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Gorlanova O, Illi S, Toncheva AA, Usemann J, Latzin P, Kabesch M, Dalphin JC, Lauener R, Pekkanen JR, Von Mutius E, Riedler J, Kuehni CE, Röösli M, Frey U. Protective effects of breastfeeding on respiratory symptoms in infants with 17q21 asthma risk variants. Allergy 2018; 73:2388-2392. [PMID: 30030842 DOI: 10.1111/all.13568] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- O. Gorlanova
- University Children's Hospital (UKBB); University of Basel; Basel Switzerland
| | - S. Illi
- Dr von Hauner Children's Hospital; Ludwig Maximilian University; Munich Germany
- Comprehensive Pneumology Center Munich (CPC-M); Munich Germany
- Member of the German Center for Lung Research; Munich Germany
| | - A. A. Toncheva
- Department of Pediatric Pneumology and Allergy; University Children's Hospital Regensburg (KUNO); Regensburg Germany
| | - J. Usemann
- University Children's Hospital (UKBB); University of Basel; Basel Switzerland
- Division of Respiratory Medicine; Department of Paediatrics, Inselspital; Bern University Hospital; University of Bern; Bern Switzerland
| | - P. Latzin
- Division of Respiratory Medicine; Department of Paediatrics, Inselspital; Bern University Hospital; University of Bern; Bern Switzerland
| | - M. Kabesch
- Department of Pediatric Pneumology and Allergy; University Children's Hospital Regensburg (KUNO); Regensburg Germany
| | - J.-C. Dalphin
- Department of Respiratory Disease; UMR/CNRS 6249 Chrono-environment; University Hospital; University of Besançon; Besançon France
| | - R. Lauener
- Children's Hospital of Eastern Switzerland; St. Gallen Switzerland
- Christine Kühne Center for Allergy Research and Education (CK-CARE); Davos Switzerland
| | - J. R. Pekkanen
- National Institute for Health and Welfare; Kuopio Finland
- Department of Public Health; University of Helsinki; Helsinki Finland
| | - E. Von Mutius
- Dr von Hauner Children's Hospital; Ludwig Maximilian University; Munich Germany
- Comprehensive Pneumology Center Munich (CPC-M); Munich Germany
- Member of the German Center for Lung Research; Munich Germany
| | - J. Riedler
- Children's Hospital Schwarzach; Teaching Hospital Paracelsus Private Medical University Salzburg; Salzburg Austria
| | - C. E. Kuehni
- Institute for Social and Preventive Medicine; University of Bern; Bern Switzerland
| | - M. Röösli
- Swiss Tropical and Public Health Institute Basel; Basel Switzerland
| | - U. Frey
- University Children's Hospital (UKBB); University of Basel; Basel Switzerland
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2
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Straub Piccirillo D, Schmid‐Grendelmeier P, Hitzler M, Lauener R. Continuing medical education activities for improved management of allergy patients. Allergy 2018; 73:1351-1353. [PMID: 29575064 DOI: 10.1111/all.13443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- D. Straub Piccirillo
- Christine Kühne—Center for Allergy Research and Education (CK‐CARE) Davos Switzerland
| | - P. Schmid‐Grendelmeier
- Christine Kühne—Center for Allergy Research and Education (CK‐CARE) Davos Switzerland
- Allergy Unit Department of Dermatology University Hospital of Zürich Zürich Switzerland
| | - M. Hitzler
- Paediatric Community Practice Baar Switzerland
| | - R. Lauener
- Christine Kühne—Center for Allergy Research and Education (CK‐CARE) Davos Switzerland
- Childrens Hospital of Eastern Switzerland St. Gallen Switzerland
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3
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Ferstl R, Frei R, Barcik W, Schiavi E, Wanke K, Ziegler M, Rodriguez-Perez N, Groeger D, Konieczna P, Zeiter S, Nehrbass D, Lauener R, Akdis C, O'Mahony L. Histamine receptor 2 modifies iNKT cell activity within the inflamed lung. Allergy 2017; 72:1925-1935. [PMID: 28618071 DOI: 10.1111/all.13227] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/09/2017] [Indexed: 01/08/2023]
Abstract
BACKGROUND Histamine is a key immunoregulatory mediator and can dampen proinflammatory responses via activation of histamine receptor 2 (H2 R). The aim of this study was to determine the role of H2 R in modulating lung inflammatory responses. METHODS H2 R was blocked using famotidine or activated using dimaprit in both the ovalbumin (OVA) and house dust mite extract (HDM) murine models of respiratory inflammation. H2 R-deficient animals and CD1d/H2 R-deficient animals were utilized to examine the CD1d presentation of lipid antigens (αGalCer or OCH) to invariant natural killer T (iNKT) cells. RESULTS Famotidine treatment resulted in more severe airway disease in the OVA model, while dimaprit treatment significantly reduced disease severity. Both OVA and HDM-induced airway diseases were more severe in H2 R-deficient animals. Flow cytometric analysis of lung tissue from H2 R-deficient animals revealed increased numbers of CD1d+ dendritic cells and increased numbers of iNKT cells. In vitro, αGalCer-stimulated iNKT cells from H2 R-deficient mice secreted higher levels of IL-4, IL-5, and GM-CSF. In vivo, αGalCer or OCH administration to the lung resulted in enhanced mucus secretion, inflammatory cell recruitment, and cytokine production in H2 R-deficient or famotidine-treated animals, while dimaprit dampened the lung iNKT cell response to αGalCer. Removal of iNKT cells in H2 R-deficient (CD1d-/- H2 R-/- ) animals normalized the lung response to HDM. CONCLUSION The deliberate activation of H2 R, or its downstream signaling molecules, may represent a novel therapeutic target for chronic lung inflammatory diseases, especially when CD1d-mediated presentation of lipid antigens to iNKT cells is contributing to the pathology.
