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Litovkina A, Byazrova M, Smolnikov E, Nikonova A, Elisyutina O, Fedenko E, Ilina N, Akinfenwa O, Campana R, Kudlay D, Valenta R, Khaitov M. Allergic sensitization to Mal d 1 without detectable specific serum IgE. Pediatr Allergy Immunol 2022; 33:e13891. [PMID: 36564883 PMCID: PMC10107674 DOI: 10.1111/pai.13891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 10/02/2022] [Accepted: 11/09/2022] [Indexed: 12/12/2022]
Affiliation(s)
- Alla Litovkina
- National Research Center, Institute of Immunology FMBA of Russia, Moscow, Russian Federation.,Peoples' Friendship University of Russia (RUDN University), Moscow, Russian Federation
| | - Maria Byazrova
- National Research Center, Institute of Immunology FMBA of Russia, Moscow, Russian Federation.,Peoples' Friendship University of Russia (RUDN University), Moscow, Russian Federation.,Lomonosov Moscow State University, Moscow, Russian Federation
| | - Evgenii Smolnikov
- National Research Center, Institute of Immunology FMBA of Russia, Moscow, Russian Federation.,Peoples' Friendship University of Russia (RUDN University), Moscow, Russian Federation
| | - Alexandra Nikonova
- National Research Center, Institute of Immunology FMBA of Russia, Moscow, Russian Federation.,Peoples' Friendship University of Russia (RUDN University), Moscow, Russian Federation
| | - Olga Elisyutina
- National Research Center, Institute of Immunology FMBA of Russia, Moscow, Russian Federation.,Peoples' Friendship University of Russia (RUDN University), Moscow, Russian Federation
| | - Elena Fedenko
- National Research Center, Institute of Immunology FMBA of Russia, Moscow, Russian Federation
| | - Nataliya Ilina
- National Research Center, Institute of Immunology FMBA of Russia, Moscow, Russian Federation
| | - Oluwatoyin Akinfenwa
- Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Raffaela Campana
- Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Dmitry Kudlay
- National Research Center, Institute of Immunology FMBA of Russia, Moscow, Russian Federation.,Department of Clinical Immunology and Allergy, Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - Rudolf Valenta
- National Research Center, Institute of Immunology FMBA of Russia, Moscow, Russian Federation.,Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria.,Department of Clinical Immunology and Allergy, Sechenov First Moscow State Medical University, Moscow, Russian Federation.,Karl Landsteiner University of Health Sciences, Krems, Austria
| | - Musa Khaitov
- National Research Center, Institute of Immunology FMBA of Russia, Moscow, Russian Federation.,Pirogov Russian National Research Medical University, Moscow, Russian Federation
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Douladiris N, Garib V, Focke-Tejkl M, Valenta R, Papadopoulos NG, Linhart B. Detection of genuine grass pollen sensitization in children by skin testing with a recombinant grass pollen hybrid. Pediatr Allergy Immunol 2019; 30:59-65. [PMID: 30317676 PMCID: PMC6378406 DOI: 10.1111/pai.12991] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 09/10/2018] [Accepted: 10/05/2018] [Indexed: 01/02/2023]
Abstract
BACKGROUND Skin testing represents a commonly used first diagnostic method in clinical practice, but allergen extracts may vary in composition and often contain cross-reactive allergens and therefore do not always allow the precise identification of the sensitizing allergen source. Our aim was to investigate the suitability of a single recombinant hybrid molecule, consisting of the four major timothy grass pollen allergens (Phl p 1, Phl p 2, Phl p 5, and Phl p 6) for in vivo diagnosis of genuine grass pollen allergy in children suffering from pollinosis. METHODS Sixty-four children aged from 6 to 17 years with a positive skin reaction and/or specific IgE to grass pollen extract and respiratory symptoms of pollinosis as well as 9 control children with allergy to other allergen sources were studied. SPT was performed with the recombinant hybrid, the four recombinant timothy grass pollen allergens, and grass pollen extract. Specific IgE reactivity to 176 micro-arrayed allergen molecules was determined using ImmunoCAP ISAC technology. IgE reactivity to the hybrid was detected by non-denaturing RAST-based dot blot assay. RESULTS Genuine grass pollen sensitization was confirmed in 94% of the children with positive SPT to grass pollen extract by SPT and IgE reactivity to the hybrid. The four hybrid-negative children showed IgE reactivity to cross-reactive allergens such as Phl p 4, Phl p 11, and Phl p 12 and had also sensitizations to pollen allergens from unrelated plants. CONCLUSIONS The recombinant hybrid molecule represents a useful tool for in vivo diagnosis of genuine grass pollen sensitization.
