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Li Y, Li X, Zhang B, Yu Q, Lu Y. Predictive biomarkers for response to omalizumab in patients with severe allergic asthma: a meta-analysis. Expert Rev Respir Med 2022; 16:1023-1033. [PMID: 35730466 DOI: 10.1080/17476348.2022.2092100] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Predicting omalizumab treatment response has been a challenge and significant aspect for selecting suitable severe allergic asthma patients for omalizumab use. OBJECTIVE To determine which domains of pretreatment baseline characteristics predict omalizumab treatment response among asthmatic patients. METHODS Electronic bases were searched for eligible studies that reported potential biomarkers that could predict omalizumab responsiveness and efficacy. Patients who accepted omalizumab treatment were stratified into responders and non-responders. WMD, OR, and their 95%CI were used to access the differences between those omalizumab receivers. Sensitivity analysis and subgroup analysis were conducted for potential heterogeneity. RESULTS A total of 41 studies evaluating efficacy predictors of omalizumab were included in this meta-analysis. The pooled results showed that omalizumab responders had significantly younger age in the adult subgroup, higher pretreatment total serum IgE level, percent predicted FEV1 and FeNO than that non-responder. We further confirmed that higher blood eosinophil counts and total serum IgE levels are useful markers for selecting asthma patients who may benefit more from omalizumab. CONCLUSIONS Pre-treatment blood eosinophil counts and total serum IgE level can be a useful efficacy predictor in selecting allergic asthma patients for omalizumab treatment.
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Affiliation(s)
- Yaqin Li
- Department of Pediatric, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaoyan Li
- Department of Pediatric, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Biyu Zhang
- Department of Pediatric, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qing Yu
- Department of Pediatric, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yanming Lu
- Department of Pediatric, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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2
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Benes J, Skulec R, Jilek D, Fibigr O, Cerny V. Successful treatment of refractory status asthmaticus with omalizumab: a case report. Allergy Asthma Clin Immunol 2021; 17:128. [PMID: 34886898 PMCID: PMC8656026 DOI: 10.1186/s13223-021-00629-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Accepted: 11/18/2021] [Indexed: 11/10/2022] Open
Abstract
Refractory status asthmaticus is the cause of rare cases of in-hospital death due to acute bronchial asthma. The most severe cases unresponsive to first, second and next line treatment may be fatal despite aggressive organ support with invasive ventilation and extracorporeal membrane oxygenation. Omalizumab, a humanized recombinant monoclonal anti-IgE antibody, is an approved add-on biological treatment for severe asthma. However, it is not indicated in an acute setting. Here, we report the case of a young patient with status asthmaticus fully dependent on extracorporeal membrane oxygenation refractory to any therapy for six days, who was successfully treated with omalizumab.
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Wedi B, Traidl S. Anti-IgE for the Treatment of Chronic Urticaria. Immunotargets Ther 2021; 10:27-45. [PMID: 33628747 PMCID: PMC7898214 DOI: 10.2147/itt.s261416] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 01/22/2021] [Indexed: 12/27/2022] Open
Abstract
Urticaria and angioedema are very common. Management of chronic urticaria subtypes, which usually persist for many years, is challenging. Recent years have demonstrated that targeting IgE with antibodies provides a safe and efficient treatment approach. Whilst several anti-IgE antibodies have been developed, omalizumab is currently the only one approved for use. International and national guidelines recommend its use after failure of antihistamines at standard and increased dose. Whilst not yet approved, many new anti-IgE approaches are currently being investigated in pre-clinical studies or clinical trials. This non-systematic focused review summarizes current knowledge of omalizumab and other anti-IgE biologics in chronic urticaria using data extracted from PubMed, Google Scholar and clinical trial databases, clinicaltrials.gov and clinicaltrials.eu. For adults, there is good evidence from randomized clinical trials and real-world data that symptomatic treatment with omalizumab is efficacious and safe in chronic spontaneous urticaria (CSU), whereas evidence in chronic inducible urticaria (CINDU) and special populations is limited. Easy-to-use tools to identify non-responders and predict the required duration of treatment have not been established yet. Phase 2 b results of ligelizumab have not only demonstrated efficacy and safety but also superiority to omalizumab. Indeed, there is preliminary evidence that omalizumab non- or partial responders benefit from ligelizumab. Whereas further development of quilizumab was discontinued, other approaches, eg UB-221 or DARPins are under investigation. Anti-IgE treatment with omalizumab represents a landmark in the treatment of chronic urticaria, with and without angioedema, and there is light on the horizon suggesting success may come with various next-generation anti-IgE approaches.
