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Jiménez M, Cervantes-García D, Córdova-Dávalos LE, Pérez-Rodríguez MJ, Gonzalez-Espinosa C, Salinas E. Responses of Mast Cells to Pathogens: Beneficial and Detrimental Roles. Front Immunol 2021; 12:685865. [PMID: 34211473 PMCID: PMC8240065 DOI: 10.3389/fimmu.2021.685865] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 05/28/2021] [Indexed: 12/19/2022] Open
Abstract
Mast cells (MCs) are strategically located in tissues close to the external environment, being one of the first immune cells to interact with invading pathogens. They are long living effector cells equipped with different receptors that allow microbial recognition. Once activated, MCs release numerous biologically active mediators in the site of pathogen contact, which induce vascular endothelium modification, inflammation development and extracellular matrix remodeling. Efficient and direct antimicrobial mechanisms of MCs involve phagocytosis with oxidative and non-oxidative microbial destruction, extracellular trap formation, and the release of antimicrobial substances. MCs also contribute to host defense through the attraction and activation of phagocytic and inflammatory cells, shaping the innate and adaptive immune responses. However, as part of their response to pathogens and under an impaired, sustained, or systemic activation, MCs may contribute to tissue damage. This review will focus on the current knowledge about direct and indirect contribution of MCs to pathogen clearance. Antimicrobial mechanisms of MCs are addressed with special attention to signaling pathways involved and molecular weapons implicated. The role of MCs in a dysregulated host response that can increase morbidity and mortality is also reviewed and discussed, highlighting the complexity of MCs biology in the context of host-pathogen interactions.
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Affiliation(s)
- Mariela Jiménez
- Laboratory of Immunology, Department of Microbiology, Universidad Autónoma de Aguascalientes, Aguascalientes, Mexico
| | - Daniel Cervantes-García
- Laboratory of Immunology, Department of Microbiology, Universidad Autónoma de Aguascalientes, Aguascalientes, Mexico.,Cátedras CONACYT, National Council of Science and Technology, Mexico City, Mexico
| | - Laura E Córdova-Dávalos
- Laboratory of Immunology, Department of Microbiology, Universidad Autónoma de Aguascalientes, Aguascalientes, Mexico
| | - Marian Jesabel Pérez-Rodríguez
- Department of Pharmacobiology, Centro de Investigación y de Estudios Avanzados (Cinvestav), Unidad Sede Sur, Mexico City, Mexico
| | - Claudia Gonzalez-Espinosa
- Department of Pharmacobiology, Centro de Investigación y de Estudios Avanzados (Cinvestav), Unidad Sede Sur, Mexico City, Mexico
| | - Eva Salinas
- Laboratory of Immunology, Department of Microbiology, Universidad Autónoma de Aguascalientes, Aguascalientes, Mexico
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2
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Dawod B, Haidl ID, Azad MB, Marshall JS. Toll-like receptor 2 impacts the development of oral tolerance in mouse pups via a milk-dependent mechanism. J Allergy Clin Immunol 2020; 146:631-641.e8. [DOI: 10.1016/j.jaci.2020.01.049] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 01/05/2020] [Accepted: 01/30/2020] [Indexed: 12/31/2022]
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3
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Verhoeckx K, Bøgh KL, Dupont D, Egger L, Gadermaier G, Larré C, Mackie A, Menard O, Adel-Patient K, Picariello G, Portmann R, Smit J, Turner P, Untersmayr E, Epstein MM. The relevance of a digestibility evaluation in the allergenicity risk assessment of novel proteins. Opinion of a joint initiative of COST action ImpARAS and COST action INFOGEST. Food Chem Toxicol 2019; 129:405-423. [PMID: 31063834 DOI: 10.1016/j.fct.2019.04.052] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 04/25/2019] [Accepted: 04/27/2019] [Indexed: 01/09/2023]
Abstract
The current allergenicity assessment of novel proteins is based on the EFSA GMO guidance. Recently, EFSA launched a new guidance document on allergenicity assessment of GM plants (2017). This document describes, amongst other topics, the new scientific and regulatory developments on in vitro protein digestibility tests. The EFSA GMO Panel stated that for in vitro protein digestibility tests, additional investigations are needed before any additional recommendation in the form of guidance can be provided. To this end, an interim phase is considered necessary to evaluate the revisions to the in vitro gastrointestinal digestion test, proposed by EFSA. This prompted the establishment of a joint workshop through two COST Action networks: COST Action ImpARAS and COST Acton INFOGEST. In 2017, a workshop was organised to discuss the relevance of digestion in allergenicity risk assessment and how to potentially improve the current methods and readouts. The outcome of the workshop is that there is no rationale for a clear readout that is predictive for allergenicity and we suggest to omit the digestion test from the allergenicity assessment strategy for now, and put an effort into filling the knowledge gaps as summarized in this paper first.
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Affiliation(s)
| | - Katrine Lindholm Bøgh
- National Food Institute, Technical University of Denmark, DK-2800, Kgs. Lyngby, Denmark.
| | | | - Lotti Egger
- Agroscope, Schwarzenburgstr. 161, 3003, Bern, Charlotte, Switzerland.
| | - Gabriele Gadermaier
- University of Salzburg, Department of Biosciences, Hellbrunnerstraße 34, 5020 Salzburg, Austria.
| | - Colette Larré
- INRA UR1268 BIA, Rue de la Géraudière, BP 71627, 44316 Nantes, France.
| | - Alan Mackie
- School of Food Science and Nutrition, University of Leeds, LS2 9JT, UK.
| | | | - Karine Adel-Patient
- UMR Service de Pharmacologie et Immunoanalyse, Laboratoire d'Immuno-Allergie Alimentaire, CEA, INRA, Université Paris-Saclay, F-91191, Gif-sur-Yvette Cedex, France.
| | | | - Reto Portmann
- Agroscope, Schwarzenburgstr. 161, 3003 Bern, Switzerland.
| | - Joost Smit
- Institute of Risk Assessment Sciences, Utrecht University, Yalelaan 104, 3584CM, Utrecht, the Netherlands.
| | - Paul Turner
- Section of Paediatrics, Imperial College London, London, United Kingdom.
| | - Eva Untersmayr
- Institute of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
| | - Michelle M Epstein
- Department of Dermatology, Experimental Allergy Laboratory, Medical University of Vienna, Waehringer Guertel 18-20 room 4P9.02, 1090, Vienna, Austria.
