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Figo DD, Cordeiro Macedo PR, Gadermaier G, Remuzgo C, Castro FFM, Kalil J, Galvão CES, Santos KS. IgE and IgG4 Epitopes of Dermatophagoides and Blomia Allergens before and after Sublingual Immunotherapy. Int J Mol Sci 2023; 24:ijms24044173. [PMID: 36835585 PMCID: PMC9958541 DOI: 10.3390/ijms24044173] [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: 12/14/2022] [Revised: 02/04/2023] [Accepted: 02/13/2023] [Indexed: 02/22/2023] Open
Abstract
Sublingual immunotherapy (SLIT) is used worldwide to treat house dust mites (HDM) allergy. Epitope specific immunotherapy with peptide vaccines is used far less, but it is of great interest in the treatment of allergic reactions, as it precludes the drawbacks of allergen extracts. The ideal peptide candidates would bind to IgG, blocking IgE-binding. To better elucidate IgE and IgG4 epitope profiles during SLIT, sequences of main allergens, Der p 1, 2, 5, 7, 10, 23 and Blo t 5, 6, 12, 13, were included in a 15-mer peptide microarray and tested against pooled sera from 10 patients pre- and post-1-year SLIT. All allergens were recognized to some extent by at least one antibody isotype and peptide diversity was higher post-1-year SLIT for both antibodies. IgE recognition diversity varied among allergens and timepoints without a clear tendency. Der p 10, a minor allergen in temperate regions, was the molecule with more IgE-peptides and might be a major allergen in populations highly exposed to helminths and cockroaches, such as Brazil. SLIT-induced IgG4 epitopes were directed against several, but not all, IgE-binding regions. We selected a set of peptides that recognized only IgG4 or were able to induce increased ratios of IgG4:IgE after one year of treatment and might be potential targets for vaccines.
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Affiliation(s)
- Daniele Danella Figo
- LIM-19, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo 05403-900, Brazil
- Laboratorio de Imunologia, INCOR, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo 05403-900, Brazil
- Departamento de Clinica Medica, Disciplina de Imunologia Clinica e Alergia, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo 01246-903, Brazil
| | - Priscilla Rios Cordeiro Macedo
- Departamento de Clinica Medica, Disciplina de Imunologia Clinica e Alergia, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo 01246-903, Brazil
- Servico de Imunologia Clinica e Alergia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo 05403-000, Brazil
| | - Gabriele Gadermaier
- Department of Biosciences and Medical Biology, Paris Lodron University Salzburg, 5020 Salzburg, Austria
| | - Cesar Remuzgo
- Laboratorio de Imunologia, INCOR, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo 05403-900, Brazil
| | - Fábio Fernandes Morato Castro
- Departamento de Clinica Medica, Disciplina de Imunologia Clinica e Alergia, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo 01246-903, Brazil
- Servico de Imunologia Clinica e Alergia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo 05403-000, Brazil
- Instituto Nacional de Ciencia e Tecnologia de Investigação em Imunologia (iii-INCT), Sao Paulo 05403-900, Brazil
| | - Jorge Kalil
- LIM-19, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo 05403-900, Brazil
- Laboratorio de Imunologia, INCOR, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo 05403-900, Brazil
- Departamento de Clinica Medica, Disciplina de Imunologia Clinica e Alergia, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo 01246-903, Brazil
- Instituto Nacional de Ciencia e Tecnologia de Investigação em Imunologia (iii-INCT), Sao Paulo 05403-900, Brazil
| | - Clovis Eduardo Santos Galvão
- Departamento de Clinica Medica, Disciplina de Imunologia Clinica e Alergia, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo 01246-903, Brazil
- Servico de Imunologia Clinica e Alergia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo 05403-000, Brazil
| | - Keity Souza Santos
- LIM-19, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo 05403-900, Brazil
- Laboratorio de Imunologia, INCOR, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo 05403-900, Brazil
- Departamento de Clinica Medica, Disciplina de Imunologia Clinica e Alergia, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo 01246-903, Brazil
- Instituto Nacional de Ciencia e Tecnologia de Investigação em Imunologia (iii-INCT), Sao Paulo 05403-900, Brazil
- Correspondence:
