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Korhonen J, Siiskonen H, Haimakainen S, Harvima RJ, Harvima IT. Expression of mast cell tryptase and immunoglobulin E is increased in cutaneous photodamage: implications for carcinogenesis. J DERMATOL TREAT 2024; 35:2307488. [PMID: 38291602 DOI: 10.1080/09546634.2024.2307488] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 01/15/2024] [Indexed: 02/01/2024]
Abstract
Purpose: Mast cells, their serine proteinase tryptase, and immunoglobulin E (IgE) can be involved in cutaneous carcinogenesis.Materials and methods: To study the association of tryptase+ and IgE+ cells with photodamage and skin cancers 385 adult patients (201 males, 184 females, 75 with immunosuppression) at risk of any type of skin cancer were examined. Skin biopsies were taken from the sun-protected medial arm and from the photodamaged dorsal forearm skin followed by immunohistochemical staining for tryptase and IgE.Results: The results show that tryptase+ and IgE+ cells are significantly higher in number in the photodamaged than sun-protected skin, both in immunocompetent and -compromised subjects, and there is a strong correlation between tryptase+ and IgE+ cells. The numbers of forearm tryptase+ and especially IgE+ cells associated significantly with the forearm photodamage severity. In the logistic regression analysis, the forearm to upper arm ratio of IgE+ cells produced a univariate odds ratio of 1.521 (p = .010) and a multivariate one of 3.875 (p = .047) for the history of squamous cell carcinoma. The serum level of total IgE correlated significantly to the IgE to tryptase ratio in both skin sites.Conclusions: Therefore, IgE+ mast cells participate in photodamage and carcinogenesis, though it is unclear whether they are tumor-protective or -causative.
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Affiliation(s)
- Jenni Korhonen
- Department of Dermatology, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Hanna Siiskonen
- Department of Dermatology, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Salla Haimakainen
- Department of Dermatology, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Rauno J Harvima
- Department of Dermatology, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Ilkka T Harvima
- Department of Dermatology, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
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Zhao W, An Y, Cheng F, Zhao C. Expression of NMU and NMUR1 in tryptase-positive mast cells and PBLs in allergic rhinitis patients' nasal mucosa. Am J Rhinol Allergy 2024; 38:146-152. [PMID: 38378005 DOI: 10.1177/19458924241228764] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
Abstract
BACKGROUND The neuropeptide U (NMU) has been proven to elicit the release of mediators from mast cells (MCs) through its receptor NMUR1 in allergic inflammatory models. However, little is known about the correlations between NMU and MCs in human allergic rhinitis (AR). OBJECTIVE The objective of this study is to investigate the expressions of NMU and NMUR1 in the tryptase + MCs and the peripheral blood leukocytes (PBLs) in human nasal mucosa with AR. METHODS Specimens of nasal mucosa from patients with AR (n = 10) and control patients without AR (n = 8) were collected and soaked in frozen tissue liquid solution (OCT) in tum. Cryostat sections were prepared for immunofluorescence staining. Tryptase was used as a marker to detect mast cells and other tryptase + immune cells. The expression of NMU and NMUR1 was respectively determined by double staining using a confocal microscope. RESULTS Neither NMU nor NMUR1 were detected in the tryptase + mast cells in the human nasal mucosa. To our surprise, both NMU and NMUR1 were co-expressed with tryptase in the PBLs within peripheral blood vessels in AR and controls. CONCLUSION Our findings showed that NMU could not influence human nasal tryptase + mast cells directly through NMUR1 in AR. The co-expression of both NMU and NMUR1 with tryptase in the PBLs provided new insight into the potential roles of NMU and tryptase in the circulation PBLs, and the infiltrated PBLs may promote nasal allergic inflammation by producing tryptase and NMU.
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Affiliation(s)
- Wei Zhao
- Shanxi Medical University, Taiyuan, China
- Department of Otolaryngology-Head and Neck Surgery, The Second Hospital, Shanxi Medical University, Taiyuan, China
- Key Research Laboratory of Airway Neuroimmunology, Shanxi Province, Taiyuan, China
| | - Yunfang An
- Department of Otolaryngology-Head and Neck Surgery, The Second Hospital, Shanxi Medical University, Taiyuan, China
- Key Research Laboratory of Airway Neuroimmunology, Shanxi Province, Taiyuan, China
| | - Fengli Cheng
- Department of Otolaryngology-Head and Neck Surgery, The Second Hospital, Shanxi Medical University, Taiyuan, China
- Key Research Laboratory of Airway Neuroimmunology, Shanxi Province, Taiyuan, China
| | - Changqing Zhao
- Department of Otolaryngology-Head and Neck Surgery, The Second Hospital, Shanxi Medical University, Taiyuan, China
- Key Research Laboratory of Airway Neuroimmunology, Shanxi Province, Taiyuan, China
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Niedoszytko M, Gorska A, Brockow K, Bonadonna P, Lange M, Kluin-Nelemans H, Oude-Elberink H, Sabato V, Shoumariyeh K, von Bubnoff D, Müller S, Illerhaus A, Doubek M, Angelova-Fischer I, Hermine O, Arock M, Elena C, Malcovati L, Yavuz AS, Schug TD, Fortina AB, Judit V, Gotlib J, Panse J, Vucinic V, Reiter A, Schwaab J, Triggiani M, Mattsson M, Breynaert C, Romantowski J, Zanotti R, Olivieri E, Zink A, van de Ven A, Stefan A, Barete S, Caroppo F, Perkins C, Kennedy V, Christen D, Jawhar M, Luebke J, Parente R, Levedahl K, Hadzijusufovic E, Hartmann K, Nedoszytko B, Sperr WR, Valent P. Prevalence of hypersensitivity reactions in various forms of mastocytosis: A pilot study of 2485 adult patients with mastocytosis collected in the ECNM registry. Allergy 2024. [PMID: 38651829 DOI: 10.1111/all.16132] [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: 10/07/2023] [Revised: 03/20/2024] [Accepted: 03/25/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND Hypersensitivity reactions (HR) are common in mastocytosis. However, little is known about triggers and risk factors. The registry of the European Competence Network on Mastocytosis (ECNM) enables reliable studies in a larger cohort of mastocytosis patients. We assessed prevalence, triggers and risk factors of HR in adults with mastocytosis in the ECNM registry. METHODS Data were collected in 27 ECNM centers. We analyzed potential triggers (Hymenoptera venoms, food, drug, inhalant and others) and risk factors at diagnosis and during follow-up. The study group consisted of 2485 adults with mastocytosis, 1379 women (55.5%) and 1106 men (44.5%). Median age was 48.2 years (range 18-91 years). RESULTS Nine hundred and forty eight patients (38.1%) reported one or more HR`. Most common triggers were Hymenoptera venoms in cutaneous mastocytosis (CM) and indolent systemic mastocytosis (ISM), whereas in advanced SM (advSM), most common elicitors were drugs, including nonsteroidal anti-inflammatory agents and penicillin. In multivariate analyses, tryptase level < 90 ng/mL, <15% infiltration by mast cells in bone marrow biopsy-sections, and diagnosis of ISM were identified as independent risk factors for HR. For drug-induced HR, prominent risk factors were advSM and high tryptase levels. New reactions were observed in 4.8% of all patients during 4 years follow-up. CONCLUSIONS HR are mainly triggered by Hymenoptera venoms in patients with CM and ISM and by drugs in patients with advSM. Tryptase levels <90 ng/mL, mast cell bone marrow infiltration <15%, and WHO category ISM are predictors of HR. New HR occur in 4.8% of all patients within 4 years.
