Interferon-gamma and interleukin-4 production of ovalbumin-stimulated lymphocytes in egg-sensitive children

T cell proliferation and cytokine responses to ovalbumin and ovomucoid detected in children with and without egg allergy

BACKGROUND

The specific T cell responses in egg allergy and resolution have not been fully elucidated.

OBJECTIVE

To characterize egg allergen-specific T cells of children with active and resolved egg allergy, in comparison with non-allergic controls.

METHOD

We studied children with active (n=35) or resolved (n=20) egg allergy determined by oral challenge, and non-allergic controls (n=15). Peripheral blood mononuclear cells were labelled with carboxyfluorescein succinimidyl ester (CFSE) and stimulated with ovalbumin (OVA), ovomucoid (OM) or tetanus toxoid. Flow cytometry was used to detect divided CD3+ CFSE(lo) cells that expressed intra-cytoplasmic IL-4 or IFN-gamma. The cell division index (CDI) was calculated as a measure of allergen-specific proliferation. Peanut-specific T cells of a subgroup of children who also had peanut allergy were also studied.

RESULTS

OVA-specific T cells were found in subjects with active (87%) or resolved (75%) egg allergy and in controls (67%), with a trend towards increased T cell proliferation in allergy. OM-induced weaker T cell responses than OVA, stimulating fewer responders (46% allergic, 50% resolved, 60% controls) and 10-fold less proliferation [CDI(OVA) 2.0 (median), 25.6 (maximum) vs. CDI(OM) 0.2 (median), 15.1 (maximum); P<0.01]. Both egg allergens induced significant IL-4+ (median 10%, range 1.4-58%) and IFN-gamma+ (median 28%, range 4.5-63%) cells in responders, including non-allergics. There were no significant differences in IFN-gamma+ or IL-4+ cells or in IFN-gamma/IL-4 ratios between groups. Peanut-specific T cell proliferation was significantly higher in peanut allergy [CDI(CPE) 16.5 (median), 24.8 (maximum)] compared with controls [CDI(CPE) 2.1 (median), 16.1 (maximum)] but cytokine profiles were not different. Tetanus-specific T cells were seen in 90% of the subjects, with no significant inter-group differences in responses.

CONCLUSION

Egg allergen-specific T cells are readily detected in all groups and not restricted to egg allergy. In contrast, peanut-specific proliferation was significantly higher in peanut allergy. This suggests that T cell responses in peanut and egg allergy may differ. We did not find T helper type 2-deviated cytokine responses in egg or peanut allergy.

Cow's milk allergy in infants with atopic eczema is associated with aberrant production of interleukin-4 during oral cow's milk challenge

OBJECTIVES

A failure in the establishment and maintenance of oral tolerance in infancy may result in food allergy. To further assess the role of the intestinal immune system in cow's milk allergy (CMA), we investigated the systemic production of the pro-allergenic Th2 cytokine interleukin (IL)-4 and anti-allergenic cytokines IL-10, transforming growth factor (TGF)-beta1 and TGF-beta2 in infants suffering from atopic eczema with and without CMA during antigen elimination diet and oral antigen exposure.

METHODS

18 infants (mean age, 9.6 months; 95% confidence interval 8.1-11.1 months) with atopic eczema and CMA and 17 infants (mean age, 9.7 months; 95% confidence interval 8.6-10.9 months) with atopic eczema tolerant to milk as assessed by a double blind, placebo-controlled cow's milk challenge were investigated. Peripheral blood mononuclear cells were obtained during antigen elimination diet and during oral cow's milk challenge and stimulated with Concanavalin-A or cow's milk or were left unstimulated. The cytokine concentrations were measured by enzyme-linked immunosorbent assay.