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Nittner-Marszalska M, Kopeć A, Foks-Ciekalska A, Lata A, Bogacz- Piaseczyńska A, Rosiek-Biegus M, Zajac M, Bożek A. Monitoring of molecular profiling of allergen-antibody responses in HDM-immunotherapy patients. Hum Vaccin Immunother 2022; 18:2148815. [PMID: 36444880 PMCID: PMC9762793 DOI: 10.1080/21645515.2022.2148815] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Among the potential hazards of HDM immunotherapy (AIT) with HDM allergenic extracts is the possible initiation of de novosensitizations caused by a lack of complementarity between a given HDM vaccine's content and a patient's molecular sensitization profile. To investigate whether immunotherapy with HDM extracts affects changes in the profile of sensitizations to allergens contained in the extract and whether neosensitizations occur. Serum samples from patients with HDM allergies (N=63) who received 1 year of treatment with subcutaneous AIT were tested for allergen-specific IgE (sIgE) reactivity to 7 microarrayed HDM allergen molecules (Der p 1, 2,10,11,23; D far 1 and 2) with ImmunoCAP. The HDM non-AIT patients (N=22) who did not receive immunotherapy constituted the study's control group. The obtained data were analysed at baseline and after 6 and 12 months. In the HDM-AIT group, no neosensitizations after 6 and 12 months of immunotherapy were reported. Conversely, in the HDM non-AIT group, only neosensitizations to Der p 10 were observed. In the study group, sIgE levels against the HDM extract of D. pteronyssinus, D. farinae, rDer p 1, rDer p 2 and Der f 2 decreased after 12 months of AIT (p< .05). SIgE levels against Der f 1, Der p 10, 11 and 23 remained unchanged in the course of 12 months of immunotherapy. In patients with allergic rhinitis with or without concomitant HDM-induced asthma treated with HDM AIT for 12 months, no neosensitizations related to the examined HDM molecules were observed.
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Affiliation(s)
- Marita Nittner-Marszalska
- Department of Internal Diseases, Pneumonology and Allergology, Medical University of Wroclaw, Wroclaw, Poland
| | - Agnieszka Kopeć
- Department of Internal Diseases, Pneumonology and Allergology, Medical University of Wroclaw, Wroclaw, Poland
| | - Aleksandra Foks-Ciekalska
- Clinical Department of Internal Diseases, Dermatology and Allergology, Medical University of Silesia, Katowice, Poland
| | - Aleksandra Lata
- Department of Internal Diseases, Pneumonology and Allergology, Medical University of Wroclaw, Wroclaw, Poland
| | | | - Marta Rosiek-Biegus
- Department of Internal Diseases, Pneumonology and Allergology, Medical University of Wroclaw, Wroclaw, Poland
| | - Magdalena Zajac
- Clinical Department of Internal Diseases, Dermatology and Allergology, Medical University of Silesia, Katowice, Poland
| | - Andrzej Bożek
- Clinical Department of Internal Diseases, Dermatology and Allergology, Medical University of Silesia, Katowice, Poland,CONTACT Andrzej Bożek Clinical Department of Internal Diseases, Dermatology and Allergology, Medical University of Silesia, Sklodowskiej 10, Zabrze41-800, Poland
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Potapova E, Bordas-Le Floch V, Schlederer T, Vrtala S, Huang HJ, Canonica GW, Valenta R, Matricardi PM, Mascarell L. Molecular reactivity profiling upon immunotherapy with a 300 IR sublingual house dust mite tablet reveals marked humoral changes towards major allergens. Allergy 2022; 77:3084-3095. [PMID: 35474582 DOI: 10.1111/all.15327] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 03/21/2022] [Accepted: 03/30/2022] [Indexed: 01/28/2023]
Abstract
BACKGROUND Molecular antibody reactivity profiles have not yet been studied in depth in patients treated by sublingual house dust mite (HDM) tablet immunotherapy. Humoral immune responses to a large panel of HDM mite allergens were studied using allergen microarray technology in a subset of clinically defined high and low responder patients from a double-blind placebo-controlled allergen-specific immunotherapy (AIT) trial using sublingual 300 IR HDM tablets. METHODS Serum levels of IgE, IgG and IgG4 to 13 Dermatophagoides pteronyssinus molecules were measured at baseline and after 1-year AIT, using allergen microarrays in 100 subjects exhibiting high or low clinical benefit. RESULTS Der p 1, Der p 2 and Der p 23 were the most frequently recognized allergens in the study population. Patients with HDM-related asthma had significantly higher allergen-specific IgE levels to Der p 1 and Der p 23. No significant difference in the distribution of allergen sensitization pattern was observed between high and low responders. An increase in serum allergen-specific IgG and IgG4 occurred upon AIT, in particular to allergens Der p 1, Der p 2 and Der p 23 (p < 0.0001). CONCLUSIONS We confirm for our study population that Der p 1- and Der p 23-specific IgE levels are associated with asthma. IgE reactivity profiles were not predicitive of sublingual AIT outcomes, with 300 IR tablets as efficacious in pauci- and multi-sensitized subjects. Our study is the first to demonstrate the induction of IgG and IgG4 specific for the HDM allergens Der p 1, Der p 2 and Der p 23 by sublingual AIT.