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Affiliation(s)
- R. Ferstl
- Swiss Institute of Allergy and Asthma Research (SIAF); University of Zurich; Davos Switzerland
| | - R. Frei
- Swiss Institute of Allergy and Asthma Research (SIAF); University of Zurich; Davos Switzerland
- Christine Kühne - Center for Allergy Research and Education (CK-CARE); Davos Switzerland
| | - W. Barcik
- Swiss Institute of Allergy and Asthma Research (SIAF); University of Zurich; Davos Switzerland
| | - E. Schiavi
- Swiss Institute of Allergy and Asthma Research (SIAF); University of Zurich; Davos Switzerland
| | - K. Wanke
- Swiss Institute of Allergy and Asthma Research (SIAF); University of Zurich; Davos Switzerland
- Christine Kühne - Center for Allergy Research and Education (CK-CARE); Davos Switzerland
| | - M. Ziegler
- Swiss Institute of Allergy and Asthma Research (SIAF); University of Zurich; Davos Switzerland
| | - N. Rodriguez-Perez
- Swiss Institute of Allergy and Asthma Research (SIAF); University of Zurich; Davos Switzerland
| | - D. Groeger
- Swiss Institute of Allergy and Asthma Research (SIAF); University of Zurich; Davos Switzerland
- Alimentary Health Pharma Davos; Davos Switzerland
| | - P. Konieczna
- Swiss Institute of Allergy and Asthma Research (SIAF); University of Zurich; Davos Switzerland
| | - S. Zeiter
- AO Research Institute Davos (ARI); Davos Switzerland
| | - D. Nehrbass
- AO Research Institute Davos (ARI); Davos Switzerland
| | - R. Lauener
- Christine Kühne - Center for Allergy Research and Education (CK-CARE); Davos Switzerland
- Children's Hospital of Eastern Switzerland; St. Gallen Switzerland
| | - C.A. Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF); University of Zurich; Davos Switzerland
- Christine Kühne - Center for Allergy Research and Education (CK-CARE); Davos Switzerland
| | - L. O'Mahony
- Swiss Institute of Allergy and Asthma Research (SIAF); University of Zurich; Davos Switzerland
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4
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Chauveau A, Dalphin ML, Mauny F, Kaulek V, Schmausser-Hechfellner E, Renz H, Riedler J, Pekkanen J, Karvonen AM, Lauener R, Roduit C, Vuitton DA, von Mutius E, Dalphin JC. Skin prick tests and specific IgE in 10-year-old children: Agreement and association with allergic diseases. Allergy 2017; 72:1365-1373. [PMID: 28235151 DOI: 10.1111/all.13148] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/20/2017] [Indexed: 01/01/2023]
Abstract
BACKGROUND Accurate assessment of atopic sensitization is pivotal to clinical practice and research. Skin prick test (SPT) and specific IgE (sIgE) are often used interchangeably. Some studies have suggested a disagreement between these two methods, and little is known about their association with allergic diseases. The aims of our study were to evaluate agreement between SPT and sIgE, and to compare their association with allergic diseases in 10-year-old children. METHODS Skin prick test, sIgE measurements, and assessment of allergic diseases were performed in children aged 10 years in the Protection against Allergy: STUdy in Rural Environments (PASTURE) cohort. The agreement between SPT and sIgE was assessed by Cohen's kappa coefficient with different cutoff values. RESULTS Skin prick tests and sIgE were performed in 529 children. The highest agreement (κ=.44) was found with a cutoff value of 3 and 5 mm for SPT, and 3.5 IU/mL for sIgE. The area under the curve (AUC) obtained with SPT was not significantly different from that obtained with sIgE. For asthma and hay fever, SPT (cutoff value at 3 mm) had a significantly higher specificity (P<.0001) than sIgE (cutoff value at 0.35 IU/mL) and the specificity was not different between both tests (P=.1088). CONCLUSION Skin prick test and sIgE display moderate agreement, but have a similar AUC for allergic diseases. At the cutoff value of 3 mm for SPT and 0.35 IU/mL for sIgE, SPT has a higher specificity for asthma and hay fever than sIgE without difference for sensitivity.
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Affiliation(s)
- A. Chauveau
- Pediatrics Department; University Hospital of Besançon; Besançon France
- Pediatric Allergy Department; University Hospital of Nancy; Nancy France
- UMR 6249 Chrono-Environment; CNRS and University of Franche-Comté; Besançon France
| | - M.-L. Dalphin
- Pediatrics Department; University Hospital of Besançon; Besançon France
| | - F. Mauny
- UMR 6249 Chrono-Environment; CNRS and University of Franche-Comté; Besançon France
- Clinical Methodology Center; University Hospital of Besançon; Besançon France
| | - V. Kaulek
- UMR 6249 Chrono-Environment; CNRS and University of Franche-Comté; Besançon France
- Respiratory Diseases Department; University Hospital of Besançon; Besançon France
| | | | - H. Renz
- Institute for Laboratory Medicine, Pathobiochemistry and Molecular Diagnostics; Philipps University of Marburg; Marburg Germany
| | - J. Riedler
- Children's Hospital Schwarzach; Salzburg Austria
| | - J. Pekkanen
- Department of Health Protection; National Institute for Health and Welfare; Kuopio Finland
- Department of Public Health; University of Helsinki; Helsinki Finland
| | - A. M. Karvonen
- Department of Health Protection; National Institute for Health and Welfare; Kuopio Finland
| | - R. Lauener
- Christine Kühne Center for Allergy Research and Education (CK-CARE); Davos Switzerland
- Children's Hospital of Eastern Switzerland; St. Gallen Switzerland
| | - C. Roduit
- Christine Kühne Center for Allergy Research and Education (CK-CARE); Davos Switzerland
- University Children's Hospital Zurich; Zurich Switzerland
| | - D. A. Vuitton
- EA 3181; University of Franche-Comté; Besançon France
| | - E. von Mutius
- Dr. von Hauner Children's Hospital; Ludwig Maximilians University Munich; Munich Germany
- CPC-M; Member of the German Center for Lung Research; Giessen Germany
| | - J.-C. Dalphin
- UMR 6249 Chrono-Environment; CNRS and University of Franche-Comté; Besançon France
- Respiratory Diseases Department; University Hospital of Besançon; Besançon France
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5
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Schröder PC, Illi S, Casaca VI, Lluis A, Böck A, Roduit C, Depner M, Frei R, Genuneit J, Pfefferle PI, Roponen M, Weber J, Braun-Fahrländer C, Riedler J, Dalphin J, Pekkanen J, Lauener R, von Mutius E, Schaub B. A switch in regulatory T cells through farm exposure during immune maturation in childhood. Allergy 2017; 72:604-615. [PMID: 27732759 DOI: 10.1111/all.13069] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/08/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND Farm exposure protects against development of allergies early in life. At 4.5 years, protection against asthma by farm-milk exposure was partially mediated by regulatory T cells (Tregs). The aim of this study was to investigate the critical time window of the 'asthma-protective' farm effect via Tregs during childhood immune maturation. METHODS Tregs were assessed longitudinally at 4.5 and 6 years in 111 children (56 farm and 55 reference children) from the PASTURE/EFRAIM birth cohort (flow cytometry). Peripheral blood mononuclear cells were cultured unstimulated (U), with phorbol 12-myristate 13-acetate/ionomycin (PI) or lipopolysaccharide (LPS), and stained for Tregs (CD4+ CD25high FOXP3upper20% ). mRNA expression of Treg/Th1/Th2/Th17-associated cell markers was measured ex vivo. Suppressive capacity of Tregs on effector cells and cytokines was assessed. Detailed questionnaires assessing farm exposures and clinical phenotypes from birth until age 6 years were answered by the parents. RESULTS Treg percentage before and after stimulation and FOXP3mRNA expression ex vivo decreased from age 4.5 to 6 years (P(U,LPS) < 0.001; P(PI) = 0.051; P(FOXP3) < 0.001). High vs low farm-milk and animal-stable exposure was associated with decreased LPS-stimulated Treg percentage at age 6 years (P(LPS) = 0.045). Elevated LPS-stimulated-Treg percentage at age 6 was associated with increased risk of asthma (aOR = 11.29, CI: 0.96-132.28, P = 0.053). Tregs from asthmatics vs nonasthmatics suppressed IFN-γ (P = 0.015) and IL-9 (P = 0.023) less efficiently. mRNA expression of Th1/Th2/Th17-associated cell markers decreased between 4.5 and 6 years (P < 0.001). CONCLUSIONS Tregs at the age of 6 years were decreased with farm exposure and increased within asthmatics, opposite to age 4.5 years. This immunological switch defines a critical 'time window' for Treg-mediated asthma protection via environmental exposure before age 6 years.
