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Pan Y, Hochgerner M, Cichoń MA, Benezeder T, Bieber T, Wolf P. Langerhans cells: Central players in the pathophysiology of atopic dermatitis. J Eur Acad Dermatol Venereol 2024. [PMID: 39157943 DOI: 10.1111/jdv.20291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Accepted: 07/21/2024] [Indexed: 08/20/2024]
Abstract
Atopic dermatitis (AD) is the most common chronic inflammatory skin disease worldwide. AD is a highly complex disease with different subtypes. Many elements of AD pathophysiology have been described, but if/how they interact with each other or which mechanisms are important in which patients is still unclear. Langerhans cells (LCs) are antigen-presenting cells (APCs) in the epidermis. Depending on the context, they can act either pro- or anti-inflammatory. Many different studies have investigated LCs in the context of AD and found them to be connected to all major mechanisms of AD pathophysiology. As APCs, LCs recruit other immune cells and shape the immune response, especially adaptive immunity via polarization of T cells. As sentinel cells, LCs are primary sensors of the skin microbiome and are important for the decision of immunity versus tolerance. LCs are also involved with the integrity of the skin barrier by influencing tight junctions. Finally, LCs are important cells in the neuro-immune crosstalk in the skin. In this review, we provide an overview about the many different roles of LCs in AD. Understanding LCs might bring us closer to a more complete understanding of this highly complex disease. Potentially, modulating LCs might offer new options for targeted therapies for AD patients.
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Affiliation(s)
- Yi Pan
- Department of Dermatology and Allergy, University Hospital of Bonn, Bonn, Germany
- Department of Dermatology and Venerology, Medical University of Graz, Graz, Austria
| | - Mathias Hochgerner
- Greater Bay Area Institute of Precision Medicine (Guangzhou), School of Life Sciences, Fudan University, Shanghai, China
| | | | - Theresa Benezeder
- Department of Dermatology and Venerology, Medical University of Graz, Graz, Austria
| | - Thomas Bieber
- Department of Dermatology and Allergy, University Hospital of Bonn, Bonn, Germany
- CK-CARE, Medicine Campus, Davos, Switzerland
- Department of Dermatology, University Hospital of Zürich, Zürich, Switzerland
| | - Peter Wolf
- Department of Dermatology and Venerology, Medical University of Graz, Graz, Austria
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Zhang X, Wu G, Ma X, Cheng L. Immune Cell Alterations and PI3K-PKB Pathway Suppression in Patients with Allergic Rhinitis Undergoing Sublingual Immunotherapy. Adv Ther 2024; 41:777-791. [PMID: 38169061 DOI: 10.1007/s12325-023-02747-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Accepted: 11/20/2023] [Indexed: 01/05/2024]
Abstract
INTRODUCTION Our prior clinical study assessed the efficacy and safety of sublingual immunotherapy (SLIT) with standardized Dermatophagoides farina drops on patients with allergic rhinitis (AR) while analyzing the characteristics of adverse reactions. This study was conducted to evaluate the immune cell composition alterations in AR patients before and after SLIT, and to comprehensively investigate the role and changes of antigen-specific immune cells associated with treatment efficacy. METHODS A total of 68 AR patients who completed 12 months of SLIT were included in the study. Before the trial's initiation and after 1 year of SLIT, 10 ml of venous blood was collected. Peripheral blood mononuclear cells were isolated using the Ficoll gradient method. The mRNA transcriptome was analyzed using an Affymetrix microarray. The proportions of 22 immune cell types were calculated via the CIBERSORTx platform. Correlations between each immune cell type and SLIT were analyzed. PI3K-PKB pathway dysregulation were analyzed using quantitative PCR and Western blot. Flow cytometry was utilized to assess the percentages of Th1 and Th2 cells. RESULTS Mono-sensitized AR patients exhibited marked increases in plasma cells, activated memory T cells, regulatory T cells, and activated dendritic cells, while experiencing decreased neutrophils and resting dendritic cells. In poly-sensitized AR patients, the most notable change was an increase in regulatory T cells, coupled with decreased T follicular helper cells, resting dendritic cells, and activated mast cells. These findings indicated that SLIT reshaped immune cell profiles in AR patients, and, notably, the specific changes differed between mono-sensitized and poly-sensitized individuals. Furthermore, SLIT appeared to shift the immune response towards a Th2 decrease profile in both groups. Importantly, suppression of the PI3K-PKB pathway was evidenced as inhibition of PKB phosphorylation and the decrease of glycogen synthase kinase 3 β (GSKβ) and mammalian target of rapamycin (mTOR) expression after SLIT. CONCLUSION Our study has demonstrated that SLIT treatment led to distinct changes in immune cell profiles between mono-sensitized and poly-sensitized AR patients. Furthermore, SLIT appeared to reduce a Th2 immune response, highlighting its efficacy in AR treatment. Importantly, the study revealed the suppression of the PI3K-PKB pathway, shedding light on the immunological mechanisms underlying SLIT's effectiveness.
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Affiliation(s)
- Xinxin Zhang
- Department of Otolaryngology, Zhangjiagang Hospital Affiliated to Soochow University, Suzhou, 215600, China
| | - Geping Wu
- Department of Otolaryngology, Zhangjiagang Hospital Affiliated to Soochow University, Suzhou, 215600, China.
| | - Xingkai Ma
- Department of Otolaryngology, Zhangjiagang Hospital Affiliated to Soochow University, Suzhou, 215600, China
| | - Lei Cheng
- Department of Otorhinolaryngology and Clinical Allergy Center, The First Affiliated Hospital, Nanjing Medical University, Nanjing, 210029, China.
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Lombardo N, Della Corte M, Pelaia C, Piazzetta G, Lobello N, Del Duca E, Bennardo L, Nisticò SP. Primary Mucosal Melanoma Presenting with a Unilateral Nasal Obstruction of the Left Inferior Turbinate. ACTA ACUST UNITED AC 2021; 57:medicina57040359. [PMID: 33917690 PMCID: PMC8067990 DOI: 10.3390/medicina57040359] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 03/31/2021] [Accepted: 04/06/2021] [Indexed: 12/11/2022]
Abstract
We report the case of a primitive nasal melanoma in an 82-year-old patient, showing how this rare malignancy, with non-specific signs and symptoms, can represent a challenging diagnosis for the physician. A 82-year-old Caucasian patient presented for unilateral nasal obstruction and occasional epistaxis. Computerized tomography (CT) and magnetic resonance imaging (MRI) of the facial massif revealed turbinate hypertrophy and a polypoid phlogistic tissue isointense in T1 with an intermediate signal in T2 and Short-TI Inversion Recovery (STIR)-T2, occupying the middle meatus and the anterior upper and lower left meatus with partial obliteration of the ostium and the infundibulum of the maxillary sinus. The Positron emission tomography (PET) exam was negative for metastases. Conservatory surgery in the left anterior video rhinoscopy was performed, allowing a radical 4-cm tumor excision. Histology reported epithelioid cell melanoma, PanK−, CD45−, and PanMelanoma+. Adjuvant radiotherapy was suggested, even considering a complete resection as the result of surgery. No local or systemic relapse was noticed at the 2-month follow-up visit. Although mucosal melanoma is a rare and aggressive malignancy characterized by a poor prognosis, early diagnosis allows a more conservative approach, with little surgical difficulty and no aesthetic effect. Our case raises awareness of the importance of early intervention even in those cases where the clinic symptoms and diagnostic images show uncertain severity.
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Affiliation(s)
- Nicola Lombardo
- Department of Medical and Surgical Sciences, University “Magna Graecia” of Catanzaro, 88100 Catanzaro, Italy; (N.L.); (M.D.C.); (G.P.); (N.L.)
| | - Marcello Della Corte
- Department of Medical and Surgical Sciences, University “Magna Graecia” of Catanzaro, 88100 Catanzaro, Italy; (N.L.); (M.D.C.); (G.P.); (N.L.)
| | - Corrado Pelaia
- Department of Health Sciences, University “Magna Graecia” of Catanzaro, 88100 Catanzaro, Italy; (C.P.); (E.D.D.); (S.P.N.)
| | - Giovanna Piazzetta
- Department of Medical and Surgical Sciences, University “Magna Graecia” of Catanzaro, 88100 Catanzaro, Italy; (N.L.); (M.D.C.); (G.P.); (N.L.)
| | - Nadia Lobello
- Department of Medical and Surgical Sciences, University “Magna Graecia” of Catanzaro, 88100 Catanzaro, Italy; (N.L.); (M.D.C.); (G.P.); (N.L.)
| | - Ester Del Duca
- Department of Health Sciences, University “Magna Graecia” of Catanzaro, 88100 Catanzaro, Italy; (C.P.); (E.D.D.); (S.P.N.)
| | - Luigi Bennardo
- Department of Health Sciences, University “Magna Graecia” of Catanzaro, 88100 Catanzaro, Italy; (C.P.); (E.D.D.); (S.P.N.)
- Correspondence: ; Tel.: +39-0961-3647-195
| | - Steven Paul Nisticò
- Department of Health Sciences, University “Magna Graecia” of Catanzaro, 88100 Catanzaro, Italy; (C.P.); (E.D.D.); (S.P.N.)
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Novel Concepts: Langerhans Cells in the Tumour Microenvironment. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1273:147-158. [PMID: 33119880 DOI: 10.1007/978-3-030-49270-0_8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/12/2023]
Abstract
Langerhans cells (LCs) are immune cells that reside in the stratified epithelium of the skin and mucosal membranes. They play a range of roles in the skin, including antigen presentation and maintenance of peripheral tolerance. Reports of LC numbers have been variable in different cancer types, with the majority of studies indicating a reduction in their number. Changes in the cytokine profile and other secreted molecules, downregulation of surface molecules on cells and hypoxia all contribute to the regulation of LCs in the tumour microenvironment. Functionally, LCs have been reported to regulate immunity and carcinogenesis in different cancer types. An improved understanding of the function and biology of LCs in tumours is essential knowledge that underpins the development of new cancer immunotherapies.