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Affiliation(s)
- Marek Niedoszytko
- Department of Allergology, Medical University of Gdansk, Gdansk, Poland
| | - Aleksandra Gorska
- Department of Allergology, Medical University of Gdansk, Gdansk, Poland
| | - Knut Brockow
- Department of Dermatology and Allergy Biederstein, Technical University of Munich, School of Medicine, Munich, Germany
| | - Patrizia Bonadonna
- Allergy Unit, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy
| | - Magdalena Lange
- Department of Dermatology, Venereology and Allergology, Medical University of Gdansk, Gdansk, Poland
| | - Hanneke Kluin-Nelemans
- Department of Hematology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | | | - Vito Sabato
- Department of Immunology, Allergology Rheumatology University of Antwerp and Antwerp University Hospital, Edegem, Belgium
| | - Khalid Shoumariyeh
- Department of Medicine I, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany and German Cancer Consortium (DKTK), Partner Site Freiburg, and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Dagmar von Bubnoff
- Dagmar von Bubnoff, Department of Dermatology, Allergy and Venerology, University of Schleswig Holstein, Lübeck, Germany
| | - Sabine Müller
- Department of Dermatology, Medical Centre-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | | | | | | | - Olivier Hermine
- Unit of Dermatology and CEREMAST, Pitié-Salpêtrière Hospital, Sorbonne Université, Paris, France
| | - Michel Arock
- Department of Hematological Biology and CEREMAST, Pitié-Salpêtrière Hospital, Paris Sorbonne University, Paris, France
| | - Chiara Elena
- Department of Hematology, Fondazione IRCCS Fondazione Policlinico San Matteo, Pavia, Italy
| | - Luca Malcovati
- Department of Hematology, Fondazione IRCCS Fondazione Policlinico San Matteo, Pavia, Italy
- Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Akif Selim Yavuz
- Istanbul University, Istanbul Faculty of Medicine, Istanbul, Türkiye
| | | | - Anna Belloni Fortina
- Pediatric Dermatology, Internal Medicine, Azienda Ospedaliera, Università di Padova, Padova, Italy
| | | | - Jason Gotlib
- Stanford University, School of Medicine, Hematology Clinic, Stanford, USA
| | - Jens Panse
- Department of Oncology, Hematology, Hemostaseology and Stem Cell Transplantation, University Hospital RWTH Aachen, Center for Integrated Oncology Aachen, Bonn Cologne, Duesseldorf (CIO ABCD), Aachen, Germany
| | | | - Andreas Reiter
- Universitätsmedizin Mannheim, III.Medizinische Klinik, Mannhein, Germany
| | - Juliana Schwaab
- Universitätsmedizin Mannheim, III.Medizinische Klinik, Mannhein, Germany
| | | | | | - Christine Breynaert
- KU Leuven Department of Microbiology, Immunology and Transplantation, Allergy and Clinical Immunology ResearchGroup and MASTeL, University Hospitals Leuven, Leuven, Belgium
| | - Jan Romantowski
- Department of Allergology, Medical University of Gdansk, Gdansk, Poland
| | - Roberta Zanotti
- Department of Medicine, Section of Hematology, University of Verona, Verona, Italy
| | - Elisa Olivieri
- Allergy Unit, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy
| | - Alexander Zink
- Department of Dermatology and Allergy Biederstein, Technical University of Munich, School of Medicine, Munich, Germany
| | - Annick van de Ven
- Department of Allergology, University Medical Center, Groningen, The Netherlands
| | - Alex Stefan
- Clinic for Hematology and Oncology, Kepler University Hospital, Linz, Austria
| | - Stephane Barete
- Unit of Dermatology and CEREMAST, Pitié-Salpêtrière Hospital, Sorbonne Université, Paris, France
| | - Francesca Caroppo
- Pediatric Dermatology, Internal Medicine, Azienda Ospedaliera, Università di Padova, Padova, Italy
| | - Cecelia Perkins
- Stanford University, School of Medicine, Hematology Clinic, Stanford, USA
| | - Vanessa Kennedy
- Stanford University, School of Medicine, Hematology Clinic, Stanford, USA
| | - Deborah Christen
- Department of Oncology, Hematology, Hemostaseology and Stem Cell Transplantation, University Hospital RWTH Aachen, Center for Integrated Oncology Aachen, Bonn Cologne, Duesseldorf (CIO ABCD), Aachen, Germany
| | - Mohamad Jawhar
- Universitätsmedizin Mannheim, III.Medizinische Klinik, Mannhein, Germany
- Department of Hematology and Oncology, Helios Pforzheim, Pforzheim, Germany
| | - Johannes Luebke
- Universitätsmedizin Mannheim, III.Medizinische Klinik, Mannhein, Germany
| | | | - Kerstin Levedahl
- Uppsala University Hospital, Uppsala, Sweden
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Emir Hadzijusufovic
- Department of Internal Medicine I, Division of Hematology and Hemostaseology, Medical University of Vienna, Vienna, Austria
- Ludwig Boltzmann Institute for Hematology and Oncology, Medical University of Vienna, Vienna, Austria
| | - Karin Hartmann
- Division of Allergy, Department of Dermatology, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Boguslaw Nedoszytko
- Department of Dermatology, Venereology and Allergology, Medical University of Gdansk, Gdansk, Poland
- Invicta Fertility and Reproductive Center, Molecular Laboratory, Sopot, Poland
| | - Wolfgang R Sperr
- Department of Internal Medicine I, Division of Hematology and Hemostaseology, Medical University of Vienna, Vienna, Austria
- Ludwig Boltzmann Institute for Hematology and Oncology, Medical University of Vienna, Vienna, Austria
| | - Peter Valent
- Department of Internal Medicine I, Division of Hematology and Hemostaseology, Medical University of Vienna, Vienna, Austria
- Ludwig Boltzmann Institute for Hematology and Oncology, Medical University of Vienna, Vienna, Austria
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Budnevsky AV, Avdeev SN, Kosanovic D, Ovsyannikov ES, Savushkina IA, Alekseeva NG, Feigelman SN, Shishkina VV, Filin AA, Esaulenko DI, Perveeva IM. Involvement of Mast Cells in the Pathology of COVID-19: Clinical and Laboratory Parallels. Cells 2024; 13:711. [PMID: 38667325 PMCID: PMC11049608 DOI: 10.3390/cells13080711] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 04/12/2024] [Accepted: 04/17/2024] [Indexed: 04/28/2024] Open
Abstract
Recent studies suggested the potential role of mast cells (MCs) in the pathology of coronavirus disease 2019 (COVID-19). However, the precise description of the MCs' activation and the engagement of their proteases is still missing. The objective of this study was to further reveal the importance of MCs and their proteases (chymase, tryptase, and carboxypeptidase A3 (CPA3)) in the development of lung damage in patients with COVID-19. This study included 55 patients who died from COVID-19 and 30 controls who died from external causes. A histological analysis of the lung parenchyma was carried out to assess the protease profiles and degranulation activity of MCs. In addition, we have analyzed the general blood test, coagulogram, and C-reactive protein. The content of tryptase-positive MCs (Try-MCs) in the lungs of patients with COVID-19 was higher than in controls, but their degranulation activity was lower. The indicators of chymase-positive MCs (Chy-MCs) were significantly lower than in the controls, while the content of CPA3-positive MCs (CPA3-MCs) and their degranulation activity were higher in patients with COVID-19. In addition, we have demonstrated the existence of correlations (positive/negative) between the content of Try-MCs, Chy-MCs, and CPA3-MCs at different states of their degranulation and presence (co-adjacent/single) and the levels of various immune cells (neutrophils, eosinophils, basophils, and monocytes) and other important markers (blood hemoglobin, activated partial thromboplastin time (aPTT), international normalized ratio (INR), and fibrinogen). Thus, the identified patterns suggest the numerous and diverse mechanisms of the participation of MCs and their proteases in the pathogenesis of COVID-19, and their impact on the inflammatory process and coagulation status. At the same time, the issue requires further study in larger cohorts of patients, which will open up the possibility of using drugs acting on this link of pathogenesis to treat lung damage in patients with COVID-19.
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Affiliation(s)
- Andrey V. Budnevsky
- Department of Faculty Therapy, Voronezh State Medical University Named after N.N. Burdenko, Studencheskaya Street 10, 394622 Voronezh, Russia; (A.V.B.); (E.S.O.); (N.G.A.); (S.N.F.); (V.V.S.); (A.A.F.)
| | - Sergey N. Avdeev
- Department of Pulmonology, I.M. Sechenov First Moscow State Medical University (Sechenov University), Trubetskaya Street 8, 119991 Moscow, Russia;
| | - Djuro Kosanovic
- Department of Pulmonology, I.M. Sechenov First Moscow State Medical University (Sechenov University), Trubetskaya Street 8, 119991 Moscow, Russia;
| | - Evgeniy S. Ovsyannikov
- Department of Faculty Therapy, Voronezh State Medical University Named after N.N. Burdenko, Studencheskaya Street 10, 394622 Voronezh, Russia; (A.V.B.); (E.S.O.); (N.G.A.); (S.N.F.); (V.V.S.); (A.A.F.)
| | - Inessa A. Savushkina
- Department of Faculty Therapy, Voronezh State Medical University Named after N.N. Burdenko, Studencheskaya Street 10, 394622 Voronezh, Russia; (A.V.B.); (E.S.O.); (N.G.A.); (S.N.F.); (V.V.S.); (A.A.F.)
| | - Nadezhda G. Alekseeva
- Department of Faculty Therapy, Voronezh State Medical University Named after N.N. Burdenko, Studencheskaya Street 10, 394622 Voronezh, Russia; (A.V.B.); (E.S.O.); (N.G.A.); (S.N.F.); (V.V.S.); (A.A.F.)
| | - Sofia N. Feigelman
- Department of Faculty Therapy, Voronezh State Medical University Named after N.N. Burdenko, Studencheskaya Street 10, 394622 Voronezh, Russia; (A.V.B.); (E.S.O.); (N.G.A.); (S.N.F.); (V.V.S.); (A.A.F.)
| | - Viktoria V. Shishkina
- Department of Faculty Therapy, Voronezh State Medical University Named after N.N. Burdenko, Studencheskaya Street 10, 394622 Voronezh, Russia; (A.V.B.); (E.S.O.); (N.G.A.); (S.N.F.); (V.V.S.); (A.A.F.)
