Persistence of early crosslink-dependent signal transduction events in human basophils after desensitization

Response of peripheral blood basophils in subjects with chronic spontaneous urticaria during treatment with omalizumab

BACKGROUND

Treatment of patients with asthma or food allergy with omalizumab results in several consistent changes in circulating basophils. The multiple basophil phenotypes observed in patients with chronic spontaneous urticaria (CSU) present some unique attributes that may not respond in a similar fashion to patients with asthma or food allergy. As part of a clinical study on the therapeutic outcomes of omalizumab treatment in CSU, the basophil compartment was examined for changes in characteristics predicted by prior studies.

OBJECTIVE

This study sought to examine the changes in basophil function and its relationship to auto-antibodies in serum during treatment with omalizumab.

METHODS

At multiple time points before and during omalizumab treatment of patients with CSU, basophil surface IgE and FcεRI expression, cellular spleen tyrosine kinase (SYK) expression, IgE-mediated histamine release (HR), and the presence of auto-antibodies in serum were determined.

RESULTS

Three basophil phenotypes were enumerated in the clinical study and used to group results in this basophil study: subjects with (1) basopenia, (2) normal basophil numbers with normal IgE-mediated HR, and (3) normal basophil numbers with poor HR. Basopenia was highly associated with the presence of auto-antibodies to unoccupied FcεRI and basophil numbers did not change during treatment. Likewise, subjects who are basopenic showed no changes in SYK expression or HR during treatment. In basophils of subjects who are nonbasopenic, increases in SYK expression and HR showed the expected inverse relationship to starting SYK and HR levels. Treatment with omalizumab resulted in similar kinetics for decreases in surface FcεRI and IgE in all 3 groups.

CONCLUSIONS

A unifying interpretation of the results revolves around the presence of auto-antibodies to FcεRI in CSU. If present, basopenia and an absence of changes in basophils during omalizumab treatment are observed. If auto-antibodies are absent, the changes in the basophil compartment are consistent with prior studies of asthma and food allergy. These group differences also are related to efficacy of the treatment for clinical outcomes, as found in the parent clinical study.

Immunotherapy in allergy and cellular tests: state of art

The basophil activation test (BAT) is an in vitro assay where the activation of basophils upon exposure to various IgE-challenging molecules is measured by flow cytometry. It is a cellular test able to investigate basophil behavior during allergy and allergy immunotherapy. A panoply of critical issues and suggestive advances have rendered this assay a promising yet puzzling tool to endeavor a full comprehension of innate immunity of allergy desensitization and manage allergen or monoclonal anti-IgE therapy. In this review a brief state of art of BAT in immunotherapy is described focusing onto the analytical issue pertaining BAT performance in allergy specific therapy.

Intracellular Expression and Release of FcεRIα by Human Eosinophils

Although FcεR have been detected on human eosinophils, levels varied from moderate to extremely low or undetectable depending on the donor and methods used. We have attempted to resolve the conflicting data by measuring levels of IgE, FcεRI, and FcεRII in or on human eosinophils from a variety of donors (n = 26) and late-phase bronchoalveolar lavage fluids (n = 5). Our results demonstrated little or no cell surface IgE or IgE receptors as analyzed by immunofluorescence and flow cytometry. Culture of eosinophils for up to 11 days in the presence or absence of IgE and/or IL-4 (conditions that enhance FcεR on other cells) failed to induce any detectable surface FcεR. However, immunoprecipitation and Western blot analysis of eosinophil lysates using mAb specific for FcεRIα showed a distinct band of approximately 50 kDa, similar to that found in basophils. Western blotting also showed the presence of FcR γ-chain, but no FcεRIβ. Surface biotinylation followed by immunoprecipitation again failed to detect surface FcεRIα, although surface FcRγ was easily detected. Since we were able to detect intracellular FcεRIα, we examined its release from eosinophils. Immunoprecipitation and Western blotting demonstrated the release of FcεRIα into the supernatant of cultured eosinophils, peaking at approximately 48 h. We conclude that eosinophils possess a sizable intracellular pool of FcεRIα that is available for release, with undetectable surface levels in a variety of subjects, including those with eosinophilia and elevated serum IgE. The biological relevance of this soluble form of FcεRIα remains to be determined.

Studies of cell adhesion and flow cytometric analyses of degranulation, surface phenotype, and viability using human eosinophils, basophils, and mast cells

Products derived from eosinophils, basophils, and mast cells are considered critical to the development of allergic diseases. Studies of the selective recruitment, accumulation, and/or activation of these cells during human allergic inflammatory reactions in vitro and in vivo have been facilitated by a wide variety of methods. Some have been developed to identify and isolate these cells from a variety of sites, including blood, airway secretions, and surgical or autopsy tissues. Once enriched in purity, assays of cell adhesion to endothelium, epithelium, matrix proteins, and purified, immobilized counterligands for integrins, selectins, or immunoglobulin gene superfamily structures can be performed in vitro under both static and flow conditions. Techniques involving flow cytometry, utilizing characteristics of cellular light scatter and immunofluorescence, have permitted the elucidation of cell surface phenotype and have aided in quantification of cellular degranulation and viability. These approaches have yielded new information on the function of human eosinophils, basophils, and mast cells and have suggested unique cell-specific pathways of cell recruitment, activation, and survival that may contribute to the pathogenesis of allergic diseases.