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Affiliation(s)
- Nikolaos Douladiris
- Allergy Department, 2nd Pediatric Clinic, University of Athens, Athens, Greece
| | - Victoria Garib
- Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Margit Focke-Tejkl
- Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Rudolf Valenta
- Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria.,NRC Institute of Immunology FMBA of Russia, Moscow, Russia.,Laboratory for Immunopathology, Department of Clinical Immunology and Allergy, Sechenov First Moscow State Medical University, Moscow, Russia
| | - Nikolaos G Papadopoulos
- Allergy Department, 2nd Pediatric Clinic, University of Athens, Athens, Greece.,Division of Infection, Immunity & Respiratory Medicine, University of Manchester, Manchester, UK
| | - Birgit Linhart
- Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
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Matricardi PM, Dramburg S, Skevaki C, Renz H. "Molecular extracts" for allergy diagnostics and therapy. Pediatr Allergy Immunol 2019; 30:55-58. [PMID: 30697871 DOI: 10.1111/pai.13001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 10/19/2018] [Indexed: 01/10/2023]
Affiliation(s)
- Paolo Maria Matricardi
- Department of Pediatric Pulmonology, Immunology and Intensive Care Medicine, Charité - University Medicine Berlin, Berlin, Germany
| | - Stephanie Dramburg
- Department of Pediatric Pulmonology, Immunology and Intensive Care Medicine, Charité - University Medicine Berlin, Berlin, Germany
| | - Chrysanthi Skevaki
- Institute of Laboratory Medicine, Universities of Giessen and Marburg Lung Center (UGMLC), Philipps University Marburg, German Center for Lung Research (DZL), Marburg, Germany
| | - Harald Renz
- Institute of Laboratory Medicine, Universities of Giessen and Marburg Lung Center (UGMLC), Philipps University Marburg, German Center for Lung Research (DZL), Marburg, Germany
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Valenta R, Karaulov A, Niederberger V, Zhernov Y, Elisyutina O, Campana R, Focke-Tejkl M, Curin M, Namazova-Baranova L, Wang JY, Pawankar R, Khaitov M. Allergen Extracts for In Vivo Diagnosis and Treatment of Allergy: Is There a Future? THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2018; 6:1845-1855.e2. [PMID: 30297269 PMCID: PMC6390933 DOI: 10.1016/j.jaip.2018.08.032] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 08/27/2018] [Accepted: 08/31/2018] [Indexed: 02/07/2023]
Abstract
Today, in vivo allergy diagnosis and allergen-specific immunotherapy (AIT) are still based on allergen extracts obtained from natural allergen sources. Several studies analyzing the composition of natural allergen extracts have shown severe problems regarding their quality such as the presence of undefined nonallergenic materials, contaminants as well as high variabilities regarding contents and biological activity of individual allergens. Despite the increasing availability of sophisticated analytical technologies, these problems cannot be overcome because they are inherent to allergen sources and methods of extract production. For in vitro allergy diagnosis problems related to natural allergen extracts have been largely overcome by the implementation of recombinant allergen molecules that are defined regarding purity and biological activity. However, no such advances have been made for allergen preparations to be used in vivo for diagnosis and therapy. No clinical studies have been performed for allergen extracts available for in vivo allergy diagnosis that document safety, sensitivity, and specificity of the products. Only for very few therapeutic allergen extracts state-of-the-art clinical studies have been performed that provide evidence for safety and efficacy. In this article, we discuss problems related to the inconsistent quality of products based on natural allergen extracts and share our observations that most of the products available for in vivo diagnosis and AIT do not meet the international standards for medicinal products. We argue that a replacement of natural allergen extracts by defined recombinantly produced allergen molecules and/or mixtures thereof may be the only way to guarantee the supply of clinicians with state-of-the-art medicinal products for in vivo diagnosis and treatment of allergic patients in the future.
