1
|
Keet C, McGowan EC, Jacobs D, Post WS, Richards NE, Workman LJ, Platts-Mills TAE, Manichaikul A, Wilson JM. IgE to common food allergens is associated with cardiovascular mortality in the National Health and Examination Survey and the Multi-Ethnic Study of Atherosclerosis. J Allergy Clin Immunol 2024; 153:471-478.e3. [PMID: 37943208 PMCID: PMC10922097 DOI: 10.1016/j.jaci.2023.09.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 08/30/2023] [Accepted: 09/25/2023] [Indexed: 11/10/2023]
Abstract
BACKGROUND In individuals without symptomatic food allergy, food-specific IgE is considered clinically irrelevant. However, recent studies have suggested that galactose-α-1,3-galactose (alpha-gal) IgE is associated with cardiovascular (CV) disease. OBJECTIVE We sought to determine whether sensitization to common food allergens is associated with CV mortality. METHODS The association between IgE sensitization to foods and CV mortality ascertained to 2019 was examined in the National Health and Examination Survey (NHANES) 2005-2006 and the Wake Forest site of the Multi-Ethnic Study of Atherosclerosis (MESA) cohort; MESA enrolled adults without baseline clinical CV diseases between 2000 and 2002. Total and specific IgE was measured to cow's milk, egg, peanut, shrimp, and a panel of aeroallergens (NHANES), and to cow's milk, alpha-gal, peanut, dust mite, and timothy grass (MESA). Cox proportional hazard models were constructed, adjusting for sex, age, race/ethnicity, smoking, education, and asthma. RESULTS A total of 4414 adults from NHANES (229 CV deaths) and 960 from MESA (56 CV deaths) were included. In NHANES, sensitization to at least 1 food was associated with higher CV mortality (hazard ratio [HR], 1.7 [95% confidence interval (CI), 1.2-2.4], P = .005). Milk sensitization was particularly associated (HR, 2.0 [95% CI, 1.1-3.8], P = .026), a finding replicated in MESA (HR, 3.8 [95% CI, 1.6-9.1], P = .003). Restricting analyses in NHANES to consumers of the relevant allergen strengthened food sensitization relationships, unmasking shrimp and peanut sensitization as additional risk factors for CV mortality. CONCLUSIONS The finding that food sensitization is associated with increased risk of CV mortality challenges the current paradigm that sensitization without overt allergy is benign. Further research is needed to clarify mechanisms of this association.
Collapse
Affiliation(s)
- Corinne Keet
- Department of Pediatrics, University of North Carolina, Chapel Hill School of Medicine, Chapel Hill, NC.
| | - Emily C McGowan
- Division of Allergy and Clinical Immunology, University of Virginia School of Medicine, Charlottesville, Va
| | - David Jacobs
- University of Minnesota School of Public Health, Minneapolis, Minn
| | - Wendy S Post
- Division of Cardiology, Johns Hopkins School of Medicine, Baltimore, Md
| | - Nathan E Richards
- Division of Allergy and Clinical Immunology, University of Virginia School of Medicine, Charlottesville, Va
| | - Lisa J Workman
- Division of Allergy and Clinical Immunology, University of Virginia School of Medicine, Charlottesville, Va
| | - Thomas A E Platts-Mills
- Division of Allergy and Clinical Immunology, University of Virginia School of Medicine, Charlottesville, Va
| | - Ani Manichaikul
- Department of Public Health Sciences, Center for Public Health Genomics, University of Virginia School of Medicine, Charlottesville
| | - Jeffrey M Wilson
- Division of Allergy and Clinical Immunology, University of Virginia School of Medicine, Charlottesville, Va
| |
Collapse
|
2
|
Wilson JM, Erickson L, Levin M, Ailsworth SM, Commins SP, Platts-Mills TAE. Tick bites, IgE to galactose-alpha-1,3-galactose and urticarial or anaphylactic reactions to mammalian meat: The alpha-gal syndrome. Allergy 2024. [PMID: 38193233 DOI: 10.1111/all.16003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 12/18/2023] [Accepted: 12/19/2023] [Indexed: 01/10/2024]
Abstract
The recent recognition of a syndrome of tick-acquired mammalian meat allergy has transformed the previously held view that mammalian meat is an uncommon allergen. The syndrome, mediated by IgE antibodies against the oligosaccharide galactose-alpha-1,3-galactose (alpha-gal), can also involve reactions to visceral organs, dairy, gelatin and other products, including medications sourced from non-primate mammals. Thus, fittingly, this allergic disorder is now called the alpha-gal syndrome (AGS). The syndrome is strikingly regional, reflecting the important role of tick bites in sensitization, and is more common in demographic groups at risk of tick exposure. Reactions in AGS are delayed, often by 2-6 h after ingestion of mammalian meat. In addition to classic allergic symptomatology such as urticaria and anaphylaxis, AGS is increasingly recognized as a cause of isolated gastrointestinal morbidity and alpha-gal sensitization has also been linked with cardiovascular disease. The unusual link with tick bites may be explained by the fact that allergic cells and mediators are mobilized to the site of tick bites and play a role in resistance against ticks and tick-borne infections. IgE directed to alpha-gal is likely an incidental consequence of what is otherwise an adaptive immune strategy for host defense against endo- and ectoparasites, including ticks.
Collapse
Affiliation(s)
- Jeffrey M Wilson
- Division of Allergy and Immunology, University of Virginia, Charlottesville, Virginia, USA
| | - Loren Erickson
- Department of Microbiology, Immunology, and Cancer Biology and Beirne Carter Center for Immunology Research, University of Virginia, Charlottesville, Virginia, USA
| | | | - Samuel M Ailsworth
- Division of Allergy and Immunology, University of Virginia, Charlottesville, Virginia, USA
| | - Scott P Commins
- Division of Rheumatology, Allergy and Immunology, University of North Carolina, Chapel Hill, North Carolina, USA
| | | |
Collapse
|
3
|
Ailsworth SM, Susi A, Workman LJ, Ji YS, Patel J, Nelson MR, Platts-Mills TAE, Nylund CM, Wilson JM. Alpha-Gal IgE Prevalence Patterns in the United States: An Investigation of 3,000 Military Recruits. J Allergy Clin Immunol Pract 2024; 12:175-184.e5. [PMID: 37918651 DOI: 10.1016/j.jaip.2023.10.046] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 10/25/2023] [Accepted: 10/27/2023] [Indexed: 11/04/2023]
Abstract
BACKGROUND IgE to the oligosaccharide galactose-alpha-1,3-galactose (alpha-gal) is an important cause of allergic reactions to mammalian meat. The "alpha-gal syndrome" is strongly associated with a preceding history of tick bites and in the United States is most commonly reported in parts of the southeast, but there has been limited investigation into national alpha-gal sensitization patterns and the relevance of other risk factors. OBJECTIVE To systematically investigate alpha-gal IgE prevalence, regional patterns, and risk factors. METHODS Alpha-gal IgE was measured by ImmunoCAP in biobanked serum samples collected from 3000 service members who presented for intake to 1 of 10 military bases in the central/eastern United States. Alpha-gal IgE sensitization (cutoff 0.1 international units/mL) was related to home of record at enlistment. RESULTS Of the cohort, 2456 (81.9%) subjects were male, median age was 19 years (interquartile range: 18-22 years), and alpha-gal IgE was detected in 179 (6.0%). Home of record spanned all 50 states, with a median of 36 recruits per state (range: 3-261). The highest prevalence rates were in Arkansas (39%), Oklahoma (35%), and Missouri (29%), with several other southeastern states >10%. Granular mapping revealed sensitization patterns that closely mimicked county-level Amblyomma americanum reports and Ehrlichia chaffeensis infections. Sensitization was associated with male sex, rural residence, and White race in univariate and multivariable models. CONCLUSIONS In this systematic survey, the prevalence of alpha-gal IgE among incoming military personnel was 6.0%. There were significant regional differences, with an overall pattern consistent with the known range of the lone star tick (A. americanum) and highest frequency in an area including Arkansas, Oklahoma, and Missouri.
Collapse
Affiliation(s)
- Samuel M Ailsworth
- Division of Allergy and Immunology, Department of Medicine, University of Virginia, Charlottesville, Va
| | - Apryl Susi
- Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, Md
| | - Lisa J Workman
- Division of Allergy and Immunology, Department of Medicine, University of Virginia, Charlottesville, Va
| | - Yun-Seong Ji
- Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, Md
| | - Jaimin Patel
- Division of Allergy and Immunology, Department of Medicine, University of Virginia, Charlottesville, Va
| | - Michael R Nelson
- Division of Allergy and Immunology, Department of Medicine, University of Virginia, Charlottesville, Va
| | - Thomas A E Platts-Mills
- Division of Allergy and Immunology, Department of Medicine, University of Virginia, Charlottesville, Va
| | - Cade M Nylund
- Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, Md.
| | - Jeffrey M Wilson
- Division of Allergy and Immunology, Department of Medicine, University of Virginia, Charlottesville, Va.
| |
Collapse
|
4
|
Medernach JG, Li RC, Zhao XY, Yin B, Noonan EA, Etter EF, Raghavan SS, Borish LC, Wilson JM, Barnes BH, Platts-Mills TAE, Ewald SE, Sauer BG, McGowan EC. Immunoglobulin G4 in eosinophilic esophagitis: Immune complex formation and correlation with disease activity. Allergy 2023; 78:3193-3203. [PMID: 37497566 DOI: 10.1111/all.15826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 05/15/2023] [Accepted: 06/02/2023] [Indexed: 07/28/2023]
Abstract
BACKGROUND Recent studies have shown deposition of immunoglobulin G4 (IgG4) and food proteins in the esophageal mucosa of eosinophilic esophagitis (EoE) patients. Our aims were to assess whether co-localization of IgG4 and major cow's milk proteins (CMPs) was associated with EoE disease activity and to investigate the proteins enriched in proximity to IgG4 deposits. METHODS This study included adult subjects with EoE (n = 13) and non-EoE controls (n = 5). Esophageal biopsies were immunofluorescence stained for IgG4 and CMPs. Co-localization in paired samples from active disease and remission was assessed and compared to controls. The proteome surrounding IgG4 deposits was evaluated by the novel technique, AutoSTOMP. IgG4-food protein interactions were confirmed with co-immunoprecipitation and mass spectrometry. RESULTS IgG4-CMP co-localization was higher in the active EoE group compared to paired remission samples (Bos d 4, p = .02; Bos d 5, p = .002; Bos d 8, p = .002). Co-localization was also significantly higher in the active EoE group compared to non-EoE controls (Bos d 4, p = .0013; Bos d 5, p = .0007; Bos d 8, p = .0013). AutoSTOMP identified eosinophil-derived proteins (PRG 2 and 3, EPX, RNASE3) and calpain-14 in IgG4-enriched areas. Co-immunoprecipitation and mass spectrometry confirmed IgG4 binding to multiple food allergens. CONCLUSION These findings further contribute to the understanding of the interaction of IgG4 with food antigens as it relates to EoE disease activity. These data strongly suggest the immune complex formation of IgG4 and major cow's milk proteins. These immune complexes may have a potential role in the pathophysiology of EoE by contributing to eosinophil activation and disease progression.
Collapse
Affiliation(s)
- Jonathan G Medernach
- Division of Pediatric Gastroenterology and Hepatology, University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - Rung-Chi Li
- Division of Allergy and Immunology, University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - Xiao-Yu Zhao
- Department of Microbiology, Immunology and Cancer Biology and The Carter Immunology Center, University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - Bocheng Yin
- Department of Microbiology, Immunology and Cancer Biology and The Carter Immunology Center, University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - Emily A Noonan
- Division of Allergy and Immunology, University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - Elaine F Etter
- Division of Allergy and Immunology, University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - Shyam S Raghavan
- Department of Pathology, University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - Larry C Borish
- Division of Allergy and Immunology, University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - Jeffrey M Wilson
- Division of Allergy and Immunology, University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - Barrett H Barnes
- Division of Pediatric Gastroenterology and Hepatology, University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - Thomas A E Platts-Mills
- Division of Allergy and Immunology, University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - Sarah E Ewald
- Department of Microbiology, Immunology and Cancer Biology and The Carter Immunology Center, University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - Bryan G Sauer
- Division of Gastroenterology and Hepatology, University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - Emily C McGowan
- Division of Allergy and Immunology, University of Virginia School of Medicine, Charlottesville, Virginia, USA
- Division of Allergy and Clinical Immunology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| |
Collapse
|
5
|
McGowan EC, Medernach J, Keshavarz B, Workman LJ, Li RC, Barnes BH, Sauer B, Wilson JM, Platts-Mills TAE. Food antigen consumption and disease activity affect food-specific IgG4 levels in patients with eosinophilic esophagitis (EoE). Clin Exp Allergy 2023; 53:307-315. [PMID: 35980663 PMCID: PMC9938092 DOI: 10.1111/cea.14215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 07/15/2022] [Accepted: 08/16/2022] [Indexed: 12/01/2022]
Abstract
INTRODUCTION High levels of serum food-specific IgG4 (sIgG4) have been reported in patients with EoE. The objective of this study was to examine whether serum sIgG4 levels to foods and aeroallergens are higher in EoE patients than allergic controls and to investigate the association between sIgG4 and EoE clinical characteristics. METHODS This was a case-control study nested in a prospective EoE Cohort. EoE cases were defined per consensus guidelines, and controls were individuals with symptoms who were confirmed to be EoE-negative on upper endoscopy. Demographic and clinical information was prospectively collected. Serum IgE and sIgG4 were measured to foods and aeroallergens by ImmunoCAP. Mean levels of sIgG4 were compared between cases and controls, and logistic regression models were used to examine predictors of elevated milk sIgG4 levels. RESULTS The analysis included 123 individuals (EoE n = 93, control n = 30) with a similar distribution of allergic disease between EoE patients and controls (86% vs. 93%; p = .30). EoE patients had significantly higher sIgG4 levels to all allergens evaluated, with the exception of birch (p = .24). Milk sIgG4 levels were independently associated with milk consumption (OR 4.95; p = .01) and the presence of sIgE to milk (OR 4.23; p = .008). CONCLUSION Serum sIgG4 levels to food and aeroallergen proteins were higher in patients with EoE than non-EoE controls, and higher levels of milk sIgG4 were independently associated with milk consumption and the presence of sIgE to milk proteins. Whether sIgG4 plays a pathogenic role in EoE or could be used as an EoE biomarker remains unknown and warrants further study.