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Affiliation(s)
- P. C. Schröder
- LMU Munich; University Children's Hospital; Munich Germany
| | - S. Illi
- LMU Munich; University Children's Hospital; Munich Germany
| | - V. I. Casaca
- LMU Munich; University Children's Hospital; Munich Germany
| | - A. Lluis
- National Jewish Health; Denver CO USA
| | - A. Böck
- LMU Munich; University Children's Hospital; Munich Germany
| | - C. Roduit
- Children's Hospital; University of Zürich; Zürich Switzerland
- Christine Kühne - Center for Allergy Research and Education (CK-CARE); Davos Switzerland
| | - M. Depner
- LMU Munich; University Children's Hospital; Munich Germany
| | - R. Frei
- Christine Kühne - Center for Allergy Research and Education (CK-CARE); Davos Switzerland
- Swiss Institute of Allergy and Asthma Research (SIAF); University of Zurich; Davos Switzerland
| | - J. Genuneit
- Institute of Epidemiology and Medical Biometry; Ulm University; Ulm Germany
| | - P. I. Pfefferle
- Comprehensive Biomaterial Bank Marburg CBBM; Fachbereich Medizin der Philipps Universität Marburg; Zentrum für Tumor und Immunbiologie ZTI; Marburg Germany
- Member of the German Centre for Lung Research (DZL); Munich Germany
| | - M. Roponen
- Department of Environmental Science; Inhalation Toxicology Laboratory; University of Eastern Finland; Kuopio Finland
| | - J. Weber
- LMU Munich; University Children's Hospital; Munich Germany
| | - C. Braun-Fahrländer
- Swiss Tropical and Public Health Institute; Basel Switzerland
- University of Basel; Basel Switzerland
| | - J. Riedler
- Children's Hospital Schwarzach; Schwarzach Austria
- Teaching Hospital of Paracelsus Medical Private University Salzburg; Salzburg Austria
| | - J.C. Dalphin
- Department of Respiratory Disease; University Hospital; University of Besançon; Besançon France
| | - J. Pekkanen
- Department of Health Protection; National Institute for Health and Welfare; Kuopio Finland
- Department of Public Health; University of Helsinki; Helsinki Finland
| | - R. Lauener
- Christine Kühne - Center for Allergy Research and Education (CK-CARE); Davos Switzerland
- Children's Hospital of Eastern Switzerland; St. Gallen Switzerland
| | - E. von Mutius
- LMU Munich; University Children's Hospital; Munich Germany
- Comprehensive Pneumology Centre Munich (CPC-M); German Centre for Lung Research (DZL); Munich Germany
| | - B. Schaub
- LMU Munich; University Children's Hospital; Munich Germany
- Comprehensive Pneumology Centre Munich (CPC-M); German Centre for Lung Research (DZL); Munich Germany
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6
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Giavi S, Vissers YM, Muraro A, Lauener R, Konstantinopoulos AP, Mercenier A, Wermeille A, Lazzarotto F, Frei R, Bonaguro R, Summermatter S, Nutten S, Papadopoulos NG. Oral immunotherapy with low allergenic hydrolysed egg in egg allergic children. Allergy 2016; 71:1575-1584. [PMID: 27059671 DOI: 10.1111/all.12905] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/03/2016] [Indexed: 02/02/2023]
Abstract
BACKGROUND A major drawback of oral immunotherapy for food allergy is the possibility of severe side-effects. We assessed both safety and efficacy of a low allergenic hydrolysed egg (HydE) preparation used in a double-blind placebo-controlled randomized study in egg allergic children. METHODS In a pilot multicentre study, 29 egg allergic patients (aged 1-5.5 years) were administered daily for 6 months 9 g HydE or placebo in a blinded, randomized manner. Safety was verified by oral food challenge to assess tolerance towards HydE at the start and efficacy by an open oral food challenge (OFC, primary outcome) at the end. Additionally, changes in basophil activation and specific IgE and IgG4 were assessed. RESULTS All egg allergic patients randomized to HydE (n = 15) tolerated the full dose at day 1 and received the maintenance dose from the start at home. No statistically significant difference was observed on the final OFC (36% and 21% had a negative OFC in the treatment and placebo groups, respectively). Specific IgG4 levels increased, while both CD203c+ and CD63+ basophils decreased significantly more over time in the treatment than in the placebo group. CONCLUSIONS HydE can be regarded as a safe, low allergenic product to use in children allergic to egg. Although not significant, HydE given for 6 months increased numerically the proportion of patients becoming tolerant to egg. HydE induced a modulation of the immune response towards better tolerance. A longer treatment period and/or a higher dose may improve the clinical outcome and should be evaluated.
