil counts or allergic pruritus, respectively.
Summary
First studies for development of ASIT using pure r-Culicoides allergens have yielded promising results and need now to be tested in clinical studies for both prevention and treatment of IBH. Therapeutic vaccines inducing neutralizing antibodies against IL-5 or IL-31 will be valuable future treatments for reduction of clinical signs of IBH.
Collapse
|
10
|
Allergenspezifische Immuntherapie bei IgE-vermittelten Erkrankungen im Kindes- und Jugendalter. Monatsschr Kinderheilkd 2019. [DOI: 10.1007/s00112-018-0448-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
|
11
|
Cheng L, Chen J, Fu Q, He S, Li H, Liu Z, Tan G, Tao Z, Wang D, Wen W, Xu R, Xu Y, Yang Q, Zhang C, Zhang G, Zhang R, Zhang Y, Zhou B, Zhu D, Chen L, Cui X, Deng Y, Guo Z, Huang Z, Huang Z, Li H, Li J, Li W, Li Y, Xi L, Lou H, Lu M, Ouyang Y, Shi W, Tao X, Tian H, Wang C, Wang M, Wang N, Wang X, Xie H, Yu S, Zhao R, Zheng M, Zhou H, Zhu L, Zhang L. Chinese Society of Allergy Guidelines for Diagnosis and Treatment of Allergic Rhinitis. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2018; 10:300-353. [PMID: 29949830 PMCID: PMC6021586 DOI: 10.4168/aair.2018.10.4.300] [Citation(s) in RCA: 187] [Impact Index Per Article: 31.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Revised: 09/17/2017] [Accepted: 10/05/2017] [Indexed: 11/20/2022]
Abstract
Allergic rhinitis (AR) is a global health problem that causes major illnesses and disabilities worldwide. Epidemiologic studies have demonstrated that the prevalence of AR has increased progressively over the last few decades in more developed countries and currently affects up to 40% of the population worldwide. Likewise, a rising trend of AR has also been observed over the last 2-3 decades in developing countries including China, with the prevalence of AR varying widely in these countries. A survey of self-reported AR over a 6-year period in the general Chinese adult population reported that the standardized prevalence of adult AR increased from 11.1% in 2005 to 17.6% in 2011. An increasing number of Journal Articles and imporclinical trials on the epidemiology, pathophysiologic mechanisms, diagnosis, management and comorbidities of AR in Chinese subjects have been published in international peer-reviewed journals over the past 2 decades, and substantially added to our understanding of this disease as a global problem. Although guidelines for the diagnosis and treatment of AR in Chinese subjects have also been published, they have not been translated into English and therefore not generally accessible for reference to non-Chinese speaking international medical communities. Moreover, methods for the diagnosis and treatment of AR in China have not been standardized entirely and some patients are still treated according to regional preferences. Thus, the present guidelines have been developed by the Chinese Society of Allergy to be accessible to both national and international medical communities involved in the management of AR patients. These guidelines have been prepared in line with existing international guidelines to provide evidence-based recommendations for the diagnosis and management of AR in China.
Collapse
Affiliation(s)
- Lei Cheng
- Department of Otorhinolaryngology, The First Affiliated Hospital, Nanjing Medical University, Nanjing, China
- International Centre for Allergy Research, Nanjing Medical University, Nanjing, China
| | - Jianjun Chen
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qingling Fu
- Otorhinolaryngology Hospital, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Shaoheng He
- Allergy and Clinical Immunology Research Centre, the First Affiliated Hospital of Jinzhou Medical University, Jinzhou, China
| | - Huabin Li
- Department of Otolaryngology Head Neck Surgery, Eye & ENT Hospital of Fudan University, Shanghai, China
| | - Zheng Liu
- Department of Otolaryngology-Head and Neck Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Guolin Tan
- Department of Otolaryngology Head Neck Surgery, Third Xiangya Hospital, Central South University, Changsha, China
| | - Zezhang Tao
- Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital, Wuhan University, Wuhan, China
| | - Dehui Wang
- Department of Otolaryngology Head Neck Surgery, Eye & ENT Hospital of Fudan University, Shanghai, China
| | - Weiping Wen
- Otorhinolaryngology Hospital, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Rui Xu
- Otorhinolaryngology Hospital, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yu Xu
- Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital, Wuhan University, Wuhan, China
| | - Qintai Yang
- Department of Otolaryngology Head and Neck Surgery, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Chonghua Zhang
- Department of Otolaryngology Head Neck Surgery, Eye & ENT Hospital of Fudan University, Shanghai, China
| | - Gehua Zhang
- Department of Otolaryngology Head and Neck Surgery, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Ruxin Zhang
- Department of Otorhinolaryngology Head and Neck Surgery, Huadong Hospital, Fudan University, Shanghai, China
| | - Yuan Zhang
- Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, China
- Department of Allergy, Beijing TongRen Hospital, Capital Medical University, Beijing, China
- Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, China
| | - Bing Zhou
- Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, China
| | - Dongdong Zhu
- Department of Otorhinolaryngology Head and Neck Surgery, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Luquan Chen
- Department of Traditional Chinese Medicine, Beijing TongRen Hospital, Capital Medical University, Beijing, China
| | - Xinyan Cui
- Department of Otorhinolaryngology, The First Affiliated Hospital, Nanjing Medical University, Nanjing, China
| | - Yuqin Deng
- Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital, Wuhan University, Wuhan, China
| | - Zhiqiang Guo
- Department of Otorhinolaryngology Head and Neck Surgery, Huadong Hospital, Fudan University, Shanghai, China
| | - Zhenxiao Huang
- Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, China
| | - Zizhen Huang
- Department of Otolaryngology Head and Neck Surgery, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Houyong Li
- Department of Otolaryngology Head Neck Surgery, Eye & ENT Hospital of Fudan University, Shanghai, China
| | - Jingyun Li
- Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, China
| | - Wenting Li
- Department of Otolaryngology Head and Neck Surgery, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yanqing Li
- Department of Otolaryngology Head Neck Surgery, Eye & ENT Hospital of Fudan University, Shanghai, China
| | - Lin Xi
- Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, China
| | - Hongfei Lou
- Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, China
| | - Meiping Lu
- Department of Otorhinolaryngology, The First Affiliated Hospital, Nanjing Medical University, Nanjing, China
| | - Yuhui Ouyang
- Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, China
| | - Wendan Shi
- Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital, Wuhan University, Wuhan, China
| | - Xiaoyao Tao
- Otorhinolaryngology Hospital, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Huiqin Tian
- Department of Otorhinolaryngology, The First Affiliated Hospital, Nanjing Medical University, Nanjing, China
| | - Chengshuo Wang
- Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, China
| | - Min Wang
- Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, China
| | - Nan Wang
- Department of Otolaryngology-Head and Neck Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiangdong Wang
- Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, China
- Department of Allergy, Beijing TongRen Hospital, Capital Medical University, Beijing, China
- Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, China
| | - Hui Xie
- Department of Otorhinolaryngology, Affiliated Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Shaoqing Yu
- Department of Otolaryngology Head and Neck Surgery, Tongji Hospital, Tongji University, Shanghai, China
| | - Renwu Zhao
- Department of Otorhinolaryngology Head and Neck Surgery, Huadong Hospital, Fudan University, Shanghai, China
| | - Ming Zheng
- Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, China
| | - Han Zhou
- Department of Otorhinolaryngology, The First Affiliated Hospital, Nanjing Medical University, Nanjing, China
| | - Luping Zhu
- Department of Otorhinolaryngology, The Second Affiliated Hospital, Nanjing Medical University, Nanjing, China
| | - Luo Zhang
- Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing, China
- Department of Allergy, Beijing TongRen Hospital, Capital Medical University, Beijing, China
- Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, China.
| |
Collapse
|
12
|
Igetei JE, El-Faham M, Liddell S, Schramm G, Doenhoff MJ. Antigenic cross-reactivity between Schistosoma mansoni and pollen allergens from the birch tree (Betula verrucosa) and Timothy grass (Phleum pratense): involvement of shared glycan epitopes and implications for the hygiene hypothesis. Int J Parasitol 2018; 48:345-357. [PMID: 29510117 DOI: 10.1016/j.ijpara.2017.12.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Revised: 11/28/2017] [Accepted: 12/05/2017] [Indexed: 01/05/2023]
Abstract
Previous studies have shown that schistosome infection can protect against allergic symptoms, but the underlying mechanisms are still not fully understood. Here we have shown that rabbit IgG antibodies raised against Schistosoma mansoni soluble egg antigens (SmSEA) are cross-reactive with a wide array of molecules in Timothy grass pollen (TGP) and birch tree pollen (BTP). Five of the cross-reactive pollen molecules (two from TGP and three from BTP) were selected randomly and identified by tandem mass spectrometric (TMS) analysis to be, respectively, the TGP allergens Phl p 1 and Phl p 5b, and BTP glutathione S-transferase (GST), and the BTP allergens Bet v 1 and Bet v 6.0102. Rabbit anti-SmSEA IgG antibodies that cross-reacted with each of the five allergens were found to be reactive with three major S. mansoni egg antigens, IPSE/alpha-1, omega-1 and kappa-5. Pairwise alignment of the amino acid sequences of each of the five TMS-identified pollen allergens with each of the three egg antigens revealed a low level of amino acid sequence identity. Further experiments indicated that the schistosome antigen/allergen cross-reactivity was mostly due to similar glycans present in helminths and plants, but not in mammals: so called cross-reactive carbohydrate determinants (CCDs). Previously, CCDs have been implicated in the cross-reactivity between many plants and invertebrates. Furthermore, pollen-induced anti-CCD IgGs have been found in sera of patients undergoing allergen-specific immunotherapy (SIT) and implicated in the treatment of the allergy. Thus, our finding provides not only possible explanations for the allergy-protective effect of helminth/schistosome infections as explained by the hygiene hypothesis, but also a potential starting point for improved SIT.
