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Gil MV, Fernández-Rivera N, Gutiérrez-Díaz G, Parrón-Ballesteros J, Pastor-Vargas C, Betancor D, Nieto C, Cintas P. Antioxidant Activity and Hypoallergenicity of Egg Protein Matrices Containing Polyphenols from Citrus Waste. Antioxidants (Basel) 2024; 13:1154. [PMID: 39456407 PMCID: PMC11504875 DOI: 10.3390/antiox13101154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2024] [Revised: 09/05/2024] [Accepted: 09/16/2024] [Indexed: 10/28/2024] Open
Abstract
This study reports on the interactions of egg proteins, which represent a major health concern in food allergy, with polyphenols obtained from orange and lemon peels. The antioxidant properties of such citrus peel extracts prior to protein binding were evaluated. The resulting edible, and therefore inherently safe, matrices exhibit reduced IgE binding compared to pure proteins in indirect immunological assays (ELISA) using individual sera from patients allergic to ovalbumin and lysozyme. The reduced allergenicity could arise from the interactions with polyphenols, which alter the structure and functionality of the native proteins. It is hypothesized that the anti-inflammatory and antioxidant properties of the polyphenols, described as inhibitors of the allergic response, could add immunomodulatory features to the hypoallergenic complexes. A docking analysis using lysozyme was conducted to scrutinize the nature of the protein-polyphenol interactions. An in silico study unravelled the complexity of binding modes depending on the isoforms considered. Altogether, the presented results validate the antioxidant properties and reduced allergenicity of polyphenol-fortified proteins. Lastly, this study highlights the upgrading of vegetable wastes as a source of natural antioxidants, thus showing the benefits of a circular economy in agri-food science.
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Affiliation(s)
- María Victoria Gil
- Department of Organic and Inorganic Chemistry, IACYS-Green Chemistry and Sustainable Development Unit, Faculty of Sciences, University of Extremadura, 06006 Badajoz, Spain; (N.F.-R.); (P.C.)
| | - Nuria Fernández-Rivera
- Department of Organic and Inorganic Chemistry, IACYS-Green Chemistry and Sustainable Development Unit, Faculty of Sciences, University of Extremadura, 06006 Badajoz, Spain; (N.F.-R.); (P.C.)
| | - Gloria Gutiérrez-Díaz
- Department of Biochemistry and Molecular Biology, Faculty of Chemistry, Complutense University of Madrid, 28040 Madrid, Spain; (G.G.-D.); (J.P.-B.); (C.P.-V.)
| | - Jorge Parrón-Ballesteros
- Department of Biochemistry and Molecular Biology, Faculty of Chemistry, Complutense University of Madrid, 28040 Madrid, Spain; (G.G.-D.); (J.P.-B.); (C.P.-V.)
| | - Carlos Pastor-Vargas
- Department of Biochemistry and Molecular Biology, Faculty of Chemistry, Complutense University of Madrid, 28040 Madrid, Spain; (G.G.-D.); (J.P.-B.); (C.P.-V.)
| | - Diana Betancor
- Department of Allergy and Immunology, IIS-Fundación Jiménez Díaz, Universidad Autónoma de Madrid, 28049 Madrid, Spain;
| | - Carlos Nieto
- Department of Organic Chemistry, Faculty of Chemical Sciences, University of Salamanca, Pl. Caídos s/n, 37008 Salamanca, Spain;
| | - Pedro Cintas
- Department of Organic and Inorganic Chemistry, IACYS-Green Chemistry and Sustainable Development Unit, Faculty of Sciences, University of Extremadura, 06006 Badajoz, Spain; (N.F.-R.); (P.C.)