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Affiliation(s)
- S. Giavi
- Allergy Department; 2nd Paediatric Clinic; University of Athens; Athens Greece
| | - Y. M. Vissers
- Allergy Group, Nutrition & Health Research; Nestlé Research Center; Lausanne Switzerland
| | - A. Muraro
- Referral Centre for Food Allergy Diagnosis and Treatment, Veneto Region; Department of Women and Child Health; Padua University Hospital; Padua Italy
| | - R. Lauener
- Children's Hospital of Eastern Switzerland; St. Gallen Switzerland
- CK-CARE; Davos Switzerland
| | | | - A. Mercenier
- Allergy Group, Nutrition & Health Research; Nestlé Research Center; Lausanne Switzerland
| | - A. Wermeille
- Allergy Group, Nutrition & Health Research; Nestlé Research Center; Lausanne Switzerland
| | - F. Lazzarotto
- Referral Centre for Food Allergy Diagnosis and Treatment, Veneto Region; Department of Women and Child Health; Padua University Hospital; Padua Italy
| | - R. Frei
- Swiss Institute of Allergy and Asthma Research (SIAF); University of Zurich; Davos Switzerland
- Christine Kühne-Center for Allergy Research and Education; Zurich Switzerland
| | - R. Bonaguro
- Referral Centre for Food Allergy Diagnosis and Treatment, Veneto Region; Department of Women and Child Health; Padua University Hospital; Padua Italy
| | | | - S. Nutten
- Allergy Group, Nutrition & Health Research; Nestlé Research Center; Lausanne Switzerland
| | - N. G. Papadopoulos
- Allergy Department; 2nd Paediatric Clinic; University of Athens; Athens Greece
- Centre for Paediatrics & Child Health; Institute of Human Development; The University of Manchester; Manchester UK
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7
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Bieber T, Akdis C, Lauener R, Traidl-Hoffmann C, Schmid-Grendelmeier P, Schäppi G, Allam JP, Apfelbacher C, Augustin M, Beck L, Biedermann T, Braun-Fahrländer C, Chew FT, Clavel T, Crameri R, Darsow U, Deleuran M, Dittlein D, Duchna HW, Eichenfeld L, Eyerich K, Frei R, Gelmetti C, Gieler U, Gilles S, Glatz M, Grando K, Green J, Gutermuth J, Guttman-Yassky E, Hanifin J, Hijnen D, Hoetzenecker W, Irvine A, Kalweit A, Katoh N, Knol E, Koren H, Möhrenschlager M, Münch D, Novak N, O'Mahony L, Paller AS, Rhyner C, Roduit C, Schiesser K, Schröder J, Simon D, Simon HU, Sokolowska M, Spuls P, Stalder JF, Straub D, Szalai Z, Taieb A, Takaoka R, Todd G, Todorova A, Vestergaard C, Werfel T, Wollenberg A, Ring J. Global Allergy Forum and 3rd Davos Declaration 2015: Atopic dermatitis/Eczema: challenges and opportunities toward precision medicine. Allergy 2016; 71:588-92. [PMID: 27023268 DOI: 10.1111/all.12857] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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8
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Orivuori L, Mustonen K, de Goffau MC, Hakala S, Paasela M, Roduit C, Dalphin JC, Genuneit J, Lauener R, Riedler J, Weber J, von Mutius E, Pekkanen J, Harmsen HJM, Vaarala O. High level of fecal calprotectin at age 2 months as a marker of intestinal inflammation predicts atopic dermatitis and asthma by age 6. Clin Exp Allergy 2016; 45:928-939. [PMID: 25758537 DOI: 10.1111/cea.12522] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2014] [Revised: 01/05/2015] [Accepted: 01/16/2015] [Indexed: 01/27/2023]
Abstract
BACKGROUND Gut microbiota and intestinal inflammation regulate the development of immune-mediated diseases, such as allergies. Fecal calprotectin is a biomarker of intestinal inflammation. OBJECTIVE We evaluated the association of early-age fecal calprotectin levels to the later development of allergic diseases in children from farming and non-farming environments and further studied the effect of gut microbiota on the fecal calprotectin levels. METHODS Fecal calprotectin was measured from 758 infants participating in the PASTURE study at the age of 2 months using the ELISA method. Serum-specific IgE levels were measured at 6 years of age. Data of environmental factors, doctor-diagnosed atopic dermatitis (AD) and asthma were collected by questionnaire. Multivariate logistic regression models were used for analysis. The composition of fecal microbiota was analysed in a subgroup of 120 infants with 16S rRNA pyrosequencing. The effect of Escherichia coli lipopolysaccharide (LPS) on in vitro monocyte IL-10 secretion was studied by flow cytometry. RESULTS The infants with high fecal calprotectin levels at 2 months, that is above the 90th percentile, had an increased risk of developing AD and asthma/asthmatic bronchitis by the age of 6 years (aOR 2.02 (1.06-3.85) and 2.41 (1.25-4.64), respectively). High fecal calprotectin levels correlated negatively with fecal Escherichia. LPS from E. coli stimulated production of IL-10 in monocytes. CONCLUSION AND CLINICAL RELEVANCE High degree intestinal inflammation at 2 months of age, detected as high fecal calprotectin, predicted asthma and AD by the age of 6 years and was linked to low abundance of fecal Escherichia. Impaired IL-10 activation due to the lack of colonization with E. coli could explain the intestinal inflammation associated high fecal calprotectin and later risk of asthma and AD. Our results have implications for the design of probiotic treatments and suggest that early intestinal colonization has long-term health effects.
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Affiliation(s)
- L Orivuori
- Institute of Clinical Medicine, University of Helsinki, Helsinki, Finland.,Department of Vaccination and Immune Protection, National Institute for Health and Welfare, Helsinki, Finland
| | - K Mustonen
- Environmental Health Department, National Institute for Health and Welfare, Kuopio, Finland
| | - M C de Goffau
- Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - S Hakala
- Department of Vaccination and Immune Protection, National Institute for Health and Welfare, Helsinki, Finland
| | - M Paasela
- Department of Vaccination and Immune Protection, National Institute for Health and Welfare, Helsinki, Finland
| | - C Roduit
- Christine Kühne - Center for Allergy Research and Education (CK-CARE), Davos, Switzerland.,Children's Hospital, University of Zurich, Zurich, Switzerland
| | - J-C Dalphin
- The Department of Respiratory Disease, Université de Franche-Comté, UMR-CNRS Chrono-Environnement, University Hospital, Besançon, France
| | - J Genuneit
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - R Lauener
- Christine Kühne - Center for Allergy Research and Education (CK-CARE), Davos, Switzerland.,Children's Hospital of Eastern Switzerland, St. Gallen, Switzerland
| | - J Riedler
- Children and Young Adults' Medicine, Children's Hospital, Schwarzach, Austria
| | - J Weber
- Dr. von Hauner Children's Hospital of the Ludwig Maximilian University Munich, Munich, Germany
| | - E von Mutius
- Dr. von Hauner Children's Hospital of the Ludwig Maximilian University Munich, Munich, Germany.,Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research, Mölndal, Sweden
| | - J Pekkanen
- Environmental Health Department, National Institute for Health and Welfare, Kuopio, Finland
| | - H J M Harmsen
- Department of Medical Microbiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - O Vaarala
- Institute of Clinical Medicine, University of Helsinki, Helsinki, Finland.,Respiratory, Inflammation and Autoimmunity, Innovative Medicine, AstraZeneca R & D, Mölndal, Sweden
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9
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Orivuori L, Loss G, Roduit C, Dalphin JC, Depner M, Genuneit J, Lauener R, Pekkanen J, Pfefferle P, Riedler J, Roponen M, Weber J, von Mutius E, Braun-Fahrländer C, Vaarala O. Soluble immunoglobulin A in breast milk is inversely associated with atopic dermatitis at early age: the PASTURE cohort study. Clin Exp Allergy 2014; 44:102-12. [PMID: 24102779 DOI: 10.1111/cea.12199] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2013] [Revised: 09/05/2013] [Accepted: 09/15/2013] [Indexed: 01/24/2023]
Abstract
BACKGROUND The role of breastfeeding for the development of atopic diseases in childhood is contradictory. This might be due to differences in the composition of breast milk and levels of antimicrobial and anti-inflammatory components. OBJECTIVE The objective of this study was to examine whether levels of total immunoglobulin A (IgA) or transforming growth factor-β1 (TGF-β1) in breast milk were associated with the risk of developing atopic dermatitis (AD), atopic sensitization or asthma at early age taking breastfeeding duration into account. METHODS The birth cohort study PASTURE conducted in Finland, France, Germany and Switzerland provided 610 breast milk samples collected 2 months after delivery in which soluble IgA (sIgA) and TGF-β1 levels were measured by ELISA. Duration of breastfeeding was assessed using weekly food frequency diaries from month 3 to month 12. Data on environmental factors, AD and asthma were collected by questionnaires from pregnancy up to age 6. Atopic status was defined by specific IgE levels in blood collected at the ages of 4 and 6 years. Multivariate logistic regression models were used for statistical analysis. RESULTS Soluble IgA and TGF-β1 levels in breast milk differed between countries, and sIgA levels were associated with environmental factors related to microbial load, for example, contact to farm animals or cats during pregnancy, but not with raw milk consumption. sIgA levels were inversely associated with AD up to the of age 2 years (P-value for adjusted linear trend: 0.005), independent of breastfeeding duration. The dose of sIgA ingested in the first year of life was associated with reduced risk of AD up to the age of 2 (aOR, 95% CI: 0.74; 0.55-0.99) and 4 years (0.73; 0.55-0.96). No clear associations between sIgA and atopy or asthma up to age 6 were observed. TGF-β1 showed no consistent association with any investigated health outcome. CONCLUSION AND CLINICAL RELEVANCE IgA in breast milk might protect against the development of AD.
