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Tonto PB, Nagao M, Suga S, Taniguchi K, Hirayama M, Nakayama T, Kumagai T, Fujisawa T. High prevalence of IgE sensitization to inactivated influenza vaccines, yet robust IgG4 responses, in a healthy pediatric population. Influenza Other Respir Viruses 2022; 17:e13053. [PMID: 36086810 PMCID: PMC9835421 DOI: 10.1111/irv.13053] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 08/06/2022] [Accepted: 08/25/2022] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Anaphylaxis following influenza vaccination is a rare but serious problem. The underlying immune responses are not well understood. This study elucidated the IgE and IgG antibody responses in healthy children and adolescents following inactivated influenza vaccines (IIVs). METHODS The efficacy and safety of quadrivalent IIV (QIV) and trivalent IIV (TIV) were compared in healthy subjects aged 0-18 years. Serum IIV-specific IgE, IgG, and IgG4 levels (sIgE, sIgG, and sIgG4) were measured with ImmunoCAP. Hemagglutination inhibition (HI) assay was performed for each influenza virus subtype. Sera from earlier patients who developed anaphylaxis to different IIVs were similarly tested. RESULTS A total of 393 subjects were enrolled: 96 were 6 months-2 years old, 100 were 3-5 years old, 100 were 6-12 years old, and 97 were 13-18 years old. No anaphylaxis was observed. Generally, QIV and TIV induced similar antibody responses. IIV-sIgE levels rose significantly after vaccination in the 6 months-2 years old and 3-5 years old groups, did not change in the 6-12 years old group, and decreased in the 13-18 years old group. In contrast, the IIV-sIgG4/sIgE ratio increased significantly after vaccination in all age groups. Sensitized subjects had significantly higher HI titers and IIV-sIgG levels in the youngest age group and higher IIV-sIgG4 levels in all age groups compared with the non-sensitized. The IIV-sIgG4/sIgE ratio in five patients with anaphylaxis was significantly lower than in age-matched healthy subjects. CONCLUSION IIVs induce IgE sensitization in healthy children but also robust IgG4 responses that may protect them from anaphylaxis.
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Affiliation(s)
- Prince Baffour Tonto
- Allergy Center and Infectious Disease CenterNational Hospital Organization Mie National HospitalTsuJapan,Department of Child Health and DevelopmentMie University Graduate School of MedicineTsuJapan
| | - Mizuho Nagao
- Allergy Center and Infectious Disease CenterNational Hospital Organization Mie National HospitalTsuJapan,Department of Child Health and DevelopmentMie University Graduate School of MedicineTsuJapan
| | - Shigeru Suga
- Allergy Center and Infectious Disease CenterNational Hospital Organization Mie National HospitalTsuJapan,Department of Child Health and DevelopmentMie University Graduate School of MedicineTsuJapan
| | - Kiyosu Taniguchi
- Allergy Center and Infectious Disease CenterNational Hospital Organization Mie National HospitalTsuJapan,Department of Child Health and DevelopmentMie University Graduate School of MedicineTsuJapan
| | - Masahiro Hirayama
- Department of PediatricsMie University Graduate School of MedicineTsuJapan
| | - Tetsuo Nakayama
- Omura Satoshi Memorial InstituteKitasato University Graduate School of Infection Control SciencesTokyoJapan
| | | | - Takao Fujisawa
- Allergy Center and Infectious Disease CenterNational Hospital Organization Mie National HospitalTsuJapan,Department of Child Health and DevelopmentMie University Graduate School of MedicineTsuJapan
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Soyyiğit S, Aydın Ö, Seçil D, Doğan C, Gökmen D, Sin BA, Mısırlıgil Z, Mungan VD. Pre-seasonal immunotherapy is effective in both monosensitized and polysensitized patients with allergic rhinitis. Eur Ann Allergy Clin Immunol 2022; 55:122-130. [PMID: 35448936 DOI: 10.23822/eurannaci.1764-1489.252] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Summary Background. The effectiveness of pre-seasonal allergoid immunotherapy in polysensitized patients are not well-known. The aim of the present study was to compare the clinical efficacy and immunological changes of pre-seasonal allergoid immunotherapy in mono- and polysensitized patients with grass pollen allergy. Methods. Fourty six patients with seasonal allergic rhinitis undergoing pre-seasonal grass pollen immunotherapy and 28 cases followed