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Affiliation(s)
- Bettina Wedi
- Department of Dermatology and Allergy, Comprehensive Allergy Center, Hannover Medical School, Hannover, Germany
| | - Stephan Traidl
- Department of Dermatology and Allergy, Comprehensive Allergy Center, Hannover Medical School, Hannover, Germany
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Abstract
The SARS-CoV-2 is a β-CoV, which is enveloped by non-segmented positive-stranded RNA virüs. When β-CoV infects the respiratory tract, it can cause mild and/or severe acute respiratory syndrome (SARS) with consequent release of cytokines/mediators, including interleukin (IL)-1β, IL-2, IL-4, IL-5, IL-6, IL-7, IL-8 (CXCL8), IL-10, IP10, IL-12, IL-13, IL-17, IL-33, IL-25, IL-37, IL-38, GCSF, GM-CSF, HGF, IP-10, MCP-1, MIP-1α (also known as CCL3), IFN-γ, IFN-α, TRAIL, MCSF, and TNF-α. Our hypothesis of writing this article can be summarized as; if the monoclonal antibody (mAb) administered by us does not inhibit the immune response for the β-CoV and inhibits uncontrolled-adaptive/hyperimmune responses (also called cytokine storm) on endothelium level, then it may cause severe coronavirus disease 2019 (COVID-19). Anakinra is a human IL-1 receptor antagonist. By inhibiting IL-1α/IL-1β competitively from binding to the IL-1 type-I receptor, anakinra, neutralizes the activity that pertains to these key mediators of autoinflammatory and/or immune processes. Tocilizumab is a blocker of IL-6R that can effectively block IL-6 signal transduction pathway. Omalizumab that binds to the CH3 domain is near to the binding site for the high-affinity IgE Fc receptors type-I of human IgE. Myocardial, lung and hepatorenal injury in patients with COVID-19 could be due to cytokine storm, hypoxic injury, or/and direct endothelial/vascular injury. We propose combination of mAbs with remdesivir and/or favipiravir in severe COVID-19 cases, such as septic shock, acute respiratory deficiency syndrome, and/or multiple organ failure. Finally, we highlight the therapeutic mAbs that target patients with severe COVID-19.
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Affiliation(s)
- Arzu Didem Yalcin
- Department of Internal Medicine, Allergy and Clinical Immunology Section, Biotechnology and Moleculer Biology Unit, Academia Sinica, Genomics Research Center, Taipei, Taiwan
- Division of Allergy and Immunology, Department of Internal Medicine, Health Science University Antalya Education and Research Hospital, Antalya, Turkey
| | - Ata Nevzat Yalcin
- Medicine Faculty, Department of Infectious Disease and Clinical Microbiology, Akdeniz University, Antalya, Turkey
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YALCIN ARZUDIDEM, ONBASI KEVSER, UZUN RUSEN, HERTH FELIX, SCHNABEL PHILIPPALBERT. Human(ized) monoclonal antibodies in atopic patients - state of the art. Cent Eur J Immunol 2020; 45:195-201. [PMID: 33456331 PMCID: PMC7792442 DOI: 10.5114/ceji.2020.97909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Accepted: 04/13/2017] [Indexed: 02/05/2023] Open
Abstract
Asthma is an important chronic disease affecting a lot of people worldwide. Treatment options for asthma like biological agents are being developed more frequently nowadays. Despite a lot of treatment options, some patients still remain symptomatic. As more and more practitioners choose treatment with biologic agents as a convenient way of therapy, biologic agents and other valuable methods must be discovered in order to cope with a growing number of treatment agents. This manuscript emphasizes on new generation monoclonal human(ized) antibodies in asthmatics and off-label use . The first developed biologic agent is the anti-immunoglobulin E monoclonal antibody called omalizumab. Currently it is an approved treatment option for asthma.