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Affiliation(s)
- L Orivuori
- Department of Vaccination and Immune Protection, National Institute for Health and Welfare, Helsinki, Finland
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Ring J, Akdis C, Lauener R, Schäppi G, Traidl-Hoffmann C, Akdis M, Ammann W, Behrendt H, Bieber T, Biedermann T, Bienenstock J, Blaser K, Braun-Fahrländer C, Brockow K, Buters J, Crameri R, Darsow U, Denburg JA, Eyerich K, Frei R, Galli SJ, Gutermuth J, Holt P, Koren H, Leung D, Müller U, Muraro A, Ollert M, O'Mahony L, Pawankar R, Platts-Mills T, Rhyner C, Rosenwasser LJ, Schmid-Grendelmeier P, Schmidt-Weber CB, Schmutz W, Simon D, Simon HU, Sofiev M, van Hage M, van Ree R. Global Allergy Forum and Second Davos Declaration 2013 Allergy: Barriers to cure--challenges and actions to be taken. Allergy 2014; 69:978-82. [PMID: 25041525 DOI: 10.1111/all.12406] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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11
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Aeschlimann FA, Hofer KD, Cannizzaro E, Schroeder S, Lauener R, Saurenmann RK. SAT0461 Infliximab Treatment in Children: Frequency of Infusion Reactions and Role of Desensitization. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.2185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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12
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Michel S, Busato F, Genuneit J, Pekkanen J, Dalphin JC, Riedler J, Mazaleyrat N, Weber J, Karvonen AM, Hirvonen MR, Braun-Fahrländer C, Lauener R, von Mutius E, Kabesch M, Tost J. Farm exposure and time trends in early childhood may influence DNA methylation in genes related to asthma and allergy. Allergy 2013; 68:355-64. [PMID: 23346934 DOI: 10.1111/all.12097] [Citation(s) in RCA: 130] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/23/2012] [Indexed: 01/17/2023]
Abstract
BACKGROUND Genetic susceptibility and environmental influences are important contributors to the development of asthma and atopic diseases. Epigenetic mechanisms may facilitate gene by environment interactions in these diseases. METHODS We studied the rural birth cohort PASTURE (Protection against allergy: study in rural environments) to investigate (a) whether epigenetic patterns in asthma candidate genes are influenced by farm exposure in general, (b) change over the first years of life, and (c) whether these changes may contribute to the development of asthma. DNA was extracted from cord blood and whole blood collected at the age of 4.5 years in 46 samples per time point. DNA methylation in 23 regions in ten candidate genes (ORMDL1, ORMDL2, ORMDL3, CHI3L1, RAD50, IL13, IL4, STAT6, FOXP3, and RUNX3) was assessed by pyrosequencing, and differences between strata were analyzed by nonparametric Wilcoxon-Mann-Whitney tests. RESULTS In cord blood, regions in ORMDL1 and STAT6 were hypomethylated in DNA from farmers' as compared to nonfarmers' children, while regions in RAD50 and IL13 were hypermethylated (lowest P-value (STAT6) = 0.001). Changes in methylation over time occurred in 15 gene regions (lowest P-value (IL13) = 1.57*10(-8)). Interestingly, these differences clustered in the genes highly associated with asthma (ORMDL family) and IgE regulation (RAD50, IL13, and IL4), but not in the T-regulatory genes (FOXP3, RUNX3). CONCLUSIONS In this first pilot study, DNA methylation patterns change significantly in early childhood in specific asthma- and allergy-related genes in peripheral blood cells, and early exposure to farm environment seems to influence methylation patterns in distinct genes.
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Affiliation(s)
| | - F. Busato
- Laboratory for Epigenetics; Centre National de Génotypage; CEA-Institut de Génomique; Evry; France
| | - J. Genuneit
- Ulm University; Institute of Epidemiology and Medical Biometry; Ulm; Germany
| | | | - J.-C. Dalphin
- Department of Respiratory Disease; Université de Franche-Comté; University Hospital; Besancon; France
| | - J. Riedler
- Children's Hospital Schwarzach; Schwarzach; Austria
| | - N. Mazaleyrat
- Laboratory for Epigenetics; Centre National de Génotypage; CEA-Institut de Génomique; Evry; France
| | - J. Weber
- LMU Munich; University Children's Hospital; Munich; Germany
| | - A. M. Karvonen
- Department of Environmental Health; National Institute for Health and Welfare; Kuopio; Finland
| | | | | | | | - E. von Mutius
- LMU Munich; University Children's Hospital; Munich; Germany
| | | | - J. Tost
- Laboratory for Epigenetics; Centre National de Génotypage; CEA-Institut de Génomique; Evry; France
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Soyer OU, Akdis M, Ring J, Behrendt H, Crameri R, Lauener R, Akdis CA. Mechanisms of peripheral tolerance to allergens. Allergy 2013; 68:161-70. [PMID: 23253293 DOI: 10.1111/all.12085] [Citation(s) in RCA: 99] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/26/2012] [Indexed: 12/24/2022]
Abstract
The immune system is regulated to protect the host from exaggerated stimulatory signals establishing a state of tolerance in healthy individuals. The disequilibrium in immune regulatory vs effector mechanisms results in allergic or autoimmune disorders in genetically predisposed subjects under certain environmental conditions. As demonstrated in allergen-specific immunotherapy and in the healthy immune response to high-dose allergen exposure models in humans, T regulatory cells are essential in the suppression of Th2-mediated inflammation, maintenance of immune tolerance, induction of the two suppressive cytokines interleukin-10 and transforming growth factor-β, inhibition of allergen-specific IgE, and enhancement of IgG4 and IgA. Also, suppression of dendritic cells, mast cells, and eosinophils contributes to the construction of peripheral tolerance to allergens. This review focuses on mechanisms of peripheral tolerance to allergens with special emphasis on recent developments in the area of immune regulation.
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Affiliation(s)
| | | | | | | | - R. Crameri
- Swiss Institute of Allergy and Asthma Research (SIAF); University of Zurich; Davos; Switzerland
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Möhrenschlager M, Ring J, Lauener R. Possible in-cabin exposure to cat allergen: a 2010 airline survey on live animal transport and a review of literature. Allergy 2010; 65:1496-8. [PMID: 20557299 DOI: 10.1111/j.1398-9995.2010.02400.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- M Möhrenschlager
- Department of Dermatology and Allergology, Allergieklinik-Hochgebirgsklinik, Herman-Burchard-Str. 1, CH-7265 Davos, Switzerland.