Collapse
Affiliation(s)
- Emily C McGowan
- Department of Medicine, Division of Allergy and Clinical Immunology, University of Virginia School of Medicine, Charlottesville, Virginia, USA
- Division of Allergy and Clinical Immunology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jonathan Medernach
- Department of Pediatrics, Division of Pediatric Gastroenterology/Nutrition, University of Virginia School of Medicine, Charlottesville, Virginia, United States
| | - Behnam Keshavarz
- Department of Medicine, Division of Allergy and Clinical Immunology, University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - Lisa J Workman
- Department of Medicine, Division of Allergy and Clinical Immunology, University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - Rung-Chi Li
- Department of Medicine, Division of Allergy and Clinical Immunology, University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - Barrett H Barnes
- Department of Pediatrics, Division of Pediatric Gastroenterology/Nutrition, University of Virginia School of Medicine, Charlottesville, Virginia, United States
| | - Bryan Sauer
- Department of Medicine, Division of Gastroenterology and Hepatology, University of Virginia School of Medicine, Charlottesville, Virginia, United States
| | - Jeffrey M Wilson
- Department of Medicine, Division of Allergy and Clinical Immunology, University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - Thomas A E Platts-Mills
- Department of Medicine, Division of Allergy and Clinical Immunology, University of Virginia School of Medicine, Charlottesville, Virginia, USA
| |
Collapse
|
6
|
Platts-Mills TAE, Boyd KK, Medernach JG. Can we alter the course of allergic disease? Ann Allergy Asthma Immunol 2022; 129:271-273. [PMID: 35843517 DOI: 10.1016/j.anai.2022.07.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 06/24/2022] [Accepted: 07/05/2022] [Indexed: 10/17/2022]
Affiliation(s)
| | - Kelly K Boyd
- Division of Allergy and Immunology, University of Virginia, Charlottesville, Virginia
| | - Jonathan G Medernach
- Division of Pediatric Gastroenterology, University of Virginia, Charlottesville, Virginia
| |
Collapse
|
7
|
Keshavarz B, Richards NE, Workman LJ, Patel J, Muehling LM, Canderan G, Murphy DD, Brovero SG, Ailsworth SM, Eschenbacher WH, McGowan EC, Mann BJ, Nelson MR, Kadl A, Woodfolk JA, Platts-Mills TAE, Wilson JM. Trajectory of IgG to SARS-CoV-2 After Vaccination With BNT162b2 or mRNA-1273 in an Employee Cohort and Comparison With Natural Infection. Front Immunol 2022; 13:850987. [PMID: 35386716 PMCID: PMC8978955 DOI: 10.3389/fimmu.2022.850987] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Accepted: 02/28/2022] [Indexed: 01/14/2023] Open
Abstract
Three COVID-19 vaccines have received FDA-authorization and are in use in the United States, but there is limited head-to-head data on the durability of the immune response elicited by these vaccines. Using a quantitative assay we studied binding IgG antibodies elicited by BNT162b2, mRNA-1273 or Ad26.COV2.S in an employee cohort over a span out to 10 months. Age and sex were explored as response modifiers. Of 234 subjects in the vaccine cohort, 114 received BNT162b2, 114 received mRNA-1273 and six received Ad26.COV2.S. IgG levels measured between seven to 20 days after the second vaccination were similar in recipients of BNT162b2 and mRNA-127 and were ~50-fold higher than in recipients of Ad26.COV2.S. However, by day 21 and at later time points IgG levels elicited by BNT162b2 were lower than mRNA-1273. Accordingly, the IgG decay curve was steeper for BNT162b2 than mRNA-1273. Age was a significant modifier of IgG levels in recipients of BNT162b2, but not mRNA-1273. After six months, IgG levels elicited by BNT162b2, but not mRNA-1273, were lower than IgG levels in patients who had been hospitalized with COVID-19 six months earlier. Similar findings were observed when comparing vaccine-elicited antibodies with steady-state IgG targeting seasonal human coronaviruses. Differential IgG decay could contribute to differences observed in clinical protection over time between BNT162b2 and mRNA-1273.
Collapse
Affiliation(s)
- Behnam Keshavarz
- Division of Allergy & Clinical Immunology, Department of Medicine, University of Virginia, Charlottesville, VA, United States
| | - Nathan E Richards
- Division of Allergy & Clinical Immunology, Department of Medicine, University of Virginia, Charlottesville, VA, United States
| | - Lisa J Workman
- Division of Allergy & Clinical Immunology, Department of Medicine, University of Virginia, Charlottesville, VA, United States
| | - Jaimin Patel
- Division of Allergy & Clinical Immunology, Department of Medicine, University of Virginia, Charlottesville, VA, United States
| | - Lyndsey M Muehling
- Division of Allergy & Clinical Immunology, Department of Medicine, University of Virginia, Charlottesville, VA, United States
| | - Glenda Canderan
- Division of Allergy & Clinical Immunology, Department of Medicine, University of Virginia, Charlottesville, VA, United States
| | - Deborah D Murphy
- Division of Allergy & Clinical Immunology, Department of Medicine, University of Virginia, Charlottesville, VA, United States
| | - Savannah G Brovero
- Division of Infectious Disease and International Medicine, Department of Medicine, University of Virginia, Charlottesville, VA, United States
| | - Samuel M Ailsworth
- Division of Allergy & Clinical Immunology, Department of Medicine, University of Virginia, Charlottesville, VA, United States
| | - Will H Eschenbacher
- Division of Allergy & Clinical Immunology, Department of Medicine, University of Virginia, Charlottesville, VA, United States
| | - Emily C McGowan
- Division of Allergy & Clinical Immunology, Department of Medicine, University of Virginia, Charlottesville, VA, United States
| | - Barbara J Mann
- Division of Infectious Disease and International Medicine, Department of Medicine, University of Virginia, Charlottesville, VA, United States
| | - Michael R Nelson
- Division of Allergy & Clinical Immunology, Department of Medicine, University of Virginia, Charlottesville, VA, United States
| | - Alexandra Kadl
- Division of Pulmonary and Critical Care, Department of Medicine, University of Virginia, Charlottesville, VA, United States.,Department of Pharmacology, University of Virginia, Charlottesville, VA, United States
| | - Judith A Woodfolk
- Division of Allergy & Clinical Immunology, Department of Medicine, University of Virginia, Charlottesville, VA, United States
| | - Thomas A E Platts-Mills
- Division of Allergy & Clinical Immunology, Department of Medicine, University of Virginia, Charlottesville, VA, United States
| | - Jeffrey M Wilson
- Division of Allergy & Clinical Immunology, Department of Medicine, University of Virginia, Charlottesville, VA, United States
| |
Collapse
|
8
|
Pattarabanjird T, Wilson JM, Erickson LD, Workman LJ, Qiao H, Ghosheh Y, Gulati R, Durant C, Vallejo J, Saigusa R, Platts-Mills TAE, Taylor AM, Ley K, McNamara CA. Chemokine Receptor Activation Enhances Memory B Cell Class Switching Linked to IgE Sensitization to Alpha Gal and Cardiovascular Disease. Front Cardiovasc Med 2022; 8:791028. [PMID: 35097011 PMCID: PMC8793803 DOI: 10.3389/fcvm.2021.791028] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 12/20/2021] [Indexed: 01/10/2023] Open
Abstract
Background: Recent studies have suggested that IgE sensitization to α-gal is associated with coronary artery disease (CAD). However, the B cell subtype(s) responsible for production of IgE to α-gal and mechanisms mediating this production remain elusive. Methods: Single cell multi-omics sequencing, was utilized to phenotype B cells obtained from 60 subjects that had undergone coronary angiography in whom serum IgE was evaluated by ImmunoCAP. Bioinformatics approaches were used to identify B cell subtype(s) and transcriptomic signatures associated with α-gal sensitization. In vitro characterization of chemokine/chemokine receptor pairs on switched memory B cells associated with IgE to α-gal was performed. Results: Of the 60 patients, 17 (28%) were positive for IgE to α-gal. CITESeq identified CCR6+ class-switched memory (SWM) B cells and CXCR4 expresssion on these CCR6+ SWM B cells as significantly associated with IgE sensitization to α-gal but not to other common allergens (peanut or inhalants). In vitro studies of enriched human B cells revealed significantly greater IgE on SWM B cells with high CCR6 and CXCR4 expression 10 days after cells were treated with IL-4 and CD40 to stimulate class switch recombination. Both CCL20 (CCR6 ligand) and CXCL12 (ligand for CXCR4) increased the expression of IgE on SWM B cells expressing their receptors. However, they appeared to have unique pathways mediating this effect as only CCL20 increased activation-induced cytidine deaminase (AID), while CXCL12 drove proliferation of CXCR4+ SWM B cells. Lastly, correlation analysis indicated an association between CAD severity and the frequency of both CCR6+ SWM and CXCR4+ SWM B cells. Conclusions: CCR6+ SWM B cells were identified as potential producers of IgE to α-gal in CAD patients. Additionally, our findings highlighted non-chemotaxis roles of CCL20/CCR6 and CXCL12/CXCR4 signaling in mediating IgE class switching and cell proliferation of SWM B cells respectively. Results may have important implications for a better understanding and better therapeutic approaches for subjects with IgE sensitization to α-gal.
Collapse
Affiliation(s)
- Tanyaporn Pattarabanjird
- Carter Immunology Center, University of Virginia, Charlottesville, VA, United States,Cardiovascular Research Center, University of Virginia, Charlottesville, VA, United States,Department of Biomedical Engineering, University of Virginia, Charlottesville, VA, United States
| | - Jeffrey M. Wilson
- Division of Allergy and Immunology, Department of Medicine, University of Virginia, Charlottesville, VA, United States
| | - Loren D. Erickson
- Carter Immunology Center, University of Virginia, Charlottesville, VA, United States,Department of Microbiology, Immunology, and Cancer Biology, University of Virginia, Charlottesville, VA, United States
| | - Lisa J. Workman
- Division of Allergy and Immunology, Department of Medicine, University of Virginia, Charlottesville, VA, United States
| | - Hui Qiao
- Carter Immunology Center, University of Virginia, Charlottesville, VA, United States,Department of Microbiology, Immunology, and Cancer Biology, University of Virginia, Charlottesville, VA, United States
| | - Yanal Ghosheh
- La Jolla Institute of Immunology, La Jolla, CA, United States
| | - Rishab Gulati
- La Jolla Institute of Immunology, La Jolla, CA, United States
| | | | - Jenifer Vallejo
- La Jolla Institute of Immunology, La Jolla, CA, United States
| | - Ryosuke Saigusa
- La Jolla Institute of Immunology, La Jolla, CA, United States
| | - Thomas A. E. Platts-Mills
- Division of Allergy and Immunology, Department of Medicine, University of Virginia, Charlottesville, VA, United States
| | - Angela M. Taylor
- Division of Cardiovascular Medicine, Department of Medicine, University of Virginia, Charlottesville, VA, United States
| | - Klaus Ley
- La Jolla Institute of Immunology, La Jolla, CA, United States
| | - Coleen A. McNamara
- Carter Immunology Center, University of Virginia, Charlottesville, VA, United States,Cardiovascular Research Center, University of Virginia, Charlottesville, VA, United States,Division of Cardiovascular Medicine, Department of Medicine, University of Virginia, Charlottesville, VA, United States,*Correspondence: Coleen A. McNamara
| |
Collapse
|
9
|
Richards NE, Keshavarz B, Workman LJ, Nelson MR, Platts-Mills TAE, Wilson JM. Comparison of SARS-CoV-2 Antibody Response by Age Among Recipients of the BNT162b2 vs the mRNA-1273 Vaccine. JAMA Netw Open 2021; 4:e2124331. [PMID: 34473262 PMCID: PMC8414189 DOI: 10.1001/jamanetworkopen.2021.24331] [Citation(s) in RCA: 73] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
This cohort study compares antibody responses in a cohort in which both BNT162b2 and mRNA-1273 COVID-19 vaccines were administered.