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Affiliation(s)
- ARZU DIDEM YALCIN
- Department of Internal Medicine, Allergy and Clinical Immunology, Genomics Research Center, Academia Sinica, Taipei, Taiwan
- Department of Allergy and Clinical Immunology, Antalya Training and Research Hospital, University of Medical Science, Antalya, Turkey
- Correspondence: Arzu Didem Yalcin, Department of Internal Medicine, Allergy and Clinical Immunology, Genomics Research Center, Academia Sinica, 11529 Tapei,Taiwan, e-mail:
| | - KEVSER ONBASI
- Department of Internal Medicine, Allergy and Clinical Immunology, Dumlupinar University, Kütahya, Turkey
| | - RUSEN UZUN
- Department of Pulmonology, Antalya Training and Research Hospital, University of Medical Science, Antalya, Turkey
| | - FELIX HERTH
- Department of Pulmonary and Critical Care Medicine, Thoraxklinik Translational Lung Research Center, University of Heidelberg, Heidelberg, Germany
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6
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Yalcin AD, Uzun R. Anti-IgE Significantly Changes Circulating Interleukin-25, Vitamin-D and Interleukin-33 Levels in Patients with Allergic Asthma. Curr Pharm Des 2019; 25:3784-3795. [PMID: 31566129 DOI: 10.2174/1381612825666190930095725] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 09/24/2019] [Indexed: 02/08/2023]
Abstract
BACKGROUND Multi-center, randomized-controlled trials and observational studies have demonstrated that, in severe asthmatic patients receiving omalizumab treatment, the frequency of exacerbations, the number of urgent adverse events, and the need for oral steroids tend to decrease. MATERIALS AND METHODS This study included a total of 32 patients. The patients were divided into two groups as Group IA (pre-omalizumab) and Group IB (post-omalizumab). Serum IL-25 and IL-33 levels were measured and the number of emergency admissions, length of hospitalization (day), Asthma Control Test (ACT) scores, eosinophil cationic protein (ECP), and fractional exhaled nitric oxide (FeNO) value were analyzed. RESULTS ACT and FeNO values increased after omalizumab treatment, while IL-33, IL-25 levels decreased after the completion of omalizumab treatment. Furthermore, there was a weak, positive, and significant relationship between the changes in the ECP levels and IL-33 levels (r=0.38, p=0.03). CONCLUSION To the best of our knowledge, this is the first study to compare circulating IL-25 and IL-33 levels with specific IgE synthesis in the literature. Multivariate correlation analysis showed that the changes in serum IL-33 levels were significantly correlated with the changes in the mite sIgE levels and length of hospital stay (Fmodel=11.2, p=0.01, r2=0.45). On the other hand, there was no significant relationship between the other variables and changes in the IL-25 levels.