- Research Institute of Experimental Biology and Medicine, Voronezh State Medical University Named after N.N. Burdenko, Moskovskiy Avenue, 185, 394066 Voronezh, Russia;
| | - Andrey A. Filin
- Department of Faculty Therapy, Voronezh State Medical University Named after N.N. Burdenko, Studencheskaya Street 10, 394622 Voronezh, Russia; (A.V.B.); (E.S.O.); (N.G.A.); (S.N.F.); (V.V.S.); (A.A.F.)
- Research Institute of Experimental Biology and Medicine, Voronezh State Medical University Named after N.N. Burdenko, Moskovskiy Avenue, 185, 394066 Voronezh, Russia;
| | - Dmitry I. Esaulenko
- Research Institute of Experimental Biology and Medicine, Voronezh State Medical University Named after N.N. Burdenko, Moskovskiy Avenue, 185, 394066 Voronezh, Russia;
| | - Inna M. Perveeva
- Voronezh Regional Clinical Hospital No. 1, Moskovskiy Avenue, 151, 394066 Voronezh, Russia;
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Canè L, Poto R, Palestra F, Iacobucci I, Pirozzi M, Parashuraman S, Ferrara AL, Illiano A, La Rocca A, Mercadante E, Pucci P, Marone G, Spadaro G, Loffredo S, Monti M, Varricchi G. Thymic Stromal Lymphopoietin (TSLP) Is Cleaved by Human Mast Cell Tryptase and Chymase. Int J Mol Sci 2024; 25:4049. [PMID: 38612858 PMCID: PMC11012384 DOI: 10.3390/ijms25074049] [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: 02/22/2024] [Revised: 03/27/2024] [Accepted: 04/04/2024] [Indexed: 04/14/2024] Open
Abstract
Thymic stromal lymphopoietin (TSLP), mainly expressed by epithelial cells, plays a central role in asthma. In humans, TSLP exists in two variants: the long form TSLP (lfTSLP) and a shorter TSLP isoform (sfTSLP). Macrophages (HLMs) and mast cells (HLMCs) are in close proximity in the human lung and play key roles in asthma. We evaluated the early proteolytic effects of tryptase and chymase released by HLMCs on TSLP by mass spectrometry. We also investigated whether TSLP and its fragments generated by these enzymes induce angiogenic factor release from HLMs. Mass spectrometry (MS) allowed the identification of TSLP cleavage sites caused by tryptase and chymase. Recombinant human TSLP treated with recombinant tryptase showed the production of 1-97 and 98-132 fragments. Recombinant chymase treatment of TSLP generated two peptides, 1-36 and 37-132. lfTSLP induced the release of VEGF-A, the most potent angiogenic factor, from HLMs. By contrast, the four TSLP fragments generated by tryptase and chymase failed to activate HLMs. Long-term TSLP incubation with furin generated two peptides devoid of activating property on HLMs. These results unveil an intricate interplay between mast cell-derived proteases and TSLP. These findings have potential relevance in understanding novel aspects of asthma pathobiology.
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Affiliation(s)
- Luisa Canè
- Department of Translational Medical Sciences, University of Naples Federico II, 80131 Naples, Italy; (L.C.); (R.P.); (F.P.); (A.L.F.); (G.M.); (G.S.); (S.L.)
- World Allergy Organization (WAO), Center of Excellence (CoE), 80131 Naples, Italy
- CEINGE Advanced Biotechnologies F. Salvatore, 80131 Naples, Italy; (I.I.); (P.P.)
| | - Remo Poto
- Department of Translational Medical Sciences, University of Naples Federico II, 80131 Naples, Italy; (L.C.); (R.P.); (F.P.); (A.L.F.); (G.M.); (G.S.); (S.L.)
- World Allergy Organization (WAO), Center of Excellence (CoE), 80131 Naples, Italy
| | - Francesco Palestra
- Department of Translational Medical Sciences, University of Naples Federico II, 80131 Naples, Italy; (L.C.); (R.P.); (F.P.); (A.L.F.); (G.M.); (G.S.); (S.L.)
- World Allergy Organization (WAO), Center of Excellence (CoE), 80131 Naples, Italy
| | - Ilaria Iacobucci
- CEINGE Advanced Biotechnologies F. Salvatore, 80131 Naples, Italy; (I.I.); (P.P.)
- Department of Chemical Sciences, University of Naples Federico II, 80126 Naples, Italy
| | - Marinella Pirozzi
- Institute of Experimental Endocrinology and Oncology, National Research Council (CNR), 80131 Naples, Italy; (M.P.); (S.P.)
| | - Seetharaman Parashuraman
- Institute of Experimental Endocrinology and Oncology, National Research Council (CNR), 80131 Naples, Italy; (M.P.); (S.P.)
| | - Anne Lise Ferrara
- Department of Translational Medical Sciences, University of Naples Federico II, 80131 Naples, Italy; (L.C.); (R.P.); (F.P.); (A.L.F.); (G.M.); (G.S.); (S.L.)
- World Allergy Organization (WAO), Center of Excellence (CoE), 80131 Naples, Italy
| | - Amalia Illiano
- Thoracic Surgery Unit—Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, 80131 Naples, Italy; (A.I.); (A.L.R.); (E.M.)
| | - Antonello La Rocca
- Thoracic Surgery Unit—Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, 80131 Naples, Italy; (A.I.); (A.L.R.); (E.M.)
| | - Edoardo Mercadante
- Thoracic Surgery Unit—Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, 80131 Naples, Italy; (A.I.); (A.L.R.); (E.M.)
| | - Piero Pucci
- CEINGE Advanced Biotechnologies F. Salvatore, 80131 Naples, Italy; (I.I.); (P.P.)
| | - Gianni Marone
- Department of Translational Medical Sciences, University of Naples Federico II, 80131 Naples, Italy; (L.C.); (R.P.); (F.P.); (A.L.F.); (G.M.); (G.S.); (S.L.)
- World Allergy Organization (WAO), Center of Excellence (CoE), 80131 Naples, Italy
- Institute of Experimental Endocrinology and Oncology, National Research Council (CNR), 80131 Naples, Italy; (M.P.); (S.P.)
- Center for Basic and Clinical Immunology Research (CISI), University of Naples Federico II, 80131 Naples, Italy
| | - Giuseppe Spadaro
- Department of Translational Medical Sciences, University of Naples Federico II, 80131 Naples, Italy; (L.C.); (R.P.); (F.P.); (A.L.F.); (G.M.); (G.S.); (S.L.)
- World Allergy Organization (WAO), Center of Excellence (CoE), 80131 Naples, Italy
- Center for Basic and Clinical Immunology Research (CISI), University of Naples Federico II, 80131 Naples, Italy
| | - Stefania Loffredo
- Department of Translational Medical Sciences, University of Naples Federico II, 80131 Naples, Italy; (L.C.); (R.P.); (F.P.); (A.L.F.); (G.M.); (G.S.); (S.L.)
- World Allergy Organization (WAO), Center of Excellence (CoE), 80131 Naples, Italy
- Institute of Experimental Endocrinology and Oncology, National Research Council (CNR), 80131 Naples, Italy; (M.P.); (S.P.)
- Center for Basic and Clinical Immunology Research (CISI), University of Naples Federico II, 80131 Naples, Italy
| | - Maria Monti
- CEINGE Advanced Biotechnologies F. Salvatore, 80131 Naples, Italy; (I.I.); (P.P.)
- Department of Chemical Sciences, University of Naples Federico II, 80126 Naples, Italy
| | - Gilda Varricchi
- Department of Translational Medical Sciences, University of Naples Federico II, 80131 Naples, Italy; (L.C.); (R.P.); (F.P.); (A.L.F.); (G.M.); (G.S.); (S.L.)
- World Allergy Organization (WAO), Center of Excellence (CoE), 80131 Naples, Italy
- Institute of Experimental Endocrinology and Oncology, National Research Council (CNR), 80131 Naples, Italy; (M.P.); (S.P.)