Collapse
Affiliation(s)
- Joseph E Igetei
- School of Life Sciences, University Park, University of Nottingham, Nottinghamshire NG7 2RD, UK; Department of Animal and Environmental Biology, Faculty of Life Sciences, University of Benin, Benin City, Edo State, Nigeria.
| | - Marwa El-Faham
- School of Life Sciences, University Park, University of Nottingham, Nottinghamshire NG7 2RD, UK; Department of Medical Parasitology, Faculty of Medicine, Alexandria University, Egypt
| | - Susan Liddell
- School of Biosciences, Sutton Bonington Campus, University of Nottingham LE12 5RD, UK
| | - Gabriele Schramm
- Research Center Borstel, Priority Area Asthma and Allergy, Experimental Pneumology, Parkallee 22, D-23845 Borstel, Germany
| | - Michael J Doenhoff
- School of Life Sciences, University Park, University of Nottingham, Nottinghamshire NG7 2RD, UK
| |
Collapse
|
13
|
Klier J, Geis S, Steuer J, Geh K, Reese S, Fuchs S, Mueller RS, Winter G, Gehlen H. A comparison of nanoparticullate CpG immunotherapy with and without allergens in spontaneously equine asthma-affected horses, an animal model. Immun Inflamm Dis 2018; 6:81-96. [PMID: 29094511 PMCID: PMC5818452 DOI: 10.1002/iid3.198] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2017] [Revised: 07/14/2017] [Accepted: 08/16/2017] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION New therapeutic strategies to modulate the immune response of human and equine allergic asthma are still under extensive investigation. Immunomodulating agents stimulating T-regulatory cells offer new treatment options beyond conventional symptomatic treatment or specific immunotherapy for human and equine allergic airway diseases, with the goal of a homoeostatic T-helper cell balance. The aim of this study was to evaluate the effects of a nebulized gelatin nanoparticle-CpG formulation (CpG-GNP) with and without specific allergens for the treatment of spontaneous allergic equine asthma as a model for human asthma. METHODS Twenty equine asthma-affected horses were treated either with CpG-GNP alone or CpG-GNP with allergens. Two specific allergens were selected for each horse based on history and an in-vitro test. Each horse received seven administrations of the respective nebulized composition and was examined before treatment, immediately after and 6 weeks after the treatment course. RESULTS Clinical parameters such as breathing rate, indirect interpleural measurement, arterial blood gases, amount of tracheal mucus and percentage of neutrophils and cytokines in tracheal washes and serum samples were evaluated. Treatment with CpG-GNP alone as well as in combinations with relevant allergens resulted in clinical improvement of nasal discharge, breathing rate, amount of secretion and viscosity, neutrophil percentage and partial oxygen pressure directly after and 6 weeks after treatment. There were no significant differences between the two treatments in clinical parameters or local cytokine profiles in the tracheal wash fluid (IL-10, IFN-g, and IL-17). IL-4 concentrations decreased significantly in both groups. CONCLUSION Nonspecific CpG-GNP-based immunotherapy shows potential as a treatment for equine and possibly also human allergic asthma.
Collapse
Affiliation(s)
- John Klier
- Centre for Clinical Veterinary MedicineEquine Clinic, Ludwig‐Maximilians‐UniversityMunichGermany
| | - Sabine Geis
- Centre for Clinical Veterinary MedicineEquine Clinic, Ludwig‐Maximilians‐UniversityMunichGermany
- Department of Veterinary Medicine, Equine Clinic, Surgery and RadiologyFree University of BerlinBerlinGermany
| | - Jeanette Steuer
- Centre for Clinical Veterinary MedicineEquine Clinic, Ludwig‐Maximilians‐UniversityMunichGermany
- Department of Veterinary Medicine, Equine Clinic, Surgery and RadiologyFree University of BerlinBerlinGermany
| | - Katharina Geh
- Department of PharmacyPharmaceutical Technology and Biopharmaceutics, Ludwig‐Maximilians‐UniversityMunichGermany
| | - Sven Reese
- Department of Veterinary Science, Institute of Anatomy, Histology and EmbryologyLudwig‐Maximilians‐UniversityMunichGermany
| | - Sebastian Fuchs
- Department of PharmacyPharmaceutical Technology and Biopharmaceutics, Ludwig‐Maximilians‐UniversityMunichGermany
| | - Ralf S. Mueller
- Centre for Clinical Veterinary Medicine, Small Animal Medicine ClinicLudwig‐Maximilians‐UniversityMunichGermany
| | - Gerhard Winter
- Department of PharmacyPharmaceutical Technology and Biopharmaceutics, Ludwig‐Maximilians‐UniversityMunichGermany
| | - Heidrun Gehlen
- Department of Veterinary Medicine, Equine Clinic, Surgery and RadiologyFree University of BerlinBerlinGermany
| |
Collapse
|
14
|
Efficacy of oral immunotherapy with a rice-based edible vaccine containing hypoallergenic Japanese cedar pollen allergens for treatment of established allergic conjunctivitis in mice. Allergol Int 2018; 67:119-123. [PMID: 28676431 DOI: 10.1016/j.alit.2017.06.006] [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: 01/05/2017] [Revised: 05/23/2017] [Accepted: 05/25/2017] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND We have previously shown that prophylactic oral administration of transgenic rice seeds expressing hypoallergenic modified antigens suppressed the development of allergic conjunctivitis induced by Japanese cedar pollen. We have now investigated the efficacy of oral immunotherapy with such transgenic rice for established allergic conjunctivitis in mice. METHODS BALB/c mice were sensitized with two intraperitoneal injections of Japanese cedar pollen in alum, challenged with pollen in eyedrops, and then fed for 16 days with transgenic rice seeds expressing modified Japanese cedar pollen allergens Cry j 1 and Cry j 2 or with nontransgenic rice seeds as a control. They were then challenged twice with pollen in eyedrops, with clinical signs being evaluated at 15 min after the first challenge and the eyes, blood, spleen, and lymph nodes being isolated at 24 h after the second challenge. RESULTS The number of eosinophils in the conjunctiva and the clinical score for conjunctivitis were both significantly lower in mice fed the transgenic rice than in those fed nontransgenic rice. Oral vaccination with transgenic rice seeds also resulted in a significant increase in the production of IFN-γ by splenocytes, whereas it had no effect on the number of CD4+CD25+Foxp3+ regulatory T cells in the spleen or submandibular or mesenteric lymph nodes. CONCLUSIONS Oral administration of transgenic rice seeds expressing hypoallergenic allergens ameliorated allergic conjunctivitis in the established setting. Such a rice-based edible vaccine is potentially both safe and effective for oral immunotherapy in individuals with allergic conjunctivitis.
Collapse
|
15
|
Bao Y, Chen J, Cheng L, Guo Y, Hong S, Kong W, Lai H, Li H, Li H, Li J, Li T, Lin X, Liu S, Liu Z, Lou H, Meng J, Qiu Q, Shen K, Tang W, Tao Z, Wang C, Wang X, Wei Q, Xiang L, Xie H, Xu Y, Zhang G, Zhang Y, Zheng Y, Zhi Y, Chen D, Hong H, Li Q, Liu L, Meng Y, Wang N, Wang Y, Zhou Y, Zhang L. Chinese Guideline on allergen immunotherapy for allergic rhinitis. J Thorac Dis 2017; 9:4607-4650. [PMID: 29268533 DOI: 10.21037/jtd.2017.10.112] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The present document is based on a consensus reached by a panel of experts from Chinese Society of Allergy (CSA) and Chinese Allergic Rhinitis Collaborative Research Group (C2AR2G). Allergen immunotherapy (AIT), has increasingly been used as a treatment for allergic rhinitis (AR) globally, as it has been shown to provide a long-term effect in improving nasal and ocular symptoms, reducing medication need, and improving quality of life. AIT is currently the only curative intervention that can potentially modify the immune system in individuals suffering from AR and prevent the development of new sensitization and the progression of disease from AR to asthma. Although the use of AIT is becoming more acceptable in China, to date no AR immunotherapy guideline from China is available for use by the international community. This document has thus been produced and covers the main aspects of AIT undertaken in China; including selection of patients for AIT, the allergen extracts available on the Chinese market, schedules and doses of allergen employed in different routes of AIT, assessment of effect and safety, patients' administration and follow-up, and management of adverse reactions. The Chinese guideline for AR immunotherapy will thus serve as a reference point by doctors, healthcare professionals and organizations involved in the AIT of AR in China. Moreover, this guideline will serve as a source of information for the international community on AIT treatment strategies employed in China.
Collapse
Affiliation(s)
- Yixiao Bao
- Department of Pediatric Respiratory Medicine, Pubin Children Hospital, Shanghai Children Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
| | - Jianjun Chen
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Lei Cheng
- Department of Otorhinolaryngology, the First Affiliated Hospital, Nanjing Medical University, Nanjing 210029, China.,International Centre for Allergy Research, Nanjing Medical University, Nanjing 210029, China
| | - Yinshi Guo
- Department of Allergy & Immunology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
| | - Suling Hong
- Department of Otorhinolaryngology, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Weijia Kong
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - He Lai
- Department of Allergy, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou 510260, China
| | - Houyong Li
- Department of Otolaryngology, Head and Neck Surgery, Affiliated Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai 200031, China
| | - Huabin Li
- Department of Otolaryngology, Head and Neck Surgery, Affiliated Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai 200031, China
| | - Jing Li
- State Key Laboratory of Respiratory Disease, Allergy and Clinical Immunology, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
| | - Tianying Li
- Department of otolaryngology, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
| | - Xiaoping Lin
- The PLA Center of respiratory and allergic disease diagnosing and management, Shenyang 110016, China
| | - Shixi Liu
- Department of Otolaryngology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Zheng Liu
- Department of Otolaryngology Head and Neck Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Hongfei Lou
- Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing 100730, China.,Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing 100005, China
| | - Juan Meng
- Department of Otolaryngology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Qianhui Qiu
- Department of Otorhinolaryngology, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, China
| | - Kunling Shen
- Department of Pediatric Respiratory Medicine, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - Wei Tang
- Department of Pulmonary and Critical Care Medicine, Shanghai Ruijin Hospital affiliated to Shanghai Jiaotong University, School of Medicine, Shanghai 200025, China
| | - Zezhang Tao
- Department of Otolaryngology, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Chengshuo Wang
- Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing 100730, China.,Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing 100005, China
| | - Xiangdong Wang
- Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing 100730, China.,Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing 100005, China
| | - Qingyu Wei
- Department of Allergy, NO.202 Hospital of PLA, Shenyang 110003, China
| | - Li Xiang
- Department of Allergy, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - Hua Xie
- Department of Respiratory Medicine, the General Hospital of Shenyang Military Region, Shenyang 110016, China
| | - Yu Xu
- Department of Otolaryngology, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Gehua Zhang
- Department of Otolaryngology Head and Neck Surgery, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China
| | - Yuan Zhang
- Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing 100730, China.,Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing 100005, China
| | - Yiwu Zheng
- Scientific Affairs, ALK, Guangzhou 510300, China
| | - Yuxiang Zhi
- Department of Allergy, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100720, China
| | - Dehua Chen
- Department of otolaryngology, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
| | - Haiyu Hong
- Department of otolaryngology, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
| | - Quansheng Li
- Department of Allergy, NO.202 Hospital of PLA, Shenyang 110003, China
| | - Lin Liu
- Department of Otorhinolaryngology, the First Affiliated Hospital, Nanjing Medical University, Nanjing 210029, China
| | - Yifan Meng
- Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing 100730, China.,Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing 100005, China
| | - Nan Wang
- Department of Otolaryngology Head and Neck Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Yihui Wang
- Department of Pediatric Respiratory Medicine, Pubin Children Hospital, Shanghai Children Medical Center Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
| | - Yue Zhou
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Luo Zhang
- Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing 100730, China.,Beijing Key Laboratory of Nasal Diseases, Beijing Institute of Otolaryngology, Beijing 100005, China.,Department of Allergy, Beijing TongRen Hospital, Capital Medical University, Beijing 100730, China
| | | |
Collapse
|
16
|
Gonzalez M, Doña I, Palomares F, Campo P, Rodriguez MJ, Rondon C, Gomez F, Fernandez TD, Perkins JR, Escribese MM, Torres MJ, Mayorga C. Dermatophagoides pteronyssinus immunotherapy changes the T-regulatory cell activity. Sci Rep 2017; 7:11949. [PMID: 28931869 PMCID: PMC5607227 DOI: 10.1038/s41598-017-12261-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Accepted: 09/05/2017] [Indexed: 01/12/2023] Open
Abstract
Subcutaneous specific immunotherapy (SCIT) has been shown to modify the Dermatophagoides pteronissinus (DP) allergic response, characterized by generation of Treg cells. However, studies have reported no changes in the proportion of Treg cells after immunotherapy, indicating that the effects may be due to modifications in their regulatory activities. We aimed to determine whether Tregs generated by DP-SCIT can switch the allergic response to tolerant and study the involvement of suppressive cytokines on it. Twenty-four DP-allergic rhinitis patients were recruited, 16 treated with DP-SCIT and 8 untreated. Treg and T effector cells were isolated before and after DP-SCIT, and cocultured in different combinations with α-IL-10, α-TGF-β blocking antibodies and nDer p 1. Treg cells after DP-SCIT increased Th1 and decreased Th2 and Th9 proliferation. Similarly, they increased IL-10 and decreased IL-4 and IL-9-producing cells. α-IL-10 affected the activity of Treg cells obtained after DP-SCIT only. Finally, DP-specific IgG4 levels, Treg percentage and IL-10 production were correlated after DP-SCIT. These results demonstrate that DP-SCIT induces Treg cells with different suppressive activities. These changes could be mediated by IL-10 production and appear to play an important role in the induction of the tolerance response leading to a clinical improvement of symptoms.
