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Furci F, Caminati M, Crisafulli E, Senna G, Gangemi S. The intriguing possibility of using probiotics in allergen-specific immunotherapy. World Allergy Organ J 2023; 16:100751. [PMID: 36852412 PMCID: PMC9958496 DOI: 10.1016/j.waojou.2023.100751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 01/14/2023] [Accepted: 01/17/2023] [Indexed: 02/22/2023] Open
Abstract
Allergen immunotherapy (AIT) can be considered the etiological therapy for allergic rhinitis and hymenoptera venom allergy. Its role is increasingly emerging in the context of IgE mediated food allergy, where the achievement of tolerance, or the permanent resolution of an allergy, represents the optimal goal of AIT. AIT treatment, indicated in adults and children with allergic rhinitis, has a preventative effect on the development of asthma and can also be used when asthma is associated to rhinitis; however, it is not the first choice for treatment of isolated asthma. While knowledge on immunological mechanisms, efficacy, and safety of AIT is known, an intriguing line of investigation has arisen on how the action of AIT is modulated by the use of probiotics, starting from awareness that the microbiome is altered in allergic conditions: the use of probiotics in inducing the stimulation of innate immunity via toll-like receptor activation, thus acting as adjuvants in AIT, is hereby examined. Therefore, by analyzing literature on AIT and probiotics, we intend to draw attention to how the role and use of AIT are emerging as being increasingly important for both the short- and long-term management of allergic diseases and how recourse probiotics may represent an additional therapeutic strategy to modulate the effectiveness of AIT. However, further investigations are needed to better identify which probiotics to use, the dosage, and the optimal duration to obtain correct immunomodulation, and how to best customize their use, including a "AIT + probiotics" strategy in the field of precision medicine.
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Affiliation(s)
- Fabiana Furci
- Asthma Centre and Allergy Unit, University of Verona and Verona University Hospital, Verona, Italy
| | - Marco Caminati
- Allergy, Asthma and Clinical Immunology, Department of Medicine, University of Verona and Verona University Hospital, Verona, Italy,Corresponding author. Department of Medicine, University of Verona and Verona University Hospital, Verona, Italy.
| | - Ernesto Crisafulli
- Respiratory Medicine Unit and Section of Internal Medicine, Department of Medicine, Verona University Hospital, Verona, Italy
| | - Gianenrico Senna
- Asthma Centre and Allergy Unit, University of Verona and Verona University Hospital, Verona, Italy,Allergy, Asthma and Clinical Immunology, Department of Medicine, University of Verona and Verona University Hospital, Verona, Italy
| | - Sebastiano Gangemi
- School and Operative Unit of Allergy and Clinical Immunology, Department of Clinical and Experimental Medicine, Policlinico “G. Martino”, University of Messina, Messina, Italy
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Loke P, Chebar Lozinsky A, Orsini F, Wong LSY, Leung ASY, Tham EH, Lopata AL, Shek LPC, Tang ML. Study protocol of a phase 2, dual-centre, randomised, controlled trial evaluating the effectiveness of probiotic and egg oral immunotherapy at inducing desensitisation or sustained unresponsiveness (remission) in participants with egg allergy compared with placebo (Probiotic Egg Allergen Oral Immunotherapy for Treatment of Egg Allergy: PEAT study). BMJ Open 2021; 11:e044331. [PMID: 34233966 PMCID: PMC8264865 DOI: 10.1136/bmjopen-2020-044331] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Egg allergy is the most common food allergy in children but recent studies have shown persistence or delayed resolution into adolescence. As there is currently no effective long-term treatment, definitive treatments that improve quality of life and prevent fatalities for food allergies are required. We have previously shown that a novel treatment comprising a combination of the probiotic Lactobacillus rhamnosus CGMCC 1.3724 with peanut oral immunotherapy (OIT) is highly effective at inducing sustained unresponsiveness, with benefit persisting to 4 years after treatment cessation in the majority of initial treatment responders. In this study, we plan to extend the probiotic food OIT platform to another allergen, namely egg. We describe the protocol for a phase 2, dual-centre, randomised, controlled trial evaluating the effectiveness of probiotic and egg OIT at inducing desensitisation or sustained unresponsiveness (remission) in participants with egg allergy compared with placebo. METHODS AND ANALYSIS 80 participants aged 5-30 years of age with current egg allergy confirmed by double-blind placebo-controlled food challenge at study screening will be recruited from Australia and Singapore. There are two intervention arms-probiotic and egg OIT (active) or placebo. Interventions are administered once daily for 18 months. The primary outcome is the proportion of participants who attain 8-week sustained unresponsiveness in the active group versus placebo group. ETHICS AND DISSEMINATION This study has been approved by the Human Research Ethics Committees at the Royal Children's Hospital (HREC 2019.082) and the National Healthcare Group Domain Specific Review Board (2019/00029). Results will be published in peer-reviewed journals and disseminated via presentations at international conferences. TRIAL REGISTRATION NUMBER ACTRN12619000480189.
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Affiliation(s)
- Paxton Loke
- Allergy Immunology, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
- Monash Children's Hospital, Clayton, Victoria, Australia
| | | | - Francesca Orsini
- Clinical Epidemiology and Biostatistics Unit, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Melbourne Children's Trials Centre, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Lydia Su-Yin Wong
- Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore
| | - Agnes Sze-Yin Leung
- Allergy Immunology, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Elizabeth Huiwen Tham
- Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore
- Department of Paediatrics, National University Singapore Yong Loo Lin School of Medicine, Singapore
| | - Andreas L Lopata
- Molecular Allergy Research Laboratory, James Cook University College of Public Health Medical and Veterinary Sciences, Townsville, Queensland, Australia
| | - Lynette Pei-Chi Shek
- Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore
- Department of Paediatrics, National University Singapore Yong Loo Lin School of Medicine, Singapore
| | - Mimi Lk Tang
- Allergy Immunology, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
- Department of Allergy and Immunology, Royal Children's Hospital, Parkville, Victoria, Australia
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Radwanski NE, Morris DO, Boston RC, Cerundolo R, Lee KW. Longitudinal evaluation of immunological responses to allergen-specific immunotherapy in horses with IgE associated dermatological disease, a pilot study. Vet Dermatol 2019; 30:255-e78. [PMID: 30828914 DOI: 10.1111/vde.12732] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2018] [Indexed: 01/30/2023]
Abstract
BACKGROUND The long-term effects of allergen specific immunotherapy (ASIT) on concentrations of circulating immunoglobulin E (IgE) and immunoglobulin G (IgG) in horses have not been reported. OBJECTIVES To document changes in clinical severity of horses with atopic dermatitis (AD) and to monitor allergen-specific IgE and IgG concentrations during a two-year course of ASIT. ANIMALS Nineteen client-owned horses with a conditional diagnosis of AD. METHODS AND MATERIALS Three ASIT groups were randomly assigned based upon results obtained by either intradermal testing (IDT) for regional allergens (n = 7); enzyme-linked immunosorbent assay (ELISA) for specific IgE (n = 6); or a composite of results from both tests (n = 6). Serum concentrations of IgE and IgG specific for allergens included in ASIT were measured at time zero and at four-month intervals. A visual analog scale (VAS) was used to record severity of clinical signs at times zero, 12 and 24 months. RESULTS Positive correlations were documented between IgE and both immediate and delayed IDT results (P < 0.00001), and between immediate IDT and IgG results (P = 0.003). Specific IgE in sera decreased significantly (P < 0.05) for allergens that were included in ASIT, whereas IgG increased. Across all horses, the mean VAS score decreased by 1.2 units [95% CI: 1.28, 1.14; (P < 0.0001)] during each 12-month period of ASIT therapy. Improvement in clinical signs was noted in 76.5% of the horses following 12 months of ASIT and in 82% after 24 months on ASIT. CONCLUSIONS AND CLINICAL IMPORTANCE In this pilot study, ASIT in horses with AD provided significant clinical benefit associated with a concomitant reduction of allergen-specific IgE and elevation of IgG.
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Affiliation(s)
- Noel E Radwanski
- Blue Pearl Veterinary Partners, 3000 Busch Lake Blvd, Tampa, FL, 33614, USA
| | - Daniel O Morris
- School of Veterinary Medicine, University of Pennsylvania, 3900 Spruce St, Philadelphia, PA, 19104, USA
| | - Raymond C Boston
- School of Veterinary Medicine, University of Pennsylvania, 3900 Spruce St, Philadelphia, PA, 19104, USA
| | - Rosario Cerundolo
- Dick White Referrals Veterinary Specialist Centre, Six Mile Bottom, Cambridgeshire, CB8 OUH, UK
| | - Kenneth W Lee
- Greer Laboratories, Inc, 639 Nuway Circle NE, Lenoir, NC, 28645, USA
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Lehto M, Wolff H, Leino R, Alenius H, Savolainen J. A novel glycocluster molecule prevents timothy-induced allergic airway inflammation in mice. Allergy 2018; 73:1700-1706. [PMID: 29377154 DOI: 10.1111/all.13419] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/17/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Allergen-specific immunotherapy (SIT) effectively alleviates type I allergic diseases characterized by T helper (Th)2-type immunity. Our recent studies have shown that a synthetic trivalent glycocluster, triacedimannose (TADM), suppresses the Th2-type allergic inflammation. The aim of this study was to compare TADM with two well-known adjuvants, unmethylated cytosine-phosphate-guanine oligodeoxynucleotide (CpG) and monophosphoryl lipid A (MPLA) in a grass allergen-induced chronic allergic inflammation model in mice. METHODS Female BALB/c mice were intranasally sensitized with 50 μL of timothy grass pollen extract (TE) twice a week for a period of 15 weeks. Therapeutic intranasal treatments were then performed once a week after the tenth intranasal TE instillation using TADM (10 or 25 μg/50 μL), CpG-ODN (20 μg/50 μL) or MPLA (2 μg/50 μL). Groups of 9-10 animals per treatment were killed 24 hours after the last timothy dosage. Blood, bronchoalveolar lavage (BAL) fluids and lung biopsies were taken for subsequent analysis. RESULTS When mice were repeatedly exposed to TE for 15 weeks, the number of eosinophils and lymphocytes increased in the BAL fluids. The eosinophil and lymphocyte counts decreased dose-dependently and were practically abolished in the mice treated with TADM. Treatments with MPLA or CpG significantly increased the numbers of neutrophils, while CpG nonsignificantly decreased eosinophilia compared to timothy exposure. CONCLUSIONS A novel synthetic glycocluster molecule inhibited the development of grass-induced eosinophilic pulmonary inflammation in mice when administrated in the airways. This compound could be a candidate to be used either as an adjuvant in SIT or as a topical anti-inflammatory treatment.
