Chemokines as allergic mediators--relationship to histamine-releasing factors

Role of interleukins in the regulation of basophil development and secretion

PURPOSE OF REVIEW

It is well appreciated that differentiation, growth, and function of basophils are regulated by a network of cytokines, and that these cells express a unique composition of surface receptors including interleukin-binding sites. In the current article, most recent discoveries around cytokine regulation of basophils are discussed and compared with previous data.

RECENT FINDINGS

Confirming previous studies, the most potent growth factor for basophils remains interleukin (IL)-3, followed by granulocyte-macrophage colony-stimulating factor and IL-5. These cytokines also act on mature basophils through specific receptors, thereby mediating adhesion, migration, and releasability. Other molecules regulating basophil function are chemokines such as IL-8 or eotaxin and IL-33. Especially IL-33 has been described as a novel basophil regulator. All cytokines act on basophils via specific receptors and signal transduction pathways. The present article provides a summary of our knowledge on cytokine regulation of basophils and receptor expression, with emphasis on most recent developments in the field.

SUMMARY

Basophil regulation by cytokines in health and disease may be a more complex process than has been considered previously. Some of the affected cytokine cascades, receptors, and signal transduction molecules may serve as targets of therapy in 'basophil activation disorders' in the future.

Immunology

The concept of forbidden foods that should not be eaten goes back to the Garden of Eden and apart from its religious meanings it may also have foreshadowed the concept of foods that can provoke adverse reactions. Thus we could say that allergic diseases have plagued mankind since the beginning of life on earth. The prophet Job was affected by a condition that following the rare symptoms described by the Holy Bible might be identified as a severe form of atopic dermatitis (AD). The earliest record of an apparently allergic reaction is 2621 B.C., when death from stinging insects was first described by hieroglyphics carved into the walls of the tomb of Pharaoh Menes depicting his death following the sting of a wasp. In 79 A.D., the death of the Roman admiral Pliny the Elder was ascribed to the SO₂-rich gases emanating from the eruption of Mount Vesuvius. Hippocrates (460–377 B.C.) was probably the first to describe how cow’s milk (CM) could cause gastric upset and hives, proposing dietetic measures including both treatment and prevention for CM allergy.

Changes over 13 years in skin reactivity to histamine in cohorts of children aged 9-13 years

BACKGROUND

Several studies report substantial differences in the prevalence of skin test reactivity to allergens in children from adjacent geographic areas; others report an increased prevalence over time. To find out whether these differences depend on variations in skin reactivity to histamine, we determined the time trend of histamine wheal sizes in successive cohorts of unselected children living in the same area (Viterbo, Italy).

METHODS

We conducted three epidemiologic surveys, each including children aged 9 and 13 years. The 1983-7 study investigated 170 children (150 were tested twice); the 1992 study, 158 children; and the 1996 study, 208 children.

RESULTS

In both age groups, the mean diameter of the wheal induced by histamine skin prick tests (10 mg/ml) increased significantly over time (9-year-olds: 3.25 mm in 1983, 4.68 in 1992, and 5.89 in 1996; 13-year-olds: 3.89 mm in 1987, 5.18 in 1992, and 6.50 in 1996) (P < 0.001 between subsequent studies). The distribution of the wheal diameters for both ages showed a trend to a right shift in the three successive studies (P < 0.001). The dose-response curves for three histamine concentrations (0.2, 1, and 10 mg/ml) had significantly steeper slopes in 1996 than in 1983-7 (P < 0.001).

CONCLUSION

The marked time-related increase in the size of the histamine wheals could help to explain the trend toward an increased prevalence of positive allergen skin test reactions reported during the past years. The causes of increased skin reactivity to histamine remain conjectural.

Blood histamine levels (BHL) in infants and children with respiratory and non-respiratory diseases

BACKGROUND

Blood histamine levels are decreased after severe allergic reactions and in various chronic diseases.

AIMS

To study blood histamine levels in infants and children with acute infectious and non-infectious, non-allergic, disease.

METHODS

Blood histamine levels were investigated by a fluorometric method in infants and children admitted to hospital with bronchiolitis, non-wheezing bronchitis, acute infections of the urinary tract, skin and ear-nose-throat, gastroenteritis, or hyperthermia of unknown aetiology. Results of blood histamine levels and white blood cell counts were compared with those obtained for children recovering from benign non-infectious, non-allergic illnesses.

