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Mayorga C, Palomares F, Cañas JA, Pérez-Sánchez N, Núñez R, Torres MJ, Gómez F. New Insights in Therapy for Food Allergy. Foods 2021; 10:foods10051037. [PMID: 34068667 PMCID: PMC8151532 DOI: 10.3390/foods10051037] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 04/24/2021] [Accepted: 05/05/2021] [Indexed: 12/23/2022] Open
Abstract
Food allergy is an increasing problem worldwide, with strict avoidance being classically the only available reliable treatment. The main objective of this review is to cover the latest information about the tools available for the diagnosis and treatment of food allergies. In recent years, many efforts have been made to better understand the humoral and cellular mechanisms involved in food allergy and to improve the strategies for diagnosis and treatment. This review illustrates IgE-mediated food hypersensitivity and provides a current description of the diagnostic strategies and advances in different treatments. Specific immunotherapy, including different routes of administration and new therapeutic approaches, such as hypoallergens and nanoparticles, are discussed in detail. Other treatments, such as biologics and microbiota, are also described. Therefore, we conclude that although important efforts have been made in improving therapies for food allergies, including innovative approaches mainly focusing on efficacy and safety, there is an urgent need to develop a set of basic and clinical results to help in the diagnosis and treatment of food allergies.
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Affiliation(s)
- Cristobalina Mayorga
- Allergy Research Group, Instituto de Investigación Biomédica de Málaga (IBIMA), 29009 Málaga, Spain; (F.P.); (J.A.C.); (R.N.)
- Allergy Clinical Unit, Hospital Regional Universitario de Málaga, 29071 Málaga, Spain; (N.P.-S.); (M.J.T.); (F.G.)
- Correspondence: ; Tel.: +34-951-290-224
| | - Francisca Palomares
- Allergy Research Group, Instituto de Investigación Biomédica de Málaga (IBIMA), 29009 Málaga, Spain; (F.P.); (J.A.C.); (R.N.)
| | - José A. Cañas
- Allergy Research Group, Instituto de Investigación Biomédica de Málaga (IBIMA), 29009 Málaga, Spain; (F.P.); (J.A.C.); (R.N.)
| | - Natalia Pérez-Sánchez
- Allergy Clinical Unit, Hospital Regional Universitario de Málaga, 29071 Málaga, Spain; (N.P.-S.); (M.J.T.); (F.G.)
| | - Rafael Núñez
- Allergy Research Group, Instituto de Investigación Biomédica de Málaga (IBIMA), 29009 Málaga, Spain; (F.P.); (J.A.C.); (R.N.)
| | - María José Torres
- Allergy Clinical Unit, Hospital Regional Universitario de Málaga, 29071 Málaga, Spain; (N.P.-S.); (M.J.T.); (F.G.)
- Medicine Department, Universidad de Málaga-UMA, 29071 Málaga, Spain
| | - Francisca Gómez
- Allergy Clinical Unit, Hospital Regional Universitario de Málaga, 29071 Málaga, Spain; (N.P.-S.); (M.J.T.); (F.G.)
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Chiera F, Caminiti L, Crisafulli G, Pajno GB. Advances in Management of Food Allergy in Children. Curr Pediatr Rev 2020; 16:123-128. [PMID: 31880264 DOI: 10.2174/1573396316666191227122917] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 09/23/2019] [Accepted: 09/23/2019] [Indexed: 11/22/2022]
Abstract
Food allergy is a potentially life-threatening medical condition and a significant public health concern worldwide. The current management consists of strict avoidance of the culprit food and treating any adverse reactions from unintended food ingestion. The increasing prevalence of food allergy encouraged research and clinical trials in the field of specific allergen immunotherapy (AIT) which represents an appealing approach, especially in pediatric age. AIT consists of the gradual administration of growing amounts of the offending allergen in order to induce food desensitization, which is an increase in the threshold for reactivity while continuing on regular exposure to the allergen. AIT can be administered through oral, sublingual, epicutaneous, and subcutaneous routes. Reports on oral immunotherapy (OIT) thus far have been more extensive. The desirable goal is to achieve "post desensitization effectiveness", that is the ability to introduce food without reaction even after a period of discontinuation of the offending food. Other therapeutic approaches are being studied alongside immunotherapy such as modified proteins, probiotics, Chinese herbal supplements, biologic therapies, and DNA vaccines.