- Center for Basic and Clinical Immunology Research (CISI), University of Naples Federico II, 80131 Naples, Italy
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Gonzalez-Estrada A, Carrillo-Martin I, Morgenstern-Kaplan D, Rukasin CRF, Rank MA, Park MA, Yee CI, Volcheck GW. A United States-Based Multicenter Retrospective Report of Perioperative Anaphylaxis, 2010-2021. J Allergy Clin Immunol Pract 2024:S2213-2198(24)00342-8. [PMID: 38580206 DOI: 10.1016/j.jaip.2024.02.042] [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] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 01/18/2024] [Accepted: 02/17/2024] [Indexed: 04/07/2024]
Abstract
BACKGROUND US-based perioperative anaphylaxis (POA) studies are limited to single center experiences. A recent report found that a serum acute tryptase (sAT) > 9.8 ng/mL or mast cell activation (MCA) can predict POA causal agent identification. Urinary mast cell mediator metabolites (uMC) have not been studied in POA. OBJECTIVE To analyze the epidemiologic data of POA, to determine if sAT or MCA can predict suspected causal agent identification, and to evaluate uMC utility in POA. METHODS Retrospective multicenter review of POA cases which were subcategorized by suspected causal agent identification status. sAT, MCA (defined as sAT >2+1.2 x serum baseline tryptase), and uMC (N-methylhistamine[NMH], 11β-prostaglandin-F2α [11β-PGF2α], leukotriene E4 [LTE4]) were recorded. RESULTS Of 100 patients (mean age 52 [SD 17], 94% adult, 50% female, 90% White, 2% Hispanic) with POA, 73% had a sAT available, 41% had MCA, 16% had uMC available, and 50% had an identifiable suspected cause. POA cases with an identifiable suspected cause had a positive MCA status (100% vs 78%; p=.01) compared to POA with an unidentifiable cause. An elevated median sAT did not predict causal agent identification. Positive uMC were not associated with suspected causal agent identification during POA. Patients with positive uMC had a higher median sAT (30 vs 6.45 ng/mL; p=.001) and MCA status (96% vs 12%; p=.001) compared to negative uMC patients. Patients with POA had an elevated acute/baseline uMC ratios: 11β-PGF2α ratio > 1.6, N-MH ratio >1.7, and LTE4 ratio >1.8. CONCLUSION Presence of MCA in POA is associated with suspected causal agent identification. Positive uMC possibly correlate with a higher sAT level and MCA status but require further study. The authors suggest applying an acute/baseline uMC ratio (11β-PGF2α ratio > 1.6, N-MH ratio >1.7, and LTE4 ratio >1.87) in POA patients for MCA when a tryptase level is inconclusive during POA evaluations.
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Affiliation(s)
- Alexei Gonzalez-Estrada
- Division of Pulmonary, Allergy and Sleep Medicine, Department of Medicine, Mayo Clinic, Jacksonville, FL.
| | - Ismael Carrillo-Martin
- Division of Pulmonary, Allergy and Sleep Medicine, Department of Medicine, Mayo Clinic, Jacksonville, FL
| | - Dan Morgenstern-Kaplan
- Division of Pulmonary, Allergy and Sleep Medicine, Department of Medicine, Mayo Clinic, Jacksonville, FL
| | - Christine R F Rukasin
- Division of Allergy, Asthma and Clinical Immunology, Department of Medicine, Mayo Clinic, Scottsdale, AZ; Division of Pulmonary, Section of Allergy/Immunology, Phoenix Children's Hospital, Phoenix, AZ
| | - Matthew A Rank
- Division of Allergy, Asthma and Clinical Immunology, Department of Medicine, Mayo Clinic, Scottsdale, AZ; Division of Pulmonary, Section of Allergy/Immunology, Phoenix Children's Hospital, Phoenix, AZ
| | - Miguel A Park
- Division of Allergic Diseases, Department of Internal Medicine, Mayo Clinic, Rochester, MN
| | - Claire I Yee
- Division of Clinical Trials and Biostatistics, Mayo Clinic, Scottsdale, AZ
| | - Gerald W Volcheck
- Division of Allergic Diseases, Department of Internal Medicine, Mayo Clinic, Rochester, MN
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7
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Madsen AT, Kristiansen HP, Winther-Larsen A. Short-term biological variation of serum tryptase. Clin Chem Lab Med 2024; 62:713-719. [PMID: 37882699 DOI: 10.1515/cclm-2023-0606] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 10/17/2023] [Indexed: 10/27/2023]
Abstract
OBJECTIVES Serum tryptase is a biomarker of mast cell activation. Among others, it is used in the diagnosis of anaphylaxis where a significant increase during the acute phase supports the diagnosis. When evaluating changes in biomarker levels, it is of utmost importance to consider the biological variation of the marker. Therefore, the aim of this study was to evaluate the short-term biological variation of serum tryptase. METHODS Blood samples were drawn at 9 AM three days in a row from apparently healthy subjects. On day two, additional blood samples were drawn every third hour for 12 h. The tryptase concentration was measured in serum using a fluoroenzyme immunoassay (ImmunoCAP™, Thermo Fisher Scientific). Linear mixed-effects models were used to calculate components of biological variation. RESULTS In 32 subjects, the overall mean concentration of tryptase was 4.0 ng/mL (range, 1.3-8.0 ng/mL). The within-subject variation was 3.7 % (95 % confidence interval (CI) 3.0-4.4 %), the between-subject variation was 31.5 % (95 % CI 23.1-39.8 %), and the analytical variation was 3.4 % (95 % CI 2.9-4.1 %). The reference change value was 13.3 % for an increase in tryptase at a 95 % level of significance. No significant day-to-day variation was observed (p=0.77), while a minute decrease in the serum concentration was observed during the day (p<0.0001). CONCLUSIONS Serum tryptase is a tightly regulated biomarker with very low within-subject variation, no significant day-to-day variation, and only minor semidiurnal variation. In contrast, a considerable between-subject variation exists. This establishes serum tryptase as a well-suited biomarker for monitoring.
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Affiliation(s)
- Anne Tranberg Madsen
- Department of Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, NY, USA
| | | | - Anne Winther-Larsen
- Department of Clinical Biochemistry, Aarhus University Hospital, Aarhus N, Denmark
- Department of Clinical Medicine, Health, Aarhus University, Aarhus, Denmark
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Tacquard C, Serrier J, Viville S, Chiriac AM, Franchina S, Gouel-Cheron A, Giraudon A, Le Guen M, Le Quang D, Malinovsky JM, Petitpain N, Demoly P, Mertes PM. Epidemiology of perioperative anaphylaxis in France in 2017-2018: the 11th GERAP survey. Br J Anaesth 2024:S0007-0912(24)00093-X. [PMID: 38493055 DOI: 10.1016/j.bja.2024.01.044] [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] [Received: 11/04/2023] [Revised: 12/21/2023] [Accepted: 01/28/2024] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND Perioperative anaphylaxis is rare but is associated with significant morbidity. This complication has been well described in France by the GERAP (Groupe d'Etude des Réactions Anaphylactiques Périopératoires), a network focused on its study. The epidemiology of perioperative anaphylaxis is evolving, influenced by environmental factors and clinical practice. The aim of this study was to update the epidemiology of perioperative anaphylaxis in France. METHODS This multicentre retrospective study was performed in 26 allergy clinics of the GERAP network in 2017-8. RESULTS There were 765 patients with perioperative anaphylaxis included. Most cases were severe, with 428 (56%) reactions graded as 3 or 4 according to the Ring and Messmer classification. Skin test results were available for 676 patients, with a culprit agent identified in 471 cases (70%). Neuromuscular blocking agents were the main cause of perioperative anaphylaxis (n=281; 60%), followed by antibiotics (n=118; 25%) and patent blue dye (n=11; 2%). Cefazolin was the main antibiotic responsible for perioperative anaphylaxis (52% of antibiotic-related reactions). Suxamethonium and rocuronium were the main neuromuscular blocking agents responsible for perioperative anaphylaxis with 7.1 (6.1-8.4) and 5.6 (4.2-7.4) reactions per 100,000 vials sold, respectively, whereas cefazolin-related cases were estimated at 0.7 (0.5-0.9) reactions per 100,000 vials sold. CONCLUSIONS Our results confirm that most commonly identified triggering agents remain neuromuscular blocking agents. Reactions to antibiotics, particularly cefazolin, are becoming increasingly frequent. The origin of sensitisation to cefazolin is unknown, as no cross-sensitisation has been described, and it should be the subject of further study. Perioperative anaphylaxis should be followed over the years and understood given the changing triggers. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov (NCT04654923).