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Narasimhan PB, Marcovecchio P, Hamers AA, Hedrick CC. Nonclassical Monocytes in Health and Disease. Annu Rev Immunol 2019; 37:439-456. [DOI: 10.1146/annurev-immunol-042617-053119] [Citation(s) in RCA: 164] [Impact Index Per Article: 32.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Monocytes are innate blood cells that maintain vascular homeostasis and are early responders to pathogens in acute infections. There are three well-characterized classes of monocytes: classical (CD14+CD16−in humans and Ly6Chiin mice), intermediate (CD14+CD16+in humans and Ly6C+Treml4+in mice), and nonclassical (CD14−CD16+in humans and Ly6Cloin mice). Classical monocytes are critical for the initial inflammatory response. Classical monocytes can differentiate into macrophages in tissue and can contribute to chronic disease. Nonclassical monocytes have been widely viewed as anti-inflammatory, as they maintain vascular homeostasis. They are a first line of defense in recognition and clearance of pathogens. However, their roles in chronic disease are less clear. They have been shown to be protective as well as positively associated with disease burden. This review focuses on the state of the monocyte biology field and the functions of monocytes, particularly nonclassical monocytes, in health and disease.
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Affiliation(s)
- Prakash Babu Narasimhan
- Division of Inflammation Biology, La Jolla Institute for Allergy and Immunology, La Jolla, California 92037, USA;, , ,
| | - Paola Marcovecchio
- Division of Inflammation Biology, La Jolla Institute for Allergy and Immunology, La Jolla, California 92037, USA;, , ,
| | - Anouk A.J. Hamers
- Division of Inflammation Biology, La Jolla Institute for Allergy and Immunology, La Jolla, California 92037, USA;, , ,
| | - Catherine C. Hedrick
- Division of Inflammation Biology, La Jolla Institute for Allergy and Immunology, La Jolla, California 92037, USA;, , ,
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Sakurai D, Uchida R, Ihara F, Kunii N, Nakagawa T, Chazono H, Hanazawa T, Motohashi S, Okamoto Y. Immunosuppressive property of submandibular lymph nodes in patients with head and neck tumors: differential distribution of regulatory T cells. BMC Res Notes 2018; 11:479. [PMID: 30012191 PMCID: PMC6048882 DOI: 10.1186/s13104-018-3587-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Accepted: 07/10/2018] [Indexed: 12/26/2022] Open
Abstract
Objective Different sensitizations and immune responses are thought to be induced in response to antigens at different mucosal sites between the oral floor and nose. The aim of this study was to investigate differences in the distributions of lymphocyte subsets in the submandibular (SM) and upper jugular (UJ) lymph nodes (LNs), which are supposed to be regional LNs of the oral floor and nasal mucosa, respectively. SMLNs and UJLNs were collected from patients with head and neck tumors who underwent surgical resection. The populations of T cells, Natural Killer (NK) cells, Natural Killer T (NKT) cells, regulatory T cells (Tregs) and dendritic cells (DCs) in LNs without metastasis were analyzed by flow cytometry. The high-affinity IgE receptor (FcεRI) expression of LN cells were also evaluated. Results The proportions of CD4+CD25+Foxp3+ Tregs, CD4+CD45RA−Foxp3high effector Tregs and FcεRIα+CD33+CD11c+ DCs were significantly larger in SMLNs compared with UJLNs, while those of CD3+ T cells, CD3−CD56+ NK cells, CD3+Vα24+Vβ11+ NKT cells, and CD123+CD303+ DCs did not show any significant differences between SMLNs and UJLNs. The differential distributions of CD4+CD25+Foxp3+ Tregs were observed regardless of tumor region, LN metastasis and clinical staging. These data indicate that SMLNs may have immunosuppressive properties compared with UJLNs. Electronic supplementary material The online version of this article (10.1186/s13104-018-3587-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Daiju Sakurai
- Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan
| | - Ryosuke Uchida
- Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan
| | - Fumie Ihara
- Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan.,Department of Medical Immunology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan
| | - Naoki Kunii
- Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan
| | - Takuya Nakagawa
- Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan
| | - Hideaki Chazono
- Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan
| | - Toyoyuki Hanazawa
- Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan
| | - Shinichiro Motohashi
- Department of Medical Immunology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan
| | - Yoshitaka Okamoto
- Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan.
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Chaker AM. [Biologics in Rhinology - Forthcoming Personalized Concepts: the Future Starts Today]. Laryngorhinootologie 2018; 97:S142-S184. [PMID: 29905356 PMCID: PMC6541111 DOI: 10.1055/s-0043-123484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Sinunasale Erkrankungen zählen mit zu den häufigsten chronischen Erkrankungen und führen zu einer erheblichen Störung der Lebensqualität, ein komorbides Asthma ist häufig. Trotz leitliniengerechter Therapie ist anzunehmen, dass mind. 20% der Patienten ihre Erkrankungssymptome nicht adäquat kontrollieren können. Neben den etablierten chirurgischen und konservativen Therapieoptionen finden sich nun vielversprechende Therapieansätze, die bspw. mittels therapeutischer Antikörper mechanistisch gezielt in die Pathophysiologie der Erkrankungen eingreifen können. Die Auswahl der geeigneten Patienten durch geeignete Biomarker und die richtige Therapie zum richtigen Stadium der Erkrankung anbieten zu können, ist das Ziel stratifizierter Medizin und eine wichtige Perspektive für die HNO.Chronic diseases of the nose and the paranasal sinuses are most common, frequently associated with bronchial asthma, and result in substantial reduction of quality of life. Despite optimal treatment according to guidelines, approx. 20 % of the patients will report inadequate control of symptoms. Apart from well established surgical and conservative approaches in therapy new therapeutic antibodies are available that aim specifically pathophysiological targets. The optimal allocation of effective therapy for patients using appropriate biomarkers at the most suitable timepoint is the hallmark of stratified medicine and an important perspective in ENT.
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Affiliation(s)
- Adam M. Chaker
- Klinik für Hals-Nasen-Ohrenheilkunde und Zentrum für Allergie und Umwelt, Klinikum rechts der Isar, Technische Universität München
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Coronel R, Jesus DM, Dalle Ore L, Mymryk JS, Hertel L. Activation of Langerhans-Type Dendritic Cells Alters Human Cytomegalovirus Infection and Reactivation in a Stimulus-Dependent Manner. Front Microbiol 2016; 7:1445. [PMID: 27683575 PMCID: PMC5021960 DOI: 10.3389/fmicb.2016.01445] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Accepted: 08/30/2016] [Indexed: 12/18/2022] Open
Abstract
Oral mucosal Langerhans cells (LC) are likely to play important roles in host defense against infection by human cytomegalovirus (CMV). We previously showed that in vitro-differentiated immature LC (iLC) populations contain smaller amounts of infected cells but produce higher yields than mature LC (mLC) cultures, obtained by iLC stimulation with fetal bovine serum (FBS), CD40 ligand (CD40L) and lipopolysaccharide (LPS). Here, we sought to determine if exposure to select stimuli can improve LC permissiveness to infection, if specific components of the mLC cocktail are responsible for lowering viral yields, if this is due to defects in progeny production or release, and if these restrictions are also effective against reactivated virus. None of the stimuli tested extended the proportion of infected cells to 100%, suggesting that the block to infection onset cannot be fully removed. While CD40L and FBS exerted positive effects on viral progeny production per cell, stimulation with LPS alone or in combination with CD40L was detrimental. Reductions in viral titers were not due to defects in progeny release, and the permissive or restrictive intracellular environment established upon exposure to each stimulus appeared to act in a somewhat similar way toward lytic and latent infections.
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Affiliation(s)
- Roxanne Coronel
- Center for Immunobiology and Vaccine Development, Children's Hospital Oakland Research Institute Oakland, CA, USA
| | - Desyree M Jesus
- Center for Immunobiology and Vaccine Development, Children's Hospital Oakland Research Institute Oakland, CA, USA
| | - Lucia Dalle Ore
- Center for Immunobiology and Vaccine Development, Children's Hospital Oakland Research Institute Oakland, CA, USA
| | - Joe S Mymryk
- Department of Microbiology and Immunology and Department of Oncology, The University of Western Ontario London, ON, Canada
| | - Laura Hertel
- Center for Immunobiology and Vaccine Development, Children's Hospital Oakland Research Institute Oakland, CA, USA
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Dutzan N, Konkel JE, Greenwell-Wild T, Moutsopoulos NM. Characterization of the human immune cell network at the gingival barrier. Mucosal Immunol 2016; 9:1163-1172. [PMID: 26732676 PMCID: PMC4820049 DOI: 10.1038/mi.2015.136] [Citation(s) in RCA: 201] [Impact Index Per Article: 25.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Accepted: 11/20/2015] [Indexed: 02/04/2023]
Abstract
The oral mucosa is a barrier site constantly exposed to rich and diverse commensal microbial communities, yet little is known of the immune cell network maintaining immune homeostasis at this interface. We have performed a detailed characterization of the immune cell subsets of the oral cavity in a large cohort of healthy subjects. We focused our characterization on the gingival interface, a particularly vulnerable mucosal site, with thin epithelial lining and constant exposure to the tooth adherent biofilm. In health, we find a predominance of T cells, minimal B cells, a large presence of granulocytes/neutrophils, a sophisticated network of professional antigen-presenting cells (APCs), and a small population of innate lymphoid cells (ILCs) policing the gingival barrier. We further characterize cellular subtypes in health and interrogate shifts in immune cell populations in the common oral inflammatory disease periodontitis. In disease, we document an increase in neutrophils and an upregulation of interleukin-17 (IL-17) responses. We identify the main source of IL-17 in health and Periodontitis within the CD4(+) T-cell compartment. Collectively, our studies provide a first view of the landscape of physiologic oral immunity and serve as a baseline for the characterization of local immunopathology.
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Affiliation(s)
- Nicolas Dutzan
- Oral Immunity and Inflammation Unit, NIDCR, NIH, Bethesda, MD, USA
| | - Joanne E. Konkel
- Manchester Immunology Group, Faculty of Life Sciences, University of Manchester, Manchester, UK
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Reinartz SM, van Tongeren J, van Egmond D, de Groot EJJ, Fokkens WJ, van Drunen CM. Dendritic Cell Subsets in Oral Mucosa of Allergic and Healthy Subjects. PLoS One 2016; 11:e0154409. [PMID: 27166951 PMCID: PMC4864364 DOI: 10.1371/journal.pone.0154409] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Accepted: 03/24/2016] [Indexed: 12/24/2022] Open
Abstract
Immunohistochemistry was used to identify, enumerate, and describe the tissue distribution of Langerhans type (CD1a and CD207), myeloid (CD1c and CD141), and plasmacytoid (CD303 and CD304) dendritic cell subsets in oral mucosa of allergic and non-allergic individuals. Allergic individuals have more CD141+ myeloid cells in epithelium and more CD1a+ Langerhans cells in the lamina propria compared to healthy controls, but similar numbers for the other DC subtypes. Our data are the first to describe the presence of CD303+ plasmacytoid DCs in human oral mucosa and a dense intraepithelial network of CD141+ DCs. The number of Langerhans type DCs (CD1a and CD207) and myeloid DCs (CD1c), was higher in the oral mucosa than in the nasal mucosa of the same individual independent of the atopic status.