Collapse
Affiliation(s)
- Nathan E. Richards
- Division of Allergy and Clinical Immunology, University of Virginia, Charlottesville
| | - Behnam Keshavarz
- Division of Allergy and Clinical Immunology, University of Virginia, Charlottesville
| | - Lisa J. Workman
- Division of Allergy and Clinical Immunology, University of Virginia, Charlottesville
| | - Michael R. Nelson
- Division of Allergy and Clinical Immunology, University of Virginia, Charlottesville
| | | | - Jeffrey M. Wilson
- Division of Allergy and Clinical Immunology, University of Virginia, Charlottesville
| |
Collapse
|
10
|
Keshavarz B, Erickson LD, Platts-Mills TAE, Wilson JM. Lessons in Innate and Allergic Immunity From Dust Mite Feces and Tick Bites. Front Allergy 2021; 2:692643. [PMID: 35387017 PMCID: PMC8974698 DOI: 10.3389/falgy.2021.692643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 06/03/2021] [Indexed: 11/13/2022] Open
Abstract
Allergic diseases represent a major cause of morbidity in modern industrialized and developing countries. The origins and development of allergic immune responses have proven difficult to unravel and remain an important scientific objective. House dust mites (HDM) and ticks represent two important causes of allergic disease. Investigations into HDM fecal particles and tick bites have revealed insights which have and will continue to shape our understanding of allergic immunity. In the present review, focus is given to the role of innate immunity in shaping the respective responses to HDM and ticks. The HDM fecal particle represents a rich milieu of molecules that can be recognized by pathogen-recognition receptors of the innate immune system. Factors in tick saliva and/or tissue damage resultant from tick feeding are thought to activate innate immune signaling that promotes allergic pathways. Recent evidence indicates that innate sensing involves not only the direct recognition of allergenic agents/organisms, but also indirect sensing of epithelial barrier disruption. Although fecal particles from HDM and bites from ticks represent two distinct causes of sensitization, both involve a complex array of molecules that contribute to an innate response. Identification of specific molecules will inform our understanding of the mechanisms that contribute to allergic immunity, however the key may lie in the combination of molecules delivered to specific sites in the body.
Collapse
Affiliation(s)
- Behnam Keshavarz
- Division of Allergy and Immunology, Department of Medicine, University of Virginia, Charlottesville, VA, United States
| | - Loren D. Erickson
- Beirne B. Carter Center for Immunology Research and the Department of Microbiology, Immunology and Cancer Biology, University of Virginia School of Medicine, Charlottesville, VA, United States
| | - Thomas A. E. Platts-Mills
- Division of Allergy and Immunology, Department of Medicine, University of Virginia, Charlottesville, VA, United States
| | - Jeffrey M. Wilson
- Division of Allergy and Immunology, Department of Medicine, University of Virginia, Charlottesville, VA, United States
- *Correspondence: Jeffrey M. Wilson
| |
Collapse
|
11
|
Wilson JM, Platts-Mills TAE, Keshavarz B. Reply to: The antibody response to the glycan α-Gal correlates with COVID-19 symptoms. J Med Virol 2021; 93:5219-5220. [PMID: 33851742 PMCID: PMC8250814 DOI: 10.1002/jmv.27022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Revised: 04/10/2021] [Accepted: 04/12/2021] [Indexed: 11/19/2022]
Affiliation(s)
- Jeffrey M Wilson
- Division of Allergy & Clinical Immunology, Department of Medicine, University of Virginia, Charlottesville, Virginia, USA
| | - Thomas A E Platts-Mills
- Division of Allergy & Clinical Immunology, Department of Medicine, University of Virginia, Charlottesville, Virginia, USA
| | - Behnam Keshavarz
- Division of Allergy & Clinical Immunology, Department of Medicine, University of Virginia, Charlottesville, Virginia, USA
| |
Collapse
|
12
|
Flashner BM, Rifas-Shiman SL, Oken E, Camargo CA, Platts-Mills TAE, Workman L, Litonjua AA, Gold DR, Rice MB. Contributions of asthma, rhinitis and IgE to exhaled nitric oxide in adolescents. ERJ Open Res 2021; 7:00945-2020. [PMID: 33898613 PMCID: PMC8053905 DOI: 10.1183/23120541.00945-2020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 03/04/2021] [Indexed: 12/02/2022] Open
Abstract
Exhaled nitric oxide fraction (FeNO) is an indicator of allergic airway inflammation. However, it is unknown how asthma, allergic rhinitis (AR) and allergic sensitisation relate to FeNO, particularly among adolescents and in overlapping conditions. We sought to determine the associations between asthma, AR, and aeroallergen immunoglobulin (Ig)E and FeNO in adolescents. We measured FeNO among 929 adolescents (aged 11–16 years) in Project Viva, an unselected prebirth cohort in Massachusetts, USA. We defined asthma as ever asthma physician diagnosis plus wheezing in the past year or taking asthma medications in the past month, AR as a physician diagnosis of hay fever or AR, and aeroallergen IgE as any IgE >0.35 IU·mL−1 among 592 participants who provided blood samples. We examined associations of asthma, AR and IgE with percent difference in FeNO in linear regression models adjusted for sex, race/ethnicity, age and height, maternal education and smoking during pregnancy, and household/neighbourhood demographics. Asthma (14%) was associated with 97% higher FeNO (95% CI 70–128%), AR (21%) with 45% higher FeNO (95% CI 28–65%), and aeroallergen IgE (58%) with 102% higher FeNO (95% CI 80–126%) compared to those without each condition, respectively. In the absence of asthma or AR, aeroallergen IgE was associated with 75% higher FeNO (95% CI 52–101), while asthma and AR were not associated with FeNO in the absence of IgE. The link between asthma and AR with FeNO is limited to those with IgE-mediated phenotypes. FeNO may be elevated in those with allergic sensitisation alone, even in the absence of asthma or AR. While asthma, allergic rhinitis (AR) and allergic sensitisation are associated with higher FENO, asthma and AR in the absence of aeroallergen IgE are not associated with FENO. When elevated in asthma or AR, FENO suggests allergic sensitisation.https://bit.ly/3bGgr0r
Collapse
Affiliation(s)
- Bess M Flashner
- Division of Pulmonary, Critical Care and Sleep Medicine, Dept of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Sheryl L Rifas-Shiman
- Division of Chronic Disease Research Across the Lifecourse, Dept of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Emily Oken
- Division of Chronic Disease Research Across the Lifecourse, Dept of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Carlos A Camargo
- Channing Division of Network Medicine, Dept of Medicine, Brigham and Women's Hospital, Boston, MA, USA.,Dept of Emergency Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Thomas A E Platts-Mills
- Dept of Allergy and Immunology, University of Virginia Health System, Charlottesville, VA, USA
| | - Lisa Workman
- Dept of Allergy and Immunology, University of Virginia Health System, Charlottesville, VA, USA
| | - Augusto A Litonjua
- Pediatric Pulmonary Division, Dept of Pediatrics, Golisano Children's Hospital at Strong, University of Rochester Medical Center, Rochester, NY, USA
| | - Diane R Gold
- Channing Division of Network Medicine, Dept of Medicine, Brigham and Women's Hospital, Boston, MA, USA.,Dept of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Mary B Rice
- Division of Pulmonary, Critical Care and Sleep Medicine, Dept of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
| |
Collapse
|
13
|
Bacon SL, Platts-Mills TAE. Is It Time for Aerobic Exercise to be Included in Asthma Treatment Guidelines? J Allergy Clin Immunol Pract 2021; 8:2997-2998. [PMID: 33039014 DOI: 10.1016/j.jaip.2020.08.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 08/05/2020] [Indexed: 10/23/2022]
Affiliation(s)
- Simon L Bacon
- Montreal Behavioral Medicine Centre, CIUSSS-NIM, Montreal, QC, Canada; Department of Health, Kinesiology, and Applied Physiology, Concordia University, Portland, Ore
| | - Thomas A E Platts-Mills
- Division of Allergy and Immunology, Department of Medicine, University of Virginia, Charlottesville, Va.
| |
Collapse
|
14
|
Shi Y, Tang R, Luo F, Li H, Pan Z, Xu G, Yang Y, Zhao Z, Liang A, Wei JF, Piao Y, Chang C, Sun JL, Platts-Mills TAE. The Diagnosis and Management of Allergic Reactions Caused by Chinese Materia Medica. Clin Rev Allergy Immunol 2021; 62:103-122. [PMID: 33606192 DOI: 10.1007/s12016-020-08812-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/28/2020] [Indexed: 01/21/2023]
Abstract
Traditional Chinese medicines (TCM) have been used in China for thousands of years. Although TCM has been generally perceived to be safe, adverse reactions to Chinese materia medica (CMM) have been reported. Most of the adverse reactions are allergic in nature, but other mechanisms may play a role. This review focuses on the mechanism and clinical presentation of these allergic reactions. Allergic reactions can occur as a result of the active and inactive ingredients of CMM. Impurities and chemicals generated during the production process can also lead to allergic or adverse reactions. Environmental factors such as temperature, humidity, and light can cause changes in the allergenicity of drugs. Human error in formulating CMM drugs also contributes to adverse drug reactions. The management of allergic reactions to CMM includes taking a good history, avoidance of medications in the same class as those which caused prior reactions, the proper training of staff, adherence to manufacturer guidelines and expiration dates, evaluation of benefit and risk balance, and the formulation of a risk management strategy for the use of CMM. A small test dose of a considered drug before using, improvements in drug purification technology, and proper storage and clinical administration help reduce allergic reactions due to CMM.
Collapse
Affiliation(s)
- Yue Shi
- Department of Traditional Chinese Medicine, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, 100730, Beijing, China
| | - Rui Tang
- Department of Allergy, Peking Union Medical College Hospital, National Clinical Research Center for Dermatologic and Immunologic Diseases, Beijing Key Laboratory of Precision Medicine for Diagnosis and Treatment on Allergic Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, 100730, Beijing, China
| | - Fangmei Luo
- Department of Ophthalmology and Otorhinolaryngology, Qujing Chinese Traditional Medicine Hospital, Yunnan, 655000, Qujing, China
| | - Hong Li
- Department of Allergy, Peking Union Medical College Hospital, National Clinical Research Center for Dermatologic and Immunologic Diseases, Beijing Key Laboratory of Precision Medicine for Diagnosis and Treatment on Allergic Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, 100730, Beijing, China
| | - Zouxian Pan
- Department of Allergy, Peking Union Medical College Hospital, National Clinical Research Center for Dermatologic and Immunologic Diseases, Beijing Key Laboratory of Precision Medicine for Diagnosis and Treatment on Allergic Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, 100730, Beijing, China
| | - Guogang Xu
- Department of Respiratory Medicine, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Medical College of PLA, Chinese PLA General Hospital, 100853, Beijing, China
| | - Yongshi Yang
- Department of Allergy, Peking Union Medical College Hospital, National Clinical Research Center for Dermatologic and Immunologic Diseases, Beijing Key Laboratory of Precision Medicine for Diagnosis and Treatment on Allergic Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, 100730, Beijing, China
| | - Zuotao Zhao
- Department of Dermatology, Peking University First Hospital, Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, National Clinical Research Center for Skin and Immune Diseases, 100034, Beijing, China
| | - Aihua Liang
- Key Laboratory of Beijing for Identification and Safety Evaluation of Chinese Medicine, Institute of Chinese Materia medical, China Academy of Medical Sciences, 10070, Beijing, China
| | - Ji-Fu Wei
- Research Division of Clinical Pharmacology, The First Affiliated Hospital of Nanjing Medical University, No. 300, Guangzhou Road, 210029, Nanjing, Jiangsu, China
| | - Yuanlin Piao
- Department of Traditional Chinese Medicine, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, 100730, Beijing, China.
| | - Christopher Chang
- Division of Rheumatology, Allergy and Clinical Immunology, University of California, Davis, CA, USA. .,Division of Pediatric Immunology, Allergy and Rheumatology, Joe DiMaggio Children's Hospital, FL, Hollywood, USA.
| | - Jin-Lyu Sun
- Department of Allergy, Peking Union Medical College Hospital, National Clinical Research Center for Dermatologic and Immunologic Diseases, Beijing Key Laboratory of Precision Medicine for Diagnosis and Treatment on Allergic Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, 100730, Beijing, China.
| | | |
Collapse
|
15
|
Keshavarz B, Platts-Mills TAE, Wilson JM. The use of microarray and other multiplex technologies in the diagnosis of allergy. Ann Allergy Asthma Immunol 2021; 127:10-18. [PMID: 33450398 DOI: 10.1016/j.anai.2021.01.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 12/18/2020] [Accepted: 01/04/2021] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To give an overview and describe the strengths and weaknesses of immunoglobulin E (IgE) microarray and other multiplex assays that have been developed and are being used for allergy diagnostics. DATA SOURCES Queries for IgE microarray and multiplex assays were conducted with PubMed and Google Scholar, searching for primary articles and review papers. STUDY SELECTIONS We focused on articles written in English on commercially available IgE multiplex assays that were reported in the allergy and immunology literature. RESULTS Several commercial IgE assays that use microarray or other multiplex technology have been developed, and some have been implemented into clinical practice in Europe and Asia, with the Immuno Solid-Phase Allergen Chip being the most widely studied. Results of these assays generally correlate with results using "singleplex" IgE assays (eg, ImmunoCAP), though there can be variability among products and among allergens. A strength of the microarray technology is that IgE to a large number of allergens can be detected simultaneously in a single test, and only a small amount of patient serum is required. Cost, inadequate sensitivity under some scenarios, and difficulties with data interpretation, in some cases of 100 or more allergens, can be limitations. CONCLUSION IgE microarray assays are already a valuable tool in research applications. These assays, and also other forms of IgE multiplex assays, are likely to play an important role in the clinical practice of allergy in the future. Additional studies focused on clinical outcomes, and the development of more targeted allergen panels could facilitate increased clinical use.