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Affiliation(s)
- M. Lehto
- Department of Occupational Medicine; Finnish Institute of Occupational Health; Helsinki Finland
| | - H. Wolff
- Department of Pathology; Finnish Institute of Occupational Health; Helsinki Finland
| | - R. Leino
- Johan Gadolin Process Chemistry Centre; Laboratory of Organic Chemistry; Åbo Akademi University; Turku Finland
| | - H. Alenius
- Karolinska Institutet; Institute of Environmental Medicine; Stockholm Sweden
- Medical Faculty; University of Helsinki; Helsinki Finland
| | - J. Savolainen
- Department of Pulmonary Diseases and Clinical Allergology; University of Turku; Turku University Hospital; Turku Finland
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Moingeon P, Lombardi V, Baron-Bodo V, Mascarell L. Enhancing Allergen-Presentation Platforms for Sublingual Immunotherapy. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2017; 5:23-31. [PMID: 28065340 DOI: 10.1016/j.jaip.2016.07.020] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Revised: 07/22/2016] [Accepted: 07/25/2016] [Indexed: 01/24/2023]
Abstract
Sublingual immunotherapy (SLIT) relies on high doses of allergens to treat patients with type I allergies. Although SLIT is commonly performed without any adjuvant or delivery system, allergen(s) could be further formulated with allergen-presentation platforms to better target oral dendritic cells eliciting regulatory immune responses. Improving the availability of allergens to the immune system should enhance SLIT efficacy, while allowing to decrease allergen dosing. Herein, we present an overview of adjuvants and vector systems that have been, or could be, considered as candidate allergen-presentation platforms for the sublingual route. Such platforms encompass adjuvants capable of stimulating allergen-specific TH1 and/or regulatory CD4+ T-cell responses, including 1,25-dihydroxy vitamin D3, glucocorticoids, Toll-like receptor ligands as well as selected bacterial probiotic strains. A limiting factor for SLIT efficacy is the number of dendritic cells capturing the allergens in the upper layers of oral tissues. Thus, adsorption or encapsulation of the allergen(s) within mucoadhesive particulate vector (or delivery) systems also has the potential to significantly enhance SLIT efficacy due to a facilitated allergen uptake by tolerogenic oral dendritic cells.
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Affiliation(s)
- P Moingeon
- Research and Development, Stallergenes Greer, Antony, France.
| | - V Lombardi
- Research and Development, Stallergenes Greer, Antony, France
| | - V Baron-Bodo
- Research and Development, Stallergenes Greer, Antony, France
| | - L Mascarell
- Research and Development, Stallergenes Greer, Antony, France
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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.
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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
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Mäkinen K, Mukherjee C, Leino M, Panchadhayee R, Lehto M, Wolff H, Alenius H, Leino R, Savolainen J. A novel mannoside-glycocluster adjuvant: Compared in vitro to CpG ODN and MPL and tested in vivo in mouse asthma model. Allergol Immunopathol (Madr) 2016; 44:9-17. [PMID: 26395525 DOI: 10.1016/j.aller.2015.04.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2014] [Revised: 03/27/2015] [Accepted: 04/01/2015] [Indexed: 12/30/2022]
Abstract
BACKGROUND Allergen-specific immunotherapy balances the Th2-biased immunity towards Th1 and Treg responses. Adjuvants are used in allergen preparations to intensify the immune responses. The increased prevalence of allergies in developed societies has been associated with decreased microbial load during childhood. This has initiated a search for microbial structures to be used as adjuvants. Our study has shown that a synthetic triacedimannose (TADM) may suppress the Th2-type allergic inflammatory response. The aim of this study was to compare the properties of TADM with capacities of other adjuvants, CpG ODN and MPL, to modulate cytokine production in PBMC and regulate sensitisation in an OVA-sensitised mouse asthma model. METHODS The effects of TADM were studied in vitro on birch stimulated PBMC cultures of birch allergic rhinitis patients with other known adjuvants. Cytokines in supernatants were measured by Luminex. Effects of TADM were analysed in vivo in a mouse model of OVA-induced allergic asthma by analysing BAL, cytokine mRNA and serum antibodies. RESULTS TADM was the only adjuvant that significantly suppressed the production of all birch induced Th2-type cytokines. In a murine model, TADM significantly suppressed the specific IgE production and enhanced IFN-γ production. CONCLUSIONS TADM suppresses the birch allergen induced Th2-type cytokine responses in allergic subjects more efficiently than the two other adjuvants, MPL and CpG ODN. TADM is immunomodulatory also in vivo and decreases the IgE levels and increases the IFN-γ responses in a murine model. These results suggest that TADM may be a promising candidate for novel adjuvants in immunotherapy.
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Bioley G, Lassus A, Terrettaz J, Tranquart F, Corthésy B. Prophylactic immunization of mice with phospholipase A2-loaded gas-filled microbubbles is protective against Th2-mediated honeybee venom allergy. Clin Exp Allergy 2015; 46:153-62. [DOI: 10.1111/cea.12555] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Revised: 03/24/2015] [Accepted: 04/06/2015] [Indexed: 12/28/2022]
Affiliation(s)
- G. Bioley
- R&D Laboratory; Division of Immunology and Allergy; University State Hospital (CHUV); Epalinges Switzerland
| | - A. Lassus
- Bracco Suisse SA; Plan-Les-Ouates Switzerland
| | | | | | - B. Corthésy
- R&D Laboratory; Division of Immunology and Allergy; University State Hospital (CHUV); Epalinges Switzerland
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Coria LM, Ibañez AE, Pasquevich KA, Cobiello PLG, Frank FM, Giambartolomei GH, Cassataro J. Brucella abortus Omp19 recombinant protein subcutaneously co-delivered with an antigen enhances antigen-specific T helper 1 memory responses and induces protection against parasite challenge. Vaccine 2015; 34:430-437. [PMID: 26707377 DOI: 10.1016/j.vaccine.2015.12.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Revised: 11/27/2015] [Accepted: 12/09/2015] [Indexed: 01/18/2023]
Abstract
The discovery of effective adjuvants for many vaccines especially those with limited commercial appeal, such as vaccines to poverty-related diseases, is required. In this work, we demonstrated that subcutaneous co-administration of mice with the outer membrane protein U-Omp19 from Brucella spp. plus OVA as antigen (Ag) increases Ag-specific T cell proliferation and T helper (Th) 1 immune responses in vitro and in vivo. U-Omp19 treated dendritic cells promote IFN-γ production by specific CD4(+) T cells and increases T cell proliferation. U-Omp19 co-administration induces the production of Ag specific effector memory T cell populations (CD4(+) CD44(high) CD62L(low) T cells). Finally, subcutaneous co-administration of U-Omp19 with Trypanosoma cruzi Ags confers protection against virulent parasite challenge, reducing parasitemia and weight loss while increasing mice survival. These results indicate that the bacterial protein U-Omp19 when delivered subcutaneously could be a suitable component of vaccine formulations against infectious diseases requiring Th1 immune responses.
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Affiliation(s)
- Lorena M Coria
- Instituto de Investigaciones Biotecnológicas-Instituto Tecnológico de Chascomús (IIB-INTECH), Universidad Nacional de San Martín (UNSAM), CONICET, Buenos Aires, Argentina
| | - Andrés E Ibañez
- Instituto de Investigaciones Biotecnológicas-Instituto Tecnológico de Chascomús (IIB-INTECH), Universidad Nacional de San Martín (UNSAM), CONICET, Buenos Aires, Argentina
| | - Karina A Pasquevich
- Instituto de Investigaciones Biotecnológicas-Instituto Tecnológico de Chascomús (IIB-INTECH), Universidad Nacional de San Martín (UNSAM), CONICET, Buenos Aires, Argentina
| | - Paula L González Cobiello
- Departamento de Microbiología, Parasitología e Inmunología, Facultad de Medicina, UBA, Buenos Aires, Argentina
| | - Fernanda M Frank
- Departamento de Microbiología, Parasitología e Inmunología, Facultad de Medicina, UBA, Buenos Aires, Argentina
| | - Guillermo H Giambartolomei
- Instituto de Inmunología, Genética y Metabolismo (INIGEM), Laboratorio de Inmunogenética, Hospital de Clínicas "José de San Martín", CONICET-UBA, Buenos Aires, Argentina
| | - Juliana Cassataro
- Instituto de Investigaciones Biotecnológicas-Instituto Tecnológico de Chascomús (IIB-INTECH), Universidad Nacional de San Martín (UNSAM), CONICET, Buenos Aires, Argentina.