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Gil MV, Gutiérrez-Díaz G, Higuero N, Palma E, Fernández-Rivera N, Parrón-Ballesteros J, Betancor D, Pastor-Vargas C, Cintas P, Delgado-Adamez J. Targeting cow's milk allergy using hypoallergenic protein-polyphenol formulas: A proof of concept. Food Chem 2024; 463:141285. [PMID: 39316908 DOI: 10.1016/j.foodchem.2024.141285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2024] [Revised: 09/06/2024] [Accepted: 09/11/2024] [Indexed: 09/26/2024]
Abstract
Cow's milk allergy caused by a hypersensitivity to milk proteins has increased over the last years. Hypoallergenic responses can be induced by altering the structure of such proteins with chemical modifiers; this paper is about the creation of edible matrices based on polyphenols from orange peel. Some compounds were able to significantly lower the IgE binding from β-lactoglobulin allergic serum in sensitized patients. Such effects could also be observed for casein allergic serum in patients sensitized to both proteins. A certain inter-individual variability is observed, although polyphenols do actually induce salient structural changes. This indicates that molecular modifications aimed at oral treatments against food allergy may or may not correlate with reduced allergenicity, and hence the necessity for serum monitoring through immunological assays. Overall, the results are promising enough to validate the polyphenol-fortified approach. In addition, this study highlights the upgrading of vegetable waste, consistent with a circular economy in food chemistry.
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Affiliation(s)
- M Victoria Gil
- IACYS-Green Chemistry and Sustainable Development Unit, Department of Organic and Inorganic Chemistry, Faculty of Sciences, University of Extremadura, 06006 Badajoz, Spain.
| | - Gloria Gutiérrez-Díaz
- Department of Biochemistry and Molecular Biology, Faculty of Chemistry, Complutense University of Madrid, Madrid, Spain
| | - Nieves Higuero
- IACYS-Green Chemistry and Sustainable Development Unit, Department of Organic and Inorganic Chemistry, Faculty of Sciences, University of Extremadura, 06006 Badajoz, Spain
| | - Esther Palma
- IACYS-Green Chemistry and Sustainable Development Unit, Department of Organic and Inorganic Chemistry, Faculty of Sciences, University of Extremadura, 06006 Badajoz, Spain
| | - Nuria Fernández-Rivera
- IACYS-Green Chemistry and Sustainable Development Unit, Department of Organic and Inorganic Chemistry, Faculty of Sciences, University of Extremadura, 06006 Badajoz, Spain
| | - Jorge Parrón-Ballesteros
- Department of Biochemistry and Molecular Biology, Faculty of Chemistry, Complutense University of Madrid, Madrid, Spain
| | - Diana Betancor
- Department of Allergy and Immunology, IIS-Fundación Jiménez Díaz, UAM, Madrid, Spain
| | - Carlos Pastor-Vargas
- Department of Biochemistry and Molecular Biology, Faculty of Chemistry, Complutense University of Madrid, Madrid, Spain.
| | - Pedro Cintas
- IACYS-Green Chemistry and Sustainable Development Unit, Department of Organic and Inorganic Chemistry, Faculty of Sciences, University of Extremadura, 06006 Badajoz, Spain
| | - Jonathan Delgado-Adamez
- Technological Institute of Food and Agriculture (INTAEX), Centro de Investigaciones Científicas y Tecnológicas de Extremadura (CICYTEX). Avda. Adolfo Suárez s/n, 06007, Badajoz, Spain
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Han X, Wang X, Chen X, Liu H, Liu J, Waye MMY, Liu G, Rao S. Intervention Efficacy of Slightly Processed Allergen/Meat in Oral Immunotherapy for Seafood Allergy: A Systematic Review, Meta-Analysis, and Meta-Regression Analysis in Mouse Models and Clinical Patients. Nutrients 2024; 16:667. [PMID: 38474795 PMCID: PMC10934674 DOI: 10.3390/nu16050667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 02/20/2024] [Accepted: 02/21/2024] [Indexed: 03/14/2024] Open
Abstract
Background: Seafood allergy is a significant global health concern that greatly impacts a patient's quality of life. The intervention efficacy of oral immunotherapy (OIT), an emerging intervention strategy, for seafood allergy remains controversial. This study aimed to perform a systematic review and meta-analysis to evaluate the efficacy of slightly processed allergen/meat from fish and crustacea in OIT, both in mouse models and clinical patients. Methods: A comprehensive literature search was performed in four mainstream databases and the EBSCOhost database to identify all relevant case-control and cohort studies. The aim was to elucidate the intervention efficacy, encompassing various processing methods and assessing the efficacy of multiple major allergens in OIT. Results: The meta-analysis included five case-control studies on crustacean allergens in mouse models and 11 cohort studies on meat from fish and crustacea in clinical patients for final quantitative assessments. In mouse models, crustacean allergen substantially decreased the anaphylactic score after OIT treatment (mean difference (MD) = -1.30, p < 0.01). Subgroup analyses with low-level heterogeneities provided more reliable results for crab species (MD = -0.63, p < 0.01, I2 = 0), arginine kinase allergen (MD = -0.83, p < 0.01, I2 = 0), and Maillard reaction processing method (MD = -0.65, p < 0.01, I2 = 29%), respectively. In clinical patients, the main meta-analysis showed that the slightly processed meat significantly increased the incidence rate of oral tolerance (OT, incidence rate ratio (IRR) = 2.90, p < 0.01). Subgroup analyses for fish meat (IRR = 2.79, p < 0.01) and a simple cooking treatment (IRR = 2.36, p = 0.01) also demonstrated a substantial increase in the incidence rate of OT. Sensitivity and meta-regression analyses successfully identified specific studies contributing to heterogeneity in mouse models and clinical patients, although these studies did not impact the overall significant pooled effects. Conclusions: This meta-analysis provides preliminary evidence for the high intervention efficacy of slightly processed allergen/meat from fish and crustacea in OIT, both in mouse models and clinical patients. The Maillard reaction and cooking processing methods may emerge as potentially effective approaches to treating allergen/meat in OIT for clinical patients, offering a promising and specific treatment strategy for seafood allergy. However, these findings should be interpreted cautiously, and further supporting evidence is necessary.