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Büchele G, Genuneit J, Braun-Fahrländer C, Pekkanen J, Riedler J, Dalphin J, Renz H, Kabesch M, Lauener R, Doekes G, Mutius EV. Asthma and allergies in farming environments – The PASTURE/FORALLVENT/EFRAIM-Project. Gesundheitswesen 2010. [DOI: 10.1055/s-0030-1266705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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17
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Rochat MK, Ege MJ, Plabst D, Steinle J, Bitter S, Braun-Fahrländer C, Dalphin JC, Riedler J, Roponen M, Hirvonen MR, Büchele G, Renz H, Lauener R, Krauss-Etschmann S, von Mutius E. Maternal vitamin D intake during pregnancy increases gene expression of ILT3 and ILT4 in cord blood. Clin Exp Allergy 2009; 40:786-94. [PMID: 20030662 DOI: 10.1111/j.1365-2222.2009.03428.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Recent studies indicate that prenatal vitamin D intake may protect against the development of atopic diseases in young children. Vitamin D has been shown to induce tolerogenic antigen-presenting cells such as dendritic cells. Whether the allergy-protective potential of prenatal vitamin D is mediated through such mechanisms is, however, unknown. OBJECTIVE To evaluate the association between prenatal vitamin D supplementation and tolerogenic antigen-presenting cells in cord blood (CB) as determined by mRNA measurement of immunoglobulin-like transcripts (ILT)3 and ILT4. METHODS A prospective multi-centre birth cohort was established in rural areas of five European countries. Information on maternal exposures including vitamin D intake was collected by questionnaires during pregnancy. The gene expression of ILT3 and ILT4 was analysed by real-time PCR in the CB of 927 children. Maternal vitamin D supplementation was assessed in Finland and France (n=349). RESULTS Maternal vitamin D supplementation during pregnancy was associated with an increase in the gene expression of ILT3 (P=0.012) and ILT4 (P<0.001). This association remained significant for ILT4 (P=0.020) and showed a positive trend for the gene expression of ILT3 (P=0.059) after multivariate analysis controlling for various confounders. CONCLUSIONS Vitamin D supplementation during pregnancy may increase the mRNA levels of ILT3 and ILT4 in CB. This finding may point towards an early induction of tolerogenic immune responses by maternal vitamin D intake.
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Affiliation(s)
- M K Rochat
- Children's Hospital, University of Munich, Lindwurmstrasse 4, Munich, Germany.
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Bieli C, Frei R, Schickinger V, Steinle J, Bommer C, Loeliger S, Braun-Fahrländer C, von Mutius E, Pershagen G, Lauener R. Gene expression measurements in the context of epidemiological studies. Allergy 2008; 63:1633-6. [PMID: 19032237 DOI: 10.1111/j.1398-9995.2008.01744.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Gene expression measurements became an attractive tool to assess biological responses in epidemiological studies. However, collection of blood samples poses various technical problems. We used gene expression data from two epidemiological studies to evaluate differences between sampling methods, comparability of two methods for measuring RNA levels and stability of RNA samples over time. METHODS For the PARSIFAL study, PBLC of 1155 children were collected using EDTA tubes in two countries. In the PASTURE study, tubes containing RNA-stabilizing solutions (PAXgene) Blood RNA Tubes; PreAnalytiX) were used to collect cord blood leucocytes of 982 children in five countries. Real-time PCR (conventional single tube assay and high-throughput low density arrays) was used to quantify expression of various innate immunity genes. In 77 PARSIFAL samples, gene expression was measured repeatedly during prolonged storage. RESULTS In PARSIFAL (EDTA tubes) the median RNA yield after extraction significantly differed between the two centres (70 and 34 ng/microl). Collecting blood into an RNA-stabilizing solution markedly reduced differences in RNA yield in PASTURE (range of medians 91-107 ng/microl). The agreement [Spearman rank correlation (r)] between repeated measurements of gene expression decreased with increasing storage time [e.g., for CD14: r (first/second measurement) = 0.35; r (first/third measurement) = 0.03]. RNA levels measured with either the conventional method or low-density arrays were comparable (r > 0.9). CONCLUSION Collecting blood samples into tubes containing an RNA-stabilizing solution increases RNA yield and reduces its variability. Long-term storage of samples may lead to RNA degradation, requiring special attention in longitudinal studies.
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Affiliation(s)
- C Bieli
- Institute of Social and Preventive Medicine, University of Basel, Basel, Switzerland
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Bruce S, Nyberg F, Melén E, James A, Pulkkinen V, Orsmark-Pietras C, Bergström A, Dahlén B, Wickman M, von Mutius E, Doekes G, Lauener R, Riedler J, Eder W, van Hage M, Pershagen G, Scheynius A, Kere J. The protective effect of farm animal exposure on childhood allergy is modified by NPSR1 polymorphisms. J Med Genet 2008; 46:159-67. [PMID: 18285428 DOI: 10.1136/jmg.2007.055137] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Little is known about the asthma candidate gene neuropeptide S receptor 1 (NPSR1) in relation to environmental exposures, but recent evidences suggest its role as an effect modifier. OBJECTIVES To explore the interaction between NPSR1 polymorphisms and environmental exposures related to farming lifestyle and to study the in vitro effects of lipopolysaccharide (LPS) stimulation on NPSR1 expression levels. METHODS We studied 3113 children from PARSIFAL, a European cross-sectional study on environmental/lifestyle factors and childhood allergy, partly focused on children brought up on a farm. Information on exposures and outcomes was primarily obtained from parental questionnaires. Seven tagging polymorphisms were analysed in a conserved haplotype block of NPSR1. Multivariate logistic regression was used to evaluate a multiplicative model of interaction. NPSR1 protein and messenger RNA (mRNA) levels in monocytes were measured after LPS stimulation by fluorescence activated cell sorting (FACS) and quantitative real-time polymerase chain reaction (PCR). RESULTS A strong interaction was seen between current regular contact to farm animals and several NPSR1 polymorphisms, particularly rs323922 and rs324377 (p<0.005), with respect to allergic symptoms. Considering the timing of initiation of such current regular farm animal contact, significant interactions with these and two additional polymorphisms (SNP546333, rs740347) were revealed. In response to LPS, NPSR1-A protein levels in monocytes were upregulated (p = 0.002), as were NPSR1-A mRNA levels (p = 0.02). CONCLUSIONS The effect of farm animal contact on the development of allergic symptoms in children is modified by NPSR1 genetic background.
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Affiliation(s)
- S Bruce
- Department of Biosciences and Nutrition, Hälsovägen 7-9, 14157 Huddinge, Sweden.