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Affiliation(s)
- Rudolf Valenta
- Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria; NRC Institute of Immunology FMBA of Russia, Moscow, Russia; Laboratory for Immunopathology, Department of Clinical Immunology and Allergy, Sechenov First Moscow State Medical University, Moscow, Russia.
| | - Alexander Karaulov
- Laboratory for Immunopathology, Department of Clinical Immunology and Allergy, Sechenov First Moscow State Medical University, Moscow, Russia
| | - Verena Niederberger
- Department of Otorhinolaryngology, Medical University of Vienna, Vienna, Austria
| | - Yury Zhernov
- NRC Institute of Immunology FMBA of Russia, Moscow, Russia
| | | | - Raffaela Campana
- Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Margarete Focke-Tejkl
- Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Mirela Curin
- Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Leyla Namazova-Baranova
- Department of Pediatrics, Pirogov Russian National Research Medical University, Moscow, Russia
| | - Jiu-Yao Wang
- Center for Allergy and Immunology Research (ACIR), College of Medicine, National Cheng Kung University (Hospital), Tainan, Taiwan
| | - Ruby Pawankar
- Division of Allergy, Department of Pediatrics, Nippon Medical School, Tokyo, Japan
| | - Musa Khaitov
- NRC Institute of Immunology FMBA of Russia, Moscow, Russia
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Gangl K, Niederberger V, Valenta R. Multiple grass mixes as opposed to single grasses for allergen immunotherapy in allergic rhinitis. Clin Exp Allergy 2014; 43:1202-16. [PMID: 24152153 DOI: 10.1111/cea.12128] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2012] [Revised: 03/31/2013] [Accepted: 04/08/2013] [Indexed: 12/22/2022]
Abstract
Grass pollen allergy affects approximately 40% of allergic patients. Subcutaneous allergen immunotherapy (SCIT) is the only allergen-specific and disease-modifying treatment available. Currently available therapeutic vaccines for the treatment of grass pollen allergy are based on natural grass pollen extracts which are either made from pollen of one cross-reactive grass species or from several related grass species. Clinical studies have shown that SCIT performed with timothy grass pollen extract is effective for the treatment of grass pollen allergy. Moreover, it has been demonstrated that recombinant timothy grass pollen allergens contain the majority of relevant epitopes and can be used for SCIT in clinical trials. However, recent in vitro studies have suggested that mixes consisting of allergen extracts from several related grass species may have advantages for SCIT over single allergen extracts. Here, we review current knowledge regarding the disease-relevant allergens in grass pollen allergy, available clinical studies comparing SCIT with allergen extracts from timothy grass or from mixes of several related grass species of the Pooideae subfamily, in vitro cross-reactivity studies performed with natural allergen extracts and recombinant allergens and SCIT studies performed with recombinant timothy grass pollen allergens. In vitro and clinical studies performed with natural allergen extracts reveal no relevant advantages of using multiple grass mixes as opposed to single grass pollen extracts. Several studies analysing the molecular composition of natural allergen extracts and the molecular profile of patients' immune responses after SCIT with allergen extracts indicate that the major limitation for the production of a high quality grass pollen vaccine resides in intrinsic features of natural allergen extracts which can only be overcome with recombinant allergen-based technologies.