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Affiliation(s)
- Susanne M. Reinartz
- Department of Otorhinolaryngology, Academic Medical Center, Amsterdam, the Netherlands
| | - Joost van Tongeren
- Department of Otorhinolaryngology, Academic Medical Center, Amsterdam, the Netherlands
- * E-mail:
| | - Danielle van Egmond
- Department of Otorhinolaryngology, Academic Medical Center, Amsterdam, the Netherlands
| | - Esther J. J. de Groot
- Department of Otorhinolaryngology, Academic Medical Center, Amsterdam, the Netherlands
| | - Wytske J. Fokkens
- Department of Otorhinolaryngology, Academic Medical Center, Amsterdam, the Netherlands
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Abstract
Allergen immunotherapy with whole proteins is clinically efficacious but requires a protracted treatment period because of frequent allergic adverse events. A combination of duration of treatment and adverse events leads to poor compliance. Short synthetic peptides containing the major immunodominant T cell epitopes of allergenic proteins have been shown to reduce IgE cross-linking ability, thereby leading to fewer allergic adverse events following their administration to patients with allergies. Peptide immunotherapy has been shown to result in clinically meaningful efficacy in several Phase II, randomized, double-blind, placebo-controlled clinical trials. Exactly how peptide immunotherapy achieves its efficacy remains incompletely understood, but the mechanisms are thought to include immune deviation and induction of regulatory T cells capable of suppressing allergen-specific immune responses. Limited data are available on the effects of peptide therapy on humoral immune responses. Induction of allergen-specific IgG has been observed after peptide therapy, but the levels of antibody induced were much lower than generally seen with the utilization of whole allergen approaches. Thus, the immunological mechanisms of peptide immunotherapy appear to overlap, although not completely, with those seen in whole allergen therapy. Further studies are required to fully elucidate mechanisms of action.
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Dynamics of Human Cytomegalovirus Infection in CD34+ Hematopoietic Cells and Derived Langerhans-Type Dendritic Cells. J Virol 2015; 89:5615-32. [PMID: 25762731 DOI: 10.1128/jvi.00305-15] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2015] [Accepted: 03/02/2015] [Indexed: 12/13/2022] Open
Abstract
UNLABELLED Acquisition of human cytomegalovirus (CMV) usually occurs by contact between contaminated bodily fluids, such as urine and saliva, and host mucosal cells. Langerhans-type dendritic cells (LC) are the only type of immune cells found in the outermost layers of the oral mucosae, where they not only provide a first line of defense against CMV but can easily be targeted by orally administered vaccines, while their bone marrow resident progenitors are important sites of virus latency. In this work, we tracked the progress of infection in CD34(+) progenitor cells, immature LC (iLC), and mature LC (mLC) exposed to the clinical-like strain TB40-BAC4 or to the vaccine strain AD169varATCC, prior to their long-term maintenance under either immature or mature conditions. We show that the genomes of both strains are efficiently maintained in CD34(+) cells during their differentiation into iLC, although this requires the presence of larger amounts of input AD169varATCC DNA. Lipopolysaccharide- and CD40 ligand-induced maturation of iLC derived from latently infected progenitors was not associated with robust viral genome replication and progeny production, while maturation of directly infected iLC increased and prolonged expression of the viral immediate early proteins. While effective replication of viral genomes from both strains occurred only in mLC, both iLC and mLC produced viral progeny, suggesting that both types of LC may contribute to CMV horizontal transmission in vivo. IMPORTANCE Human CMV is usually acquired via the oral and nasal mucosae. Langerhans-type dendritic cells (LC) are the only type of immune cells found in the outermost layers of these tissues. Understanding how CMV interacts with LC and their hematopoietic progenitors is thus essential to develop innovative means of defense against this virus. Here we show that the genomes of a virulent and an attenuated strain of CMV are maintained in hematopoietic progenitor cells during their differentiation into immature LC and that maturation of these cells by exposure to lipopolysaccharide and CD40 ligand is not sufficient to trigger virus reactivation. While the extents of viral protein expression and genome replication were broadest in directly infected mature LC populations, similar amounts of viral progeny were detected in the supernatants of immature and mature LC, suggesting that these immune cells of the oral mucosa are likely to be important for CMV transmission within the human population.
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The role of FcεRI expressed in dendritic cells and monocytes. Cell Mol Life Sci 2015; 72:2349-60. [PMID: 25715742 DOI: 10.1007/s00018-015-1870-x] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Revised: 02/17/2015] [Accepted: 02/20/2015] [Indexed: 01/23/2023]
Abstract
Early studies regarding the function of FcεRI in dendritic cells (DCs) and monocytes have focused on its role in mediating inflammatory signaling and enhancing T cell immunity. It has been the case in part because FcεRI is the major receptor that mediates allergic inflammatory signaling in mast cells and basophils and because DCs and monocytes are antigen presenting cells capable of activating naïve and/or effector T cells. These studies have led to the general belief that FcεRI-mediated DC signaling and antigen presentation promote development and activation of Th2 cells and contribute to allergic inflammatory diseases. However, this belief has long suffered from a lack of evidence. Recently, studies have emerged that provide evidence supporting an opposing role: that FcεRI on DCs instead promotes immune homeostasis and regulation. In this review, we will update the current status of our understanding of FcεRI biology and function, with a specific focus on DCs and monocytes.
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15
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Bahceciler NN, Babayigit Hocaoglu A, Galip N. A milestone in house dust-mite-allergen immunotherapy: the new sublingual tablet S-524101 (actair). Expert Rev Vaccines 2014; 13:1427-38. [PMID: 25345538 DOI: 10.1586/14760584.2014.972949] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Subcutaneous allergen-specific immunotherapy has long been used in the treatment of allergic rhinitis and/or asthma and its efficacy has been confirmed. However, due to the discomfort of injections and the risk of severe adverse reactions, alternative routes of allergen administration have emerged. Delivery of allergens through the mucosal route had been proposed and investigated thoroughly, confirming the sublingual route to be the most efficacious. Later, the efficacy and safety of this route have been documented by numerous controlled trials both for house dust mite (HDM) and pollens. Recently, sublingual orodispersable grass pollen allergen tablets were in use followed by the newly developed HDM allergen tablets with satisfactory clinical results: Moreover, very recently 1 year of HDM tablet treatment was demonstrated to exert its clinical efficacy 1 year after discontinuation of tablet IT. The persistence of efficacy after only 1 year of treatment is a new and promising era. Currently, Sublingual Immunotherapy is the most easily administered and safe treatment option until more immunogenic, less allergenic and more efficient allergen extracts are developed.
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Affiliation(s)
- Nerin N Bahceciler
- Department of Pediatrics, Division of Allergy and Clinical Immunology, Nicosia, North Cyprus, Turkey
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16
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Tsurikisawa N, Saito H, Oshikata C, Tsuburai T, Ishiyama M, Mitomi H, Akiyama K. An increase of CD83+ dendritic cells ex vivo correlates with increased regulatory T cells in patients with active eosinophilic granulomatosis and polyangiitis. BMC Immunol 2014; 15:32. [PMID: 25174446 PMCID: PMC4159546 DOI: 10.1186/s12865-014-0032-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Accepted: 08/08/2014] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare disease characterized by the presence of allergic granulomatosis and necrotizing vasculitis with eosinophilic infiltration. The etiology of EGPA is unknown. Dendritic cells (DCs) are not only critical for the induction of primary immune responses; they may also be important for the induction of immunological tolerance and the regulation of the type of T-cell-mediated immune response. To investigate whether DC maturation is associated with EGPA disease status, we examined the relationship between the maturation of DCs and the differentiation of regulatory T (Treg) cells in EGPA patients. We exposed the CD14+ blood monocytes of 19 patients with EGPA in remission or relapse to stimulation with GM-CSF and IL-4 for 6 d and lipopolysaccharide for 24 h to obtain mature CD83+ DCs and immature CD206+ DCs. Using immunohistochemistry, we examined four patients for the presence of CD83+ and CD206+ DCs in the lung at the onset of EGPA. RESULTS The percentage of CD83+ cells among DCs differentiated from CD14+ monocytes was lower for EGPA patients in relapse than in remission. The percentage of CD83+ DCs was inversely correlated with the percentage of CD206+ DCs and was significantly correlated with the numbers of naturally occurring CD4+ regulatory Treg (nTreg; FOXP3+CD4+) cells and inducible Treg (iTreg; CD4+CD25+ T cells producing IL-10 or TGF-β) cells but not the number of eosinophils. The percentage of CD206+ DCs was significantly inversely correlated with the percentages of nTreg and iTreg cells but not the number of eosinophils. Immunohistochemistry revealed both CD206+ DCs and CD83+ DCs in alveoli and interstitial spaces at the onset of EGPA. CONCLUSION The maturation of DCs from monocytes was related to disease activity in patients with EGPA. Increased CD83+ DCs in EGPA patients may induce the differentiation of iTreg and nTreg cells, thereby suppressing inflammation and disease activity.