Collapse
Affiliation(s)
- M Gonzalez
- Research Laboratory-Allergy Unit, IBIMA-Regional University Hospital of Malaga, UMA, Malaga, Spain
| | - I Doña
- Allergy Service, IBIMA-Regional University Hospital of Malaga, UMA, Malaga, Spain
| | - F Palomares
- Research Laboratory-Allergy Unit, IBIMA-Regional University Hospital of Malaga, UMA, Malaga, Spain
| | - P Campo
- Allergy Service, IBIMA-Regional University Hospital of Malaga, UMA, Malaga, Spain
| | - M J Rodriguez
- Research Laboratory-Allergy Unit, IBIMA-Regional University Hospital of Malaga, UMA, Malaga, Spain
| | - C Rondon
- Allergy Service, IBIMA-Regional University Hospital of Malaga, UMA, Malaga, Spain
| | - F Gomez
- Allergy Service, IBIMA-Regional University Hospital of Malaga, UMA, Malaga, Spain
| | - T D Fernandez
- Research Laboratory-Allergy Unit, IBIMA-Regional University Hospital of Malaga, UMA, Malaga, Spain
| | - J R Perkins
- Research Laboratory-Allergy Unit, IBIMA-Regional University Hospital of Malaga, UMA, Malaga, Spain
| | - M M Escribese
- Institute for Applied Molecular Medicine (IMMA), School of Medicine, Universidad CEU San Pablo, Madrid, Spain
- Basical Medical Sciences Department, Faculty of Medicine, CEU San Pablo University, Madrid, Spain
| | - M J Torres
- Allergy Service, IBIMA-Regional University Hospital of Malaga, UMA, Malaga, Spain
| | - C Mayorga
- Research Laboratory-Allergy Unit, IBIMA-Regional University Hospital of Malaga, UMA, Malaga, Spain.
- Allergy Service, IBIMA-Regional University Hospital of Malaga, UMA, Malaga, Spain.
| |
Collapse
|
17
|
Gutowska-Owsiak D, Ogg GS. Therapeutic vaccines for allergic disease. NPJ Vaccines 2017; 2:12. [PMID: 29263869 PMCID: PMC5604746 DOI: 10.1038/s41541-017-0014-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Revised: 03/03/2017] [Accepted: 03/20/2017] [Indexed: 12/14/2022] Open
Abstract
Allergic diseases are highly prevalent worldwide and affect all age groups, contributing to a high personal and socioeconomic burden. Treatment with an “allergy vaccine” or allergen immunotherapy aims to provide long-lasting benefits by inducing unresponsiveness to the relevant antigen. The consequences of the therapy are considered disease modifying and range from dampening of the immediate immune responses to the reduction of secondary tissue remodeling. Furthermore, allergen immunotherapy interventions have a potential to slow or cease the development of additional allergic manifestations with a long-term overall effect on morbidity and quality of life. Here, we review proposed mechanisms underlying the therapeutic effects of immunotherapy for allergic diseases. Further, we discuss both standard and novel approaches and possible future directions in the development of allergen immunotherapy.
Collapse
Affiliation(s)
- Danuta Gutowska-Owsiak
- MRC Human Immunology Unit, NIHR Biomedical Research Centre, Radcliffe Department of Medicine, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK
| | - Graham S Ogg
- MRC Human Immunology Unit, NIHR Biomedical Research Centre, Radcliffe Department of Medicine, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK
| |
Collapse
|
18
|
Bachmann MF, Kündig TM. Allergen-specific immunotherapy: is it vaccination against toxins after all? Allergy 2017; 72:13-23. [PMID: 27558586 DOI: 10.1111/all.12890] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2016] [Indexed: 01/16/2023]
Abstract
IgE-mediated allergies, in particular allergic rhinoconjunctivitis and asthma, have reached epidemic proportions, affecting about one-third of the population in developed countries. The most effective treatment for allergies is specific immunotherapy (SIT), which involves the injection of increasing doses of an allergen extract to allergic individuals. The current form of SIT was first introduced in 1911 and recently celebrated its 100th birthday for the treatment of hay fever. The concept of this therapy at the time was straightforward, as it was believed that pollen contained toxins against which the patient could be vaccinated. However, the understanding became blurred with the discovery that IgE antibodies were the effector molecules of the allergic response. Subsequent research focused on the idea that SIT should induce tolerance keeping the IgE antibodies at bay. In this review, we will discuss the various hypotheses for the mechanism of SIT and we will put forward the concept that allergens may be viewed as 'protoxins' which need to be activated by IgE antibodies. Within this framework, protoxin-neutralizing antibodies are the key effector molecules while a shift to Th1 or Treg cells mainly contributes to the efficacy of SIT by helping B cells to produce neutralizing IgG antibodies.
Collapse
Affiliation(s)
- M. F. Bachmann
- Immunology; RIA; University Hospital Bern; Bern Switzerland
- The Jenner Institute; University of Oxford; Oxford UK
| | - T. M. Kündig
- Department of Dermatology; University Hospital Zürich; Zürich Switzerland
| |
Collapse
|
19
|
Bellinghausen I, Saloga J. Analysis of allergic immune responses in humanized mice. Cell Immunol 2016; 308:7-12. [PMID: 27493097 DOI: 10.1016/j.cellimm.2016.07.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Accepted: 07/13/2016] [Indexed: 12/14/2022]
Abstract
Nowadays, more than 25% of the population in industrial countries are affected by IgE-mediated (atopic) allergic diseases such as allergic rhinitis, asthma and atopic eczema. Due to intensive research on basis of in vitro studies with human immune cells and different murine in vivo models of allergy fundamental mechanisms of allergic immune responses have been elucidated during the last years. However, human studies are restricted and the immune system of mice differs from the human immune system in several aspects so that the transferability of experimental results from mice to men is limited. Humanized mice represent a new tool to analyze the interaction of human immune cells under physiological conditions as far as possible, particularly to test novel therapeutic strategies. This review summarizes the impact of humanized mouse models for the investigation and treatment of allergic diseases.
Collapse
Affiliation(s)
- Iris Bellinghausen
- Department of Dermatology, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany.
| | - Joachim Saloga
- Department of Dermatology, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
| |
Collapse
|
20
|
Corthésy B, Lassus A, Terrettaz J, Tranquart F, Bioley G. Efficacy of a therapeutic treatment using gas-filled microbubble-associated phospholipase A2 in a mouse model of honeybee venom allergy. Allergy 2016; 71:957-66. [PMID: 26850222 DOI: 10.1111/all.12859] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2016] [Indexed: 01/10/2023]
Abstract
BACKGROUND Venom immunotherapy is efficient to desensitize people suffering from insect sting allergies. However, the numerous injections required over several years and important risks of severe side reactions complicate the widespread use of immunotherapy. In the search for novel approaches to blunt the overwhelming pro-allergic Th2 response, we evaluated the therapeutic efficacy of a treatment based on a denatured form of the major allergen, phospholipase A2, associated with microbubbles (PLA2denat -MB) in a mouse model of honeybee venom allergy. METHODS Antibodies measured by ELISA, T-cell responses assessed by CFSE-based proliferation assays and ELISA, and basophil degranulation were examined after PLA2denat -MB-based therapeutic treatment of sensitized mice. Mice were challenged with a lethal dose of PLA2 to evaluate protection against anaphylaxis. RESULTS Therapeutic subcutaneous administration of two different PLA2denat -MB formulations, in contrast to PLA2denat alone, reduced allergic symptoms and protected all mice from anaphylaxis-mediated death after allergen challenge. At the functional level, the use of PLA2denat decreased IgE-mediated basophil degranulation as compared to the native form of the allergen. In comparison with PLA2denat alone, both PLA2denat -MB formulations decreased allergen-specific Th2 CD4 T-cell reactivity. At the mechanistic level, PLA2denat -MB containing 20% palmitic acid and PEG induced PLA2-specific IgA and increased Foxp3(+) Treg frequencies and TGF-β production, whereas the formulation bearing 80% palmitic acid triggered the production of IFN-γ, IgG2a, and IgG3. CONCLUSIONS In contrast to conventional PLA2 subcutaneous immunotherapy, the therapeutic administration of PLA2-MB treatment to mice that already had established allergy to PLA2 protects all subsequently challenged animals.
Collapse
Affiliation(s)
- B. Corthésy
- R&D Laboratory; Division of Immunology and Allergy; University State Hospital (CHUV); Epalinges Switzerland
| | - A. Lassus
- Bracco Suisse SA; Plan-Les-Ouates Switzerland
| | | | | | - G. Bioley
- R&D Laboratory; Division of Immunology and Allergy; University State Hospital (CHUV); Epalinges Switzerland
| |
Collapse
|
21
|
Sur B, Lee B, Yeom M, Hong JH, Kwon S, Kim ST, Lee HS, Park HJ, Lee H, Hahm DH. Bee venom acupuncture alleviates trimellitic anhydride-induced atopic dermatitis-like skin lesions in mice. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2016; 16:38. [PMID: 26825274 PMCID: PMC4731956 DOI: 10.1186/s12906-016-1019-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Accepted: 01/27/2016] [Indexed: 12/22/2022]
Abstract
BACKGROUND Bee venom acupuncture (BVA), a novel type of acupuncture therapy in which purified bee venom is injected into the specific acupuncture point on the diseased part of the body, is used primarily for relieving pain and other musculoskeletal symptoms. In the present study, therapeutic potential of BVA to improve atopic dermatitis, a representative allergic dysfunction, was evaluated in the mouse model of trimellitic anhydride (TMA)-induced skin impairment. METHODS Mice were treated with 5% TMA on the dorsal flank for sensitization and subsequently treated with 2% TMA on the dorsum of both ears for an additional 12 days after a 3-day interval. From the 7(th) day of 2% TMA treatment, bilateral subcutaneous injection of BV (BV, 0.3 mg/kg) was performed daily at BL40 acupuncture points (located behind the knee) 1 h before 2% TMA treatment for 5 days. RESULTS BVA treatment markedly inhibited the expression levels of both T helper cell type 1 (Th1) and Th2 cytokines in ear skin and lymph nodes of TMA-treated mice. Clinical features of AD-like symptoms such as ear skin symptom severity and thickness, inflammation, and lymph node weight were significantly alleviated by BV treatment. BV treatment also inhibited the proliferation and infiltration of T cells, the production of Th1 and Th2 cytokines, and the synthesis of interleukin (IL)-4 and immunoglobulin E (IgE)-typical allergic Th2 responses in blood. The inhibitory effect of BVA was more pronounced at BL40 acupoint than non-acupuncture point located at the base of the tail. CONCLUSIONS These results indicate that BV injection at specific acupuncture points effectively alleviates AD-like skin lesions by inhibiting inflammatory and allergic responses in a TMA-induced contact hypersensitivity mouse model.