RESULTS

During antigen elimination, the Concanavalin A-stimulated production of TGF-beta2 was significantly lower in infants with CMA as compared with infants without CMA: 129 pg/mL (interquartile ratio, 124-144 pg/mL) vs. 149 pg/mL (interquartile ratio, 133-169 pg/mL); P = 0.016. During oral antigen exposure, the immune responses in infants with CMA were characterized by significantly higher spontaneous production of IL-4 as compared with those without CMA: 12.0 pg/mL (interquartile ratio, 5.2-28.3 pg/mL) vs. 4.2 pg/mL (interquartile ratio, 1.5-7.6 pg/mL); P = 0.018.

CONCLUSIONS

Infants with atopic eczema and CMA exhibit markedly increased systemic pro-allergenic IL-4 responses on intestinal antigen contact, which may partially be explained by a defective ability to launch anti-allergenic TGF-beta2 responses.

Association between CD62 ligand on naïve and memory T cells and history of cow's milk hypersensitivity in atopic patients

BACKGROUND

Both IgE and non-IgE cell-mediated reactions can contribute to the immunopathogenesis of food hypersensitivity.

OBJECTIVE

To study L-selectin expression in naïve (CD45RA+) and memory (CD45RO+) T cells in atopic patients with a history of cow's milk allergy and CD69 expression.

METHODS

We evaluated 12 children with a history of cow's milk allergy. All 12 children underwent clinical history, examination, in vivo skin prick testing to inhalants and milk allergen, and in vitro radioallergosorbent testing for milk and total serum IgE levels. L-selectin levels on naive and memory T cells from patients and controls were analyzed by flow cytometry with fluorochrome-conjugated monoclonal antibodies after 4 hours or 7 days of incubation with medium alone, 1 microg/mL of pokeweed mitogen, or 50 microg/mL of casein.

RESULTS

The percentage of CD45RA+ 62L+ cells with casein was 56% +/- 11% vs 38% +/- 7.7% in healthy controls (P < .009). The percentage of CD45RO- 62L+ cells was 22% +/- 7.1% vs 39% +/- 7.6% in healthy controls (P < .001), whereas the expression of CD62L+ in CD45RA+ and CD45RO+ cells decreased 149% +/- 33% vs 540% +/- 36% for healthy controls (P < .001) and 89% -+/- 16% vs 402% +/- 103% for healthy controls (P < .001), respectively.

CONCLUSIONS

The results of the present study demonstrate the presence of CD62 ligand on naive and memory T cells, which might serve as a predictive marker for atopic dermatitis withother overlapping atopic disorders, such as asthma and allergic rhinitis.

Increased Th1 and Th2 allergen-induced cytokine responses in children with atopic disease

BACKGROUND

Polyclonal cytokine responses following stimulation of T cells with mitogens or superantigens provides information on cytokine production from a wide range of T cells. Alternatively allergen-induced T cell responses can provide information on cytokine production by allergen-reactive T cells. While there is evidence of increased Th2 and reduced Th1 cytokine production following T cell stimulation with non-specific mitogens and superantigens, the evidence that Th1 cytokine production to allergens is decreased in line with a postulated imbalance in Th1/Th2 responses is unclear, with studies finding decreased, no difference or increased IFN-gamma responses to allergens in atopic subjects.

OBJECTIVE

To examine childhood polyclonal and allergen-induced cytokine responses in parallel to evaluate cytokine imbalances in childhood atopic disease.

METHODS

PBMC cytokine responses were examined in response to a polyclonal stimulus, staphylococcal superantigen (SEB), in parallel with two inhalant allergens, house dust mite (HDM) and rye grass pollen (RYE), and an ingested allergen, ovalbumin (OVA), in (a) 35 healthy children (non-atopic) and (b) 36 children with atopic disease (asthma, eczema and/or rhinitis) (atopic).

RESULTS

Atopic children had significantly reduced IFN-gamma and increased IL-4 and IL-5 but not IL13 production to SEB superantigen stimulation when compared with non-atopic children. HDM and RYE allergens stimulated significantly increased IFN-gamma, IL-5 and IL-13, while OVA stimulated significantly increased IFN-gamma production in atopic children.