by conventional drug treatment were included. These groups were divided into monosensitized and polysensitized ones. All patients were followed between March-September with symptom-medication scores, and visual analogue scale (VAS). The quality of life was assessed using the Mini-RQLQ questionnaire. Phleum pratense (Phl p) specific IgE and IgG4 (UNI-CAP 100, Phadia) measurements were performed before and after 7 weeks of immunotherapy. Results. In the immunotherapy group, 15th weekly symptom-medication scores and VAS scores between May and August were found to be significantly lower than those in the control group (p less than 0.05). Phl p specific IgE and IgG4 levels were significantly higher after immunotherapy compared to those before immunotherapy (p = 0.001). Furthermore, Phl p specific IgG4 levels after immunotherapy were also significantly higher than in the control group (p = 0.001). Improvements in activities-practical problems and non-nose/eye symptoms quality of life scores were significantly different between two groups (p less than 0.05). There was no difference in terms of clinical and immunological parameters in mono- and polysensitized patients (p greater than 0.05). Conclusions. This study indicates that clinical improvement with pre-seasonal grass pollen immunotherapy is accompanied by important increase in specific IgG4 blocking antibodies. Furthermore, a single-allergen immunotherapy can lead to similar clinical efficacy and immunological changes in polysensitized as well as monosensitized patients with grass pollen allergy.
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Affiliation(s)
- S Soyyiğit
- Division of Immunology and Allergic Diseases, Department of Chest Diseases, Ankara University, School of Medicine, Ankara, Turkey
| | - Ö Aydın
- Division of Immunology and Allergic Diseases, Department of Chest Diseases, Ankara University, School of Medicine, Ankara, Turkey
| | - D Seçil
- Division of Immunology and Allergic Diseases, Department of Chest Diseases, Ankara University, School of Medicine, Ankara, Turkey
| | - C Doğan
- Department of Biology, Hacettepe University, School of Medicine, Ankara, Turkey
| | - D Gökmen
- Department of Biostatistics, Ankara University, School of Medicine, Ankara, Turkey
| | - B A Sin
- Division of Immunology and Allergic Diseases, Department of Chest Diseases, Ankara University, School of Medicine, Ankara, Turkey
| | - Z Mısırlıgil
- Faculty of Medicine, Istinye University, Ankara Liv Hospital, Immunology and Allergic Diseases, Turkey
| | - V D Mungan
- Division of Immunology and Allergic Diseases, Department of Chest Diseases, Ankara University, School of Medicine, Ankara, Turkey
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Nikolov G, Todordova Y, Emilova R, Hristova D, Nikolova M, Petrunov B. Allergen-Specific IgE and IgG4 as Biomarkers for Immunologic Changes during Subcutaneous Allergen Immunotherapy. Antibodies (Basel) 2021; 10:antib10040049. [PMID: 34940001 PMCID: PMC8698535 DOI: 10.3390/antib10040049] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 10/19/2021] [Revised: 11/24/2021] [Accepted: 12/03/2021] [Indexed: 12/31/2022] Open
Abstract
(1) Background: Biomarkers of efficacy for subcutaneous immunotherapy (SCIT) on allergic rhinitis have not been evaluated in details. The present study aims to assess the relevance of measuring of sIgE, sIgG4 and IgE/IgG4 ratio during SCIT in patients with allergic rhinitis; (2) Methods: 20 patients, 13 men and 7 women aged 19 to 58 years, with clinically manifested seasonal and perennial allergic rhinitis were studied. At the initiation and in the end of the three-year course of SCIT serum allergen-specific IgE and IgG4 were measured with ImmunoCAP system. The sIgE/sIgG4 ratio was calculated as a biomarker for immunologic effectiveness; (3) Results: There was a significant increase of sIgG4 antibodies (p < 0.05), while at the end of SCIT for the sIgE levels no significant changes were seen (p > 0.05). Moreover, 90% of patients showed a decrease of the IgE/IgG4 ratio; (4) Conclusions: In most of treated patients with AR, SCIT with Bulgarian allergen products leads to clear immunological changes. After a 3-year of SCIT there is a significant increase in allergen specific IgG4 levels and both decrease of sIgE and IgE/IgG4 ratio. sIgE, sIgG4 and IgE/IgG4 ratio can be used as a substantial biomarker for predicting immunological effectiveness of SCIT.