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Nanoparticle conjugation enhances the immunomodulatory effects of intranasally delivered CpG in house dust mite-allergic mice. Sci Rep 2015; 5:14274. [PMID: 26387548 PMCID: PMC4585708 DOI: 10.1038/srep14274] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2015] [Accepted: 08/17/2015] [Indexed: 12/17/2022] Open
Abstract
An emerging strategy in preventing and treating airway allergy consists of modulating the immune response induced against allergens in the lungs. CpG oligodeoxynucleotides have been investigated in airway allergy studies, but even if promising, efficacy requires further substantiation. We investigated the effect of pulmonary delivery of nanoparticle (NP)-conjugated CpG on lung immunity and found that NP-CpG led to enhanced recruitment of activated dendritic cells and to Th1 immunity compared to free CpG. We then evaluated if pulmonary delivery of NP-CpG could prevent and treat house dust mite-induced allergy by modulating immunity directly in lungs. When CpG was administered as immunomodulatory therapy prior to allergen sensitization, we found that NP-CpG significantly reduced eosinophilia, IgE levels, mucus production and Th2 cytokines, while free CpG had only a moderate effect on these parameters. In a therapeutic setting where CpG was administered after allergen sensitization, we found that although both free CpG and NP-CpG reduced eosinophilia and IgE levels to the same extent, NP conjugation of CpG significantly enhanced reduction of Th2 cytokines in lungs of allergic mice. Taken together, these data highlight benefits of NP conjugation and the relevance of NP-CpG as allergen-free therapy to modulate lung immunity and treat airway allergy.
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Akdis CA, Akdis M. Mechanisms of allergen-specific immunotherapy and immune tolerance to allergens. World Allergy Organ J 2015; 8:17. [PMID: 26023323 PMCID: PMC4430874 DOI: 10.1186/s40413-015-0063-2] [Citation(s) in RCA: 213] [Impact Index Per Article: 23.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2014] [Accepted: 02/06/2015] [Indexed: 12/25/2022] Open
Abstract
Substantial progress in understanding mechanisms of immune regulation in allergy, asthma, autoimmune diseases, tumors, organ transplantation and chronic infections has led to a variety of targeted therapeutic approaches. Allergen-specific immunotherapy (AIT) has been used for 100 years as a desensitizing therapy for allergic diseases and represents the potentially curative and specific way of treatment. The mechanisms by which allergen-AIT has its mechanisms of action include the very early desensitization effects, modulation of T- and B-cell responses and related antibody isotypes as well as inhibition of migration of eosinophils, basophils and mast cells to tissues and release of their mediators. Regulatory T cells (Treg) have been identified as key regulators of immunological processes in peripheral tolerance to allergens. Skewing of allergen-specific effector T cells to a regulatory phenotype appears as a key event in the development of healthy immune response to allergens and successful outcome in AIT. Naturally occurring FoxP3+ CD4+CD25+ Treg cells and inducible type 1 Treg (Tr1) cells contribute to the control of allergen-specific immune responses in several major ways, which can be summarized as suppression of dendritic cells that support the generation of effector T cells; suppression of effector Th1, Th2 and Th17 cells; suppression of allergen-specific IgE, and induction of IgG4; suppression of mast cells, basophils and eosinophils and suppression of effector T cell migration to tissues. New strategies for immune intervention will likely include targeting of the molecular mechanisms of allergen tolerance and reciprocal regulation of effector and regulatory T cell subsets.
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Affiliation(s)
- Cezmi A Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), Obere Strasse 22, CH7270 Davos, Switzerland
| | - Mübeccel Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), Obere Strasse 22, CH7270 Davos, Switzerland
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Frati F, Cecchi L, Scala E, Ridolo E, Dell'Albani I, Makrì E, Pajno G, Incorvaia C. New product development with the innovative biomolecular sublingual immunotherapy formulations for the management of allergic rhinitis. Biologics 2014; 8:221-6. [PMID: 25246765 PMCID: PMC4167485 DOI: 10.2147/btt.s50951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The molecular allergy technique, currently defined as component-resolved diagnosis, significantly improved the diagnosis of allergy, allowing for differentiation between molecules actually responsible for clinical symptoms (genuine sensitizers) and those simply cross-reacting or shared by several sources (panallergens), thus influencing the appropriate management of a patient's allergy. This also concerns allergen immunotherapy (AIT), which may be prescribed more precisely based on the component-resolved diagnosis results. However, the advance in diagnosis needs to be mirrored in AIT. According to consensus documents and to expectations of specialists, therapy should be based on standardized extracts containing measured amounts of the clinically relevant molecules, ie, the major allergens. The new generation of extracts for sublingual immunotherapy fulfills these requirements and are thus defined as biomolecular (BM). BM refers to natural extracts with a defined content of major allergens in micrograms. All Staloral BM products are indicated for the treatment of allergic rhinitis with or without asthma. The effectiveness of AIT is related to its ability to modify the immunological response of allergic subjects. The 5-grass and house dust mite extracts were evaluated addressing the T helper 1, T helper 2, and T helper 3 cells by polymerase chain reaction array on mRNA extracted from Waldeyer's ring tissue (adenoids). Sublingual immunotherapy with a defined content of major allergens in micrograms induced a strong downregulation of genes involved in T helper 2 and T helper 1 activation and function, allowing the definition of the immunologic effect as "bio-homeostatic". This clinical and immunological model must be implemented with respect to other allergens, thus expanding the application of a treatment with a unique disease-modifying capacity.
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Affiliation(s)
- Franco Frati
- Medical and Scientific Department, Stallergenes, Milan, Italy
| | - Lorenzo Cecchi
- Interdepartmental Centre of Bioclimatology, University of Florence, Florence, Italy ; Allergy and Clinical Immunology Section, Azienda Sanitaria di Prato, Prato, Italy
| | - Enrico Scala
- Experimental Allergy Unit, IDI-IRCCS, Rome, Italy
| | - Erminia Ridolo
- Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy
| | | | - Eleni Makrì
- Allergy/Pulmonary Rehabilitation, ICP Hospital, Milan, Italy
| | - Giovanni Pajno
- Department of Pediatrics, Allergy Unit, University of Messina, Messina, Italy
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Zaleska A, Eiwegger T, Soyer Ö, van de Veen W, Rhyner C, Soyka MB, Bekpen C, Demiröz D, Treis A, Söllner S, Palomares O, Kwok WW, Rose H, Senti G, Kündig TM, Ozoren N, Jutel M, Akdis CA, Crameri R, Akdis M. Immune regulation by intralymphatic immunotherapy with modular allergen translocation MAT vaccine. Allergy 2014; 69:1162-70. [PMID: 24934402 DOI: 10.1111/all.12461] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2014] [Indexed: 01/05/2023]
Abstract
BACKGROUND Allergen-specific immunotherapy (SIT) faces problems related to side effects and limited efficacy. Direct administration of allergen extracts into lymph nodes induces increased specific IgG production and T-cell responses using significantly lower allergen doses. METHODS In this study, mechanisms of immune regulation by MAT vaccines in vitro and in allergen-SIT of cat-allergic rhinitis patients, who received 3 inguinal intra-lymph node injections of MAT-Fel d 1 vaccine, were investigated in PBMC and cell cultures for specific T-cell proliferation, Fel d 1-tetramer-specific responses, and multiple immune regulatory molecules. RESULTS MAT-Fel d 1 vaccine was efficiently internalized by antigen-presenting cells. This was followed by precaspase 1 cleavage to caspase 1 and secretion of IL-1β, indicating inflammasome activation. Mat-Fel d 1 induced specific T-cell proliferation and an IL-10- and IFN-γ-dominated T-cell responses with decreased Th2 cytokines at 100 times lower doses than Fel d 1. Induction of immune tolerance by MAT-Fel d 1-ILIT involved multiple mechanisms of immune suppression. Early Fel d 1-specific T-cell activation was followed by full T-cell unresponsiveness to allergen after 1 year in the MAT-Fel d 1 group, characterized by increased allergen-specific T regulatory cells, decreased circulating Fel d 1 tetramer-positive cells, increased IL-10 and FOXP3 expression, and change in the HR2/HR1 ratio toward HR2. CONCLUSIONS This study demonstrates the induction of allergen tolerance after 3 intra-lymph node injections of MAT-Fel d 1 vaccine, mediated by increased cellular internalization of the allergen, activation of inflammasome, and generation of allergen-specific peripheral T-cell tolerance.