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20
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Waser M, Michels KB, Bieli C, Flöistrup H, Pershagen G, von Mutius E, Ege M, Riedler J, Schram-Bijkerk D, Brunekreef B, van Hage M, Lauener R, Braun-Fahrländer C. Inverse association of farm milk consumption with asthma and allergy in rural and suburban populations across Europe. Clin Exp Allergy 2007; 37:661-70. [PMID: 17456213 DOI: 10.1111/j.1365-2222.2006.02640.x] [Citation(s) in RCA: 200] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Dietary interventions as a means for atopy prevention attract great interest. Some studies in rural environments claimed an inverse association between consumption of farm-produced dairy products and the prevalence of allergic diseases, but current evidence is controversial. OBJECTIVE To investigate whether consumption of farm-produced products is associated with a lower prevalence of asthma and allergy when compared with shop-purchased products. METHODS Cross sectional multi-centre study (PARSIFAL) including 14,893 children aged 5-13 years from five European countries (2823 from farm families and 4606 attending Steiner Schools as well as 5440 farm reference and 2024 Steiner reference children). A detailed questionnaire including a dietary component was completed and allergen-specific IgE was measured in serum. RESULTS Farm milk consumption ever in life showed a statistically significant inverse association with asthma: covariate adjusted odds ratio (aOR) 0.74 [95% confidence interval (CI) 0.61-0.88], rhinoconjunctivitis: aOR 0.56 (0.43-0.73) and sensitization to pollen and the food mix fx5 (cut-off level of >or=3.5 kU/L): aOR 0.67 (0.47-0.96) and aOR 0.42 (0.19-0.92), respectively, and sensitization to horse dander: aOR 0.50 (95% CI 0.28-0.87). The associations were observed in all four subpopulations and independent of farm-related co-exposures. Other farm-produced products were not independently related to any allergy-related health outcome. CONCLUSION Our results indicate that consumption of farm milk may offer protection against asthma and allergy. A deepened understanding of the relevant protective components of farm milk and a better insight into the biological mechanisms underlying this association are warranted as a basis for the development of a safe product for prevention.
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Affiliation(s)
- M Waser
- Institute of Social and Preventive Medicine, University of Basel, Switzerland.
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Abstract
Allergic diseases have a peculiar characteristic: at different ages of the child they present under different forms. The typical time course, where atopic children 'grow out' of one allergic disease (e.g. atopic dermatitis) but then suffer from the next form of allergic disease (e.g. allergic asthma) has been termed 'atopic march', or 'allergic march'. Various information can help to identify early in life those children at risk for engaging in this atopic march. Sensitization to hen's egg and mites during the first year of life, long-lasting sensitization to food allergens during the first two years of age and atopic dermatitis in early infancy have been found to be predictors of allergic sensitizations and/or allergic airway disease later on in childhood. Although today no measures are available to completely prevent any manifestation of atopy before disease onset, some measures can contribute to stop or at least slow down the progression of the allergic march. Breast feeding for a least 4 to 6 months, stepwise introduction of solid food after this age only and avoidance of highly allergenic food during the first year of life can help to achieve this goal, as do measures to reduce indoor allergen exposure (especially house dust mites). For selected patients suffering from atopic dermatitis who are sensitized to grass pollen and/or house dust mites and who have highly motivated parents an early treatment with an antihistamine (cetirizine) can be considered.
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MESH Headings
- Child
- Child, Preschool
- Dermatitis, Atopic/diagnosis
- Dermatitis, Atopic/etiology
- Dermatitis, Atopic/therapy
- Female
- Follow-Up Studies
- Food Hypersensitivity/diagnosis
- Food Hypersensitivity/etiology
- Food Hypersensitivity/therapy
- Humans
- Infant
- Male
- Rhinitis, Allergic, Perennial/diagnosis
- Rhinitis, Allergic, Perennial/etiology
- Rhinitis, Allergic, Perennial/therapy
- Rhinitis, Allergic, Seasonal/diagnosis
- Rhinitis, Allergic, Seasonal/etiology
- Rhinitis, Allergic, Seasonal/therapy
- Risk Factors
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Faber J, Lauener R, Wick F, Betts D, Filgueira L, Seger RA, Güngör T. Shwachman-Diamond syndrome: early bone marrow transplantation in a high risk patient and new clues to pathogenesis. Eur J Pediatr 1999; 158:995-1000. [PMID: 10592077 DOI: 10.1007/s004310051265] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Shwachman-Diamond syndrome (SDS) is an autosomal recessive disorder characterised by exocrine pancreas insufficiency, metaphyseal dysostosis and bone marrow dysfunction. Recurrent severe bacterial infections and susceptibility to leukaemia are the major causes of morbidity and mortality occurring preferentially in patients with pancytopenia and features of myelodysplasia. Here we report a patient with SDS leading to recurrent bacterial infections and a deteriorating condition since early infancy. Extensive investigations disclosed severe pancytopenia, myelodysplasia and a clonal cytogenetic abnormality, inv(14)(q11q32), as risk factors of leukaemic transformation. He therefore underwent allogeneic geno-identical bone marrow transplantation which resulted in correction of all haematological and immunological abnormalities within an 18-month follow up period. Conclusion Bone marrow transplantation may be considered early as a valuable treatment option especially in high risk Schwachman-Diamond syndrome patients anticipating malignant transformation, life-threatening severe infections or further organ damage.
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Affiliation(s)
- J Faber
- Division of Immunology/Haematology, University Children's Hospital, Steinwiesstrasse 75, CH-8032 Zurich, Switzerland
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Schmugge M, Lauener R, Bossart W, Seger RA, Güngör T. Chronic enteroviral meningo-encephalitis in X-linked agammaglobulinaemia: favourable response to anti-enteroviral treatment. Eur J Pediatr 1999; 158:1010-1. [PMID: 10592085 DOI: 10.1007/s004310051273] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Ozsahin H, von Planta M, Müller I, Steinert HC, Nadal D, Lauener R, Tuchschmid P, Willi UV, Ozsahin M, Crompton NE, Seger RA. Successful treatment of invasive aspergillosis in chronic granulomatous disease by bone marrow transplantation, granulocyte colony-stimulating factor-mobilized granulocytes, and liposomal amphotericin-B. Blood 1998; 92:2719-24. [PMID: 9763555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023] Open
Abstract
X-linked chronic granulomatous disease (X-CGD) is a primary immunodeficiency with complete absence or malfunction of the nicotinamide adenine dinucleotide phosphate (NADPH) oxidase in the phagocytic cells. Life-threatening infections especially with aspergillus are common despite optimal antimicrobial therapy. Bone marrow transplantation (BMT) is contraindicated during invasive aspergillosis in any disease setting. We report an 8-year-old patient with CGD who underwent HLA-genoidentical BMT during invasive multifocal aspergillus nidulans infection, nonresponsive to treatment with amphotericin-B and gamma-interferon. During the first 10 days post-BMT, the patient received granulocyte colony-stimulating factor (G-CSF)-mobilized, 25 Gy irradiated granulocytes from healthy volunteers plus G-CSF beginning on day 3 to prolong the viability of the transfused granulocytes. This was confirmed in vitro by apoptosis assays and in vivo by finding nitroblue tetrazolium (NBT)-positive granulocytes in peripheral blood 12 and 36 hours after the transfusions. Clinical and biological signs of infection began to disappear on day 7 post-BMT. Positron emission tomography with F18-fluorodeoxyglucose (FDG-PET) and computed tomography (CT) scans at 3 months post-BMT showed complete disappearance of infectious foci. At 2 years post-BMT, the patient is well with full immune reconstitution and no sign of aspergillus infection. Our results show that HLA-identical BMT may be successful during invasive, noncontrollable aspergillus infection, provided that supportive therapy is optimal.