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Li J, Wei QK, Hu SL, Xiao T, Xu C, Liu X, Huang BC, Jia FJ. Establishment of lymphatic filarial specific IgG4 indirect ELISA detection method. Int J Clin Exp Med 2015; 8:16496-16503. [PMID: 26629176 PMCID: PMC4659064] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Accepted: 07/10/2015] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To establish the lymphatic filarial specific IgG4 indirect ELISA detection method and develop the kits. METHODS ELISA and the developed specific IgG4 reagent was used to explore the best way for detecting filarial specific IgG4. Combined with the production process of commercialized enzyme immunoassay kit to develop economical lymphatic filarial specific IgG4 test kit, and to explore the value of the kit in the laboratory. RESULTS We determined the most optimal detective antigen was Malay adult filarial antigen and the optimal concentration of coating antigen was 1.0 μg/ml. The appropriate serum dilution was 1:20 to 40 and the work titers of specific IgG4 agents was 1:800. We determined the optimal reaction time for substrates and developed a reproducible and stable detection kit with sensitive and specificity, which was easy to operate. CONCLUSION We successfully established the lymphatic filarial specific IgG4 indirect ELISA detection method and developed the kits with good reproducibility and stable result, which should be widely applied.
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Affiliation(s)
- Jin Li
- Shandong Academy of Medical Sciences, Shandong Institute of Parasitic Disease, WHO Collaborating Centre for Lymphatic FilariasisJining 272033, China
| | - Qing-Kuan Wei
- Shandong Academy of Medical Sciences, Shandong Institute of Parasitic Disease, WHO Collaborating Centre for Lymphatic FilariasisJining 272033, China
| | - Shao-Liang Hu
- ShenZhen Combined Biotech Co, LtdShenzhen 518054, China
| | - Ting Xiao
- Shandong Academy of Medical Sciences, Shandong Institute of Parasitic Disease, WHO Collaborating Centre for Lymphatic FilariasisJining 272033, China
| | - Chao Xu
- Shandong Academy of Medical Sciences, Shandong Institute of Parasitic Disease, WHO Collaborating Centre for Lymphatic FilariasisJining 272033, China
| | - Xin Liu
- Shandong Academy of Medical Sciences, Shandong Institute of Parasitic Disease, WHO Collaborating Centre for Lymphatic FilariasisJining 272033, China
| | - Bing-Cheng Huang
- Shandong Academy of Medical Sciences, Shandong Institute of Parasitic Disease, WHO Collaborating Centre for Lymphatic FilariasisJining 272033, China
| | - Feng-Ju Jia
- Shandong Academy of Medical Sciences, Shandong Institute of Parasitic Disease, WHO Collaborating Centre for Lymphatic FilariasisJining 272033, China
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Kuitunen M, Englund H, Remes S, Movérare R, Pelkonen A, Borres MP, Mäkelä MJ. High IgE levels to α-lactalbumin, β-lactoglobulin and casein predict less successful cow's milk oral immunotherapy. Allergy 2015; 70:955-62. [PMID: 25951431 DOI: 10.1111/all.12647] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/04/2015] [Indexed: 12/01/2022]
Abstract
BACKGROUND A new treatment option for persistent cow's milk allergy (CMA) is oral immunotherapy (OIT). Not all patients develop tolerance during therapy, and markers to identify those who will benefit from it are needed. The objective was to study the IgE and IgG4 antibody profiles to milk and milk proteins before and after OIT in relation to clinical outcome. METHODS Seventy-six children (5-17 years) with challenge-verified CMA were subjected to a 6-month OIT protocol. The treatment aimed at reaching a maintenance dose of 200 ml CM (high dose = HD). Those who did not reach target were analysed as a low-dose (LD) group. Sera were characterized before and after OIT regarding serum levels of IgE and IgG4 to milk and five milk allergen components evaluated together with clinical CMA symptoms and outcome of OIT. RESULTS Fifty-five (72%) patients reached the maintenance dose (HD) during therapy. High specific IgE levels towards the milk allergens α-lactalbumin (P = 0.048), β-lactoglobulin (P = 0.006) and casein (P = 0.015) before OIT start were associated with lower maintenance dose reached. Patients who developed desensitization had a larger increase in IgG4 levels to α-lactalbumin (P = 0.034), β-lactoglobulin (P = 0.010), casein (P = 0.047) and lactoferrin (P = 0.030) during treatment than those who failed. CONCLUSIONS Component-resolved diagnostics before OIT can help to identify children with lower probability of a successful OIT outcome, as high IgE levels to α-lactalbumin, β-lactoglobulin and casein are associated with lower maintenance dose reached. An increase in the IgG4 concentration to milk components during treatment indicated effective desensitization.