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Affiliation(s)
- A. Zaleska
- Swiss Institute for Allergy and Asthma Research (SIAF); Davos Switzerland
- Department and Clinic of Internal Diseases, Geriatry and Allergology; Wroclaw Medical University; Wroclaw Poland
| | - T. Eiwegger
- Swiss Institute for Allergy and Asthma Research (SIAF); Davos Switzerland
- Department of Pediatrics; Medical University of Vienna; Vienna Austria
| | - Ö. Soyer
- Swiss Institute for Allergy and Asthma Research (SIAF); Davos Switzerland
| | - W. van de Veen
- Swiss Institute for Allergy and Asthma Research (SIAF); Davos Switzerland
| | - C. Rhyner
- Swiss Institute for Allergy and Asthma Research (SIAF); Davos Switzerland
| | - M. B. Soyka
- Swiss Institute for Allergy and Asthma Research (SIAF); Davos Switzerland
| | - C. Bekpen
- Swiss Institute for Allergy and Asthma Research (SIAF); Davos Switzerland
- Department of Molecular Biology and Genetics; Center for Life Sciences and Technology Research; Bogazici University; Istanbul Turkey
| | - D. Demiröz
- Swiss Institute for Allergy and Asthma Research (SIAF); Davos Switzerland
- Department of Molecular Biology and Genetics; Center for Life Sciences and Technology Research; Bogazici University; Istanbul Turkey
| | - A. Treis
- Swiss Institute for Allergy and Asthma Research (SIAF); Davos Switzerland
| | - S. Söllner
- Swiss Institute for Allergy and Asthma Research (SIAF); Davos Switzerland
| | - O. Palomares
- Swiss Institute for Allergy and Asthma Research (SIAF); Davos Switzerland
- Department of Biochemistry and Molecular Biology; School of Chemistry; Complutense University of Madrid; Madrid Spain
| | - W. W. Kwok
- Benaroya Research Institute at Virginia Mason; Seattle WA USA
| | - H. Rose
- ImVisioN GmbH; Hannover Germany
| | - G. Senti
- Clinical Trials Center; University Hospital Zurich; Zurich Switzerland
| | - T. M. Kündig
- Department of Dermatology; University Hospital Zurich; Zurich Switzerland
| | - N. Ozoren
- Department of Molecular Biology and Genetics; Center for Life Sciences and Technology Research; Bogazici University; Istanbul Turkey
| | - M. Jutel
- Swiss Institute for Allergy and Asthma Research (SIAF); Davos Switzerland
- Department of Clinical Immunology; Wroclaw Medical University; Wroclaw Poland
| | - C. A. Akdis
- Swiss Institute for Allergy and Asthma Research (SIAF); Davos Switzerland
| | - R. Crameri
- Swiss Institute for Allergy and Asthma Research (SIAF); Davos Switzerland
| | - M. Akdis
- Swiss Institute for Allergy and Asthma Research (SIAF); Davos Switzerland
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Alam S, Lukawska J, Corrigan C. Adjuvants in Allergy: State of the Art. CURRENT TREATMENT OPTIONS IN ALLERGY 2014. [DOI: 10.1007/s40521-013-0008-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Ibañez AE, Smaldini P, Coria LM, Delpino MV, Pacífico LGG, Oliveira SC, Risso GS, Pasquevich KA, Fossati CA, Giambartolomei GH, Docena GH, Cassataro J. Unlipidated outer membrane protein Omp16 (U-Omp16) from Brucella spp. as nasal adjuvant induces a Th1 immune response and modulates the Th2 allergic response to cow's milk proteins. PLoS One 2013; 8:e69438. [PMID: 23861971 PMCID: PMC3703917 DOI: 10.1371/journal.pone.0069438] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2012] [Accepted: 06/13/2013] [Indexed: 01/18/2023] Open
Abstract
The discovery of novel mucosal adjuvants will help to develop new formulations to
control infectious and allergic diseases. In this work we demonstrate that
U-Omp16 from Brucella spp. delivered by the nasal
route (i.n.) induced an inflammatory immune response in bronchoalveolar lavage
(BAL) and lung tissues. Nasal co-administration of U-Omp16 with the model
antigen (Ag) ovalbumin (OVA) increased the amount of Ag in lung tissues and
induced OVA-specific systemic IgG and T helper (Th) 1 immune responses. The
usefulness of U-Omp16 was also assessed in a mouse model of food allergy.
U-Omp16 i.n. administration during sensitization ameliorated the
hypersensitivity responses of sensitized mice upon oral exposure to Cow’s Milk
Protein (CMP), decreased clinical signs, reduced anti-CMP IgE serum antibodies
and modulated the Th2 response in favor of Th1 immunity. Thus, U-Omp16 could be
used as a broad Th1 mucosal adjuvant for different Ag formulations.
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Affiliation(s)
- Andrés E. Ibañez
- Laboratorio de Inmunogenética, INIGEM-CONICET, Hospital de Clínicas “José
de San Martín”, Facultad de Medicina, Universidad de Buenos Aires (UBA), Buenos
Aires, Argentina
| | - Paola Smaldini
- Laboratorio de Investigaciones del Sistema Inmune (LISIN), Facultad de
Ciencias Exactas, Universidad Nacional de la Plata, Buenos Aires,
Argentina
| | - Lorena M. Coria
- Laboratorio de Inmunogenética, INIGEM-CONICET, Hospital de Clínicas “José
de San Martín”, Facultad de Medicina, Universidad de Buenos Aires (UBA), Buenos
Aires, Argentina
| | - María V. Delpino
- Laboratorio de Inmunogenética, INIGEM-CONICET, Hospital de Clínicas “José
de San Martín”, Facultad de Medicina, Universidad de Buenos Aires (UBA), Buenos
Aires, Argentina
| | - Lucila G. G. Pacífico
- Department of Biochemistry and Immunology, Institute of Biological
Sciences, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais,
Brazil
| | - Sergio C. Oliveira
- Department of Biochemistry and Immunology, Institute of Biological
Sciences, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais,
Brazil
| | - Gabriela S. Risso
- Laboratorio de Inmunogenética, INIGEM-CONICET, Hospital de Clínicas “José
de San Martín”, Facultad de Medicina, Universidad de Buenos Aires (UBA), Buenos
Aires, Argentina
| | - Karina A. Pasquevich
- Laboratorio de Inmunogenética, INIGEM-CONICET, Hospital de Clínicas “José
de San Martín”, Facultad de Medicina, Universidad de Buenos Aires (UBA), Buenos
Aires, Argentina
| | - Carlos Alberto Fossati
- Laboratorio de Investigaciones del Sistema Inmune (LISIN), Facultad de
Ciencias Exactas, Universidad Nacional de la Plata, Buenos Aires,
Argentina
- Instituto de Estudios de la Inmunidad Humoral (IDEHU-CONICET), Facultad
de Farmacia y Bioquímica, Universidad de Buenos Aires (UBA), Buenos Aires,
Argentina
| | - Guillermo H. Giambartolomei
- Laboratorio de Inmunogenética, INIGEM-CONICET, Hospital de Clínicas “José
de San Martín”, Facultad de Medicina, Universidad de Buenos Aires (UBA), Buenos
Aires, Argentina
| | - Guillermo H. Docena
- Laboratorio de Investigaciones del Sistema Inmune (LISIN), Facultad de
Ciencias Exactas, Universidad Nacional de la Plata, Buenos Aires,
Argentina
| | - Juliana Cassataro
- Laboratorio de Inmunogenética, INIGEM-CONICET, Hospital de Clínicas “José
de San Martín”, Facultad de Medicina, Universidad de Buenos Aires (UBA), Buenos
Aires, Argentina
- * E-mail:
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Moingeon P. Adjuvants for allergy vaccines. Hum Vaccin Immunother 2012; 8:1492-8. [PMID: 23095872 PMCID: PMC3660771 DOI: 10.4161/hv.21688] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2012] [Revised: 07/11/2012] [Accepted: 08/01/2012] [Indexed: 12/19/2022] Open
Abstract
Allergen-specific immunotherapy is currently performed via either the subcutaneous or sublingual routes as a treatment for type I (IgE dependent) allergies. Aluminum hydroxide or calcium phosphate are broadly used as adjuvants for subcutaneous allergy vaccines, whereas commercial sublingual vaccines rely upon high doses of aqueous allergen extracts in the absence of any immunopotentiator. Adjuvants to be included in the future in products for allergen specific immunotherapy should ideally enhance Th1 and CD4+ regulatory T cell responses. Imunomodulators impacting dendritic or T cell functions to induce IL10, IL12 and IFNγ production are being investigated in preclinical allergy models. Such candidate adjuvants encompass synthetic or biological immunopotentiators such as glucocorticoids, 1,25-dihydroxy vitamin D3, selected probiotic strains (e.g., Lactobacillus and Bifidobacterium species) as well as TLR2 (Pam3CSK4), TLR4 (monophosphoryl lipid A, synthetic lipid A analogs) or TLR9 (CpGs) ligands. Furthermore, the use of vector systems such as mucoadhesive particules, virus-like particles or liposomes are being considered to enhance allergen uptake by tolerogenic antigen presenting cells present in mucosal tissues.
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18
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Zhou B, Yuan J, Zhou Y, Yang J, James AW, Nair U, Shu X, Liu W, Kanangat S, Yoo TJ. The attenuation of cockroach allergy by DNA vaccine encoding cockroach allergen Bla g 2. Cell Immunol 2012; 278:120-4. [PMID: 22960278 DOI: 10.1016/j.cellimm.2012.05.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2012] [Revised: 05/25/2012] [Accepted: 05/30/2012] [Indexed: 02/05/2023]
Abstract
Bla g 2 is one of the most potent cockroach allergens. No effective treatment or vaccination strategies are yet available. We evaluated the prophylactic efficacy of Bla g 2 DNA vaccination in a mouse model of allergic airway inflammation. C57/BL6 mice were given Bla g 2 DNA vaccine prior to sensitization with recombinant Bla g 2 (rBla g 2) antigens, followed by nebulized rBla g 2 challenge. Bla g 2 vaccine could express at both transcriptional and translational levels in mammalian cells. Moreover, Bla g 2 vaccine significantly reduced the total inflammatory cell infiltrate and eosinophilia in bronchoalveolar lavage fluid, and markedly decreased allergen-induced inflammatory infiltrates in the lungs and Bla g 2-specific IgE in serum upon challenge with rBla g 2. Importantly, Bla g 2 vaccine could induce the production of antigen-specific IFN-γ and downregulated Th2 pro-inflammatory cytokines IL-4, IL-5, and IL-13. Thus, DNA vaccination showed protective efficacy against a clinically relevant allergen, Bla g 2.