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Affiliation(s)
- Naomi Tsurikisawa
- />Departments of Allergy and Respirology, 18-1 Sakuradai, Minami-ku Sagamihara, Kanagawa 252-0392 Japan
| | - Hiroshi Saito
- />Clinical Research Center for Allergy and Rheumatology, National Hospital Organization, Sagamihara National Hospital, 18-1 Sakuradai, Minami-ku Sagamihara, Kanagawa 252-0392 Japan
| | - Chiyako Oshikata
- />Departments of Allergy and Respirology, 18-1 Sakuradai, Minami-ku Sagamihara, Kanagawa 252-0392 Japan
| | - Takahiro Tsuburai
- />Departments of Allergy and Respirology, 18-1 Sakuradai, Minami-ku Sagamihara, Kanagawa 252-0392 Japan
| | - Miyako Ishiyama
- />Laboratory Medicine, Kanagawa Rehabilitation Hospital, 516 Nanasawa Atsugi, Kanagawa, 243-0121 Japan
| | - Hiroyuki Mitomi
- />Department of Surgical and Molecular Pathology, Dokkyo Medical University, 880 Kitakobayashi, Shimotsuga-gun, Mibu-machi, Tochigi 321-0293 Japan
| | - Kazuo Akiyama
- />Departments of Allergy and Respirology, 18-1 Sakuradai, Minami-ku Sagamihara, Kanagawa 252-0392 Japan
- />Clinical Research Center for Allergy and Rheumatology, National Hospital Organization, Sagamihara National Hospital, 18-1 Sakuradai, Minami-ku Sagamihara, Kanagawa 252-0392 Japan
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Frischmeyer-Guerrerio PA, Keet CA, Guerrerio AL, Chichester KL, Bieneman AP, Hamilton RG, Wood RA, Schroeder JT. Modulation of dendritic cell innate and adaptive immune functions by oral and sublingual immunotherapy. Clin Immunol 2014; 155:47-59. [PMID: 25173802 DOI: 10.1016/j.clim.2014.08.006] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2014] [Revised: 08/16/2014] [Accepted: 08/19/2014] [Indexed: 10/24/2022]
Abstract
Sublingual (SLIT) and oral immunotherapy (OIT) are promising treatments for food allergy, but underlying mechanisms are poorly understood. Dendritic cells (DCs) induce and maintain Th2-type allergen-specific T cells, and also regulate innate immunity through their expression of Toll-like receptors (TLRs). We examined how SLIT and OIT influenced DC innate and adaptive immune responses in children with IgE-mediated cow's milk (CM) allergy. SLIT, but not OIT, decreased TLR-induced IL-6 secretion by myeloid DCs (mDCs). SLIT and OIT altered mDC IL-10 secretion, a potent inhibitor of FcεRI-dependent pro-inflammatory responses. OIT uniquely augmented IFN-α and decreased IL-6 secretion by plasmacytoid DCs (pDCs), which was associated with reduced TLR-induced IL-13 release in pDC-T cell co-cultures. Both SLIT and OIT decreased Th2 cytokine secretion to CM in pDC-T, but not mDC-T, co-cultures. Therefore, SLIT and OIT exert unique effects on DC-driven innate and adaptive immune responses, which may inhibit allergic inflammation and promote tolerance.
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Affiliation(s)
- Pamela A Frischmeyer-Guerrerio
- Division of Allergy and Immunology, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Corinne A Keet
- Division of Allergy and Immunology, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Anthony L Guerrerio
- Division of Gastroenterology, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Kristin L Chichester
- Division of Allergy and Immunology, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Anja P Bieneman
- Division of Allergy and Clinical Immunology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Robert G Hamilton
- Division of Allergy and Clinical Immunology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Robert A Wood
- Division of Allergy and Immunology, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - John T Schroeder
- Division of Allergy and Clinical Immunology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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18
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Hertel L. Human cytomegalovirus tropism for mucosal myeloid dendritic cells. Rev Med Virol 2014; 24:379-95. [PMID: 24888709 DOI: 10.1002/rmv.1797] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Revised: 05/01/2014] [Accepted: 05/07/2014] [Indexed: 02/01/2023]
Abstract
Human CMV infections are a serious source of morbidity and mortality for immunocompromised patients and for the developing fetus. Because of this, the development of new strategies to prevent CMV acquisition and transmission is a top priority. Myeloid dendritic cells (DC) residing in the oral and nasal mucosae are among the first immune cells to encounter CMV during entry and greatly contribute to virus dissemination, reactivation from latency, and horizontal spread. Albeit affected by the immunoevasive tactics of CMV, mucosal DC remain potent inducers of cellular and humoral immune responses against this virus. Their natural functions could thus be exploited to generate long-lasting protective immunity against CMV by vaccination via the oronasal mucosae. Although related, epithelial Langerhans-type DC and dermal monocyte-derived DC interact with CMV in dramatically different ways. Whereas immature monocyte-derived DC are fully permissive to infection, for instance, immature Langerhans-type DC are completely resistant. Understanding these differences is essential to design innovative vaccines and new antiviral compounds to protect these cells from CMV infection in vivo.
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Affiliation(s)
- Laura Hertel
- Center for Immunobiology and Vaccine Development, Children's Hospital Oakland Research Institute, Oakland, CA, 94609, USA
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19
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Baghi HB, Laval K, Favoreel H, Nauwynck HJ. Isolation and characterization of equine nasal mucosal CD172a + cells. Vet Immunol Immunopathol 2013; 157:155-63. [PMID: 24370377 DOI: 10.1016/j.vetimm.2013.12.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2013] [Revised: 11/21/2013] [Accepted: 12/01/2013] [Indexed: 12/22/2022]
Abstract
The nasal mucosa surface is continuously confronted with a broad variety of environmental antigens, ranging from harmless agents to potentially harmful pathogens. This area is under rigorous control of professional antigen presenting cells (APCs), such as dendritic cells (DCs) and macrophages. Mucosal APCs play a crucial role in inducing primary immune responses and the establishment of an immunological memory. In the present study, a detailed characterization of CD172a(+) cells, containing the APCs residing in the equine nasal mucosa was performed for the first time. CD172a(+) cells were isolated from collagenase-treated equine nasal mucosa fragments by MACS. Expression of surface markers was determined by flow cytometry and functional analysis was done by measuring the uptake of FITC conjugated ovalbumin (FITC-OVA). Cell surface phenotype of the isolated cells was as follows: 90% CD172a(+), 30% CD1c(+), 46% CD83(+), 42% CD206(+) and 28% MHC II(+). This clearly differs from the phenotype of blood-derived monocytes: 96% CD172a(+), 4% CD1c(+), 11% CD83(+), 9% CD206(+), 72% MHC II(+) and blood monocyte derived DCs: 99% CD172a(+), 13% CD1c(+), 30% CD83(+), 51% CD206(+) and 93% MHC II(+). The CD172a(+) nasal mucosal cells were functionally able to endocytose FITC-OVA but to a lesser degree than monocyte-derived DCs. Together, these results demonstrate that the isolated CD172a(+) nasal mucosal cells resemble immature DCs in the nasal area.
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Affiliation(s)
- Hossein Bannazadeh Baghi
- Laboratory of Virology, Department of Virology, Parasitology and Immunology, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, B-9820 Merelbeke, Belgium
| | - Kathlyn Laval
- Laboratory of Virology, Department of Virology, Parasitology and Immunology, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, B-9820 Merelbeke, Belgium
| | - Herman Favoreel
- Laboratory of Immunology, Department of Virology, Parasitology and Immunology, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, B-9820 Merelbeke, Belgium
| | - Hans J Nauwynck
- Laboratory of Virology, Department of Virology, Parasitology and Immunology, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, B-9820 Merelbeke, Belgium.
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20
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Ozdemir C, Kucuksezer UC, Akdis M, Akdis CA. Under the skin or under the tongue: differences and similarities in mechanisms of sublingual and subcutaneous immunotherapy. Immunotherapy 2013; 5:1151-8. [DOI: 10.2217/imt.13.117] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Affiliation(s)
- Cevdet Ozdemir
- Memorial Health Group, Atasehir Hospital, Department of Pediatric Allergy, Istanbul, Turkey
| | - Umut C Kucuksezer
- Istanbul University, Institute of Experimental Medicine (DETAE), Department of Immunology, Istanbul, Turkey
| | - Mübeccel Akdis
- Swiss Institute of Allergy & Asthma Research (SIAF), University of Zürich Obere Strasse 22, CH-7270 Davos Platz, Switzerland
| | - Cezmi A Akdis
- Swiss Institute of Allergy & Asthma Research (SIAF), University of Zürich Obere Strasse 22, CH-7270 Davos Platz, Switzerland and Christine Kühne – Center for Allergy Research & Education, Davos, Switzerland
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Human cytomegalovirus infection of langerhans-type dendritic cells does not require the presence of the gH/gL/UL128-131A complex and is blocked after nuclear deposition of viral genomes in immature cells. J Virol 2013; 88:403-16. [PMID: 24155395 DOI: 10.1128/jvi.03062-13] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Human cytomegalovirus (CMV) enters its host via the oral and genital mucosae. Langerhans-type dendritic cells (LC) are the most abundant innate immune cells at these sites, where they constitute a first line of defense against a variety of pathogens. We previously showed that immature LC (iLC) are remarkably resistant to CMV infection, while mature LC (mLC) are more permissive, particularly when exposed to clinical-strain-like strains of CMV, which display a pentameric complex consisting of the viral glycoproteins gH, gL, UL128, UL130, and UL131A on their envelope. This complex was recently shown to be required for the infection of immature monocyte-derived dendritic cells. We thus sought to establish if the presence of this complex is also necessary for virion penetration of LC and if defects in entry might be the source of iLC resistance to CMV. Here we report that the efficiency of LC infection is reduced, but not completely abolished, in the absence of the pentameric complex. While virion penetration and nuclear deposition of viral genomes are not impaired in iLC, the transcription of the viral immediate early genes UL122 and UL123 and of the delayed early gene UL50 is substantially lower than that in mLC. Together, these data show that the UL128, UL130, and UL131A proteins are dispensable for CMV entry into LC and that progression of the viral cycle in iLC is restricted at the step of viral gene expression.
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Upadhyay J, Upadhyay RB, Agrawal P, Jaitley S, Shekhar R. Langerhans cells and their role in oral mucosal diseases. NORTH AMERICAN JOURNAL OF MEDICAL SCIENCES 2013; 5:505-14. [PMID: 24251267 PMCID: PMC3818822 DOI: 10.4103/1947-2714.118923] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Dendritic cells are arguably the most potent antigen-presenting cells and may be the only cells capable of initiating the adaptive immune response. The epithelial residents of dendritic cells are Langerhans cells, which serve as the "sentinels" of the mucosa, altering the immune system not only to pathogen entry but also of tolerance to self antigen and commensal microbes. Oral mucosal Langerhans cells are capable of engaging and internalizing a wide variety of pathogens and have been found responsive to nickel in patients with nickel allergies, oral Candida species, oral lichen planus, lichenoid drug eruptions, graft versus host diseases, periodontal diseases median rhomboid glossitis, human immunodeficiency virus infection, hairy leukoplakia of the tongue, and oral squamous cell carcinoma. Review focuses on the role of antigen-presenting cells in particular Langerhans cells to better understand the mechanisms underlying immune responses. In this review, comprehensive detail about mucosal diseases has been compiled using the PubMed database and through textbooks.