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Affiliation(s)
- Fernanda Chiera
- Department of Pediatrics, Ospedale San Giovanni di Dio, Crotone, Italy
| | - Lucia Caminiti
- Department of Pediatrics, Allergy Unit, University of Messina, Messina, Italy
| | - Giuseppe Crisafulli
- Department of Pediatrics, Allergy Unit, University of Messina, Messina, Italy
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Eichhorn S, Hörschläger A, Steiner M, Laimer J, Jensen BM, Versteeg SA, Pablos I, Briza P, Jongejan L, Rigby N, Asturias JA, Portolés A, Fernandez‐Rivas M, Papadopoulos NG, Mari A, Poulsen LK, Lackner P, van Ree R, Ferreira F, Gadermaier G. Rational Design, Structure-Activity Relationship, and Immunogenicity of Hypoallergenic Pru p 3 Variants. Mol Nutr Food Res 2019; 63:e1900336. [PMID: 31207117 PMCID: PMC6790652 DOI: 10.1002/mnfr.201900336] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 05/28/2019] [Indexed: 11/09/2022]
Abstract
SCOPE Allergies to lipid transfer proteins involve severe adverse reactions; thus, effective and sustainable therapies are desired. Previous attempts disrupting disulfide bonds failed to maintain immunogenicity; thus, the aim is to design novel hypoallergenic Pru p 3 variants and evaluate the applicability for treatment of peach allergy. METHODS AND RESULTS Pru p 3 proline variant (PV) designed using in silico mutagenesis, cysteine variant (CV), and wild-type Pru p 3 (WT) are purified from Escherichia coli. Variants display homogenous and stable protein conformations with an altered secondary structure in circular dichroism. PV shows enhanced long-term storage capacities compared to CV similar to the highly stable WT. Using sera of 33 peach allergic patients, IgE-binding activity is reduced by 97% (PV) and 71% (CV) compared to WT. Both molecules show strong hypoallergenicity in Pru p 3 ImmunoCAP cross-inhibition and histamine release assays. Immunogenicity of PV is demonstrated with a phosphate-based adjuvant formulation in a mouse model. CONCLUSIONS An in silico approach is used to generate a PV without targeting disulfide bonds, T cell epitopes, or previously reported IgE epitopes of Pru p 3. PV is strongly hypoallergenic while structurally stable and immunogenic, thus representing a promising candidate for peach allergen immunotherapy.
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Affiliation(s)
- Stephanie Eichhorn
- Department of BiosciencesUniversity of SalzburgHellbrunnerstraße 345020SalzburgAustria
| | - Angelika Hörschläger
- Department of BiosciencesUniversity of SalzburgHellbrunnerstraße 345020SalzburgAustria
| | - Markus Steiner
- Department of BiosciencesUniversity of SalzburgHellbrunnerstraße 345020SalzburgAustria
| | - Josef Laimer
- Department of BiosciencesUniversity of SalzburgHellbrunnerstraße 345020SalzburgAustria
| | - Bettina M Jensen
- Allergy Clinic, Dept. 22Herlev‐Gentofte HospitalKildegaardsvej 282900HellerupDenmark
| | - Serge A Versteeg
- Department of Experimental ImmunologyAmsterdam University Medical CentersMeibergdreef 91105AZAmsterdamThe Netherlands
| | - Isabel Pablos
- Department of BiosciencesUniversity of SalzburgHellbrunnerstraße 345020SalzburgAustria
| | - Peter Briza
- Department of BiosciencesUniversity of SalzburgHellbrunnerstraße 345020SalzburgAustria