Collapse
Affiliation(s)
- Bongjun Sur
- Acupuncture and Meridian Science Research Center, College of Korean Medicine, Kyung Hee University, Hoegi-ding, Dongdaemoon-gu, Seoul, 130-701, Republic of Korea
| | - Bombi Lee
- Acupuncture and Meridian Science Research Center, College of Korean Medicine, Kyung Hee University, Hoegi-ding, Dongdaemoon-gu, Seoul, 130-701, Republic of Korea
| | - Mijung Yeom
- Acupuncture and Meridian Science Research Center, College of Korean Medicine, Kyung Hee University, Hoegi-ding, Dongdaemoon-gu, Seoul, 130-701, Republic of Korea
| | - Ju-Hee Hong
- Acupuncture and Meridian Science Research Center, College of Korean Medicine, Kyung Hee University, Hoegi-ding, Dongdaemoon-gu, Seoul, 130-701, Republic of Korea
| | - Sunoh Kwon
- Acupuncture and Meridian Science Research Center, College of Korean Medicine, Kyung Hee University, Hoegi-ding, Dongdaemoon-gu, Seoul, 130-701, Republic of Korea
| | - Seung-Tae Kim
- Division of Meridian and Structural Medicine, School of Korean Medicine, Pusan National University, Yangsan, 628-870, Republic of Korea
| | - Hyang Sook Lee
- Acupuncture and Meridian Science Research Center, College of Korean Medicine, Kyung Hee University, Hoegi-ding, Dongdaemoon-gu, Seoul, 130-701, Republic of Korea
- The Graduate School of Basic Science of Korean Medicine, College of Korean Medicine, Kyung Hee University, Seoul, 130-701, Republic of Korea
| | - Hi-Joon Park
- Acupuncture and Meridian Science Research Center, College of Korean Medicine, Kyung Hee University, Hoegi-ding, Dongdaemoon-gu, Seoul, 130-701, Republic of Korea
- The Graduate School of Basic Science of Korean Medicine, College of Korean Medicine, Kyung Hee University, Seoul, 130-701, Republic of Korea
| | - Hyejung Lee
- Acupuncture and Meridian Science Research Center, College of Korean Medicine, Kyung Hee University, Hoegi-ding, Dongdaemoon-gu, Seoul, 130-701, Republic of Korea
- The Graduate School of Basic Science of Korean Medicine, College of Korean Medicine, Kyung Hee University, Seoul, 130-701, Republic of Korea
| | - Dae-Hyun Hahm
- Acupuncture and Meridian Science Research Center, College of Korean Medicine, Kyung Hee University, Hoegi-ding, Dongdaemoon-gu, Seoul, 130-701, Republic of Korea.
- The Graduate School of Basic Science of Korean Medicine, College of Korean Medicine, Kyung Hee University, Seoul, 130-701, Republic of Korea.
| |
Collapse
|
22
|
Urra JM, Cabrera CM, Alfaya T, Feo-Brito F. Agreement of skin test with IL-4 production and CD40L expression by T cells upon immunotherapy of subjects with systemic reactions to Hymenoptera stings. Mol Immunol 2016; 70:134-9. [PMID: 26774053 DOI: 10.1016/j.molimm.2015.12.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Revised: 12/16/2015] [Accepted: 12/19/2015] [Indexed: 10/22/2022]
Abstract
Venom immunotherapy is the only curative intervention for subjects with Hymenoptera venom allergy who suffering systemic reactions upon bee or wasp stings. Venom immunotherapy can restore normal immunity against venom allergens, as well as providing to allergic subjects a lifetime tolerance against venoms. Nevertheless, it is necessary using safety assays to monitoring the development of tolerance in the VIT protocols to avoid fatal anaphylactic reactions. The purpose of this study was to assess the modifications in several markers of tolerance induction in subjects with Hymenoptera venom allergy undergoing immunotherapy. The studies were performed at baseline time and after six month of VIT. Intradermal skin tests, basophil activation tests, specific IgE levels; and the T-cell markers (IL-4 and IFN-γ producing cells; and expression of the surface activation markers CD40L and CTLA-4) were assayed. At six month of immunotherapy all parameters studied had significant alterations. All decreased, except the IFN-γ producing cells. In addition, modifications in intradermal skin test showed a significant correlation with both, CD40L expression on CD4 T lymphocytes (p=0.043) and IL-4 producing T lymphocytes (p=0.012). Neither basophil activation test nor serum levels of sIgE demonstrated any correlation with the immunological parameters studied nor among them. These results suggest that both IL-4 production and CD40L expression could be two good indicators of the beneficial effects of venom immunotherapy which translate into skin tests.
Collapse
Affiliation(s)
- José M Urra
- Immunology Section, Hospital General Universitario de Ciudad Real, Spain; Medical Faculty of Ciudad Real, University of Castilla La Mancha, Spain.
| | | | - Teresa Alfaya
- Alergology Section, Hospital General Universitario de Ciudad Real, Spain
| | - Francisco Feo-Brito
- Alergology Section, Hospital General Universitario de Ciudad Real, Spain; Medical Faculty of Ciudad Real, University of Castilla La Mancha, Spain
| |
Collapse
|
23
|
Pravettoni V, Piantanida M, Primavesi L, Forti S, Pastorello EA. Determinants of venom-specific IgE antibody concentration during long-term wasp venom immunotherapy. Clin Mol Allergy 2015; 13:29. [PMID: 26674806 PMCID: PMC4678606 DOI: 10.1186/s12948-015-0036-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Accepted: 10/27/2015] [Indexed: 11/10/2022] Open
Abstract
Background Venom immunotherapy (VIT) is an effective treatment for subjects with systemic allergic reactions (SR) to Hymenoptera stings, however there are few studies concerning the relevance of the venom specific IgE changes to decide about VIT cessation. We assessed IgE changes during a 5-year VIT, in patients stung and protected within the first 3 years (SP 0–3) or in the last 2 years (SP 3–5), and in patients not stung (NoS), to evaluate possible correlations between IgE changes and clinical protection. Methods Yellow jacket venom (YJV)-allergic patients who completed 5 years of VIT were retrospectively evaluated. Baseline IgE levels and after the 3rd and the 5th year of VIT were determined; all patients were asked about field stings and SRs. Results A total of 232 YJV-allergic patients were included and divided into the following groups: 84 NoS, 72 SP 0–3 and 76 SP 3–5. IgE levels decreased during VIT compared to baseline values (χ2 = 346.029, p < 0.001). Recent vespid stings accounted for significantly higher IgE levels despite clinical protection. IgE levels after 5 years of VIT correlated significantly with Mueller grade (F = 2.778, p = 0.012) and age (F = 6.672, p = 0.002). During follow-up from 1 to 10 years after VIT discontinuation, 35.2 % of the contacted patients reported at least one field sting without SR. Conclusions The yellow jacket-VIT temporal stopping criterion of 5 years duration did not result in undetectable IgE levels, despite a long-lasting protection. A mean IgE decrease from 58 to 70 % was observed, and it was less marked in elderly patients or in subjects with higher Mueller grade SR.
Collapse
Affiliation(s)
- Valerio Pravettoni
- Clinical Allergy and Immunology Unit, Foundation IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Marta Piantanida
- Clinical Allergy and Immunology Unit, Foundation IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Laura Primavesi
- Clinical Allergy and Immunology Unit, Foundation IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Stella Forti
- Unit of Audiology, Foundation IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Elide A Pastorello
- Unit of Allergology and Immunology, Niguarda Ca' Granda Hospital, Milan, Italy
| |
Collapse
|
24
|
Meulenbroeks C, van der Meide NMA, Willemse T, Rutten VPMG, Tijhaar E. Recombinant Culicoides obsoletus complex allergens stimulate antigen-specific T cells of insect bite hypersensitive Shetland ponies in vitro. Vet Dermatol 2015; 26:467-75, e108-9. [PMID: 26345148 DOI: 10.1111/vde.12251] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/15/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND Ponies may suffer from Insect bite hypersensitivity (IBH), an allergic IgE-mediated pruritic skin disorder, induced by allergens from biting midges of the Culicoides spp. HYPOTHESIS/OBJECTIVES To determine whether recombinant Culicoides obsoletus allergens are able to activate T cells of ponies exposed to C. obsoletus and whether these allergen-specific responses differ between IBH-affected and healthy ponies. ANIMALS Ten IBH-affected Shetland ponies and 10 age-matched healthy controls taken from the same stables, to ensure similar exposure to midges. METHOD Peripheral blood mononuclear cells (PBMC) were cultured with two different pools of recombinant C. obsoletus complex allergens to expand the allergen-specific T cells. These PBMC cultures were subsequently co-cultured with mature dendritic cells (DCs) loaded with the same antigens. Induction of Th1, Th2 and regulatory T (Treg) cells in these DC/PBMC co-cultures was assessed by analysis of IFN-γ, IL-4, IL-10 and FoxP3 expression levels using quantitative RT-PCR and phenotyping by flow cytometry. RESULTS Recombinant C. obsoletus allergens increased IFN-γ mRNA expression levels, percentages of IFN-γ expressing (Th1) cells and CD25(high) FoxP3(+) IL-10(+) Tregs compared to unstimulated DC/PBMC co-cultures. Stimulation of IL-4 expressing Th2 cells by the recombinant allergens was far less pronounced. The DC/PBMC co-cultures did not reveal significant differences between healthy and IBH-affected ponies for any of the analysed parameters, except for higher IL-4 mRNA levels in IBH affected ponies after stimulation with one of the two allergen pools. CONCLUSION AND CLINICAL IMPORTANCE The recombinant C. obsoletus complex allergens can stimulate antigen-specific Th1 and IL10 producing Treg cells and are therefore promising candidates for the immunotherapy of IBH.