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Affiliation(s)
- Bin Zhou
- Department of Medicine, University of Tennessee Health Science Center, Memphis, TN 38163, USA
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19
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Zhou B, Ensell M, Zhou Y, Nair U, Glickstein J, Kermany MH, Cai Q, Cai C, Liu W, Deng YP, Kakigi A, Barbieri M, Mora M, Kanangat S, Yoo TJ. Prevention and treatment of DNA vaccine encoding cockroach allergen Bla g 1 in a mouse model of allergic airway inflammation. Allergy 2012; 67:166-74. [PMID: 21958323 DOI: 10.1111/j.1398-9995.2011.02727.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND One-fourth of the US population is sensitized to the German cockroach. Primary German cockroach allergen Bla g 1 is detected in 63% of homes and 52% of childcare facilities in the United States. No effective treatment or vaccination strategies are yet available. OBJECTIVES We evaluated the prophylactic and therapeutic efficacy of a plasmid DNA-mediated vaccination using the Bla g 1 gene in a mouse model of allergic inflammatory airway disease. METHODS A plasmid DNA vector coding for the Bla g 1 allergen controlled by cytomegalovirus promoter was constructed. To estimate the protective efficacy, BALB/c mice were given three injections of plasmid DNA-Bla g 1 prior to sensitization with two priming doses of recombinant Bla g 1 (rBla g 1) antigens, followed by nebulized rBla g 1 challenge. In the therapeutic approach, sensitization was followed by administering Bla g 1 DNA vaccine. RESULTS Bla g 1 vaccination significantly reduced allergen-induced airway inflammation, even after mice were presensitized and a Th2-dominant response was established. The Bla g 1 vaccination significantly reduced total inflammatory cell infiltrate, eosinophilia, secretion of Th2 cytokines IL-4 and IL-5 in bronchoalveolar lavage fluid, allergen-induced inflammatory infiltrates in the lungs, and Bla g 1-specific IgE in serum upon challenge with rBla g 1. Importantly, Bla g 1 DNA vaccination was able to induce IL-10-secreting regulatory T cells that could suppress the allergen-specific Th2 cells. CONCLUSION DNA vaccination showed protective and therapeutic efficacy against a clinically relevant allergen Bla g 1.
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Affiliation(s)
- B Zhou
- Department of Medicine, University of Tennessee Health Science Center, Memphis, USA
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20
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Ozdemir C, Kucuksezer UC, Akdis M, Akdis CA. Mechanisms of immunotherapy to wasp and bee venom. Clin Exp Allergy 2011; 41:1226-34. [PMID: 21729181 DOI: 10.1111/j.1365-2222.2011.03812.x] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Hymenoptera venoms are important allergens that can elicit both local and systemic allergic reactions, including life-threatening anaphylaxis. Venom immunotherapy (VIT) remains the most effective treatment, reducing the risk of systemic reactions in individuals with Hymenoptera venom allergy. VIT can restore normal immunity against venom allergens and provide patients with a lifetime of tolerance to venoms. During VIT, peripheral tolerance is induced by the generation of allergen-specific regulatory T (Treg) cells, which suppress proliferative and cytokine responses against the venom allergens. Treg cells are characterized by IL-10 secretion that directly or indirectly influence effector cells of allergic inflammation, such as mast cells, basophils and eosinophils. Treg cells also have influence on B cells, suppressing IgE production and inducing the production of blocking type IgG4 antibodies against venom allergens. An accumulating body of evidence suggests that Treg cells may affect allergen sensitization and methods for enhancing this cell population may eventually improve the efficacy of VIT. In this article, immune mechanisms enrolled in bee and wasp VIT are reviewed.
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Affiliation(s)
- C Ozdemir
- Swiss Institute of Allergy and Asthma Research, Davos, Switzerland
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Borodina I, Jensen BM, Wagner T, Hachem MA, Søndergaard I, Poulsen LK. Expression of enzymatically inactive wasp venom phospholipase A1 in Pichia pastoris. PLoS One 2011; 6:e21267. [PMID: 21731687 PMCID: PMC3121754 DOI: 10.1371/journal.pone.0021267] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2011] [Accepted: 05/25/2011] [Indexed: 12/30/2022] Open
Abstract
Wasp venom allergy is the most common insect venom allergy in Europe. It is manifested by large local reaction or anaphylactic shock occurring after a wasp sting. The allergy can be treated by specific immunotherapy with whole venom extracts. Wasp venom is difficult and costly to obtain and is a subject to composition variation, therefore it can be advantageous to substitute it with a cocktail of recombinant allergens. One of the major venom allergens is phospholipase A1, which so far has been expressed in Escherichia coli and in insect cells. Our aim was to produce the protein in secreted form in yeast Pichia pastoris, which can give high yields of correctly folded protein on defined minimal medium and secretes relatively few native proteins simplifying purification. Residual amounts of enzymatically active phospholipase A1 could be expressed, but the venom protein had a deleterious effect on growth of the yeast cells. To overcome the problem we introduced three different point mutations at the critical points of the active site, where serine137, aspartate165 or histidine229 were replaced by alanine (S137A, D165A and H229A). All the three mutated forms could be expressed in P. pastoris. The H229A mutant did not have any detectable phospholipase A1 activity and was secreted at the level of several mg/L in shake flask culture. The protein was purified by nickel-affinity chromatography and its identity was confirmed by MALDI-TOF mass spectrometry. The protein could bind IgE antibodies from wasp venom allergic patients and could inhibit the binding of wasp venom to IgE antibodies specific for phospholipase A1 as shown by Enzyme Allergo-Sorbent Test (EAST). Moreover, the recombinant protein was allergenic in a biological assay as demonstrated by its capability to induce histamine release of wasp venom-sensitive basophils. The recombinant phospholipase A1 presents a good candidate for wasp venom immunotherapy.
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Affiliation(s)
- Irina Borodina
- Center for Microbial Biotechnology, Institute of Systems Biology, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - Bettina M. Jensen
- Allergy Clinic, Dermato-Allergological Dept. K, CUH-Gentofte, Rigshospitalet Dept 7551, København Ø, Denmark
| | - Tim Wagner
- Center for Microbial Biotechnology, Institute of Systems Biology, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - Maher A. Hachem
- Enzyme and Protein Center, Institute of Systems Biology, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - Ib Søndergaard
- Center for Microbial Biotechnology, Institute of Systems Biology, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - Lars K. Poulsen
- Allergy Clinic, Dermato-Allergological Dept. K, CUH-Gentofte, Rigshospitalet Dept 7551, København Ø, Denmark
- * E-mail:
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Abstract
Incidences of allergic disease have recently increased worldwide. Allergen-specific immunotherapy (SIT) has long been a controversial treatment for allergic diseases. Although beneficial effects on clinically relevant outcomes have been demonstrated in clinical trials by subcutaneous immunotherapy (SCIT), there remains a risk of severe and sometimes fatal anaphylaxis. Mucosal immunotherapy is one advantageous choice because of its non-injection routes of administration and lower side-effect profile. This study reviews recent progress in mucosal immunotherapy for allergic diseases. Administration routes, antigen quality and quantity, and adjuvants used are major considerations in this field. Also, direct uses of unique probiotics, or specific cytokines, have been discussed. Furthermore, some researchers have reported new therapeutic ideas that combine two or more strategies. The most important strategy for development of mucosal therapies for allergic diseases is the improvement of antigen formulation, which includes continuous searching for efficient adjuvants, collecting more information about dominant T-cell epitopes of allergens, and having the proper combination of each. In clinics, when compared to other mucosal routes, sublingual immunotherapy (SLIT) is a preferred choice for therapeutic administration, although local and systemic side effects have been reported. Additionally, not every allergen has the same beneficial effect. Further studies are needed to determine the benefits of mucosal immunotherapy for different allergic diseases after comparison of the different administration routes in children and adults. Data collected from large, well-designed, double-blind, placebo-controlled, and randomized trials, with post-treatment follow-up, can provide robust substantiation of current evidence.