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Affiliation(s)
- Arzu D Yalcin
- Internal Medicine, Allergy and Clinical Immunology, Academia Sinica, Genomics Research Center, 11529, Taipei, Taiwan
| | - Rusen Uzun
- University of Medical Science, Antalya Hospital, Antalya 07070, Turkey
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7
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Yang G, Cheng BH, Yang SB, Liu ZQ, Qiu SQ, Yang LT, Xie RD, Geng XR, Li MG, Gao L, Liu ZG, Yang PC. Targeting histone-acetyltransferase Tat-interactive protein 60 inhibits intestinal allergy. Allergy 2018; 73:387-394. [PMID: 28871603 DOI: 10.1111/all.13304] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2017] [Indexed: 01/06/2023]
Abstract
BACKGROUND The overproduction of IgE plays a critical role in the pathogenesis of allergy; the mechanism is unclear. Histone-acetyltransferase (HAT) activities are required in gene transcription of a large number of molecules in the immune system of the body. OBJECTIVES This study tests a hypothesis that HAT Tat-interactive protein 60 (Tip60) plays an important role in the initiation of IgE-mediated allergy. METHODS The effects of Tip60 on regulating IgE expression were assessed with B cells. An intestinal allergy mouse model was developed to assess the role of Tip60 in the induction of IgE-mediated allergic inflammation. RESULTS High levels of Tip60 were observed in the peripheral B cells of patients with FA. Tat-interactive protein 60 (Tip60) was required in the expression of IgE and IgG1 in B cells by inducing the chromatin remolding at the gene locus, in which histone acetylation, signal transducer and activator of transcription 6 (STAT6), and nuclear factor-κB at the locus of Iε promoter were markedly increased. Blocking Tip60 significantly attenuated the allergic inflammation in the mouse intestinal mucosa. CONCLUSIONS Tat-interactive protein 60 (Tip60) plays an important role in the induction of IgE in B cells. Blocking Tip60 inhibits the allergic inflammation in the intestine, suggesting Tip60 inhibitor may be a potential anti-allergy drug.
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Affiliation(s)
- G. Yang
- The Affiliated ENT Hospital and the Research Center of Allergy & Immunology; Shenzhen University School of Medicine; Shenzhen China
- The Brain Body Institute; McMaster University; Hamilton ON Canada
| | - B.-H. Cheng
- The Affiliated ENT Hospital and the Research Center of Allergy & Immunology; Shenzhen University School of Medicine; Shenzhen China
| | - S.-B. Yang
- Department of Cadre Clinic; Chinese PLA General Hospital; Beijing China
| | - Z.-Q. Liu
- The Affiliated ENT Hospital and the Research Center of Allergy & Immunology; Shenzhen University School of Medicine; Shenzhen China
- The Brain Body Institute; McMaster University; Hamilton ON Canada
| | - S.-Q. Qiu
- The Affiliated ENT Hospital and the Research Center of Allergy & Immunology; Shenzhen University School of Medicine; Shenzhen China
| | - L.-T. Yang
- The Affiliated ENT Hospital and the Research Center of Allergy & Immunology; Shenzhen University School of Medicine; Shenzhen China
- The Brain Body Institute; McMaster University; Hamilton ON Canada
| | - R.-D. Xie
- The Affiliated ENT Hospital and the Research Center of Allergy & Immunology; Shenzhen University School of Medicine; Shenzhen China
| | - X.-R. Geng
- The Affiliated ENT Hospital and the Research Center of Allergy & Immunology; Shenzhen University School of Medicine; Shenzhen China
- The Brain Body Institute; McMaster University; Hamilton ON Canada
| | - M.-G. Li
- The Affiliated ENT Hospital and the Research Center of Allergy & Immunology; Shenzhen University School of Medicine; Shenzhen China
| | - L. Gao
- The Affiliated ENT Hospital and the Research Center of Allergy & Immunology; Shenzhen University School of Medicine; Shenzhen China
| | - Z.-G. Liu
- The Affiliated ENT Hospital and the Research Center of Allergy & Immunology; Shenzhen University School of Medicine; Shenzhen China
| | - P.-C. Yang
- The Affiliated ENT Hospital and the Research Center of Allergy & Immunology; Shenzhen University School of Medicine; Shenzhen China
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8
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Tonacci A, Billeci L, Pioggia G, Navarra M, Gangemi S. Omalizumab for the Treatment of Chronic Idiopathic Urticaria: Systematic Review of the Literature. Pharmacotherapy 2017; 37:464-480. [DOI: 10.1002/phar.1915] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Alessandro Tonacci