Collapse
Affiliation(s)
- Chantal Meulenbroeks
- Division of Immunology, Department of Infectious Diseases & Immunology, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 1, Utrecht, 3584 CL, the Netherlands
| | - Nathalie M A van der Meide
- Cell Biology and Immunology group, Wageningen University, De Elst 1, Wageningen, 6708 WD, the Netherlands
| | - Ton Willemse
- Division of Immunology, Department of Infectious Diseases & Immunology, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 1, Utrecht, 3584 CL, the Netherlands.,Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 108, Utrecht, 3584 CM, the Netherlands
| | - Victor P M G Rutten
- Division of Immunology, Department of Infectious Diseases & Immunology, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 1, Utrecht, 3584 CL, the Netherlands.,Department of Veterinary Tropical Diseases, Faculty of Veterinary Science, University of Pretoria, Private Bag X04, Onderstepoort, 0110, South Africa
| | - Edwin Tijhaar
- Cell Biology and Immunology group, Wageningen University, De Elst 1, Wageningen, 6708 WD, the Netherlands
| |
Collapse
|
25
|
Hanci D, Şahin E, Muluk NB, Cingi C. Immunotherapy in all aspects. Eur Arch Otorhinolaryngol 2015; 273:1347-55. [PMID: 25673026 DOI: 10.1007/s00405-015-3553-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2014] [Accepted: 02/05/2015] [Indexed: 01/02/2023]
Abstract
Allergen immunotherapy is a form of long-term treatment that decreases symptoms for many people with allergic rhinitis, allergic asthma, conjunctivitis (eye allergy) or stinging insect allergy. In this review, we presented the important topics in immunotherapy. The important aspects of immunotherapy are considered to be "Immunologıcal responses to immunotherapy"; "The principal types of immunotherapy"; "Effectiveness"; "Indications"; "Contraindications"; "Allergen immunotherapy in children"; "Safety"; and "Anaphylactic reactions after immunotherapy". The principal types of immunotherapy are subcutaneous immunotherapy (SCIT) and sublingual immunotherapy. Both of them can be used in indicated cases. When using SCIT, physicians must be more careful because of reported rare fatal cases. The risks and benefits of continuing allergen immunotherapy in patients who have experienced severe systemic reactions should be carefully considered.
Collapse
Affiliation(s)
- Deniz Hanci
- Okmeydanı Training and Research Hospital, ENT Clinics, Istanbul, Turkey
| | - Ethem Şahin
- Bayındır Göztepe Hospital, ENT Clinics, Istanbul, Turkey
| | - Nuray Bayar Muluk
- ENT Department, Medical Faculty, Kırıkkale University, Kirikkale, Turkey. .,, Birlik Mahallesi, Zirvekent 2. Etap Sitesi, C-3 blok, No: 62/43, 06610, Çankaya, Ankara, Turkey.
| | - Cemal Cingi
- ENT Department, Medical Faculty, Eskisehir Osmangazi University, Eskisehir, Turkey
| |
Collapse
|
26
|
Böhm L, Maxeiner J, Meyer-Martin H, Reuter S, Finotto S, Klein M, Schild H, Schmitt E, Bopp T, Taube C. IL-10 and regulatory T cells cooperate in allergen-specific immunotherapy to ameliorate allergic asthma. THE JOURNAL OF IMMUNOLOGY 2014; 194:887-97. [PMID: 25527785 DOI: 10.4049/jimmunol.1401612] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Human studies demonstrated that allergen-specific immunotherapy (IT) represents an effective treatment for allergic diseases. IT involves repeated administration of the sensitizing allergen, indicating a crucial contribution of T cells to its medicinal benefit. However, the underlying mechanisms of IT, especially in a chronic disease, are far from being definitive. In the current study, we sought to elucidate the suppressive mechanisms of IT in a mouse model of chronic allergic asthma. OVA-sensitized mice were challenged with OVA or PBS for 4 wk. After development of chronic airway inflammation, mice received OVA-specific IT or placebo alternately to airway challenge for 3 wk. To analyze the T cell-mediated mechanisms underlying IT in vivo, we elaborated the role of T-bet-expressing Th1 cells, T cell-derived IL-10, and Ag-specific thymic as well as peripherally induced Foxp3(+) regulatory T (Treg) cells. IT ameliorated airway hyperresponsiveness and airway inflammation in a chronic asthma model. Of note, IT even resulted in a regression of structural changes in the airways following chronic inhaled allergen exposure. Concomitantly, IT induced Th1 cells, Foxp3(+), and IL-10-producing Treg cells. Detailed analyses revealed that thymic Treg cells crucially contribute to the effectiveness of IT by promoting IL-10 production in Foxp3-negative T cells. Together with the peripherally induced Ag-specific Foxp3(+) Treg cells, thymic Foxp3(+) Treg cells orchestrate the curative mechanisms of IT. Taken together, we demonstrate that IT is effective in a chronic allergic disease and dependent on IL-10 and thymic as well as peripherally induced Ag-specific Treg cells.
Collapse
Affiliation(s)
- Livia Böhm
- Institute for Immunology, University Medical Center Mainz, 55131 Mainz, Germany
| | - Joachim Maxeiner
- Institute for Immunology, University Medical Center Mainz, 55131 Mainz, Germany
| | - Helen Meyer-Martin
- Department of Pulmonary Medicine, III Medical Clinic, University Medical Center Mainz, 55131 Mainz, Germany
| | - Sebastian Reuter
- Department of Pulmonary Medicine, III Medical Clinic, University Medical Center Mainz, 55131 Mainz, Germany
| | - Susetta Finotto
- Institute of Molecular Pneumology, Friedrich-Alexander-University Erlangen-Nürnberg, 91054 Erlangen, Germany; and
| | - Matthias Klein
- Institute for Immunology, University Medical Center Mainz, 55131 Mainz, Germany
| | - Hansjörg Schild
- Institute for Immunology, University Medical Center Mainz, 55131 Mainz, Germany
| | - Edgar Schmitt
- Institute for Immunology, University Medical Center Mainz, 55131 Mainz, Germany
| | - Tobias Bopp
- Institute for Immunology, University Medical Center Mainz, 55131 Mainz, Germany
| | - Christian Taube
- Department of Pulmonology, University Medical Center Leiden, 2333 ZA Leiden, the Netherlands
| |
Collapse
|
27
|
Cingi C, Muluk NB, Hanci D, Ulusoy S, Sahin F. Updating the role played by immunotherapy for allergic rhinitis: meta-analysis. Int Forum Allergy Rhinol 2014; 5:132-42. [DOI: 10.1002/alr.21447] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2014] [Revised: 10/08/2014] [Accepted: 10/10/2014] [Indexed: 12/15/2022]
Affiliation(s)
- Cemal Cingi
- Department of Otorhinolaryngology; Medical Faculty, Eskisehir Osmangazi University; Eskisehir Turkey
| | - Nuray Bayar Muluk
- Department of Otorhinolaryngology; Medical Faculty, Kirikkale University; Kirikkale Turkey
| | - Deniz Hanci
- Ear Nose and Throat (ENT) Department; Liv Hospital; Istanbul Turkey
| | - Seckin Ulusoy
- ENT Clinics; Gaziosmanpaşa Taksim Education and Research Hospital; Istanbul Turkey
| | - Fezan Sahin
- Department of Biostatistics, Medical Faculty; Eskisehir Osmangazi University; Eskisehir Turkey
| |
Collapse
|
28
|
Cabrera CM, Urra JM, Alfaya T, Roca FDL, Feo-Brito F. Expression of Th1, Th2, lymphocyte trafficking and activation markers on CD4+ T-cells of Hymenoptera allergic subjects and after venom immunotherapy. Mol Immunol 2014; 62:178-85. [PMID: 25004111 DOI: 10.1016/j.molimm.2014.06.023] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Revised: 06/13/2014] [Accepted: 06/16/2014] [Indexed: 11/28/2022]
Abstract
Systemic reactions to Hymenoptera stings can be fatal and represent a reduction in the quality of life. The immune mechanisms involved in venom allergic subjects are barely known. Nevertheless, a shift towards a Th1-type response with an increase in IFNγ levels has been observed after venom immunotherapy (VIT). There is currently no information available about the expression of markers on CD4+ T-cells or their involvement in venom allergy, nor following VIT. For this, we have studied the expression of Th1 and Th2-cell markers, homing receptors and activation markers on CD4+ T-cells of subjects who presented systemic allergic reactions, mainly to Polistes dominulus, and after receiving a 4-month conventional VIT protocol. The markers studied were: CD26 (Th1), CD30 (Th2), CXCR4, CXCR3 (Th1), CCR4 (Th2), CD154 (CD40L), CD152 (CTLA-A), and ICOS. We also determined the IL-4 (Th2) and IFNγ (Th1) intracellular cytokine levels in T-cells and carried out a basophil activation test (BAT). Comparing venom allergic subjects with non-allergic healthy controls, we have found up-regulation of CD26, CXCR4, CXCR3, CD154 and ICOS. Conversely, a down-regulation of CD30, CD154 and CD152 occurred upon immune intervention, whereas the remaining markers were not affected. Equally, VIT has been shown to be effective, as evidenced by the decrease of basophil degranulation and increase of IFNγ levels in T-cells after the fourth month of treatment. These new findings highlight the possible application of these surface molecules as markers to distinguish between symptomatic and asymptomatic subjects sensitized to Hymenoptera venom, as well as revealing information about the immune changes associated with VIT.
Collapse
Affiliation(s)
- Carmen M Cabrera
- Immunology Section, Servicio de Análisis Clínicos, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain.
| | - José M Urra
- Immunology Section, Servicio de Análisis Clínicos, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain
| | - Teresa Alfaya
- Allergy Section, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain
| | - Federico De La Roca
- Allergy Section, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain
| | - Francisco Feo-Brito
- Allergy Section, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain
| |
Collapse
|
29
|
Heydenreich B, Bellinghausen I, Lund L, Henmar H, Lund G, Adler Würtzen P, Saloga J. Adjuvant effects of aluminium hydroxide-adsorbed allergens and allergoids - differences in vivo and in vitro. Clin Exp Immunol 2014; 176:310-9. [PMID: 24528247 DOI: 10.1111/cei.12294] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/05/2014] [Indexed: 12/26/2022] Open
Abstract
Allergen-specific immunotherapy (SIT) is a clinically effective therapy for immunoglobulin (Ig)E-mediated allergic diseases. To reduce the risk of IgE-mediated side effects, chemically modified allergoids have been introduced. Furthermore, adsorbance of allergens to aluminium hydroxide (alum) is widely used to enhance the immune response. The mechanisms behind the adjuvant effect of alum are still not completely understood. In the present study we analysed the effects of alum-adsorbed allergens and allergoids on their immunogenicity in vitro and in vivo and their ability to activate basophils of allergic donors. Human monocyte derived dendritic cells (DC) were incubated with native Phleum pratense or Betula verrucosa allergen extract or formaldehyde- or glutaraldehyde-modified allergoids, adsorbed or unadsorbed to alum. After maturation, DC were co-cultivated with autologous CD4(+) T cells. Allergenicity was tested by leukotriene and histamine release of human basophils. Finally, in-vivo immunogenicity was analysed by IgG production of immunized mice. T cell proliferation as well as interleukin (IL)-4, IL-13, IL-10 and interferon (IFN)-γ production were strongly decreased using glutaraldehyde-modified allergoids, but did not differ between alum-adsorbed allergens or allergoids and the corresponding unadsorbed preparations. Glutaraldehyde modification also led to a decreased leukotriene and histamine release compared to native allergens, being further decreased by adsorption to alum. In vivo, immunogenicity was reduced for allergoids which could be partly restored by adsorption to alum. Our results suggest that adsorption of native allergens or modified allergoids to alum had no consistent adjuvant effect but led to a reduced allergenicity in vitro, while we observed an adjuvant effect regarding IgG production in vivo.
