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Furiness KN, El Ansari YS, Oettgen HC, Kanagaratham C. Allergen-specific IgA and IgG antibodies as inhibitors of mast cell function in food allergy. FRONTIERS IN ALLERGY 2024; 5:1389669. [PMID: 38919913 PMCID: PMC11196826 DOI: 10.3389/falgy.2024.1389669] [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: 02/21/2024] [Accepted: 05/21/2024] [Indexed: 06/27/2024] Open
Abstract
Food allergy, a group of adverse immune responses to normally innocuous food protein antigens, is an increasingly prevalent public health issue. The most common form is IgE-mediated food allergy in which food antigen-induced crosslinking of the high-affinity IgE-receptor, FcεRI, on the surface of mast cells triggers the release of inflammatory mediators that contribute to a wide range of clinical manifestations, including systemic anaphylaxis. Mast cells also play a critical function in adaptive immunity to foods, acting as adjuvants for food-antigen driven Th2 cell responses. While the diagnosis and treatment of food allergy has improved in recent years, no curative treatments are currently available. However, there is emerging evidence to suggest that both allergen-specific IgA and IgG antibodies can counter the activating effects of IgE antibodies on mast cells. Most notably, both antigen-specific IgA and IgG antibodies are induced in the course of oral immunotherapy. In this review, we highlight the role of mast cells in food allergy, both as inducers of immediate hypersensitivity reactions and as adjuvants for type 2 adaptive immune responses. Furthermore, we summarize current understanding of the immunomodulatory effects of antigen-specific IgA and IgG antibodies on IgE-induced mast cell activation and effector function. A more comprehensive understanding of the regulatory role of IgA and IgG in food allergy may provide insights into physiologic regulation of immune responses to ingested antigens and could seed novel strategies to treat allergic disease.
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Affiliation(s)
- Kameryn N. Furiness
- Division of Immunology, Department of Pediatrics, Boston Children’s Hospital, Boston, MA, United States
| | - Yasmeen S. El Ansari
- Division of Immunology, Department of Pediatrics, Boston Children’s Hospital, Boston, MA, United States
- Institute of Laboratory Medicine, Philipps University Marburg, Marburg, Germany
| | - Hans C. Oettgen
- Division of Immunology, Department of Pediatrics, Boston Children’s Hospital, Boston, MA, United States
- Department of Pediatrics, Harvard Medical School, Boston, MA, United States
| | - Cynthia Kanagaratham
- Division of Immunology, Department of Pediatrics, Boston Children’s Hospital, Boston, MA, United States
- Department of Pediatrics, Harvard Medical School, Boston, MA, United States
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2
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Storni F, Vogel M, Bachmann MF, Engeroff P. IgG in the control of FcεRI activation: a battle on multiple fronts. Front Immunol 2024; 14:1339171. [PMID: 38274816 PMCID: PMC10808611 DOI: 10.3389/fimmu.2023.1339171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 12/11/2023] [Indexed: 01/27/2024] Open
Abstract
The rising global incidence of IgE-mediated allergic reactions poses a significant challenge to the quality of life of affected individuals and to healthcare systems, with current treatments being limited in effectiveness, safety, and disease-modifying capabilities. IgE acts by sensitizing the high-affinity IgE receptor FcεRI expressed by mast cells and basophils, tuning these cells for inflammatory degranulation in response to future allergen encounters. In recent years, IgG has emerged as an essential negative regulator of IgE-dependent allergic inflammation. Mechanistically, studies have proposed different pathways by which IgG can interfere with the activation of IgE-mediated inflammation. Here, we briefly summarize the major proposed mechanisms of action by which IgG controls the IgE-FcεRI inflammatory axis and how those mechanisms are currently applied as therapeutic interventions for IgE-mediated inflammation.
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Affiliation(s)
- Federico Storni
- Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Department of BioMedical Research, University of Bern, Bern, Switzerland
| | - Monique Vogel
- Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Department of Rheumatology and Immunology, University Hospital Bern, Bern, Switzerland
| | - Martin F. Bachmann
- Department of BioMedical Research, University of Bern, Bern, Switzerland
- Department of Rheumatology and Immunology, University Hospital Bern, Bern, Switzerland
| | - Paul Engeroff
- Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Department of Rheumatology and Immunology, University Hospital Bern, Bern, Switzerland
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3
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Baghlaf MA, Eid NM, Enani S, Kokandi S, Alhussaini B, Waked MS. Prevalence and Risk Factors for IgE and IgG Cow's Milk Protein Allergies in Saudi Arabia. Cureus 2023; 15:e50812. [PMID: 38125695 PMCID: PMC10730981 DOI: 10.7759/cureus.50812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/19/2023] [Indexed: 12/23/2023] Open
Abstract
Cow's milk protein allergies (CMPAs) particularly occur in infancy and early childhood due to an immunological allergic reaction to milk proteins. This issue is increasing in Saudi Arabia and requires research to improve health status and provide alternatives. Our study aims to investigate the important aspects of immunoglobulin E (IgE) and IgG CMPA in Saudi Arabia regarding its prevalence and association with demographic and health-related factors in both adult and pediatric populations. A descriptive retrospective cross-sectional study was conducted on 376 patients, comprising 314 adults aged between 19 and 86 years, and 62 pediatric patients aged between one and 12 years. The study focused on individuals who attended a private medical center in Jeddah city over the past five years. Laboratory results for food allergy of IgE and IgG tests, including cow's milk proteins (CMPs), serum 25-hydroxyvitamin D (25OHD), specific IgE inhalant allergy results, and other health-related factors were collected from an electronic record system. Results have shown that casein was the most common sensitizing allergen of CMPs in adults, whereas α-lactalbumin was the most common sensitizing allergen in pediatrics. The most frequent sensitizing allergen in IgG CMP was cow's milk in 54/92 (58.7%) adults, followed by cow's sour milk products 41 (44.6%). Cow's milk was the most common sensitizing allergen in 20/20 (100%) children. The rate of CMPA was significantly higher in children younger than five years old (P =0.003), while children who interacted with pets had a marginal significantly reduced rate (P = 0.054). Thus, cow's milk is the most sensitizing allergen in IgG CMPs in adults and pediatrics.
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Affiliation(s)
- Mashail A Baghlaf
- Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, SAU
| | - Noura M Eid
- Department of Clinical Nutrition, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, SAU
- King Fahd Center for Medical Research, King Abdulaziz University, Jeddah, SAU
| | - Sumia Enani
- Department of Food and Nutrition, Faculty of Human Sciences and Design, King Abdulaziz University, Jeddah, SAU
- Food, Nutrition, and Lifestyle Unit, King Fahd Center for Medical Research, King Abdulaziz University, Jeddah, SAU
| | - Samia Kokandi
- Department of Nutrition, International Medical Center, Jeddah, SAU
| | - Bakr Alhussaini
- Department of Pediatric Gastroenterology, Faculty of Medicine, King Abdulaziz University, Jeddah, SAU
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Garib V, Trifonova D, Freidl R, Linhart B, Schlederer T, Douladiris N, Pampura A, Dolotova D, Lepeshkova T, Gotua M, Varlamov E, Beltyukov E, Naumova V, Taka S, Kiyamova A, Katsamaki S, Karaulov A, Valenta R. Milk Allergen Micro-Array (MAMA) for Refined Detection of Cow's-Milk-Specific IgE Sensitization. Nutrients 2023; 15:nu15102401. [PMID: 37242284 DOI: 10.3390/nu15102401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 05/04/2023] [Accepted: 05/11/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND Immunoglobulin-E(IgE)-mediated hypersensitivity to cow's milk allergens is a frequent cause of severe and life-threatening anaphylactic reactions. Besides case histories and controlled food challenges, the detection of the IgE antibodies specific to cow's milk allergens is important for the diagnosis of cow-milk-specific IgE sensitization. Cow´s milk allergen molecules provide useful information for the refined detection of cow-milk-specific IgE sensitization. METHODS A micro-array based on ImmunoCAP ISAC technology was developed and designated milk allergen micro-array (MAMA), containing a complete panel of purified natural and recombinant cow's milk allergens (caseins, α-lactalbumin, β-lactoglobulin, bovine serum albumin-BSA and lactoferrin), recombinant BSA fragments, and α-casein-, α-lactalbumin- and β-lactoglobulin-derived synthetic peptides. Sera from 80 children with confirmed symptoms related to cow's milk intake (without anaphylaxis: n = 39; anaphylaxis with a Sampson grade of 1-3: n = 21; and anaphylaxis with a Sampson grade of 4-5: n = 20) were studied. The alterations in the specific IgE levels were analyzed in a subgroup of eleven patients, i.e., five who did not and six who did acquire natural tolerance. RESULTS The use of MAMA allowed a component-resolved diagnosis of IgE sensitization in each of the children suffering from cow's-milk-related anaphylaxis according to Sampson grades 1-5 requiring only 20-30 microliters of serum. IgE sensitization to caseins and casein-derived peptides was found in each of the children with Sampson grades of 4-5. Among the grade 1-3 patients, nine patients showed negative reactivity to caseins but showed IgE reactivity to alpha-lactalbumin (n = 7) or beta-lactoglobulin (n = 2). For certain children, an IgE sensitization to cryptic peptide epitopes without detectable allergen-specific IgE was found. Twenty-four children with cow-milk-specific anaphylaxis showed additional IgE sensitizations to BSA, but they were all sensitized to either caseins, alpha-lactalbumin, or beta-lactoglobulin. A total of 17 of the 39 children without anaphylaxis lacked specific IgE reactivity to any of the tested components. The children developing tolerance showed a reduction in allergen and/or peptide-specific IgE levels, whereas those remaining sensitive did not. CONCLUSIONS The use of MAMA allows for the detection, using only a few microliters of serum, of IgE sensitization to multiple cow's milk allergens and allergen-derived peptides in cow-milk-allergic children with cow-milk-related anaphylaxis.
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Affiliation(s)
- Victoria Garib
- Center for Pathophysiology, Infectiology and Immunology, Institute of Pathophysiology and Allergy Research, Medical University of Vienna, 1090 Vienna, Austria
- International Center of Molecular Allergology, Ministry of Innovation Development, Tashkent 100174, Uzbekistan
| | - Daria Trifonova
- Center for Pathophysiology, Infectiology and Immunology, Institute of Pathophysiology and Allergy Research, Medical University of Vienna, 1090 Vienna, Austria
- Laboratory of Immunopathology, Department of Clinical Immunology and Allergy, Sechenov First Moscow State Medical University, 119991 Moscow, Russia
| | - Raphaela Freidl
- Center for Pathophysiology, Infectiology and Immunology, Institute of Pathophysiology and Allergy Research, Medical University of Vienna, 1090 Vienna, Austria
| | - Birgit Linhart
- Center for Pathophysiology, Infectiology and Immunology, Institute of Pathophysiology and Allergy Research, Medical University of Vienna, 1090 Vienna, Austria
| | - Thomas Schlederer
- Center for Pathophysiology, Infectiology and Immunology, Institute of Pathophysiology and Allergy Research, Medical University of Vienna, 1090 Vienna, Austria
| | - Nikolaos Douladiris
- Allergy Department, 2nd Pediatric Clinic, National & Kapodistrian University of Athens, 11527 Athens, Greece
| | - Alexander Pampura
- Department of Allergology and Clinical Immunology, Research and Clinical Institute for Pediatrics Named after Yuri Veltischev at the Pirogov Russian National Research Medical University of the Russian Ministry of Health, 117997 Moscow, Russia
| | - Daria Dolotova
- Department of Bioinformatics, Department of Pediatric Surgery, Pirogov Russian National Research Medical University of the Russian Ministry of Health, 117997 Moscow, Russia
| | - Tatiana Lepeshkova
- Department of Faculty Therapy, Endocrinology, Allergology and Immunology, Ural State Medical University, 620028 Ekaterinburg, Russia
| | - Maia Gotua
- Center of Allergy and Immunology, 123182 Tbilisi, Georgia
| | - Evgeniy Varlamov
- Department of Allergology and Clinical Immunology, Research and Clinical Institute for Pediatrics Named after Yuri Veltischev at the Pirogov Russian National Research Medical University of the Russian Ministry of Health, 117997 Moscow, Russia
| | - Evgeny Beltyukov
- Department of Faculty Therapy, Endocrinology, Allergology and Immunology, Ural State Medical University, 620028 Ekaterinburg, Russia
| | - Veronika Naumova
- Department of Faculty Therapy, Endocrinology, Allergology and Immunology, Ural State Medical University, 620028 Ekaterinburg, Russia
| | - Styliani Taka
- Allergy Department, 2nd Pediatric Clinic, National & Kapodistrian University of Athens, 11527 Athens, Greece
| | - Alina Kiyamova
- International Center of Molecular Allergology, Ministry of Innovation Development, Tashkent 100174, Uzbekistan
| | - Stefani Katsamaki
- International Center of Molecular Allergology, Ministry of Innovation Development, Tashkent 100174, Uzbekistan
| | - Alexander Karaulov
- Laboratory of Immunopathology, Department of Clinical Immunology and Allergy, Sechenov First Moscow State Medical University, 119991 Moscow, Russia
| | - Rudolf Valenta
- Center for Pathophysiology, Infectiology and Immunology, Institute of Pathophysiology and Allergy Research, Medical University of Vienna, 1090 Vienna, Austria
- Laboratory of Immunopathology, Department of Clinical Immunology and Allergy, Sechenov First Moscow State Medical University, 119991 Moscow, Russia
- NRC Institute of Immunology FMBA of Russia, 115478 Moscow, Russia
- Karl Landsteiner University for Health Sciences, 3500 Krems, Austria
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‘Early Introduction’ of Cow’s Milk for Children with IgE-Mediated Cow’s Milk Protein Allergy: A Review of Current and Emerging Approaches for CMPA Management. Nutrients 2023; 15:nu15061397. [PMID: 36986127 PMCID: PMC10057913 DOI: 10.3390/nu15061397] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 03/09/2023] [Accepted: 03/10/2023] [Indexed: 03/16/2023] Open
Abstract
IgE-mediated cow’s milk protein allergy (CMPA) is one of the most prevalent food allergies in early childhood. Though the cornerstone of management involves the strict avoidance of milk products while awaiting natural tolerance, research increasingly shows that the rates of resolution are slowing down. Therefore, there is a need to explore alternative pathways to promote tolerance to cow’s milk in pediatric populations. This review aims to combine and appraise the scientific literature regarding the three CMPA management methods: avoidance, the milk ladder, and oral immunotherapy (OIT) and their outcomes in terms of efficacy, safety, and immunological effects. Cow’s milk (CM) avoidance virtually protects against allergic reaction until natural tolerance occurs, with hypoallergenic substitutes available in the market, but accidental ingestion represents the main issue for this strategy. Introduction to baked milk using the milk ladder was designed, with most CMPA patients successfully completing the ladder. Similar to baked milk treatment, many OIT protocols also demonstrated decreased IgE and increased IgG4 levels post protocol, as well as a reduction in wheal size diameter. Though these strategies are shown to be safe and effective in CMPA, future clinical trials should compare the safety and effectiveness of these three management strategies.