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Affiliation(s)
- M. Kuitunen
- Children's Hospital; University of Helsinki; Helsinki Finland
| | - H. Englund
- Thermo Fisher Scientific; Uppsala Sweden
| | - S. Remes
- Kuopio University Hospital; University of Eastern; Finland Finland
| | - R. Movérare
- Thermo Fisher Scientific; Uppsala Sweden
- Department of Medical Sciences, Respiratory Medicine and Allergology; Uppsala University; Uppsala Sweden
| | - A. Pelkonen
- Skin and Allergy Hospital; University of Helsinki; Helsinki Finland
| | - M. P. Borres
- Thermo Fisher Scientific; Uppsala Sweden
- Department of Women's and Children's Health; Uppsala University; Uppsala Sweden
| | - M. J. Mäkelä
- Skin and Allergy Hospital; University of Helsinki; Helsinki Finland
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Nam YH, Hwang EK, Ban GY, Jin HJ, Yoo HS, Shin YS, Ye YM, Nahm DH, Park HS, Lee SK. Immunologic evaluation of patients with cefotetan-induced anaphylaxis. Allergy Asthma Immunol Res 2014; 7:301-3. [PMID: 25749763 PMCID: PMC4397372 DOI: 10.4168/aair.2015.7.3.301] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/23/2013] [Revised: 12/27/2013] [Accepted: 02/20/2014] [Indexed: 12/12/2022]
Abstract
Cefotetan is a commonly prescribed second-generation cephalosporin that acts against a wide range of bacteria. However, cefotetan-induced hypersensitivity has rarely been reported. We report 2 cases of cefotetan-induced anaphylaxis with immunologic evaluation. The first case was a 70-year-old asthmatic woman who had dyspnea and hypotension during administration of cefotetan, in which high serum-specific IgE to cefotetan-human serum albumin (HSA) conjugate was detected by enzyme-linked immunosorbent assay. The second case was a 63-year-old asthmatic woman who complained of chest tightness and dyspnea during cefotetan infusion, in which high serum-specific IgG1 and IgG4 with no serum specific IgE to cefotetan-HSA conjugate was detected. The basophil activation test using basophils from the patient showed a significant up-regulation of CD63 with the addition of anti-IgG4 antibody compared with that in non-atopic healthy controls. In conclusion, cefotetan can induce anaphylaxis, which may involve both IgE- and IgG4-mediated responses in the pathogenic mechanism.
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Affiliation(s)
- Young Hee Nam
- Department of Internal Medicine, College of Medicine, Dong-A University, Busan, Korea
| | - Eui Kyung Hwang
- Department of Allergy & Clinical Immunology, Ajou University School of Medicine, Suwon, Korea
| | - Ga Young Ban
- Department of Allergy & Clinical Immunology, Ajou University School of Medicine, Suwon, Korea
| | - Hyun Jung Jin
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Hye Soo Yoo
- Department of Allergy & Clinical Immunology, Ajou University School of Medicine, Suwon, Korea
| | - Yoo Seob Shin
- Department of Allergy & Clinical Immunology, Ajou University School of Medicine, Suwon, Korea
| | - Young Min Ye
- Department of Allergy & Clinical Immunology, Ajou University School of Medicine, Suwon, Korea
| | - Dong Ho Nahm
- Department of Allergy & Clinical Immunology, Ajou University School of Medicine, Suwon, Korea
| | - Hae Sim Park
- Department of Allergy & Clinical Immunology, Ajou University School of Medicine, Suwon, Korea
| | - Soo Keol Lee
- Department of Internal Medicine, College of Medicine, Dong-A University, Busan, Korea.
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