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4
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Samadi N, Klems M, Untersmayr E. The role of gastrointestinal permeability in food allergy. Ann Allergy Asthma Immunol 2018; 121:168-173. [PMID: 29803708 DOI: 10.1016/j.anai.2018.05.010] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Revised: 05/04/2018] [Accepted: 05/14/2018] [Indexed: 02/06/2023]
Affiliation(s)
- Nazanin Samadi
- Institute for Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, 1090 Vienna, Austria
| | - Martina Klems
- Institute for Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, 1090 Vienna, Austria
| | - Eva Untersmayr
- Institute for Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, 1090 Vienna, Austria.
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Kyburz A, Urban S, Altobelli A, Floess S, Huehn J, Cover TL, Müller A. Helicobacter pylori and its secreted immunomodulator VacA protect against anaphylaxis in experimental models of food allergy. Clin Exp Allergy 2017; 47:1331-1341. [PMID: 28802077 DOI: 10.1111/cea.12996] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Revised: 07/28/2017] [Accepted: 08/02/2017] [Indexed: 12/28/2022]
Abstract
BACKGROUND Food allergy is an increasingly common health problem in Western populations. Epidemiological studies have suggested both positive and negative associations between food allergy and infection with the gastric bacterium Helicobacter pylori. OBJECTIVE The objective of this work was to investigate whether experimental infection with H. pylori, or prophylactic treatment with H. pylori-derived immunomodulatory molecules, affects the onset and severity of food allergy, either positively or negatively. METHODS We infected neonatal C57BL/6 or C3H mice with H. pylori or treated animals with H. pylori components (bacterial lysate or the immunomodulator VacA) and subsequently subjected them to four different protocols for food allergy induction, using either ovalbumin or peanut extract as allergens for sensitization and challenge. Readouts included anaphylaxis scoring, quantification of allergen-specific serum IgE and IgG1 and of the mast cell protease MCPT1, as well as splenic T-helper-2 cell-derived cytokine production. Mesenteric lymph node CD4+ FoxP3+ regulatory T cells were subjected to flow cytometric quantification and sorting followed by qRT-PCR, and to DNA methylation analyses of the Treg-specific demethylated region (TSDR) within the FOXP3 locus. RESULTS Mice that had been infected with H. pylori or treated with H. pylori-derived immunomodulators showed reduced anaphylaxis upon allergen sensitization and challenge, irrespective of the allergen used. Most of the immunologic assays confirmed a protective effect of H. pylori. CD4+ FoxP3+ T cells were more abundant in protected mice and exhibited a stable Treg phenotype characterized by FOXP3 TSDR demethylation. CONCLUSIONS AND CLINICAL RELEVANCE Helicobacter pylori confers protection against the anaphylaxis associated with ovalbumin and peanut allergy and affects the epigenome of T cells, thereby promoting stable Treg differentiation and functionality. Prophylactic treatment with H. pylori-derived immunomodulators appears to be a promising strategy for food allergy prevention.
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Affiliation(s)
- A Kyburz
- Institute of Molecular Cancer Research, University of Zürich, Zürich, Switzerland
| | - S Urban
- Institute of Molecular Cancer Research, University of Zürich, Zürich, Switzerland
| | - A Altobelli
- Institute of Molecular Cancer Research, University of Zürich, Zürich, Switzerland
| | - S Floess
- Department Experimental Immunology, Helmholtz Center for Infection Research, Braunschweig, Germany
| | - J Huehn
- Department Experimental Immunology, Helmholtz Center for Infection Research, Braunschweig, Germany
| | - T L Cover
- Vanderbilt University Medical Center and Veterans Affairs Tennessee Valley Healthcare System, Nashville, TN, USA
| | - A Müller
- Institute of Molecular Cancer Research, University of Zürich, Zürich, Switzerland
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Castaño-Rodríguez N, Kaakoush NO, Lee WS, Mitchell HM. Dual role of Helicobacter and Campylobacter species in IBD: a systematic review and meta-analysis. Gut 2017; 66:235-249. [PMID: 26508508 DOI: 10.1136/gutjnl-2015-310545] [Citation(s) in RCA: 140] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Revised: 10/03/2015] [Accepted: 10/05/2015] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To conduct a comprehensive global systematic review and meta-analysis on the association between Helicobacter pylori infection and IBD. As bacterial antigen cross-reactivity has been postulated to be involved in this association, published data on enterohepatic Helicobacter spp (EHS) and Campylobacter spp and IBD was also analysed. DESIGN Electronic databases were searched up to July 2015 for all case-control studies on H. pylori infection/EHS/Campylobacter spp and IBD. Pooled ORs (P-OR) and 95% CIs were obtained using the random effects model. Heterogeneity, sensitivity and stratified analyses were performed. RESULTS Analyses comprising patients with Crohn's disease (CD), UC and IBD unclassified (IBDU), showed a consistent negative association between gastric H. pylori infection and IBD (P-OR: 0.43, p value <1e-10). This association appears to be stronger in patients with CD (P-OR: 0.38, p value <1e-10) and IBDU (P-OR: 0.43, p value=0.008) than UC (P-OR: 0.53, p value <1e-10). Stratification by age, ethnicity and medications showed significant results. In contrast to gastric H. pylori, non H. pylori-EHS (P-OR: 2.62, p value=0.001) and Campylobacter spp, in particular C. concisus (P-OR: 3.76, p value=0.006) and C. showae (P-OR: 2.39, p value=0.027), increase IBD risk. CONCLUSIONS H. pylori infection is negatively associated with IBD regardless of ethnicity, age, H. pylori detection methods and previous use of aminosalicylates and corticosteroids. Antibiotics influenced the magnitude of this association. Closely related bacteria including EHS and Campylobacter spp increase the risk of IBD. These results infer that H. pylori might exert an immunomodulatory effect in IBD.
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Affiliation(s)
- Natalia Castaño-Rodríguez
- School of Biotechnology and Biomolecular Sciences, The University of New South Wales, Sydney, New South Wales, Australia
| | - Nadeem O Kaakoush
- School of Biotechnology and Biomolecular Sciences, The University of New South Wales, Sydney, New South Wales, Australia
| | - Way Seah Lee
- Department of Paediatrics, University Malaya Medical Centre, Kuala Lumpur, Malaysia.,University Malaya Pediatrics and Child Health Research Group, University Malaya, Kuala Lumpur, Malaysia
| | - Hazel M Mitchell
- School of Biotechnology and Biomolecular Sciences, The University of New South Wales, Sydney, New South Wales, Australia
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Ma ZF, Majid NA, Yamaoka Y, Lee YY. Food Allergy and Helicobacter pylori Infection: A Systematic Review. Front Microbiol 2016; 7:368. [PMID: 27047479 PMCID: PMC4804492 DOI: 10.3389/fmicb.2016.00368] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2015] [Accepted: 03/07/2016] [Indexed: 01/05/2023] Open
Abstract
Introduction: Based on the hygiene hypothesis, a low prevalence of Helicobacter pylori (H. pylori) infection may explain the recent high prevalence of allergic diseases including food allergy. However, there are very few studies that investigate the relationship between H. pylori and food allergy. Summary: We searched for PubMed, Ovid Medline and the Cochrane library for relevant articles published in English from inception to November 2015. The inverse relationship between H. pylori and food allergy remains unproven because of contradictory and limited evidence at the moment. Likewise, only limited studies have examined the relationship between CagA; one of H. pylori virulence factor and food allergy. On the other hand, in vitro evidence seems to point out a role of H. pylori in the causation of food allergy. The inconsistent results from epidemiological data may be due to small sample size, heterogeneous populations and unstandardised methods or food allergens. Conclusion: Available studies do not support the role of H. pylori in food allergy.