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Akdis CA, Akdis M. Mechanisms of allergen-specific immunotherapy. J Allergy Clin Immunol 2011; 127:18-27; quiz 28-9. [PMID: 21211639 DOI: 10.1016/j.jaci.2010.11.030] [Citation(s) in RCA: 304] [Impact Index Per Article: 23.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2010] [Revised: 11/22/2010] [Accepted: 11/22/2010] [Indexed: 01/05/2023]
Abstract
Allergen-specific immunotherapy has been used for 100 years as a desensitizing therapy for allergic diseases and represents the potentially curative and specific method of treatment. The mechanisms of action of allergen-specific immunotherapy include the very early desensitization effects, modulation of T-and B-cell responses and related antibody isotypes, and migration of eosinophils, basophils, and mast cells to tissues, as well as release of their mediators. Regulatory T (Treg) cells have been identified as key regulators of immunologic processes in peripheral tolerance to allergens. Skewing of allergen-specific effector T cells to a regulatory phenotype appears as a key event in the development of healthy immune response to allergens and successful outcome in patients undergoing allergen-specific immunotherapy. Naturally occurring forkhead box protein 3-positive CD4(+)CD25(+) Treg cells and inducible T(R)1 cells contribute to the control of allergen-specific immune responses in several major ways, which can be summarized as suppression of dendritic cells that support the generation of effector T cells; suppression of effector T(H)1, T(H)2, and T(H)17 cells; suppression of allergen-specific IgE and induction of IgG4; suppression of mast cells, basophils, and eosinophils; and suppression of effector T-cell migration to tissues. New strategies for immune intervention will likely include targeting of the molecular mechanisms of allergen tolerance and reciprocal regulation of effector and Treg cell subsets.
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Affiliation(s)
- Cezmi A Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland.
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O'Mahony L, Akdis M, Crameri R, Akdis CA. Novel immunotherapeutic approaches for allergy and asthma. Autoimmunity 2011; 43:493-503. [PMID: 20380589 DOI: 10.3109/08916931003674725] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
The immune response is a tightly regulated process, which normally results in protection from infection and tolerance of innocuous environmental antigens. However, in allergic disease, the activated immune response results in a chronic pro-inflammatory state characterized by antibody secretion (IgE) and T cell activation to normally well-tolerated antigens. Currently, the treatment of allergic disease is focused on the suppression of key inflammatory mediators or inflammatory cell populations and include anti-histamines, anti-leukotrienes, β2 adrenergic receptor agonists and corticosteroids. However, these approaches only provide a temporary suppression of disease symptoms. Successful long-term treatment can only be provided by allergen-specific immunotherapy (allergen-SIT), which restores normal immunity against allergens. This review will discuss novel approaches to the management of allergy and asthma by targeting the T regulatory cell via modulation of the commensal microbiota and allergen-SIT.
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Affiliation(s)
- Liam O'Mahony
- Swiss Institute of Allergy and Asthma Research, University of Zürich, Davos, Switzerland.
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Marcucci F, Sensi L, Di Cara G, Incorvaia C, Puccinelli P, Scurati S, Frati F. Which allergen extract for grass pollen immunotherapy? An in vitro study. Immunol Invest 2010; 39:635-44. [PMID: 20653430 DOI: 10.3109/08820131003796876] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Grass pollen is a major cause of allergy throughout the world. The only treatment targeting the causes and not only the symptoms of allergy is specific immunotherapy (IT). A number of controlled trials demonstrated the efficacy of IT in grass pollen allergic subjects, most using extracts of multiple grasses but some using extracts of a single grass. The optimal grass extract for IT has not yet been established. METHODS This study is aimed at investigating the IgE-binding pattern in sera from IT-naïve patients from central Italy with allergic rhinitis and/or asthma caused by grass pollen. A 5-grass extract was used (containing Dactylis glomerata, Poa pratensis, Lolium perenne, Antoxanthum odoratum and Phleum pratense) and compared to Phleum pratense alone, which is the most frequently used single grass extract, by the RAST-inhibition technique. RESULTS The 5-grass extract showed, by RAST-inhibition, a significantly higher binding compared to the Phleum pratense extract for Antoxanthum odoratum and Poa pratensis, while the two extracts for immunotherapy showed similar binding affinity for Phleum pratense and the non-Pooideae grass, Cynodon dactylon. CONCLUSIONS The use of a mixed-grass pollen extract seems to be the optimal choice when applying specific IT in grass pollen-allergic subjects from the Mediterranean area.
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Affiliation(s)
- F Marcucci
- Institute of Pediatrics, Department of Medical and Surgical Specialty and Public Health, Perugia, Italy
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26
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Modular antigen-translocation as a novel vaccine strategy for allergen-specific immunotherapy. Curr Opin Allergy Clin Immunol 2010; 9:568-73. [PMID: 19680120 DOI: 10.1097/aci.0b013e3283310fdf] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE OF REVIEW The purpose of the present review is to describe recent approaches aimed at improving the treatment of allergic diseases through allergen-specific immunotherapy (SIT). Special emphasis will be given to the approach based on specific targeting of the major histocompatibility complex (MHC) class-II antigen-presentation pathway. RECENT FINDINGS It is well recognized that IgE-mediated allergic diseases including rhinitis, atopic eczema and allergic asthma are increasing worldwide to a pandemic dimension. The only curative treatment remains allergen-SIT, which, however, requires a long treatment time of 3-5 years with up to 80 injections to confer protection. Recent findings strongly indicate that the treatment time and the number of injections could be drastically reduced by turning immunotherapy to a true vaccination. Direct injection of allergen extracts into the inguinal lymph nodes and targeting the MHC class-II antigen-presentation pathway by recombinant modular antigen-translocating vaccines have the potential to cure allergic diseases in a very short time. SUMMARY The mechanisms of allergic inflammation can be divided into four distinct stages: T cell activation, organ-selective homing, survival/reactivation and effector functions. On the basis of this new knowledge several novel concepts aimed at treating allergic diseases have been developed. The area of allergen-SIT is experiencing exciting developments. Reciprocal regulation of effector and regulatory T cell subsets is being more and more used to develop novel strategies for immunomodulation.
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Lührmann A, Tschernig T, von der Leyen H, Hecker M, Pabst R, Wagner AH. Decoy oligodeoxynucleotide against STAT transcription factors decreases allergic inflammation in a rat asthma model. Exp Lung Res 2010; 36:85-93. [DOI: 10.3109/01902140903144138] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Tanasa RI, Trad A, Lange H, Grötzinger J, Lemke H. Allergen IgE-isotype-specific suppression by maternally derived monoclonal anti-IgG-idiotype. Allergy 2010; 65:16-23. [PMID: 19624555 DOI: 10.1111/j.1398-9995.2009.02104.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND The dramatic increase of IgE-mediated allergic diseases in western countries demonstrates the urgent need for new therapeutic or prophylactic approaches. In mice, a prophylactic long-lasting allergen-specific suppression of IgE responsiveness is induced by maternal IgG antibodies to allergens like ovalbumin, phospholipase A(2) (bvPLA(2)) or ovomucoid. As neonatal application or maternally derived pathogen-reactive antibodies (idiotypes) as well as corresponding anti-idiotypes can induce anti-microbial protection, we probed the transgenerational IgE-suppressive mechanism with a syngeneic monoclonal anti-idiotypic antibody. METHODS The monoclonal bee-venom-phospholipase A(2) (bvPLA(2))-reactive IgG antibody MS613 (idiotype) or the corresponding syngeneic anti-idiotype II/2-19 were injected during the first 2 days postpartum to the dams. Immunization of offspring with minute doses of IgE-inducing bvPLA(2) was started at an adult age of 3(1/2) months. RESULTS The postnatal transfer of the anti-bvPLA(2) idiotype MS613 or the corresponding anti-idiotype II/2-19 induced long-lasting allergen-specific IgE suppression in a dose-dependent manner, while the IgG response to the allergen developed normally. Quantitatively, the anti-idiotype was more effective than idiotype. Molecular modeling of the idiotype-anti-idiotype complex and its comparison with the bvPLA(2) structure revealed that the anti-idiotype does not mimic bvPLA(2) epitopes and thus can not be regarded as an internal image antibody and, consequently, does not function as a surrogate antigen. CONCLUSIONS Idiotypic network reactivity is at least one major factor for induction of transgenerational IgE suppression by maternal IgG antibodies. If applicable to humans, these data suggest the possibility of a prophylactic and possibly therapeutic treatment of IgE-mediated allergic diseases with anti-idiotypic antibodies.
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Affiliation(s)
- R I Tanasa
- Biochemical Institute of the Medical Faculty, Christian-Albrechts University, Kiel, Germany
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Akdis M, Akdis CA. Therapeutic manipulation of immune tolerance in allergic disease. Nat Rev Drug Discov 2009; 8:645-60. [PMID: 19644474 DOI: 10.1038/nrd2653] [Citation(s) in RCA: 152] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Immune tolerance - the adaptation of the immune system to external antigens or allergens - might be therapeutically manipulated to restore normal immunity in conditions such as allergy, asthma and autoimmune diseases. The field of allergen-specific immunotherapy is experiencing exciting and novel developments for the treatment of allergic and autoimmune diseases, and recent insights into the reciprocal regulation and counter-balance between different T-cell subsets is foreseen to facilitate new strategies for immunointervention. This Review highlights current knowledge of immunomodulatory therapies for the manipulation of immune tolerance and highlights recent approaches to improve allergen-specific immunotherapy for the treatment of allergic diseases.
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Affiliation(s)
- Mübeccel Akdis
- Swiss Institute of Allergy and Asthma Research, University of Zurich, Obere Strasse 22, Davos Platz, Switzerland.