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Kauppila TK, Hinkkanen V, Savinko T, Karisola P, Kukkonen AK, Paassilta M, Pelkonen AS, Mäkelä MJ. Long-term changes in milk component immunoglobulins reflect milk oral immunotherapy outcomes in Finnish children. Allergy 2023; 78:454-463. [PMID: 35969113 PMCID: PMC10087274 DOI: 10.1111/all.15479] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 06/17/2022] [Accepted: 07/12/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND Milk oral immunotherapy (OIT) may increase the amount of milk protein that can be ingested without triggering an allergic reaction. It is important to understand why some patients benefit from the treatment while others do not. OBJECTIVE The aim was to define the differences in the milk allergen component-specific (casein, α-lactalbumin, ß-lactoglobulin) immunoglobulin (sIg [sIgE, sIgG4, and sIgA]) levels relative to the long-term outcomes of milk OIT. METHODS In this long-term, open-label follow-up study, 286 children started milk OIT between 2005 and 2015. Follow-up data were collected at two points: the post-buildup phase and long term (range 1-11 years, median 6 years). Comparisons of sIg levels were made among three outcome groups of self-reported long-term milk consumption (high-milk dose, low-milk dose, and avoidance). RESULTS A total of 168 (59%) of the 286 patients on OIT participated. Most patients (57%) were in the high-dose group; here, 80% of these patients had a baseline casein sIgE value less than 28 kUA/L, they had the lowest casein sIgE levels at all time (p < .001), their casein sIgG4/IgE levels increased, and long-term casein sIgA was highest compared with the low-dose and avoidance groups (p = .02). Low-milk dose group had the highest casein sIgG4/IgE levels in long term (p = .002). CONCLUSION The baseline Ig profiles and responses to milk OIT differed depending on long-term milk consumption. Lower casein sIgE levels were associated with better outcome. Milk casein sIgA differed in the long term among high-milk consumers.
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Affiliation(s)
- Tiina Kaisa Kauppila
- University of Helsinki, Skin and Allergy Hospital, Helsinki University Hospital, Helsinki, Finland
| | | | - Terhi Savinko
- Skin and Allergy Hospital, Helsinki University Hospital, Helsinki, Finland
| | | | | | | | - Anna S Pelkonen
- Skin and Allergy Hospital, Helsinki University Hospital, Helsinki, Finland
| | - Mika J Mäkelä
- University of Helsinki, Skin and Allergy Hospital, Helsinki University Hospital, Helsinki, Finland
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7
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Nuyttens L, De Vlieger L, Diels M, Schrijvers R, Bullens DMA. The clinical and immunological basis of early food introduction in food allergy prevention. FRONTIERS IN ALLERGY 2023; 4:1111687. [PMID: 36756279 PMCID: PMC9899849 DOI: 10.3389/falgy.2023.1111687] [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: 11/29/2022] [Accepted: 01/04/2023] [Indexed: 01/24/2023] Open
Abstract
IgE-mediated food allergy has an estimated prevalence of 6%-10% in developed countries. Allergen avoidance has long been the main focus in the prevention of food allergy and late solid food introduction after 6-12 months of age was recommended in high-risk infants. However, the rising prevalence of food allergy despite delayed exposure to allergens and the observations that IgE-mediated sensitization to food products could even occur before the introduction of solid foods resulted in a shift towards early solid food introduction as an attempt to prevent IgE-mediated food allergy. Since then, many trials focused on the clinical outcome of early allergen introduction and overall seem to point to a protective effect on the development of IgE-mediated food allergies. For non-IgE-mediated diseases of food allergy, evidence of early food introduction seems less clear. Moreover, data on the underlying immunological processes in early food introduction is lacking. The goal of this review is to summarize the available data of immunological changes in early food introduction to prevent IgE and non-IgE mediated food allergy.
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Affiliation(s)
- L. Nuyttens
- Allergy and Clinical Immunology Research Group, Department of Microbiology, Immunology & Transplantation, KU Leuven, Leuven, Belgium,Department of Pediatrics, University Hospitals Leuven, Leuven, Belgium
| | - L. De Vlieger
- Allergy and Clinical Immunology Research Group, Department of Microbiology, Immunology & Transplantation, KU Leuven, Leuven, Belgium
| | - M. Diels
- Department of Pediatrics, University Hospitals Leuven, Leuven, Belgium
| | - R. Schrijvers
- Allergy and Clinical Immunology Research Group, Department of Microbiology, Immunology & Transplantation, KU Leuven, Leuven, Belgium,Department of General Internal Medicine, Division of Allergy and Clinical Immunology, University Hospitals Leuven, Leuven, Belgium
| | - D. M. A. Bullens
- Allergy and Clinical Immunology Research Group, Department of Microbiology, Immunology & Transplantation, KU Leuven, Leuven, Belgium,Department of Pediatrics, University Hospitals Leuven, Leuven, Belgium,Correspondence: D. M. A Bullens
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Martínez-Botas J, Fernández-Lozano C, Vaquero-Rey A, de la Hoz B. IgE and IgG4 Epitope Mapping of Food Allergens with a Peptide Microarray Immunoassay. Methods Mol Biol 2023; 2578:219-236. [PMID: 36152291 DOI: 10.1007/978-1-0716-2732-7_16] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Peptide microarrays are a powerful tool to identify linear epitopes of food allergens in a high-throughput manner. The main advantages of the microarray-based immunoassay are as follows: the possibility to assay thousands of targets simultaneously, the requirement of a low volume of serum, the more robust statistical analysis, and the possibility to test simultaneously several immunoglobulin subclasses. Among them, the last one has a special interest in the field of food allergy, because the development of tolerance to food allergens has been associated with a decrease in IgE and an increase in IgG4 levels against linear epitopes. However, the main limitation to the clinical use of microarray is the automated analysis of the data. Recent studies mapping the linear epitopes of food allergens with peptide microarray immunoassays have identified peptide biomarkers that can be used for early diagnosis of food allergies and to predict their severity or the self-development of tolerance. Using this approach, we have worked on epitope mapping of the two most important food allergens in the Spanish population, cow's milk, and chicken eggs. The final aim of these studies is to define subsets of peptides that could be used as biomarkers to improve the diagnosis and prognosis of food allergies. This chapter describes the protocol to produce microarrays using a library of overlapping peptides corresponding to the primary sequences of food allergens and data acquisition and analysis of IgE and IgG4 binding epitopes.
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Affiliation(s)
- Javier Martínez-Botas
- Servicio de Bioquímica-Investigación, Hospital Universitario Ramón y Cajal - Unidad de Microarray IRYCIS, Madrid, Spain.
- CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN) - Instituto de la Salud Carlos III, Madrid, Spain.
| | - Carlos Fernández-Lozano
- Servicio de Bioquímica-Investigación, Hospital Universitario Ramón y Cajal - Unidad de Microarray IRYCIS, Madrid, Spain
| | - Aida Vaquero-Rey
- Servicio de Alergología, Hospital Universitario Ramón y Cajal - Unidad de Microarray IRYCIS, Madrid, Spain
| | - Belén de la Hoz
- Servicio de Alergología, Hospital Universitario Ramón y Cajal - Unidad de Microarray IRYCIS, Madrid, Spain
- Red de Alergia ARADyAL (RD16/0006/0009) - Instituto de la Salud Carlos III, Madrid, Spain
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9
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Oettgen HC. Mast cells in food allergy: Inducing immediate reactions and shaping long-term immunity. J Allergy Clin Immunol 2023; 151:21-25. [PMID: 36328809 DOI: 10.1016/j.jaci.2022.10.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 09/08/2022] [Accepted: 10/04/2022] [Indexed: 11/11/2022]
Abstract
Mast cells are distributed throughout the gastrointestinal tract and function as the main effector cells of IgE-mediated allergic reactions to foods. Allergen-induced cross-linking of IgE antibodies bound to high-affinity IgE receptors, FcεRI, on the surface of mast cells triggers their activation, resulting in the release of mediators of immediate hypersensitivity. These mediators rapidly induce both local gastrointestinal and systemic physiological responses including anaphylaxis. Emerging evidence has revealed that, in addition to inciting immediate reactions, mast cells are key regulators of adaptive immunity to foods. In the gastrointestinal mucosa they provide the priming cytokines that initiate and, over time, consolidate adaptive TH2 responses to ingested allergens as well as TNF and chemokines that orchestrate the recruitment of tissue-infiltrating leukocytes that drive type 2 tissue inflammation. Patients with atopic dermatitis have increased intestinal mast cell numbers and are at a greater risk for food allergy. Recent studies have uncovered a skin-gut axis in which epicutaneous allergen exposure drives intestinal mast cell expansion. The activating effects of IgE antibodies in mast cells are countered by food-specific IgG antibodies that signal via the inhibitory IgG receptor, FcγR2b, suppressing both immediate allergic reactions to foods and the type 2 immune adjuvant activity of mast cells.
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Affiliation(s)
- Hans C Oettgen
- Department of Pediatrics, Boston Children's Hospital, Boston, Mass; Department of Pediatrics, Harvard Medical School, Boston, Mass.
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10
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El Ansari YS, Kanagaratham C, Burton OT, Santos JV, Hollister BMA, Lewis OL, Renz H, Oettgen HC. Allergen-Specific IgA Antibodies Block IgE-Mediated Activation of Mast Cells and Basophils. Front Immunol 2022; 13:881655. [PMID: 35865546 PMCID: PMC9294179 DOI: 10.3389/fimmu.2022.881655] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 05/30/2022] [Indexed: 11/13/2022] Open
Abstract
Mast cells and basophils have long been implicated in the pathogenesis of IgE-mediated hypersensitivity reactions. They express the high-affinity IgE receptor, FcϵRI, on their surface. Antigen-induced crosslinking of IgE antibodies bound to that receptor triggers a signaling cascade that results in activation, leading to the release of an array of preformed vasoactive mediators and rapidly synthesized lipids, as well as the de novo production of inflammatory cytokines. In addition to bearing activating receptors like FcεRI, these effector cells of allergy express inhibitory ones including FcγR2b, an IgG Fc receptor with a cytosolic inhibitory motif that activates protein tyrosine phosphatases that suppress IgE-mediated activation. We and others have shown that food allergen-specific IgG antibodies strongly induced during the course of oral immunotherapy (OIT), signal via FcγR2b to suppress IgE-mediated mast cell and basophil activation triggered by food allergen challenge. However, the potential inhibitory effects of IgA antibodies, which are also produced in response to OIT and are present at high levels at mucosal sites, including the intestine where food allergens are encountered, have not been well studied. Here we uncover an inhibitory function for IgA. We observe that IgA binds mouse bone marrow-derived mast cells (BMMCs) and peritoneal mast cells. Binding to BMMCs is dependent on calcium and sialic acid. We also found that IgA antibodies inhibit IgE-mediated mast cell degranulation in an allergen-specific fashion. Antigen-specific IgA inhibits IgE-mediated mast cell activation early in the signaling cascade, suppressing the phosphorylation of Syk, the proximal protein kinase mediating FcεRI signaling, and suppresses mast cell production of cytokines. Furthermore, using basophils from a peanut allergic donor we found that IgA binds to basophils and that activation by exposure to peanuts is effectively suppressed by IgA. We conclude that IgA serves as a regulator of mast cell and basophil degranulation, suggesting a physiologic role for IgA in the maintenance of immune homeostasis at mucosal sites.
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Affiliation(s)
- Yasmeen S. El Ansari
- Division of Immunology, Department of Pediatrics, Boston Children’s Hospital, Boston, MA, United States
- Institute of Laboratory Medicine, Philipps University Marburg, Marburg, Germany
| | - Cynthia Kanagaratham
- Division of Immunology, Department of Pediatrics, Boston Children’s Hospital, Boston, MA, United States
- Department of Pediatrics, Harvard Medical School, Boston, MA, United States
| | - Oliver T. Burton
- Laboratory of Lymphocyte Signaling and Development, The Babraham Institute, Cambridge, United Kingdom
| | - Jenna V. Santos
- Division of Immunology, Department of Pediatrics, Boston Children’s Hospital, Boston, MA, United States
| | | | - Owen L. Lewis
- Division of Immunology, Department of Pediatrics, Boston Children’s Hospital, Boston, MA, United States
| | - 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
| | - Hans C. Oettgen
- Division of Immunology, Department of Pediatrics, Boston Children’s Hospital, Boston, MA, United States
- Department of Pediatrics, Harvard Medical School, Boston, MA, United States
- *Correspondence: Hans C. Oettgen,
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11
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Wu M, Wang X, Sun L, Chen Z. Associations between food-specific IgG and health outcomes in an asymptomatic physical examination cohort. Nutr Metab (Lond) 2022; 19:22. [PMID: 35305694 PMCID: PMC8933923 DOI: 10.1186/s12986-022-00657-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 03/01/2022] [Indexed: 12/02/2022] Open
Abstract
Background Although the association of food-specific IgG with the development and progression of specific diseases was shown by many studies, it is also present in the population without clinical symptoms. However, the association between food-specific IgG and physical examination outcomes in healthy people has not been studied yet. Methods An asymptomatic physical examination cohort (APEC) was selected according to the inclusion and exclusion criteria, the physical examination data were compared between IgG positive and IgG negative groups, and their odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using multivariable logistic regression. Results The data of 28,292 subjects were included in the analysis. The overall IgG positive rate was up to 52.30%, mostly with mild to moderate IgG positivity. The multivariable Logistic regression showed the prevalence of hypertriglyceridemia, abnormal fasting blood glucose and overweight was lower in the IgG (+) positive group (OR 0.87, 95% CI 0.83–0.92; OR 0.93, 95% CI 0.87–0.99; OR 0.92, 95% CI 0.87–0.96) but there was a higher prevalence of thyroid disease (OR 1.09, 95% CI 1.04–1.15). Conclusion Food-specific IgG positivity was widespread in the APEC and was associated with lower prevalence of hypertriglyceridemia, abnormal fasting blood glucose and overweight. The underlying physiological mechanism merits further study.
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Affiliation(s)
- Mingxia Wu
- Health Management Center, First Affiliated Hospital of Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Xiaofang Wang
- Health Management Center, First Affiliated Hospital of Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Li Sun
- Health Management Center, First Affiliated Hospital of Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Zongtao Chen
- Health Management Center, First Affiliated Hospital of Army Medical University (Third Military Medical University), Chongqing, 400038, China.