RESULTS

As compared with control children, white blood cell numbers were significantly increased in children with acute infections of the urinary tract, skin and ear-nose-throat, and were significantly decreased in children with gastroenteritis. Blood histamine levels were significantly lower in children with gastroenteritis and hyperthermia than in children with other diseases and control children. It was not possible to correlate blood histamine levels and the number of blood basophils.

CONCLUSIONS

BHL are significantly decreased in infants and children with acute gastroenteritis and hyperthermia of unknown aetiology. The mechanisms responsible for the decrease in blood histamine levels in children with gastroenteritis and hyperthermia are discussed.

Are chemokines essential or secondary participants in allergic responses?

OBJECTIVES

This review will provide a concise and critical overview of the rapidly evolving concepts in chemokine biology with a special relevance to allergic responses. The article is intended for clinicians with little or no expertise in chemokine biology.

DATA SOURCES

A detailed literature search was performed through MEDLINE (PubMed). Those reports considered important and relevant to the topic were critically reviewed and their conclusions included.

RESULTS

Chemokines are a group of structurally related small proteins with a common biological activity of inducing directional migration (chemotaxis) of various cell types. Chemokines such as eotaxins and MCP-4 play a key role in selective eosinophil recruitment to sites of inflammation in allergies and asthma. Several other chemokine activities relevant to allergic responses are: activation of basophils and eosinophils to release inflammatory mediators, regulation of IgE responses, and Th1/Th2-type cytokine balance. A number of therapeutic strategies aimed at inhibiting chemokine function are being tested in animal models of allergies and asthma.

CONCLUSIONS

Chemokines have been widely viewed as pathogenic mediators of acute and chronic inflammation and tissue damage in allergies and asthma. On the other hand, recent evidence suggests that endogenous production of certain chemokines might be beneficial to the host in preventing allergic response. Met-RANTES, a modified antagonist of RANTES, and eotaxin receptor (CCR3) antagonists, represent promising novel therapeutic agents potentially useful in atopic disorders. Thus, suppression of chemokines may interrupt the sequence of signals culminating in an allergic response. Whether chemokines are actually essential for an allergic response awaits confirmation with gene knockout animal experiments.

Monocyte Chemoattractant Protein-1 Mediates Cockroach Allergen-Induced Bronchial Hyperreactivity in Normal But Not CCR2−/− Mice: The Role of Mast Cells

Bronchial eosinophil and mononuclear cell infiltrates are a hallmark of the asthmatic lung and are associated with the induction of reversible airway hyperreactivity. In these studies, we have found that monocyte chemotactic protein-1 (MCP-1), a CC (β) chemokine, mediates airway hyperreactivity in normal and allergic mice. Using a murine model of cockroach Ag-induced allergic airway inflammation, we have demonstrated that anti-MCP-1 Abs inhibit changes in airway resistance and attenuate histamine release into the bronchoalveolar lavage, suggesting a role for MCP-1 in mast cell degranulation. In normal mice, instillation of MCP-1 induced prolonged airway hyperreactivity and histamine release. In addition, MCP-1 directly induced pulmonary mast cell degranulation in vitro. These latter effects would appear to be selective because no changes were observed when macrophage-inflammatory protein-1α, eotaxin, or MCP-3 were instilled into the airways of normal mice or when mast cells were treated in vitro. Airway hyperreactivity was mediated by MCP-1 through CCR2 because allergen-induced as well as direct MCP-1 instilled-induced changes in airway hyperreactivity were significantly attenuated in CCR2 −/− mice. The neutralization of MCP-1 in allergic animals and instillation of MCP-1 in normal animals was related to leukotriene C4 levels in the bronchoalveolar lavage and was directly induced in pulmonary mast cells by MCP-1. Thus, these data identify MCP-1 and CCR2 as potentially important therapeutic targets for the treatment of hyperreactive airway disease.

Human basophil activation measured by CD63 expression and LTC4 release in IgE-mediated food allergy

BACKGROUND

IgE-dependent basophil activation induced by an allergen elicit the release of LTC4 and the expression of the CD63 membrane marker.

OBJECTIVE

The aim of this study was to check if flow cytometric analysis of basophil activation could be applied to food allergy diagnosis and if this method paralleled LTC4 release.