CONCLUSION

We show that a polyclonal stimulus induces a reduced Th1 (IFN-gamma) and increased Th2 (IL-4 and IL-5) cytokine pattern. In contrast, the allergen-induced cytokine responses in atopic children were associated with both increased Th1 (INF-gamma) and Th2 (IL-5 and IL-13) cytokine production. The increased Th1 response to allergen is likely to reflect prior sensitization and indicates that increases in both Th1 and Th2 cytokine production to allergens exists concomitantly with a decreased Th1 response to a polyclonal stimulus in atopic children.

The relevance of TH1 and TH2 cells in immediate and nonimmediate reactions to gelatin-containing vaccine

BACKGROUND

The immune mechanism of gelatin allergy, especially the participation of TH1 and TH2 cells and their cytokine secretion, has not been investigated.

OBJECTIVE

We investigated the characteristics of T lymphocytes from patients allergic to gelatin-containing vaccine by secondary in vitro stimulation of circulating mononuclear cells with gelatin.

METHODS

We studied 8 children with a history of immediate-type reactions and 8 with nonimmediate-type reactions after inoculation of gelatin-containing vaccine. The expression of IFN-gamma (TH1 ), IL-2 (TH1 ), IL-4 (TH2 ), and IL-13 (TH2 ) mRNA was examined semiquantitatively by using a reverse transcriptase PCR. IgE antibody to bovine gelatin was measured with the fluorometric ELISA system, and gelatin-specific T-cell responses were detected by an in vitro lymphocyte proliferation assay.

RESULTS

Patients with an immediate reaction all had gelatin-specific IgE antibody, whereas others did not. However, all patients exhibited positive T-lymphocyte responses specific to gelatin. Lymphocytes from subjects with nonimmediate-type reactions generally expressed very weak or sometimes no IFN-gamma, IL-2, or IL-13 genes and especially no IL-4 gene. On the other hand, the lymphocytes of subjects with immediate-type reactions significantly expressed not only IL-4 and IL-13 but also IFN-gamma and IL-2 mRNA.

CONCLUSION

Our observations suggest that both gelatin-specific TH2 and TH1 responses are involved in the pathogenesis of the immediate reaction to gelatin. The gelatin-specific IL-4 and/or IL-13 responses consistently observed in patients with an immediate reaction may be associated with the production of gelatin-specific IgE antibody.

Enhanced IL-4 but normal interferon-gamma production in children with isolated IgE mediated food hypersensitivity

Atopic disorders such as atopic dermatitis and asthma have been characterised by an imbalance in interferon-gamma (INF-gamma) and IL-4. Whether similar imbalances are found in atopic disorders with different clinical manifestations, such as IgE mediated immediate food hypersensitivity, is not clear. We have examined the in vitro production of INF-gamma and IL-4 in peripheral blood mononuclear cells (PBMC) following phytohaemagglutinin stimulation from children with isolated immediate IgE mediated food hypersensitivity (egg, milk, "nut"), children with moderate and severe atopic dermatitis, and normal children. Children with immediate food reactions were excluded if they had a history or evidence of atopic dermatitis or asthma. PBMC from children with IgE mediated food hypersensitivity produced significantly more IL-4 (p = 0.013) but equivalent INF-gamma (p = 0.26) compared to PBMC from control children. In contrast, PBMC from children with atopic dermatitis produced significantly less INF-gamma (p < 0.001) and more IL-4 (p < 0.008) than PBMC from normal children. In addition, there was no difference in IL-4 (p = 0.74) but significantly less INF-gamma (p < 0.001) produced by PBMC from the children with atopic dermatitis than food hypersensitivity. We demonstrate that children with IgE mediated food hypersensitivity and no other manifestation of atopic disease have enhanced IL-4 production without the defect in INF-gamma production observed in childhood AD and asthma. We postulate that isolated IL-4 enhancement promotes the development of IgE mediated hypersensitivity disorders such as food allergy, whilst the combination of defective INF-gamma and enhanced IL-4 production promotes inflammatory atopic disorders such as AD and asthma.