Collapse
Affiliation(s)
- Behnam Keshavarz
- Division of Allergy and Immunology, Department of Medicine, University of Virginia, Charlottesville, Virginia
| | - Thomas A E Platts-Mills
- Division of Allergy and Immunology, Department of Medicine, University of Virginia, Charlottesville, Virginia
| | - Jeffrey M Wilson
- Division of Allergy and Immunology, Department of Medicine, University of Virginia, Charlottesville, Virginia.
| |
Collapse
|
16
|
Keshavarz B, Wiencek JR, Workman LJ, Straesser MD, Muehling LM, Canderan G, Drago F, Bonham CA, Sturek JM, Ramani C, McNamara CA, Woodfolk JA, Kadl A, Platts-Mills TAE, Wilson JM. Quantitative measurement of IgG to SARS-CoV-2 proteins using ImmunoCAP. medRxiv 2020. [PMID: 33200147 DOI: 10.1101/2020.11.09.20228411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Background Detailed understanding of the immune response to SARS-CoV-2, the cause of coronavirus disease 2019 (COVID-19), has been hampered by a lack of quantitative antibody assays. Objective To develop a quantitative assay for IgG to SARS-CoV-2 proteins that could readily be implemented in clinical and research laboratories. Methods The biotin-streptavidin technique was used to conjugate SARS-CoV-2 spike receptor-binding-domain (RBD) or nucleocapsid protein to the solid-phase of the ImmunoCAP resin. Plasma and serum samples from patients with COVID-19 (n=51) and samples from donors banked prior to the emergence of COVID-19 (n=109) were used in the assay. SARS-CoV-2 IgG levels were followed longitudinally in a subset of samples and were related to total IgG and IgG to reference antigens using an ImmunoCAP 250 platform. Results Performance characteristics demonstrated 100% sensitivity and 99% specificity at a cut-off level of 2.5 µg/mL for both SARS-CoV-2 proteins. Among 36 patients evaluated in a post-hospital follow-up clinic, median levels of IgG to spike-RBD and nucleocapsid were 34.7 µg/mL (IQR 18-52) and 24.5 µg/mL (IQR 9-59), respectively. Among 17 patients with longitudinal samples there was a wide variation in the magnitude of IgG responses, but generally the response to spike-RBD and to nucleocapsid occurred in parallel, with peak levels approaching 100 µg/mL, or 1% of total IgG. Conclusions We have described a quantitative assay to measure IgG to SARS-CoV-2 that could be used in clinical and research laboratories and implemented at scale. The assay can easily be adapted to measure IgG to novel antigens, has good performance characteristics and a read-out in standardized units.
Collapse
|
17
|
Straesser M, Keshavarz B, Borish L, Khokhar D, Holian A, Charlton NP, Platts-Mills TAE, Wilson JM. α-Gal on Crotalidae-polyvalent Fab antivenom (CroFab): Investigating the relevance to immediate hypersensitivity reactions. J Allergy Clin Immunol Pract 2020; 9:1015-1017.e1. [PMID: 33122101 DOI: 10.1016/j.jaip.2020.10.026] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 10/06/2020] [Accepted: 10/07/2020] [Indexed: 11/25/2022]
Affiliation(s)
- Matthew Straesser
- Division of Allergy and Clinical Immunology, University of Virginia Health System, Charlottesville, Va
| | - Behnam Keshavarz
- Division of Allergy and Clinical Immunology, University of Virginia Health System, Charlottesville, Va
| | - Larry Borish
- Division of Allergy and Clinical Immunology, University of Virginia Health System, Charlottesville, Va; Department of Microbiology, University of Virginia, Charlottesville, Va
| | - Dilawar Khokhar
- Division of Allergy and Clinical Immunology, University of Virginia Health System, Charlottesville, Va
| | - Angela Holian
- Department of Emergency Medicine, University of Virginia Health System, Charlottesville, Va
| | - Nathan P Charlton
- Department of Emergency Medicine, University of Virginia Health System, Charlottesville, Va
| | - Thomas A E Platts-Mills
- Division of Allergy and Clinical Immunology, University of Virginia Health System, Charlottesville, Va
| | - Jeffrey M Wilson
- Division of Allergy and Clinical Immunology, University of Virginia Health System, Charlottesville, Va.
| |
Collapse
|
18
|
Hawkins RB, Wilson JM, Mehaffey JH, Platts-Mills TAE, Ailawadi G. Safety of Intravenous Heparin for Cardiac Surgery in Patients With Alpha-Gal Syndrome. Ann Thorac Surg 2020; 111:1991-1997. [PMID: 33031779 DOI: 10.1016/j.athoracsur.2020.07.050] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Revised: 07/14/2020] [Accepted: 07/31/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND Alpha-gal syndrome is a tick-acquired disease caused by immunoglobulin E (IgE) to the oligosaccharide galactose-alpha-1,3-galactose (alpha-gal), causing allergic reactions to meat and products sourced from nonprimate mammals. As heparin is porcine-derived, we hypothesized that patients with alpha-gal syndrome who received high-dose heparin for cardiac surgery would have increased risk of anaphylaxis. METHODS All cardiac surgery patients at an academic medical center from 2007 to 2019 were cross-referenced with research and clinical databases for the alpha-gal IgE blood test. Clinical data were obtained through the institutional Society of Thoracic Surgeons Adult Cardiac Database and chart review. Patients were stratified by development of an allergic reaction for univariate statistical analysis. RESULTS Of the 8819 patients, 17 (0.19%) had a positive alpha-gal test before cardiac surgery. Of these 17 patients, 4 (24%) had a severe allergic reaction. The median alpha-gal titer was significantly higher in patients with a reaction (75 [interquartile range, 61-96] IU/mL vs 8 [interquartile range, 3-18] IU/mL; P = .006). There were no differences in median heparin loading dose, total dose, or maximum activated clotting time (all P > .05). In a subgroup of 8 patients with recent alpha-gal IgE level, 4 (50%) developed an allergic reaction. CONCLUSIONS Although alpha-gal is rare in patients undergoing cardiac surgery, there is up to a 50% risk of serious allergic reaction to heparin for cardiopulmonary bypass. Higher preoperative alpha-gal titers may confer a higher risk of severe allergic reaction. For patients with a clinical suspicion of alpha-gal syndrome, we recommend prescreening with IgE levels and premedicating before receiving high doses of intravenous heparin.
Collapse
Affiliation(s)
- Robert B Hawkins
- Division of Thoracic and Cardiovascular Surgery, Department of Surgery, University of Virginia, Charlottesville, Virginia.
| | - Jeffrey M Wilson
- Division of Allergy and Clinical Immunology, University of Virginia, Charlottesville, Virginia
| | - J Hunter Mehaffey
- Division of Thoracic and Cardiovascular Surgery, Department of Surgery, University of Virginia, Charlottesville, Virginia
| | - Thomas A E Platts-Mills
- Division of Allergy and Clinical Immunology, University of Virginia, Charlottesville, Virginia
| | - Gorav Ailawadi
- Division of Thoracic and Cardiovascular Surgery, Department of Surgery, University of Virginia, Charlottesville, Virginia
| |
Collapse
|
19
|
Wilson JM, Keshavarz B, Retterer M, Workman LJ, Schuyler AJ, McGowan EC, Lane C, Kandeel A, Purser J, Rönmark E, LaRussa J, Commins SP, Merritt T, Platts-Mills TAE. A dynamic relationship between two regional causes of IgE-mediated anaphylaxis: α-Gal syndrome and imported fire ant. J Allergy Clin Immunol 2020; 147:643-652.e7. [PMID: 32522461 DOI: 10.1016/j.jaci.2020.05.034] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 04/21/2020] [Accepted: 05/12/2020] [Indexed: 01/11/2023]
Abstract
BACKGROUND A syndrome of mammalian meat allergy relating to IgE specific for galactose-α-1,3-galactose (α-Gal) was first reported 10 years ago in the southeastern United States and has been related to bites of the lone star tick (Amblyomma americanum). OBJECTIVE Here we investigated the epidemiology of the "α-Gal syndrome" in the United States and sought additional evidence for the connection to tick bites. METHODS A survey of allergists was conducted by using a snowball approach. A second tier of the survey included questions about anaphylaxis to imported fire ants (IFAs). History of tick bites and tick-related febrile illness were assessed as part of a case-control study in Virginia. Antibody assays were conducted on sera from subjects reporting allergic reactions to mammalian meat or IFA. RESULTS In North America the α-Gal syndrome is recognized across the Southeast, Midwest, and Atlantic Coast, with many providers in this area managing more than 100 patients each. The distribution of cases generally conformed to the reported range of A americanum, although within this range there was an inverse relationship between α-Gal cases and cases of IFA anaphylaxis that were closely related to the territory of IFA. The connection between tick bites and α-Gal sensitization was further supported by patients' responses to a questionnaire and the results of serologic tests. CONCLUSIONS The α-Gal syndrome is commonly acquired in adulthood as a consequence of tick bites and has a regional distribution that largely conforms to the territory of the lone star tick. The epidemiology of the syndrome is expected to be dynamic and shifting north because of climate change and ecologic competition from IFA.
Collapse
Affiliation(s)
- Jeffrey M Wilson
- Division of Allergy & Clinical Immunology, University of Virginia, Charlottesville, Va
| | - Behnam Keshavarz
- Division of Allergy & Clinical Immunology, University of Virginia, Charlottesville, Va
| | - Maya Retterer
- Division of Allergy & Clinical Immunology, University of Virginia, Charlottesville, Va
| | - Lisa J Workman
- Division of Allergy & Clinical Immunology, University of Virginia, Charlottesville, Va
| | - Alexander J Schuyler
- Division of Allergy & Clinical Immunology, University of Virginia, Charlottesville, Va
| | - Emily C McGowan
- Division of Allergy & Clinical Immunology, University of Virginia, Charlottesville, Va
| | | | | | | | - Eva Rönmark
- Department of Public Health and Clinical Medicine, OLIN Unit, Umeå University, Umeå, Sweden
| | | | - Scott P Commins
- Division of Rheumatology, Allergy & Immunology, University of North Carolina, Chapel Hill, NC
| | - Tina Merritt
- The Allergy and Asthma Clinic of Northwest Arkansas, Bentonville, Ark
| | | |
Collapse
|
20
|
Shaker M, Platts-Mills TAE. The Law of Unintended Consequences in Pertussis Vaccination: An Ounce of Prevention, a Pound of Cure, and … Food Allergy? J Allergy Clin Immunol Pract 2020; 8:2015-2016. [PMID: 32499040 DOI: 10.1016/j.jaip.2020.01.005] [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] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 01/07/2020] [Indexed: 10/24/2022]
Affiliation(s)
- Marcus Shaker
- Dartmouth-Hitchcock Medical Center, Section of Allergy and Immunology, Lebanon, NH; Geisel School of Medicine at Dartmouth, Hanover, NH.
| | | |
Collapse
|
21
|
Affiliation(s)
- Jeffrey M Wilson
- Division of Allergy and Immunology, University of Virginia, Charlottesville, VA 22908, USA
| | - Coleen A McNamara
- Division of Cardiology and Robert Berne Cardiovascular Center, University of Virginia, Charlottesville, VA 22908, USA
| | | |
Collapse
|
22
|
Muehling LM, Heymann PW, Wright PW, Eccles JD, Agrawal R, Carper HT, Murphy DD, Workman LJ, Word CR, Ratcliffe SJ, Capaldo BJ, Platts-Mills TAE, Turner RB, Kwok WW, Woodfolk JA. Human T H1 and T H2 cells targeting rhinovirus and allergen coordinately promote allergic asthma. J Allergy Clin Immunol 2020; 146:555-570. [PMID: 32320734 DOI: 10.1016/j.jaci.2020.03.037] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 03/03/2020] [Accepted: 03/27/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Allergic asthmatic subjects are uniquely susceptible to acute wheezing episodes provoked by rhinovirus. However, the underlying immune mechanisms and interaction between rhinovirus and allergy remain enigmatic, and current paradigms are controversial. OBJECTIVE We sought to perform a comprehensive analysis of type 1 and type 2 innate and adaptive responses in allergic asthmatic subjects infected with rhinovirus. METHODS Circulating virus-specific TH1 cells and allergen-specific TH2 cells were precisely monitored before and after rhinovirus challenge in allergic asthmatic subjects (total IgE, 133-4692 IU/mL; n = 28) and healthy nonallergic controls (n = 12) using peptide/MHCII tetramers. T cells were sampled for up to 11 weeks to capture steady-state and postinfection phases. T-cell responses were analyzed in parallel with 18 cytokines in the nose, upper and lower airway symptoms, and lung function. The influence of in vivo IgE blockade was also examined. RESULTS In uninfected asthmatic subjects, higher numbers of circulating virus-specific PD-1+ TH1 cells, but not allergen-specific TH2 cells, were linked to worse lung function. Rhinovirus infection induced an amplified antiviral TH1 response in asthmatic subjects versus controls, with synchronized allergen-specific TH2 expansion, and production of type 1 and 2 cytokines in the nose. In contrast, TH2 responses were absent in infected asthmatic subjects who had normal lung function, and in those receiving anti-IgE. Across all subjects, early induction of a minimal set of nasal cytokines that discriminated high responders (G-CSF, IFN-γ, TNF-α) correlated with both egress of circulating virus-specific TH1 cells and worse symptoms. CONCLUSIONS Rhinovirus induces robust TH1 responses in allergic asthmatic subjects that may promote disease, even after the infection resolves.