- Clinical Physiology Institute; National Research Council of Italy (IFC-CNR); Pisa Italy
| | - Lucia Billeci
- Clinical Physiology Institute; National Research Council of Italy (IFC-CNR); Pisa Italy
| | - Giovanni Pioggia
- Institute of Applied Sciences and Intelligent Systems “Eduardo Caianiello” (ISASI); National Research Council of Italy (CNR); Messina Italy
| | - Michele Navarra
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences; University of Messina; Messina Italy
| | - Sebastiano Gangemi
- Institute of Applied Sciences and Intelligent Systems “Eduardo Caianiello” (ISASI); National Research Council of Italy (CNR); Messina Italy
- School and Division of Allergy and Clinical Immunology, Department of Clinical and Experimental Medicine; University Hospital “G. Martino”; Messina Italy
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9
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Magen E, Chikovani T. Possible therapeutic role of IgE blockade in irritable bowel syndrome. World J Gastroenterol 2016; 22:9451-9456. [PMID: 27920467 PMCID: PMC5116590 DOI: 10.3748/wjg.v22.i43.9451] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Revised: 09/23/2016] [Accepted: 10/27/2016] [Indexed: 02/06/2023] Open
Abstract
Omalizumab is a humanized monoclonal antibody that binds to the high-affinity type-I IgE Fc receptors on mast cells (MCs) and basophils, inhibiting the IgE immune pathway. Irritable bowel syndrome (IBS) is the most common functional gastrointestinal disorder, and dysregulation of the immune system likely contributes to its etiology and/or symptomatology. Colonic biopsies from patients with IBS demonstrate considerable increase in the number of degranulating MCs releasing histamine in proximity to nerves, and this event may underlie the common IBS symptom of abdominal pain. Pharmacologic control of MC activation and mediator release is a current area of active interest in the field of IBS research. Recently, we and Pearson et al described 2 cases of patients with IBS with diarrhea (IBS-D) showing positive clinical response to omalizumab. In both cases, the female patients had severe, long-lasting IBS-D and achieved an almost complete resolution of IBS symptoms. Both patients were also able to discontinue all IBS medications after commencing the anti-IgE therapy. For both patients, the omalizumab treatment showed a relatively rapid onset of action, resembling the efficacy observed in and previously reported for patients with chronic spontaneous urticaria. In this Editorial, we discuss the possible biological mechanisms that may underlie the clinical efficacy of omalizumab in IBS. We suggest that there is a need for a well-designed prospective study to investigate the therapeutic effects of anti-IgE in IBS.
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Uzun R, Yalcin AD, Celik B, Bulut T, Yalcin AN. Levofloxacin Induced Toxic Epidermal Necrolysis: Successful Therapy with Omalizumab (Anti-IgE) and Pulse Prednisolone. AMERICAN JOURNAL OF CASE REPORTS 2016; 17:666-71. [PMID: 27634312 PMCID: PMC5027856 DOI: 10.12659/ajcr.899823] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Toxic epidermal necrolysis (TEN) is characterized by widespread erythematous and bullous lesions on the skin. Nowadays, considerable progress has been made in the understanding of its pathogenesis. Immunologically it is similar to graft-versus-host disease. Therefore, we may propose that TEN is a disorder of cell-mediated immunity. CASE REPORT Our patient was a 74-year-old white female who had pneumonia and was positive for hepatitis C virus (HCV), and who had been on levofloxacin therapy. After the first levofloxacin dose, erythematous dusky red macules occurred on her extremities and trunk, and on the following day, confluent purpuric lesions tended to run together over 85% of her body. Her biopsy results indicated TEN. Laboratory testing for serum ECP (eosinophil cationic peptide) and serum immunoglobulin (Ig) levels were performed, and blister fluid was investigated. The patient responded positively to omalizumab treatment and after treatment laboratory tests revealed decreased high sensitive CRP, ECP, IgG1, IgG2, IgG3, IgG4, IgA, and IgM levels. CONCLUSIONS To the best of our knowledge, this is the first case of a patient with HCV who developed cutaneous adverse drug reaction on levofloxacin medication and recovered with omalizumab treatment. This is the first documentation of omalizumab treatment of a TEN patient.