Collapse
Affiliation(s)
- B Heydenreich
- Department of Dermatology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | | | | | | | | | | | | |
Collapse
|
30
|
Escobar A, Aguirre A, Guzmán MA, González R, Catalán D, Acuña-Castillo C, Larrondo M, López M, Pesce B, Rolland J, O’Hehir R, Aguillón JC. Tolerogenic dendritic cells derived from donors with natural rubber latex allergy modulate allergen-specific T-cell responses and IgE production. PLoS One 2014; 9:e85930. [PMID: 24465795 PMCID: PMC3899084 DOI: 10.1371/journal.pone.0085930] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2013] [Accepted: 12/03/2013] [Indexed: 11/25/2022] Open
Abstract
Natural rubber latex (NRL; Hevea brasiliensis) allergy is an IgE-mediated reaction to latex proteins. When latex glove exposure is the main sensitizing agent, Hev b 5 is one of the major allergens. Dendritic cells (DC), the main antigen presenting cells, modulated with pharmacological agents can restore tolerance in several experimental models, including allergy. In the current study, we aimed to generate DC with tolerogenic properties from NRL-allergic patients and evaluate their ability to modulate allergen-specific T and B cell responses. Here we show that dexamethasone-treated DC (dxDC) differentiated into a subset of DC, characterized by low expression of MHC class II, CD40, CD80, CD86 and CD83 molecules. Compared with LPS-matured DC, dxDC secreted lower IL-12 and higher IL-10 after CD40L activation, and induced lower alloantigenic T cell proliferation. We also show that dxDC pulsed with the dominant Hev b 5 T-cell epitope peptide, Hev b 546–65, inhibited both proliferation of Hev b 5-specific T-cell lines and the production of Hev b 5-specific IgE. Additionally, dxDC induced a subpopulation of IL-10-producing regulatory T cells that suppressed proliferation of Hev b 5-primed T cells. In conclusion, dxDC generated from NRL-allergic patients can modulate allergen-specific T-cell responses and IgE production, supporting their potential use in allergen-specific immunotherapy.
Collapse
Affiliation(s)
- Alejandro Escobar
- Research Institute of Dental Science, Faculty of Dentistry, University of Chile, Santiago, Chile
- * E-mail: (AE); (JCA)
| | - Adam Aguirre
- Department of Pharmacy, Faculty of Chemistry, Catholic University of Chile, Santiago, Chile
| | - María Antonieta Guzmán
- Allergy Center, Clinical Hospital of University of Chile, University of Chile, Santiago, Chile
| | - Rodrigo González
- Blood bank Clinical Hospital of University of Chile, University of Chile, Santiago, Chile
| | - Diego Catalán
- Immunology Program, Faculty of Medicine, University of Chile Millennium Institute on Immunology and Immunotherapy, Santiago, Chile
| | - Claudio Acuña-Castillo
- Department of Biology, Faculty of Chemistry and Biology, University of Santiago, Santiago, Chile
| | - Milton Larrondo
- Blood bank Clinical Hospital of University of Chile, University of Chile, Santiago, Chile
| | - Mercedes López
- Immunology Program, Faculty of Medicine, University of Chile Millennium Institute on Immunology and Immunotherapy, Santiago, Chile
| | - Barbara Pesce
- Immunology Program, Faculty of Medicine, University of Chile Millennium Institute on Immunology and Immunotherapy, Santiago, Chile
| | - Jennifer Rolland
- Department of Immunology, AMREP, Monash University, Melbourne, Australia
| | - Robyn O’Hehir
- Department of Immunology, AMREP, Monash University, Melbourne, Australia
| | - Juan Carlos Aguillón
- Immunology Program, Faculty of Medicine, University of Chile Millennium Institute on Immunology and Immunotherapy, Santiago, Chile
- * E-mail: (AE); (JCA)
| |
Collapse
|
31
|
|
32
|
Abstract
Introduction Broad-spectrum grass pollen immunotherapies contain large numbers of allergenic proteins from multiple species. The principle of homologous grouping is used as a tool to assist in the standardization of allergen immunotherapy. This study reviews the principle of homologous grouping, questions what an exemplar grass should be, and queries whether a 1-way system of inferring homology is appropriate. Methods Grass pollens were extracted and analyzed using a variety of techniques, including enzyme-linked immunosorbent assay, Bradford protein assay, sodium dodecyl sulfate-polyacrylamide gel electrophoresis, and quantitative analysis of Western blots. Results Variation in protein content, IgG, IgE, and Phl p 5 reactivity is evident among all grasses analyzed. There is significant evidence of similarity but also disparity consistent with variation resulting from evolutionary change. Proprietary software called Gel Electrophoresis Protein Profile Analysis has been developed, which highlights that each grass exhibits a greater than 55% similarity measure; this is considered high similarity. Discussion None of the grass species examined display an identical biological profile. However, data indicate that there is a high degree of homology, and Crested Dogstail is similar to each of the other 12 species analyzed; these levels of similarity can only be possible because of molecular profile and extensive sharing of epitopes. These data are considered to be sufficient to include Crested Dogstail within the sweet grasses group of the Pooideae family; however, the subtle differences in grasses also justify the inclusion of multiple species to create a broad-spectrum immunotherapy.
Collapse
|
33
|
Čelesnik N, Vesel T, Rijavec M, Šilar M, Eržen R, Košnik M, Kloft Žitnik SE, Avčin T, Korošec P. Short-term venom immunotherapy induces desensitization of FcεRI-mediated basophil response. Allergy 2012; 67:1594-600. [PMID: 23066930 DOI: 10.1111/all.12044] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/30/2012] [Indexed: 12/01/2022]
Abstract
BACKGROUND The precise immunological mechanisms for the early clinical protection of venom immunotherapy (VIT) have not yet been explained. Our aim was to evaluate whether high-affinity IgE receptor (FcεRI) and the related basophil function have a role in the induction of short-term VIT protection. METHODS We included 60 adults and 48 children. Basophil threshold sensitivity (CD-sens) to anti-FcεRI stimulation, and FcεRI gene and cell-surface expression were assessed at the beginning and just before the first maintenance dose (MD) of 100 μg of ultra-rush VIT (day 5) and at the beginning, during buildup, and just before the first MD of 70 μg and of 100 μg of semi-rush VIT (weeks 1-2 and 5). RESULTS We demonstrated a significant reduction in CD-sens to anti-FcεRI stimulation before the first MD in both ultra-rush and semi-rush VIT in all included subjects. FcεRI gene and/or cell-surface expression was decreased in 34-100% of subjects, with different dynamics between VIT protocols. CONCLUSION We found a marked desensitization of FcεRI-activated basophils after short-term VIT. This suppression, which could be highly relevant for the development of early protective mechanisms, might be also related to the changes at the level of FcεRI expression.
Collapse
Affiliation(s)
- N. Čelesnik
- University Clinic of Respiratory and Allergic Diseases Golnik; Golnik; Slovenia
| | - T. Vesel
- Department of Allergy, Rheumatology and Clinical Immunology; Ljubljana University Children's Hospital; Ljubljana; Slovenia
| | - M. Rijavec
- University Clinic of Respiratory and Allergic Diseases Golnik; Golnik; Slovenia
| | - M. Šilar
- University Clinic of Respiratory and Allergic Diseases Golnik; Golnik; Slovenia
| | - R. Eržen
- University Clinic of Respiratory and Allergic Diseases Golnik; Golnik; Slovenia
| | - M. Košnik
- University Clinic of Respiratory and Allergic Diseases Golnik; Golnik; Slovenia
| | - S. E. Kloft Žitnik
- Department of Allergy, Rheumatology and Clinical Immunology; Ljubljana University Children's Hospital; Ljubljana; Slovenia
| | - T. Avčin
- Department of Allergy, Rheumatology and Clinical Immunology; Ljubljana University Children's Hospital; Ljubljana; Slovenia
| | - P. Korošec
- University Clinic of Respiratory and Allergic Diseases Golnik; Golnik; Slovenia
| |
Collapse
|
34
|
Vaughan K, Peters B, Larche M, Pomes A, Broide D, Sette A. Strategies to query and display allergy-derived epitope data from the immune epitope database. Int Arch Allergy Immunol 2012; 160:334-45. [PMID: 23172234 DOI: 10.1159/000343880] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
The recognition of specific epitopes on allergens by antibodies and T cells is a key element in allergic processes. Analysis of epitope data may be of interest for basic immunopathology or for potential application in diagnostics or immunotherapy. The Immune Epitope Database (IEDB) is a freely available repository of epitope data from infectious disease agents, as well as epitopes defined for allergy, autoimmunity, and transplantation. The IEDB curates the experiments associated with each epitope and thus provides a variety of different ways to search the data. This review aims to demonstrate the utility of the IEDB and its query strategies, including searching by epitope structure (peptidic/nonpeptidic), by assay methodology, by host, by the allergen itself, or by the organism from which the allergen was derived. Links to tools for visualization of 3-D structures, epitope prediction, and analyses of B and T cell reactivity by host response frequency score are also highlighted.
Collapse
Affiliation(s)
- Kerrie Vaughan
- Immune Epitope Database and Analysis Resource (IEDB), La Jolla Institute for Allergy and Immunology, La Jolla, CA 92037, USA.
| | | | | | | | | | | |
Collapse
|
35
|
Chung ES, Kim H, Lee G, Park S, Kim H, Bae H. Neuro-protective effects of bee venom by suppression of neuroinflammatory responses in a mouse model of Parkinson's disease: role of regulatory T cells. Brain Behav Immun 2012; 26:1322-30. [PMID: 22974722 DOI: 10.1016/j.bbi.2012.08.013] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2012] [Revised: 08/15/2012] [Accepted: 08/25/2012] [Indexed: 10/27/2022] Open
Abstract
In the present study, we sought to determine whether bee venom (BV) promotes the survival of dopaminergic (DA) neurons in the 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) mouse model of Parkinson's disease (PD). Treatment with BV prevented degeneration of DA neurons in the substantia nigra (SN). This neuro-protective effect of BV was associated with microglial deactivation and reduction of CD4 T cell infiltration. Additionally, BV treatment significantly increased the proportion of CD4(+)CD25(+)Foxp3(+) Tregs in vivo and in vitro. The increased proportion of Tregs by BV treatment remained suppressive ex vivo. Interestingly, BV treatment did not prevent MPTP neurotoxicity in mice depleted of Tregs by anti-CD25 antibody injection. Therefore, our present studies suggest that modulation of peripheral immune tolerance by Treg may contribute to the neuroprotective effect of BV in the MPTP model of Parkinson's disease.