METHODS

Patients were selected by the clinical history, skin tests, and provocation tests. Basophil activation induced by food extracts was studied in 24 control subjects and in 27 patients having a food allergy by LTC4 release test (LRT) and by flow cytometric anti-IgE+, CD63 + cell counting (BAT = basophil activation test). In case of negative anti-IgE response a passive blood donor basophil passive sensitization step was added to LRT and BAT. Leucocyte histamine release test was performed in 11 patients.

RESULTS

Basophil activation test was positive in 18/31 cases and LRT in 22/34 cases for food-allergic patients and, respectively, in 1/33 and 1/35 cases for the controls. A correlation was observed between specific IgE, BAT, and LRT. Basophil activation test and LRT performed after passive sensitization had an excellent sensitivity only for specific IgE levels ranging between 3.5 and 35 KU/L.

CONCLUSION

The present study shows that allergen-induced LTC4 release and anti-IgE, antiCD63 bicolor flow cytometric analysis of basophil activation may be used for food allergy diagnosis. Both tests have a good sensitivity and specificity. Basophil activation test and LRT are more efficient than histamine release test in case of high spontaneous histamine release, frequently observed in case of food allergy.

Comparison of inflammatory events during developing immunoglobulin E-mediated late-phase reactions and delayed-hypersensitivity reactions

To compare cellular and mediator responses in early developing late-phase skin reactions (LPR) and delayed-hypersensitivity (DH) reactions in the same subjects, responses in skin chambers overlying sites of challenge with pollen antigen and Candida albicans antigens were compared in six humans with demonstrated prominent LPR and DH responses. Histamine levels in overlying chamber fluids at 1 h were much higher at LPR than at DH sites (P = 0.002). After the next 4 h, leukocyte exudation was higher at LPR than at DH sites (P = 0.005). Most leukocytes were activated neutrophils with greater frequency of superoxide-secreting cells and released lactoferrin at LPR than at DH sites (P = 0.01 and P = 0.02, respectively). The frequency of exuding eosinophils was higher, but not significantly so (P = 0.5), at LPR sites. Although significantly more eosinophils at LPR sites were activated (P = 0.02), the levels of released eosinophilic cationic protein were not significantly higher at LPR sites (P = 0.09). The levels of interleukin-8 (IL-8), but not IL-6, were greater at LPR than at DH sites. During the first 5 h of challenge there was greater mast cell activation and subsequent exudation of activated neutrophils at sites of developing LPR than at DH sites, possibly related to greater local IL-8 levels. The frequency of activated eosinophils was also greater at LPR sites. These different initial inflammatory responses could play a role in determining expression of LPR or DH reactions.

Cytokine levels and inflammatory responses in developing late-phase allergic reactions in the skin

BACKGROUND

Cytokines could play roles in the attraction of leukocytes into sites of IgE-mediated late-phase reactions (LPR) or in the activation of such cells at the sites. Previous studies found increased release of IL-6, IL-1, and granulocyte-macrophage colony-stimulating factor into skin chambers overlying allergen-challenged sites, mainly after 6 hours when LPR are already well-developed.

OBJECTIVE

To compare levels of several cytokines with inflammatory responses in skin chambers overlying developing LPRs.

METHODS

Skin chambers were appended to denuded blister bases in 15 sensitive subjects, then challenged over a 5-hour period with pollen allergens (Ag) or buffer control (B). Levels of several chemotactic cytokines, eosinophil cationic product (released from eosinophils), and lactoferrin (released from neutrophils) were measured and leukocyte accumulation was assessed.

RESULTS

Levels of the chemokines IL-8, RANTES, and monocyte chemotactic protein-1 (but not IL-1, IL-6, or granulocyte-macrophage colony-stimulating factor) were significantly higher at Ag-challenge sites than at B-challenge sites. IL-5 was not detected. In individual chamber fluids at Ag-challenge sites, (1) IL-8 levels correlated strongly with levels of lactoferrin but not with eosinophil cationic protein levels; (2) RANTES levels correlated with numbers of eosinophils but not with eosinophil cationic protein levels; and (3) levels of monocyte chemotactic protein-1 correlated weakly with histamine released after the first hour.

CONCLUSIONS

During LPRs developing during the first 5 hours of Ag challenge, there is increased local release of several chemokines, which could play roles in the observed attraction and subsequent activation of leukocytes and continued histamine release observed at such sites.