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Affiliation(s)
- Charles Tacquard
- Department of Anesthesia and Intensive Care, Strasbourg University Hospital, Strasbourg, France.
| | - Julien Serrier
- Department of Immunology and Histocompatibility, Caen University Hospital, Caen, France
| | - Simon Viville
- Department of Anesthesia and Intensive Care, Strasbourg University Hospital, Strasbourg, France
| | - Anca-Mirela Chiriac
- Department of Pulmonology, Division of Allergy, Hôpital Arnaud de Villeneuve, University Hospital of Montpellier, IDESP, University of Montpellier, Montpellier, France
| | - Sébastien Franchina
- Perioperative Allergic Reaction Exploration Unit, Department of Anesthesia and Intensive Care, Rouen University Hospital, Rouen, France
| | - Aurélie Gouel-Cheron
- Paris City University, Paris, France; Department of Anaesthesiology and Critical Care Medicine, Bichat Hospital, AP-HP, Paris, France; Antibody in Therapy and Pathology, Pasteur Institute, INSERM, Paris, France
| | - Antoine Giraudon
- Department of Anesthesiology and Critical Care, Bordeaux University Hospital, Bordeaux, France
| | - Morgan Le Guen
- Department of Anesthesia and Pain Medicine, Université de Versailles Saint-Quentin, Versailles, France
| | - Diane Le Quang
- Department of Anaesthesia and Intensive Care, Lyon Sud University Hospital, Hospices Civils de Lyon, Lyon, France
| | | | - Nadine Petitpain
- Regional Centre of Pharmacovigilance, University Hospital of Nancy, Nancy, France
| | - Pascal Demoly
- Department of Pulmonology, Division of Allergy, Hôpital Arnaud de Villeneuve, University Hospital of Montpellier, IDESP, University of Montpellier, Montpellier, France
| | - Paul M Mertes
- Department of Anesthesia and Intensive Care, Strasbourg University Hospital, Strasbourg, France
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9
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Vinnes EW, Alnaes MB, Storaas T. Serum mast cell tryptase reference intervals in European populations. Clin Exp Allergy 2024; 54:145-147. [PMID: 37963601 DOI: 10.1111/cea.14421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 10/23/2023] [Accepted: 10/26/2023] [Indexed: 11/16/2023]
Affiliation(s)
- Erik Wilhelm Vinnes
- Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Marie Bjørbak Alnaes
- Department of Occupational Medicine, Section for Allergology, Haukeland University Hospital, Bergen, Norway
| | - Torgeir Storaas
- Department of Occupational Medicine, Section for Allergology, Haukeland University Hospital, Bergen, Norway
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10
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Valentini P, Akula S, Alvarado-Vazquez A, Hallgren J, Fu Z, Racicot B, Braasch I, Thorpe M, Hellman L. Extended Cleavage Specificity of two Hematopoietic Serine Proteases from a Ray-Finned Fish, the Spotted Gar ( Lepisosteus oculatus). Int J Mol Sci 2024; 25:1669. [PMID: 38338947 PMCID: PMC10855939 DOI: 10.3390/ijms25031669] [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: 01/03/2024] [Revised: 01/23/2024] [Accepted: 01/26/2024] [Indexed: 02/12/2024] Open
Abstract
The extended cleavage specificities of two hematopoietic serine proteases originating from the ray-finned fish, the spotted gar (Lepisosteus oculatus), have been characterized using substrate phage display. The preference for particular amino acids at and surrounding the cleavage site was further validated using a panel of recombinant substrates. For one of the enzymes, the gar granzyme G, a strict preference for the aromatic amino acid Tyr was observed at the cleavable P1 position. Using a set of recombinant substrates showed that the gar granzyme G had a high selectivity for Tyr but a lower activity for cleaving after Phe but not after Trp. Instead, the second enzyme, gar DDN1, showed a high preference for Leu in the P1 position of substrates. This latter enzyme also showed a high preference for Pro in the P2 position and Arg in both P4 and P5 positions. The selectivity for the two Arg residues in positions P4 and P5 suggests a highly specific substrate selectivity of this enzyme. The screening of the gar proteome with the consensus sequences obtained by substrate phage display for these two proteases resulted in a very diverse set of potential targets. Due to this diversity, a clear candidate for a specific immune function of these two enzymes cannot yet be identified. Antisera developed against the recombinant gar enzymes were used to study their tissue distribution. Tissue sections from juvenile fish showed the expression of both proteases in cells in Peyer's patch-like structures in the intestinal region, indicating they may be expressed in T or NK cells. However, due to the lack of antibodies to specific surface markers in the gar, it has not been possible to specify the exact cellular origin. A marked difference in abundance was observed for the two proteases where gar DDN1 was expressed at higher levels than gar granzyme G. However, both appear to be expressed in the same or similar cells, having a lymphocyte-like appearance.
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Affiliation(s)
- Paolo Valentini
- Department of Cell and Molecular Biology, Uppsala University, P.O. Box 596, SE-751 24 Uppsala, Sweden; (P.V.); (S.A.); (Z.F.); (M.T.)
| | - Srinivas Akula
- Department of Cell and Molecular Biology, Uppsala University, P.O. Box 596, SE-751 24 Uppsala, Sweden; (P.V.); (S.A.); (Z.F.); (M.T.)
| | - Abigail Alvarado-Vazquez
- Department of Medical Biochemistry and Microbiology, Uppsala University Biomedical Centre (BMC), P.O. Box 582, SE-751 23 Uppsala, Sweden; (A.A.-V.); (J.H.)
| | - Jenny Hallgren
- Department of Medical Biochemistry and Microbiology, Uppsala University Biomedical Centre (BMC), P.O. Box 582, SE-751 23 Uppsala, Sweden; (A.A.-V.); (J.H.)
| | - Zhirong Fu
- Department of Cell and Molecular Biology, Uppsala University, P.O. Box 596, SE-751 24 Uppsala, Sweden; (P.V.); (S.A.); (Z.F.); (M.T.)
| | - Brett Racicot
- Department of Integrative Biology, Michigan State University, East Lansing, MI 48825, USA; (B.R.); (I.B.)
| | - Ingo Braasch
- Department of Integrative Biology, Michigan State University, East Lansing, MI 48825, USA; (B.R.); (I.B.)
- Ecology, Evolution and Behavior Program, Michigan State University, East Lansing, MI 48825, USA
| | - Michael Thorpe
- Department of Cell and Molecular Biology, Uppsala University, P.O. Box 596, SE-751 24 Uppsala, Sweden; (P.V.); (S.A.); (Z.F.); (M.T.)
| | - Lars Hellman
- Department of Cell and Molecular Biology, Uppsala University, P.O. Box 596, SE-751 24 Uppsala, Sweden; (P.V.); (S.A.); (Z.F.); (M.T.)
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11
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Carvalho N, Carolino E, Ferreira M, Coelho H, Santos CR, Barreira AL, Henriques S, Cardoso C, Moita L, Costa PM. Tryptase in Acute Appendicitis: Unveiling Allergic Connections through Compelling Evidence. Int J Mol Sci 2024; 25:1645. [PMID: 38338923 PMCID: PMC10855922 DOI: 10.3390/ijms25031645] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 01/23/2024] [Accepted: 01/24/2024] [Indexed: 02/12/2024] Open
Abstract
The aetiology of acute appendicitis (AA), the most frequent abdominal surgical emergency, is still unclarified. Recent epidemiologic, clinical and laboratorial data point to an allergic component in the pathophysiology of AA. Mastocytes participate in the Th2 immune response, releasing inflammatory mediators from their granules upon stimulation by IgE-specific antigens. Among the well-known mediators are histamine, serotonin and tryptase, which are responsible for the clinical manifestations of allergies. We conducted a prospective single-centre study to measure histamine and serotonin (commercial ELISA kit) and tryptase (ImmunoCAP System) concentrations in appendicular lavage fluid (ALF) and serum. Consecutive patients presenting to the emergency department with a clinical diagnosis of AA were enrolled: 22 patients with phlegmonous AA and 24 with gangrenous AA The control group was composed of 14 patients referred for colectomy for colon malignancy. Appendectomy was performed during colectomy. Tryptase levels were strikingly different between histological groups, both in ALF and serum (p < 0.001); ALF levels were higher than serum levels. Tryptase concentrations in ALF were 109 times higher in phlegmonous AA (APA) (796.8 (194.1-980.5) pg/mL) and 114 times higher in gangrenous AA (AGA) (837.4 (272.6-1075.1) pg/mL) than in the control group (7.3 (4.5-10.3) pg/mL. For the diagnosis of AA, the discriminative power of serum tryptase concentration was good (AUC = 0.825), but discriminative power was weak (AUC = 0.559) for the differential diagnosis between APA and AGA. Mastocytes are involved in AA during clinical presentations of both phlegmonous and gangrenous appendicitis, and no significant differences in concentration were found. No differences were found in serum and ALF concentrations of histamine and serotonin between histological groups. Due to their short half-lives, these might have elapsed by the time the samples were collected. In future research, these determinations should be made immediately after appendectomy. Our findings confirm the hypersensitivity type I reaction as an event occurring in the pathogenesis of AA: tryptase levels in ALF and serum were higher among patients with AA when compared to the control group, which is in line with a Th2 immune response and supports the concept of the presence of an allergic reaction in the pathogenesis of acute appendicitis. Our results, if confirmed, may have clinical implications for the treatment of AA.
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Affiliation(s)
- Nuno Carvalho
- Serviço Cirurgia Geral, Hospital Garcia de Orta, 2805-267 Almada, Portugal; (M.F.); (A.L.B.); (S.H.); (P.M.C.)