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Affiliation(s)
- Rusen Uzun
- Department of Pulmonology, Antalya Education and Research Hospital, Antalya, Turkey
| | - Arzu Didem Yalcin
- Department of Internal Medicine, Allergy and Clinical Immunology, Academia Sinica, Genomics Research Center, Taipei, Taiwan
- Antalya Education and Research Hospital, Antalya, Turkey
- Corresponding Author: Arzu Didem Yalcin, e-mail:
| | - Betul Celik
- Department of Pathology, Antalya Education and Research Hospital, Antalya, Turkey
| | - Tangul Bulut
- Department of Pathology, Antalya Education and Research Hospital, Antalya, Turkey
| | - Ata Nevzat Yalcin
- Department of Infectious Disease, Akdeniz University, Faculty of Medicine, Antalya, Turkey
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11
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Li LJ, Ma N, Zeng L, Mo LH, Li XX, Xu LZ, Yang B, Liu ZG, Feng BS, Zheng PY, Zhang HP, Yang PC. Flagellin modulates IgE expression in B cells to initiate food allergy in mice. Am J Transl Res 2016; 8:2748-2757. [PMID: 27398157 PMCID: PMC4931168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Accepted: 06/08/2016] [Indexed: 06/06/2023]
Abstract
The initiation mechanism of IgE expression has not been fully understood. Flagellin (FGN) is an important microbial factor in the regulation of immune responses in the intestine. This study tests a hypothesis that FGN plays a crucial role in the isotype switching of IgE in B cells and the initiation of food allergy. In this study, the expression of IgE in B cells was analyzed by real time RT-PCR, Western blotting and chromatin immunoprecipitation. A mouse model was developed to assess the role of Toll like receptor-5 in the development of IgE-mediated allergic reaction in the intestinal mucosa. The results showed that exposure to FGN suppressed the expression of Bcl6 in B cells via increasing the levels of histone deacetylase (HDAC) 7; the latter up regulated the levels of methylated H3K9 and H3K27, down regulated RNA polymerase II and STAT3 (signal transducer and activator of transcription 3) at the Bcl6 promoter locus. Exposure to FGN and IL-4 markedly increased the expression of IgE in B cells via activating p300, H3K4, Pol II and STAT6 at the IgE promoter locus. As compared with the sensitized wild mice, the sensitized TLR5-deficient mice showed no detectable OVA-specific IgE in the serum; mast cells in the intestinal mucosa were not activated, no apparent allergic symptoms were evoked after the specific antigen challenge. In conclusion, FGN facilitates the initiation of food allergy in mice by triggering IgE transcription in B cells in a Th2 polarization environment via activating HDAC7 and suppressing Bcl6 expression.