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Affiliation(s)
- K Gangl
- Department of Otorhinolaryngology, Medical University of Vienna, Vienna, Austria
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Niederberger V, Eckl-Dorna J, Pauli G. Recombinant allergen-based provocation testing. Methods 2014; 66:96-105. [PMID: 23920475 PMCID: PMC3988965 DOI: 10.1016/j.ymeth.2013.07.037] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2013] [Revised: 07/08/2013] [Accepted: 07/15/2013] [Indexed: 01/02/2023] Open
Abstract
Over the last 25 years, recombinant allergens from all important allergen sources have been cloned and are now available as recombinant proteins. These molecules can be produced in practically unlimited amounts without biological or batch-to-batch variability. It has been shown in provocation tests that recombinant allergens have similar clinical effects as their natural counterparts. With the help of these tools it is possible to reveal the precise reactivity profiles of patients and to uncover and differentiate cross-reactivity from genuine sensitization to an allergen source. Although it has been shown some time ago that it would be possible to replace crude allergen extracts with recombinant allergens for skin prick testing, and even though the use of allergen components can improve routine diagnosis, these tools are still not available for clinical routine applications. The use of provocation tests is a crucial step in the development of new, hypoallergenic vaccines for therapy of allergic disease. Here we describe important provocation methods (skin prick test, intradermal test, atopy patch test, nasal provocation, colonoscopic provocation test) and give an overview of the clinical provocation studies which have been performed with recombinant allergens so far.
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Affiliation(s)
| | - Julia Eckl-Dorna
- Dept. of Otorhinolaryngology, Medical University of Vienna, Austria
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7
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Marzban G, Herndl A, Maghuly F, Katinger H, Laimer M. Mapping of fruit allergens by 2D electrophoresis and immunodetection. Expert Rev Proteomics 2014; 5:61-75. [DOI: 10.1586/14789450.5.1.61] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Pasha I, Saeed F, Sultan MT, Batool R, Aziz M, Ahmed W. Wheat Allergy and Intolerence; Recent Updates and Perspectives. Crit Rev Food Sci Nutr 2013; 56:13-24. [DOI: 10.1080/10408398.2012.659818] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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9
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Casset A, Mari A, Purohit A, Resch Y, Weghofer M, Ferrara R, Thomas WR, Alessandri C, Chen KW, de Blay F, Valenta R, Vrtala S. Varying allergen composition and content affects the in vivo allergenic activity of commercial Dermatophagoides pteronyssinus extracts. Int Arch Allergy Immunol 2012; 159:253-62. [PMID: 22722650 DOI: 10.1159/000337654] [Citation(s) in RCA: 128] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2011] [Accepted: 02/22/2012] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Diagnosis and immunotherapy of house-dust mite (HDM) allergy is still based on natural allergen extracts. The aim of this study was to analyze commercially available Dermatophagoides pteronyssinus extracts from different manufacturers regarding allergen composition and content and whether variations may affect their allergenic activity. METHODS Antibodies specific for several D. pteronyssinus allergens (Der p 1, 2, 5, 7, 10 and 21) were used to analyze extracts from 10 different manufacturers by immunoblotting. Sandwich ELISAs were used to quantify Der p 1 and Der p 2 in the extracts. Mite-allergic patients (n = 45) were skin-tested with the extracts and tested for immunoglobulin E (IgE) reactivity to a panel of 10 mite allergens (Der p 1, 2, 4, 5, 7, 8, 10, 14, 20 and 21) by dot blot. RESULTS Only Der p 1 and Der p 2 were detected in all extracts but their concentrations and ratios showed high variability (Der p 1: 6.0-40.8 µg ml(-1); Der p 2: 1.7-45.0 µg ml(-1)). At least 1 out of 4 allergens (i.e. Der p 5, 7, 10 and 21) was not detected in 8 of the studied extracts. Mite-allergic subjects showed different IgE reactivity profiles to the individual mite allergens, the extracts showed different allergenic activity in skin-prick tests and false-negative results. CONCLUSIONS Commercially available D. pteronyssinus extracts lack important allergens, show great variability regarding allergen composition and content and some gave false-negative diagnostic test results in certain patients.