- Faculdade Medicina, Universidade Lisboa, 1649-028 Lisboa, Portugal
| | - Elisabete Carolino
- H & TRC—Health & Technology Research Centre, ESTeSL—Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, 1549-020 Lisboa, Portugal;
| | - Margarida Ferreira
- Serviço Cirurgia Geral, Hospital Garcia de Orta, 2805-267 Almada, Portugal; (M.F.); (A.L.B.); (S.H.); (P.M.C.)
- Faculdade Medicina, Universidade Lisboa, 1649-028 Lisboa, Portugal
| | - Hélder Coelho
- Serviço de Anatomia Patológica, Hospital Garcia de Orta, 2805-267 Almada, Portugal;
| | - Catarina Rolo Santos
- Serviço de Cirurgia Geral, Hospital de Nossa Senhora do Rosário, 2830-003 Barreiro, Portugal;
| | - Ana Lúcia Barreira
- Serviço Cirurgia Geral, Hospital Garcia de Orta, 2805-267 Almada, Portugal; (M.F.); (A.L.B.); (S.H.); (P.M.C.)
| | - Susana Henriques
- Serviço Cirurgia Geral, Hospital Garcia de Orta, 2805-267 Almada, Portugal; (M.F.); (A.L.B.); (S.H.); (P.M.C.)
| | - Carlos Cardoso
- Dr. Joaquim Chaves Laboratório de Análises Clínicas, 1495-068 Algés, Portugal;
| | - Luís Moita
- Innate Immunity and Inflammation Lab., Instituto Gulbenkian de Ciência Oeiras, 2780-156 Oeiras, Portugal;
- Instituto de Histologia e Biologia do Desenvolvimento, Faculdade Medicina, Universidade Lisboa, 1649-028 Lisboa, Portugal
| | - Paulo Matos Costa
- Serviço Cirurgia Geral, Hospital Garcia de Orta, 2805-267 Almada, Portugal; (M.F.); (A.L.B.); (S.H.); (P.M.C.)
- Faculdade Medicina, Universidade Lisboa, 1649-028 Lisboa, Portugal
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12
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Rydz A, Lange M, Ługowska-Umer H, Sikorska M, Nowicki RJ, Morales-Cabeza C, Alvarez-Twose I. Diffuse Cutaneous Mastocytosis: A Current Understanding of a Rare Disease. Int J Mol Sci 2024; 25:1401. [PMID: 38338679 DOI: 10.3390/ijms25031401] [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: 12/01/2023] [Revised: 01/06/2024] [Accepted: 01/19/2024] [Indexed: 02/12/2024] Open
Abstract
Mastocytosis is a heterogeneous disease characterized by the expansion and accumulation of neoplastic mast cells in various tissues. Diffuse cutaneous mastocytosis (DCM) is a rare and most severe form of cutaneous mastocytosis, which typically occurs in childhood. There have been reports of a familial DCM with specific gene mutations, indicating both sporadic and hereditary factors involved in its pathogenesis. DCM is associated with severe MC mediator-related symptoms and an increased risk of anaphylaxis. The diagnosis is based on the appearance of skin lesions, which typically show generalized thickening, erythroderma, blistering dermographism, and a positive Darier's sign. Recognition, particularly in infants, is challenging due to DCMs resemblance to other bullous skin disorders. Therefore, in unclear cases, a skin biopsy is crucial. Treatment focuses on symptom management, mainly including antihistamines and mast cell stabilizers. In extremely severe cases, systemic steroids, tyrosine kinase inhibitors, phototherapy, or omalizumab may be considered. Patients should be equipped with an adrenaline autoinjector. Herein, we conducted a comprehensive review of literature data on DCM since 1962, which could help to better understand both the management and prognosis of DCM, which depends on the severity of skin lesions, intensity of mediator-related symptoms, presence of anaphylaxis, and treatment response.
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Affiliation(s)
- Agnieszka Rydz
- Student's Scientific Circle Practical and Experimental Dermatology, Medical University of Gdansk, 80-211 Gdańsk, Poland
| | - Magdalena Lange
- Department of Dermatology, Venereology and Allergology, Medical University of Gdańsk, 80-211 Gdańsk, Poland
| | - Hanna Ługowska-Umer
- Department of Dermatology, Venereology and Allergology, Medical University of Gdańsk, 80-211 Gdańsk, Poland
| | - Monika Sikorska
- Department of Dermatology, Venereology and Allergology, Medical University of Gdańsk, 80-211 Gdańsk, Poland
| | - Roman J Nowicki
- Department of Dermatology, Venereology and Allergology, Medical University of Gdańsk, 80-211 Gdańsk, Poland
| | - Cristina Morales-Cabeza
- Instituto de Estudios de Mastocitosis de Castilla-La Mancha (CLMast)-Spanish Reference Center for Mastocytosis, Hospital Virgen del Valle-Complejo Hospitalario Universitario de Toledo, 45071 Toledo, Spain
| | - Iván Alvarez-Twose
- Instituto de Estudios de Mastocitosis de Castilla-La Mancha (CLMast)-Spanish Reference Center for Mastocytosis, Hospital Virgen del Valle-Complejo Hospitalario Universitario de Toledo, 45071 Toledo, Spain
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13
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Chantran Y, Renaudin H, Arock M, Guiddir T, Nemni A. Case Report: A family history of peanut allergy and hereditary alpha- tryptasemia. Front Allergy 2024; 4:1322117. [PMID: 38327735 PMCID: PMC10848325 DOI: 10.3389/falgy.2023.1322117] [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: 10/15/2023] [Accepted: 12/15/2023] [Indexed: 02/09/2024] Open
Abstract
Context Hereditary alpha-tryptasemia (HαT) is associated with elevated basal serum tryptase (bST) and is associated with a higher risk of severe anaphylactic reactions in patients with clonal mast cell disorders or IgE-mediated Hymenoptera venom-induced anaphylaxis. The consequence of this genetic trait remains to be determined in other allergic diseases and food allergy in particular. Objectives Here, we describe three cases of peanut allergy among siblings from a single family of four: two of them were associated with HαT, and the third one was associated with the tryptase wild-type genotype. Methods TPSAB1/TPSB2 genotypes were determined by digital PCR. After the case description, we provided a review of the literature regarding bST levels and tryptase genotypes in anaphylaxis, with a particular focus on food allergy. Results Compared to the sibling with the conventional tryptase genotype, the two siblings with HαT presented a lower peanut threshold at the initial oral food challenge, higher peanut skin prick test reactivity, higher levels of specific IgE to peanut, Ara h 2, and Ara h 6, and a lower IgG4/IgE ratio after 10 years of oral immunotherapy. Conclusion The tryptase genotype and HαT status might modify the clinical presentation and biological features of food allergy.
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Affiliation(s)
- Yannick Chantran
- Molecular Platform for the Analysis of cKIT Mutations and Other Gene Defects, Centre National de Référence des Mastocytoses, Saint-Antoine Hospital, DMU BioGeMH, AP-HP.Sorbonne University, Paris, France
- Department of Biological Immunology, Saint-Antoine Hospital, DMU BioGeMH, AP-HP.Sorbonne University, Paris, France
- Health Environmental Risk Assessment (HERA) Team, Centre of Research in Epidemiology and Statistics (CRESS), Inserm/INRAE, Faculty of Pharmacy, Université Paris Cité, Paris, France
| | - Hélène Renaudin
- Children-Adult Allergology Department, Robert Ballanger Hospital, Aulnay Sous-Bois, France
| | - Michel Arock
- Molecular Platform for the Analysis of cKIT Mutations and Other Gene Defects, Centre National de Référence des Mastocytoses, Saint-Antoine Hospital, DMU BioGeMH, AP-HP.Sorbonne University, Paris, France
- Department of Biological Haematology, Pitié-Salpétrière Hospital, DMU BioGeMH, AP-HP.Sorbonne University, Paris, France
| | - Tamazoust Guiddir
- Pediatric Pulmonology and Allergology Unit, Bicêtre Hospital, AP-HP, Paris-Saclay University, Le Kremlin Bicêtre, France
| | - Ariane Nemni
- Children-Adult Allergology Department, Robert Ballanger Hospital, Aulnay Sous-Bois, France
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14
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de Chaisemartin L, Ciocan D, Gouel-Chéron A, Granger V, Longrois D, Montravers P, Cassard AM, Chollet-Martin S. Circulating microbiome analysis in patients with perioperative anaphylaxis. Front Immunol 2024; 14:1241851. [PMID: 38274796 PMCID: PMC10808669 DOI: 10.3389/fimmu.2023.1241851] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 11/02/2023] [Indexed: 01/27/2024] Open
Abstract
Background Perioperative anaphylaxis is a rare and acute systemic manifestation of drug-induced hypersensitivity reactions that occurs following anesthesia induction; the two main classes of drugs responsible for these reactions being neuromuscular blocking agents (NMBA) and antibiotics. The sensitization mechanisms to the drugs are not precisely known, and few risk factors have been described. A growing body of evidence underlines a link between occurrence of allergy and microbiota composition. However, no data exist on microbiota in perioperative anaphylaxis. The aim of this study was to compare circulating microbiota richness and composition between perioperative anaphylaxis patients and matched controls. Methods Circulating 16s rDNA was quantified and sequenced in serum samples from 20 individuals with fully characterized IgE-mediated NMBA-related anaphylaxis and 20 controls matched on sex, age, NMBA received, type of surgery and infectious status. Microbiota composition was analyzed with a published bioinformatic pipeline and links with patients clinical and biological data investigated. Results Analysis of microbiota diversity showed that anaphylaxis patients seem to have a richer circulating microbiota than controls, but no major differences of composition could be detected with global diversity indexes. Pairwise comparison showed a difference in relative abundance between patients and controls for Saprospiraceae, Enterobacteriaceae, Veillonellaceae, Escherichia-Shigella, Pseudarcicella, Rhodoferax, and Lewinella. Some taxa were associated with concentrations of mast cell tryptase and specific IgE. Conclusion We did not find a global difference in terms of microbiota composition between anaphylaxis patient and controls. However, several taxa were associated with anaphylaxis patients and with their biological data. These findings must be further confirmed in different settings to broaden our understanding of drug anaphylaxis pathophysiology and identify predisposition markers.