Collapse
Affiliation(s)
- Lyndsey M Muehling
- Department of Medicine, University of Virginia School of Medicine, Charlottesville; Department of Microbiology, University of Virginia School of Medicine, Charlottesville
| | - Peter W Heymann
- Department of Pediatrics, University of Virginia School of Medicine, Charlottesville
| | - Paul W Wright
- Department of Medicine, University of Virginia School of Medicine, Charlottesville
| | - Jacob D Eccles
- Department of Medicine, University of Virginia School of Medicine, Charlottesville; Department of Microbiology, University of Virginia School of Medicine, Charlottesville
| | - Rachana Agrawal
- Department of Medicine, University of Virginia School of Medicine, Charlottesville
| | - Holliday T Carper
- Department of Pediatrics, University of Virginia School of Medicine, Charlottesville
| | - Deborah D Murphy
- Department of Pediatrics, University of Virginia School of Medicine, Charlottesville
| | - Lisa J Workman
- Department of Medicine, University of Virginia School of Medicine, Charlottesville
| | - Carolyn R Word
- Department of Pediatrics, University of Virginia School of Medicine, Charlottesville
| | - Sarah J Ratcliffe
- Department of Public Health Sciences, University of Virginia School of Medicine, Charlottesville
| | - Brian J Capaldo
- Department of Microbiology, University of Virginia School of Medicine, Charlottesville
| | | | - Ronald B Turner
- Department of Pediatrics, University of Virginia School of Medicine, Charlottesville
| | | | - Judith A Woodfolk
- Department of Medicine, University of Virginia School of Medicine, Charlottesville; Department of Microbiology, University of Virginia School of Medicine, Charlottesville.
| |
Collapse
|
23
|
Platts-Mills TAE, Commins SP, Biedermann T, van Hage M, Levin M, Beck LA, Diuk-Wasser M, Jappe U, Apostolovic D, Minnicozzi M, Plaut M, Wilson JM. On the cause and consequences of IgE to galactose-α-1,3-galactose: A report from the National Institute of Allergy and Infectious Diseases Workshop on Understanding IgE-Mediated Mammalian Meat Allergy. J Allergy Clin Immunol 2020; 145:1061-1071. [PMID: 32057766 DOI: 10.1016/j.jaci.2020.01.047] [Citation(s) in RCA: 68] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 01/29/2020] [Accepted: 01/31/2020] [Indexed: 12/16/2022]
Abstract
The mammalian meat allergy known as the "α-Gal syndrome" relates to IgE specific for galactose-α-1,3-galactose (α-Gal), an oligosaccharide that is present in cells and tissues of nonprimate mammals. The recognition of delayed reactions to food derived from mammals in patients with IgE to α-Gal and also the association with tick bites have been increasing worldwide. In 2018, the National Institute of Allergy and Infectious Diseases, Division of Allergy, Immunology and Transplantation, sponsored a workshop on this emerging tick-related disease. International experts from the fields of tick biology, allergy, immunology, infectious disease, and dermatology discussed the current state of our understanding of this emerging medical condition. The participants provided suggestions for specific research priorities and for the development of resources to advance our knowledge of the mechanisms, diagnosis, management, and prevention of this allergic disease. This publication is a summary of the workshop and the panel's recommendations are presented herein.
Collapse
Affiliation(s)
| | - Scott P Commins
- Departments of Medicine & Pediatrics, University of North Carolina, Chapel Hill, NC
| | - Tilo Biedermann
- Department of Dermatology and Allergy, Technical University of Munich and Unit Clinical Allergology (EKA), Helmholtz Zentrum München, Munich, Germany
| | - Marianne van Hage
- Division of Immunology and Allergy, Department of Medicine Solna, Karolinska Institutet and University Hospital, Stockholm, Sweden
| | - Michael Levin
- Division of Paediatric Allergy, University of Cape Town, Cape Town, South Africa
| | - Lisa A Beck
- Department of Dermatology, University of Rochester Medical Center, Rochester, NY
| | - Maria Diuk-Wasser
- Department of Ecology, Evolution, and Environmental Biology, Columbia University, New York, NY
| | - Uta Jappe
- Division of Clinical and Molecular Allergology, Research Center Borstel, Airway Research, Center North (ARCN), Member of the German Center for Lung Research, Borstel, Germany; Interdisciplinary Allergy Outpatient Clinic, Department of Pneumology, University of Lübeck, Lübeck, Germany
| | - Danijela Apostolovic
- Division of Immunology and Allergy, Department of Medicine Solna, Karolinska Institutet and University Hospital, Stockholm, Sweden
| | - Michael Minnicozzi
- Division of Allergy, Immunology and Transplantation, Allergy, Asthma and Airway Biology Branch, National Institute of Allergy and Infectious Diseases, NIH, Rockville, Md
| | - Marshall Plaut
- Division of Allergy, Immunology and Transplantation, Allergy, Asthma and Airway Biology Branch, National Institute of Allergy and Infectious Diseases, NIH, Rockville, Md
| | - Jeffrey M Wilson
- Division of Allergy & Clinical Immunology, University of Virginia, Charlottesville, Va
| |
Collapse
|
24
|
Heymann PW, Platts-Mills TAE, Woodfolk JA, Borish L, Murphy DD, Carper HT, Conaway MR, Steinke JW, Muehling L, Gerald Teague W, Kennedy JL, Irani AM, McGraw MD, Early SV, Wheatley LM, Adams AP, Turner RB. Understanding the asthmatic response to an experimental rhinovirus infection: Exploring the effects of blocking IgE. J Allergy Clin Immunol 2020; 146:545-554. [PMID: 32018030 DOI: 10.1016/j.jaci.2020.01.035] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 12/20/2019] [Accepted: 01/15/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND Rhinovirus frequently causes asthma exacerbations among children and young adults who are allergic. The interaction between allergen and rhinovirus-induced symptoms and inflammation over time is unclear. OBJECTIVE Our aim was to compare the response to an experimental inoculation with rhinovirus-16 in allergic asthmatics with the response in healthy controls and to evaluate the effects of administrating omalizumab before and during the infection. METHODS Two clinical trials were run in parallel. In one of these trials, the response to an experimental inoculation with rhinovirus-16 among asthmatics with high levels of total IgE was compared to the response in healthy controls. The other trial compared the effects of administering omalizumab versus placebo to asthmatics in a randomized, double-blind placebo-controlled investigation. The primary outcome for both trials compared lower respiratory tract symptoms (LRTSs) between study groups over the first 4 days of infection. RESULTS Frequent comparisons of symptoms, lung function, and blood eosinophil counts revealed differences that were more pronounced among allergic asthmatics than among controls by days 2 and 3 after virus inoculation. Additionally, an augmentation of upper respiratory tract symptom scores and LRTS scores occurred among the atopic asthmatics versus the controls during the resolution of symptoms (P < .01 for upper respiratory symptom tract scores and P < .001 for LRTS scores). The beneficial effects of administering omalizumab on reducing LRTSs and improving lung function were strongest over the first 4 days. CONCLUSIONS LRTSs and blood eosinophil counts were augmented and lung function was reduced among allergic asthmatics early after rhinovirus inoculation but increased late in the infection during symptom resolution. The effect of administering omalizumab on the response to rhinovirus was most pronounced during the early/innate phase of the infection.
Collapse
Affiliation(s)
- Peter W Heymann
- Asthma and Allergic Diseases Center, University of Virginia, Charlottsville, Va; Division of Pediatric Respiratory Medicine, University of Virginia, Charlottsville, Va.
| | | | - Judith A Woodfolk
- Asthma and Allergic Diseases Center, University of Virginia, Charlottsville, Va
| | - Larry Borish
- Asthma and Allergic Diseases Center, University of Virginia, Charlottsville, Va
| | - Deborah D Murphy
- Asthma and Allergic Diseases Center, University of Virginia, Charlottsville, Va; Division of Pediatric Respiratory Medicine, University of Virginia, Charlottsville, Va
| | - Holliday T Carper
- Asthma and Allergic Diseases Center, University of Virginia, Charlottsville, Va; Division of Pediatric Respiratory Medicine, University of Virginia, Charlottsville, Va
| | - Mark R Conaway
- Department of Public Health Sciences, University of Virginia, Charlottsville, Va
| | - John W Steinke
- Asthma and Allergic Diseases Center, University of Virginia, Charlottsville, Va
| | - Lyndsey Muehling
- Asthma and Allergic Diseases Center, University of Virginia, Charlottsville, Va
| | - W Gerald Teague
- Division of Pediatric Respiratory Medicine, University of Virginia, Charlottsville, Va
| | - Joshua L Kennedy
- Division of Allergy and Immunology, University of Arkansas for Medical Sciences, Little Rock, Ark
| | - Anne-Marie Irani
- Division of Pediatric Allergy and Immunology, Virginia Commonwealth University, Richmond, Va
| | - Matthew D McGraw
- Division of Pediatric Pulmonology, University of Rochester, Rochester, NY
| | - Stephen V Early
- Division of Pediatric Otolaryngology, University of Virginia, Charlottsville, Va
| | - Lisa M Wheatley
- Allergy, Asthma and Airways Biology Branch, Division of Allergy, Immunology, and Transplantation/National Institute of Allergy and Infectious Diseases, Bethesda, Md
| | - Amy P Adams
- Department of Pharmacy, University of Virginia, Charlottsville, Va
| | - Ronald B Turner
- Department of Pediatric Infectious Diseases, University of Virginia, Charlottsville, Va
| |
Collapse
|
25
|
Apostolovic D, Mihailovic J, Commins SP, Wijnveld M, Kazimirova M, Starkhammar M, Stockinger H, Platts-Mills TAE, Cirkovic Velickovic T, Hamsten C, van Hage M. Allergenomics of the tick Ixodes ricinus reveals important α-Gal-carrying IgE-binding proteins in red meat allergy. Allergy 2020; 75:217-220. [PMID: 31301243 PMCID: PMC8304496 DOI: 10.1111/all.13978] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Danijela Apostolovic
- Division of Immunology and Allergy, Department of Medicine Solna, Karolinska Institutet and University Hospital, Stockholm, Sweden
| | - Jelena Mihailovic
- University of Belgrade - Faculty of Chemistry, Department of Biochemistry, Center of Excellence for Molecular Food Sciences, Belgrade, Serbia
| | - Scott P. Commins
- Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Michiel Wijnveld
- Institute for Hygiene and Applied Immunology, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Maria Kazimirova
- Institute of Zoology, Slovak Academy of Sciences, Bratislava, Slovakia
| | | | - Hannes Stockinger
- Institute for Hygiene and Applied Immunology, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | | | - Tanja Cirkovic Velickovic
- University of Belgrade - Faculty of Chemistry, Department of Biochemistry, Center of Excellence for Molecular Food Sciences, Belgrade, Serbia
- Ghent University Global Campus, Yeonsugu, Incheon, South Korea
- Ghent University, Faculty of Bioscience Engineering, Ghent, Belgium
| | - Carl Hamsten
- Division of Immunology and Allergy, Department of Medicine Solna, Karolinska Institutet and University Hospital, Stockholm, Sweden
| | - Marianne van Hage
- Division of Immunology and Allergy, Department of Medicine Solna, Karolinska Institutet and University Hospital, Stockholm, Sweden
| |
Collapse
|
26
|
Coulson E, Rifas-Shiman SL, Sordillo J, Bunyavanich S, Camargo CA, Platts-Mills TAE, Coull BA, Luttmann-Gibson H, Oken E, Gold DR, Rice MB. Racial, ethnic, and socioeconomic differences in adolescent food allergy. J Allergy Clin Immunol Pract 2020; 8:336-338.e3. [PMID: 31233938 PMCID: PMC7083174 DOI: 10.1016/j.jaip.2019.06.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 06/06/2019] [Accepted: 06/08/2019] [Indexed: 10/26/2022]
Affiliation(s)
- Elise Coulson
- Division of Allergy and Immunology, Department of Medicine, University of Michigan, Ann Arbor, Mich; Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Mass.
| | - Sheryl L Rifas-Shiman
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Mass
| | - Joanne Sordillo
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Mass
| | - Supinda Bunyavanich
- Division of Allergy and Immunology, Department of Pediatrics and Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Carlos A Camargo
- Department of Emergency Medicine, Massachusetts General Hospital, Boston, Mass; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass
| | - Thomas A E Platts-Mills
- Asthma and Allergic Diseases Center, University of Virginia Health System, Charlottesville, Va
| | - Brent A Coull
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Mass
| | - Heike Luttmann-Gibson
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Mass
| | - Emily Oken
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Mass
| | - Diane R Gold
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass
| | - Mary B Rice
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Mass
| |
Collapse
|
27
|
Wilson JM, Platts-Mills TAE. α-Gal and other recent findings that have informed our understanding of anaphylaxis. Ann Allergy Asthma Immunol 2019; 124:135-142. [PMID: 31785367 DOI: 10.1016/j.anai.2019.11.024] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 11/19/2019] [Accepted: 11/20/2019] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To summarize the current understanding of anaphylaxis, with an emphasis on major findings that have been reported within the last 10 years. DATA SOURCES Queries relating to anaphylaxis, immunoglobulin E (IgE), and mast cells were conducted with PubMed and Google Scholar, searching for primary articles and review papers. STUDY SELECTIONS We focused on articles written in English and which were reported in major allergy and immunology journals. RESULTS Anaphylaxis represents an extreme manifestation of a form of allergic immunity that appears to have evolved to protect against "toxic" threats that present at skin and mucosal barriers. The factors that have contributed to a rise in anaphylaxis are increasingly appreciated to relate to changes in hygiene and microbial ecology that have occurred with industrialization. Induction of allergen-specific IgG4 is often part of the allergic response and is associated with protection against anaphylaxis. The recognition of the α-Gal syndrome suggests that carbohydrates can be epitopes that are relevant to anaphylaxis and that IgE-mediated reactions do not always occur "immediately." CONCLUSION Our understanding of anaphylaxis has advanced significantly over the past 10 years. It is anticipated that ongoing research will build on this foundation to further advance our knowledge of anaphylaxis and also translate into clinically meaningful therapies.