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Affiliation(s)
- Juhi Upadhyay
- Department of Oral and Maxillofacial Pathology, K.D. Dental College and Hospital, Mathura, India
| | - Ram B Upadhyay
- Department of Oral and Maxillofacial Pathology, K.D. Dental College and Hospital, Mathura, India
| | - Pankaj Agrawal
- Department of Oral and Maxillofacial Pathology, K.D. Dental College and Hospital, Mathura, India
| | - Shweta Jaitley
- Department of Oral and Maxillofacial Pathology, K.D. Dental College and Hospital, Mathura, India
| | - Rhitu Shekhar
- Department of Conservative Dentistry, K.D. Dental College and Hospital, Mathura, Uttar Pradesh, India
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23
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Inamine A, Sakurai D, Horiguchi S, Yonekura S, Hanazawa T, Hosokawa H, Matuura-Suzuki A, Nakayama T, Okamoto Y. Sublingual administration of Lactobacillus paracasei KW3110 inhibits Th2-dependent allergic responses via upregulation of PD-L2 on dendritic cells. Clin Immunol 2012; 143:170-9. [DOI: 10.1016/j.clim.2012.01.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2011] [Revised: 01/14/2012] [Accepted: 01/16/2012] [Indexed: 12/15/2022]
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Gomez de Agüero M, Vocanson M, Hacini-Rachinel F, Taillardet M, Sparwasser T, Kissenpfennig A, Malissen B, Kaiserlian D, Dubois B. Langerhans cells protect from allergic contact dermatitis in mice by tolerizing CD8(+) T cells and activating Foxp3(+) regulatory T cells. J Clin Invest 2012; 122:1700-11. [PMID: 22523067 DOI: 10.1172/jci59725] [Citation(s) in RCA: 136] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2011] [Accepted: 02/15/2012] [Indexed: 12/15/2022] Open
Abstract
Allergic contact dermatitis is the most frequent occupational disease in industrialized countries. It is caused by CD8(+) T cell-mediated contact hypersensitivity (CHS) reactions triggered at the site of contact by a variety of chemicals, also known as weak haptens, present in fragrances, dyes, metals, preservatives, and drugs. Despite the myriad of potentially allergenic substances that can penetrate the skin, sensitization is relatively rare and immune tolerance to the substance is often induced by as yet poorly understood mechanisms. Here we show, using the innocuous chemical 2,4-dinitrothiocyanobenzene (DNTB), that cutaneous immune tolerance in mice critically depends on epidermal Langerhans cells (LCs), which capture DNTB and migrate to lymph nodes for direct presentation to CD8(+) T cells. Depletion and adoptive transfer experiments revealed that LCs conferred protection from development of CHS by a mechanism involving both anergy and deletion of allergen-specific CD8(+) T cells and activation of a population of T cells identified as ICOS(+)CD4(+)Foxp3(+) Tregs. Our findings highlight the critical role of LCs in tolerance induction in mice to the prototype innocuous hapten DNTB and suggest that strategies targeting LCs might be valuable for prevention of cutaneous allergy.
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Bahceciler NN, Cobanoglu N. Subcutaneous versus sublingual immunotherapy for allergic rhinitis and/or asthma. Immunotherapy 2012; 3:747-56. [PMID: 21668312 DOI: 10.2217/imt.11.48] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Subcutaneous allergen-specific immunotherapy has long been used in allergic rhinitis and/or asthma and has been recognized to be efficacious. However, owing to the inconvenience of injection and the risk of serious side effects, alternative concepts inspiring the search for effective noninjective routes, namely sublingual administration of allergens, have emerged. Sublingual immunotherapy (SLIT) appears to be associated with a lower incidence of systemic reactions. The clinical efficacy of subcutaneous immunotherapy (SCIT) is well established for both rhinitis and asthma. Meta-analyses relating to its efficacy on asthma and rhinitis are available. SLIT has also been validated in this respect. Comparative clinical studies of SLIT versus SCIT are scarce demonstrating both routes to be clinically efficient. Knowledge of the exact mechanism of action of SLIT has been increasing in the last decade. In addition, recent studies have proved similarities of the immunological changes with the treatment of both routes. Further comparative clinical and immunological studies of SLIT versus SCIT are needed to confirm the long-term efficacy and to complete the knowledge of immunological mechanisms of both routes. Moreover, better understanding of the interaction of allergen and oral mucosal dendritic cells during SLIT may allow improved targeting of SLIT vaccines.
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Abstract
PURPOSE OF REVIEW To summarize novel insights into the immunological mechanisms of sublingual immunotherapy (SLIT). Within the recent decades, several alternative noninvasive allergen application strategies have been investigated in allergen-specific immunotherapy (AIT), of which intra-oral allergen application to sublingual mucosa has been proven to be well tolerated and effective. RECENT FINDINGS To date, SLIT is widely accepted by most allergists as an alternative option to conventional subcutaneous immunotherapy (SCIT). Although detailed immunological mechanisms remain to be elucidated, much scientific effort has been made to shed some light on local and systemic immunological responses to SLIT in mice as well as humans. Only a few studies focused on the detailed mechanisms following allergen application to the oral mucosa as part of the sophisticated mucosal immunological network. Within this network, the pro-tolerogenic properties of local antigen-presenting cells (APCs) such as dendritic cells - which are able to enforce tolerogenic mechanisms and to induce T-cell immune responses - play a central role. Further on, basic research focused not only on the immune response in nasal and bronchial mucosa but also on the systemic T-cell immune response. SUMMARY Thus, much exiting data have been published providing a better understanding of immunological features of SLIT but far more investigations are necessary to uncover further exciting details on the key mechanisms of SLIT.
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Abstract
Vaccinations in medicine are typically administered into the muscle beneath the skin or into the subcutaneous fat. As a consequence, the vaccine is immunologically processed by antigen-presenting cells of the skin or the muscle. Recent evidence suggests that the clinically seldom used intradermal route is effective and possibly even superior to the conventional subcutaneous or intramuscular route. Several types of professional antigen-presenting cells inhabit the healthy skin. Epidermal Langerhans cells (CD207/langerin(+)), dermal langerin(neg), and dermal langerin(+) dendritic cells (DC) have been described, the latter subset so far only in mouse skin. In human skin langerin(neg) dermal DC can be further classified based on their reciprocal expression of CD1a and CD14. The relative contributions of these subsets to the generation of immunity or tolerance are still unclear. Yet, specializations of these different populations have become apparent. Langerhans cells in human skin appear to be specialized for induction of cytotoxic T lymphocytes; human CD14(+) dermal DC can promote antibody production by B cells. It is currently attempted to rationally devise and improve vaccines by harnessing such specific properties of skin DC. This could be achieved by specifically targeting functionally diverse skin DC subsets. We discuss here advances in our knowledge on the immunological properties of skin DC and strategies to significantly improve the outcome of vaccinations by applying this knowledge.
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A novel approach in allergen-specific immunotherapy: combination of sublingual and subcutaneous routes. J Allergy Clin Immunol 2011; 128:808-815.e7. [PMID: 21641635 DOI: 10.1016/j.jaci.2011.04.033] [Citation(s) in RCA: 88] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2010] [Revised: 03/20/2011] [Accepted: 04/11/2011] [Indexed: 11/22/2022]
Abstract
BACKGROUND Subcutaneous allergen-specific immunotherapy (SIT) has an early onset of action, whereas repeated injections and safety concerns have limited its use in the pediatric age group. Meanwhile, the improved safety profile of the sublingual route has been accepted as an alternative despite its relatively late onset of action. OBJECTIVE We sought to improve the efficacy and safety of SIT with a combination of the subcutaneous route in the build-up phase and sublingual maintenance in comparison with the sublingual or subcutaneous routes alone. METHODS Fifty-one house dust mite-sensitized children with mild-to-moderate asthma were randomized into one of 4 groups to receive either (1) subcutaneous immunotherapy (SCIT), (2) sublingual immunotherapy (SLIT), (3) SCIT plus SLIT, or (4) pharmacotherapy. Clinical parameters were evaluated at baseline and months 1, 4, 12, and 18. Allergen-specific immunoglobulin levels and allergen-induced IL-5, IL-10, IL-13, IL-17, TGF-β, and IFN-γ levels were evaluated as well. RESULTS In the SCIT and SCIT plus SLIT groups, the number of asthma attacks and inhaled corticosteroid dosage decreased compared with baseline values at the months 4, 12, and 18 but only at month 12 in the SLIT group. The improvement in visual analog scores for rhinitis was significant only in the SCIT plus SLIT group. Increases in the levels of regulatory and T(H)1 cytokines were observed both in the SCIT and SLIT groups, with some differences in dynamics. Antigen-specific IgG(4) levels increased in the SCIT and SCIT plus SLIT groups but not in the SLIT group. Clinical symptom scores were correlated positively with IL-5 levels and negatively with antigen-specific IgG(4), IFN-γ, and TGF-β levels. CONCLUSION Our novel regimen of immunotherapy, SCIT plus SLIT, appeared promising in that it successfully combined the advantages of the 2 alternatives: rapid onset and potency in SCIT and safety and avoidance of injections in SLIT.
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Abstract
Within the last 100 years of allergen-specific immunotherapy, many clinical and scientific efforts have been made to establish alternative noninvasive allergen application strategies. Thus, intra-oral allergen delivery to the sublingual mucosa has been proven to be safe and effective. As a consequence, to date, sublingual immunotherapy (SLIT) is widely accepted by most allergists as an alternative to conventional subcutaneous immunotherapy. Although immunological mechanisms remain to be elucidated in detail, several studies in mice and humans within recent years provided deeper insights into local as well as systemic immunological features in response to SLIT. First of all, it was shown that the target organ, the oral mucosa, harbours a sophisticated immunological network as an important prerequisite for SLIT, which contains among other cells, local antigen-presenting cells (APC), such as dendritic cells (DCs), with a constitutive disposition to enforce tolerogenic mechanisms. Further on, basic research on local DCs within the oral mucosa gave rise to possible alternative strategies to deliver the allergens to other mucosal regions than sublingual tissue, such as the vestibulum oris. Moreover, characterization of oral DCs led to the identification of target structures for both allergens as well as adjuvants, which could be applied during SLIT. Altogether, SLIT came a long way since its very beginning in the last century and some, but not all questions about SLIT could be answered so far. However, recent research efforts as well as clinical approaches paved the way for another exciting 100 years of SLIT.