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12
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Abstract
PURPOSE OF REVIEW B cells are known in food allergy pathogenesis for their production of IgE but their roles in the development of tolerance to foods are not well understood. Further understanding of B-cell biology in the context of food allergy is essential for the creation of effective prevention strategies and therapies. RECENT FINDINGS The majority of allergen-specific IgE in humans appears to arise from antigen-experienced B cells that have already undergone class switch recombination to other antibody isotypes, such as IgG1, and can also be produced by cells class switching to IgE locally in the gastrointestinal tract. Allergen-specific IgG4 can have protective effects in individuals and is associated with tolerance. Regulatory B cells, which can produce allergen-specific IgG4, are reduced in food-allergic individuals and may also be an important component of tolerance. Therapeutic approaches that block the generation and action of IgE and that enhance tolerizing immune responses are being evaluated for the treatment of food allergy. SUMMARY B cells play several roles in the development of food allergy versus tolerance. Their functions may translate into the care of food allergy as biomarkers or therapeutic targets and can be employed in other atopic diseases to better understand their pathogenesis and create new avenues for treatment.
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Affiliation(s)
- Chioma Udemgba
- Allergy and Clinical Immunology Fellowship Program, National Institute of Allergy and Infectious Diseases, Bethesda, MD
| | - Adora Lin
- Center for Cancer and Immunology Research, Children’s National Research Institute, Washington, DC
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13
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Chen G, Shrock EL, Li MZ, Spergel JM, Nadeau KC, Pongracic JA, Umetsu DT, Rachid R, MacGinnitie AJ, Phipatanakul W, Schneider L, Oettgen HC, Elledge SJ. High-resolution epitope mapping by AllerScan reveals relationships between IgE and IgG repertoires during peanut oral immunotherapy. CELL REPORTS MEDICINE 2021; 2:100410. [PMID: 34755130 PMCID: PMC8563412 DOI: 10.1016/j.xcrm.2021.100410] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 07/18/2021] [Accepted: 09/21/2021] [Indexed: 10/24/2022]
Abstract
Peanut allergy can result in life-threatening reactions and is a major public health concern. Oral immunotherapy (OIT) induces desensitization to food allergens through administration of increasing amounts of allergen. To dissect peanut-specific immunoglobulin E (IgE) and IgG responses in subjects undergoing OIT, we have developed AllerScan, a method that leverages phage-display and next-generation sequencing to identify the epitope targets of peanut-specific antibodies. We observe a striking diversification and boosting of the peanut-specific IgG repertoire after OIT and a reduction in pre-existing IgE levels against individual epitopes. High-resolution epitope mapping reveals shared recognition of public epitopes in Ara h 1, 2, 3, and 7. In individual subjects, OIT-induced IgG specificities overlap extensively with IgE and exhibit strikingly similar antibody footprints, suggesting related clonal lineages or convergent evolution of peanut-specific IgE and IgG B cells. Individual differences in epitope recognition identified via AllerScan could inform safer and more effective personalized immunotherapy.
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Affiliation(s)
- Genghao Chen
- Department of Genetics, Harvard Medical School, Boston, MA 02115, USA.,Division of Genetics, Department of Medicine, Howard Hughes Medical Institute, Brigham and Women's Hospital, Boston, MA 02115, USA.,Program in Biological and Biomedical Sciences, Harvard University, Cambridge, MA 02115, USA
| | - Ellen L Shrock
- Department of Genetics, Harvard Medical School, Boston, MA 02115, USA.,Division of Genetics, Department of Medicine, Howard Hughes Medical Institute, Brigham and Women's Hospital, Boston, MA 02115, USA.,Program in Biological and Biomedical Sciences, Harvard University, Cambridge, MA 02115, USA
| | - Mamie Z Li
- Department of Genetics, Harvard Medical School, Boston, MA 02115, USA.,Division of Genetics, Department of Medicine, Howard Hughes Medical Institute, Brigham and Women's Hospital, Boston, MA 02115, USA
| | - Jonathan M Spergel
- Division of Allergy and Immunology, Children's Hospital of Philadelphia, Philadelphia, PA, USA.,Department of Pediatrics, Perelman School of Medicine of University of Pennsylvania, Philadelphia, PA, USA
| | - Kari C Nadeau
- Department of Medicine, Sean N Parker Center for Allergy and Asthma Research, Stanford University, Palo Alto, CA, USA
| | - Jacqueline A Pongracic
- Division of Pediatric Allergy and Immunology, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA.,Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL 60611, USA
| | - Dale T Umetsu
- Division of Immunology, Department of Pediatrics, Boston Children's Hospital, Boston, MA 02115, USA.,Department of Pediatrics, Harvard Medical School, Boston, MA 02115, USA
| | - Rima Rachid
- Division of Immunology, Department of Pediatrics, Boston Children's Hospital, Boston, MA 02115, USA.,Department of Pediatrics, Harvard Medical School, Boston, MA 02115, USA
| | - Andrew J MacGinnitie
- Division of Immunology, Department of Pediatrics, Boston Children's Hospital, Boston, MA 02115, USA.,Department of Pediatrics, Harvard Medical School, Boston, MA 02115, USA
| | - Wanda Phipatanakul
- Division of Immunology, Department of Pediatrics, Boston Children's Hospital, Boston, MA 02115, USA.,Department of Pediatrics, Harvard Medical School, Boston, MA 02115, USA
| | - Lynda Schneider
- Division of Immunology, Department of Pediatrics, Boston Children's Hospital, Boston, MA 02115, USA.,Department of Pediatrics, Harvard Medical School, Boston, MA 02115, USA
| | - Hans C Oettgen
- Division of Immunology, Department of Pediatrics, Boston Children's Hospital, Boston, MA 02115, USA.,Department of Pediatrics, Harvard Medical School, Boston, MA 02115, USA
| | - Stephen J Elledge
- Department of Genetics, Harvard Medical School, Boston, MA 02115, USA.,Division of Genetics, Department of Medicine, Howard Hughes Medical Institute, Brigham and Women's Hospital, Boston, MA 02115, USA
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14
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Naito M, Matsui T, Yamada C, Tagami K, Ito K, Izumi H. Evaluation of cross-reactivity between casein components using inhibition assay and in silico analysis. Pediatr Allergy Immunol 2021; 32:544-551. [PMID: 33140423 DOI: 10.1111/pai.13405] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 09/20/2020] [Accepted: 10/14/2020] [Indexed: 01/29/2023]
Abstract
BACKGROUND We previously reported that the specific IgE levels to αs1-casein (CN) and β-CN in patients with cow's milk allergy decreased with similar dynamics during oral immunotherapy. Therefore, we hypothesized that αs1- and β-CN have strong cross-reactivity among CN components, despite the low similarity in the full-length amino acid sequences. METHODS The αs1-, β-, and κ-CN were purified from commercial cow's milk. We recruited 39 patients with cow's milk allergy, and the serum IgE levels for each CN component were measured by enzyme-linked immunosorbent assay (ELISA). Cross-reactivity between CN components was investigated by competitive ELISA against αs1-CN. Sequence homology between CN components at the peptide level was calculated using in silico analysis and quantified by the property distance (PD) value. RESULTS The αs1-CN-specific IgE levels exhibited a strong positive correlation with the β-CN-specific IgE (r = 0.945, P < .001). Complete competition was observed by β-CN against αs1-CN, suggesting the presence of common epitopes between them. In silico analysis detected 24 peptide sets with PD values lower than 10 between αs1- and β-CN, and 14 sets between αs1- and κ-CN. The amino acid sequences of αs1-CN (E61-E70) and β-CN (I12-E21) that showed the lowest PD value (5.30) were present in the characteristic sequence known as casein phosphopeptide (CPP). CONCLUSION We detected strong cross-reactivity between CN components. Furthermore, we found highly homologous sequences in the CPP region, which contains a core sequence of "SSSEE" with phosphorylated serine residues.
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Affiliation(s)
- Michihiro Naito
- School of Nutritional Sciences, Nagoya University of Arts and Sciences, Aichi, Japan
| | - Teruaki Matsui
- Department of Allergy, Aichi Children's Health and Medical Center, Aichi, Japan
| | - Chikako Yamada
- School of Nutritional Sciences, Nagoya University of Arts and Sciences, Aichi, Japan
| | - Kazunori Tagami
- Department of Allergy, Aichi Children's Health and Medical Center, Aichi, Japan.,Institute of Health and Nutrition, Nagoya University of Arts and Sciences, Aichi, Japan
| | - Komei Ito
- Department of Allergy, Aichi Children's Health and Medical Center, Aichi, Japan
| | - Hidehiko Izumi
- School of Nutritional Sciences, Nagoya University of Arts and Sciences, Aichi, Japan
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15
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Yoneyama T, Nakano N, Hara M, Yamada H, Izawa K, Uchida K, Kaitani A, Ando T, Kitaura J, Ohtsuka Y, Ogawa H, Okumura K, Shimizu T. Notch signaling contributes to the establishment of sustained unresponsiveness to food allergens by oral immunotherapy. J Allergy Clin Immunol 2021; 147:1063-1076.e9. [DOI: 10.1016/j.jaci.2020.07.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 06/02/2020] [Accepted: 07/01/2020] [Indexed: 12/14/2022]
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16
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Ghosh D, Bernstein JA. Health Effects of Trimellitic Anhydride Occupational Exposure: Insights from Animal Models and Immunosurveillance Programs. Clin Rev Allergy Immunol 2021; 59:61-77. [PMID: 32594360 DOI: 10.1007/s12016-020-08801-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Acid anhydrides are used by chemical industries as plasticizers. Trimellitic acid (TMA) is an acid anhydride widely utilized in factories to produce paints, varnishes, and plastics. In addition to causing direct irritant effects, TMA can augment antibody responses in exposed factory workers leading to occupational asthma. Therefore, industries producing TMA have implemented occupational immunosurveillance programs (OISPs) to ensure early diagnosis and medical management, involving exposure reduction/ complete removal of sensitized workers from exposure areas. Multiple animal models (mice strains, rat stains, guinea pig, swine) with different exposure patterns (dermal, nasal, vapor inhalation exposures for different time frames) have been described to elucidate the pathophysiology of TMA exposure. In TMA factories, in spite of implementing advanced environmental controls and personal protective measures to limit exposure, workers become TMA-sensitized. Animal models revealed sIgG, sIgE, sIgA, and sIgM along with pulmonary lesions, cellular infiltrates, alveolar hemorrhage, and pneumonitis associated with TMA exposure. Molecular studies showed involvement of specific functional gene clusters related to cytokine and chemokine responses, lung remodeling, and arginase function. However, thus far, there is no evidence supporting fetotoxic or carcinogenic effects of TMA. OISP data showed IgG and IgE responses in exposed factory workers. Interestingly, timelines for detectable sIgG response, in conjunction with its magnitude, have been shown to be a predictor for future sIgE response. OISPs have been very successful so far at creating a healthy and safe working environment for TMA-exposed factory workers. Graphical Abstract Trimellitic Acid (TMA), used to produce paints, varnishes and plastics, can cause irritant-mediated and immune-mediated occupational health problems. NCBI pubmed search indicated that multiple animal models (different animal types, with chronic vs. acute exposure type, using TMA dust/suspension applied via dermal or other routes) have been used by investigators to elucidate the pathobiology of TMA-exposure. Several outcomes have been measured including humoral, lung/ airway, lymph nodes and dermal/ ear thickening responses. Studies on human subjects have been conducted mostly as parts of Occupational immunosurveillance programs (OISPs) implemented to identify TMA-sensitized workers (using ImmunoCAP and Skin prick testing), monitoring them longitudinally and their medical management including exposure reduction/ complete removal of sensitized workers from exposure areas. Clinical management also includes identification of irritant-induced and/ or immune-mediated outcomes of TMA occupational exposure. Collectively, these studies have led to important insights into the pathomechanism of TMA-exposure and have been very successful at creating a safe working environment for TMA-exposed factory workers.
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Affiliation(s)
- Debajyoti Ghosh
- Division of Immunology, Allergy Section, Department of Internal Medicine, University of Cincinnati College of Medicine, 231 Albert Sabin Way, Cincinnati, OH, 45267, USA
| | - Jonathan A Bernstein
- Division of Immunology, Allergy Section, Department of Internal Medicine, University of Cincinnati College of Medicine, 231 Albert Sabin Way, Cincinnati, OH, 45267, USA.
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17
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Paranjape A, Tsai M, Mukai K, Hoh RA, Joshi SA, Chinthrajah RS, Nadeau KC, Boyd SD, Galli SJ. Oral Immunotherapy and Basophil and Mast Cell Reactivity in Food Allergy. Front Immunol 2020; 11:602660. [PMID: 33381123 PMCID: PMC7768812 DOI: 10.3389/fimmu.2020.602660] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 11/10/2020] [Indexed: 12/19/2022] Open
Abstract
Basophil activation tests (BATs) can closely monitor, in vitro, a patient's propensity to develop type I hypersensitivity reactions. Because of their high specificity and sensitivity, BATs have become promising diagnostic tools, especially in cases with equivocal clinical histories, skin prick test results, and/or levels of specific IgE to allergen extracts. BATs also are useful as tools for monitoring the effects of treatment, since oral immunotherapy (OIT) studies report a diminution in patients' basophil responsiveness over the course of OIT. This review will discuss the BAT findings obtained before, during, and after OIT for food allergy. We will mainly focus on the association of basophil responsiveness, and alterations in basophil surface markers, with clinical outcomes and other clinical features, such as blood levels of specific IgG and IgE antibodies. The detailed analysis of these correlations will ultimately facilitate the use of BATs, along with other blood biomarkers, to differentiate short-term desensitization versus sustained unresponsiveness and to improve treatment protocols. Given the critical anatomic location of mast cells adjacent to the many IgE+ plasma cells found in the gastrointestinal tissues of allergic individuals, we will also discuss the role of gastrointestinal mast cells in manifestations of food allergies.