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Affiliation(s)
- Xinyu Han
- College of Ocean Food and Biological Engineering, Xiamen Key Laboratory of Marine Functional Food, Fujian Provincial Engineering Technology Research Center of Marine Functional Food, Jimei University, Xiamen 361021, China; (X.H.); (H.L.); (J.L.)
| | - Xinya Wang
- Department of Bioinformatics, Fujian Key Laboratory of Medical Bioinformatics, Institute of Precision Medicine, School of Medical Technology and Engineering, Fujian Medical University, Fuzhou 350122, China; (X.W.); (X.C.)
| | - Xiaotong Chen
- Department of Bioinformatics, Fujian Key Laboratory of Medical Bioinformatics, Institute of Precision Medicine, School of Medical Technology and Engineering, Fujian Medical University, Fuzhou 350122, China; (X.W.); (X.C.)
| | - Hong Liu
- College of Ocean Food and Biological Engineering, Xiamen Key Laboratory of Marine Functional Food, Fujian Provincial Engineering Technology Research Center of Marine Functional Food, Jimei University, Xiamen 361021, China; (X.H.); (H.L.); (J.L.)
| | - Jingwen Liu
- College of Ocean Food and Biological Engineering, Xiamen Key Laboratory of Marine Functional Food, Fujian Provincial Engineering Technology Research Center of Marine Functional Food, Jimei University, Xiamen 361021, China; (X.H.); (H.L.); (J.L.)
| | - Mary Miu Yee Waye
- The Nethersole School of Nursing, Croucher Laboratory for Human Genomics, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong SAR, China;
| | - Guangming Liu
- College of Ocean Food and Biological Engineering, Xiamen Key Laboratory of Marine Functional Food, Fujian Provincial Engineering Technology Research Center of Marine Functional Food, Jimei University, Xiamen 361021, China; (X.H.); (H.L.); (J.L.)
| | - Shitao Rao
- Department of Bioinformatics, Fujian Key Laboratory of Medical Bioinformatics, Institute of Precision Medicine, School of Medical Technology and Engineering, Fujian Medical University, Fuzhou 350122, China; (X.W.); (X.C.)