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Affiliation(s)
- Anne Casset
- Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
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10
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Tripodi S, Frediani T, Lucarelli S, Macrì F, Pingitore G, Di Rienzo Businco A, Dondi A, Pansa P, Ragusa G, Asero R, Faggian D, Plebani M, Matricardi PM. Molecular profiles of IgE to Phleum pratense in children with grass pollen allergy: implications for specific immunotherapy. J Allergy Clin Immunol 2011; 129:834-839.e8. [PMID: 22206774 DOI: 10.1016/j.jaci.2011.10.045] [Citation(s) in RCA: 110] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2011] [Revised: 09/26/2011] [Accepted: 10/20/2011] [Indexed: 01/03/2023]
Abstract
BACKGROUND The so-called component-resolved immunotherapy of allergies proposes an immunization tailored to the molecular sensitization profiles of individual patients. OBJECTIVES We sought (1) to investigate the profiles of IgE sensitization to Phleum pratense in children with grass pollen allergy and (2) to define the compatibility of these profiles with a mixture of recombinant allergenic molecules of P pratense previously proposed for specific immunotherapy. METHODS We examined 200 children (age, 4-18 years; 126 boys) with allergic rhinitis, asthma, or both ascertained through validated questionnaires. Each child underwent skin prick testing (ALK-Abelló) and serum IgE assays (ImmunoCAP, Phadia) with 9 pollen extracts. Sera reacting against P pratense were tested for the individual molecules (rPhl p 1, rPhl p 2, rPhl p 4, nPhl p 4, rPhl p 5b, rPhl p 6, rPhl p 7, rPhl p 11, and Phl p 12). Through a combinatorial approach, the IgE individual sensitization profiles were matched against an experimental allergen-specific immunotherapy (SIT) preparation containing Phl p 1, Phl p 2, Phl p 5, and Phl p 6. RESULTS Among the 176 of 200 children with IgE sensitization to P pratense extract, 39 profiles of sensitization to the 8 allergenic molecules tested (cutoff, 0.35 kU/L) were identified. This high heterogeneity was reduced by considering only 6 or 4 P pratense molecules but not by increasing the cutoff levels of IgE positivity. The molecular profile of the experimental SIT preparation matched that of 7 (4%) of 176 patients only; the remaining 169 patients were classified in 4 mismatch categories: underpowered (29%), overpowered (32%), underpowered/overpowered (32%), and unrelated (3%). CONCLUSIONS IgE sensitization profiles to P pratense are highly heterogeneous. Molecularly designed SIT preparations tailored to patients' needs should consider this high heterogeneity and be driven by locally performed population studies.
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Kizilpinar I, Civelek E, Tuncer A, Dogan C, Karabulut E, Sahiner UM, Yavuz ST, Sackesen C. Pollen counts and their relationship to meteorological factors in Ankara, Turkey during 2005-2008. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2011; 55:623-631. [PMID: 20953636 DOI: 10.1007/s00484-010-0363-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2010] [Revised: 08/30/2010] [Accepted: 09/02/2010] [Indexed: 05/30/2023]
Abstract
Pollen plays an important role in the development and exacerbation of allergic diseases. We aimed to investigate the days with highest counts of the most allergenic pollens and to identify the meteorological factors affecting pollen counts in the atmosphere of Ankara, Turkey. Airborne pollen measurements were carried out from 2005 to 2008 with a Burkard volumetric 7-day spore trap. Microscope counts were converted into atmospheric concentrations and expressed as pollen grains/m(3). Meteorological parameters were obtained from the State Meteorological Service. All statistical analyses were done with pollen counts obtained from March to October for each year. The percentages of tree, grass and weed pollens were 72.1% (n = 24,923), 12.8% (n = 4,433) and 15.1% (n = 5,219), respectively. The Pinaceae family from tree taxa (39% to 57%) and the Chenopodiaceae/Amaranthaceae family from weed taxa, contributed the highest percentage of pollen (25% to 43%), while from the grass taxa, only the Poaceae family was detected from 2005 to 2008. Poaceae and Chenopodiaceae/Amaranthaceae families, which are the most allergenic pollens, were found in high numbers from May to August in Ankara. In multiple logistic regression analysis, wind speed (OR = 1.18, CI95% = 1.02-1.36, P = 0.023) for tree pollen, daily mean temperature (OR = 1.10, CI95% = 1.04-1.17, P = 0.001) and sunshine hours (OR = 1.15, CI95% = 1.01-1.30, P = 0.033) for grass pollen, and sunshine hours (OR = 3.79, CI95% = 1.03-13.92, P = 0.044) for weed pollen were found as significant risk factors for high pollen count. The pollen calendar and its association with meteorological factors depend mainly on daily temperature, sunshine hours and wind speed, which may help draw the attention of physicians and allergic patients to days with high pollen counts.