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Affiliation(s)
- Luc de Chaisemartin
- AP-HP, Immunology Department, Bichat Hospital, Paris, France
- Université Paris-Saclay, Inserm, Inflammation, Microbiome, Immunosurveillance, Orsay, France
| | - Dragos Ciocan
- Université Paris-Saclay, Inserm, Inflammation, Microbiome, Immunosurveillance, Orsay, France
- AP-HP, Hepatogastroenterology and Nutrition, Hôpital Antoine-Béclère, Clamart, France
| | - Aurélie Gouel-Chéron
- Département d’Anesthésie-Réanimation, CHU Bichat-Claude Bernard, DMU PARABOL, AP-HP.Nord, AP-HP, Paris, France
- Institut Pasteur, Antibodies in Therapy and Pathology, Inserm UMR 1222, Paris, France
- Division of Clinical Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, United States
| | - Vanessa Granger
- AP-HP, Immunology Department, Bichat Hospital, Paris, France
- Université Paris-Saclay, Inserm, Inflammation, Microbiome, Immunosurveillance, Orsay, France
| | - Dan Longrois
- Université de Paris, FHU PROMICE, Paris, France
- Anaesthesiology and Critical Care Medicine Department, DMU PARABOL, Bichat-Claude Bernard and Louis Mourier Hospitals, AP-HP, Paris, France
- INSERM UMR 1148, Atherothrombotic Disease in Heart and Brain, Paris, France
| | - Philippe Montravers
- Département d’Anesthésie-Réanimation, CHU Bichat-Claude Bernard, DMU PARABOL, AP-HP.Nord, AP-HP, Paris, France
- Université Paris Cité, Inserm, PHERE, Paris, France
| | - Anne-Marie Cassard
- Université Paris-Saclay, Inserm, Inflammation, Microbiome, Immunosurveillance, Orsay, France
- Paris Center for Microbiome Medicine (PaCeMM) FHU, Paris, France
| | - Sylvie Chollet-Martin
- AP-HP, Immunology Department, Bichat Hospital, Paris, France
- Université Paris-Saclay, Inserm, Inflammation, Microbiome, Immunosurveillance, Orsay, France
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15
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Forzese E, Pitrone C, Cianci V, Sapienza D, Ieni A, Tornese L, Cianci A, Gualniera P, Asmundo A, Mondello C. An Insight into Kounis Syndrome: Bridging Clinical Knowledge with Forensic Perspectives. Life (Basel) 2024; 14:91. [PMID: 38255706 PMCID: PMC10817466 DOI: 10.3390/life14010091] [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] [Received: 11/29/2023] [Revised: 01/02/2024] [Accepted: 01/04/2024] [Indexed: 01/24/2024] Open
Abstract
Kounis syndrome (KS) is an acute coronary syndrome triggered by allergic or hypersensitivity reactions. Incidence rates vary, with studies reporting 19.4 per 100.000 among all admissions and 3.4% among allergy patients. This review explores the expanding understanding of KS, encompassing various manifestations, and focusing on both clinical data and forensic findings useful in performing a diagnosis. The pathophysiology of this syndrome involves a complex interplay between allergic reactions and the cardiovascular system. Mast cell activation, histamine release, leukotrienes, cytokines, and platelet activation can contribute to coronary events. Three types of classification systems (allergic angina, allergic myocardial infarction, allergic stent thrombosis) aid in categorizing presentations. The diagnosis of KS relies on clinical presentation, laboratory findings, and imaging. Postmortem assessment of KS is based on the integration of circumstantial data, autopsy, and histological findings. Biochemical and immunohistochemical analyses also contribute to postmortem diagnosis. In conclusion, a combined, multidisciplinary approach should be used to ease the diagnostic process, which is crucial for forensic practitioners in confirming KS occurrence.
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Affiliation(s)
- Elena Forzese
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Via Consolare Valeria 1, 98125 Messina, Italy; (E.F.); (C.P.); (D.S.); (L.T.); (P.G.); (C.M.)
| | - Claudia Pitrone
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Via Consolare Valeria 1, 98125 Messina, Italy; (E.F.); (C.P.); (D.S.); (L.T.); (P.G.); (C.M.)
| | - Vincenzo Cianci
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Via Consolare Valeria 1, 98125 Messina, Italy; (E.F.); (C.P.); (D.S.); (L.T.); (P.G.); (C.M.)
| | - Daniela Sapienza
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Via Consolare Valeria 1, 98125 Messina, Italy; (E.F.); (C.P.); (D.S.); (L.T.); (P.G.); (C.M.)
| | - Antonio Ieni
- Department of Human Pathology in Adult and Developmental Age “Gaetano Barresi”, Section of Pathology, University of Messina, 98125 Messina, Italy;
| | - Lorenzo Tornese
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Via Consolare Valeria 1, 98125 Messina, Italy; (E.F.); (C.P.); (D.S.); (L.T.); (P.G.); (C.M.)
| | - Alessio Cianci
- Department of Cardiovascular Medicine, Fondazione Policlinico Universitario A. Gemelli—IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy;
| | - Patrizia Gualniera
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Via Consolare Valeria 1, 98125 Messina, Italy; (E.F.); (C.P.); (D.S.); (L.T.); (P.G.); (C.M.)
| | - Alessio Asmundo
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Via Consolare Valeria 1, 98125 Messina, Italy; (E.F.); (C.P.); (D.S.); (L.T.); (P.G.); (C.M.)
| | - Cristina Mondello
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Via Consolare Valeria 1, 98125 Messina, Italy; (E.F.); (C.P.); (D.S.); (L.T.); (P.G.); (C.M.)
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16
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Akula S, Tripathi SR, Franke K, Wernersson S, Babina M, Hellman L. Cultures of Human Skin Mast Cells, an Attractive In Vitro Model for Studies of Human Mast Cell Biology. Cells 2024; 13:98. [PMID: 38201301 PMCID: PMC10778182 DOI: 10.3390/cells13010098] [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: 11/24/2023] [Revised: 12/21/2023] [Accepted: 12/27/2023] [Indexed: 01/12/2024] Open
Abstract
Studies of mast cell biology are dependent on relevant and validated in vitro models. Here, we present detailed information concerning the phenotype of both freshly isolated human skin mast cells (MCs) and of in vitro cultures of these cells that were obtained by analyzing their total transcriptome. Transcript levels of MC-related granule proteins and transcription factors were found to be remarkably stable over a 3-week culture period. Relatively modest changes were also seen for important cell surface receptors including the high-affinity receptor for IgE, FCER1A, the low-affinity receptor for IgG, FCGR2A, and the receptor for stem cell factor, KIT. FCGR2A was the only Fc receptor for IgG expressed by these cells. The IgE receptor increased by 2-5-fold and an approximately 10-fold reduction in the expression of FCGR2A was observed most likely due to the cytokines, SCF and IL-4, used for expanding the cells. Comparisons of the present transcriptome against previously reported transcriptomes of mouse peritoneal MCs and mouse bone marrow-derived MCs (BMMCs) revealed both similarities and major differences. Strikingly, cathepsin G was the most highly expressed granule protease in human skin MCs, in contrast to the almost total absence of this protease in both mouse MCs. Transcript levels for the majority of cell surface receptors were also very low compared to the granule proteases in both mouse and human MCs, with a difference of almost two orders of magnitude. An almost total absence of T-cell granzymes was observed in human skin MCs, indicating that granzymes have no or only a minor role in human MC biology. Ex vivo skin MCs expressed high levels of selective immediate early genes and transcripts of heat shock proteins. In validation experiments, we determined that this expression was an inherent property of the cells and not the result of the isolation process. Three to four weeks in culture results in an induction of cell growth-related genes accompanying their expansion by 6-10-fold, which increases the number of cells for in vitro experiments. Collectively, we show that cultured human skin MCs resemble their ex vivo equivalents in many respects and are a more relevant in vitro model compared to mouse BMMCs for studies of MC biology, in particular human MC biology.