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Affiliation(s)
- Zheng Fei Ma
- Department of Human Nutrition, University of Otago Dunedin, New Zealand
| | - Noorizan A Majid
- School of Medical Sciences, Universiti Sains Malaysia Kubang Kerian, Malaysia
| | - Yoshio Yamaoka
- Department of Medicine, Gastroenterology and Hepatology Section, Baylor College of Medicine, HoustonTX, USA; Department of Environmental and Preventive Medicine, Oita University Faculty of MedicineYufu, Japan
| | - Yeong Yeh Lee
- School of Medical Sciences, Universiti Sains Malaysia Kubang Kerian, Malaysia
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8
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Pedullà M, Fierro V, Del Tufo E, Alfano R, Triassi M, Perrone L. Helicobacter pylori immunization and atopic dermatitis in South Italian children. United European Gastroenterol J 2014; 2:263-7. [PMID: 25083283 DOI: 10.1177/2050640614544314] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2014] [Accepted: 06/02/2014] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The epidemiological decrease of Helicobacter pylori (Hp) infection has been recently associated to the increase of several extra-intestinal allergic disorders. OBJECTIVE We investigated the role of specific Hp IgG production in the development of IgE or not IgE mediated food allergy (FA) in children affected by atopic dermatitis (AD). METHODS From January 2010 to July 2013, 290 South Italian children, aged between 26 and 142 months, were consecutively referred to the Pediatric Clinic of the Pediatric Department at Second University of Naples and were diagnosed as affected by AD. The patients were classified in two groups on the basis of diagnosis of food allergy (88 FA affected and 202 not FA affected) and further divided on the basis of the diagnosis of atopy (63 IgE mediated and 23 not IgE mediated). Hp serum IgG was detected using an enzyme linked immunosorbent assay (ELISA) kit (Wampole® Helicobactor pylori IgG ELISA II, Wampole Laboratories, Cranbury, NJ) and Hp stool antigens using enzyme immunoassay (Premier Platinum HpSa plus, Cincinnati OH). RESULTS We found a statistically significant higher prevalence of Hp serology positivity in not FA vs. FA AD-affected children (p = 0.032) and a significant inverse association between FA and Hp immunization (1/OR 0.32 95% CI 0.11-0.95). Further, we identified an absolute prevalence Hp serology positivity in not-IgE-mediated rather than in IgE-mediated FA AD-affected patients (p = 0.0006). CONCLUSION We hypothesize that specific Hp IgG production could protect against the development of both FA and atopy in AD-affected children.
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Affiliation(s)
- Marcella Pedullà
- Department of Pediatrics "Francesco Fede" - Second University of Naples, Naples, Italy
| | - Vincenzo Fierro
- Department of Pediatrics "Francesco Fede" - Second University of Naples, Naples, Italy
| | - Ester Del Tufo
- Department of Pediatrics "Francesco Fede" - Second University of Naples, Naples, Italy
| | - Rossella Alfano
- Department of Public Health - University of Naples Federico II, Naples, Italy
| | - Maria Triassi
- Department of Public Health - University of Naples Federico II, Naples, Italy
| | - Laura Perrone
- Department of Pediatrics "Francesco Fede" - Second University of Naples, Naples, Italy
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Sugita R, Hata E, Miki A, Andoh R, Umeda C, Takemura N, Sonoyama K. Gut Colonization by Candida albicans Inhibits the Induction of Humoral Immune Tolerance to Dietary Antigen in BALB/c Mice. BIOSCIENCE OF MICROBIOTA, FOOD AND HEALTH 2012; 31:77-84. [PMID: 24936353 PMCID: PMC4034285 DOI: 10.12938/bmfh.31.77] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/10/2012] [Accepted: 05/07/2012] [Indexed: 12/27/2022]
Abstract
We previously observed that gut colonization by Candida albicans
promoted serum antibody response to orally administered ovalbumin in mice. We therefore
postulated that C. albicans affects oral tolerance induction. The present
study tested this idea. BALB/c mice were intragastrically administered with either
C. albicans (1 × 107) or vehicle, and the colonization was
confirmed by weekly fecal cultures. Mice were further divided into two subgroups and
intragastrically administered with either ovalbumin (20 mg) or vehicle for five
consecutive days. Thereafter, all mice were intraperitoneally immunized with ovalbumin in
alum. In mice without C. albicans inoculation, ovalbumin feeding prior to
immunization significantly suppressed the increase in ovalbumin-specific IgE, IgG1 and
IgG2a in sera, suggesting oral tolerance induction. In C.
albicans-inoculated mice, however, the antibody levels were the same between
ovalbumin- and vehicle-fed mice. In contrast, ovalbumin feeding significantly suppressed
cellular immune responses, as evidenced by reduced proliferation of splenocytes
restimulated by ovalbumin ex vivo, in both C.
albicans-inoculated and uninoculated mice. Ex vivo
supplementation with neither heat-killed C. albicans nor the culture
supernatant of C. albicans enhanced the production of ovalbumin-specific
IgG1 in splenocytes restimulated by the antigen. These results suggest that gut
colonization by C. albicans inhibits the induction of humoral immune
tolerance to dietary antigen in mice, whereas C. albicans may not
directly promote antibody production. We therefore propose that C.
albicans gut colonization could be a risk factor for triggering food allergy in
susceptible individuals.