- School of Biomedical Sciences, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong SAR, China
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Zhang Y, Shang M, Tian Y, Liu X, Sun X, Gao L. Allergen sensitization study in Dongying, China: An epidemiological study. Medicine (Baltimore) 2024; 103:e36862. [PMID: 38241586 PMCID: PMC10798692 DOI: 10.1097/md.0000000000036862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 12/14/2023] [Indexed: 01/21/2024] Open
Abstract
BACKGROUND To explore the relationship between specific immunoglobulin E levels in response to prevalent pollen and food allergens among patients suffering from localized allergic diseases in the Dongying area of China, and to analyze the interconnectivity among these factors. METHODS This research encompassed allergic patients who visited the Allergy Department of Shengli Oilfield Central Hospital from January 2022 to January 2023. We examined the specific immunoglobulin E levels in the blood of 230 patients utilizing the Fobock platform provided by Jiangsu Haoeubo Company. Statistical analysis was conducted with SPSS 25.0 statistical software. The chi-square test evaluated the relevance of differences in gender and age. A value of P < .05 was considered statistically significant. RESULTS In this study, eggs emerged as the allergen with the highest number of sensitized individuals, closely followed by dust mite. Conversely, the least sensitized allergen was the cypress tree, closely followed by mango. Notably, male patients exhibited higher sensitivities to cottonwood (P < .05) and egg (P < .001) compared to female patients. Children aged 0 to 10 years showed increased sensitivity to variety of allergens. A significant correlation was observed among different allergens. The top ten allergen pairs with the highest correlation included Birch Tree and Cottonwood (0.88, P < .001), Cottonwood and Pine Tree (0.86, P < .001), Birch Tree and Pine Tree (0.84, P < .001), Pine Tree and Paulownia (0.81, P < .001), Dust Mite and House Dust Mite (0.76, P < .001), Birch Tree and Paulownia (0.73, P < .001), Cashew and Pistachio (0.71, P < .001), Apple and Hazelnut (0.71, P < .001), Cottonwood and Paulownia (0.71, P < .001), and Pine Tree and Ordinary Ragweed (0.70, P < .001). CONCLUSION This research sheds light on the patterns of allergen sensitization in Dongying, Shandong, highlighting that egg is the most prevalent sensitizing allergen. A notably high correlation was observed between Birch Tree and Cottonwood. This study enhanced the understanding of allergic diseases, explored the causes and mechanisms of allergies, strengthened the management of allergic diseases. Furthermore, it offers valuable insights for the clinical diagnosis and prevention of allergic diseases.
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Affiliation(s)
- Yingying Zhang
- Department of Pediatrics, Shengli Oilfield Central Hospital, Dongying City, Shandong Province, China
| | - Mei Shang
- Department of Pediatrics, Shengli Oilfield Central Hospital, Dongying City, Shandong Province, China
| | - Ying Tian
- Department of Pediatrics, Shengli Oilfield Central Hospital, Dongying City, Shandong Province, China
| | - Xuwei Liu
- Department of Pediatrics, Shengli Oilfield Central Hospital, Dongying City, Shandong Province, China
| | - Xuhui Sun
- Department of Pediatrics, Shengli Oilfield Central Hospital, Dongying City, Shandong Province, China
| | - Lianjun Gao
- Department of Pediatrics, Shengli Oilfield Central Hospital, Dongying City, Shandong Province, China
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Mohanan MM, Shetty R, Bang-Berthelsen CH, Mudnakudu-Nagaraju KK. Role of Mesenchymal Stem Cells and Short Chain Fatty Acids in Allergy: A Prophylactic Therapy for Future. Immunol Lett 2023:S0165-2478(23)00096-2. [PMID: 37271295 DOI: 10.1016/j.imlet.2023.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 05/30/2023] [Accepted: 06/01/2023] [Indexed: 06/06/2023]
Abstract
Allergic diseases are broadly classified as IgE-mediated type-I hypersensitivity immune reactions due to exposure to typically harmless substances known as allergens. These allergenic substances activate antigen presenting cells, which further triggers T-helper 2 cells immune response and class switch B-cells for synthesis of allergen-specific IgE, followed by classical activation of inflammatory mast cells and eosinophils, which releases preformed mediators involved in the cascade of allergic symptoms. However, the role of Mesenchymal stem cells (MSCs) in tissue repair ability and immunomodulation, makes them as an appropriate tool for treatment of various allergic diseases. Several clinical and preclinical studies show that MSCs could be a promising alternative therapy to allergic diseases. Further, short chain fatty acids, produced from gut microbes by breaking down complex fibre-rich foods, acts through G-coupled receptor mediated activation of MSCs, and their role as key players involved in amelioration of allergic inflammation needs further investigation. Therefore, there is a need for understating the role of SCFAs on the activation of MSCs, which might shed light on the development of new therapeutic regime in allergy treatment. In summary, this review focuses on the underlying of therapeutic role of MSCs in different allergic diseases and the prospects of SCFA and MSC therapy.