Collapse
Affiliation(s)
- Jeffrey M Wilson
- Division of Allergy & Immunology, University of Virginia, Charlottesville, VA, 22908
| | | |
Collapse
|
28
|
Ardura-Garcia C, Arias E, Hurtado P, Bonnett LJ, Sandoval C, Maldonado A, Workman LJ, Platts-Mills TAE, Cooper PJ, Blakey JD. Predictors of severe asthma attack re-attendance in Ecuadorian children: a cohort study. Eur Respir J 2019; 54:13993003.02419-2018. [PMID: 31515399 PMCID: PMC6860994 DOI: 10.1183/13993003.02419-2018] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 08/11/2019] [Indexed: 01/23/2023]
Abstract
Asthma is a common cause of emergency care attendance in low- and middle-income countries (LMICs). While few prospective studies of predictors for emergency care attendance have been undertaken in high-income countries, none have been performed in a LMIC. We followed a cohort of 5–15-year-old children treated for asthma attacks in emergency rooms of public health facilities in Esmeraldas City, Ecuador. We collected blood and nasal wash samples, and performed spirometry and exhaled nitric oxide fraction measurements. We explored potential predictors for recurrence of severe asthma attacks requiring emergency care over 6 months’ follow-up. We recruited 283 children of whom 264 (93%) were followed-up for ≥6 months or until their next asthma attack. Almost half (46%) had a subsequent severe asthma attack requiring emergency care. Predictors of recurrence in adjusted analyses were (adjusted OR, 95% CI) younger age (0.87, 0.79–0.96 per year), previous asthma diagnosis (2.2, 1.2–3.9), number of parenteral corticosteroid courses in previous year (1.3, 1.1–1.5), food triggers (2.0, 1.1–3.6) and eczema diagnosis (4.2, 1.02–17.6). A parsimonious Cox regression model included the first three predictors plus urban residence as a protective factor (adjusted hazard ratio 0.69, 95% CI 0.50–0.95). Laboratory and lung function tests did not predict recurrence. Factors independently associated with recurrent emergency attendance for asthma attacks were identified in a low-resource LMIC setting. This study suggests that a simple risk-assessment tool could potentially be created for emergency rooms in similar settings to identify higher-risk children on whom limited resources might be better focused. Among children in a low-resource setting in Latin America, younger age, an established asthma diagnosis and history of severe asthma attacks in the previous year were associated with recurrence of severe asthma attacks, irrespective of biomarkershttp://bit.ly/2TBzJcP
Collapse
Affiliation(s)
- Cristina Ardura-Garcia
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland .,Liverpool School of Tropical Medicine, Liverpool, UK
| | - Erick Arias
- Fundación Ecuatoriana Para Investigación en Salud, Quito, Ecuador
| | - Paola Hurtado
- Fundación Ecuatoriana Para Investigación en Salud, Quito, Ecuador
| | - Laura J Bonnett
- Dept of Biostatistics, University of Liverpool, Liverpool, UK
| | - Carlos Sandoval
- Fundación Ecuatoriana Para Investigación en Salud, Quito, Ecuador
| | - Augusto Maldonado
- Colegio de Ciencias de la Salud, Universidad San Francsico de Quito, Quito, Ecuador
| | - Lisa J Workman
- Asthma and Allergic Diseases Center, University of Virginia, Charlottesville, VA, USA
| | | | - Philip J Cooper
- Fundación Ecuatoriana Para Investigación en Salud, Quito, Ecuador.,Facultad de Ciencias Medicas, de la Salud y la Vida, Universidad Internacional del Ecuador, Quito, Ecuador.,Institute of Infection and Immunity, St George's University of London, London, UK.,Both authors contributed equally
| | - John D Blakey
- Respiratory Medicine, Sir Charles Gairdner Hospital, Perth, Australia.,Medical School, Curtin University, Perth, Australia.,Both authors contributed equally
| |
Collapse
|
29
|
Affiliation(s)
- Karlyn Pollack
- Department of Dermatology, University of Virginia, Charlottesville
| | | | - Larry C Borish
- Department of Medicine, University of Virginia, Charottesville.,Department of Microbiology, University of Virginia, Charottesville
| | - Scott P Commins
- Division of Rheumatology, Allergy & Immunology, The University of North Carolina at Chapel Hill, Chapel Hill
| | - Thomas A E Platts-Mills
- Department of Medicine, University of Virginia, Charottesville.,Department of Microbiology, University of Virginia, Charottesville
| | | |
Collapse
|
30
|
Sordillo JE, Rifas-Shiman SL, Switkowski K, Coull B, Gibson H, Rice M, Platts-Mills TAE, Kloog I, Litonjua AA, Gold DR, Oken E. Prenatal oxidative balance and risk of asthma and allergic disease in adolescence. J Allergy Clin Immunol 2019; 144:1534-1541.e5. [PMID: 31437488 DOI: 10.1016/j.jaci.2019.07.044] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 07/10/2019] [Accepted: 07/12/2019] [Indexed: 01/12/2023]
Abstract
BACKGROUND Fetal oxidative balance (achieved when protective prenatal factors counteract sources of oxidative stress) might be critical for preventing asthma and allergic disease. OBJECTIVE We examined prenatal intakes of hypothesized protective nutrients (including antioxidants) in conjunction with potential sources of oxidative stress in models of adolescent asthma and allergic disease. METHODS We used data from 996 mother-child pairs in Project Viva. Exposures of interest were maternal prepregnancy body mass index and prenatal nutrients (energy-adjusted intakes of vitamins D, C, and E; β-carotene; folate; choline; and n-3 and n-6 polyunsaturated fatty acids [PUFAs]), air pollutant exposures (residence-specific third-trimester black carbon or particulate matter with a diameter of less than 2.5 μm [PM2.5]), acetaminophen, and smoking. Outcomes were offspring's current asthma, allergic rhinitis, and allergen sensitization at a median age of 12.9 years. We performed logistic regression. Continuous exposures were log-transformed and modeled as z scores. RESULTS We observed protective associations for vitamin D (odds ratio [OR], 0.69 [95% CI, 0.53-0.89] for allergic rhinitis), the sum of the n-3 PUFAs eicosapentaenoic acid and docosahexaenoic acid (OR, 0.81 [95% CI, 0.66-0.99] for current asthma), and the n-3 PUFA α-linolenic acid (OR, 0.78 [95% CI, 0.64-0.95] for allergen sensitization and OR, 0.80 [95% CI 0.65-0.99] for current asthma). Black carbon and PM2.5 were associated with an approximately 30% increased risk for allergen sensitization. No multiplicative interactions were observed for protective nutrient intakes with sources of oxidative stress. CONCLUSIONS We identified potential protective prenatal nutrients (vitamin D and n-3 PUFAs), as well as adverse prenatal pro-oxidant exposures that might alter the risk of asthma and allergic disease into adolescence.
Collapse
Affiliation(s)
- Joanne E Sordillo
- Division of Chronic Disease Research Across the Lifecourse (CoRAL), Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Mass.
| | - Sheryl L Rifas-Shiman
- Division of Chronic Disease Research Across the Lifecourse (CoRAL), Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Mass
| | - Karen Switkowski
- Division of Chronic Disease Research Across the Lifecourse (CoRAL), Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Mass
| | - Brent Coull
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Mass
| | - Heike Gibson
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Mass
| | - Mary Rice
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Mass
| | - Thomas A E Platts-Mills
- Asthma and Allergic Diseases Center, University of Virginia Health System, Charlottesville, Va
| | - Itai Kloog
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Mass
| | - Augusto A Litonjua
- Division of Pediatric Pulmonary Medicine, University of Rochester Medical Center, Rochester, NY
| | - Diane R Gold
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Mass; Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass
| | - Emily Oken
- Division of Chronic Disease Research Across the Lifecourse (CoRAL), Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Mass
| |
Collapse
|
31
|
Wilson JM, Schuyler AJ, Workman L, Gupta M, James HR, Posthumus J, McGowan EC, Commins SP, Platts-Mills TAE. Investigation into the α-Gal Syndrome: Characteristics of 261 Children and Adults Reporting Red Meat Allergy. J Allergy Clin Immunol Pract 2019; 7:2348-2358.e4. [PMID: 30940532 DOI: 10.1016/j.jaip.2019.03.031] [Citation(s) in RCA: 84] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 03/09/2019] [Accepted: 03/13/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND Red meat allergy has historically been understood as a rare disease of atopic children, but the discovery of the "α-Gal syndrome," which relates to IgE to the oligosaccharide galactose-α-1,3-galactose (α-Gal), has challenged that notion. OBJECTIVE To describe the clinical and immunologic characteristics of a large group of subjects with self-reported allergy to mammalian meat. METHODS This was an observational study of 261 children and adults (range, 5-82 years) who presented for evaluation for allergic reactions to mammalian meat. Results were based on serum assays and a detailed questionnaire. RESULTS α-Gal specific IgE ≥ 0.35 IU/mL was detected in 245 subjects and symptom onset occurred ≥2 hours after eating mammalian meat in 211 (81%). Component testing supported a diagnosis of α-Gal syndrome in 95%, pork-cat syndrome in 1.9%, and primary beef allergy in 1.1%. Urticaria was reported by 93%, anaphylaxis by 60%, and gastrointestinal symptoms by 64%. Levels of IgE and IgG specific to α-Gal were similar in subjects who reported early- or delayed-onset symptoms, and in those with and without anaphylaxis. Levels of α-Gal specific IgE and severity of reactions were similar among those with and without traditional atopy, and among children (n = 35) and adults (n = 226). Blood group B trended toward being under-represented among α-Gal-sensitized subjects; however, α-Gal specific IgE titers were high in symptomatic cases with B-antigen. CONCLUSIONS The α-Gal syndrome is a regionally common form of food allergy that has a characteristic but not universal delay in symptom onset, includes gastrointestinal symptoms, can develop at any time in life, and is equally common in otherwise nonatopic individuals.
Collapse
Affiliation(s)
- Jeffrey M Wilson
- Division of Allergy and Clinical Immunology, University of Virginia, Charlottesville, Va
| | - Alexander J Schuyler
- Division of Allergy and Clinical Immunology, University of Virginia, Charlottesville, Va
| | - Lisa Workman
- Division of Allergy and Clinical Immunology, University of Virginia, Charlottesville, Va
| | - Monica Gupta
- Division of Allergy and Clinical Immunology, University of Virginia, Charlottesville, Va
| | - Hayley R James
- Division of Allergy and Clinical Immunology, University of Virginia, Charlottesville, Va
| | | | - Emily C McGowan
- Division of Allergy and Clinical Immunology, University of Virginia, Charlottesville, Va
| | - Scott P Commins
- Division of Rheumatology, Allergy and Immunology, University of North Carolina, Chapel Hill, NC.
| | | |
Collapse
|
32
|
McGowan EC, Platts-Mills TAE, Wilson JM. Food allergy, eosinophilic esophagitis, and the enigma of IgG4. Ann Allergy Asthma Immunol 2019; 122:563-564. [PMID: 30928417 DOI: 10.1016/j.anai.2019.03.024] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 03/21/2019] [Accepted: 03/21/2019] [Indexed: 01/13/2023]
Affiliation(s)
- Emily C McGowan
- University of Virginia School of Medicine, Division of Allergy and Clinical Immunology, Charlottesville, Virginia; Johns Hopkins University School of Medicine, Division of Allergy and Clinical Immunology, Baltimore, Maryland
| | - Thomas A E Platts-Mills
- University of Virginia School of Medicine, Division of Allergy and Clinical Immunology, Charlottesville, Virginia
| | - Jeffrey M Wilson
- University of Virginia School of Medicine, Division of Allergy and Clinical Immunology, Charlottesville, Virginia.
| |
Collapse
|
33
|
Hamed A, Preston DC, Eschenbacher W, Khokhar D, Workman L, Steinke JW, Heymann P, Lawrence M, Soto-Quiros M, Platts-Mills TAE, Payne S, Borish L. Nasal IgE production in allergic rhinitis: Impact of rhinovirus infection. Clin Exp Allergy 2019; 49:847-852. [PMID: 30776162 DOI: 10.1111/cea.13372] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 01/18/2019] [Accepted: 02/11/2019] [Indexed: 12/01/2022]
Abstract
BACKGROUND Rhinovirus (RV) infections exacerbate asthma in part by enhancing an allergic state, and these exacerbations can be mitigated via administration of anti-IgE. OBJECTIVE We investigated the presence of local IgE production in the nose of allergic and non-allergic subjects and assessed whether this was enhanced by RV. METHODS Local production of specific IgE was determined by comparing ratios of specific to total IgE concentrations between nasal and serum samples. Our initial studies were performed in subjects presenting to the emergency department for allergic and non-allergic respiratory complaints. Subsequently, we investigated influences of experimental RV infection on nasal sIgE production in an allergic cohort. RESULTS We found evidence of local sIgE production to Dermatophagoides pteronyssinus in 30.3% and to Blomia tropicalis in 14.6% of allergic subjects. None of the non-allergic subjects demonstrated local IgE. Subjects with active RV infection were more than twice as likely to have local sIgE (45% vs 14%), and subjects with local sIgE being produced were ~3 times more likely to be having an asthma exacerbation. Experimental RV infection was able to induce local sIgE production. CONCLUSION These studies confirm local IgE production in a large subset of allergic subjects and demonstrate that allergic asthmatics with local IgE are more likely to develop an asthma exacerbation when infected with RV. Our RV challenge studies demonstrate that at least some allergic asthmatics can be induced to secrete locally generated IgE in their nasal airway after RV infection.