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Affiliation(s)
- Ryusuke Sugita
- Graduate School of Agriculture, Hokkaido University, Kita 9 Nishi 9, Kita-ku, Sapporo 060-8589, Japan
| | - Erina Hata
- Graduate School of Life Science, Hokkaido University, Kita 9 Nishi 9, Kita-ku, Sapporo 060-8589, Japan
| | - Atsuko Miki
- Graduate School of Life Science, Hokkaido University, Kita 9 Nishi 9, Kita-ku, Sapporo 060-8589, Japan
| | - Ryoko Andoh
- Graduate School of Agriculture, Hokkaido University, Kita 9 Nishi 9, Kita-ku, Sapporo 060-8589, Japan
| | - Chisato Umeda
- Graduate School of Agriculture, Hokkaido University, Kita 9 Nishi 9, Kita-ku, Sapporo 060-8589, Japan
| | - Naoki Takemura
- Graduate School of Agriculture, Hokkaido University, Kita 9 Nishi 9, Kita-ku, Sapporo 060-8589, Japan
| | - Kei Sonoyama
- Research Faculty of Agriculture, Hokkaido University, Kita 9 Nishi 9, Kita-ku, Sapporo 060-8589, Japan
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Untersmayr E, Diesner SC, Oostingh GJ, Selzle K, Pfaller T, Schultz C, Zhang Y, Krishnamurthy D, Starkl P, Knittelfelder R, Förster-Waldl E, Pollak A, Scheiner O, Pöschl U, Jensen-Jarolim E, Duschl A. Nitration of the egg-allergen ovalbumin enhances protein allergenicity but reduces the risk for oral sensitization in a murine model of food allergy. PLoS One 2010; 5:e14210. [PMID: 21151984 PMCID: PMC2996297 DOI: 10.1371/journal.pone.0014210] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2010] [Accepted: 11/10/2010] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Nitration of proteins on tyrosine residues, which can occur due to polluted air under "summer smog" conditions, has been shown to increase the allergic potential of allergens. Since nitration of tyrosine residues is also observed during inflammatory responses, this modification could directly influence protein immunogenicity and might therefore contribute to food allergy induction. In the current study we have analyzed the impact of protein nitration on sensitization via the oral route. METHODOLOGY/PRINCIPAL FINDINGS BALB/c mice were immunized intragastrically by feeding untreated ovalbumin (OVA), sham-nitrated ovalbumin (snOVA) or nitrated ovalbumin (nOVA) with or without concomitant acid-suppression. To analyze the impact of the sensitization route, the allergens were also injected intraperitoneally. Animals being fed OVA or snOVA under acid-suppressive medication developed significantly elevated levels of IgE, and increased titers of specific IgG1 and IgG2a antibodies. Interestingly, oral immunizations of nOVA under anti-acid treatment did not result in IgG and IgE formation. In contrast, intraperitoneal immunization induced high levels of OVA specific IgE, which were significantly increased in the group that received nOVA by injection. Furthermore, nOVA triggered significantly enhanced mediator release from RBL cells passively sensitized with sera from allergic mice. Gastric digestion experiments demonstrated protein nitration to interfere with protein stability as nOVA was easily degraded, whereas OVA and snOVA remained stable up to 120 min. Additionally, HPLC-chip-MS/MS analysis showed that one tyrosine residue (Y(107)) being very efficiently nitrated is part of an ovalbumin epitope recognized exclusively after oral sensitization. CONCLUSIONS/SIGNIFICANCE These data indicated that despite the enhanced triggering capacity in existing allergy, nitration of OVA may be associated with a reduced de novo sensitizing capability via the oral route due to enhanced protein digestibility and/or changes in antibody epitopes.
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Affiliation(s)
- Eva Untersmayr
- Department of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria.
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11
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Desnues B, Al Moussawi K, Raoult D. Defining causality in emerging agents of acute bacterial diarrheas: a step beyond the Koch’s postulates. Future Microbiol 2010; 5:1787-97. [DOI: 10.2217/fmb.10.141] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Diarrheal illnesses account for significant morbidity and mortality worldwide. Most cases of diarrhea are caused by bacteria, viruses or parasites. Advances in molecular biology and epidemiology have allowed the identification of emerging pathogens that may cause or, at least, may be associated with diarrhea. However, the same advances have also revealed the complexity of the gut microbiome, suggesting that a potential agent of diarrhea may also been found in healthy individuals. In addition, most of the newly identified emerging agents of diarrhea are ubiquitous and have not yet fulfilled Koch’s postulates. Research investigations should address appropriate matched controls and integrate findings from medical microbiology, epidemiology and molecular biology. This integrative approach should provide insights to our knowledge regarding exposition to common source or risk factors. Here, we aim to review some of these emerging bacterial agents of diarrheas and propose guidelines or prescriptions that may help in defining causality.
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Affiliation(s)
- Benoit Desnues
- Unité de Recherche sur les Maladies Infectieuses et Tropicales Émergentes (URMITE), Centre National de la Recherche Scientifique, UMR 6236, Faculté de Médecine de la Timone, 27 boulevard Jean Moulin, 13385 Marseille Cedex 5, France
| | - Khatoun Al Moussawi
- Unité de Recherche sur les Maladies Infectieuses et Tropicales Émergentes (URMITE), Centre National de la Recherche Scientifique, UMR 6236, Faculté de Médecine de la Timone, 27 boulevard Jean Moulin, 13385 Marseille Cedex 5, France
| | - Didier Raoult
- Unité de Recherche sur les Maladies Infectieuses et Tropicales Émergentes (URMITE), Centre National de la Recherche Scientifique, UMR 6236, Faculté de Médecine de la Timone, 27 boulevard Jean Moulin, 13385 Marseille Cedex 5, France
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Abstract
Intestinal permeability is a critical feature of the gastrointestinal epithelium as it must allow an efficient passage of nutrients and restrict the entry of larger molecules, such as protein antigen, in order to facilitate appropriate immune responses towards food antigens. The proper regulation of the epithelial barrier relies on multiple, intricate physiological and immunologic mechanisms, in terms of which recent progresses regarding the cellular and molecular components have been unravelled. In genetically predisposed individuals, breakdown of oral tolerance can occur, leading to the inadequate production of allergen-specific IgE and the recruitment of mast cells in the gastrointestinal mucosa. Under such conditions, the intestinal permeability towards allergen is altered via different mechanisms, with IgE-CD23-mediated transport across the mucosa playing an important amplification role. Additionally, during the effector phase of the allergic reaction, when mast cells degranulate, a series of inflammatory mediators, such as proteases and cytokines, are released and further affects intestinal permeability. This leads to an increase in the passage of allergens and hence contributes to perpetuate the inflammatory reaction. In this review, we describe the importance of properly balanced intestinal permeability in oral tolerance induction and address the processes involved in damaging the intestinal barrier in the sensitized epithelium and during allergic reactions. We conclude by speculating on the effect of increased intestinal permeability on the onset of sensitization towards dietary antigens.