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Affiliation(s)
- Mrudula M Mohanan
- Department of Biotechnology & Bioinformatics, JSS Academy of Higher Education & Research, Mysore 570015, Karnataka, India
| | - Radhakrishna Shetty
- Research Group for Microbial Biotechnology and Biorefining, National Food Institute, Technical University of Denmark, Kemitorvet, Building 202, 2800, Kongens, Lyngby, Denmark
| | - Claus Heiner Bang-Berthelsen
- Research Group for Microbial Biotechnology and Biorefining, National Food Institute, Technical University of Denmark, Kemitorvet, Building 202, 2800, Kongens, Lyngby, Denmark.
| | - Kiran Kumar Mudnakudu-Nagaraju
- Department of Biotechnology & Bioinformatics, JSS Academy of Higher Education & Research, Mysore 570015, Karnataka, India..
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Üzülmez Ö, Kalic T, Mayr V, Lengger N, Tscheppe A, Radauer C, Hafner C, Hemmer W, Breiteneder H. The Major Peanut Allergen Ara h 2 Produced in Nicotiana benthamiana Contains Hydroxyprolines and Is a Viable Alternative to the E. Coli Product in Allergy Diagnosis. FRONTIERS IN PLANT SCIENCE 2021; 12:723363. [PMID: 34671372 PMCID: PMC8522509 DOI: 10.3389/fpls.2021.723363] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 08/17/2021] [Indexed: 05/12/2023]
Abstract
Peanut allergy is a potentially life-threatening disease that is mediated by allergen-specific immunoglobulin E (IgE) antibodies. The major peanut allergen Ara h 2, a 2S albumin seed storage protein, is one of the most dangerous and potent plant allergens. Ara h 2 is posttranslationally modified to harbor four disulfide bridges and three hydroxyprolines. These hydroxyproline residues are required for optimal IgE-binding to the DPYSPOHS motifs representing an immunodominant IgE epitope. So far, recombinant Ara h 2 has been produced in Escherichia coli, Lactococcus lactis, Trichoplusia ni insect cell, and Chlamydomonas reinhardtii chloroplast expression systems, which were all incapable of proline hydroxylation. However, molecular diagnosis of peanut allergy is performed using either natural or E. coli-produced major peanut allergens. As IgE from the majority of patients is directed to Ara h 2, it is of great importance that the recombinant Ara h 2 harbors all of its eukaryotic posttranslational modifications. We produced hydroxyproline-containing and correctly folded Ara h 2 in the endoplasmic reticulum of leaf cells of Nicotiana benthamiana plants, using the plant virus-based magnICON® transient expression system with a yield of 200 mg/kg fresh biomass. To compare prokaryotic with eukaryotic expression methods, Ara h 2 was expressed in E. coli together with the disulfide-bond isomerase DsbC and thus harbored disulfide bridges but no hydroxyprolines. The recombinant allergens from N. benthamiana and E. coli were characterized and compared to the natural Ara h 2 isolated from roasted peanuts. Natural Ara h 2 outperformed both recombinant proteins in IgE-binding and activation of basophils via IgE cross-linking, the latter indicating the potency of the allergen. Interestingly, significantly more efficient IgE cross-linking by the N. benthamiana-produced allergen was observed in comparison to the one induced by the E. coli product. Ara h 2 from N. benthamiana plants displayed a higher similarity to the natural allergen in terms of basophil activation due to the presence of hydroxyproline residues, supporting so far published data on their contribution to the immunodominant IgE epitope. Our study advocates the use of N. benthamiana plants instead of prokaryotic expression hosts for the production of the major peanut allergen Ara h 2.