Collapse
Affiliation(s)
- Ahmed Hamed
- Department of Medicine, University of Virginia Health System, Charlottesville, Virginia
| | - DeVon C Preston
- Department of Medicine, University of Virginia Health System, Charlottesville, Virginia
| | - Will Eschenbacher
- Department of Medicine, University of Virginia Health System, Charlottesville, Virginia
| | - Dilawar Khokhar
- Department of Medicine, University of Virginia Health System, Charlottesville, Virginia
| | - Lisa Workman
- Department of Medicine, University of Virginia Health System, Charlottesville, Virginia
| | - John W Steinke
- Department of Medicine, University of Virginia Health System, Charlottesville, Virginia
| | - Peter Heymann
- Department of Pediatrics, University of Virginia Health System, Charlottesville, Virginia
| | - Monica Lawrence
- Department of Medicine, University of Virginia Health System, Charlottesville, Virginia
| | | | - Thomas A E Platts-Mills
- Department of Medicine, University of Virginia Health System, Charlottesville, Virginia.,Department of Microbiology, University of Virginia Health System, Charlottesville, Virginia
| | - Spencer Payne
- Department of Medicine, University of Virginia Health System, Charlottesville, Virginia.,Department of Otolaryngology, University of Virginia Health System, Charlottesville, Virginia
| | - Larry Borish
- Department of Medicine, University of Virginia Health System, Charlottesville, Virginia.,Department of Microbiology, University of Virginia Health System, Charlottesville, Virginia
| |
Collapse
|
34
|
Cox KM, Commins SP, Capaldo BJ, Workman LJ, Platts-Mills TAE, Amir EAD, Lannigan JA, Schuyler AJ, Erickson LD. An integrated framework using high-dimensional mass cytometry and fluorescent flow cytometry identifies discrete B cell subsets in patients with red meat allergy. Clin Exp Allergy 2019; 49:615-625. [PMID: 30506749 DOI: 10.1111/cea.13322] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 11/14/2018] [Accepted: 11/25/2018] [Indexed: 12/19/2022]
Abstract
BACKGROUND B cells play a critical role in the development and maintenance of food allergy by producing allergen-specific IgE. Despite the importance of B cells in IgE-mediated food allergy, the identity of sIgE-producing human B cells and how IgE is regulated are poorly understood. OBJECTIVE To identify the immunophenotypes of circulating B cells associated with the production of galactose-alpha-1,3-galactose-specific IgE production in patients with red meat allergy. METHODS B cells in PBMC samples obtained from 19 adults with physician-diagnosed red meat allergy and 20 non-meat allergic healthy controls were assessed by mass cytometry along with a bioinformatics analysis pipeline to identify discrete B cell phenotypes that associated with serum sIgE. Fluorescent flow cytometry was then applied to sort purify discrete B cell subsets, and B cells were functionally evaluated on an individual cell level for the production of sIgE by ELISPOT. RESULTS Discrete B cell phenotypes abundant in meat allergic subjects compared to non-meat allergic controls were found in peripheral blood that do not share typical characteristics of classical isotype-switched memory B cells that express high levels of CD27. These B cell subsets shared higher IgD and lower IgM expression levels coupled with CXCR4, CCR6 and CD25 expression. In vitro polyclonal stimulation of purified B cell subsets from meat allergic subjects demonstrated that these subsets were enriched for cells induced to secrete sIgE. CONCLUSIONS AND CLINICAL RELEVANCE Circulating B cells display increased abundance of discrete B cell subsets in meat allergic subjects. This observation, coupled with the capacity of individual B cell subsets to produce sIgE following activation, implicates these novel B cell phenotypes in promoting IgE in meat allergy.
Collapse
Affiliation(s)
- Kelly M Cox
- Department of Microbiology, Immunology, and Cancer Biology, University of Virginia School of Medicine, Charlottesville, Virginia.,Beirne B. Carter Center for Immunology Research, University of Virginia School of Medicine, Charlottesville, Virginia
| | - Scott P Commins
- Division of Rheumatology, Allergy and Immunology, Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Brian J Capaldo
- Flow Cytometry Core Facility, University of Virginia School of Medicine, Charlottesville, Virginia
| | - Lisa J Workman
- Asthma and Allergic Diseases Center, University of Virginia School of Medicine, Charlottesville, Virginia
| | - Thomas A E Platts-Mills
- Beirne B. Carter Center for Immunology Research, University of Virginia School of Medicine, Charlottesville, Virginia.,Asthma and Allergic Diseases Center, University of Virginia School of Medicine, Charlottesville, Virginia
| | | | - Josephine A Lannigan
- Flow Cytometry Core Facility, University of Virginia School of Medicine, Charlottesville, Virginia
| | - Alexander J Schuyler
- Asthma and Allergic Diseases Center, University of Virginia School of Medicine, Charlottesville, Virginia
| | - Loren D Erickson
- Department of Microbiology, Immunology, and Cancer Biology, University of Virginia School of Medicine, Charlottesville, Virginia.,Beirne B. Carter Center for Immunology Research, University of Virginia School of Medicine, Charlottesville, Virginia
| |
Collapse
|
35
|
Abstract
Thomas Platts-Mills and Matthew Perzanowski provide their expert Perspective on a translational study from Custovic and colleagues that identifies pairings of IgE that show value in estimating risk of concurrent asthma.
Collapse
Affiliation(s)
| | - Matthew Perzanowski
- Columbia University Mailman School of Public Health, New York, New York, United States of America
| |
Collapse
|
36
|
Platts-Mills TAE. Dr. Kimishige Ishizaka: 1926-2018: The discovery of IgE and the revolution in the study of allergic disease. Ann Allergy Asthma Immunol 2018; 122:2-7. [PMID: 30287256 DOI: 10.1016/j.anai.2018.09.464] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Accepted: 09/17/2018] [Indexed: 01/22/2023]
|
37
|
Maslova E, Rifas-Shiman SL, Oken E, Platts-Mills TAE, Gold DR. Fatty acids in pregnancy and risk of allergic sensitization and respiratory outcomes in childhood. Ann Allergy Asthma Immunol 2018; 122:120-122.e3. [PMID: 30217620 DOI: 10.1016/j.anai.2018.09.450] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 09/03/2018] [Accepted: 09/07/2018] [Indexed: 11/18/2022]
Affiliation(s)
- Ekaterina Maslova
- Centre for Fetal Programming, Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark; Department of Primary Care and Public Health, Imperial College London, United Kingdom; Danish Diabetes Academy, Odense, Denmark.
| | - Sheryl L Rifas-Shiman
- The Division of Chronic Disease Research Across the Lifecourse (CoRAL), Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts
| | - Emily Oken
- The Division of Chronic Disease Research Across the Lifecourse (CoRAL), Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts; Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Thomas A E Platts-Mills
- Asthma and Allergic Diseases Center, University of Virginia Health System, Charlottesville, Virginia
| | - Diane R Gold
- Channing Laboratory, Harvard Medical School, Boston, Massachusetts; Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| |
Collapse
|
38
|
|
39
|
Stoltz LP, Cristiano LM, Dowling APG, Wilson JM, Platts-Mills TAE, Traister RS. Could chiggers be contributing to the prevalence of galactose-alpha-1,3-galactose sensitization and mammalian meat allergy? J Allergy Clin Immunol Pract 2018; 7:664-666. [PMID: 30053595 DOI: 10.1016/j.jaip.2018.07.014] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 06/28/2018] [Accepted: 07/04/2018] [Indexed: 02/06/2023]
Affiliation(s)
- Lindsey P Stoltz
- Division of Allergy and Immunology, Wake Forest Baptist Health, Winston-Salem, NC
| | - Leslie M Cristiano
- Division of Allergy and Immunology, Wake Forest Baptist Health, Winston-Salem, NC
| | | | - Jeffrey M Wilson
- Division of Allergy and Immunology, University of Virginia, Charlottesville, Va
| | | | - Russell S Traister
- Division of Allergy and Immunology, Wake Forest Baptist Health, Winston-Salem, NC.
| |
Collapse
|
40
|
Wilson JM, Platts-Mills TAE. Reply. J Allergy Clin Immunol Pract 2018; 6:1436-1437. [PMID: 30033927 PMCID: PMC6474409 DOI: 10.1016/j.jaip.2018.04.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 04/18/2018] [Indexed: 06/08/2023]
Affiliation(s)
- Jeffrey M Wilson
- Division of Allergy and Immunology, University of Virginia, Charlottesville, Va
| | | |
Collapse
|
41
|
Wilson JM, Nguyen AT, Schuyler AJ, Commins SP, Taylor AM, Platts-Mills TAE, McNamara CA. IgE to the Mammalian Oligosaccharide Galactose-α-1,3-Galactose Is Associated With Increased Atheroma Volume and Plaques With Unstable Characteristics-Brief Report. Arterioscler Thromb Vasc Biol 2018; 38:1665-1669. [PMID: 29903734 PMCID: PMC6039405 DOI: 10.1161/atvbaha.118.311222] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 05/08/2018] [Indexed: 11/16/2022]
Abstract
Supplemental Digital Content is available in the text. Objective— Emerging evidence suggests a link between coronary artery disease and type 2 immunity. We sought to test the hypothesis that IgE sensitization to the mammalian oligosaccharide galactose-α-1,3-galactose (α-Gal)—the target allergen of delayed anaphylaxis to red meat—is associated with coronary artery disease. Approach and Results— Total IgE and specific IgE to α-Gal were assayed on sera from 118 subjects who presented for cardiac catheterization and underwent intravascular ultrasound. IgE to α-Gal was detected in 26%, and atheroma burden was higher in sensitized subjects (P=0.02). Because α-Gal sensitization relates to an environmental exposure that could be a risk factor for early-onset coronary artery disease (ie, tick bites), we age stratified the cohort. In subjects ≤65 years of age, the strength of the association with atheroma burden was stronger (P<0.001), and plaques in the sensitized group had less stable features based on intravascular ultrasound. To address the specificity of the association with IgE to α-Gal, IgE to inhalants and peanut were assayed and were not associated with coronary artery disease. Total IgE and α-Gal–specific IgE were strongly associated with each other, but the strength of the relationship with atheroma burden was stronger for α-Gal–specific IgE. This association was significant when adjusted for sex, diabetes mellitus, hypertension, statin use, and total IgE (regression coefficient, 12.2; SE, 5.2; P=0.02). Conclusions— Increased atheroma burden and plaques with more unstable features were associated with IgE to α-Gal—an effect most pronounced in subjects ≤65 years of age. IgE sensitization to α-Gal may represent a novel, and potentially modifiable, risk factor for coronary atherosclerosis.
Collapse
Affiliation(s)
- Jeffrey M Wilson
- From the Division of Allergy and Immunology (J.M.W., A.J.S., T.A.E.P.-M.)
| | - Anh T Nguyen
- Division of Cardiology, Robert M. Berne Cardiovascular Center (A.T.N., A.M.T., C.A.M.), University of Virginia, Charlottesville
| | | | - Scott P Commins
- Division of Rheumatology, Allergy, and Immunology, University of North Carolina, Chapel Hill (S.P.C.)
| | - Angela M Taylor
- Division of Cardiology, Robert M. Berne Cardiovascular Center (A.T.N., A.M.T., C.A.M.), University of Virginia, Charlottesville
| | | | - Coleen A McNamara
- Division of Cardiology, Robert M. Berne Cardiovascular Center (A.T.N., A.M.T., C.A.M.), University of Virginia, Charlottesville
| |
Collapse
|
42
|
Lochte L, Petersen PE, Nielsen KG, Andersen A, Platts-Mills TAE. Associations of physical activity with childhood asthma, a population study based on the WHO - health behaviour in school-aged children survey. Asthma Res Pract 2018; 4:6. [PMID: 29736253 PMCID: PMC5925826 DOI: 10.1186/s40733-018-0042-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Accepted: 04/05/2018] [Indexed: 11/11/2022] Open
Abstract
Background Asthma in paediatric populations is one of the highest public health concerns. In this study of children and adolescents, we hypothesized that low levels of physical activity (PA) would show associations with asthma that vary by asthma outcome. The objective was to assess whether PA was associated with ever asthma and/or current asthma. Methods Analyses were based on 4824 Danish schoolchildren aged 11–15 years old (48.7% boys) participating in the HBSC survey. The study variables were (1) physician-diagnosed asthma (ever asthma) and (2) physician-diagnosed asthma plus wheezing and/or physician or hospital consultation for wheezing (current asthma). Associations with PA by gender were analysed with multivariate logistic regression using the “variance covariance (vce) cluster” method. Results The prevalence of ever asthma was 14.3% (boys) and 12.8% (girls), and that of current asthma was 6.8% (boys) and 7.0% (girls). Boys with current asthma showed important differences in low and high PA. We found inverse associations between low PA and ever asthma, odds ratio [95% confidence interval] male: .55 [.30; .99] and female: .47 [.24; .93], and current asthma, male: .27 [.12; .60] (P linear trend = .007) and female: .32 [.11; .94]. Conclusions The lowest activity levels showed significant inverse associations with asthma, regardless of the definition. For boys, the more stringent (current asthma) of the two paediatric asthma definitions revealed a significant trend with PA, and the direction of associations shifted to positive as weekly PA increased. Electronic supplementary material The online version of this article (10.1186/s40733-018-0042-9) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Lene Lochte
- 1Department of Odontology, University of Copenhagen, 1014 Copenhagen, Denmark
| | - Poul Erik Petersen
- 1Department of Odontology, University of Copenhagen, 1014 Copenhagen, Denmark
| | - Kim G Nielsen
- 2Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, Denmark
| | - Anette Andersen
- 3National Institute of Public Health, University of Southern Denmark, 1455 Copenhagen, Denmark
| | - Thomas A E Platts-Mills
- 4Department of Medicine, Division of Allergy and Clinical Immunology, University of Virginia, Charlottesville, VA 22908 USA
| |
Collapse
|
43
|
Abstract
IgE-mediated hypersensitivity to ingested animal products, including both mammalian and avian sources, is increasingly appreciated as an important form of food allergy. Traditionally described largely in children, it is now clear that allergy to meat (and animal viscera) impacts both children and adults and represents a heterogeneous group of allergic disorders with multiple distinct syndromes. The recognition of entities such as pork-cat syndrome and delayed anaphylaxis to red meat, i.e- the α-Gal syndrome, have shed light on fundamental, and in some cases newly appreciated, features of allergic disease. These include insights into routes of exposure and mechanisms of sensitization, as well as the realization that IgE-mediated reactions can be delayed by several hours. Here we review mammalian and avian meat allergy with an emphasis on the molecular allergens and pathways that contribute to disease, as well as the role of in vitro IgE testing in diagnosis and management.