| | - Laurian Jongejan
- Department of Experimental ImmunologyAmsterdam University Medical CentersMeibergdreef 91105AZAmsterdamThe Netherlands
| | - Neil Rigby
- Food & Health ProgrammeInst. of Food ResearchNorwichNorfolkNR4 7UQUnited Kingdom
| | - Juan A Asturias
- R&D DepartmentROXALL GroupParque Científico y Tecnológico de BizkaiaEdif. 40148170ZamudioSpain
| | - Antonio Portolés
- Department of Clinical PharmacologyHospital Clinico San Carlosc/ Prof. Martín Lagos s/n28040MadridSpain
| | | | - Nikolaos G Papadopoulos
- Division of Infection, Immunity & Respiratory MedicineUniversity of ManchesterRoyal Manchester Children's HospitalManchesterM13 9WLUnited Kingdom
- Allergy Dpt, 2nd Pediatric Clinic, University of Athens41, FidippidouAthens115 27Greece
| | - Adriano Mari
- Center of Molecular AllergologyIDIVia dei Monti di Creta 104ZIP 00167RomeItaly
- Associated Centers for Molecular AllergologyVia Portuense 700ZIP 00149RomeItaly
| | - Lars K Poulsen
- Allergy Clinic, Dept. 22Herlev‐Gentofte HospitalKildegaardsvej 282900HellerupDenmark
| | - Peter Lackner
- Department of BiosciencesUniversity of SalzburgHellbrunnerstraße 345020SalzburgAustria
| | - Ronald van Ree
- Department of Experimental ImmunologyAmsterdam University Medical CentersMeibergdreef 91105AZAmsterdamThe Netherlands
- Department of OtorhinolaryngologyAmsterdam University Medical CentersMeibergdreef 91105AZAmsterdamThe Netherlands
| | - Fatima Ferreira
- Department of BiosciencesUniversity of SalzburgHellbrunnerstraße 345020SalzburgAustria
| | - Gabriele Gadermaier
- Department of BiosciencesUniversity of SalzburgHellbrunnerstraße 345020SalzburgAustria
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Ukleja-Sokołowska N, Zacniewski R, Gawrońska-Ukleja E, Żbikowska-Gotz M, Lis K, Sokołowski Ł, Adamczak R, Bartuzi Z. Food-dependent, exercise-induced anaphylaxis in a patient allergic to peach. Int J Immunopathol Pharmacol 2018; 32:2058738418803154. [PMID: 30270687 PMCID: PMC6168719 DOI: 10.1177/2058738418803154] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Determining the single factor that triggered anaphylactic shock can be challenging. We present an interesting case of a 25-year-old female patient with recurrent anaphylactic reactions developing after eating various foods, particularly in presence of co-factors of allergic reactions. Symptoms occurred after consumption of various kinds of foods - peach, pancakes with cottage cheese and fruit, a meal from a Chinese restaurant - all eaten on other occasions without symptoms. During diagnosis, skin prick tests were negative for all tested allergen extracts (both inhalatory and food) from Allergopharma. Prick by prick tests were positive for the peach - wheal diameter - 6 mm, nectarine - 4 mm (histamine 4 mm, negative control 0 mm). Increased levels of asIgE were found for allergens of peach (0.55 kU/L).Open challenge test with one mid-size peach combined with the physical exercise challenge test was positive. ImmunoCAP ISAC test indicated increased levels of IgE specific for the lipid transfer protein (LTP) for walnut (nJug r 3), peach (Pru p 3), wheat (rTri a 14) and plane tree (rPla a 3). The patient was diagnosed with food-dependent, exercise-induced anaphylaxis associated with an allergy to lipid transport proteins (LTPs).