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Affiliation(s)
- Anuya Paranjape
- Department of Pathology, Stanford University School of Medicine, Stanford, CA, United States
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University School of Medicine, Stanford, CA, United States
| | - Mindy Tsai
- Department of Pathology, Stanford University School of Medicine, Stanford, CA, United States
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University School of Medicine, Stanford, CA, United States
| | - Kaori Mukai
- Department of Pathology, Stanford University School of Medicine, Stanford, CA, United States
| | - Ramona A. Hoh
- Department of Pathology, Stanford University School of Medicine, Stanford, CA, United States
| | - Shilpa A. Joshi
- Department of Pathology, Stanford University School of Medicine, Stanford, CA, United States
| | - R. Sharon Chinthrajah
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University School of Medicine, Stanford, CA, United States
- Division of Pulmonary, Allergy and Critical Care Medicine and Division of Allergy, Immunology and Rheumatology, Stanford University, Stanford University School of Medicine, Stanford, CA, United States
| | - Kari C. Nadeau
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University School of Medicine, Stanford, CA, United States
- Division of Pulmonary, Allergy and Critical Care Medicine and Division of Allergy, Immunology and Rheumatology, Stanford University, Stanford University School of Medicine, Stanford, CA, United States
| | - Scott D. Boyd
- Department of Pathology, Stanford University School of Medicine, Stanford, CA, United States
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University School of Medicine, Stanford, CA, United States
| | - Stephen J. Galli
- Department of Pathology, Stanford University School of Medicine, Stanford, CA, United States
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University School of Medicine, Stanford, CA, United States
- Department of Microbiology and Immunology, Stanford University School of Medicine, Stanford, CA, United States
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18
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Kanagaratham C, El Ansari YS, Lewis OL, Oettgen HC. IgE and IgG Antibodies as Regulators of Mast Cell and Basophil Functions in Food Allergy. Front Immunol 2020; 11:603050. [PMID: 33362785 PMCID: PMC7759531 DOI: 10.3389/fimmu.2020.603050] [Citation(s) in RCA: 87] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 10/22/2020] [Indexed: 12/15/2022] Open
Abstract
Food allergy is a major health issue, affecting the lives of 8% of U.S. children and their families. There is an urgent need to identify the environmental and endogenous signals that induce and sustain allergic responses to ingested allergens. Acute reactions to foods are triggered by the activation of mast cells and basophils, both of which release inflammatory mediators that lead to a range of clinical manifestations, including gastrointestinal, cutaneous, and respiratory reactions as well as systemic anaphylaxis. Both of these innate effector cell types express the high affinity IgE receptor, FcϵRI, on their surface and are armed for adaptive antigen recognition by very-tightly bound IgE antibodies which, when cross-linked by polyvalent allergen, trigger degranulation. These cells also express inhibitory receptors, including the IgG Fc receptor, FcγRIIb, that suppress their IgE-mediated activation. Recent studies have shown that natural resolution of food allergies is associated with increasing food-specific IgG levels. Furthermore, oral immunotherapy, the sequential administration of incrementally increasing doses of food allergen, is accompanied by the strong induction of allergen-specific IgG antibodies in both human subjects and murine models. These can deliver inhibitory signals via FcγRIIb that block IgE-induced immediate food reactions. In addition to their role in mediating immediate hypersensitivity reactions, mast cells and basophils serve separate but critical functions as adjuvants for type 2 immunity in food allergy. Mast cells and basophils, activated by IgE, are key sources of IL-4 that tilts the immune balance away from tolerance and towards type 2 immunity by promoting the induction of Th2 cells along with the innate effectors of type 2 immunity, ILC2s, while suppressing the development of regulatory T cells and driving their subversion to a pathogenic pro-Th2 phenotype. This adjuvant effect of mast cells and basophils is suppressed when inhibitory signals are delivered by IgG antibodies signaling via FcγRIIb. This review summarizes current understanding of the immunoregulatory effects of mast cells and basophils and how these functions are modulated by IgE and IgG antibodies. Understanding these pathways could provide important insights into innovative strategies for preventing and/or reversing food allergy in patients.
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Affiliation(s)
- Cynthia Kanagaratham
- Division of Immunology, Department of Pediatrics, Boston Children’s Hospital, Boston, MA, United States
- Department of Pediatrics, Harvard Medical School, Boston, MA, United States
| | - Yasmeen S. El Ansari
- Division of Immunology, Department of Pediatrics, Boston Children’s Hospital, Boston, MA, United States
- Institute of Laboratory Medicine, Philipps University Marburg, Marburg, Germany
| | - Owen L. Lewis
- Division of Immunology, Department of Pediatrics, Boston Children’s Hospital, Boston, MA, United States
| | - Hans C. Oettgen
- Division of Immunology, Department of Pediatrics, Boston Children’s Hospital, Boston, MA, United States
- Department of Pediatrics, Harvard Medical School, Boston, MA, United States
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19
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Digestomics of Cow's Milk: Short Digestion-Resistant Peptides of Casein Form Functional Complexes by Aggregation. Foods 2020; 9:foods9111576. [PMID: 33143174 PMCID: PMC7692894 DOI: 10.3390/foods9111576] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 10/18/2020] [Accepted: 10/26/2020] [Indexed: 01/28/2023] Open
Abstract
The aim of this study was to identify short digestion-resistant peptides (SDRPs) released by pepsin digestion of the whole cow’s milk and examine their IgE reactivity and allergenicity. Raw milk was subjected to simulated gastric digestion. SDRPs were fractionated from the digests and identified by MS. Milk SDRPs were evaluated for aggregability, propensity to compete for IgE binding with individual milk allergens, and ability to bind IgG4 from allergic and milk-tolerant individuals. The majority of milk SDRPs originated from caseins (97% of peptides) and overlapped with the known IgE epitopes of cow’s milk allergens. SDRPs competed with milk proteins for binding to human IgE and readily formed aggregates. The average peptide length was 10.6 ± 3.5 amino acids. The ability to provoke allergenic in vivo responses was confirmed by skin-prick testing (SPT) in five milk-allergic subjects. This was attributed to the peptide ability to aggregate into non-covalent complexes. SDRPs are able to induce response in SPT, but only in 50% of the sera SDRPs were able to inhibit IgG4 binding to caseins. Hence, SDRPs corresponding to the mainly continuous epitopes of milk proteins induce allergenic in vivo responses in milk-allergic subjects due to aggregation.
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20
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Patterson MF, Dorris SL. Food Allergy: Unproven diagnostics and therapeutics. JOURNAL OF FOOD ALLERGY 2020; 2:91-94. [PMID: 39022151 PMCID: PMC11250541 DOI: 10.2500/jfa.2020.2.200013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 07/20/2024]
Abstract
Food allergy or intolerance is often attributed by patients as the cause of many symptoms unknown to be directly related to food ingestion. For immunoglobulin E (IgE) mediated food allergy, diagnostic modalities are currently limited to the combination of clinical history, evidence of sensitization with food-specific IgE testing and skin-prick testing, and oral food challenge. Many patients find an appeal in the promise of identification of the etiology of their symptoms through alternative food allergy or intolerance diagnostic modalities. These patients may seek guidance from allergists or their general providers as to the legitimacy of these tests or interpretation of results. These tests include food-specific serum IgG or IgG4 testing, flow cytometry to measure the change in leukocyte volume after exposure to food, intradermal or sublingual provocation-neutralization, electrodermal testing, applied kinesiology, hair analysis, and iridology. In addition, there are some unconventional therapeutic modalities for adverse reactions to foods, including rotary diets. None of these have been supported by scientific evidence, and some even carry the risk of severe adverse reactions. It is important that we offer our patients evidence-based, accurate counseling of these unproven modalities by understanding their methods, their paucity of credible scientific support, and their associated risks.
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Affiliation(s)
- Megan F Patterson
- From the Division of Allergy, Immunology and Pulmonary Medicine, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Stacy L Dorris
- From the Division of Allergy, Immunology and Pulmonary Medicine, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
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21
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Sackesen C, Erman B, Gimenez G, Grishina G, Yilmaz O, Yavuz ST, Sahiner UM, Buyuktiryaki B, Yilmaz EA, Cavkaytar O, Sampson HA. IgE and IgG4 binding to lentil epitopes in children with red and green lentil allergy. Pediatr Allergy Immunol 2020; 31:158-166. [PMID: 31598994 DOI: 10.1111/pai.13136] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 08/11/2019] [Accepted: 09/30/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND The consumption of lentil is common in the Mediterranean area and is one of the causes of IgE-mediated food allergy in many countries. Len c 1 is a well-defined allergen of lentil and approximately 80% of the patients with lentil allergy recognize the purified Len c 1 protein. We sought to identify IgE and IgG4 sequential epitopes of Len c 1 in patients with red and/or green lentil allergy. We also aimed to determine IgE and IgG4 binding differences between those patients who had outgrown or remained reactive to lentil. METHODS Children with IgE-mediated lentil allergy were included in the study. We applied a microarray immunoassay to determine the characterization of positive IgE and IgG4 binding to Len c 1 epitopes in the patients' sera. RESULTS The peptides specifically recognized by IgE and IgG4 antibodies were mainly detected between peptides 107 and 135 of Len c 1. The signal intensities of positive epitopes were significantly greater in reactive patients than tolerant ones (P = .008 for IgE and P = .002 for IgG4). Moreover, IgE and IgG4 antibodies bound largely the same sequential epitopes in patients who remained reactive or outgrew their allergy. CONCLUSION IgG4-binding epitopes in lentil allergy were identified and IgE and IgG4 binding to epitopes in both red and green lentils was compared. Our data regarding signal intensity differences between reactive and outgrown patients and overlap binding of IgE and IgG4 antibodies may be important for the development of more accurate diagnostic tests and understanding of natural tolerance development.
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Affiliation(s)
- Cansin Sackesen
- Division of Pediatric Allergy, School of Medicine, Koc University, Istanbul, Turkey.,Division of Pediatric Allergy, Hacettepe University School of Medicine, Ankara, Turkey.,Division of Pediatric Allergy and Immunology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Baran Erman
- Division of Pediatric Allergy, School of Medicine, Koc University, Istanbul, Turkey.,Department of Molecular Biology and Genetics, Istinye University, Istanbul, Turkey
| | - Gustavo Gimenez
- Division of Pediatric Allergy and Immunology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Galina Grishina
- Division of Pediatric Allergy and Immunology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ozlem Yilmaz
- Division of Pediatric Allergy, School of Medicine, Koc University, Istanbul, Turkey
| | - Suleyman T Yavuz
- Division of Pediatric Allergy, Hacettepe University School of Medicine, Ankara, Turkey
| | - Umit M Sahiner
- Division of Pediatric Allergy, Hacettepe University School of Medicine, Ankara, Turkey
| | - Betul Buyuktiryaki
- Division of Pediatric Allergy, Hacettepe University School of Medicine, Ankara, Turkey
| | - Ebru A Yilmaz
- Division of Pediatric Allergy, Hacettepe University School of Medicine, Ankara, Turkey
| | - Ozlem Cavkaytar
- Division of Pediatric Allergy, Hacettepe University School of Medicine, Ankara, Turkey
| | - Hugh A Sampson
- Division of Pediatric Allergy and Immunology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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22
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Sánchez-Ruano L, de la Hoz B, Martínez-Botas J. Clinical utility of microarray B-cell epitope mapping in food allergies: A systematic review. Pediatr Allergy Immunol 2020; 31:175-185. [PMID: 31655013 DOI: 10.1111/pai.13141] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 09/13/2019] [Accepted: 09/30/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Peptide microarray technology has been proposed as a useful tool for diagnosing food allergy. However, there is considerable heterogeneity in the clinical methods and analytical procedures used to assess its diagnostic and prognostic performance. We performed a systematic review of studies that have used B-cell epitopes by peptide microarray in food allergies to identify the clinical utility of this immunologic technique. METHODS Studies were screened in PubMed, Web of Science, and Embase according to an established keyword algorithm. Data extraction was performed, and information was collected in an Excel database. Descriptive analysis was carried out using Stata software. RESULTS Thirty relevant studies were identified. Most articles were cross-sectional (n = 24), included epitope mapping (n = 9), and assessed diagnostic utility (n = 11). All studies recruited allergic patients, and some included additional patients (sensitized, persistent, and tolerant). The primary microarray variables studied were IgE intensity (n = 29), IgG4 intensity (n = 15), and number of peptides (n = 17). Statistical approaches differed significantly between studies, with the Wilcoxon test being the most frequently used (n = 10). CONCLUSIONS Sensitization to particular epitopes of milk, peanut, and shrimp allergens can be used to determine clinical reactivity, persistence, severity, or response to oral immunotherapy; however, important methodological questions need to be addressed before drawing definitive conclusions. More research is needed to address the accuracy and clinical benefits of microarray-based technology. Standards are required to improve consistency and reproducibility, and to allow for better understanding of research findings.
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Affiliation(s)
- Laura Sánchez-Ruano
- Servicio de Bioquímica-Investigación, Hospital Universitario Ramón y Cajal (IRYCIS), Madrid, Spain
| | - Belén de la Hoz
- Servicio de Alergología, Hospital Universitario Ramón y Cajal (IRYCIS), Madrid, Spain.,ARADyAL Network RD16/0006/0009, Instituto de Salud Carlos III, Madrid, Spain
| | - Javier Martínez-Botas
- Servicio de Bioquímica-Investigación, Hospital Universitario Ramón y Cajal (IRYCIS), Madrid, Spain.,CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
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23
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Tian X, Deng Z, Wang S, Wang Y. Basic Research and Clinical Reports Associated with Low Serum IgG4 Concentrations. Int Arch Allergy Immunol 2019; 181:149-158. [PMID: 31805576 DOI: 10.1159/000503967] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 10/07/2019] [Indexed: 11/19/2022] Open
Abstract
Elevated IgG4 concentrations in serum have received a great deal of attention recently, whereas the significance of decreased IgG4 levels was frequently neglected in spite of its close relation with infectious and noninfectious inflammations. In this review, based on the structural and functional characteristics of IgG4, we bring together case reports and research related to low levels of IgG4 and try to scratch the importance of decreased IgG4 concentrations in serum. As with elevated IgG4 levels, low serum IgG4-related diseases can be involved in multiple systems such as infection in the respiratory system, stroke in the circulatory system, and glomerulonephritis in the urinary system. Both genetic and immune dysregulation can contribute to decreased IgG4 levels. In the light of animal experiments, we believe that the mystery of low IgG4 can be revealed as long as enough attention is acquired.