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Affiliation(s)
- Ilginc Kizilpinar
- Department of Biology, Faculty of Sciences, Hacettepe University, Ankara, Turkey.
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13
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Lucas J. Microarrays: molecular allergology and nanotechnology for personalised medicine (I). Allergol Immunopathol (Madr) 2010; 38:153-61. [PMID: 20398997 DOI: 10.1016/j.aller.2010.03.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2010] [Accepted: 03/02/2010] [Indexed: 02/07/2023]
Abstract
The diagnosis of antibody-mediated allergic disorders is based on the clinical findings and the detection of allergen-specific IgE based on in vitro and in vivo techniques, together with allergen provocation tests. In vitro diagnostic techniques have progressed enormously following the introduction of the advances made in proteomics and nanotechnology--offering tools for the diagnosis and investigation of allergy at molecular level. The most advanced developments are the microarray techniques, which in genomics allowed rapid description of the human genetic code, and which now have been applied to proteomics, broadening the field for research and clinical use. Together with these technological advances, the characterisation of most of the different proteins generating specific IgE and which conform each natural allergen, as well as their purification or genetic engineering-based synthesis, have been crucial elements--offering the possibility of identifying disease-causing allergens at molecular level, establishing a component-resolved diagnosis (CRD), using them to study the natural course of the disease, and applying them to improvements in specific immunotherapy. Microarrays of allergic components offer results relating to hundreds of these allergenic components in a single test, and use a small amount of serum that can be obtained from capillary blood. The availability of new molecules will allow the development of panels including new allergenic components and sources, which will require evaluation for clinical use. The present study reviews these new developments, component-resolved diagnosis, and the development of microarray techniques as a critical element for furthering our knowledge of allergic disease.
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Focke M, Swoboda I, Marth K, Valenta R. Developments in allergen-specific immunotherapy: from allergen extracts to allergy vaccines bypassing allergen-specific immunoglobulin E and T cell reactivity. Clin Exp Allergy 2010; 40:385-97. [DOI: 10.1111/j.1365-2222.2009.03443.x] [Citation(s) in RCA: 89] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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15
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Mothes-Luksch N, Stumvoll S, Linhart B, Focke M, Krauth MT, Hauswirth A, Valent P, Verdino P, Pavkov T, Keller W, Grote M, Valenta R. Disruption of allergenic activity of the major grass pollen allergen Phl p 2 by reassembly as a mosaic protein. THE JOURNAL OF IMMUNOLOGY 2008; 181:4864-73. [PMID: 18802090 DOI: 10.4049/jimmunol.181.7.4864] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
The recognition of conformational epitopes on respiratory allergens by IgE Abs is a key event in allergic inflammation. We report a molecular strategy for the conversion of allergens into vaccines with reduced allergenic activity, which is based on the reassembly of non-IgE-reactive fragments in the form of mosaic proteins. This evolution process is exemplified for timothy grass pollen-derived Phl p 2, a major allergen for more than 200 million allergic patients. In a first step, the allergen was disrupted into peptide fragments lacking IgE reactivity. cDNAs coding for these peptides were reassembled in altered order and expressed as a recombinant mosaic molecule. The mosaic molecule had lost the three-dimensional structure, the IgE reactivity, and allergenic activity of the wild-type allergen, but it induced high levels of allergen-specific IgG Abs upon immunization. These IgG Abs crossreacted with group 2 allergens from other grass species and inhibited allergic patients' IgE binding to the wild-type allergen. The mosaic strategy is a general strategy for the reduction of allergenic activity of protein allergens and can be used to convert harmful allergens into safe vaccines.