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Veaute C, Furlong LI, Cameo M, Harris JD, Vazquez-Levin MH. Antiacrosin antibodies and infertility. II. Gene immunization with human proacrosin to assess the effect of immunity toward proacrosin/acrosin upon protein activities and animal fertility. Fertil Steril 2009; 91:1256-68. [DOI: 10.1016/j.fertnstert.2008.01.082] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2007] [Revised: 01/22/2008] [Accepted: 01/22/2008] [Indexed: 01/08/2023]
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Criado MT, Sánchez S, Ferreirós CM. [Classic vaccinology and advances in vaccine design]. Enferm Infecc Microbiol Clin 2008; 26:564-72. [PMID: 19100177 DOI: 10.1157/13128274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The prevention of many infectious diseases, allergies, autoimmune diseases, and cancer continues to be a challenge in the twenty-first century. Nonetheless, considerable advances have already been made, such as the eradication of certain infectious diseases and effective control of many others, and new technology is being developed in areas related to molecular biology, recombinant DNA, protein biochemistry, microbiology, and immunology. The current trends point to continued progress in coming years. Technical skills will become highly refined, so that any antigen or epitope can be presented in a highly immunogenic form within a vaccine. Modern technology has led to the formulation of a new paradigm in vaccine development, in which the genomic and/or proteomic aspects of diseases are analyzed a priori to identify factors implicated in the immune response that may serve as promising vaccine candidates.
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Affiliation(s)
- María Teresa Criado
- Departamento de Microbiología y Parasitología, Facultad de Farmacia, Universidad de Santiago de Compostela, Santiago de Compostela, Spain.
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Russano AM, Agea E, Casciari C, de Benedictis FM, Spinozzi F. Complementary roles for lipid and protein allergens in triggering innate and adaptive immune systems. Allergy 2008; 63:1428-37. [PMID: 18925879 DOI: 10.1111/j.1398-9995.2008.01810.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
BACKGROUND Recent advances in allergy research mostly focussed on two major headings: improving protein allergen purification, which is aimed towards a better characterization of IgE- and T-cell reactive epitopes, and the potential new role for unconventional innate and regulatory T cells in controlling airway inflammation. These advancements could appear to be in conflict each other, as innate T cells have a poorly-defined antigen specificity that is often directed toward nonprotein substances, such as lipids. METHOD To reconcile these contrasting findings, the model of cypress pollinosis as paradigmatic for studying allergic diseases in adults is suggested. RESULTS The biochemical characterization of major native protein allergens from undenatured pollen grain demonstrated that the most relevant substance with IgE-binding activity is a glycohydrolase enzyme, which easily denaturizes in stored grains. Moreover, lipids from the pollen membrane are implicated in early pollen grain capture and recognition by CD1(+) dendritic cells (DC) and CD1-restricted T lymphocytes. These T cells display Th0/Th2 functional activity and are also able to produce regulatory cytokines, such as IL-10 and TGF-beta. CD1(+) immature DCs expand in the respiratory mucosa of allergic subjects and are able to process both proteins and lipids. CONCLUSION A final scenario may suggest that expansion and functional activation of CD1(+) DCs is a key step for mounting a Th0/Th2-deviated immune response, and that such innate response does not confer long-lasting protective immunity.
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Affiliation(s)
- A M Russano
- Laboratory of Experimental Immunology and Allergy, Department of Clinical and Experimental Medicine, University of Perugia, Perugia, Italy
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Lee BC, O'Sullivan I, Kim E, Park SG, Hwang SY, Cho D, Kim TS. A DNA adjuvant encoding a fusion protein between anti-CD3 single-chain Fv and AIMP1 enhances T helper type 1 cell-mediated immune responses in antigen-sensitized mice. Immunology 2008; 126:84-91. [PMID: 18547366 DOI: 10.1111/j.1365-2567.2008.02880.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
T helper type 1 (Th1) cell-mediated immune responses contribute to host defences against intracellular pathogen infections and cancer. Previously, we found that aminoacyl tRNA synthetase-interacting multifunctional protein 1 (AIMP1) activated macrophages and dendritic cells to enhance Th1 responses. Herein, we manipulated this property to improve Th1 immune responses in vivo by constructing a mammalian expression plasmid (pAnti-CD3sFv/AIMP1) encoding AIMP1 fused to the anti-CD3 single-chain Fv (sFv), the smallest unit of the antibody that interacts with the CD3epsilon region of the T-cell receptor. Intramuscular injection of ovalbumin (OVA)-sensitized BALB/c mice with pAnti-CD3sFv/AIMP1 DNA adjuvant increased the OVA-specific, interferon-gamma production by their CD4(+) T cells and the levels of anti-OVA immunoglobulin G2a (IgG2a) isotype in their sera. Furthermore, the pAnti-CD3sFv/AIMP1 DNA adjuvant decreased interleukin-4 production and anti-OVA IgE levels in the OVA-injected mice. Importantly, the pAnti-CD3sFv/AIMP1 was more efficient than a mixture of pAnti-CD3sFv and pAIMP1 in inducing OVA-specific Th1 immune responses and also in inhibiting OVA-specific Th2 responses during antigen priming. These studies indicated that the pAnti-CD3sFv/AIMP1 fusion DNA adjuvant enhanced Th1 immune responses in antigen-sensitized mice.
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Affiliation(s)
- Byeong Cheol Lee
- School of Life Sciences and Biotechnology, Korea University, Seoul, Korea
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Abstract
Important developments in the design of recombinant lactic acid bacteria (LAB) as mucosal carriers for a range of health-beneficial compounds, such as antigens, allergens, immune modulators, antimicrobial and trefoil peptides, single-chain antibodies and a few enzymes, have taken place in the past decade. The different approaches, strategies and proof-of-concept studies that have been conducted in animal models are reviewed in this article. The rationale for the use of lactic acid bacteria as mucosal delivery vehicles and key aspects of their interaction with the host mucosal surfaces are discussed. An overview of the progress in the field of LAB-based mucosal vaccines and a discussion of protection studies that have been conducted in rodents, mainly by intranasal and intragastric immunization, are provided. The latest developments in the use of LAB as vechicles for DNA vaccination are described. Studies that deal with successful delivery of cytokines or trefoil peptides to treat experimental colitis in rodents are reviewed. Notably, the first Phase I trial has been conducted with patients that suffer from inflammatory bowel disease using safe biologically contained recombinant lactococci that secrete human interleukin-10. Efforts to induce oral tolerance and develop preventive strategies against type I allergies using LAB are highlighted. Anti-infective strategies that are based on the delivery of microbicidal peptides are discussed, with a special emphasis on the prevention of HIV-1 infection. The concluding section captures the key learning points in the field, identifies major questions that remain to be answered and highlights challenges for the future.
The development of lactic acid bacteria as delivery vehicles for therapeutics, anti-infectives and vaccines at mucosa is discussed in this Review. Engineered LAB could be deployed to treat conditions such as allergy and inflammatory bowel disease, and might also be adopted in the fight against pathogens, including HIV-1 infection. Studies of lactic acid bacteria (LAB) as delivery vehicles have focused mainly on the development of mucosal vaccines, with much effort being devoted to the generation of genetic tools for antigen expression in different bacterial locations. Subsequently, interleukins have been co-expressed with antigens in LAB to enhance the immune response that is raised against the antigen. LAB have also been used as a delivery system for a range of molecules that have different applications, including anti-infectives, therapies for allergic diseases and therapies for gastrointestinal diseases. Now that the first human trial with a Lactococcus strain that expresses recombinant interleukin-10 has been completed, we discuss what we have learnt, what we do not yet understand and what the future holds for therapy and prophylaxis with LAB.
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Abstract
PURPOSE OF REVIEW To describe recent developments as well as the pros and cons of allergen specific immunotherapy as a putative therapeutic option for a subgroup of patients with atopic dermatitis. RECENT FINDINGS The question whether specific immunotherapy would impair or improve the severity and course of atopic dermatitis has been a matter of debate for a long time. Double-blind placebo-controlled studies on the safety and efficacy of subcutaneous and sublingual specific immunotherapy in atopic dermatitis are rare; however, a systematic review of the literature on all published studies on specific immunotherapy in atopic dermatitis, together with the results of the most recent controlled studies, provides promising results. SUMMARY The review discusses developments and recent advances in the field of specific immunotherapy as a causal therapy of sensitizations in atopic dermatitis. The most promising approaches, outlining putative immunologic as well as clinical changes which might go along with specific immunotherapy in atopic dermatitis patients, are highlighted. Further, we discuss how upcoming clinical studies and research could help to open new avenues for specific immunotherapy as a treatment for atopic dermatitis in the near future.
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Wagner AH, Wittjen I, Stojanovic T, Middel P, Meingassner JG, Hecker M. Signal transducer and activator of transcription 1 decoy oligodeoxynucleotide suppression of contact hypersensitivity. J Allergy Clin Immunol 2007; 121:158-165.e5. [PMID: 17981315 DOI: 10.1016/j.jaci.2007.09.015] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2007] [Revised: 08/16/2007] [Accepted: 09/11/2007] [Indexed: 02/05/2023]
Abstract
BACKGROUND Cytokines play a pivotal role in allergy development through activating signaling mechanisms, such as the Janus kinase/signal transducer and activator of transcription (STAT) pathway, which controls the expression of numerous proinflammatory genes. OBJECTIVE In comparison with 2 different corticosteroids and a calcineurin inhibitor, the efficacy of a STAT1 decoy oligodeoxynucleotide (dODN)-containing ointment on hapten-induced contact hypersensitivity was examined in 3 different animal models. METHODS After sensitization, the test compounds were administered before hapten challenge, after hapten challenge, or both to different sites of the animal skin. Subsequent erythema and edema formation was scored macroscopically, microscopically, or by a shift in ear weight. Biopsy specimens were taken and processed for histopathology, immunohistochemistry, and real-time PCR analyses. RESULTS Treatment with the STAT1 dODN but not the corresponding control ODN markedly improved the clinical signs of inflammation in all 3 animal models in a dose-related manner. In guinea pig skin this was accompanied by a distinct decrease in leukocyte infiltration into the dermis after 24 hours. In addition, expression of CD40, IFN-gamma, IL-1beta, IL-8, IL-12, and TNF-alpha was strongly attenuated. The dODN was equally effective in the domestic pig model when administered therapeutically, and its preventive effect in the mouse model lasted for more than 48 hours. CONCLUSIONS Altogether, treatment with the dODN proved to be at least as effective as treatment with the reference compounds.