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Affiliation(s)
- Xinyu Tian
- Department of Nephrology, Peking University Third Hospital, Beijing, China
| | - Zhenling Deng
- Department of Nephrology, Peking University Third Hospital, Beijing, China
| | - Song Wang
- Department of Nephrology, Peking University Third Hospital, Beijing, China
| | - Yue Wang
- Department of Nephrology, Peking University Third Hospital, Beijing, China,
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24
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Novel Bead-Based Epitope Assay is a sensitive and reliable tool for profiling epitope-specific antibody repertoire in food allergy. Sci Rep 2019; 9:18425. [PMID: 31804555 PMCID: PMC6895130 DOI: 10.1038/s41598-019-54868-7] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 11/09/2019] [Indexed: 12/16/2022] Open
Abstract
Identification of allergenic IgE epitopes is instrumental for the development of novel diagnostic and prognostic methods in food allergy. In this work, we present the quantification and validation of a Bead-Based Epitope Assay (BBEA) that through multiplexing of epitopes and multiple sample processing enables completion of large experiments in a short period of time, using minimal quantities of patients’ blood. Peptides that are uniquely coupled to beads are incubated with serum or plasma samples, and after a secondary fluorophore-labeled antibody is added, the level of fluorescence is quantified with a Luminex reader. The signal is then normalized and converted to epitope-specific antibody binding values. We show that the effect of technical artifacts, i.e. well position or reading order, is minimal; and batch effects - different individual microplate runs - can be easily estimated and eliminated from the data. Epitope-specific antibody binding quantified with BBEA is highly reliable, reproducible and has greater sensitivity of epitope detection compared to peptide microarrays. IgE directed at allergenic epitopes is a sensitive biomarker of food allergy and can be used to predict allergy severity and phenotypes; and quantification of the relationship between epitope-specific IgE and IgG4 can further improve our understanding of the immune mechanisms behind allergic sensitization.
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25
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Unproven Diagnostic Tests for Adverse Reactions to Foods. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2019. [PMID: 29524991 DOI: 10.1016/j.jaip.2017.08.021] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Patients often seek opinions from allergists regarding unconventional testing for adverse reactions to foods. These tests include flow cytometry to measure the change in white blood cell volumes after incubation with foods, measurement of serum IgG or IgG4 antibodies directed against foods, intradermal provocation-neutralization with food allergens, hair analysis, electrodermal testing, and applied kinesiology. In some cases, although the laboratory methods may be valid, there are no studies showing correlation with disease. In other cases, blinded, controlled studies have shown a lack of reproducibility and a lack of correlation with disease. Most of the tests lack biologic plausibility. By understanding the methodology of these tests and the lack of evidence supporting their utility, allergists can provide knowledgeable, evidence-based information to patients who inquire about them.
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26
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Calamelli E, Liotti L, Beghetti I, Piccinno V, Serra L, Bottau P. Component-Resolved Diagnosis in Food Allergies. ACTA ACUST UNITED AC 2019; 55:medicina55080498. [PMID: 31426616 PMCID: PMC6723663 DOI: 10.3390/medicina55080498] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 07/31/2019] [Accepted: 08/15/2019] [Indexed: 12/18/2022]
Abstract
Component-resolved diagnostics (CRD) in food allergies is an approach utilized to characterize the molecular components of each allergen involved in a specific IgE (sIgE)-mediated response. In the clinical practice, CRD can improve diagnostic accuracy and assist the physician in many aspects of the allergy work-up. CRD allows for discriminatory co-sensitization versus cross-sensitization phenomena and can be useful to stratify the clinical risk associated with a specific sensitization pattern, in addition to the oral food challenge (OFC). Despite this, there are still some unmet needs, such as the risk of over-prescribing unnecessary elimination diets and adrenaline auto-injectors. Moreover, up until now, none of the identified sIgE cutoff have shown a specificity and sensitivity profile as accurate as the OFC, which is the gold standard in diagnosing food allergies. In light of this, the aim of this review is to summarize the most relevant concepts in the field of CRD in food allergy and to provide a practical approach useful in clinical practice.
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Affiliation(s)
| | - Lucia Liotti
- Pediatric Unit, Civic Hospital, 60019 Senigallia, Italy
| | - Isadora Beghetti
- Pediatric Unit, Department of Medical and Surgical Sciences (DIMEC), S.Orsola-Malpighi Hospital, University of Bologna, 40138 Bologna, Italy
| | | | - Laura Serra
- Pediatric and Neonatology Unit, Imola Hospital, 40026 Imola, Italy
| | - Paolo Bottau
- Pediatric and Neonatology Unit, Imola Hospital, 40026 Imola, Italy
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27
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Brandström J, Vetander M, Sundqvist A, Lilja G, Johansson SGO, Melén E, Sverremark‐Ekström E, Nopp A, Nilsson C. Individually dosed omalizumab facilitates peanut oral immunotherapy in peanut allergic adolescents. Clin Exp Allergy 2019; 49:1328-1341. [DOI: 10.1111/cea.13469] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 05/15/2019] [Accepted: 07/01/2019] [Indexed: 12/21/2022]
Affiliation(s)
- Josef Brandström
- Sachs' Children and Youth Hospital Södersjukhuset Stockholm Sweden
- Department of Clinical Science and Education, Södersjukhuset Karolinska Institutet Stockholm Sweden
| | - Mirja Vetander
- Sachs' Children and Youth Hospital Södersjukhuset Stockholm Sweden
- Institute of Environmental Medicine Karolinska Institutet Stockholm Sweden
- Center for Allergy Research Karolinska Institutet Stockholm Sweden
| | | | - Gunnar Lilja
- Sachs' Children and Youth Hospital Södersjukhuset Stockholm Sweden
- Department of Clinical Science and Education, Södersjukhuset Karolinska Institutet Stockholm Sweden
| | - S. G. O. Johansson
- Sachs' Children and Youth Hospital Södersjukhuset Stockholm Sweden
- Department of Clinical Science and Education, Södersjukhuset Karolinska Institutet Stockholm Sweden
| | - Erik Melén
- Sachs' Children and Youth Hospital Södersjukhuset Stockholm Sweden
- Institute of Environmental Medicine Karolinska Institutet Stockholm Sweden
| | - Eva Sverremark‐Ekström
- Department of Molecular Biosciences, TheWenner‐Gren Institute Stockholm University Stockholm Sweden
| | - Anna Nopp
- Sachs' Children and Youth Hospital Södersjukhuset Stockholm Sweden
- Department of Clinical Science and Education, Södersjukhuset Karolinska Institutet Stockholm Sweden
| | - Caroline Nilsson
- Sachs' Children and Youth Hospital Södersjukhuset Stockholm Sweden
- Department of Clinical Science and Education, Södersjukhuset Karolinska Institutet Stockholm Sweden
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28
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Linhart B, Freidl R, Elisyutina O, Khaitov M, Karaulov A, Valenta R. Molecular Approaches for Diagnosis, Therapy and Prevention of Cow´s Milk Allergy. Nutrients 2019; 11:E1492. [PMID: 31261965 PMCID: PMC6683018 DOI: 10.3390/nu11071492] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 06/24/2019] [Accepted: 06/25/2019] [Indexed: 12/12/2022] Open
Abstract
Cow´s milk is one of the most important and basic nutrients introduced early in life in our diet but can induce IgE-associated allergy. IgE-associated allergy to cow´s milk can cause severe allergic manifestations in the gut, skin and even in the respiratory tract and may lead to life-threatening anaphylactic shock due to the stability of certain cow´s milk allergens. Here, we provide an overview about the allergen molecules in cow´s milk and the advantages of the molecular diagnosis of IgE sensitization to cow´s milk by serology. In addition, we review current strategies for prevention and treatment of cow´s milk allergy and discuss how they could be improved in the future by innovative molecular approaches that are based on defined recombinant allergens, recombinant hypoallergenic allergen derivatives and synthetic peptides.
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Affiliation(s)
- Birgit Linhart
- Department of Pathophysiology and Allergy Research, Medical University of Vienna, 1090 Vienna, Austria.
| | - Raphaela Freidl
- Department of Pathophysiology and Allergy Research, Medical University of Vienna, 1090 Vienna, Austria
| | - Olga Elisyutina
- NRC Institute of Immunology FMBA of Russia, 115478, Moscow, Russia
| | - Musa Khaitov
- NRC Institute of Immunology FMBA of Russia, 115478, Moscow, Russia
| | - Alexander Karaulov
- Laboratory of Immunopathology, Department of Clinical Immunology and Allergy, Sechenov First Moscow State Medical University, 119435 Moscow, Russia
| | - Rudolf Valenta
- Department of Pathophysiology and Allergy Research, Medical University of Vienna, 1090 Vienna, Austria
- NRC Institute of Immunology FMBA of Russia, 115478, Moscow, Russia
- Laboratory of Immunopathology, Department of Clinical Immunology and Allergy, Sechenov First Moscow State Medical University, 119435 Moscow, Russia
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29
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Sackesen C, Suárez-Fariñas M, Silva R, Lin J, Schmidt S, Getts R, Gimenez G, Yilmaz EA, Cavkaytar O, Buyuktiryaki B, Soyer O, Grishina G, Sampson HA. A new Luminex-based peptide assay to identify reactivity to baked, fermented, and whole milk. Allergy 2019; 74:327-336. [PMID: 30058196 DOI: 10.1111/all.13581] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Accepted: 07/12/2018] [Indexed: 01/20/2023]
Abstract
BACKGROUND The majority of children with cow's milk allergy (CMA) tolerate baked milk. However, reactivity to fermented milk products such as yogurt/cheese has not been previously evaluated. We sought to determine whether children with CMA could tolerate yogurt/cheese and whether a patient's IgE and IgG4-binding pattern to milk protein epitopes could distinguish clinical reactivity. METHODS Four groups of reactivity were identified by Oral food challenge: baked milk reactive, fermented milk reactive, whole milk reactive, and outgrown. sIgE and sIgG4 binding to milk protein epitopes were assessed with a novel Luminex-based peptide assay (LPA). Using machine learning techniques, a model was developed to predict different degrees of CMA. RESULTS The baked milk reactive patients demonstrated the highest degree of IgE epitope binding, which was followed sequentially by fermented milk reactive, whole milk reactive, and outgrown. Data were randomly divided into two groups with 75% of the data utilized for model development (n = 68) and 25% for testing (n = 21). All 68 children used for training were correctly classified with models using IgE and IgG4 epitopes. The average cross-validation accuracy was much higher for models using IgE plus IgG4 epitopes by LPA (84.8%), twice the performance of the serum component proteins assayed by UniCAP (41.9%). The performance of the model on "unseen data" was tested using the 21 withheld patients, and the accuracy of IgE was 86% (AUC = 0.89) while of IgE+IgG4 model was 81% (AUC = 0.94). CONCLUSION Using a novel high-throughput LPA, we were able to distinguish the diversity of IgE/IgG4 binding to epitopes in the varying CMA phenotypes. LPA is a promising tool to predict correctly different degrees of CMA.
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Affiliation(s)
- Cansin Sackesen
- Division of Pediatric Allergy; Koc University School of Medicine; Istanbul Turkey
- Division of Pediatric Allergy; Hacettepe University School of Medicine; Ankara Turkey
- Division of Pediatric Allergy and Immunology; Icahn School of Medicine at Mount Sinai; New York New York
| | - Mayte Suárez-Fariñas
- Center for Biostatistics; Icahn Institute for Genomics and Multiscale Biology; Icahn School of Medicine at Mount Sinai; New York New York
| | - Ronaldo Silva
- Center for Biostatistics; Icahn Institute for Genomics and Multiscale Biology; Icahn School of Medicine at Mount Sinai; New York New York
| | - Jing Lin
- Division of Pediatric Allergy and Immunology; Icahn School of Medicine at Mount Sinai; New York New York
- Institute of High Performance Computing; A*STAR; Singapore City Singapore
| | | | - Robert Getts
- Genisphere LLC; Hatfield Pennsylvania
- AllerGenis LLC; Hatfield Pennsylvania
| | - Gustavo Gimenez
- Division of Pediatric Allergy and Immunology; Icahn School of Medicine at Mount Sinai; New York New York
| | - Ebru A. Yilmaz
- Division of Pediatric Allergy; Hacettepe University School of Medicine; Ankara Turkey
| | - Ozlem Cavkaytar
- Division of Pediatric Allergy; Hacettepe University School of Medicine; Ankara Turkey
| | - Betul Buyuktiryaki
- Division of Pediatric Allergy; Hacettepe University School of Medicine; Ankara Turkey
| | - Ozge Soyer
- Division of Pediatric Allergy; Hacettepe University School of Medicine; Ankara Turkey
| | - Galina Grishina
- Division of Pediatric Allergy and Immunology; Icahn School of Medicine at Mount Sinai; New York New York
| | - Hugh A. Sampson
- Division of Pediatric Allergy and Immunology; Icahn School of Medicine at Mount Sinai; New York New York
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30
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Sackesen C, Altintas DU, Bingol A, Bingol G, Buyuktiryaki B, Demir E, Kansu A, Kuloglu Z, Tamay Z, Sekerel BE. Current Trends in Tolerance Induction in Cow's Milk Allergy: From Passive to Proactive Strategies. Front Pediatr 2019; 7:372. [PMID: 31620408 PMCID: PMC6760011 DOI: 10.3389/fped.2019.00372] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Accepted: 08/30/2019] [Indexed: 12/15/2022] Open
Abstract
This review addresses the current strategies of inducing tolerance development in infant and childhood cow's milk protein allergy (CMPA). The change in prevention strategies for CMPA has been emphasized based on the lack of evidence to support the efficacy of food allergen avoidance in infancy and the concept of the dual-allergen-exposure hypothesis, which suggests that allergen exposure through the skin leads to sensitization, whereas early oral consumption of allergenic food protein induces oral tolerance. The new approach is based on the likelihood of early introduction of allergenic foods to the infant's diet to reduce the development of food allergies through oral tolerance induction. The latest treatment guidelines recommend the continuation of breast feeding and the elimination of cow's milk and products from the maternal diet in exclusively breast-fed infants with CMPA, the use of an extensively hydrolyzed infant formula (eHF) with proven efficacy in CMPA as the first elimination diet in formula-fed infants with CMPA and the use of amino acid-based formula (AAF) in severe cases, such as anaphylaxis, enteropathy, eosinophilic esophagitis, and food protein-induced enterocolitis syndrome (FPIES), as well as cases of multiple system involvement, multiple food allergies, and intolerance to extensively hydrolyzed formula (eHF). In conclusion, this paper presents the current knowledge on tolerance development in infants and children with CMPA to increase the awareness of the clinicians concerning the new approaches in CMPA treatment Tolerance development is considered a relatively new concept in CMPA, inducing a shift in interventions in CMPA from a passive (avoidance of responsible allergen) toward a proactive (tolerance induction) strategy.