Collapse
Affiliation(s)
- Jeffrey M Wilson
- Division of Allergy & Immunology, University of Virginia, Charlottesville, VA, USA
| | | |
Collapse
|
44
|
Schuyler AJ, Wilson JM, Tripathi A, Commins SP, Ogbogu PU, Kruzsewski PG, Barnes BH, McGowan EC, Workman LJ, Lidholm J, Rifas-Shiman SL, Oken E, Gold DR, Platts-Mills TAE, Erwin EA. Specific IgG 4 antibodies to cow's milk proteins in pediatric patients with eosinophilic esophagitis. J Allergy Clin Immunol 2018; 142:139-148.e12. [PMID: 29678750 DOI: 10.1016/j.jaci.2018.02.049] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Revised: 02/13/2018] [Accepted: 02/20/2018] [Indexed: 01/06/2023]
Abstract
BACKGROUND Allergen-specific IgG4 (sIgG4) antibodies are often associated with tolerance, but sIgG4 antibodies to causally relevant foods have been reported recently in adults with eosinophilic esophagitis (EoE). Prevalence and levels of food sIgG4 are not well established in the general pediatric population. OBJECTIVE We sought to investigate serum food sIgG4 with component diagnostics in children with EoE and children from an unselected birth cohort and to explore the effects of sex, age, and milk consumption on sIgG4 levels. METHODS Sera from 71 pediatric patients with EoE and 210 early adolescent children from an unselected birth cohort (Project Viva) were assayed for sIgG4 and specific IgE (sIgE) to major cow's milk (CM) proteins (α-lactalbumin, β-lactoglobulin, and caseins) and to wheat, soy, egg, and peanut proteins. RESULTS In the EoE cohort high-titer sIgG4 (≥10 μg/mL) to CM proteins was more common than in control sera and achieved odds ratios for EoE ranging from 5.5 to 8.4. sIgE levels to CM proteins were mostly 4 IU/mL or less in patients with EoE, such that sIgG4/sIgE ratios were often 10,000 or greater. When adjusted for age and milk consumption, high-titer sIgG4 to CM proteins was strongly associated with EoE, with an odds ratio of greater than 20 to all 3 CM proteins in boys. CONCLUSIONS sIgG4 to CM proteins are common and high titer in children with EoE. Although it is not clear that this response is pathogenic, sIgG4 levels imply that these antibodies are an important feature of the local immune response that gives rise to EoE.
Collapse
Affiliation(s)
- Alexander J Schuyler
- Division of Allergy & Clinical Immunology, University of Virginia, Charlottesville, Va
| | - Jeffrey M Wilson
- Division of Allergy & Clinical Immunology, University of Virginia, Charlottesville, Va
| | - Anubha Tripathi
- Division of Allergy & Clinical Immunology, University of Virginia, Charlottesville, Va
| | - Scott P Commins
- Division of Rheumatology, Allergy & Immunology, University of North Carolina, Chapel Hill, NC
| | - Princess U Ogbogu
- Allergy and Immunology, Department of Otolaryngology, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Patrice G Kruzsewski
- Division of Pediatric Gastroenterology, Hepatology & Nutrition, Emory University, Atlanta, Ga
| | - Barrett H Barnes
- Division of Pediatric Gastroenterology, University of Virginia, Charlottesville, Va
| | - Emily C McGowan
- Division of Allergy & Clinical Immunology, University of Virginia, Charlottesville, Va
| | - Lisa J Workman
- Division of Allergy & Clinical Immunology, University of Virginia, Charlottesville, Va
| | | | - Sheryl L Rifas-Shiman
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass
| | - Emily Oken
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass
| | - Diane R Gold
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Mass
| | | | - Elizabeth A Erwin
- Center for Innovation in Pediatric Practice, Nationwide Children's Hospital, Columbus, Ohio.
| |
Collapse
|
45
|
Lawrence MG, Palacios-Kibler TV, Workman LJ, Schuyler AJ, Steinke JW, Payne SC, McGowan EC, Patrie J, Fuleihan RL, Sullivan KE, Lugar PL, Hernandez CL, Beakes DE, Verbsky JW, Platts-Mills TAE, Cunningham-Rundles C, Routes JM, Borish L. Low Serum IgE Is a Sensitive and Specific Marker for Common Variable Immunodeficiency (CVID). J Clin Immunol 2018; 38:225-233. [PMID: 29453744 DOI: 10.1007/s10875-018-0476-0] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Accepted: 01/04/2018] [Indexed: 11/26/2022]
Abstract
Although small prior studies have suggested that IgE can be low in common variable immunodeficiency (CVID), the workup for patients with recurrent infections and suspected hypogammaglobulinemia does not include the routine measurement of serum IgE. We sought to test the hypothesis that low/undetectable serum IgE is characteristic of CVID by comparing the frequency of low/undetectable serum IgE in healthy controls and patients with CVID. We measured total serum IgE in a large multi-center cohort of patients with CVID (n = 354) and compared this to large population-based cohorts of children and adults. We further compared IgE levels in patients with CVID to those with other forms of humoral immunodeficiency, and in a subset, measured levels of allergen-specific serum IgE and IgG subclasses. Lastly, we evaluated for the presence of IgE in commercially available immunoglobulin replacement therapy (IgRT) products. An undetectable serum IgE (< 2 IU/ml) occurs in only 3.3% (95% CI, 1.9-5.7%) of the general population. In contrast, an undetectable IgE occurs in 75.6% (95% CI, 65.6-85.7%) of patients with CVID. Conversely, a high IgE (> 180 IU/ml) is very uncommon in CVID (0.3% of patients). IgE is > 2 IU/ml in 91.2% of patients with secondary hypogammaglobulinemia, and thus, an IgE < LLOD is suggestive of a primary humoral immunodeficiency. Allergen-specific IgE is not detectable in 96.5% of patients with CVID. Sufficient quantities of IgE to change the total serum IgE are not contained in IgRT. The IgG1/IgG4 ratio is increased in subjects with low IgE, regardless of whether they are controls or have CVID. These findings support the routine measurement of serum IgE in the workup of patients with hypogammaglobulinemia.
Collapse
Affiliation(s)
- Monica G Lawrence
- Department of Medicine, University of Virginia, Box 801355, Charlottesville, VA, 22908, USA.
| | | | - Lisa J Workman
- Department of Medicine, University of Virginia, Box 801355, Charlottesville, VA, 22908, USA
| | - Alexander J Schuyler
- Department of Medicine, University of Virginia, Box 801355, Charlottesville, VA, 22908, USA
| | - John W Steinke
- Department of Medicine, University of Virginia, Box 801355, Charlottesville, VA, 22908, USA
| | - Spencer C Payne
- Department of Medicine, University of Virginia, Box 801355, Charlottesville, VA, 22908, USA
- Department of Otolaryngology, University of Virginia, Charlottesville, VA, USA
| | - Emily C McGowan
- Department of Medicine, University of Virginia, Box 801355, Charlottesville, VA, 22908, USA
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - James Patrie
- Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA
| | - Ramsay L Fuleihan
- Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Kathleen E Sullivan
- Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Patricia L Lugar
- Department of Medicine, Duke University Health System, Durham, NC, USA
| | - Camellia L Hernandez
- Division of Allergy-Immunology, Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - Douglas E Beakes
- Division of Allergy-Immunology, Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - James W Verbsky
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA
| | | | | | - John M Routes
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Larry Borish
- Department of Medicine, University of Virginia, Box 801355, Charlottesville, VA, 22908, USA
- Department of Microbiology, Carter Immunology Center, University of Virginia, Charlottesville, VA, USA
| |
Collapse
|
46
|
Retterer MKC, Workman LJ, Bacon JR, Platts-Mills TAE. Specific IgE to gelatin as a cause of anaphylaxis to zoster vaccine. J Allergy Clin Immunol 2018; 141:1956-1957. [PMID: 29361333 DOI: 10.1016/j.jaci.2017.08.047] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Accepted: 08/24/2017] [Indexed: 11/24/2022]
Affiliation(s)
- Maya K C Retterer
- Asthma and Allergic Disease Center, Carter Immunology Center, Department of Medicine, University of Virginia Health System, Charlottesville, Va
| | - Lisa J Workman
- Asthma and Allergic Disease Center, Carter Immunology Center, Department of Medicine, University of Virginia Health System, Charlottesville, Va
| | - John R Bacon
- University of Maryland St Joseph Medical Center, Towson, Md; Greater Baltimore Medical Center, Baltimore, Md
| | - Thomas A E Platts-Mills
- Asthma and Allergic Disease Center, Carter Immunology Center, Department of Medicine, University of Virginia Health System, Charlottesville, Va.
| |
Collapse
|
47
|
Platts-Mills TAE, Woodfolk JA. Mite Avoidance as a Logical Treatment for Severe Asthma in Childhood. Why Not? Am J Respir Crit Care Med 2017; 196:119-121. [PMID: 28707970 DOI: 10.1164/rccm.201703-0450ed] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Thomas A E Platts-Mills
- 1 Department of Medicine University of Virginia School of Medicine Charlottesville, Virginia
| | - Judith A Woodfolk
- 1 Department of Medicine University of Virginia School of Medicine Charlottesville, Virginia
| |
Collapse
|
48
|
Schuyler AJ, Tripathi A, Workman LJ, Wilson JM, Erwin EA, Lawrence MG, McGowan EC, Hamilton RG, Platts-Mills TAE. Underestimation of specific IgE measurements using extract-based assays on undiluted sera revealed through dilution. J Allergy Clin Immunol Pract 2017; 6:1070-1072.e4. [PMID: 29226806 DOI: 10.1016/j.jaip.2017.10.037] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Revised: 10/20/2017] [Accepted: 10/27/2017] [Indexed: 01/29/2023]
Affiliation(s)
- Alexander J Schuyler
- Division of Allergy & Clinical Immunology, University of Virginia, Charlottesville, Va
| | - Anubha Tripathi
- Division of Allergy & Clinical Immunology, University of Virginia, Charlottesville, Va
| | - Lisa J Workman
- Division of Allergy & Clinical Immunology, University of Virginia, Charlottesville, Va
| | - Jeffrey M Wilson
- Division of Allergy & Clinical Immunology, University of Virginia, Charlottesville, Va
| | - Elizabeth A Erwin
- Center for Innovation in Pediatric Practice, Nationwide Children's Hospital, Columbus, Ohio
| | - Monica G Lawrence
- Division of Allergy & Clinical Immunology, University of Virginia, Charlottesville, Va
| | - Emily C McGowan
- Division of Allergy & Clinical Immunology, University of Virginia, Charlottesville, Va
| | - Robert G Hamilton
- Division of Allergy and Clinical Immunology, Johns Hopkins University School of Medicine, Baltimore, Md
| | | |
Collapse
|
49
|
Amoah AS, Asuming-Brempong EK, Obeng BB, Versteeg SA, Larbi IA, Aryeetey Y, Platts-Mills TAE, Mari A, Brzezicka K, Gyan BA, Mutocheluh M, Boakye DA, Reichardt NC, van Ree R, Hokke CH, van Diepen A, Yazdanbakhsh M. Identification of dominant anti-glycan IgE responses in school children by glycan microarray. J Allergy Clin Immunol 2017; 141:1130-1133. [PMID: 29128671 DOI: 10.1016/j.jaci.2017.09.040] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 09/07/2017] [Accepted: 09/29/2017] [Indexed: 11/19/2022]
Affiliation(s)
- Abena S Amoah
- Department of Parasitology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana; Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands.
| | - Elias K Asuming-Brempong
- Department of Parasitology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Benedicta B Obeng
- Department of Parasitology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana; Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands
| | - Serge A Versteeg
- Department of Experimental Immunology, Academic Medical Center, Amsterdam, The Netherlands
| | - Irene A Larbi
- Department of Parasitology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Yvonne Aryeetey
- Department of Parasitology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Thomas A E Platts-Mills
- Asthma and Allergic Diseases Center, University of Virginia Health System, Charlottesville, Va
| | - Adriano Mari
- Associated Centers for Molecular Allergology, Rome, Italy
| | | | - Ben A Gyan
- Department of Immunology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Mohamed Mutocheluh
- Department of Clinical Microbiology, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Daniel A Boakye
- Department of Parasitology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
| | | | - Ronald van Ree
- Department of Experimental Immunology, Academic Medical Center, Amsterdam, The Netherlands; Department of Otorhinolaryngology, Academic Medical Center, Amsterdam, The Netherlands
| | - Cornelis H Hokke
- Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands
| | - Angela van Diepen
- Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands
| | - Maria Yazdanbakhsh
- Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands
| |
Collapse
|
50
|
Hoyt AEW, Chapman MD, King EM, Platts-Mills TAE, Steinke JW. Food allergen component proteins are not detected in early-childhood vaccines. J Allergy Clin Immunol Pract 2017; 6:677-679. [PMID: 29100866 DOI: 10.1016/j.jaip.2017.09.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Revised: 09/19/2017] [Accepted: 09/28/2017] [Indexed: 11/25/2022]
Affiliation(s)
- Alice E W Hoyt
- Department of Medicine, University of Virginia Health System, Charlottesville, Va; Department of Pediatrics, University of Virginia Health System, Charlottesville, Va
| | | | - Eva M King
- Indoor Biotechnologies, Charlottesville, Va
| | - Thomas A E Platts-Mills
- Department of Medicine, University of Virginia Health System, Charlottesville, Va; Carter Immunology Center, University of Virginia Health System, Charlottesville, Va
| | - John W Steinke
- Department of Medicine, University of Virginia Health System, Charlottesville, Va; Carter Immunology Center, University of Virginia Health System, Charlottesville, Va.
| |
Collapse
|