Histamine-releasing activity in supernatants of mononuclear cells: contribution of monocyte chemotactic protein-1 activity compared with IgE-dependent activity

BACKGROUND

Supernatants of cultured human mononuclear cells contain factors that induce histamine release from basophils. Some of the histamine-releasing factors present are IgE-independent, but an IgE-dependent form has also been described. The IgE that does respond to the IgE-dependent histamine-releasing factor was defined as IgE+.

OBJECTIVE

This study was conducted to analyze the contribution of chemokines, such as monocyte chemotactic protein-1 (IgE-independent), to improve the detection of IgE-dependent histamine-releasing factor.

METHODS

Supernatants were prepared from mononuclear cells of three subjects. Monocyte chemotactic protein-1 content and histamine-releasing activity (HRA) were measured. Depletion of chemokine activity was carried out with heparin-Sepharose (Pharmacia, Uppasala, Sweden).

RESULTS

Replacing IgE- on basophils with IgE+ serum decreased the correlation between monocyte chemotactic protein-1 and histamine release (rho = 0.80, n = 280 vs p = 0.12, n = 18; p for difference between p values; < 0.05). After depletion of chemokines in three supernatants derived from mononuclear cells, IgE-dependent HRA was still present.

CONCLUSION

We conclude that in supernatants derived from mononuclear cells, the IgE-independent HRA masks the IgE-dependent HRA. The latter can be more clearly detected after depletion of chemokine activity with heparin-Sepharose.

Histamine release in intact human skin by monocyte chemoattractant factor-1, RANTES, macrophage inflammatory protein-1 alpha, stem cell factor, anti-IgE, and codeine as determined by an ex vivo skin microdialysis technique

BACKGROUND

The chemokines monocyte chemoattractant factor-1, RANTES, and macrophage inflammatory protein-1 alpha release histamine from human basophils, as well as rat and mouse mast cells. The purpose of this investigation was to determine whether these chemokines release histamine from human skin mast cells in situ.

METHODS

A microdialysis technique was used to measure histamine release in skin. First, the model was validated by using anti-IgE, codeine, and stem cell factor (SCF); then the histamine-releasing effects of the chemokines were investigated. A total of 47 skin specimens from 41 donors were investigated. Hollow microdialysis fibers were inserted intradermally, and each fiber was slowly perfused (3 microliters/min). Anti-IgE, codeine, SCF, or chemokines were injected intradermally above individual fibers, and dialysate was collected at 2-minute intervals for 20 minutes. Each series of investigations comprised five to eight single experiments.

RESULTS

Anti-IgE (4 to 4000 U/ml), codeine (0.001 to 1 mg/ml), and SCF (5.4 x (10(-11) to 10(-8) mol/L)) released histamine in a dose-dependent manner; maximum histamine release was 97.4, 116.3, and 9.5 pmol/20 min, respectively. Monocyte chemoattractant factor-1, RANTES, and macrophage inflammatory protein-1 alpha in concentrations of 10(-10) to 10(-6) mol/L did not release histamine; histamine release by 10(-6) mol/L chemokine was less than 0.2 pmol/20 min. None of the chemokines modulated anti-IgE-induced histamine release. In contrast, SCF significantly potentiated anti-IgE-induced histamine release by 33%. All chemokines, but not SCF, released histamine from human basophils.

CONCLUSION

We conclude that the chemokines monocyte chemoattractant factor-1, RANTES, and macrophage inflammatory protein-1 alpha do not release histamine from human skin mast cells.