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Affiliation(s)
- Natalija Novak
- Department of Dermatology and Allergy, University of Bonn, Bonn, Germany.
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30
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Abstract
Asthma is a chronic inflammatory disorder of the airways in which many cells and cellular elements play a role. Chronic inflammation is associated with airway hyper-responsiveness that leads to recurrent episodes of wheezing, breathlessness, chest tightness and coughing, as well as variable airflow obstruction within the lung. With time, such airflow obstruction may become permanent due to remodeling. It has been treated for more than 100 years by subcutaneous immunotherapy with allergen extracts but in recent years, other forms and types of immunotherapy have been introduced. Perhaps the most successful of these to date, is sublingual immunotherapy, which has attained significant usage in European countries but has yet to make inroads into clinical practice in North America. Other mechanisms to modify the inflammatory responses of asthma have included immunotherapy with recombinant allergens, the use of allergen peptides targeting antigen-specific T cells and the administration of Toll-like receptor agonists coupled to allergen proteins. As the inflammatory responses in asthma frequently involve IgE, a modified monoclonal antibody to IgE and interfering with its binding to the IgE receptor have gained acceptance for treating severe allergic asthma. Other monoclonal antibodies or recombinant receptor antagonists are being assessed for their ability to block other contributors to the inflammatory response. Finally, attempts have been made to generate autoantibody responses to cytokines implicated in asthma. Most of these therapies aim to modify or inhibit the so-called Th 2 immune response, which is implicated in many forms of asthma, or to inhibit cytokines involved in these responses. However, an added benefit of classical immunotherapy seems to be the ability to prevent the allergic progression to new sensitivities and new forms of allergic disease.
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Affiliation(s)
- Richard Warrington
- University of Manitoba, GC319, 820 Sherbook Street, Winnipeg, Manitoba, R3A 1R9, Canada.
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31
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Blázquez AB, Mayorga C, Blanca-López N, Jaén MJT. Sublingual immunotherapy and oral mucosal langerhans cells. Immunotherapy 2010; 3:9-11. [PMID: 21174551 DOI: 10.2217/imt.10.98] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Ana Belén Blázquez
- Research laboratory for Allergic Diseases, IMABIS Fundation, Carlos Haya Hospital, Malaga, Spain
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Fries PN, Griebel PJ. Mucosal dendritic cell diversity in the gastrointestinal tract. Cell Tissue Res 2010; 343:33-41. [PMID: 20824287 DOI: 10.1007/s00441-010-1030-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2010] [Accepted: 07/28/2010] [Indexed: 12/16/2022]
Abstract
The discovery of dendritic cells (DCs) in skin by Paul Langerhans in 1868 identified a cell type which has since been recognized as a key link between innate and adaptive immunity. DCs originate from bone marrow and disseminate through blood to all tissues in the body, and distinct DC subpopulations have been identified in many different tissues. DC diversity is apparent throughout all mucosal surfaces of the body, but the focus of this review article is DC diversity throughout the gastro-intestinal tract (GIT). DC subpopulations have been well characterized in the oral cavity and small intestine, but DC characterization in other regions, such as the esophagus and stomach, is limited. Substantial research has focused on DC function during disease, but understanding the regulation of inflammation and the induction of acquired immune responses requires combined phenotypic and functional characterization of individual DC subpopulations. Furthermore, little is known regarding mucosal DC subpopulations in the GIT of the neonate and how these DC populations change following colonization by commensal microflora. The current review will highlight mucosal DC diversity and discuss factors that may influence mucosal DC differentiation.
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Affiliation(s)
- Patrick N Fries
- Vaccine and Infectious Disease Organization, University of Saskatchewan, 120 Veterinary Road, Saskatoon, SK S7N 5E3, Canada
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Endonasal phototherapy significantly alleviates symptoms of allergic rhinitis, but has a limited impact on the nasal mucosal immune cells. Eur Arch Otorhinolaryngol 2010; 268:393-9. [PMID: 20814689 DOI: 10.1007/s00405-010-1375-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2010] [Accepted: 08/20/2010] [Indexed: 10/19/2022]
Abstract
The literature documents the fact that UV irradiation of cutaneous Langerhans cells (LC) in vivo prevents the development of contact allergy and produces long-lasting immunosuppression. However, not much is known about the effect of UV irradiation on the LC of the nasal mucosa and their connection with clinical scores. Local antigen presentation may be necessary for both primary and recall T cell responses to birch pollen in patients with hay fever. Endonasal phototherapy combination of UVB (5%), UVA (25%) and visible light (70%) utilises the immunosuppressive effects of UV irradiation. The aim of this study was to correlate clinical symptom scores with possible changes in the LC of the nasal mucosa induced by UV radiation. The clinical effectiveness of this form of treatment is discussed. Nasal biopsies were obtained from ten birch pollen-sensitive patients with seasonal rhinitis before and after endonasal phototherapy. All patients showed a significant clinical benefit post-treatment as assessed by standardised instruments, including total nasal symptom score, nasal congestion score, nasal itching score, sneezing score, nasal secretion score and impairment-to-health score. However, we found no significant morphological changes, to, or quantitative differences in, the CD1a+, CD4, CD8 or CD31 cells before and 14 days after treatment. Despite the positive clinical effect, the study revealed no effect of UV irradiation on the LC and other analysed cells of the nasal mucosa immune system. Possible reasons for this are discussed.
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Flores-Mendoza L, Sotelo-Mundo RR, Dawson H, Mwangi W, Hernández J. Characterization of porcine CD205. DEVELOPMENTAL AND COMPARATIVE IMMUNOLOGY 2010; 34:715-721. [PMID: 20188754 DOI: 10.1016/j.dci.2010.02.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2010] [Revised: 02/18/2010] [Accepted: 02/18/2010] [Indexed: 05/28/2023]
Abstract
Dendritic cells express a type cell-surface receptor, CD205 that plays a role in antigen capture and delivery to the endocytic pathway. Besides DCs, high CD205 expression is also detected on thymic epithelial cells but B cells, macrophages, and T cells have limited or no expression. CD205 has been characterized in several animal species except swine. The aim of this work was to characterize porcine CD205 and mRNA expression on different cells and tissues involved in immune responses. A complete porcine CD205 sequence of 5175bp was obtained from porcine thymus cDNA by PCR gene-walking strategy and this gene encoded a protein of 1723 amino acids. The multi-domain structure reported for murine, human, and bovine CD205 was also conserved in porcine with an overall amino acid identity of 74, 81, and 85%, respectively. Quantitative RT-PCR analysis of the CD205 mRNA profiles in normal porcine tissues and cells showed that thymus and Langerhans cells expressed the highest levels. Further characterization of porcine CD205 will lead to better understanding of the role of this receptor and development of contemporary strategies for antigen targeting to DCs in swine.
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MESH Headings
- Amino Acid Sequence
- Animals
- Antigens, CD/genetics
- Antigens, CD/immunology
- Base Sequence
- Cloning, Molecular
- Langerhans Cells/immunology
- Lectins, C-Type/genetics
- Lectins, C-Type/immunology
- Minor Histocompatibility Antigens
- Molecular Sequence Data
- Phylogeny
- RNA, Messenger/biosynthesis
- RNA, Messenger/genetics
- Receptors, Cell Surface/genetics
- Receptors, Cell Surface/immunology
- Reverse Transcriptase Polymerase Chain Reaction/veterinary
- Sequence Alignment
- Sequence Analysis, DNA
- Swine/genetics
- Swine/immunology
- Thymus Gland/immunology
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Affiliation(s)
- Lilian Flores-Mendoza
- Laboratorio de Inmunología, Centro de Investigación en Alimentación y Desarrollo, A.C., Carretera a la Victorias Km. 0.6, Hermosillo, Sonora, Mexico
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Allam JP, Würtzen PA, Reinartz M, Winter J, Vrtala S, Chen KW, Valenta R, Wenghoefer M, Appel T, Gros E, Niederhagen B, Bieber T, Lund K, Novak N. Phl p 5 resorption in human oral mucosa leads to dose-dependent and time-dependent allergen binding by oral mucosal Langerhans cells, attenuates their maturation, and enhances their migratory and TGF-beta1 and IL-10-producing properties. J Allergy Clin Immunol 2010; 126:638-45.e1. [PMID: 20584546 DOI: 10.1016/j.jaci.2010.04.039] [Citation(s) in RCA: 103] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2009] [Revised: 03/26/2010] [Accepted: 04/27/2010] [Indexed: 12/12/2022]
Abstract
BACKGROUND Sublingual immunotherapy (SLIT) is safe and effective as treatment of allergic rhinitis and mild asthma. Oral mucosal Langerhans cells (oLCs) play a central role. However, little is known about allergen binding by oLCs during mucosal allergen resorption and its impact on oLC functions. OBJECTIVE Binding of Phl p 5 to oLCs was studied in a standardized ex vivo model to investigate mechanisms important for SLIT. METHODS Human oral mucosal biopsies were incubated with the grass pollen allergen Phl p 5. Migration, binding of Phl p 5, phenotype and cytokine production, and T-cell priming of Phl p 5-binding oLCs were analyzed. RESULTS Significant uptake required more than 5 minutes, and dose-dependent binding of Phl p 5 to oLCs was saturated at 100 microg/mL Phl p 5. Furthermore, Phl p 5 significantly increased the migratory capacity of oLCs but attenuated their maturation and strongly promoted the release of TGF-beta1 and IL-10 by oLCs themselves as well as by cocultured T cells. CONCLUSION Oral mucosal Langerhans cells bind Phlp5 in a dose-dependent and time-dependent manner, leading to an increased production of tolerogenic cytokines and an enhanced migratory capacity but decelerated maturation of oLCs.