Collapse
Affiliation(s)
- Eun Sook Chung
- Department of Physiology, College of Oriental Medicine, Kyung Hee University, Seoul, Republic of Korea
| | | | | | | | | | | |
Collapse
|
36
|
Eiwegger T, Gruber S, Szépfalusi Z, Akdis CA. Novel developments in the mechanisms of immune tolerance to allergens. Hum Vaccin Immunother 2012; 8:1485-91. [PMID: 23095863 DOI: 10.4161/hv.20903] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Allergy is the result of a disbalanced immune response to environmental innocuous antigens. Despite of accumulating data to define the pathomechanisms that take place in case of allergic diseases a detailed understanding of sequence of events that lead to the "normal" scenario of tolerance development are still under debate. Allergen-specific immunotherapy is the only causal treatment of allergic diseases. It modifies the immune response to a particular antigen to achieve tolerance against the symptom-causing allergen. This process is considered to mirror physiological peripheral tolerance induction. A number of immunological changes have been described to occur under allergen immunotherapy, including the generation of allergen-specific regulatory T cells, the induction of allergen-specific IgG4, an increase in the Th1/Th2 cytokine ratio and decreased activation and function of effector cells such as mast cells, basophils and eosinophils.
Collapse
Affiliation(s)
- Thomas Eiwegger
- Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Austria
| | | | | | | |
Collapse
|
37
|
Evaluation of immunostimulatory activities of synthetic mannose-containing structures mimicking the β-(1->2)-linked cell wall mannans of Candida albicans. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2012; 19:1889-93. [PMID: 22993407 DOI: 10.1128/cvi.00298-12] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Immunostimulatory properties of synthetic structures mimicking the β-(1→2)-linked mannans of Candida albicans were evaluated in vitro. Contrary to earlier observations, tumor necrosis factor (TNF) production was not detected after stimulation with mannotetraose in mouse macrophages. Divalent disaccharide 1,4-bis(α-D-mannopyranosyloxy)butane induced TNF and some molecules induced low levels of gamma interferon (IFN-γ) in human peripheral blood mononuclear cells (PBMC).
Collapse
|
38
|
Faith A, Singh N, Farooque S, Dimeloe S, Richards DF, Lu H, Roberts D, Chevretton E, Lee TH, Corrigan CJ, Hawrylowicz CM. T cells producing the anti-inflammatory cytokine IL-10 regulate allergen-specific Th2 responses in human airways. Allergy 2012; 67:1007-13. [PMID: 22671764 DOI: 10.1111/j.1398-9995.2012.02852.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2012] [Indexed: 12/25/2022]
Abstract
BACKGROUND Murine models suggest a critical functional role for the anti-inflammatory cytokine IL-10 in local regulation of allergic airways inflammation. There is little corresponding information on human airway cells. This study aimed to investigate whether local IL-10 production regulates responses by respiratory mucosal leucocytes isolated from nasal polyps. MATERIALS AND METHODS Nasal polyp tissue was harvested from 24 patients sensitised to aeroallergens with chronic rhinitis and polyposis undergoing routine polypectomy. Cells were isolated by matrix proteolysis. Cytokine production by polyp cells was determined by cytometric bead array (CBA) and intracellular cytokine analysis. Surface marker expression by polyp cells was determined by flow cytometry. RESULTS Allergen stimulation significantly enhanced production of IL-10, but not IL-5 or IFN-γ by nasal polyp cell suspensions. Under the same conditions, neutralisation of IL-10 significantly increased allergen-specific IL-5 and IFN-γ production by nasal polyp cells. Cell depletion experiments showed that T cells themselves were primarily responsible for IL-10 production or for inducing its production by other cells. Intracellular cytokine staining confirmed production of IL-10 in the absence of IL-2 production by T cells in response to allergen. CONCLUSION T cells within the human respiratory mucosa produce IL-10, which is capable of inhibiting pro-inflammatory Th2 and Th1 cytokine production in an antigen-specific fashion.
Collapse
Affiliation(s)
- A. Faith
- MRC-Asthma UK Centre in Allergic Mechanisms of Asthma; King's College London School of Medicine; UK
| | | | - S. Farooque
- MRC-Asthma UK Centre in Allergic Mechanisms of Asthma; King's College London School of Medicine; UK
| | - S. Dimeloe
- MRC-Asthma UK Centre in Allergic Mechanisms of Asthma; King's College London School of Medicine; UK
| | - D. F. Richards
- MRC-Asthma UK Centre in Allergic Mechanisms of Asthma; King's College London School of Medicine; UK
| | - H. Lu
- MRC-Asthma UK Centre in Allergic Mechanisms of Asthma; King's College London School of Medicine; UK
| | - D. Roberts
- The Ear Nose and Throat Department; Guy's and St Thomas' Hospitals; King's College London; London; UK
| | - E. Chevretton
- The Ear Nose and Throat Department; Guy's and St Thomas' Hospitals; King's College London; London; UK
| | - T. H. Lee
- MRC-Asthma UK Centre in Allergic Mechanisms of Asthma; King's College London School of Medicine; UK
| | - C. J. Corrigan
- MRC-Asthma UK Centre in Allergic Mechanisms of Asthma; King's College London School of Medicine; UK
| | - C. M. Hawrylowicz
- MRC-Asthma UK Centre in Allergic Mechanisms of Asthma; King's College London School of Medicine; UK
| |
Collapse
|
39
|
Etto T, de Boer C, Prickett S, Gardner LM, Voskamp A, Davies JM, O'Hehir RE, Rolland JM. Unique and cross-reactive T cell epitope peptides of the major Bahia grass pollen allergen, Pas n 1. Int Arch Allergy Immunol 2012; 159:355-66. [PMID: 22832594 DOI: 10.1159/000338290] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2011] [Accepted: 03/16/2012] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Bahia grass pollen (BaGP) is a major cause of allergic rhinitis. Subcutaneous allergen-specific immunotherapy is effective for grass pollen allergy, but is unsuitable for patients with moderate to severe asthma due to the risk of anaphylaxis. T cell-reactive but IgE nonreactive peptides provide a safer treatment option. This study aimed to identify and characterize dominant CD4(+) T cell epitope peptides of the major BaGP allergen, Pas n 1. METHODS Pas n 1-specific T cell lines generated from the peripheral blood of BaGP-allergic subjects were tested for proliferative and cytokine response to overlapping 20-mer Pas n 1 peptides. Cross-reactivity to homologous peptides from Lol p 1 and Cyn d 1 of Ryegrass and Bermuda grass pollen, respectively, was assessed using Pas n 1 peptide-specific T cell clones. MHC class II restriction of Pas n 1 peptide T cell recognition was determined by HLA blocking assays and peptide IgE reactivity tested by dot blotting. RESULTS Three Pas n 1 peptides showed dominant T cell reactivity; 15 of 18 (83%) patients responded to one or more of these peptides. T cell clones specific for dominant Pas n 1 peptides showed evidence of species-specific T cell reactivity as well as cross-reactivity with other group 1 grass pollen allergens. The dominant Pas n 1 T cell epitope peptides showed HLA binding diversity and were non-IgE reactive. CONCLUSIONS The immunodominant T cell-reactive Pas n 1 peptides are candidates for safe immunotherapy for individuals, including those with asthma, who are allergic to Bahia and possibly other grass pollens.
Collapse
Affiliation(s)
- Tamara Etto
- Department of Immunology, Monash University, Melbourne, Vic., Australia
| | | | | | | | | | | | | | | |
Collapse
|
40
|
Heydenreich B, Bellinghausen I, Lorenz S, Henmar H, Strand D, Würtzen PA, Saloga J. Reduced in vitro T-cell responses induced by glutaraldehyde-modified allergen extracts are caused mainly by retarded internalization of dendritic cells. Immunology 2012; 136:208-17. [PMID: 22348538 DOI: 10.1111/j.1365-2567.2012.03571.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Although allergen-specific immunotherapy is a clinically effective therapy for IgE-mediated allergic diseases, the risk of IgE-mediated adverse effects still exists. For this reason, chemically modified allergoids have been introduced, which may destroy IgE-binding sites while T-cell activation should be retained. The aim of the study was to analyse the differences between intact allergens and differently modified/aggregated allergoids concerning their internalization as well as T-cell and basophil activation. For this purpose human monocyte-derived immature dendritic cells (DC) were incubated with Phleum pratense or Betula verrucosa pollen extract or with the corresponding allergoids, modified with formaldehyde or glutaraldehyde. After an additional maturation process, the antigen-loaded mature DC were co-cultured with autologous CD4(+) T cells. Allergenicity was tested by leukotriene release from basophils. In addition, the uptake of intact allergens and allergoids by immature DC was analysed. The proliferation of, as well as the interleukin-4 (IL-4), IL-10, IL-13 and interferon-γ production by, CD4(+) T cells which had been stimulated with glutaraldehyde allergoid-treated DC was reduced compared with CD4(+) T cells stimulated with intact allergen-treated or formaldehyde allergoid-treated DC. In line with this, glutaraldehyde-modified allergoids were more aggregated and were internalized more slowly. Furthermore, only the allergoids modified with glutaraldehyde induced a decreased leukotriene release by activated basophils. These findings suggest that IgE-reactive epitopes were destroyed more efficiently by modification with glutaraldehyde than with formaldehyde under the conditions chosen for these investigations. Glutaraldehyde-modified allergoids also displayed lower T-cell stimulatory capacity, which is mainly the result of greater modification/aggregation and diminished uptake by DC.
Collapse
Affiliation(s)
- Bärbel Heydenreich
- Department of Dermatology, University Medical Centre, Johannes Gutenberg-University, Mainz, Germany
| | | | | | | | | | | | | |
Collapse
|
41
|
Wang S, Delgado JC, Ravkov E, Eckels DD, Georgelas A, Pavlov IY, Cusick M, Sebastian K, Gleich GJ, Wagner LA. Penaeus monodon tropomyosin induces CD4 T-cell proliferation in shrimp-allergic patients. Hum Immunol 2011; 73:426-31. [PMID: 22244920 DOI: 10.1016/j.humimm.2011.12.019] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2011] [Revised: 12/02/2011] [Accepted: 12/21/2011] [Indexed: 11/25/2022]
Abstract
Shellfish allergy affects approximately 2% of the population and can cause immediate hypersensitivity reactions such as urticaria, swelling, difficulty breathing, and, in some cases, anaphylaxis. Tropomyosin is the major shrimp allergen and binds IgE in two-thirds of patients. A total of 38 shrimp-allergic patients and 20 negative control subjects were recruited and evaluated on the basis of history, skin prick testing, specific immunoglobulin E (IgE) levels, and peripheral blood mononuclear cell proliferation in response to shrimp tropomyosin or shrimp tropomyosin-derived peptides. Of the classically allergic patients by history, 59% tested positive for serum shrimp IgE antibodies. Of patients with shrimp-specific IgE in sera, 70% also had significant IgE levels specific for shrimp tropomyosin. Peripheral blood mononuclear cells from classically shrimp-allergic patients proliferated in a dose-dependent manner in response to to tropomyosin. In addition, a T-cell line derived from a shrimp-allergic patient proliferated specifically in response to tropomyosin-derived peptides. These studies suggest a strategy for immunotherapy using a tropomyosin-derived T-cell epitope vaccination.