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Affiliation(s)
- Natalia Ukleja-Sokołowska
- 1 Department of Allergology, Clinical Immunology and Internal Diseases, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Bydgoszcz, Poland
| | - Robert Zacniewski
- 1 Department of Allergology, Clinical Immunology and Internal Diseases, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Bydgoszcz, Poland
| | - Ewa Gawrońska-Ukleja
- 1 Department of Allergology, Clinical Immunology and Internal Diseases, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Bydgoszcz, Poland
| | - Magdalena Żbikowska-Gotz
- 1 Department of Allergology, Clinical Immunology and Internal Diseases, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Bydgoszcz, Poland
| | - Kinga Lis
- 1 Department of Allergology, Clinical Immunology and Internal Diseases, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Bydgoszcz, Poland
| | - Łukasz Sokołowski
- 2 Division of Ergonomics and Exercise Physiology, Department of Hygiene, Epidemiology and Ergonomics, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Bydgoszcz, Poland
| | - Rafał Adamczak
- 3 Department of Obstetrics and Gynecology, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Bydgoszcz, Poland
| | - Zbigniew Bartuzi
- 1 Department of Allergology, Clinical Immunology and Internal Diseases, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Bydgoszcz, Poland
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Rodriguez MJ, Palomares F, Bogas G, Torres MJ, Diaz-Perales A, Rojo J, Plaza-Seron MDC, Rodriguez-Nogales A, Orengo C, Mayorga C, Perkins JR. Transcriptional Profiling of Dendritic Cells in a Mouse Model of Food-Antigen-Induced Anaphylaxis Reveals the Upregulation of Multiple Immune-Related Pathways. Mol Nutr Food Res 2018; 63:e1800759. [PMID: 30458065 DOI: 10.1002/mnfr.201800759] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 11/05/2018] [Indexed: 12/18/2022]
Abstract
SCOPE Much of the knowledge about gene expression during anaphylaxis comes from candidate gene studies. Despite their potential role, expression changes in dendritic cells (DCs) have not been studied in this context using high throughput methods. The molecular mechanisms underlying food-antigen-induced anaphylaxis are investigated using DCs from an animal model. METHODS AND RESULTS RNA sequencing is used to study gene expression in lymph-node-derived DCs from anaphylactic mice sensitized intranasally with the major peach allergen Pru p 3 during the acute reaction phase, induced intraperitoneally. In total, 237 genes changed significantly, 181 showing at least twofold changes. Almost three-quarters of these increase during anaphylaxis. A subset is confirmed using RT-PCR in a second set of samples obtained from a new batch of mice. Enrichment analysis shows an overrepresentation of genes involved in key immune system and inflammatory processes, including TGF-β signaling. Comparison with a study using anaphylactic human subjects show significant overlap. CONCLUSIONS The findings provide a comprehensive overview of the transcriptional changes occurring in DCs during anaphylaxis and help elucidate the mechanisms involved. They add further weight to the putative role of these cells in anaphylaxis and highlight genes that may represent potential therapeutic targets.
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Affiliation(s)
- Maria Jose Rodriguez
- Research Laboratory, IBIMA-Regional University Hospital of Malaga, UMA, 29009, Malaga, Spain
| | - Francisca Palomares
- Research Laboratory, IBIMA-Regional University Hospital of Malaga, UMA, 29009, Malaga, Spain
| | - Gador Bogas
- Allergy Unit, IBIMA-Regional University Hospital of Malaga, UMA, 29009, Malaga, Spain
| | - Maria Jose Torres
- Allergy Unit, IBIMA-Regional University Hospital of Malaga, UMA, 29009, Malaga, Spain
| | - Araceli Diaz-Perales
- Centro de Biotecnología y Genómica de Plantas (CBGP, UPM-INIA), Universidad Politécnica de Madrid (UPM), 28223, Pozuelo de Alarcon, Spain
| | - Javier Rojo
- Laboratory, Instituto de Investigaciones Químicas (IIQ), CSIC-Universidad de Sevilla, 41092, Sevilla, Spain
| | | | - Alba Rodriguez-Nogales
- Research Laboratory, IBIMA-Regional University Hospital of Malaga, UMA, 29009, Malaga, Spain
| | - Christine Orengo
- Institute of Structural and Molecular Biology, Division of Biosciences, University College London, London, WC1E 6BT, UK
| | - Cristobalina Mayorga
- Research Laboratory, IBIMA-Regional University Hospital of Malaga, UMA, 29009, Malaga, Spain.,Allergy Unit, IBIMA-Regional University Hospital of Malaga, UMA, 29009, Malaga, Spain
| | - James Richard Perkins
- Research Laboratory, IBIMA-Regional University Hospital of Malaga, UMA, 29009, Malaga, Spain
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