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Affiliation(s)
- Jean-Pierre Allam
- Department of Dermatology and Allergy, University of Bonn, Bonn, Germany
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Romani N, Clausen BE, Stoitzner P. Langerhans cells and more: langerin-expressing dendritic cell subsets in the skin. Immunol Rev 2010; 234:120-41. [PMID: 20193016 DOI: 10.1111/j.0105-2896.2009.00886.x] [Citation(s) in RCA: 308] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Langerhans cells (LCs) are antigen-presenting dendritic cells (DCs) that reside in epithelia. The best studied example is the LC of the epidermis. By electron microscopy, their identifying feature is the unique rod- or tennis racket-shaped Birbeck granule. The phenotypic hallmark is their expression of the C-type lectin receptor langerin/CD207. Langerin, however, is also expressed on a recently discovered population of DC in the dermis and other tissues of the body. These 'dermal langerin(+) dendritic cells' are unrelated to LCs. The complex field of langerin-negative dermal DCs is not dealt with here. In this article, we briefly review the history, ontogeny, and homeostasis of LCs. More emphasis is laid on the discussion of functional properties in vivo. Novel models using genetically engineered mice are contributing tremendously to our understanding of the role of LCs in eliciting adaptive immune responses against pathogens or tumors and in inducing and maintaining tolerance against self antigens and innocuous substances in vivo. Also, innate effector functions are increasingly being recognized. Current activities in this area are reviewed, and possibilities for future exploitation of LC in medicine, e.g. for the improvement of vaccines, are contemplated.
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Affiliation(s)
- Nikolaus Romani
- Department of Dermatology & Venereology, Innsbruck Medical University, Innsbruck, Austria.
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Abstract
PURPOSE OF REVIEW A recent meta-analysis confirmed that sublingual immunotherapy represents a safe and efficient alternative to traditional subcutaneous immunotherapy in the treatment of allergic rhinitis. However, the immunological mechanisms have not been elucidated in detail yet. The current concept postulates a Th2/Th1 shift along with tolerance induction. Without doubt, oral mucosal antigen-presenting cells such as dendritic cells play a central role as they process antigens to initialize and modulate T-cell activation. RECENT FINDINGS Oral mucosal dendritic cells (oDCs) are capable of processing antigen applied on mucosal surfaces. The natural pro-tolerogenic character of oDCs has been demonstrated by the induction of tolerogenic T cells in response to oDCs activated by either externally applied antigens such as ovalbumin or antigens originating from commensal bacteria like Toll-like receptor ligands, which have been shown to be promising candidates for adjuvants. Nevertheless, the finding of relatively low numbers of oDCs within the sublingual region opens the search for different allergen application sites within the oral cavity such as the vestibular region where higher numbers of oDCs are detectable. SUMMARY oDCs display a natural pro-tolerogenic character, which is suspected to be essential for successful sublingual immunotherapy. Further knowledge about oDCs behaviour might give rise to new sublingual immunotherapy strategies such as adjuvant supplementation.
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Novak N, Gros E, Bieber T, Allam JP. Human skin and oral mucosal dendritic cells as 'good guys' and 'bad guys' in allergic immune responses. Clin Exp Immunol 2010; 161:28-33. [PMID: 20408854 DOI: 10.1111/j.1365-2249.2010.04162.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Recent progress achieved by an impressive number of studies focusing upon the ontogenesis and immunobiology of epidermal Langerhans cells (LCs) and other cutaneous dendritic cell (DC) populations as well as DCs at oral mucosal tissue has profoundly revised our understanding of the role of DCs in different tissues and microenvironments. By sensing their environment for microbial signals or allergens and bridging innate and adaptive immunity in a sophisticated manner, subtypes of DCs play a critical role in the maintenance of the immunological homeostasis in the periphery. Thereby, DCs, located directly at the interface to the environment, fulfil opposing tasks as they are key players in both the control and the generation of allergic inflammation. Furthermore, it is under ongoing debate whether DCs attenuate or aggravate allergic inflammation. As a consequence, accumulated knowledge gained in this field within the last few years has provided an excellent basis for innovative therapeutic opportunities which tend to target specifically the multi-faceted properties of DCs at distinct anatomical sites.
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Affiliation(s)
- N Novak
- Department of Dermatology and Allergy, University of Bonn, Bonn, Germany.
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Abstract
The sublingual route has become an interesting and novel therapeutic option for the immunotherapeutic management of patients with allergies. Immunotherapy modifies the immune response by decreasing the specific IgE levels and Th2-type inflammation in the mucosa when allergen exposure occurs, shifting this toward a Th1-type response. Credible evidence exists of both effectiveness and safety of sublingual immunotherapy (SLIT) from several placebo-controlled double-blind studies. SLIT has been shown to be an effective treatment of allergic rhinitis and asthma in both children and adults. The therapy is well tolerated with mainly minor gastrointestinal side effects that subside in few weeks. The ideal treatment length and dosage still require further verification. Additional studies evaluating long-term efficacy and the immune response of SLIT still need to be performed, and additional standardized antigens still need to be developed.
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Affiliation(s)
- Elina Toskala
- Department of Otorhinolaryngology, Finnish Institute of Occupational Health, Helsinki, Finland.
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40
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Faith A, Singh N, Chevretton E, Roberts D, Lee T, Corrigan C, Hawrylowicz C. Counter regulation of the high affinity IgE receptor, FcepsilonRI, on human airway dendritic cells by IL-4 and IL-10. Allergy 2009; 64:1602-7. [PMID: 19385959 DOI: 10.1111/j.1398-9995.2009.02060.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Immunoglobulin E is a signalling molecule within the environment of the respiratory tract, the high affinity receptor for which, FcepsilonRI, is expressed by dendritic cells (DC). Little is known, however, of the expression and function of FcepsilonRI on DC in the human respiratory tract. METHODS CD1c(+) DC were purified from surgically resected nasal turbinates of 11 atopic and 12 nonatopic patients with chronic rhinosinusitis. Expression of FcepsilonRI was determined by flow cytometry. Cytokine production by DC was determined by cytometric bead array. RESULTS Expression of FcepsilonRI was significantly elevated on respiratory tract dendritic cells (RTDC) from atopic as compared to nonatopic patients. Activation of RTDC through FcepsilonRI induced production of the pro-inflammatory cytokines IL-6 and TNF-alpha, and the anti-inflammatory cytokine IL-10. The production of IL-6 and TNF-alpha was elevated in atopic compared to nonatopic patients studied. Conversely IL-10 production was elevated in nonatopic patients. Concomitant activation of FcepsilonRI and stimulation of RTDC with IL-4 inhibited production of IL-10 by RTDC. Neutralization experiments with anti-IL-10 Ab enhanced whereas addition of exogenous IL-10 to RTDC inhibited FcepsilonRI-mediated inflammatory cytokine production. CONCLUSION The function of FcepsilonRI on RTDC from patients with rhinosinusitis is susceptible to counter regulation by IL-4 and IL-10.
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Affiliation(s)
- A Faith
- MRC-Asthma UK Centre in Allergic Mechanisms of Asthma, King's College, London, UK
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Abstract
Canine IgE discovery and characterization historically closely paralleled that of human IgE. The reason for this would seem to be the early recognition of the spontaneous manifestation of allergic diseases in dogs that are nearly identical to human allergic diseases. The discovery and characterization of human IgE being dependent upon its biological activity in sensitizing mast cells and basophils was matched early on by analogous approaches readily applied to dogs. Following the early work on IgE, cloning and sequencing of the IgE heavy chain, epsilon, lagged well behind the human and rodent for want of IgE producing canine myelomas. As with human allergic diseases, measurement of allergen-specific and total IgE in canine tissues and body fluids revealed the same associations with various disease manifestations that some times defied discovery of straight-forward cause and effect relationships because of the complexity of pathogenesis in spontaneous allergic disease. However it is clear that research on IgE in spontaneously allergic dogs offers many opportunities to explore novel immunotherapeutic approaches to the control of allergic disease that will benefit both dogs and humans.
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Affiliation(s)
- Bruce Hammerberg
- Department of Population Health and Pathobiology, College of Veterinary Medicine, North Carolina State University, 4700 Hillsborough Street, Raleigh, NC 27606, USA.
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42
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Akdis M, Akdis CA. Therapeutic manipulation of immune tolerance in allergic disease. Nat Rev Drug Discov 2009; 8:645-60. [PMID: 19644474 DOI: 10.1038/nrd2653] [Citation(s) in RCA: 152] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Immune tolerance - the adaptation of the immune system to external antigens or allergens - might be therapeutically manipulated to restore normal immunity in conditions such as allergy, asthma and autoimmune diseases. The field of allergen-specific immunotherapy is experiencing exciting and novel developments for the treatment of allergic and autoimmune diseases, and recent insights into the reciprocal regulation and counter-balance between different T-cell subsets is foreseen to facilitate new strategies for immunointervention. This Review highlights current knowledge of immunomodulatory therapies for the manipulation of immune tolerance and highlights recent approaches to improve allergen-specific immunotherapy for the treatment of allergic diseases.
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Affiliation(s)
- Mübeccel Akdis
- Swiss Institute of Allergy and Asthma Research, University of Zurich, Obere Strasse 22, Davos Platz, Switzerland.
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43
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Immune tolerance in allergy. Curr Opin Immunol 2009; 21:700-7. [PMID: 19700272 DOI: 10.1016/j.coi.2009.07.012] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2009] [Revised: 07/14/2009] [Accepted: 07/15/2009] [Indexed: 01/01/2023]
Abstract
Research on the mechanisms of immune regulation in allergy and asthma has shown substantial progress in recent years and has led to a variety of allergen-specific therapeutic and preventive approaches. Studies on the area of allergen-specific immunotherapy (allergen-SIT) have provided substantial knowledge on the mechanisms of allergic disease with novel developments for treatment and prevention. Several studies have demonstrated that increased numbers and the activation of allergen-specific T regulatory cells correlate with successful allergen-SIT. Particularly, targeting of the molecular mechanisms of immune tolerance and reciprocal regulation of effector and regulatory T-cell subsets are foreseen for the development of new strategies for immune intervention. This review focuses on current knowledge of immune tolerance to allergens in healthy immune response to allergens and allergen-SIT.