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Affiliation(s)
- Ekaterina Potapova
- Department of Pediatric Pulmonology, Immunology and Critical Care Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | | | - Thomas Schlederer
- Department of Pathophysiology and Allergy Research, Division of Immunopathology, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna and Krems, Austria
| | - Susanne Vrtala
- Department of Pathophysiology and Allergy Research, Division of Immunopathology, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna and Krems, Austria
| | - Huey-Jy Huang
- Department of Pathophysiology and Allergy Research, Division of Immunopathology, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna and Krems, Austria
| | - Giorgio W Canonica
- Personalized Medicine, Asthma and Allergy, Humanitas Clinical and Research Center IRCCS, Milan, Italy
| | - Rudolf Valenta
- Department of Pathophysiology and Allergy Research, Division of Immunopathology, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna and Krems, Austria.,NRC Institute of Immunology, Federal Biomedical Agency of Russia, Moscow, Russia.,Department of Clinical Immunology and Allergy, Sechenov First State Medical University, Moscow, Russia.,Karl Landsteiner University of Health Sciences, Krems, Austria
| | - Paolo M Matricardi
- Department of Pediatric Pulmonology, Immunology and Critical Care Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany
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Ndlovu V, Chimbari M, Ndarukwa P, Sibanda E. Sensitisation to Imbrasia belina (mopane worm) and other local allergens in rural Gwanda district of Zimbabwe. Allergy Asthma Clin Immunol 2022; 18:33. [PMID: 35397611 PMCID: PMC8994392 DOI: 10.1186/s13223-022-00668-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Accepted: 03/08/2022] [Indexed: 11/30/2022] Open
Abstract
Background The prevalence of allergic diseases is increasing in Zimbabwe and the data relate to local as well as exotic allergen sources. As entomophagy, the practice of eating insects, is a recognised source of local allergens, we sought to measure the prevalence of and risk factors for sensitisation to Imbrasia belina (mopane worm), a popular edible insect. This was investigated alongside other locally relevant allergens in a rural community in Gwanda district, south of Zimbabwe. Methods A cross sectional study was conducted among 496 adults and children aged 10 years and above in Gwanda district, a mopane worm harvesting area in Zimbabwe. Data on individual characteristics and mopane worm exposure factors were collected using questionnaires. Sensitivity to allergens was assessed by performing skin prick tests at a local clinic using 10 different commercial allergen extracts (Stallergenes, France) and in-house extracts of mopane worm (Imbrasia belina) and mopane leaves (Colophospermum mopane). Data were analysed using Stata version 13 software. Results The prevalence of sensitisation to at least one allergen was 31.17% (n = 144). The prevalence of atopy was higher in adults (33.33%) than in children (23.53%) (p = 0.059). The commonest inhalant allergen sources were mopane worm (14.29%), Tyrophagus putrescentiae (14.29%), mopane leaves (13.42%), Alternaria alternata (6.49%) and Dermatophagoides pteronyssinus (6.49%). Polysensitisation was demonstrated in the study population and of the 108 participants (75%) who were sensitised to two or more allergens, 66 (61%) were women. Sensitisation to mopane worm and mopane leaves often clustered with Tyrophagus putrescentiae amongst adults. Adjusted logistic regression analyses between mopane worm sensitisation and self-reported exposure variables showed that sensitisation was more likely amongst mopane worm harvesters (OR = 1.92, 95%CI = 0.77–4.79), those who cooked or roasted mopane worms during harvesting (OR = 2.69, 95%CI = 0.78–9.31) and harvesting without personal protective equipment (PPE) (OR = 2.12, 95%CI = 0.83–5.44) compared to non-harvesters. Conclusion Atopic sensitization was common in this mopane worm harvesting community in Gwanda district of Zimbabwe. There was frequent co-sensitisation of mopane worm and mopane leaves with Tyrophagus putrescentiae in children and adults. It is important to determine the clinical relevance of our findings, particularly relating to mopane worm sensitisation. Supplementary Information The online version contains supplementary material available at 10.1186/s13223-022-00668-0.