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Affiliation(s)
- Lin-Jing Li
- Department of Gastroenterology, The First Hospital, Zhengzhou UniversityZhengzhou 450052, China
- Brain Body Institute and Department of Pathology & Molecular Medicine, McMaster UniversityHamilton, ON, L8N 3Z5, Canada
| | - Na Ma
- Department of Gastroenterology, The First Hospital, Zhengzhou UniversityZhengzhou 450052, China
- The Research Center of Allergy & Immunology, Shenzhen University School of MedicineShenzhen 518060, China
| | - Lu Zeng
- The Research Center of Allergy & Immunology, Shenzhen University School of MedicineShenzhen 518060, China
| | - Li-Hua Mo
- The Research Center of Allergy & Immunology, Shenzhen University School of MedicineShenzhen 518060, China
| | - Xiao-Xi Li
- The Research Center of Allergy & Immunology, Shenzhen University School of MedicineShenzhen 518060, China
| | - Ling-Zhi Xu
- The Research Center of Allergy & Immunology, Shenzhen University School of MedicineShenzhen 518060, China
| | - Bo Yang
- The Research Center of Allergy & Immunology, Shenzhen University School of MedicineShenzhen 518060, China
| | - Zhi-Gang Liu
- The Research Center of Allergy & Immunology, Shenzhen University School of MedicineShenzhen 518060, China
| | - Bai-Sui Feng
- Department of Gastroenterology, The Second Hospital, Zhengzhou UniversityZhengzhou 450052, China
| | - Peng-Yuan Zheng
- Department of Gastroenterology, The Fifth Hospital, Zhengzhou UniversityZhengzhou 450052, China
| | - Huan-Ping Zhang
- Brain Body Institute and Department of Pathology & Molecular Medicine, McMaster UniversityHamilton, ON, L8N 3Z5, Canada
| | - Ping-Chang Yang
- The Research Center of Allergy & Immunology, Shenzhen University School of MedicineShenzhen 518060, China
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12
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Best LG, O'Leary RA, O'Leary MA, Yracheta JM. Humoral immune factors and asthma among American Indian children: a case-control study. BMC Pulm Med 2016; 16:93. [PMID: 27295946 PMCID: PMC4906591 DOI: 10.1186/s12890-016-0257-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Accepted: 06/04/2016] [Indexed: 01/12/2023] Open
Abstract
Background Asthma is recognized as intimately related to immunologic factors and inflammation, although there are likely multiple phenotypes and pathophysiologic pathways. Biomarkers of inflammation may shed light on causal factors and have potential clinical utility. Individual and population genetic factors are correlated with risk for asthma and improved understanding of these contributions could improve treatment and prevention of this serious condition. Methods A population-based sample of 108 children with clinically defined asthma and 216 control children were recruited from a small community in the northern plains of the United States. A complete blood count, high sensitivity C-reactive protein, total IgE and specific antibodies to 5 common airborne antigens (CAA), in addition to basic demographic and anthropomorphic data were obtained. Logistic regression was primarily used to determine the association between these humoral factors and risk of asthma. Results The body mass index (BMI) of those with asthma and their total leukocyte counts, percentage of eosinophils, and levels of total IgE were all greater than corresponding control values in univariate analysis. The presence of detectable, specific IgE antibodies to five common airborne antigens was more likely among cases compared with controls. In multivariate analysis, total IgE was independently associated with asthma; but not after inclusion of a cumulative measure of specific IgE sensitization. Conclusion Many previously reported associations between anthropomorphic and immune factors and increased risk of asthma appear to be also present in this American Indian population. In this community, asthma is strongly associated with sensitization to CAA.
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Affiliation(s)
- Lyle G Best
- Missouri Breaks Industries Research Inc, Eagle Butte, SD, USA. .,Turtle Mountain Community College, Belcourt, ND, USA. .,, 1935 118th Ave NW, Watford City, ND, 58854, USA.
| | - Rae A O'Leary
- Missouri Breaks Industries Research Inc, Eagle Butte, SD, USA
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13
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Yalcin AD. A case of netherton syndrome: successful treatment with omalizumab and pulse prednisolone and its effects on cytokines and immunoglobulin levels. Immunopharmacol Immunotoxicol 2016; 38:162-6. [PMID: 26592187 DOI: 10.3109/08923973.2015.1115518] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
CONTEXT Netherton syndrome (NS) is associated with the mutation in the SPINK5 gene, which codes LEKTI (lymphoepithelial Kazaltype related inhibitor), a serine protease inhibitor. As a result of aging coupled with immune deficiency, clinical symptoms may vary. METHODS The patient was presented to our clinic with sparse and brittle hair along with pruritic, erythematous and scaling cutaneous lesions. The patient underwent a clinical examination and laboratory analyzes. Based on the clinical and laboratory findings, the patient was diagnosed with NS. Moreover, CRP, Complement-3 (C3), C4 IL-4, IL-5, IL-1β and IL-17A levels of serum were investigated as an apoptotic marker and a negative marker for inflammation. RESULTS Having undergone omalizumab treatment and a short-term (4 months) later, he had a decreased IgE, Ig G, prolactin, CRP, IL-4, IL-5, IL-1β and IL-17A levels. The IgA, IgM and C3, C4 levels were insignificant between before and after Omalizumab treatment. CONCLUSION To the best of our knowledge, this is the first time that an association between omalizumab and NS was documented. In conclusion allergic skin symptoms (pruritus, erythema and desquamation) and mucosal symptoms decreased in the patient.