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Feng P, Yee KK, Rawson NE, Feldman LM, Feldman RS, Breslin PAS. Immune cells of the human peripheral taste system: dominant dendritic cells and CD4 T cells. Brain Behav Immun 2009; 23:760-6. [PMID: 19268521 PMCID: PMC2730635 DOI: 10.1016/j.bbi.2009.02.016] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2008] [Revised: 02/06/2009] [Accepted: 02/15/2009] [Indexed: 11/24/2022] Open
Abstract
Taste loss or alterations can seriously impact health and quality of life due to the resulting negative influence on eating habits and nutrition. Infection and inflammation are thought to be some of the most common causes of taste perception disorders. Supporting this view, neuro-immune interactions in the peripheral gustatory system have been identified, underlying the importance of this tissue in mucosal immunity, but we have little understanding of how these interactions influence taste perception directly or indirectly. This limited understanding is evident by the lack of even a basic knowledge of the resident immune cell populations in or near taste tissues. The present study characterized the distribution and population of the major immune cells and their subsets in healthy human anterior, lingual, fungiform papillae (FP) using immunohistochemistry. Dendritic cells (DCs) were the predominant innate immune cells in this tissue, including four subtypes: CD11c(+) DCs, DC-SIGN+ immature DCs, CD83(+) mature DCs, and CD1a(+) DCs (Langerhans cells). While most DCs were localized beneath the lamina propria and only moderately in the epithelium, CD1a(+) Langerhans cells were exclusively present within the epithelium and not in sub-strata. A small number of macrophages were observed. T lymphocytes were present throughout the FP with CD4(+) T cells more prevalent than CD8(+) T cells. Very few CD19(+) B lymphocytes were detected. The results show that DCs, macrophages, and T lymphocytes are the constitutive guardians of human FP taste tissue, with DCs and CD4 T cells being dominant, while B lymphocytes are rare under normal, healthy conditions. These observations provide a basic anatomical foundation for the immune response in the healthy human tongue as a basis for subsequent disease-related studies, but none of the present data indicate that the immune cell populations identified are, in fact, altered in individuals with abnormal taste perception.
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Affiliation(s)
- Pu Feng
- Monell Chemical Senses Center, 3500 Market Street, Philadelphia, PA
- Academy of Medical Science of Gansu Province, China
| | - Karen K. Yee
- Monell Chemical Senses Center, 3500 Market Street, Philadelphia, PA
| | - Nancy E. Rawson
- Monell Chemical Senses Center, 3500 Market Street, Philadelphia, PA
- WellGen, Inc. North Brunswick, NJ
| | | | - Roy S. Feldman
- Monell Chemical Senses Center, 3500 Market Street, Philadelphia, PA
- Dental Service, Philadelphia Veterans Affairs Medical Center, Philadelphia PA
- School of Dental Medicine, University of Pennsylvania, Philadelphia PA, USA
| | - Paul A. S. Breslin
- Monell Chemical Senses Center, 3500 Market Street, Philadelphia, PA
- School of Dental Medicine, University of Pennsylvania, Philadelphia PA, USA
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Enrique E. Immunotherapy in the treatment of food allergy. Does it have a future? Allergol Immunopathol (Madr) 2009; 37:143-5. [DOI: 10.1016/s0301-0546(09)71726-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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46
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Behnecke A, Li W, Chen L, Saxon A, Zhang K. IgE-mediated allergen gene vaccine platform targeting human antigen-presenting cells through the high-affinity IgE receptor. J Allergy Clin Immunol 2009; 124:108-13. [PMID: 19423156 DOI: 10.1016/j.jaci.2009.03.020] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2008] [Revised: 03/06/2009] [Accepted: 03/06/2009] [Indexed: 01/15/2023]
Abstract
BACKGROUND Treatment of IgE-mediated food allergy with standard protein-based allergen immunotherapy has proved both unsuccessful and hazardous. Allergen gene vaccination represents a promising alternative, but difficulties in gene targeting and expression in antigen-presenting cells represent a major limitation for efficient gene vaccination. OBJECTIVE We sought to construct a genetically engineered human epsilon-polylysine (EPL) fusion protein that binds allergen gene expression systems and targets the gene vaccine complex to antigen-presenting cells through the interaction of EPL and the high-affinity receptor for IgE for efficient allergen gene vaccination. METHODS Genetic engineering was used to design and produce the EPL fusion gene, consisting of the human CHepsilon2-4 linked to 55 lysine residues, and the conventional approaches were used to characterize the biologic features of EPL. RESULTS EPL was assembled as functional dimers and capable of binding DNA plasmids in both an EPL protein and plasmid DNA concentration-dependent manner. EPL targeted plasmid DNA to the high-affinity receptor for IgE on cell surfaces and increased the model gene uptake/expression. The EPL-DNA complexes were shown not to trigger mast cell degranulation. CONCLUSION EPL is able to function as a gene carrier system to target allergen gene to the high-affinity receptor for IgE-expressing cells through ligand receptor-mediated interactions.
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Affiliation(s)
- Anne Behnecke
- Hart and Louise Lyon Immunology Laboratory, Section of Clinical Immunology/Allergy, Division of Pulmonary, Critical Care and Clinical Immunology/Allergy, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA
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Srivastava D, Arora N, Singh BP. Current immunological approaches for management of allergic rhinitis and bronchial asthma. Inflamm Res 2009; 58:523-36. [PMID: 19333724 DOI: 10.1007/s00011-009-0033-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2008] [Revised: 02/18/2009] [Accepted: 03/12/2009] [Indexed: 01/15/2023] Open
Abstract
A large population world over is affected with allergic diseases and asthma. Pharmacotherapy for allergic diseases and asthma is effective in controlling symptoms but on discontinuation of medication, symptoms reoccur. In contrast, immunotherapy modifies and corrects the underlying pathological immune responses in an antigen-specific manner. Immunotherapy shows an increase in IgG (blocking antibody) that competes with IgE for allergen, inhibiting the release of inflammatory mediators. Recent studies suggest that immunotherapy acts by modifying CD4+ T-cell responses either by immune deviation, T-cell anergy and/or both. Current immunological approaches for management of allergies and asthma involve immunization with native allergen, modified allergen, peptides/cDNA of allergen, anti-IgE, adjuvants coupled allergen, including immunostimulatory DNA sequences, cytokines, and bacterial products. These approaches modulate the immune response and are intended to give long-term benefit.
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Affiliation(s)
- Deepsikha Srivastava
- Allergy and Immunology Section, Institute of Genomics and Integrative Biology (CSIR), Delhi University Campus, Mall Road, Delhi, 110007, India
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48
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Lee-Fowler TM, Cohn LA, DeClue AE, Spinka CM, Reinero CR. Evaluation of subcutaneous versus mucosal (intranasal) allergen-specific rush immunotherapy in experimental feline asthma. Vet Immunol Immunopathol 2008; 129:49-56. [PMID: 19144412 DOI: 10.1016/j.vetimm.2008.12.008] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2008] [Revised: 11/14/2008] [Accepted: 12/02/2008] [Indexed: 11/17/2022]
Abstract
Rush immunotherapy (RIT) is effective for the treatment of experimental feline allergic asthma. In humans, the safety profile of immunotherapy is improved by delivering allergen by a mucosal route. We hypothesized that mucosal (intranasal) RIT would have similar efficacy to subcutaneous RIT with improved safety. Twelve cats sensitized and challenged with Bermuda grass allergen (BGA) were randomized to receive subcutaneous (SC) or intranasal (IN) RIT. Increasing doses of BGA (20-200 microg) were administered over 24h followed by 200 microg BGA weekly as maintenance. Adverse reactions were recorded. Clinical respiratory scores after BGA aerosol challenge, bronchoalveolar lavage fluid (BALF) % eosinophils, and cytokine concentrations were measured before RIT (day 1) and at months 1, 3 and 6 (M1, M3, M6). More adverse events were recorded with SC RIT (n=12) compared with IN RIT (n=6). Respiratory scores were lower by M6 compared with D1 in both the groups. The % BALF eosinophils declined significantly after RIT for both groups (mean+/-SEM, SC RIT D1 62+/-12, M6 9+/-4; IN RIT D1 54+/-9, M6 14+/-6). The BALF IL-4:IFN-gamma ratio significantly decreased over time in the IN RIT group (mean+/-SEM, D1 2.4+/-0.2, M6 1.0+/-0.2). While both protocols decreased eosinophilic airway inflammation, the SC RIT protocol did not cause life-threatening adverse events and demonstrated more consistent resolution of clinical signs after allergen challenge. Either protocol could be considered for the treatment of feline allergic asthma.
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Affiliation(s)
- Tekla M Lee-Fowler
- Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, MO 65211, USA
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49
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Pfaar O, Klimek L. [Specific immunotherapy for allergic rhinitis. Current methods and innovative developments]. HNO 2008; 56:764-75. [PMID: 18668217 DOI: 10.1007/s00106-008-1732-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Apart from allergen avoidance and pharmaceutical medication, specific immunotherapy (SIT) represents the third most important mainstay in a balanced therapeutic concept for the treatment of allergic rhinitis. For subcutaneous immunotherapy (SCIT) there is evidence for therapeutic clinical effectiveness, duration of the therapeutic result, prevention of bronchial asthma, reduced generation of additional co-sensitization and safety of the procedure. The present guidelines on allergen-specific immunotherapy (SIT) were established by the German allergy societies in 2006. Another option for specific immunotherapy in future is the sublingual route (SLIT). This method might play an important role as in-vitro studies indicated that oral Langerhans cells are potential target cells involved in the tolerance-induction of SLIT. However, questions concerning SLIT and prevention of bronchial asthma, reduced generation of co-sensitization and long-term effects have not yet been fully clarified. Furthermore, this paper gives an overview on recent innovative strategies in SCIT and SLIT, such as cluster and rush schemes, pre-seasonal therapy, recombinant allergen extracts and additive therapy with adjuvants or IgE-specific antibodies, high-dosis SLIT preparation or allergen tablets.
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Affiliation(s)
- O Pfaar
- Zentrum für Rhinologie und Allergologie der HNO-Universitätsklinik Mannheim, An den Quellen 10, 65183 Wiesbaden.
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Skripak JM, Sampson HA. Towards a cure for food allergy. Curr Opin Immunol 2008; 20:690-6. [PMID: 18848884 DOI: 10.1016/j.coi.2008.09.002] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2008] [Revised: 09/03/2008] [Accepted: 09/03/2008] [Indexed: 11/18/2022]
Abstract
Over the past two decades, food allergies have become both more prevalent and long lasting. This burgeoning problem has not been met with any therapeutic options to date, and patients must attempt to avoid known allergenic foods and treat any allergic reactions with 'as-needed' medications. There are a number of promising emerging therapeutic modalities for food allergy, including allergen-specific and allergen non-specific immunotherapeutic approaches. Although the allergen-specific approaches have some distinct differences, they all attempt to induce tolerance by exposing the patient to an allergen via the mucosal route (oral tolerance induction). Allergen non-specific approaches include biologics to suppress free total IgE levels (e.g. anti-IgE antibody) or to induce more general immune suppression (Chinese herbal medication).
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