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Affiliation(s)
- C Perrier
- Division of Gastroenterology, University Hospital, Catholic University Leuven, Leuven, Belgium
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13
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Luther J, Dave M, Higgins PD, Kao JY. Association between Helicobacter pylori infection and inflammatory bowel disease: a meta-analysis and systematic review of the literature. Inflamm Bowel Dis 2010; 16:1077-84. [PMID: 19760778 PMCID: PMC4865406 DOI: 10.1002/ibd.21116] [Citation(s) in RCA: 148] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Epidemiologic data suggest a protective effect of Helicobacter pylori infection against the development of autoimmune disease. Laboratory data illustrate H. pylori's ability to induce immune tolerance and limit inflammatory responses. Numerous observational studies have investigated the association between H. pylori infection and inflammatory bowel disease (IBD). Our aim was to perform a systematic review and meta-analysis of this association. METHODS Medline, EMBASE, bibliographies, and meeting abstracts were searched by 2 independent reviewers. Of 369 abstracts reviewed, 30 promising articles were reviewed in detail. Twenty-three studies met our inclusion criteria (subject N = 5903). Meta-analysis was performed with the metan command in Stata 10.1. RESULTS Overall, 27.1% of IBD patients had evidence of infection with H. pylori compared to 40.9% of patients in the control group. The estimated relative risk of H. pylori infection in IBD patients was 0.64 (95% confidence interval [CI]: 0.54-0.75). There was significant heterogeneity in the included studies that could not be accounted for by the method of IBD and H. pylori diagnosis, study location, or study population age. CONCLUSIONS These results suggest a protective benefit of H. pylori infection against the development of IBD. Heterogeneity among studies and the possibility of publication bias limit the certainty of this finding. Further studies investigating the effect of eradication of H. pylori on the development of IBD are warranted. Because environmental hygiene and intestinal microbiota may be strong confounders, further mechanistic studies in H. pylori mouse models are also necessary to further define the mechanism of this negative association.
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Affiliation(s)
- Jay Luther
- University of Michigan Medical Center, Ann Arbor, Michigan
| | | | | | - John Y. Kao
- University of Michigan Medical Center, Ann Arbor, Michigan
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Cam S, Ertem D, Bahceciler N, Akkoc T, Barlan I, Pehlivanoglu E. The interaction between Helicobacter pylori and atopy: does inverse association really exist? Helicobacter 2009; 14:1-8. [PMID: 19191889 DOI: 10.1111/j.1523-5378.2009.00660.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
AIM To date, cross-sectional and case-control studies suggest an inverse association between Helicobacter pylori infection and atopic diseases, whereas the immunologic basis has not been studied yet. In this study we investigated T helper (Th) cell function in H. pylori-infected children and compared cytokine responses in atopic and non-atopic groups. METHODS The study groups was recruited from a cohort of 327 healthy children evaluated and followed-up for 6 years to assess the natural history of H. pylori infection. Seventy-four of 136 healthy children who underwent (13)C urea breath test were eligible and accepted to participate. All participants were evaluated by a questionnaire, and skin-prick testing. According to the results, children were divided into four groups with respect to the presence or absence of H. pylori and atopy. Peripheral blood mononuclear cells isolated from 34 of 74 children were cultured with H. pylori, Der p 1, and phytohemagglutinin (PHA). Interferon-gamma (IFN-gamma), interleukin (IL)-4 and IL-10, transforming growth factor-beta (TGF-beta) levels were measured in supernatants. RESULTS The frequency of atopy was lower in H. pylori-infected group (31.9% vs. 48.1, p = .22), while atopic symptoms were similar between infected and non-infected children. While PHA and H. pylori induced IFN-gamma levels were significantly higher in H. pylori-infected children, concomitant presence of both atopy and H. pylori decreased the level of PHA and H. pylori induced IFN-gamma production. PHA and Der p 1-induced IL-4 levels were higher in atopic children, and IL-4 production was suppressed when they were concomitantly infected with H. pylori. The production of TGF-beta was found to be suppressed in atopic children irrespective of the presence of H. pylori infection. CONCLUSION The results of the current study demonstrated a counteractive Th1 and Th2 cytokine interaction between H. pylori infection and atopy. However, this counteractive immunologic balance did not protect against atopy.
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Affiliation(s)
- Sebahat Cam
- Marmara University School of Medicine, Istanbul, Turkey
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15
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Forbes EE, Groschwitz K, Abonia JP, Brandt EB, Cohen E, Blanchard C, Ahrens R, Seidu L, McKenzie A, Strait R, Finkelman FD, Foster PS, Matthaei KI, Rothenberg ME, Hogan SP. IL-9- and mast cell-mediated intestinal permeability predisposes to oral antigen hypersensitivity. J Exp Med 2008; 205:897-913. [PMID: 18378796 PMCID: PMC2292227 DOI: 10.1084/jem.20071046] [Citation(s) in RCA: 214] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2007] [Accepted: 03/05/2008] [Indexed: 11/21/2022] Open
Abstract
Previous mouse and clinical studies demonstrate a link between Th2 intestinal inflammation and induction of the effector phase of food allergy. However, the mechanism by which sensitization and mast cell responses occurs is largely unknown. We demonstrate that interleukin (IL)-9 has an important role in this process. IL-9-deficient mice fail to develop experimental oral antigen-induced intestinal anaphylaxis, and intestinal IL-9 overexpression induces an intestinal anaphylaxis phenotype (intestinal mastocytosis, intestinal permeability, and intravascular leakage). In addition, intestinal IL-9 overexpression predisposes to oral antigen sensitization, which requires mast cells and increased intestinal permeability. These observations demonstrate a central role for IL-9 and mast cells in experimental intestinal permeability in oral antigen sensitization and suggest that IL-9-mediated mast cell responses have an important role in food allergy.
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Affiliation(s)
- Elizabeth E Forbes
- Division of Allergy and Immunology, Cincinnati Children's Hospital Medical Center, USA
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16
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Abstract
The intestinal epithelium is a selective barrier where incompletely-digested food antigens are transmitted to the immune system. Food antigens are often the starting point of intestinal diseases such as food allergy or coeliac disease. The intestinal epithelial cells (IEC) take up and process food antigens mainly by fluid-phase transcytosis involving two functional pathways, one minor direct pathway without degradation and another major lysosomal degradative pathway. Among the peptidic metabolites generated during transepithelial transport of luminal antigens, some have a molecular mass compatible with a binding to restriction (major histocompatibility complex; MHC) molecules; the latter can be up regulated on enterocytes, especially in inflammatory conditions. Indeed, interferon-γ not only increases the paracellular absorption of antigens, but also their transcytosis across epithelial cells. It has been reported that enterocytes may even directly present peptidic epitopes to underlying T-cells. As a new potential way of transmitting peptidic information to the local or systemic immune system, the secretion by IEC of antigen-presenting vesicles called exosomes and bearing MHC–peptide complexes has recently been proposed. Many other factors such as nutritional or environmental factors can also influence the properties of the epithelial barrier and the outcome of the immune response to lumen antigens.