Collapse
Affiliation(s)
- Shuping Wang
- Department of Dermatology, University of Utah, Salt Lake City, Utah, USA
| | | | | | | | | | | | | | | | | | | |
Collapse
|
42
|
In-vitro-Diagnostik und Monitoring bei Insektengifthyposensibilisierung. Hautarzt 2011; 62:677-82. [DOI: 10.1007/s00105-011-2160-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
43
|
Krishna MT, Ewan PW, Diwakar L, Durham SR, Frew AJ, Leech SC, Nasser SM. Diagnosis and management of hymenoptera venom allergy: British Society for Allergy and Clinical Immunology (BSACI) guidelines. Clin Exp Allergy 2011; 41:1201-20. [DOI: 10.1111/j.1365-2222.2011.03788.x] [Citation(s) in RCA: 129] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
44
|
Shakir EM, Cheung DS, Grayson MH. Mechanisms of immunotherapy: a historical perspective. Ann Allergy Asthma Immunol 2011; 105:340-7; quiz 348, 368. [PMID: 21055659 DOI: 10.1016/j.anai.2010.09.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2010] [Revised: 09/08/2010] [Accepted: 09/09/2010] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To provide a historical review of mechanisms proposed during the last century to explain the efficacy of immunotherapy. DATA SOURCES We retrieved review articles and original research from MEDLINE, OVID, and PubMed that addressed our topic of interest. STUDY SELECTION Articles were selected for their relevance to immunotherapy and mechanisms. RESULTS Early studies focused on the production of blocking antibodies induced by immunotherapy, with mechanistic explanations aimed at understanding a relationship between blocking antibodies and clinical response. This was followed by a period when the effects of immunotherapy on levels and function of effector cells in the allergic response were studied. Aiding in characterization of this response was the discovery of IgE and its role in allergic sensitization, which brought a renewed focus on the antibody-mediated effects of immunotherapy. In an attempt to create a unifying hypothesis to explain humoral and cellular mechanisms of immunotherapy, recent approaches have been focused on the role of the T cell and, specifically, regulatory T cells. CONCLUSIONS Although the clinical practice of immunotherapy has been refined since its introduction 100 years ago, our understanding of the mechanisms that underlie this success has awaited discoveries in basic immunology.
Collapse
Affiliation(s)
- Ebrahim M Shakir
- Section of Allergy and Immunology, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin 53226, USA
| | | | | |
Collapse
|
45
|
Clinical practice: Allergen-specific immunotherapy in children: facts and FAQs. Eur J Pediatr 2011; 170:137-48. [PMID: 21153032 DOI: 10.1007/s00431-010-1348-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2010] [Accepted: 11/04/2010] [Indexed: 10/18/2022]
Abstract
Allergen-specific immunotherapy (SIT) in its various application forms represents the main treatment approach of IgE-mediated allergic diseases in adults and children. Despite this clear recommendation, many particularities of products, patient characteristics, and product availability in different countries hamper the use of allergen-specific immunotherapy in particular in children. The frequently asked questions by parents, patients, and physicians are the backbone of this review. Thus, the potentials and limitations of allergen-specific immunotherapy in children and adolescents will be highlighted. IgE-mediated allergic diseases are affecting about 20% of the population. They manifest commonly early in life, and hence, the use of SIT should be considered also early in the course of the disease.
Collapse
|
46
|
Cox L, Nelson H, Lockey R, Calabria C, Chacko T, Finegold I, Nelson M, Weber R, Bernstein DI, Blessing-Moore J, Khan DA, Lang DM, Nicklas RA, Oppenheimer J, Portnoy JM, Randolph C, Schuller DE, Spector SL, Tilles S, Wallace D. Allergen immunotherapy: A practice parameter third update. J Allergy Clin Immunol 2011; 127:S1-55. [DOI: 10.1016/j.jaci.2010.09.034] [Citation(s) in RCA: 597] [Impact Index Per Article: 45.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2010] [Accepted: 09/23/2010] [Indexed: 10/18/2022]
|
47
|
Safety, tolerability, and immunologic effects of a food allergy herbal formula in food allergic individuals: a randomized, double-blinded, placebo-controlled, dose escalation, phase 1 study. Ann Allergy Asthma Immunol 2010; 105:75-84. [PMID: 20642207 DOI: 10.1016/j.anai.2010.05.005] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Food allergy is a common and serious health problem. A new herbal product, called food allergy herbal formula 2 (FAHF-2), has been demonstrated to have a high safety profile and potent long-term efficacy in a murine model of peanut-induced anaphylaxis. OBJECTIVE To evaluate the safety and tolerability of FAHF-2 in patients with food allergy. METHODS In this randomized, double-blinded, placebo-controlled, dose escalation, phase 1 trial, patients received 1 of 3 doses of FAHF-2 or placebo: 2.2 g (4 tablets), 3.3 g (6 tablets), or 6.6 g (12 tablets) 3 times a day for 7 days. Four active and 2 placebo patients were treated at each dose level. Vital signs, physical examination results, laboratory data, pulmonary function test results, and electrocardiogram data were monitored. Immunomodulatory studies were also performed. RESULTS Nineteen food allergic participants were included in the study. Two patients (1 in the FAHF-2 group and 1 in the placebo group) reported mild gastrointestinal symptoms. One patient withdrew from the study because of an allergic reaction that was unlikely related to the study medication. No significant differences were found in vital signs, physical examination results, laboratory data, pulmonary function test results, and electrocardiogram data obtained before and after treatment visits. Significantly decreased interleukin (IL) 5 levels were found in the active treatment group after 7 days. In vitro studies of peripheral blood mononuclear cells cultured with FAHF-2 also demonstrated a significant decrease in IL-5 and an increase in culture supernatant interferon gamma and IL-10 levels. CONCLUSIONS FAHF-2 appeared to be safe and well tolerated in patients with food allergy.
Collapse
|
48
|
Abstract
The absolute requirement of the pulmonary immune system is to limit the inflammatory consequences of inhaled infectious agents while maintaining tolerance to harmless aeroallergens. This tolerance is maintained by a complex network of cells and molecules interacting with lung stromal cells. However, in some individuals there is a breakdown in tolerance to particles such as pollens, animal dander, or dust, resulting in the development of allergic pathology. Emerging evidence suggests that this breakdown in tolerance is influenced by the genetic background of individuals as well as environmental considerations such as early exposure to respiratory pathogens. Further understanding of the mechanisms used by the pulmonary immune system to maintain tolerance might result in exploitation of novel avenues for therapy to treat the growing number of chronic asthmatic patients.
Collapse
Affiliation(s)
- C M Lloyd
- Leukocyte Biology Section, National Heart and Lung Institute, Faculty of Medicine, Imperial College, London, UK.
| | | |
Collapse
|
49
|
Aslam A, Chan H, Warrell DA, Misbah S, Ogg GS. Tracking antigen-specific T-cells during clinical tolerance induction in humans. PLoS One 2010; 5:e11028. [PMID: 20543955 PMCID: PMC2882953 DOI: 10.1371/journal.pone.0011028] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2009] [Accepted: 04/25/2010] [Indexed: 11/21/2022] Open
Abstract
Allergen immunotherapy presents an opportunity to define mechanisms of induction of clinical tolerance in humans. Significant progress has been made in our understanding of changes in T cell responses during immunotherapy, but existing work has largely been based on functional T cell assays. HLA-peptide-tetrameric complexes allow the tracking of antigen-specific T-cell populations based on the presence of specific T-cell receptors and when combined with functional assays allow a closer assessment of the potential roles of T-cell anergy and clonotype evolution. We sought to develop tools to facilitate tracking of antigen-specific T-cell populations during wasp-venom immunotherapy in people with wasp-venom allergy. We first defined dominant immunogenic regions within Ves v 5, a constituent of wasp venom that is known to represent a target antigen for T-cells. We next identified HLA-DRB1*1501 restricted epitopes and used HLA class II tetrameric complexes alongside cytokine responses to Ves v 5 to track T-cell responses during immunotherapy. In contrast to previous reports, we show that there was a significant initial induction of IL-4 producing antigen-specific T-cells within the first 3–5 weeks of immunotherapy which was followed by reduction of circulating effector antigen-specific T-cells despite escalation of wasp-venom dosage. However, there was sustained induction of IL-10-producing and FOXP3 positive antigen-specific T cells. We observed that these IL-10 producing cells could share a common precursor with IL-4-producing T cells specific for the same epitope. Clinical tolerance induction in humans is associated with dynamic changes in frequencies of antigen-specific T-cells, with a marked loss of IL-4-producing T-cells and the acquisition of IL-10-producing and FOXP3-positive antigen-specific CD4+ T-cells that can derive from a common shared precursor to pre-treatment effector T-cells. The development of new approaches to track antigen specific T-cell responses during immunotherapy can provide novel insights into mechanisms of tolerance induction in humans and identify new potential treatment targets.
Collapse
Affiliation(s)
- Aamir Aslam
- Medical Research Council Human Immunology Unit, National Institute of Health Research Biomedical Research Centre, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, United Kingdom
| | - Hsien Chan
- Medical Research Council Human Immunology Unit, National Institute of Health Research Biomedical Research Centre, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, United Kingdom
| | - David A. Warrell
- Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom
| | - Siraj Misbah
- Department of Clinical Immunology, John Radcliffe Hospital, Oxford, United Kingdom
| | - Graham S. Ogg
- Medical Research Council Human Immunology Unit, National Institute of Health Research Biomedical Research Centre, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, United Kingdom
- * E-mail:
| |
Collapse
|
50
|
Rosewich M, Schulze J, Eickmeier O, Telles T, Rose MA, Schubert R, Zielen S. Tolerance induction after specific immunotherapy with pollen allergoids adjuvanted by monophosphoryl lipid A in children. Clin Exp Immunol 2010; 160:403-10. [PMID: 20345983 DOI: 10.1111/j.1365-2249.2010.04106.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Specific immunotherapy (SIT) is a well-established and clinically effective treatment for allergic diseases. A pollen allergoid formulated with the T helper type 1 (Th1)-inducing adjuvant monophosphoryl lipid A (MPL) facilitates short-term SIT. Little is known about mechanisms of tolerance induction in this setting. In a prospective study, 34 patients allergic to grass pollen (25 male, nine female, median age 10.2 years) received a total of 44 SIT courses (20 in the first, 24 in the second) with MPL-adjuvanted pollen allergoids. Immunogenicity was measured by levels of specific immunoglobulin G (IgG(grass)) and IgG4(grass) by antibody blocking properties on basophil activation, and by induction of CD4(+), CD25(+) and forkhead box P3 (FoxP3(+)) regulatory T cells (T(reg)). Specific IgG and IgG4 levels increased only slightly in the first year of SIT. In the second year these changes reached significance (P < 0.0001). In keeping with these findings, we were able to show an increase of T(reg) cells and a decreased release of leukotrienes after the second year of treatment. In the first year of treatment we found little evidence for immunological changes. A significant antibody induction was seen only after the second course of SIT. Short-course immunotherapy with pollen allergoids formulated with the Th1-inducing adjuvant MPL needs at least two courses to establish tolerance.
Collapse
Affiliation(s)
- M Rosewich
- Paediatric Pulmonology and Allergology, Goethe University, Frankfurt/Main, Germany.
| | | | | | | | | | | | | |
Collapse
|