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Affiliation(s)
- H Ozsahin
- Divisions of Immunology/Hematology and Radiology, University Children's Hospital of Zurich, Switzerland
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Ozşahin H, Tuchschmid P, Lauener R, Waldvogel K, Nadal D, Seger RA. Blockade of acute grade IV skin and eye graft-versus-host disease by anti-interleukin-2 receptor monoclonal antibody in genoidentical bone marrow transplantation setting. Turk J Pediatr 1998; 40:231-5. [PMID: 9677728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
A six-year-old boy with homozygous beta-thalassemia in the favorable class 1 risk group received a bone marrow transplant, from his histocompatible sister. He developed grade IV skin and eye graft-versus-host disease (GVHD) following varicella zoster reactivation. Despite the appropriate prophylactic use of cyclosporin A (CsA), methotrexate (MTX), and prompt treatment with high-dose steroids, GVHD progressed resulting in total body epidermal necrolysis. Anti-IL-2 receptor monoclonal antibodies (anti-IL-2R moAb) in combination with steroids were administered to selectively block the activated T cells. After 27 days of daily administration, followed by 17 doses of alternate-day therapy with anti-IL-2R moAb, the severe skin and eye GVHD resolved. The patient, at two years posttransplant, has full engraftment and immune reconstitution without chronic GVHD (cGVHD). In conclusion, we suggest that in the HLA-genoidentical bone marrow transplantation setting, very severe and steroid-resistant GVHD can be controlled through the use of anti-IL-2 receptor antibodies which specifically block the activated IL-2 receptor expressing T cells.
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Affiliation(s)
- H Ozşahin
- Division of Immunology/Hematology, University Children's Hospital, Zürich, Switzerland
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Jackson JK, Lauener R, Duronio V, Burt HM. The involvement of phosphatidylinositol 3-kinase in crystal induced human neutrophil activation. J Rheumatol 1997; 24:341-8. [PMID: 9034995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE We investigated whether phosphatidylinositol (PI) 3-kinase is involved in the signal transduction pathway leading to neutrophil activation by inflammatory microcrystals. METHODS Neutrophil chemiluminescence and degranulation responses to opsonized crystals were measured in the presence of selective inhibitors known to inhibit PI 3-kinase activity in neutrophils. RESULTS Wortmannin and LY 294002, 2 selective inhibitors of PI 3-kinase, were shown to inhibit neutrophil activation induced by plasma opsonized crystals of calcium pyrophosphate dihydrate (CPPD) [both monoclinic (M) and triclinic (T) forms] and monosodium urate monohydrate (MSUM). IC50 for wortmannin or LY 294002 inhibition of crystal induced respiratory burst (measured by chemiluminescence) was about 3 nM and 0.3 microM, respectively, proving the pivotal role of PI 3-kinase in neutrophil respiratory burst activation by all 3 crystals. Degranulation responses of neutrophils to CPPD(M) and CPPD(T) crystals were also inhibited by about 50% by wortmannin in the 10 to 20 nM concentration range, supporting the direct involvement of PI 3-kinase in signal transduction pathways leading to crystal induced neutrophil degranulation. All 3 crystals induced the activation of PI 3-kinase in neutrophils as measured by the increased PI 3-kinase activity associated with immunoprecipitated tyrosine phosphorylated proteins from 1 min crystal-neutrophil incubations. Neutrophils pretreated with wortmannin at 10 nM showed sub-basal levels of PI 3-kinase activity at all time points measured. CONCLUSION PI 3-kinase plays a central role in the signal transduction pathways leading to respiratory burst and degranulation responses in neutrophils activated by inflammatory microcrystals.
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Affiliation(s)
- J K Jackson
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, Canada
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Lauener R, Shen Y, Duronio V, Salari H. Selective inhibition of phosphatidylinositol 3-kinase by phosphatidic acid and related lipids. Biochem Biophys Res Commun 1995; 215:8-14. [PMID: 7575628 DOI: 10.1006/bbrc.1995.2427] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Activation of phosphatidylinositol 3-kinase (PI 3-kinase) is necessary for stimulation of cell division and inhibition of apoptosis in several cell types. We report that a synthetic phosphonolipid, 4-(hexadecyloxy)-3-(S)-methoxybutyl phosphonic acid (PoA), as well as the naturally occurring lipids, phosphatidic acid and lyso-phosphatidic acid, are potent and specific inhibitors of PI 3-kinase. The IC50's for inhibition using phosphatidylinositol as substrate ranged from 10-20 microM. PoA is also the putative primary intracellular metabolite following phospholipase D hydrolysis of the anti-tumour ether lipid, 2'-(trimethylammonio) ethyl-4-(hexadecyloxy)-3-(S)-methoxybutanephosphonate. These results suggests that inhibition of PI 3-kinase following metabolic degradation of ether lipids by phospholipase D may contribute to the cytotoxicity of these compounds. The sensitivity of PI 3-kinase to PA and lyso-PA could imply cross-talk between the phospholipase D and PI 3-kinase signal transduction pathways in vivo.
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Affiliation(s)
- R Lauener
- Department of Medicine, University of British Columbia, Vancouver, Canada
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Seger R, Lauener R, Kjellman M. [Immunological basis of IgE-mediated allergies. A contribution to the understanding of new therapy forms]. Ther Umsch 1989; 46:588-95. [PMID: 2529660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The pathogenesis of IgE mediated allergies has been elucidated. We are dealing primarily with diseases of the T lymphocyte system. Due to overactivity of so-called T helper lymphocytes there is pathologic overproduction of IgE and inflammatory cells, mast cells and eosinophils, after antigen contact. Following exposure to nutrient and inhalant allergens in the presence of adjuvants, this atopic constitution manifests itself clinically. Mast cell mediators (e.g. histamine and leukotrienes) elicit immediate symptoms at the ports of entrance of allergens (at skin and mucosal surfaces); eosinophil mediators (e.g. platelet activating factor [PAF], eosinophil cationic protein [ECP], and major basic protein [MBP]) are responsible for late symptoms and hyperreactivity. Current antiinflammatory treatment tries to suppress this allergic inflammation (e.g. with cromoglycate and topical steroids). The regulatory immunotherapy of the near future attempts to regulate IgE synthesis by interleukins (e.g. gamma-Interferon) or antagonists of interleukins (e.g. anti-IL-4-antibodies).
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Lauener R, Seger R, Jörg W, Hallé F, Aeppli R, Schinzel A. Immunodeficiency associated with Dandy-Walker-like malformation, congenital heart defect, and craniofacial abnormalities. Am J Med Genet 1989; 33:280-1. [PMID: 2590300 DOI: 10.1002/ajmg.1320330227] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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