Chemokines in seasonal allergic rhinitis

Monocyte chemotactic and activating factor/monocyte chemoattractant protein-1 (MCAF/MCP-1), RANTES, and macrophage inflammatory protein (MIP)-1 alpha are chemokines known to activate basophils (MCAF/RANTES) and eosinophils (RANTES/MIP-1 alpha). IL-8 inhibits MCAF-induced histamine release from basophils. We questioned whether a relationship exists between the levels of these chemokines and various inflammatory mediators released from mast cells, eosinophils, and basophils as assessed in nasal secretions obtained from patients during the allergy season and out of season. Samples were assessed for MCAF/MCP-1, RANTES, MIP-1 alpha, IL-8, histamine, tryptase and eosinophil cationic protein (ECP) in three subject groups: subjects with allergic rhinitis (n = 18), atopic subjects without rhinitis (n = 9), and healthy individuals (n = 6). Statistically significant differences were apparent only in the subjects with symptoms as follows. MCAF/MCP-1 increased during the season from 336 +/- 47 pg/ml to 829 +/- 137 pg/ml (p < 0.001), whereas IL-8 decreased from a baseline of 1932 +/- 335 pg/ml to 1070 +/- 202 pg/ml (p < 0.028). The ratio of IL-8 to MCAF/MCP-1 decreased during the symptomatic season from the baseline of 6.66 +/- 1.06 seen during winter to 1.3 +/- 0.22 during ragweed season (p < 0.001). Histamine increased from 6.3 +/- 1.5 to 89 +/- 15.5 ng/ml (p < 0.001), ECP increased from 20.6 +/- 6.4 to 237.1 +/- 50.2 ng/ml (p < 0.001), and tryptase increased from 2.34 +/- 0.6 to 9.7 +/- 2.3 U/ml (p < 0.001). Most samples did not have detectable quantities of MIP-1 alpha or RANTES. We also found a correlation between the level of MCAF/MCP-1 and IL-8 and the level of histamine or IL-8 and ECP. Our results suggest that the chemokines MCAF/MCP-1 and IL-8 may participate in the pathogenesis of allergic rhinitis, contributing to the attraction of the proinflammatory cells and mediator release, which might be very important during the late phase of the allergic reaction. Furthermore, the ratio of certain chemokines, such as MCAF/MCP-1 and IL-8 may reflect the magnitude of the reaction, as does the presence of histamine and ECP.

Airway basophil and mast cell density in patients with bronchial asthma: relationship to bronchial hyperresponsiveness

We investigated the role of basophils and mast cells in the pathogenesis of bronchial asthma. Eight asthmatics (6 atopic, 2 nonatopic) and 6 control subjects were enrolled in this study. Bronchial responsiveness to acetylcholine (PC20ACh) was measured in asthmatics and endobronchial biopsy from right upper lobe bronchus was performed on the same day. Basophils and mast cells in the airways were identified by immunohistochemistry using a monoclonal antibody against tryptase and anti-IgE. The number of basophils of asthmatics was 52.2 +/- 12.5/mm(2). In contrast, no basophils were found in the airways of control subjects. There was a significant increase of number of mast cells in the asthma group compared to the control group (168.6 +/- 32.6 vs. 22.3 +/- 6.1, p<0.01). There was an inverse correlation between airway basophil and mast cell numbers and PC20ACh (r=-0.82, r=0.72, p<0.05). These findings suggest a possible role for basophils and mast cells in the pathophysiology of asthma.

Effects of PBMC-derived histamine-releasing factors on histamine release from human skin and lung mast cells

BACKGROUND

A field of study which has attracted much recent interest is the ability of mononuclear cells and neutrophils to interact with histamine releasing cells by production of specific histamine releasing factors (HRFs). However, almost all of these studies have been performed on basophils rather than human mast cells.

OBJECTIVE

We have investigated the effects of lyophilized fractions of HRF preparations on histamine release from human skin and lung mast cells.

METHODS

Lyophilized fractions of HRF preparations include crude supernatant from mononuclear cell/platelet (crude), void peak from anion exchange chromatography column (void), second peak from anion exchange chromatography (peak 2), neutrophil-activating peptide-2 (NAP-2), which was purified from void peak at molecular weight of 8-12 kDa, and monocyte chemotactic-activating factor (MCAF). Mast cells were enzymatically dispersed.

RESULTS

Crude (24.2 micrograms/mL-2.42 mg/mL), void (5.4 micrograms/mL-0.54 mg/mL), peak 2 (3.5 micrograms/mL-0.35 mg/mL), and NAP-2 (1-20 micrograms/mL) failed to release histamine from lung mast cells. In skin mast cells, only higher concentrations of crude and void caused minimal release of histamine. MCAF up to micromolar concentrations failed to have an effect on mast cells from either source. However, these HRFs induced histamine release from human basophils. We also explored whether HRFs and stem cell factor could act as either priming agents for each other or for anti-IgE. The response of skin mast cells to all these preparations was not enhanced by preincubation in stem cell factor at 1 ng/mL, nor did the HRFs and MCAF enhance the response of skin mast cells to anti-IgE.

CONCLUSION

These results suggest that these HRFs have no significant effect on dispersed human cutaneous and lung mast cells.