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17
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Affiliation(s)
- Andre G Buret
- Department of Biological Sciences, University of Calgary, 2500 University Dr., NW, Calgary, AB, T2N 1N4, Canada.
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Fedwick JP, Lapointe TK, Meddings JB, Sherman PM, Buret AG. Helicobacter pylori activates myosin light-chain kinase to disrupt claudin-4 and claudin-5 and increase epithelial permeability. Infect Immun 2006; 73:7844-52. [PMID: 16299274 PMCID: PMC1307049 DOI: 10.1128/iai.73.12.7844-7852.2005] [Citation(s) in RCA: 100] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Helicobacter pylori is a spiral, gram-negative bacterium that specifically and persistently infects the human stomach. In some individuals, H. pylori-induced chronic gastritis may progress to gastroduodenal ulcers and gastric cancer. Currently, the host-microbe interactions that determine the clinical outcome of infection are not well defined. H. pylori strains capable of disrupting the gastric epithelial barrier may increase the likelihood of developing serious disease. In this study, H. pylori strain SS1 increased gastric, but not small intestinal, permeability in C57BL/6 mice. H. pylori strain SS1 was able to directly increase paracellular permeability, in the absence of host inflammatory cells, by disrupting the tight-junctional proteins occludin, claudin-4, and claudin-5 in confluent nontransformed epithelial cells. H. pylori SS1 also reduced claudin-4 protein levels in human gastric AGS cells. The ability of H. pylori SS1 to increase permeability appeared to be independent of the well-characterized virulence factors vacuolating cytotoxin and CagA protein. H. pylori activated myosin light-chain kinase in epithelial cells to phosphorylate myosin light chain and increase permeability by disrupting claudin-4 and claudin-5. The bacterial factor responsible for increasing epithelial permeability was heat sensitive, membrane bound, and required apical contact with monolayers. In conclusion, disruptions of the tight junctions observed in this study implicate host cell signaling pathways, including the phosphorylation of myosin light chain and the regulation of tight-junctional proteins claudin-4 and claudin-5, in the pathogenesis of H. pylori infection.
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Affiliation(s)
- Jason P Fedwick
- Department of Biological Sciences, University of Calgary, 2500 University Drive N.W., Calgary, Alberta, Canada T2N 1N4
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19
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Abstract
Intestinal permeability tests used in the diagnosis of allergic diseases in response to oral food challenge have led to the conclusion that constitutive defects of the intestinal barrier are not the primary cause of allergic diseases. However, perturbation of environmental factors (infection, stress), by increasing intestinal permeability and enhancing danger signals, may favour food allergy in susceptible individuals. The mechanisms of enhanced permeability to specific and bystander antigens have been delineated as well as the molecular events involved in the sequential phases of allergic reactions. Intestinal absorption of food antigens and immune responses are mutually dependent, and luminal (environmental) and serosal (intrinsic) factors synergize to maintain a self-perpetuating cycle in which antigens penetrate the mucosa and induce allergic inflammation.
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Affiliation(s)
- Martine Heyman
- Faculté de Médecine Necker-Enfants Malades, Paris, France.
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20
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Nizami SQ, Bhutta ZA, Weaver L, Preston T. Helicobacter pylori colonization in infants in a peri-urban community in Karachi, Pakistan. J Pediatr Gastroenterol Nutr 2005; 41:191-4. [PMID: 16056098 DOI: 10.1097/01.mpg.0000172263.12920.6b] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND The prevalence and incidence of Helicobacter pylori in children in Pakistan is not known. OBJECTIVES To measure the prevalence and age of acquisition of Helicobacter pylori infection/colonization in infants in a peri-urban community in Karachi, Pakistan. SETTING Field based epidemiologic study in a peri-urban community in Karachi, Pakistan. METHODS Infants aged 1 to 3 months were recruited from a birth cohort from the community. C-urea breath test (C-UBT) was performed on recruitment, and the test was repeated at 2, 3, 6, and 9 months of age. RESULTS One hundred forty-eight infants were recruited and had C-UBT on 319 occasions over a period of 2 years. Two hundred thirty-one=(72%) tests were positive: 80% (49/61) infants at 1 month of age, 79% (33/42) at 2 month of age, 76% (92/121) at 3 month of age, 58% (37/64) at 6 months of age, and 67% (20/30) at 9 months of age. CONCLUSIONS The study reveals an early colonization/infection of infants and a high prevalence of Helicobacter pylori in a peri-urban community in Karachi, Pakistan.
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21
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Kolho KL, Haapaniemi A, Haahtela T, Rautelin H. Helicobacter pylori and specific immunoglobulin E antibodies to food allergens in children. J Pediatr Gastroenterol Nutr 2005; 40:180-3. [PMID: 15699693 DOI: 10.1097/00005176-200502000-00018] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVES It has been suggested that chronic Helicobacter pylori infection may increase gastric permeability, predisposing infected children for the development of food allergies. We assessed the presence of food-specific immunoglobulin (Ig)E antibodies in H. pylori positive children and controls. METHODS We measured specific IgE values to six major food allergens (Pharmacia CAP-system) in a group of school-aged Caucasian (n = 36) and non-Caucasian (n = 38) children with a known H. pylori status. All children had undergone upper gastrointestinal endoscopy because of abdominal complaints. RESULTS Among H. pylori positive children (mean age, 8.8 years; range, 5-15 years, 25 female, 26 male), 33% (17 of 51) had an elevated food-specific IgE level to at least one of the food allergens tested. Unexpectedly, the majority of those with elevated serum food-specific IgE levels (12 of 17) were to cow's milk. Among H. pylori negative children (mean age, 9.3 years; range, 5-15 years, 13 female, 10 male), 26% (6 of 23) of the children had an elevated serum IgE level to at least one of the food allergens tested, and 9% (2 of 23) were positive to cow's milk. The difference in the number of children with an elevated serum IgE level for cow's milk in H. pylori positive and negative children was not significant. The severity of gastritis did not correlate with the presence of food-specific IgEs. CONCLUSIONS H. pylori infection had no effect on the manifestation of specific IgE to major food allergens in school-aged children. An IgE response to cow's milk was common among these school-aged children.