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Affiliation(s)
- Andreas H Wagner
- Institute of Physiology and Pathophysiology, University of Heidelberg, Heidelberg, Germany
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Daniel C, Repa A, Mercenier A, Wiedermann U, Wells J. The European LABDEL project and its relevance to the prevention and treatment of allergies. Allergy 2007; 62:1237-42. [PMID: 17919137 DOI: 10.1111/j.1398-9995.2007.01496.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
In March 2001, the European Commission funded a 3-year project (contract no. QLK3-CT-2000-00340) under the fifth Framework Programme to develop and test prototype products based on the oral delivery of vaccine and therapeutic agents using harmless lactic acid bacteria (LAB). The project, best known under its acronym LABDEL (for LAB delivery) also included research on LAB fermentation and technological innovations aimed at enhancing the efficiency of LAB delivery systems (1). One of the key scientific objectives was to investigate the possibility to prevent or treat a type I allergic disease using mucosal administration of LAB expressing the pollen allergen Bet v 1. The aim of this paper was to describe the background of the project with reference to a limited selection of articles and recent reviews as well as the results and major conclusions arising from this part of the project.
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Affiliation(s)
- C Daniel
- Laboratoire des Bactéries Lactiques et Immunité des Muqueuses, Institut Pasteur de Lille, Lille Cedex, France
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Yang L, Suzuki K, Hirose S, Wakasa Y, Takaiwa F. Development of transgenic rice seed accumulating a major Japanese cedar pollen allergen (Cry j 1) structurally disrupted for oral immunotherapy. PLANT BIOTECHNOLOGY JOURNAL 2007; 5:815-26. [PMID: 17714439 DOI: 10.1111/j.1467-7652.2007.00287.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Rice seed-based edible vaccines expressing T-cell epitope peptides derived from Japanese cedar major pollen allergens have been used to successfully suppress allergen-specific Th2-mediated immunoglobulin E (IgE) responses in mouse experiments. In order to further expand the application of seed-based allergen-specific immunotherapy for controlling Japanese cedar pollinosis, we generated transgenic rice plants that specifically express recombinant Cry j 1 allergens in seeds. Cry j 1 allergens give low specific IgE-binding activity but contain all of the T-cell epitopes. The allergens were expressed directly or as a protein fusion with the major rice storage protein glutelin. Fusion proteins expressed under the control of the strong rice endosperm-specific GluB-1 promoter accumulated in rice endosperm tissue up to 15% of total seed protein. The fusion proteins aggregated with cysteine-rich prolamin and were deposited in endoplasmic reticulum-derived protein body I. The production of transgenic rice expressing structurally disrupted Cry j 1 peptides with low IgE binding activity but spanning the entire Cry j1 region can be used as a universal, safe and effective tolerogen for rice seed-based oral immunotherapy for cedar pollen allergy in humans and other mammals.
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Affiliation(s)
- Lijun Yang
- Transgenic Crop Research and Development Center, National Institute of Agrobiological Sciences, Kannondai 2-1-2, Tsukuba, Ibaraki 305-8602, Japan
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Van Overtvelt L, Lombardi V, Razafindratsita A, Saint-Lu N, Horiot S, Moussu H, Mascarell L, Moingeon P. IL-10-inducing adjuvants enhance sublingual immunotherapy efficacy in a murine asthma model. Int Arch Allergy Immunol 2007; 145:152-62. [PMID: 17848808 DOI: 10.1159/000108140] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2007] [Accepted: 05/24/2007] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND IL-10-inducing adjuvants could enhance the efficacy of allergy vaccines in establishing allergen-specific tolerance. The aim of this study was to identify such adjuvants using in vitro cultures of human and murine cells and to evaluate them in a therapeutic murine model of sublingual immunotherapy (SLIT). METHODS Adjuvants stimulating IL-10 gene expression by human or murine immune cells were tested sublingually in BALB/c mice sensitized to ovalbumin (OVA), assessing the reduction in airway hyperresponsiveness (AHR) by whole-body plethysmography. The induction of regulatory T cells (T(reg)) was evaluated using phenotypic and functional assays. T-cell proliferation in cervical lymph nodes (LNs) was assessed following intravenous transfer of CFSE-labelled OVA-specific T cells and FACS analysis. RESULTS A combination of 1,25-dihydroxyvitamin D3 plus dexamethasone (VitD3/Dex) as well as Lactobacillus plantarum were found to induce IL-10 production by human and murine dendritic cells (DCs). The former inhibits LPS-induced DC maturation, whereas L. plantarum induces DC maturation. Following stimulation with VitD3/Dex-pretreated DCs, CD4+ naïve T cells exhibit a T(reg) profile. In contrast, a Th1/T(reg) pattern of differentiation is observed in the presence of DCs treated with L. plantarum. Both adjuvants significantly enhance SLIT efficacy in mice, in association with either induction of Foxp3+ T(reg) cells (for VitD3/Dex) or proliferation of OVA-specific T cells in cervical LNs (for L. plantarum). CONCLUSIONS Both VitD3/Dex and L. plantarum polarize naïve T cells towards IL-10-expressing T cells, through distinct mechanisms. As adjuvants, they both enhance SLIT efficacy in a murine asthma model.
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MESH Headings
- Adjuvants, Immunologic/pharmacology
- Administration, Sublingual
- Animals
- Asthma/therapy
- Calcitriol/administration & dosage
- Calcitriol/pharmacology
- Cells, Cultured/drug effects
- Cells, Cultured/immunology
- Dendritic Cells/drug effects
- Dendritic Cells/immunology
- Desensitization, Immunologic
- Dexamethasone/administration & dosage
- Dexamethasone/pharmacology
- Drug Evaluation, Preclinical
- Female
- Humans
- Interleukin-10/biosynthesis
- Interleukin-10/genetics
- Lactobacillus plantarum/immunology
- Lacticaseibacillus rhamnosus/immunology
- Lymph Nodes/immunology
- Mice
- Mice, Inbred BALB C
- Mice, Transgenic
- Ovalbumin/toxicity
- T-Lymphocyte Subsets/drug effects
- T-Lymphocyte Subsets/immunology
- T-Lymphocytes, Regulatory/drug effects
- T-Lymphocytes, Regulatory/immunology
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Rodriguez-Perez R, Caballero ML, Gonzalez-Munoz M, Rodriguez-Mahillo A, Moneo I. Cloning and expression of a biologically active Anisakis simplex allergen Ani s 1 in the yeast Pichia pastoris. Mol Biochem Parasitol 2007; 154:115-8. [PMID: 17537527 DOI: 10.1016/j.molbiopara.2007.04.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2007] [Revised: 04/02/2007] [Accepted: 04/07/2007] [Indexed: 10/23/2022]
Affiliation(s)
- Rosa Rodriguez-Perez
- Servicio de Inmunologia, Hospital Carlos III, C/Sinesio Delgado 10, 28029 Madrid, Spain.
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Akdis M, Akdis CA. Mechanisms of allergen-specific immunotherapy. J Allergy Clin Immunol 2007; 119:780-91. [PMID: 17321578 DOI: 10.1016/j.jaci.2007.01.022] [Citation(s) in RCA: 220] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2006] [Revised: 01/14/2007] [Accepted: 01/16/2007] [Indexed: 10/23/2022]
Abstract
Allergen-specific immunotherapy (SIT) has been used for almost a century as a desensitizing therapy for allergic diseases and represents the only curative and specific method of treatment. Administration of appropriate concentrations of allergen extracts has been shown to be reproducibly effective when patients are carefully selected. The mechanisms by which allergen-SIT has its effects include the modulation of T-cell and B-cell responses and related antibody isotypes as well as effector cells of allergic inflammation, such as eosinophils, basophils, and mast cells. The balance between allergen-specific T-regulatory (Treg) and T(H)2 cells appears to be decisive in the development of allergic and healthy immune responses against allergens. Treg cells consistently represent the dominant subset specific for common environmental allergens in sensitized healthy individuals. In contrast, there is a high frequency of allergen-specific T(H)2 cells in patients with allergy. The induction of a tolerant state in peripheral T cells represents an essential step in allergen-SIT. Peripheral T-cell tolerance is characterized mainly by generation of allergen-specific Treg cells leading to suppressed T-cell proliferation and T(H)1 and T(H)2 cytokine responses against the allergen. This is accompanied by a significant increase in allergen-specific IgG(4), and also IgG(1) and IgA, and a decrease in IgE in the late stage of the disease. In addition, decreased tissue infiltration of mast cells and eosinophils and their mediator release including circulating basophils takes place. Current understanding of mechanisms of allergen-SIT, particularly the role of Treg cells in peripheral tolerance, may enable novel treatment strategies.
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Affiliation(s)
- Mübeccel Akdis
- Swiss Institute of Allergy and Asthma Research, Davos, Switzerland
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