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Affiliation(s)
- Nadine Mothes-Luksch
- Division of Immunopathology, Department of Pathophysiology, Center of Physiology, Pathophysiology and Immunology, Vienna General Hospital, Medical University of Vienna, Vienna, Austria
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Akdis CA. New insights into mechanisms of immunoregulation in 2007. J Allergy Clin Immunol 2008; 122:700-709. [PMID: 19014761 DOI: 10.1016/j.jaci.2008.07.048] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2008] [Accepted: 07/11/2008] [Indexed: 11/25/2022]
Abstract
Substantial progress in understanding the mechanisms of immune regulation in allergic diseases and asthma has been made during the last year. In asthma, rhinitis, and atopic dermatitis the immune system is activated by allergens, autoantigens, and components of superimposed infectious agents. Immune regulation in the lymphatic organs and in the tissue has an important role in the control and suppression of allergic disease in all stages of the inflammatory process, such as cell migration to tissues, cells gaining an inflammatory and tissue-destructive phenotype in the tissues, and their interaction with resident tissue cells to augment the inflammation. After the discovery of regulatory T cells, the importance of their unique suppressive capacity was strongly emphasized for the suppression of effector T-cell responses. However, it seems that all 3 subsets of effector T(H)1, T(H)2, and T(H)17 cells, as well as regulatory T cells, regulate each other at the level of transcription, major cytokines, and surface molecules. This review highlights key advances in immune regulation that were published in the Journal of Allergy and Clinical Immunology.
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Affiliation(s)
- Cezmi A Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), Davos, Switzerland.
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Linhart B, Mothes-Luksch N, Vrtala S, Kneidinger M, Valent P, Valenta R. A hypoallergenic hybrid molecule with increased immunogenicity consisting of derivatives of the major grass pollen allergens, Phl p 2 and Phl p 6. Biol Chem 2008; 389:925-33. [PMID: 18627317 DOI: 10.1515/bc.2008.105] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Allergen-specific immunotherapy is currently based on the administration of allergen extracts containing natural allergens. However, its broad application is limited by the poor quality of these extracts. Based on recombinant allergens, well-defined allergy vaccines for allergen-specific immunotherapy can be produced. Furthermore, they can be modified to reduce their allergenic activity and to avoid IgE-mediated side effects. Here, we demonstrate that the immunogenicity of two grass pollen-derived hypoallergenic allergen derivatives could be increased by engineering them as a single hybrid molecule. We used a hypoallergenic Phl p 2 mosaic, generated by fragmentation of the Phl p 2 sequence and reassembly of the resulting peptides in an altered order, and a truncated Phl p 6 allergen, to produce a hybrid protein. The hybrid retained the reduction of IgE reactivity and allergenic activity of its components as shown by ELISA and basophil activation assays. Immunization with the hybrid molecule demonstrated the increased immunogenicity of this molecule, leading to higher levels of allergen-specific IgG antibodies compared to the single components. These antibodies could inhibit patients' IgE binding to the wild-type allergens. Thus, the described strategy allows the development of safer and more efficacious vaccines for the treatment of grass pollen allergy.
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Affiliation(s)
- Birgit Linhart
- Division of Immunopathology, Department of Pathophysiology, Center of Physiology, Pathophysiology and Immunology, Medical University of Vienna, Vienna, Austria.
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18
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Broide D. New perspectives on mechanisms underlying chronic allergic inflammation and asthma in 2007. J Allergy Clin Immunol 2008; 122:475-80. [PMID: 18694589 DOI: 10.1016/j.jaci.2008.06.025] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2008] [Accepted: 06/19/2008] [Indexed: 12/16/2022]
Abstract
This review summarizes selected articles appearing from January to December 2007 in the Journal of Allergy and Clinical Immunology. Articles were chosen that related to advances in mechanisms of chronic allergic inflammation and asthma, including those describing gene association studies, mast cells, IgE, eosinophils, cytokines, the inception of allergy, airway remodeling, preclinical therapeutic targets, and virally induced asthma.
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Affiliation(s)
- David Broide
- Department of Medicine, University of California San Diego, La Jolla, CA 92093-0635, USA.