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Affiliation(s)
- Kaija-Leena Kolho
- Hospital for Children and Adolescents, University of Helsinki, Stenbäckinkatu 11, FIN-00029 HUS.
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22
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Matysiak-Budnik T, Heyman M, Mégraud F. [Gastric permeability and Helicobacter pylori]. ACTA ACUST UNITED AC 2004; 28:444-54. [PMID: 15243317 DOI: 10.1016/s0399-8320(04)94954-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Tamara Matysiak-Budnik
- INSERM EMI-0212, Faculté de Médecine Necker-Enfants Malades, 156, rue de Vaugirard, 75015, Paris.
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Matysiak-Budnik T, Coffin B, Lavergne-Slove A, Sabate JM, Mégraud F, Heyman M. Helicobacter pylori increases the epithelial permeability to a food antigen in human gastric biopsies. Am J Gastroenterol 2004; 99:225-32. [PMID: 15046209 DOI: 10.1111/j.1572-0241.2004.04080.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
AIMS We have previously shown that H. pylori increases the passage of intact protein across the digestive epithelium, in vitro and in vivo in mice. The aim of this study was to test whether H. pylori can alter gastric permeability to a food-type antigen in humans. METHODS Antral and corpus gastric biopsies obtained from H. pylori-positive and H. pylori-negative patients suffering from nonulcer dyspepsia with normal esogastroduodenal endoscopy were mounted in adapted Ussing chambers to measure gastric permeability. Electrical resistance (R, an index of epithelial integrity) and fluxes of 14C-mannitol (JMan, a marker of paracellular permeability) and 3H-horseradish peroxidase (HRP, a test protein of antigen transport and processing) under intact (JHRPi) and degraded (JD) form, across the biopsies, were measured. RESULTS At the corpus level, biopsies obtained from H. pylori-positive patients, as compared to H. pylori-negative patients, presented significantly higher intact--but not degraded--HRP fluxes (JHRPi = 446 +/- 297 and 219 +/- 265 ng/h cm2, p < 0.05; JD = 4,247 +/- 3,884 and 3,575 +/- 2,594 ng/h x cm2, respectively), and an increase in paracellular permeability (Jman = 0.35 +/- 0.1 vs 0.24 +/- 0.08 micromol/h x cm2, p < 0.02, respectively). At the antrum level, a tendency to increased intact HRP fluxes in H. pylori-positive patients, as compared to H. pylori-negative patients, was observed (JHRPi = 284 +/- 250 vs 207 +/- 203 ng/h x cm2, p < 0.09), without modifications of paracellular permeability. CONCLUSIONS H. pylori infection increases absorption of an intact food antigen across the corpus gastric mucosa. This phenomenon may contribute to the maintenance of gastric inflammation and could play a role in the development of allergic sensitization to dietary antigens in susceptible individuals.
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Matysiak-Budnik T, van Niel G, Mégraud F, Mayo K, Bevilacqua C, Gaboriau-Routhiau V, Moreau MC, Heyman M. Gastric Helicobacter infection inhibits development of oral tolerance to food antigens in mice. Infect Immun 2003; 71:5219-24. [PMID: 12933867 PMCID: PMC187370 DOI: 10.1128/iai.71.9.5219-5224.2003] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
The increase in the transcellular passage of intact antigens across the digestive epithelium infected with Helicobacter pylori may interfere with the regulation of mucosal immune responses. The aim of this work was to study the capacity of Helicobacter infection to inhibit the development of oral tolerance or to promote allergic sensitization and the capacity of a gastro-protective agent, rebamipide, to interfere with these processes in mice. Oral tolerance to ovalbumin (OVA) was studied in 48 C3H/He 4-week-old mice divided into four groups: (i) OVA-sensitized mice; (ii) OVA-"tolerized" mice (that is, mice that were rendered immunologically tolerant); (iii) H. felis-infected, OVA-tolerized mice; (iv) and H. felis-infected, OVA-tolerized, rebamipide-treated mice. Oral sensitization to hen egg lysozyme (HEL) was studied in 48 mice divided into four groups: (i) controls; (ii) HEL-sensitized mice; (iii) H. felis-infected, HEL-sensitized mice; and (iv) H. felis-infected, HEL-sensitized, rebamipide-treated mice. Specific anti-OVA or anti-HEL immunoglobulin E (IgE) and IgG1/IgG2a serum titers were measured by enzyme-linked immunosorbent assay. Additionally, the capacity of rebamipide to interfere with antigen presentation and T-cell activation in vitro, as well as absorption of rebamipide across the epithelial monolayer, was tested. H. felis infection led to the inhibition of oral tolerance to OVA, but rebamipide prevented this inhibitive effect of H. felis. H. felis infection did not enhance the sensitization to HEL, but rebamipide inhibited the development of this sensitization. Moreover, rebamipide inhibited in a dose-dependent manner antigen presentation and T-cell activation in vitro and was shown to be able to cross the epithelium at a concentration capable of inducing this inhibitory effect. We conclude that H. felis can inhibit the development of oral tolerance to OVA in mice and that this inhibition is prevented by rebamipide.
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25
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Matysiak-Budnik T, Heyman M, Mégraud F. Review article: rebamipide and the digestive epithelial barrier. Aliment Pharmacol Ther 2003; 18 Suppl 1:55-62. [PMID: 12925141 DOI: 10.1046/j.1365-2036.18.s1.6.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Rebamipide exerts a positive effect on the digestive epithelial barrier by reinforcing its integrity in normal and in inflammatory conditions, and by normalizing the macromolecular transport across this barrier, increased by Helicobacter infection. Moreover, in mice, rebamipide is capable of diminishing allergic sensitization and of counteracting the inhibitory effect of Helicobacter pylori on oral tolerance to dietary antigens. These properties of rebamipide could explain its anti-inflammatory activity with respect to the digestive mucosa and could provide protection against allergic sensitization to foreign antigens in susceptible individuals.
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Affiliation(s)
- T Matysiak-Budnik
- INSERM EMI-0212, Faculté de Médecine Necker-Enfants Malades, Paris, France.