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Affiliation(s)
- Öykü Üzülmez
- Institute of Pathophysiology and Allergy Research, Medical University of Vienna, Vienna, Austria
| | - Tanja Kalic
- Institute of Pathophysiology and Allergy Research, Medical University of Vienna, Vienna, Austria
- Department of Dermatology, University Hospital St. Pölten, Karl Landsteiner University of Health Sciences, St. Pölten, Austria
| | - Vanessa Mayr
- Institute of Pathophysiology and Allergy Research, Medical University of Vienna, Vienna, Austria
| | - Nina Lengger
- Institute of Pathophysiology and Allergy Research, Medical University of Vienna, Vienna, Austria
| | - Angelika Tscheppe
- Institute of Pathophysiology and Allergy Research, Medical University of Vienna, Vienna, Austria
| | - Christian Radauer
- Institute of Pathophysiology and Allergy Research, Medical University of Vienna, Vienna, Austria
| | - Christine Hafner
- Department of Dermatology, University Hospital St. Pölten, Karl Landsteiner University of Health Sciences, St. Pölten, Austria
- Karl Landsteiner Institute for Dermatological Research, St. Pölten, Austria
| | | | - Heimo Breiteneder
- Institute of Pathophysiology and Allergy Research, Medical University of Vienna, Vienna, Austria
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Molecular and allergenic characterization of recombinant tropomyosin from mud crab Scylla olivacea. Mol Biol Rep 2021; 48:6709-6718. [PMID: 34427887 DOI: 10.1007/s11033-021-06661-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Accepted: 08/17/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND Tropomyosin is a major allergen in crustaceans, including mud crab species, but its molecular and allergenic properties in Scylla olivacea are not well known. Thus, this study aimed to produce the recombinant tropomyosin protein from S. olivacea and subsequently investigate its IgE reactivity. METHODS AND RESULTS The tropomyosin gene was cloned and expressed in the Escherichia coli system, followed by SDS-PAGE and immunoblotting test to identify the allergenic potential of the recombinant protein. The 855-base pair of tropomyosin gene produced was found to be 99.18% homologous to Scylla serrata. Its 284 amino acids matched the tropomyosin of crustaceans, arachnids, insects, and Klebsiella pneumoniae, ranging from 79.03 to 95.77%. The tropomyosin contained 89.44% alpha-helix folding with a tertiary structure of two-chain alpha-helical coiled-coil structures comprising a homodimer heptad chain. IPTG-induced histidine tagged-recombinant tropomyosin was purified at the size of 42 kDa and confirmed as tropomyosin using anti-tropomyosin monoclonal antibodies. The IgE binding of recombinant tropomyosin protein was reactive in 90.9% (20/22) of the sera from crab-allergic patients. CONCLUSIONS This study has successfully produced an allergenic recombinant tropomyosin from S. olivacea. This recombinant tropomyosin may be used as a specific allergen for the diagnosis of allergy.
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Pfaar O, Creticos PS, Kleine-Tebbe J, Canonica GW, Palomares O, Schülke S. One Hundred Ten Years of Allergen Immunotherapy: A Broad Look Into the Future. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2021; 9:1791-1803. [PMID: 33966868 DOI: 10.1016/j.jaip.2020.12.067] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 12/14/2020] [Accepted: 12/18/2020] [Indexed: 12/15/2022]
Abstract
Allergen immunotherapy (AIT) is the only disease-modifying treatment option for patients with type 1-mediated allergic diseases such as allergic rhinitis/rhinoconjunctivitis with/without allergic asthma. Although many innovations have been developed since the first clinical report of Noon et al in 1911, the improvement of clinical efficacy and tolerability of this treatment is still an important unmet need. Hence, much progress has been made in the characterization of the cell types, cytokines, and intracellular signaling events involved in the development, maintenance, and regulation of allergic reactions, and also in the understanding of the mechanisms of tolerance induction in AIT. This comprehensive review aims to summarize the current innovative approaches in AIT, but also gives an outlook on promising candidates of the future. On the basis of an extensive literature review, integrating a clinical point of view, this article focuses on recent and future innovations regarding biologicals, allergen-derived peptides, recombinant allergens, "Toll"-like receptor agonists and other adjuvants, and novel application routes being developed for future AIT.
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Affiliation(s)
- Oliver Pfaar
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Marburg, Philipps-Universität Marburg, Marburg, Germany.
| | - Peter S Creticos
- Division of Allergy & Clinical Immunology, Johns Hopkins University School of Medicine, Baltimore, Md; Creticos Research Group, Crownsville, Md
| | - Jörg Kleine-Tebbe
- Allergy & Asthma Center Westend, Outpatient & Clinical Research Center, Hanf, Ackermann & Kleine-Tebbe, Berlin, Germany
| | - Giorgio Walter Canonica
- Personalized Medicine Asthma & Allergy Clinic, Humanitas University & Research Hospital-IRCCS, Milano, Italy
| | - Oscar Palomares
- Department of Biochemistry and Molecular Biology, School of Chemistry, Complutense University, Madrid, Spain
| | - Stefan Schülke
- Vice Presidents Research Group, Paul-Ehrlich-Institut, Langen, Germany
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