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Saltoun C, Avila PC. Advances in upper airway diseases and allergen immunotherapy in 2007. J Allergy Clin Immunol 2008; 122:481-7. [PMID: 18694591 DOI: 10.1016/j.jaci.2008.06.027] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2008] [Revised: 06/22/2008] [Accepted: 06/24/2008] [Indexed: 01/08/2023]
Abstract
The purpose of this review is to highlight important articles on upper airway diseases and immunotherapy that appeared in 2007. Advances in rhinitis include the realization that allergic rhinitis might be caused by local nasal IgE sensitization to aeroallergens in the absence of systemic evidence of IgE sensitization. After inhalation, allergens might reach systemic circulation. Epidemiologic studies continue to show that allergic rhinitis impairs school performance and is a risk factor for future asthma. New pathways are being identified in chronic sinusitis, as well as in different types of allergic ocular diseases. New treatments for patients with allergic rhinitis include use of beta-1,3-glucan, a mushroom product that can reduce allergic symptoms by inducing T(H)1 response, and olopatadine nasal spray. Studies on immunotherapy in 2007 suggest that sublingual immunotherapy induces similar immunologic alterations as those induced by subcutaneous immunotherapy, although to a lesser degree. Among allergists in the United States, there is a sizable variation in clinical practice, particularly related to concomitant administration of immunotherapy and beta-blockers, to administration of angiotensin-converting enzyme inhibitors, and to patients with HIV or autoimmune diseases. The combination of omalizumab with allergen subcutaneous immunotherapy can enhance clinical efficacy. Recombinant technology can modify allergen structure to prevent binding to IgE (allergenicity) while enhancing immunogenicity (stimulation of T cells), which might improve the safety and efficacy of immunotherapy.
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MESH Headings
- Administration, Sublingual
- Anti-Allergic Agents/therapeutic use
- Antibodies, Anti-Idiotypic
- Antibodies, Monoclonal/therapeutic use
- Antibodies, Monoclonal, Humanized
- Asthma/immunology
- Asthma/physiopathology
- Asthma/therapy
- Conjunctivitis/drug therapy
- Conjunctivitis/immunology
- Conjunctivitis, Allergic
- Desensitization, Immunologic
- Humans
- Hypersensitivity/immunology
- Hypersensitivity/physiopathology
- Hypersensitivity/therapy
- Immunoglobulin E/blood
- Omalizumab
- Respiratory Tract Diseases/immunology
- Respiratory Tract Diseases/physiopathology
- Respiratory Tract Diseases/therapy
- Rhinitis, Allergic, Seasonal/immunology
- Rhinitis, Allergic, Seasonal/therapy
- Sinusitis/drug therapy
- Sinusitis/immunology
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Affiliation(s)
- Carol Saltoun
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
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Bhalla PL, Singh MB. Biotechnology-based allergy diagnosis and vaccination. Trends Biotechnol 2008; 26:153-61. [PMID: 18222557 DOI: 10.1016/j.tibtech.2007.11.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2007] [Revised: 11/21/2007] [Accepted: 11/21/2007] [Indexed: 10/22/2022]
Abstract
The diagnosis and immunotherapy currently applied to allergic diseases involve the use of crude extracts of the allergen source without defining the allergy-eliciting molecule(s). Advances in recombinant DNA technology have made identification, cloning, expression and epitope mapping of clinically significant allergens possible. Recombinant allergens that retain the immunological features of natural allergens form the basis of accurate protein-chip-based methods for diagnosing allergic conditions. The ability to produce rationally designed hypoallergenic forms of allergens is leading to the development of novel and safe forms of allergy vaccines with improved efficacy. The initial clinical tests on recombinant-allergen-based vaccine preparations have provided positive results, and ongoing developments in areas such as alternative routes of vaccine delivery will enhance patient compliance.
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Affiliation(s)
- Prem L Bhalla
- Plant Molecular Biology and Biotechnology Laboratory, Australian Research Council Centre of Excellence for Integrative Legume Research, Faculty of Land and Food Resources, The University of Melbourne, Parkville, Victoria, Australia.
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Leb VM, Jahn-Schmid B, Schmetterer KG, Kueng HJ, Haiderer D, Neunkirchner A, Fischer GF, Nissler K, Hartl A, Thalhamer J, Bohle B, Seed B, Pickl WF. Molecular and functional analysis of the antigen receptor of Art v 1–specific helper T lymphocytes. J Allergy Clin Immunol 2008; 121:64-71. [DOI: 10.1016/j.jaci.2007.10.006] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2007] [Revised: 10/05/2007] [Accepted: 10/08/2007] [Indexed: 10/22/2022]
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