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26
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Kawakami E, Machado RS, Reber M, Patrício FRS. 13 C-urea breath test with infrared spectroscopy for diagnosing helicobacter pylori infection in children and adolescents. J Pediatr Gastroenterol Nutr 2002; 35:39-43. [PMID: 12142808 DOI: 10.1097/00005176-200207000-00010] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND OBJECTIVE Studies support the accuracy of 13C-urea breath test for diagnosing and confirming cure of Helicobacter pylori infection in children. Three methods are used to assess 13CO2 increment in expired air: mass spectrometry, infrared spectroscopy, and laser-assisted ratio analysis. In this study, the 13C-urea breath test performed with infrared spectroscopy in children and adolescents was evaluated. METHODS Seventy-five patients (6 months to 18 years old) were included. The gold standard for diagnosis was a positive culture or positive histology and a positive rapid urease test. Tests were performed with 50 mg of 13C-urea diluted in 100 mL orange juice in subjects weighing up to 30 kg, or with 75 mg of 13C-urea diluted in 200 mL commercial orange juice for subjects weighing more than 30 kg. Breath samples were collected just before and at 30 minutes after tracer ingestion. The 13C-urea breath test was considered positive when delta over baseline (DOB) was greater than 4.0%. RESULTS Tests were positive for H. pylori in 31 of 75 patients. Sensitivity was 96.8%, specificity was 93.2%, positive predictive value was 90.9%, negative predictive value was 97.6%, and accuracy was 94.7%. CONCLUSIONS 13C-urea breath test performed with infrared spectroscopy is a reliable, accurate, and noninvasive diagnostic tool for detecting H. pylori infection.
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Affiliation(s)
- Elisabete Kawakami
- Universidade Federal de São Paulo, Escola Paulista de Medicina, São Paulo, Brazil.
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Passaro DJ, Taylor DN, Meza R, Cabrera L, Gilman RH, Parsonnet J. Acute Helicobacter pylori infection is followed by an increase in diarrheal disease among Peruvian children. Pediatrics 2001; 108:E87. [PMID: 11694671 DOI: 10.1542/peds.108.5.e87] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Cohort and case-crossover studies were conducted to evaluate whether new Helicobacter pylori infections are followed by increased diarrhea. METHODS Participants were 6-month-old to 12-year-old shantytown residents living near Lima, Peru. Baseline data were collected from community households. Health interviews were completed daily, and sera, drawn every 4 months, were tested for H pylori immunoglobulin G. Diarrhea rates among newly H pylori-infected (seroconverting) children were compared with rates among persistently uninfected and infected children using cohort and case-crossover analyses. RESULTS Sera were obtained from 345 children from January 1, 1995, through September 1, 1997. H pylori incidence was 12% per year (36 H pylori infections in 109 866 seronegative days). In adjusted cohort analyses, seroconverters had more diarrhea days (rate ratio: 2.0; 95% confidence interval: 1.6-2.4), episodes, and sick days in the year after infection than did uninfected children; and more diarrhea days and sick days than did persistently infected children. This effect was strongest in the first 2 months. Case-crossover analyses supported these findings. CONCLUSION Preventing H pylori infection may help reduce pediatric diarrheal disease.
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Affiliation(s)
- D J Passaro
- Division of Infectious Diseases and Geographic Medicine, Stanford University Medical Center, Stanford, California, USA.
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29
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Corrado G, Luzzi I, Pacchiarotti C, Lucarelli S, Frediani T, Cavaliere M, Rea P, Cardi E. Helicobacter pylori seropositivity in children with atopic dermatitis as sole manifestation of food allergy. Pediatr Allergy Immunol 2000; 11:101-5. [PMID: 10893012 DOI: 10.1034/j.1399-3038.2000.00028.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
A positive association between Helicobacter pylori antibodies and food allergy presenting with gastrointestinal symptoms has recently been reported. A subset of a H. pylori strain possesses an antigen, CagA, as a virulence factor. Anti-H. pylori and anti-CagA IgG titre have been determined in children with atopic dermatitis (AD) as the sole clinical manifestation of food allergy. In this study, thirty patients with AD as the sole clinical manifestation of food allergy were examined (group A). For comparative purposes, 30 patients affected by food allergy with gastrointestinal symptoms (group B) and 30 affected by atopic asthma (group C) were studied. Anti-H. pylori and anti-CagA immunoglobulin G (IgG) were determined in all individuals by means of the enzyme-linked immunosorbent assay. The anti-H. pylori IgG titre was significantly higher in group A and group B vs. group C (p < 0.05); no significant difference was detected between group A and group B (p > 0.05). No significant difference in anti-CagA titre was found between the groups. These data demonstrate a positive association between H. pylori antibodies and AD as the sole manifestation of food allergy. Further investigations are needed to evaluate the cause-effect relationship between H. pylori seropositivity and AD.
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Affiliation(s)
- G Corrado
- Servizio Speciale di Gastroenterologia Pediatrica, Istituto di Clinica Pediatrica, Università degli Studi di Roma La Sapienza, Rome, Italy.
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Vandenplas Y. Helicobacter pylori infection. World J Gastroenterol 2000; 6:20-31. [PMID: 11819516 PMCID: PMC4723591 DOI: 10.3748/wjg.v6.i1.20] [Citation(s) in RCA: 46] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/1999] [Revised: 08/02/1999] [Accepted: 08/15/1999] [Indexed: 02/06/2023] Open
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Louis-Jacques O, Perman JA. Disorders of the stomach and duodenum in children. Curr Opin Gastroenterol 1999; 15:516-20. [PMID: 17023999 DOI: 10.1097/00001574-199911000-00010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
Over the past year, there have been continued efforts to increase our understanding of the epidemiology, natural history, and pathogenic mechanisms of Helicobacter pylori infection in children. In an attempt to delineate the spectrum of disease associated with this organism, several teams of investigators have also examined the association of H. pylori infection with other disorders, from food allergy to inflammatory bowel disease. Developmental aspects of gastric and duodenal motility, risk factors for gastrointestinal bleeding in pediatric intensive care unit patients, and the use of uncooked cornstarch in the treatment of dumping syndrome are among other topics covered in this review.
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Affiliation(s)
- O Louis-Jacques
- Department of Pediatrics, University of Maryland, Baltimore, Maryland 21201, USA
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Abstract
Helicobacter pylori is a gram-negative, spiral organism that colonizes the gastric mucosa and causes primary antral gastritis and peptic ulcer disease. Recent studies indicate that H. pylori infection acquired in childhood may cause gastric cancer in later life. H. pylori is present in both asymptomatic and symptomatic children as determined by various epidemiologic studies. The natural history of H. pylori infection is still an enigma. Its association with varied symptoms in children is considered controversial because it is frequently associated with nonulcerative gastritis in this age group. This article focuses on some of the newer developments addressing the epidemiology, transmission, pathophysiology, clinical presentation, and treatment of H. pylori infection in the pediatric population.
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Affiliation(s)
- V Tolia
- Division of Gastroenterology and Nutrition, Children's Hospital of Michigan, 3901 Beaubien Boulevard, Detroit, MI 48201, USA
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