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Affiliation(s)
- Arzu Didem Yalcin
- a Department of Internal Medicine , Clinical Immunology and Allergy Unit, Antalya Training and Research Hospital , Antalya , Turkey
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Cherrez Ojeda I, Calderon JC, Plaza K, Vanegas E, Cherrez A, Cano J. Urticaria as initial finding of a patient with carcinoid tumor. World Allergy Organ J 2015; 8:34. [PMID: 26681999 PMCID: PMC4675029 DOI: 10.1186/s40413-015-0083-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Accepted: 11/11/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Typical carcinoid syndrome is characterized by flushing, abdominal pain and diarrhea and occurs in <10 % of carcinoid tumor patients. Very rarely, initial signs include skin manifestations. Our purpose is to highlight cutaneous manifestations in the diagnosis and assessment of a patient with atypical manifestation of type I gastric carcinoid tumor. CASE PRESENTATION A 50-year-old woman presented with anemia, chronic urticaria and angioedema. Urticaria was triggered principally by seafood and appeared in the first hour after. Urticaria Activity Score 7 was 24, and quality of life (CU-Q2oL) was 3.61. P. Laboratory findings showed anemia, diminished iron, ferritin, and vitamin B12, with increased gastrin and anti-parietal cell antibody levels. 15 gastric carcinoids 5 mm in diameter were observed in the greater curvature of the stomach during gastric endoscopy and confirmed by biopsy, suggesting that this patient had type I gastric carcinoids. Four additional tumors were found in the small intestine upon examination via video capsule. Endoscopic argon plasma therapy was performed. The patient experienced definitive improvement in quality of life and urticaria activity score. CONCLUSION This patient, whose principal symptoms were anemia, urticaria and angioedema, was found to have atypical carcinoid syndrome, with tumors located in the stomach. Allergists, immunologists, internists and primary care physicians should consider the possibility of neuroendocrine malignancies, specifically type I carcinoid tumors, when evaluating patients with urticaria, and consider screening patients with chronic urticaria for elevated anti-parietal cell antibody levels.
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Affiliation(s)
- Ivan Cherrez Ojeda
- />Universidad de Especialidades Espíritu Santo, School of Medicine, Samborondón, Ecuador
- />Respiralab Research Group, Clínica Kennedy, Guayaquil, Ecuador
| | - Juan Carlos Calderon
- />Universidad de Especialidades Espíritu Santo, School of Medicine, Samborondón, Ecuador
- />Respiralab Research Group, Clínica Kennedy, Guayaquil, Ecuador
| | - Karin Plaza
- />Universidad de Especialidades Espíritu Santo, School of Medicine, Samborondón, Ecuador
| | - Emanuel Vanegas
- />Universidad de Especialidades Espíritu Santo, School of Medicine, Samborondón, Ecuador
| | - Annia Cherrez
- />Respiralab Research Group, Clínica Kennedy, Guayaquil, Ecuador
- />University of Heidelberg, School of Medicine, Heidelberg, Germany
| | - José Cano
- />Universidad de Especialidades Espíritu Santo, School of Medicine, Samborondón, Ecuador
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