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Affiliation(s)
- Cansin Sackesen
- Division of Pediatric Allergy, Department of Pediatrics, Koc University School of Medicine, Istanbul, Turkey
| | - Derya Ufuk Altintas
- Division of Pediatric Allergy, Department of Pediatrics, Cukurova University School of Medicine, Adana, Turkey
| | - Aysen Bingol
- Division of Pediatric Allergy and Immunology, Department of Pediatrics, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - Gulbin Bingol
- Division of Pediatric Allergy and Immunology, Department of Pediatrics, Acibadem University School of Medicine, Istanbul, Turkey
| | - Betul Buyuktiryaki
- Division of Pediatric Allergy and Asthma, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Esen Demir
- Division of Pediatric Allergy, Department of Pediatrics, Ege University School of Medicine, Izmir, Turkey
| | - Aydan Kansu
- Division of Pediatric Gastroenterology, Department of Pediatrics, Ankara University School of Medicine, Ankara, Turkey
| | - Zarife Kuloglu
- Division of Pediatric Gastroenterology, Department of Pediatrics, Ankara University School of Medicine, Ankara, Turkey
| | - Zeynep Tamay
- Division of Pediatric Allergy and Immunology, Department of Pediatrics, Istanbul University Istanbul School of Medicine, Istanbul, Turkey
| | - Bulent Enis Sekerel
- Division of Pediatric Allergy and Asthma, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
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31
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Datema MR, Eller E, Zwinderman AH, Poulsen LK, Versteeg SA, van Ree R, Bindslev-Jensen C. Ratios of specific IgG 4 over IgE antibodies do not improve prediction of peanut allergy nor of its severity compared to specific IgE alone. Clin Exp Allergy 2018; 49:216-226. [PMID: 30269403 PMCID: PMC7379576 DOI: 10.1111/cea.13286] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 07/15/2018] [Accepted: 08/01/2018] [Indexed: 01/04/2023]
Abstract
Background IgG4 antibodies have been suggested to play a protective role in the translation of peanut sensitization into peanut allergy. Whether they have added value as diagnostic read‐out has not yet been reported. Objective To evaluate whether (a) peanut‐specific IgG, IgG4 and/or IgA antibodies are associated with tolerance and/or less severe reactions and (b) they can improve IgE‐based diagnostic tests. Methods Sera of 137 patients with challenge‐proven peanut allergy and of 25 subjects that tolerated peanut, both with known IgE profiles to peanut extract and five individual peanut allergens, were analyzed for specific IgG and IgG4. Antibody levels and ratios thereof were associated with challenge outcome including symptom severity grades. For comparison of the discriminative performance, receiver operating characteristic curve (ROC) analysis was used. Results IgE against Ara h 2 was significantly higher in allergic than in tolerant patients and associated with severity of reactions (P < 0.001) with substantial diagnostic capability (AUC 0.91, 95%CI 0.87‐0.96 and 0.80, 95%CI 0.73‐0.87, respectively). IgG and IgG4 were also positively associated albeit significantly weaker (AUCs from 0.65 to 0.72). On the other hand, ratios of IgG and IgG4 over IgE were greater in patients that were tolerant or had mild symptoms as compared to severe patients but they did not predict challenge outcomes better than IgE alone (AUCs from 0.54 to 0.89). Conclusion IgE against Ara h 2 is the best biomarker for predicting peanut challenge outcomes including severity and IgG and IgG4 antibody ratios over IgE do not improve these outcomes.
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Affiliation(s)
- Mareen R Datema
- Department of Experimental Immunology, Academic Medical Center, Amsterdam, the Netherlands.,Department of Clinical Epidemiology, Academic Medical Centre, Biostatistics and Bioinformatics, Amsterdam, the Netherlands
| | - Esben Eller
- Department of Dermatology and Allergy Center, Odense Research Center for Anaphylaxis (ORCA), Odense University Hospital, Odense, Denmark
| | - Aeilko H Zwinderman
- Department of Clinical Epidemiology, Academic Medical Centre, Biostatistics and Bioinformatics, Amsterdam, the Netherlands
| | - Lars K Poulsen
- Allergy Clinic, Copenhagen University Hospital at Gentofte, Copenhagen, Denmark
| | - Serge A Versteeg
- Department of Experimental Immunology, Academic Medical Center, Amsterdam, the Netherlands
| | - Ronald van Ree
- Department of Experimental Immunology, Academic Medical Center, Amsterdam, the Netherlands.,Department of Otorhinolaryngology, Academic Medical Center, Amsterdam, the Netherlands
| | - Carsten Bindslev-Jensen
- Department of Dermatology and Allergy Center, Odense Research Center for Anaphylaxis (ORCA), Odense University Hospital, Odense, Denmark
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32
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Ehlers AM, Blankestijn MA, Knulst AC, Klinge M, Otten HG. Can alternative epitope mapping approaches increase the impact of B-cell epitopes in food allergy diagnostics? Clin Exp Allergy 2018; 49:17-26. [PMID: 30294841 PMCID: PMC7380004 DOI: 10.1111/cea.13291] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 09/14/2018] [Accepted: 09/17/2018] [Indexed: 01/08/2023]
Abstract
In vitro allergy diagnostics are currently based on the detection of specific IgE binding on intact allergens or a mixture thereof. This approach has drawbacks as it may yield false‐negative and/or false‐positive results. Thus, we reviewed the impact of known B‐cell epitopes of food allergens to predict transience or persistence, tolerance or allergy and the severity of an allergic reaction and to examine new epitope mapping strategies meant to improve serum‐based allergy diagnostics. Recent epitope mapping approaches have been worthwhile in epitope identification and may increase the specificity of allergy diagnostics by using epitopes predominately recognized by allergic patients in some cases. However, these approaches did not lead to discrimination between clinically relevant and irrelevant epitopes so far, since the polyclonal serum IgE‐binding epitope spectrum seems to be too individual, independent of the disease status of the patients. New epitope mapping strategies are necessary to overcome these obstacles. The use of patient‐derived monoclonal antibodies instead of patient sera for functional characterization of clinically relevant and irrelevant epitope combinations, distinguished by their ability to induce degranulation, might be a promising approach to gain more insight into the allergic reaction and to improve serum‐based allergy diagnostics.
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Affiliation(s)
- Anna M Ehlers
- Laboratory of Translational Immunology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.,Department of Dermatology and Allergology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Mark A Blankestijn
- Laboratory of Translational Immunology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.,Department of Dermatology and Allergology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Andre C Knulst
- Laboratory of Translational Immunology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.,Department of Dermatology and Allergology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | | | - Henny G Otten
- Laboratory of Translational Immunology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
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33
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Burton OT, Epp A, Fanny ME, Miller SJ, Stranks AJ, Teague JE, Clark RA, van de Rijn M, Oettgen HC. Tissue-Specific Expression of the Low-Affinity IgG Receptor, FcγRIIb, on Human Mast Cells. Front Immunol 2018; 9:1244. [PMID: 29928276 PMCID: PMC5997819 DOI: 10.3389/fimmu.2018.01244] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Accepted: 05/17/2018] [Indexed: 11/13/2022] Open
Abstract
Immediate hypersensitivity reactions are induced by the interaction of allergens with specific IgE antibodies bound via FcεRI to mast cells and basophils. While these specific IgE antibodies are needed to trigger such reactions, not all individuals harboring IgE exhibit symptoms of allergy. The lack of responsiveness seen in some subjects correlates with the presence of IgG antibodies of the same specificity. In cell culture studies and in vivo animal models of food allergy and anaphylaxis such IgG antibodies have been shown to exert suppression via FcγRIIb. However, the reported absence of this inhibitory receptor on primary mast cells derived from human skin has raised questions about the role of IgG-mediated inhibition of immediate hypersensitivity in human subjects. Here, we tested the hypothesis that mast cell FcγRIIb expression might be tissue specific. Utilizing a combination of flow cytometry, quantitative PCR, and immunofluorescence staining of mast cells derived from the tissues of humanized mice, human skin, or in fixed paraffin-embedded sections of human tissues, we confirm that FcγRIIb is absent from dermal mast cells but is expressed by mast cells throughout the gastrointestinal tract. IgE-induced systemic anaphylaxis in humanized mice is strongly inhibited by antigen-specific IgG. These findings support the concept that IgG, signaling via FcγRIIb, plays a physiological role in suppressing hypersensitivity reactions.
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Affiliation(s)
- Oliver T Burton
- Division of Immunology, Boston Children's Hospital, Harvard Medical School, Boston, MA, United States
| | - Alexandra Epp
- Division of Immunology, Boston Children's Hospital, Harvard Medical School, Boston, MA, United States
| | - Manoussa E Fanny
- Division of Immunology, Boston Children's Hospital, Harvard Medical School, Boston, MA, United States
| | - Samuel J Miller
- Division of Immunology, Boston Children's Hospital, Harvard Medical School, Boston, MA, United States
| | - Amanda J Stranks
- Division of Immunology, Boston Children's Hospital, Harvard Medical School, Boston, MA, United States
| | - Jessica E Teague
- Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - Rachael A Clark
- Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - Matt van de Rijn
- Department of Pathology, Stanford University Medical Center, Palo Alto, CA, United States
| | - Hans C Oettgen
- Division of Immunology, Boston Children's Hospital, Harvard Medical School, Boston, MA, United States
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Ghosh D, Clay C, Bernstein JA. The utility of monitoring trimellitic anhydride (TMA)-specific IgG to predict IgE-mediated sensitization in an immunosurveillance program. Allergy 2018; 73:1075-1083. [PMID: 29117440 DOI: 10.1111/all.13348] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/02/2017] [Indexed: 01/27/2023]
Abstract
BACKGROUND Workplace exposure to trimellitic anhydride (TMA) can elicit TMA-specific IgE (sIgE), which may lead to occupational asthma (OA). An occupational immunosurveillance program (OISP) has been implemented to monitor TMA exposure and immunologic outcomes. The purpose of this study was to determine whether TMA-specific IgG (sIgG) responses can discriminate between TMA-exposed workers with and without sIgE responses. METHODS Serum TMA-specific antibody (IgG, IgG4, and IgE) levels were estimated longitudinally (years 2006 to 2014) in TMA-exposed workers recruited in low, medium, and high exposure areas. sIgG and sIgE titers plotted against exposure duration were compared between workers with (a) sIgG only and (b) with sIgG who developed sIgE. RESULTS Among 92 TMA-exposed workers continuously monitored for sIgG and sIgE, 38 developed sIgG; 11 developed a sIgE response 342.38 ± 186.03 days posthire and were removed from exposure. The average detection time of sIgG in removed workers (159 ± 92 days) was significantly shorter than for actively exposed workers with only sIgG (346 ± 187 days). Workers with earlier sIgG responses of higher titer (mean value 42.25 μg/mL) compared to delayed responders with lower sIgG titers (mean value 14.79 μg/mL) more frequently developed sIgE responses. Hierarchical clustering showed the initial magnitude and exposure time required for detectable sIgG production discriminated between workers with only sIgG from workers who subsequently produced sIgE. CONCLUSIONS This study demonstrates the utility of longitudinally monitoring TMA-specific antibodies in an OISP as exposed workers with early sIgG responses and of higher magnitude are more likely to develop TMA sIgE sensitization.
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Affiliation(s)
- D. Ghosh
- Division of Immunology/Allergy Section; Department of Internal Medicine; University of Cincinnati College of Medicine; Cincinnati OH USA
| | - C. Clay
- Division of Immunology/Allergy Section; Department of Internal Medicine; University of Cincinnati College of Medicine; Cincinnati OH USA
| | - J. A. Bernstein
- Division of Immunology/Allergy Section; Department of Internal Medicine; University of Cincinnati College of Medicine; Cincinnati OH USA
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Scott‐Taylor TH, Axinia S, Amin S, Pettengell R. Immunoglobulin G; structure and functional implications of different subclass modifications in initiation and resolution of allergy. Immun Inflamm Dis 2018; 6:13-33. [PMID: 29164823 PMCID: PMC5818455 DOI: 10.1002/iid3.192] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Revised: 07/14/2017] [Accepted: 07/23/2017] [Indexed: 12/24/2022] Open
Abstract
IgE and not IgG is usually associated with allergy. IgE lodged on mast cells in skin or gut and basophils in the blood allows for the prolonged duration of allergy through the persistent expression of high affinity IgE receptors. However, many allergic reactions are not dependent on IgE and are generated in the absence of allergen specific and even total IgE. Instead, IgG plasma cells are involved in induction of, and for much of the pathogenesis of, allergic diseases. The pattern of IgG producing plasma cells in atopic children and the tendency for direct or further class switching to IgE are the principle factors responsible for long-lasting sensitization of mast cells in allergic children. Indirect class switching from IgG producing plasma cells has been shown to be the predominant pathway for production of IgE while a Th2 microenvironment, genetic predisposition, and the concentration and nature of allergens together act on IgG plasma cells in the atopic tendency to undergo further immunoglobulin gene recombination. The seminal involvement of IgG in allergy is further indicated by the principal role of IgG4 in the natural resolution of allergy and as the favourable immunological response to immunotherapy. This paper will look at allergy through the role of different antibodies than IgE and give current knowledge of the nature and role of IgG antibodies in the start, maintenance and resolution of allergy.
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Affiliation(s)
| | - Stefan‐Claudiu Axinia
- School of Life SciencesLondon Metropolitan University166‐220 Holloway RoadLondon, N7 8DB
| | - Sumeya Amin
- School of Life SciencesLondon Metropolitan University166‐220 Holloway RoadLondon, N7 8DB
| | - Ruth Pettengell
- Department of HaematologySt George's University of LondonCranmer TerraceLondon SW17 0RE
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Li X, Yuan S, Huang M, Gao J, Wu Z, Tong P, Yang A, Chen H. Identification of IgE and IgG epitopes on native Bos d 4 allergen specific to allergic children. Food Funct 2018; 7:2996-3005. [PMID: 27273451 DOI: 10.1039/c6fo00416d] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Alpha-lactalbumin (ALA) is one of the major allergens in cow's milk. However, research on its conformational epitopes has been relatively limited. In our study, specific antibodies against cow's milk ALA were purified from eight children by two-step affinity chromatography. Subsequently, mimotopes against IgG and IgE were biopanned from Ph.D.-12 and Ph.D.-C7C, respectively. Based on the mimotopes, linear epitopes were defined with the UniProt alignment tool. Conformational epitopes were computed using the Pepitope Server. Six IgE and seven IgG linear epitopes were identified. Meanwhile, five IgE and three IgG conformational epitopes were revealed with PyMOL. The results showed that common residues were identified in both IgE and IgG epitopes and some residues of the conformational epitopes were composed of linear epitopes on bovine α-lactalbumin. The results indicated that the data could be used for developing hypoallergenic dairy products on the basis of epitopes and providing a diagnostic tool for the assessment of patients who are allergic to cow's milk.