Immobilization of the type I receptor for IgE initiates signal transduction in mast cells

Clustering of the type I receptor for IgE (Fc(epsilon) RI) on mast cells initiates a cascade of biochemical processes that results in the secretion of inflammatory mediators. We have studied this clustering process in order to obtain information about receptor density and mobility required for initiating that cascade. Specifically, we examined the role of new cluster formation in sustaining the secretory response and the minimal cluster density required for initiating secretion. The experimental protocol adopted for these studies employed photoactivatable antigens and antigen-carrying solid surfaces which enabled us to control the density and mobility of the Fc epsilon RI within the cluster. Our results show that recruitment of new Fc(epsilon) RI into clusters, either by antigen exchange among Fc(epsilon) RI-bound IgE molecules or by IgE-bound Fc(epsilon) RI exchange with vacant receptors, is not required for sustaining the cellular secretory response. Furthermore, we find that the cell's secretory response is very sensitive to the density of immobilized Fc(epsilon) RIs, increasing steeply above a density of ca. 1000 immobilized molecules/microns 2. Taken together, these finding suggest that immobilization of a fraction of the randomly distributed Fc(epsilon) RIs that are in sufficient proximity on the surface of mucosal-type mast cells of the RBL-2H3 line initiates a degranulation signal, and that this is maintained as long as these receptors are kept within this distance. The above conclusions and the experimental protocol presented in this study are expected to have wider applications for the study and understanding of signaling by immuno (as well as other) receptors.

Single cell analysis of free cytosolic calcium changes in human lung mast cells--II. The relationship between desensitization and the cellular regulation of calcium changes

Stimulation of mast cells results in two opposing reactions, activation events that cause degranulation and desensitization events that inhibit mediator release. Previous studies of human lung mast cells and murine mast cells have suggested that desensitization resulted from events that negatively regulated free cytosolic calcium ([Ca2+]i) levels; the current studies suggest otherwise. Stimulation of purified human lung mast cells with anti-IgE demonstrated that histamine release had reached a maximum at a time (5 mins) when [Ca2+]i levels were still near their maximum elevation. While there was a slow return of [Ca2+]i levels to baseline (T1/2 = 7.8 min), this rate of return could not clearly account for the cessation of histamine release. The heterogeneity in this decay parameter was also calculated to be insufficient to account for the heterogeneity in the peak calcium response while heterogeneity in the cell surface IgE density could adequately account for the heterogeneity in calcium responses. Preincubation of mast cells with anti-IgE antibody without extracellular calcium did lead to a progressive loss of the subsequent [Ca2+]i response when calcium was added back to the reaction, but the rate of desensitization determined by this measure, T1/2 of 8 min, was slower than the rate determined by measuring the progressive inhibition of histamine release (T1/2 of 4.5 min). In addition, no correlation existed for the rate of desensitization as measured by histamine release and that measured by the peak calcium response. These data suggested that the extent of histamine release was not strictly controlled by regulation of free cytosolic calcium and that desensitization events measured by the progressive loss in histamine release and calcium response were also not strictly related.

A comparative study of releasing and nonreleasing human basophils: nonreleasing basophils lack an early component of the signal transduction pathway that follows IgE cross-linking

Basophils from approximately one fifth of the population were found to be unresponsive (nonreleasers), in terms of both histamine and leukotriene release, to an IgE cross-linking stimulus, such as anti-IgE antibody. Although unresponsive to any IgE-mediated stimulation, these basophils responded to non-IgE-mediated stimuli, such as the phorbol ester, 12-o-tetradecanoyl phorbol-13 acetate, the calcium ionophore, A23187, and to formyl-methionyl-leucyl-phenylalanine peptide. These stimuli produced equal dose-response curves in both releaser (basophils able to respond with greater than 5% histamine release to anti-IgE antibody) and nonreleaser basophils. Nonreleaser basophils possessed statistically similar densities of cell-surface IgE antibody (287,000 versus 400,000 IgE molecules per basophil for releaser and nonreleaser basophils, respectively), and with 12-o-tetradecanoyl phorbol-13 acetate as a probe of anti-IgE-induced cross-linking, the IgE on nonreleaser basophils was found to be cross-linked by the polyclonal anti-IgE antibody used for these studies. Interleukin-3 (IL-3) has previously been demonstrated to enhance markedly both histamine and leukotriene release in human basophils. However, IL-3 was unable to convert nonreleasing basophils into releasing basophils, as measured by anti-IgE antibody. IL-3 equivalently enhanced formyl methionine peptide-induced release in both releaser and nonreleaser basophils, suggesting that the lack of an effect on anti-IgE-induced release was not due to a lack of IL-3 receptors. Although there are several possible interpretations of these data, these results and results of our previous studies of protein kinase C activation and cytosolic Ca++ elevations in human basophils suggest that nonreleasing basophils have a defect in early signal transduction, possibly involving the influx of Ca++.

Flow cytometric methods for the analysis of human basophil surface antigens and viability

Fluorescence and flow microfluorometric methods have been established for the detection and evaluation of IgE-bearing human leukocytes in various cell preparations including those where basophils are present at low percentages. Quantitative techniques for the determination of basophil purity, viability, and cell surface antigens including IgE are described. Use of these methods will facilitate the identification and phenotypic analysis of human IgE-bearing cells in a wide variety of biological fluids.