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Affiliation(s)
- Vuyelwa Ndlovu
- School of Nursing and Public Health, College of Health Sciences, Howard College Campus, University of KwaZulu-Natal, Durban, South Africa. .,Department of Environmental Science and Health, Faculty of Applied Sciences, National University of Science and Technology, Corner Gwanda Road and Cecil Avenue, PO Box AC 939, Ascot, Bulawayo, Zimbabwe.
| | - Moses Chimbari
- School of Nursing and Public Health, College of Health Sciences, Howard College Campus, University of KwaZulu-Natal, Durban, South Africa.,Great Zimbabwe University , P.O Box 1235, Masvingo, Zimbabwe
| | - Pisirai Ndarukwa
- School of Nursing and Public Health, College of Health Sciences, Howard College Campus, University of KwaZulu-Natal, Durban, South Africa.,Department of Health Sciences and Faculty of Sciences, Bindura University of Science Education, P Bag 1020, Bindura, Zimbabwe
| | - Elopy Sibanda
- Asthma, Allergy and Immune Dysfunction Clinic, Twin Palms Medical Centre, 113 Kwame Nkrumah Avenue, Harare, Zimbabwe.,Department of Pathology, Medical School, National University of Science and Technology, Bulawayo, Zimbabwe
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Bircher AJ, Spoerl D, Scherer Hofmeier K. Wespe statt Biene – Akzidentelle Neusensibilisierung auf Wespengift unter Immuntherapie mit Bienengift. AKTUELLE DERMATOLOGIE 2022. [DOI: 10.1055/a-1660-4731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
ZusammenfassungWährend einer laufenden Immuntherapie mit Bienengift bei einer auf Bienengift monosensibilisierten Patientin wurde im 3. Jahr irrtümlicherweise eine Erhaltungsdosis Wespengift verabreicht. Es traten keine unmittelbaren Nebenwirkungen auf, hingegen konnte nach einigen Wochen ein Anstieg der initial negativen wespengiftspezifischen IgE- und IgG-Antikörper dokumentiert werden. Es muss somit von einer aktiven Sensibilisierung durch die hohe Einmaldosis Wespengift ausgegangen werden. Die Immuntherapie mit Bienengift konnte nach der empfohlenen Dauer von 5 Jahren vollendet werden. Eine akzidentelle nachweislich aktive Sensibilisierung auf ein Allergen ist sehr selten, dürfte aber einen Verstoß gegen die Pflichten aus dem Behandlungsvertrag darstellen und möglicherweise sogar den Tatbestand der Körperverletzung erfüllen. Die permanente Schädigung kann rechtlich schwerer wiegen als ein einmaliger Dosierungsfehler. Die strikte Anwendung von Leitlinienempfehlungen ist zur Vermeidung von systematischen und menschlichen Fehlern unabdingbar.
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Affiliation(s)
- Andreas J. Bircher
- Allergologie, Universitätsspital Basel, Schweiz
- Facoltà di scienze biomediche, Università della Svizzera italiana, Lugano, Schweiz
| | - David Spoerl
- Service d'immunologie et d'allergologie, Département de médecine, Hôpitaux Universitaires de Genève, Genève, Schweiz
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Gradman J, Halken S. Preventive Effect of Allergen Immunotherapy on Asthma and New Sensitizations. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2021; 9:1813-1817. [PMID: 33746088 DOI: 10.1016/j.jaip.2021.03.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 03/12/2021] [Accepted: 03/12/2021] [Indexed: 02/05/2023]
Abstract
Allergen immunotherapy (AIT) is a disease-modifying treatment for some IgE-mediated allergic diseases with the potential to have important preventive effects. Children with allergic rhinitis have a high risk of developing asthma, and treating allergic rhinitis with AIT may interfere with disease progression and prevent onset of asthma. Although the evidence is limited due to relatively few and heterogeneous studies, data nevertheless suggest that AIT has a preventive effect on development of asthma especially in children with rhinitis due to grass pollen allergy. AIT may also affect the development of new sensitizations. Both the degree of sensitization and the specific sensitization pattern may influence future disease severity and development of comorbidities. Hitherto, the indication for AIT for prevention of development of asthma in grass/birch pollen allergic children has been the same as for treatment of allergic rhinitis. Probably, AIT should be applied in the early stage of the allergic disease to have the greatest preventive effect on disease progression. Consequently, in the future, the potential preventive effects should influence the timing of initiating AIT. The window of opportunity to prevent asthma may primarily exist in young children with mild symptoms and a low degree of sensitization.
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Affiliation(s)
- Josefine Gradman
- Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark
| | - Susanne Halken
- Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark.
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