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Affiliation(s)
- Xin Li
- State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang 330047, P.R.China and School of Food Science & Technology, Nanchang University, Nanchang 330047, P.R.China
| | - Shuilin Yuan
- State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang 330047, P.R.China and School of Food Science & Technology, Nanchang University, Nanchang 330047, P.R.China
| | - Meijia Huang
- State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang 330047, P.R.China and School of Food Science & Technology, Nanchang University, Nanchang 330047, P.R.China
| | - Jinyan Gao
- School of Food Science & Technology, Nanchang University, Nanchang 330047, P.R.China
| | - Zhihua Wu
- State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang 330047, P.R.China and Jiangxi-OAI Joint Research Institute, Nanchang University, Nanchang 330047, P.R.China.
| | - Ping Tong
- State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang 330047, P.R.China and School of Food Science & Technology, Nanchang University, Nanchang 330047, P.R.China
| | - Anshu Yang
- State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang 330047, P.R.China and Jiangxi-OAI Joint Research Institute, Nanchang University, Nanchang 330047, P.R.China.
| | - Hongbing Chen
- State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang 330047, P.R.China and Jiangxi-OAI Joint Research Institute, Nanchang University, Nanchang 330047, P.R.China.
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Abstract
Food allergies manifest in a variety of clinical conditions within the gastrointestinal tract, skin and lungs, with the most dramatic and sometimes fatal manifestation being anaphylactic shock. Major progress has been made in basic, translational and clinical research, leading to a better understanding of the underlying immunological mechanisms that lead to the breakdown of clinical and immunological tolerance against food antigens, which can result in either immunoglobulin E (IgE)-mediated reactions or non-IgE-mediated reactions. Lifestyle factors, dietary habits and maternal-neonatal interactions play a pivotal part in triggering the onset of food allergies, including qualitative and quantitative composition of the microbiota. These factors seem to have the greatest influence early in life, an observation that has led to the generation of hypotheses to explain the food allergy epidemic, including the dual-allergen exposure hypothesis. These hypotheses have fuelled research in preventive strategies that seek to establish desensitization to allergens and/or tolerance to allergens in affected individuals. Allergen-nonspecific therapeutic strategies have also been investigated in a number of clinical trials, which will eventually improve the treatment options for patients with food allergy.
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Mattoo H, Stone JH, Pillai S. Clonally expanded cytotoxic CD4 + T cells and the pathogenesis of IgG4-related disease. Autoimmunity 2017; 50:19-24. [PMID: 28166682 DOI: 10.1080/08916934.2017.1280029] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
IgG4-related disease (IgG4-RD) is a systemic condition of unknown cause characterized by highly fibrotic lesions, with dense lymphoplasmacytic infiltrates containing a preponderance of IgG4-expressing plasma cells. CD4+ T cells and B cells constitute the major inflammatory cell populations in IgG4-RD lesions. IgG4-RD patients with active, untreated disease show a marked expansion of plasmablasts in the circulation. Although the therapeutic depletion of B cells suggests a role for these cells in the disease, a direct role for B cells or IgG4 in the pathogenesis of IgG4-RD is yet to be demonstrated. Among the CD4+ T-cell subsets, Th2 cells were initially thought to contribute to IgG4-RD pathogenesis, but many previous studies were confounded by the concomitant history of allergic diseases in the patients studied and the failure to use multi-color staining to definitively identify T-cell subsets in tissue samples. More recently, using an unbiased approach to characterize CD4+ T-cell subsets in patients with IgG4-RD - based on their clonal expansion and ability to infiltrate affected tissue sites - CD4+ CTLs have been identified as the major CD4+ T-cell subset in disease lesions as well as in the circulation. CD4+ CTLs in affected tissues secrete pro-fibrotic cytokines including IL-1β, TGF-β1, and IFN-γ as well as cytolytic molecules such as perforin and granzymes A and B. In this review, we examine possible mechanisms by which activated B cells and plasmablasts may collaborate with the expanded CD4+ CTLs in driving the fibrotic pathology of the disease and describe the lacunae in the field and in our understanding of IgG4-RD pathogenesis.
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Affiliation(s)
- Hamid Mattoo
- a Massachusetts General Hospital, Harvard Medical School , Boston , MA , USA
| | - John H Stone
- a Massachusetts General Hospital, Harvard Medical School , Boston , MA , USA
| | - Shiv Pillai
- a Massachusetts General Hospital, Harvard Medical School , Boston , MA , USA
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Van Hemelrijck M, Karagiannis SN, Rohrmann S. Atopy and prostate cancer: Is there a link between circulating levels of IgE and PSA in humans? Cancer Immunol Immunother 2017; 66:1557-1562. [PMID: 28795218 PMCID: PMC11029349 DOI: 10.1007/s00262-017-2048-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Accepted: 07/28/2017] [Indexed: 01/08/2023]
Abstract
BACKGROUND Atopy has been investigated as a potential risk factor for prostate cancer. IgE antibodies may be major players in protective responses against tumours, through engendering antigen presentation and enhancing adaptive immune responses targeted towards a specific allergen, but potentially also against tumour-associated antigens such as prostate-specific antigen (PSA). We therefore cross-sectionally investigated associations between circulating levels of PSA and IgE in the National Health and Nutrition Examination Survey 2005-2006. METHODS We focused on all men aged 40+ years with measurements for PSA and IgE, and no previous diagnosis of prostate cancer (n = 1312). We estimated the association between total and specific IgE concentration and levels of PSA with logistic regression models, adjusted for age, ethnicity/race, education, smoking status, body mass index (BMI), physical activity status, and history of asthma. RESULTS Both total IgE and the sum of specific IgE were inversely associated with the risk of having PSA levels ≥10 ng/mL, though most findings were not statistically significant. The odds ratios for the second and third tertile of total IgE as compared to the first were 0.21 (95% CI 0.06-0.72) and 0.42 (0.08-2.31). The odds ratio for sum of abnormal specific IgE measurements was 0.77 (0.44-1.34). CONCLUSION Despite statistical insignificance, the observed trend warrants further research given the increasing evidence of the role of atopy and IgE antibodies in protective responses against tumours. A lifecourse approach of measuring IgE, specific subtypes, and other markers of the humoral immune system (i.e. IgG) could shed more light on its potential anti-cancer characteristics.
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Affiliation(s)
- Mieke Van Hemelrijck
- Division of Cancer Studies, King's College London, Translational Oncology and Urology Research (TOUR), London, UK
| | - Sophia N Karagiannis
- Division of Genetics and Molecular Medicine, Faculty of Life Sciences and Medicine, St. John's Institute of Dermatology, King's College London and NIHR Biomedical Research Centre at Guy's and St. Thomas's Hospitals and King's College London, London, UK
| | - Sabine Rohrmann
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland.
- Cancer Registry Zurich and Zug, Vogelsangstrasse 10, 8091, Zurich, Switzerland.
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40
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Caubet JC, Lin J, Ahrens B, Gimenez G, Bardina L, Niggemann B, Sampson HA, Beyer K. Natural tolerance development in cow's milk allergic children: IgE and IgG4 epitope binding. Allergy 2017; 72:1677-1685. [PMID: 28345783 DOI: 10.1111/all.13167] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/22/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND Although most of cow's milk (CM) allergic children will outgrow their allergy, the pathomechanism of the natural development of tolerance remains poorly understood. It has been suggested that the balance between milk-specific IgE and IgG4 plays a major role. OBJECTIVE We aimed to investigate differences in IgE and IgG4 antibody binding to CM epitopes between patients with persistent CM allergy (CMA) and those that naturally became tolerant. METHODS Sera from 35 children with proven CMA (median age at inclusion of 10 months) were analyzed retrospectively; 22 patients have become tolerant (median age at tolerance acquisition of 51 months) during the study period as confirmed by a negative oral food challenge. IgE and IgG4 binding to sequential epitopes derived from five major CM proteins were measured with a peptide microarray-based immunoassay. RESULTS At baselines, greater intensity and broader diversity of IgE and IgG4 binding have been found in children with persistent CMA beyond 5 years of age compared to patients with transient CMA. Moreover, children with transient CMA had IgE and IgG4 antibodies that more often recognized the same epitopes, compared to those with persistent CMA. From baseline to the time of tolerance development, both IgE and IgG4 binding intensity decreased significantly, particularly in areas of α-s- and β-casein (P<.01, false discovery rate [FDR]<.1). Interestingly, differences between IgE and IgG4 binding intensity to CM peptides decreased when the patients became tolerant. CONCLUSIONS Our results suggest that the overlap between IgE and IgG4 might be important in natural tolerance acquisition. Further studies are needed to confirm our data and can eventually lead to development of more targeted treatment of food allergy.
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Affiliation(s)
- J. C. Caubet
- Geneva University Hospital Geneva Switzerland
- Department of Pediatrics Division of Allergy and Immunology Jaffe Food Allergy Institute Icahn School of Medicine at Mount Sinai New York NY USA
| | - J. Lin
- Department of Pediatrics Division of Allergy and Immunology Jaffe Food Allergy Institute Icahn School of Medicine at Mount Sinai New York NY USA
- Bioinformatics Institute Institute of High Performance Computing A*STAR Singapore Singapore
| | - B. Ahrens
- Department of Pediatric Pneumology and Immunology Charité Universitätsmedizin Berlin Berlin Germany
| | - G. Gimenez
- Department of Pediatrics Division of Allergy and Immunology Jaffe Food Allergy Institute Icahn School of Medicine at Mount Sinai New York NY USA
| | - L. Bardina
- Department of Pediatrics Division of Allergy and Immunology Jaffe Food Allergy Institute Icahn School of Medicine at Mount Sinai New York NY USA
| | - B. Niggemann
- Department of Pediatric Pneumology and Immunology Charité Universitätsmedizin Berlin Berlin Germany
| | - H. A. Sampson
- Department of Pediatrics Division of Allergy and Immunology Jaffe Food Allergy Institute Icahn School of Medicine at Mount Sinai New York NY USA
| | - K. Beyer
- Department of Pediatrics Division of Allergy and Immunology Jaffe Food Allergy Institute Icahn School of Medicine at Mount Sinai New York NY USA
- Department of Pediatric Pneumology and Immunology Charité Universitätsmedizin Berlin Berlin Germany
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41
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Bartuzi Z, Cocco RR, Muraro A, Nowak-Węgrzyn A. Contribution of Molecular Allergen Analysis in Diagnosis of Milk Allergy. Curr Allergy Asthma Rep 2017; 17:46. [PMID: 28597347 DOI: 10.1007/s11882-017-0716-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE OF REVIEW We sought to describe the available evidence supporting the utilization of the molecular allergen analysis (MAA) for diagnosis and management of cow milk protein allergy (CMPA). RECENT FINDINGS Cow milk proteins are among the most common food allergens in IgE- and non-IgE-mediated food allergic disorders in children. Most individuals with CMPA are sensitized to both caseins and whey proteins. Caseins are more resistant to high temperatures compared to whey proteins. MAA is not superior to the conventional diagnostic tests based on the whole allergen extracts for diagnosis of CMPA. However, MAA can be useful in diagnosing tolerance to extensively heated milk proteins in baked foods. Children with CMPA and high levels of casein IgE are less likely to tolerate baked milk compared to children with low levels of casein IgE. Specific IgE-binding patterns to casein and betalactoglobulin peptides may predict the natural course of CMPA and differentiate subjects who are more likely to develop CMPA at a younger age versus those with a more persistent CMPA. Specific IgE-binding patterns to casein and beta-lactoglobulin peptides may also predict response to milk OITand identify patientsmost likely to benefit fromOIT.
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Affiliation(s)
- Zbigniew Bartuzi
- Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Toruń, Poland
| | - Renata Rodrigues Cocco
- Allergy and Immunology Division, Department of Pediatrics, Federal University of São Paulo, São Paulo, Brazil
| | - Antonella Muraro
- Food Allergy Referral Centre Veneto Region, Department of Women and Child Health, Padua General University Hospital, Padua, Italy
| | - Anna Nowak-Węgrzyn
- Division of Allergy and Immunology, Jaffe Food Allergy Institute, One Gustave L. Levy Place, Box 1198, New York, NY, 10029, USA.
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Turcanu V, Brough HA, Du Toit G, Foong RX, Marrs T, Santos AF, Lack G. Immune mechanisms of food allergy and its prevention by early intervention. Curr Opin Immunol 2017; 48:92-98. [PMID: 28892729 DOI: 10.1016/j.coi.2017.08.009] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Revised: 07/25/2017] [Accepted: 08/16/2017] [Indexed: 12/12/2022]
Abstract
The environmental factors driving the increase in food allergies are unclear and possibly involve dual exposure to allergens, microbiome-driven effects or other mechanisms. Until they can be better understood, early intervention aiming at establishing oral tolerance provides an effective way to decrease the window-of-risk when children may develop allergic sensitisation to foods due to the absence of a protective immune response. Thus, the recent LEAP (Learning Early About Peanut allergy) and LEAP-On studies achieved a high level of peanut allergy prevention by early introduction of peanuts in the infants diet and conveyed more information regarding the evolution of IgE and IgG4 antibody responses to food antigens over time.
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Affiliation(s)
- Victor Turcanu
- Department of Paediatric Allergy, King's College London, Guy's & St Thomas' NHS Foundation Trust, St Thomas' Hospital, Westminster Bridge Road, London SE1 7EH United Kingdom
| | - Helen A Brough
- Department of Paediatric Allergy, King's College London, Guy's & St Thomas' NHS Foundation Trust, St Thomas' Hospital, Westminster Bridge Road, London SE1 7EH United Kingdom
| | - George Du Toit
- Department of Paediatric Allergy, King's College London, Guy's & St Thomas' NHS Foundation Trust, St Thomas' Hospital, Westminster Bridge Road, London SE1 7EH United Kingdom
| | - Ru-Xin Foong
- Department of Paediatric Allergy, King's College London, Guy's & St Thomas' NHS Foundation Trust, St Thomas' Hospital, Westminster Bridge Road, London SE1 7EH United Kingdom
| | - Tom Marrs
- Department of Paediatric Allergy, King's College London, Guy's & St Thomas' NHS Foundation Trust, St Thomas' Hospital, Westminster Bridge Road, London SE1 7EH United Kingdom
| | - Alexandra F Santos
- Department of Paediatric Allergy, King's College London, Guy's & St Thomas' NHS Foundation Trust, St Thomas' Hospital, Westminster Bridge Road, London SE1 7EH United Kingdom
| | - Gideon Lack
- Department of Paediatric Allergy, King's College London, Guy's & St Thomas' NHS Foundation Trust, St Thomas' Hospital, Westminster Bridge Road, London SE1 7EH United Kingdom.
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Chen Y, Tu Z, Wang H, Zhang Q, Zhang L, Sha X, Huang T, Ma D, Pang J, Yang P. The Reduction in the IgE-Binding Ability of β-Lactoglobulin by Dynamic High-Pressure Microfluidization Coupled with Glycation Treatment Revealed by High-Resolution Mass Spectrometry. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2017; 65:6179-6187. [PMID: 28654282 DOI: 10.1021/acs.jafc.7b00934] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Our previous study indicated that pretreatment by dynamic high-pressure microfluidization (DHPM) and glycation with galactose was a promising method for decreasing the immunoglobulin E (IgE)-binding ability of β-lactoglobulin (β-LG). In this work, the conformational alteration of β-LG subjected to DHPM and glycation treatment was investigated in relation to IgE-binding ability by orbitrap mass spectrometry. After DHPM pretreatment, lower IgE-binding ability of glycated β-LG was observed with increasing pressures. Prior to DHPM pretreatment, 11 glycated sites were identified, while the number of glycation sites was increased to 12 after pretreatment. However, there was no significant difference of the glycation sites at the pressures of 50, 100, and 200 MPa, respectively. Average degree of substitution per peptide molecule of β-LG (DSP) was investigated to assess the degree of glycation per glycation site. All of the samples pretreated by DHPM exhibited a higher glycation level than those without DHPM pretreatment. The shielding effects of epitopes owing to glycation contributed to the reduction of IgE-binding capacity. Orbitrap mass spectrometry could provide a comprehensive understanding of the nature of protein glycation.
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Affiliation(s)
- Yuan Chen
- Key Laboratory of Functional Small Organic Molecule, Jiangxi Normal University, Ministry of Education , Nanchang 330022, China
| | - Zongcai Tu
- Key Laboratory of Functional Small Organic Molecule, Jiangxi Normal University, Ministry of Education , Nanchang 330022, China
- State Key Laboratory of Food Science and Technology, Nanchang University , Nanchang 330047, China
| | - Hui Wang
- State Key Laboratory of Food Science and Technology, Nanchang University , Nanchang 330047, China
| | - Qiuting Zhang
- College of Ginling, Nanjing Normal University , Nanjing 210097, China
| | - Lu Zhang
- Key Laboratory of Functional Small Organic Molecule, Jiangxi Normal University, Ministry of Education , Nanchang 330022, China
| | - Xiaomei Sha
- Key Laboratory of Functional Small Organic Molecule, Jiangxi Normal University, Ministry of Education , Nanchang 330022, China
| | - Tao Huang
- State Key Laboratory of Food Science and Technology, Nanchang University , Nanchang 330047, China
| | - Da Ma
- State Key Laboratory of Food Science and Technology, Nanchang University , Nanchang 330047, China
| | - Juanjuan Pang
- Key Laboratory of Functional Small Organic Molecule, Jiangxi Normal University, Ministry of Education , Nanchang 330022, China
| | - Ping Yang
- Key Laboratory of Functional Small Organic Molecule, Jiangxi Normal University, Ministry of Education , Nanchang 330022, China
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Moingeon P, Mascarell L. Differences and similarities between sublingual immunotherapy of allergy and oral tolerance. Semin Immunol 2017; 30:52-60. [PMID: 28760498 DOI: 10.1016/j.smim.2017.07.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Accepted: 07/13/2017] [Indexed: 12/27/2022]
Abstract
Allergen immunotherapy is the only treatment altering the natural course of IgE-mediated allergies. Whereas the subcutaneous route for immunotherapy (SCIT) has been historically considered as a reference, we discuss herein the relative advantages of the sublingual and oral routes as alternatives to SCIT in order to elicit allergen-specific tolerance. The buccal and gut immune systems are similarly organized to favor immune tolerance to antigens/allergens, due to the presence of tolerogenic dendritic cells and macrophages promoting the differentiation of CD4+ regulatory T cells. Sublingual immunotherapy (SLIT) is now established as a valid treatment option, with clinical efficacy demonstrated in allergic rhinoconjunctivitis (to either grass, tree, weed pollens or mite allergens) and encouraging results obtained in the management of mild/moderate allergic asthma. While still exploratory, oral immunotherapy (OIT) has shown promising results in the desensitization of patients with food allergies. We review at both biological and clinical levels the perspectives currently pursued for those two mucosal routes.
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Affiliation(s)
- Philippe Moingeon
- Research Department, Stallergenes Greer, 6 rue Alexis de Tocqueville, 92160 Antony, France.
| | - Laurent Mascarell
- Research Department, Stallergenes Greer, 6 rue Alexis de Tocqueville, 92160 Antony, France
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45
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Seppo AE, Savilahti EM, Berin MC, Sampson HA, Järvinen KM. Breast milk IgA to foods has different epitope specificity than serum IgA-Evidence for entero-mammary link for food-specific IgA? Clin Exp Allergy 2017; 47:1275-1284. [PMID: 28449395 DOI: 10.1111/cea.12945] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Revised: 03/14/2017] [Accepted: 03/22/2017] [Indexed: 12/20/2022]
Abstract
BACKGROUND We have previously shown that maternal cow's milk (CM) elimination results in downregulation of CM-specific IgA antibody levels in BM, but not in serum, suggesting that an entero-mammary link may exist for food-specific antibody-secreting cells. OBJECTIVE We sought to investigate whether food-specific IgA epitope profiles differ intra-individually between mother's serum and BM. We also examined how infants' food epitope-specific IgA develops in early infancy and the relationship of IgA epitope recognition with development of cow's milk allergy (CMA). METHODS We measured specific IgA to a series of overlapping peptides in major CM allergens (αs1 -, αs2 -, β- and κ-caseins and β-lactoglobulin) in paired maternal and infant serum as well as BM samples in 31 mother-infant dyads within the first 15 post-partum months utilizing peptide microarray. RESULTS There was significant discordance in epitope specificity between BM and maternal sera ranging from only 13% of sample pairs sharing at least one epitope in αs1 -casein to 73% in κ-casein. Epitope-specific IgA was detectable in infants' sera starting at less than 3 months of age. Sera of mothers with a CMA infant had increased binding of epitope-specific IgA to CM proteins compared to those with a non-CMA infant. CONCLUSION & CLINICAL RELEVANCE These findings support the concept that mother's milk has a distinct antifood antibody repertoire when compared to the antibody repertoire of the peripheral blood. Increased binding of serum epitope-specific IgA to CM in mothers of infants with CMA may reflect inherited systemic immunogenicity of CM proteins in these families, although specific IgA in breast milk was not proportionally up-regulated.
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Affiliation(s)
- A E Seppo
- Division of Pediatric Allergy and Immunology & Center for Food Allergy, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | - E M Savilahti
- Children's Hospital, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
| | - M C Berin
- Division of Pediatric Allergy & Immunology and Jaffe Institute for Food Allergy, The Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - H A Sampson
- Division of Pediatric Allergy & Immunology and Jaffe Institute for Food Allergy, The Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - K M Järvinen
- Division of Pediatric Allergy and Immunology & Center for Food Allergy, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA.,Division of Pediatric Allergy & Immunology and Jaffe Institute for Food Allergy, The Icahn School of Medicine at Mount Sinai, New York, NY, USA
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46
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Radauer C. Navigating through the Jungle of Allergens: Features and Applications of Allergen Databases. Int Arch Allergy Immunol 2017; 173:1-11. [PMID: 28456806 DOI: 10.1159/000471806] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
The increasing number of available data on allergenic proteins demanded the establishment of structured, freely accessible allergen databases. In this review article, features and applications of 6 of the most widely used allergen databases are discussed. The WHO/IUIS Allergen Nomenclature Database is the official resource of allergen designations. Allergome is the most comprehensive collection of data on allergens and allergen sources. AllergenOnline is aimed at providing a peer-reviewed database of allergen sequences for prediction of allergenicity of proteins, such as those planned to be inserted into genetically modified crops. The Structural Database of Allergenic Proteins (SDAP) provides a database of allergen sequences, structures, and epitopes linked to bioinformatics tools for sequence analysis and comparison. The Immune Epitope Database (IEDB) is the largest repository of T-cell, B-cell, and major histocompatibility complex protein epitopes including epitopes of allergens. AllFam classifies allergens into families of evolutionarily related proteins using definitions from the Pfam protein family database. These databases contain mostly overlapping data, but also show differences in terms of their targeted users, the criteria for including allergens, data shown for each allergen, and the availability of bioinformatics tools.
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Affiliation(s)
- Christian Radauer
- Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
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Chen X, Dreskin SC. Application of phage peptide display technology for the study of food allergen epitopes. Mol Nutr Food Res 2017; 61. [PMID: 27995755 DOI: 10.1002/mnfr.201600568] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Revised: 11/09/2016] [Accepted: 12/05/2016] [Indexed: 12/16/2022]
Abstract
Phage peptide display technology has been used to identify IgE-binding mimotopes (mimics of natural epitopes) that mimic conformational epitopes. This approach is effective in the characterization of those epitopes that are important for eliciting IgE-mediated allergic responses by food allergens and those that are responsible for cross-reactivity among allergenic food proteins. Application of this technology will increase our understanding of the mechanisms whereby food allergens elicit allergic reactions, will facilitate the discovery of diagnostic reagents and may lead to mimotope-based immunotherapy.
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Affiliation(s)
- Xueni Chen
- Division of Allergy and Clinical Immunology, Departments of Medicine and Immunology, University of Colorado Denver, Aurora, CO, USA
| | - Stephen C Dreskin
- Division of Allergy and Clinical Immunology, Departments of Medicine and Immunology, University of Colorado Denver, Aurora, CO, USA
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Maina E, Pelst M, Hesta M, Cox E. Food-specific sublingual immunotherapy is well tolerated and safe in healthy dogs: a blind, randomized, placebo-controlled study. BMC Vet Res 2017; 13:25. [PMID: 28100257 PMCID: PMC5241990 DOI: 10.1186/s12917-017-0947-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Accepted: 01/12/2017] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Food allergies are increasing in prevalence but no treatment strategies are currently available to cure dogs with food allergy. Over the past decade, experimental food allergen-specific sublingual immunotherapy (FA-SLIT) has emerged as a potential treatment for food allergies in human medicine. However, FA-SLIT has not been investigated in dogs. Therefore, the objective of this study was to prospectively evaluate the safety, tolerability and dispenser sterility of FA-SLIT in healthy dogs before testing it in food allergic dogs. Eight experimental healthy beagle dogs, never orally exposed to peanut, were randomized in two groups to receive SLIT with peanut or placebo for 4 months. Subjects were monitored daily for local and systemic adverse effects. Blood samples for complete blood count and serum biochemistry, and urine for urinalysis were collected and the dogs' body weight was recorded at day 0, 35 and 119 of the SLIT treatment. Sera for the determination of peanut-specific IgG and IgE were collected at day 0, 35, 49, 70, 91, 105 and 119. Intradermal tests were performed before (day 0) and after (day 119) the experiment. The content of each dispenser used to administer treatment or placebo was tested for sterility after usage. In order to assess the presence or absence of sensitization, dogs were challenged 6 months after the end of the study with 2000 μg of peanut extract daily for 7 to 14 days. RESULTS All dogs completed the study. The treatment did not provoke either local or systemic side-effects. Peanut-specific IgG significantly increased in treatment group. Even though a significant increase in peanut-specific IgE was also seen, intradermal tests were negative in all dogs before and after the experiment, and the challenge test did not trigger any adverse reactions in the treated dogs, which shows the protocol did not cause sensitization to peanut, but nevertheless primed the immune system as indicated by the humoral immune response. All dispenser solutions were sterile. CONCLUSIONS Our results demonstrate that the used peanut-SLIT protocol is well tolerated and safe in healthy dogs. Further studies should evaluate tolerability, safety and efficacy in dogs with food allergy.
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Affiliation(s)
- E. Maina
- Laboratory of Immunology, Ghent University, Faculty of Veterinary Medicine, Merelbeke, Belgium
| | - M. Pelst
- Laboratory of Immunology, Ghent University, Faculty of Veterinary Medicine, Merelbeke, Belgium
| | - M. Hesta
- Laboratory of Animal Nutrition, Department of Animal Nutrition, Genetics, Breeding and Ethology., Ghent University, Faculty of Veterinary Medicine, Merelbeke, Belgium
| | - E. Cox
- Laboratory of Immunology, Ghent University, Faculty of Veterinary Medicine, Merelbeke, Belgium
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Perezábad L, Reche M, Valbuena T, López-Fandiño R, Molina E, López-Expósito I. Oral Food Desensitization in Children With IgE-Mediated Cow's Milk Allergy: Immunological Changes Underlying Desensitization. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2017; 9:35-42. [PMID: 27826960 PMCID: PMC5102834 DOI: 10.4168/aair.2017.9.1.35] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Revised: 06/18/2016] [Accepted: 06/26/2016] [Indexed: 01/30/2023]
Abstract
Purpose This study aimed to evaluate the safety and efficacy to induce clinical desensitization to cow's milk (CM) of an oral immunotherapy (OIT) protocol in a pediatric population with cow's milk allergy (CMA). In addition, the immune responses against β-casein, of peripheral blood mononuclear cells (PBMCs) from CMA patients, before and after the protocol were evaluated and compared to a nonallergic population. Methods A group of 20 children with IgE-mediated CMA and 15 nonallergic children were recruited. Allergic subjects underwent an OIT protocol based on weekly doses of commercial semi-skimmed ultra-high temperature treated (UHT) CM, followed by a maintenance phase. Immune profiles and changes in all subjects were investigated by measuring Th1, Th2, and Treg cytokines, transcription factors, and specific IgE and IgG4 levels. Results The CM-OIT protocol enabled to desensitize 70% of the allergic patients. Successful OIT was accompanied by significant increases in casein-specific IgG4 levels, together with a reduction in the concentration of antigen-specific IgE and in IL-5, IL-13, and IL-10 production by β-casein-stimulated PBMCs. Baseline significant differences observed between allergic and nonallergic children in IL-13 and IL-5 levels were no longer found once the protocol had finished. Conclusions The OIT protocol was safe and effective in inducing milk desensitization in 70% of the children with CMA, leading to alterations in their immune profiles toward a nonallergic phenotype.
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Affiliation(s)
- Laura Perezábad
- Instituto de Investigación en Ciencias de la Alimentación (CIAL) (CSIC-UAM), Madrid, Spain
| | - Marta Reche
- Servicio de alergología, Hospital Infanta Sofía, San Sebastián de los Reyes, Madrid, Spain
| | - Teresa Valbuena
- Servicio de alergología, Hospital Infanta Sofía, San Sebastián de los Reyes, Madrid, Spain
| | - Rosina López-Fandiño
- Instituto de Investigación en Ciencias de la Alimentación (CIAL) (CSIC-UAM), Madrid, Spain
| | - Elena Molina
- Instituto de Investigación en Ciencias de la Alimentación (CIAL) (CSIC-UAM), Madrid, Spain.
| | - Iván López-Expósito
- Instituto de Investigación en Ciencias de la Alimentación (CIAL) (CSIC-UAM), Madrid, Spain
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