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Affiliation(s)
- Srinivas Akula
- Department of Cell and Molecular Biology, Uppsala University, The Biomedical Center, Box 596, SE-75124 Uppsala, Sweden;
- Department of Anatomy, Physiology, and Biochemistry, Swedish University of Agricultural Sciences, Box 7011, SE-75007 Uppsala, Sweden;
| | - Shiva Raj Tripathi
- Institute of Allergology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Hindenburgdamm 30, 12203 Berlin, Germany; (S.R.T.); (K.F.)
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology IA, Hindenburgdamm 30, 12203 Berlin, Germany
| | - Kristin Franke
- Institute of Allergology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Hindenburgdamm 30, 12203 Berlin, Germany; (S.R.T.); (K.F.)
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology IA, Hindenburgdamm 30, 12203 Berlin, Germany
| | - Sara Wernersson
- Department of Anatomy, Physiology, and Biochemistry, Swedish University of Agricultural Sciences, Box 7011, SE-75007 Uppsala, Sweden;
| | - Magda Babina
- Institute of Allergology, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Hindenburgdamm 30, 12203 Berlin, Germany; (S.R.T.); (K.F.)
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology and Allergology IA, Hindenburgdamm 30, 12203 Berlin, Germany
| | - Lars Hellman
- Department of Cell and Molecular Biology, Uppsala University, The Biomedical Center, Box 596, SE-75124 Uppsala, Sweden;
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17
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Fukaura A, Numata T, Chiyotanda M, Maeda T, Egusa C, Ito T, Harada K, Okubo Y. [MACULOPAPULAR CUTANEOUS MASTOCYTOSIS HARBORING A KIT MUTATION (ASP419DEL): A CASE REPORT]. Arerugi 2024; 73:189-195. [PMID: 38522933 DOI: 10.15036/arerugi.73.189] [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] [Subscribe] [Scholar Register] [Indexed: 03/26/2024]
Abstract
A 2-year-old, male patient presented with an 18-month history of scattered, brown macules and nodules up to 2 cm in size on his trunk and extremities. These macules were accompanied by pruritus and were positive for Darier's sign. A skin biopsy of a brown macule on the left thigh revealed a dense accumulation of CD117-positive, round or oval cells with amphophilic cytoplasm within the upper to middle dermis. The patient was otherwise healthy and had normal laboratory and imaging test results. Sequence analysis of genomic DNA from a skin biopsy demonstrated the presence of an Asp419del mutation in exon 8 of the KIT gene. Based on these findings, maculopapular cutaneous mastocytosis (MPCM) was diagnosed. The patient received H 1-antihistamine. Although the pruritus resolved, the brown macules remained for one year after the initial treatment. To the best of our knowledge, only three cases of cutaneous mastocytosis (CM) with an Asp419del mutation, including the present case, have been reported in the Japanese literature to date; moreover, while the previous two cases were of DCM, the present case was the first instance of MPCM. Normally, the symptoms of childhood-onset MPCM are dormant until puberty. However, a recent study reported that many MPCM patients may experience persistent or exacerbated symptoms. The present study therefore evaluated 53 Japanese cases of childhood onset MPCM with a KIT gene mutation and discussed the patients' clinical outcomes.
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Affiliation(s)
| | | | - Masako Chiyotanda
- Department of Pediatrics and Adolescent Medicine, Tokyo Medical University
| | - Tatsuo Maeda
- Department of Dermatology, Tokyo Medical University
| | - Chizu Egusa
- Department of Dermatology, Tokyo Medical University
| | - Tomonobu Ito
- Department of Dermatology, Tokyo Medical University
| | | | - Yukari Okubo
- Department of Dermatology, Tokyo Medical University
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18
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Kupriyanov DD, Fedulova MV. [Detection of some markers of the early phase of the inflammatory and reparative process in mechanical skin injuries]. Sud Med Ekspert 2024; 67:17-19. [PMID: 38587153 DOI: 10.17116/sudmed20246702117] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Abstract
OBJECTIVE To examine the applicability of IHC staining method: with TGF-β1 antibodies (serial examination, statistically processed results) and with mast cell tryptase antibodies for injuries vitality determination. MATERIAL AND METHODS 261 skin autopsy samples with mechanical injuries from 29 persons were divided to 3 groups (87 in each group): vital injuries, postmortal injuries, control non-injured samples. A routine histological examination using standard H&E stain and IHC both with TGF-β1 and mast cells tryptase antibodies was performed. RESULTS AND CONCLUSION The positive TGF-β1 staining (score 2-3) was found in keratinocytes in vitally injured skin and the negative or weak one (score 0-1) was found in control postmortally injured and non-injured samples. Additionally, dermal TGF-β1 expression was found in some vitally injured skin samples. The difference between vitally injured skin and control samples was statistically significant (p<0.05). No significant difference of dermal mast cells density in groups 1, 2, 3 was found.
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Affiliation(s)
- D D Kupriyanov
- Russian Center for Forensic Medical Expertise, Moscow, Russia
| | - M V Fedulova
- Russian Center for Forensic Medical Expertise, Moscow, Russia
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19
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Rosell A, Karlström C, Dahlin JS, Boey D, Klimkowska M, Ax K, Thålin C, Ungerstedt J. No indication of aberrant neutrophil extracellular trap release in indolent or advanced systemic mastocytosis. Scand J Immunol 2024; 99:e13333. [PMID: 38112220 DOI: 10.1111/sji.13333] [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: 05/28/2023] [Revised: 09/13/2023] [Accepted: 09/16/2023] [Indexed: 12/21/2023]
Abstract
In disease states with chronic inflammation, there is a crosstalk between mast cells and neutrophil granulocytes in the inflamed microenvironment, which may be potentiated by tryptase. In systemic mastocytosis (SM), mast cells are constitutively active and tryptase is elevated in blood. Mast cell activation in SM leads to symptoms from various organs depending on where the active mast cells reside, for example, palpitations, flush, allergic symptoms including anaphylactic reactions, and osteoporosis. Whether neutrophil function is altered in SM is not well understood. In the current study, we assessed nucleosomal citrullinated histone H3 (H3Cit-DNA) as a proxy for neutrophil extracellular trap release in plasma from 55 patients with indolent and advanced SM. We observed a strong trend towards a correlation between leukocyte count, eosinophil count and neutrophil count and H3Cit-DNA levels in patients with advanced SM but not in indolent SM; however, no differences in H3Cit-DNA levels in SM patients compared with healthy controls. H3Cit-DNA levels did not correlate with SM disease burden, tryptase levels, history of anaphylaxis or presence of cutaneous mastocytosis; thus, there is no evidence of a general neutrophil extracellular trap release in SM. Interestingly, H3Cit-DNA levels and leukocyte counts were elevated in a subgroup of SM patients with aberrant mast cell CD2 expression, which warrants further investigation. In conclusion, we found no evidence of global increase in neutrophil extracellular trap release in SM.
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Affiliation(s)
- Axel Rosell
- Center for Hematology and Regenerative Medicine (HERM), NEO, Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden
- Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden
- ME Hematology, Karolinska University Hospital, Stockholm, Sweden
| | - Cecilia Karlström
- Center for Hematology and Regenerative Medicine (HERM), NEO, Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden
- ME Hematology, Karolinska University Hospital, Stockholm, Sweden
| | - Joakim S Dahlin
- Center for Molecular Medicine, Department of Medicine Solna, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Daryl Boey
- Center for Molecular Medicine, Department of Medicine Solna, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Monika Klimkowska
- Pathology Unit, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Clinical Pathology and Cytology, Karolinska University Hospital, Stockholm, Sweden
| | - Kajsa Ax
- Center for Hematology and Regenerative Medicine (HERM), NEO, Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - Charlotte Thålin
- Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Johanna Ungerstedt
- Center for Hematology and Regenerative Medicine (HERM), NEO, Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden
- ME Hematology, Karolinska University Hospital, Stockholm, Sweden
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20
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Thorpe M, Akula S, Fu Z, Hellman L. The Extended Cleavage Specificity of Channel Catfish Granzyme-like II, A Highly Specific Elastase, Expressed by Natural Killer-like Cells. Int J Mol Sci 2023; 25:356. [PMID: 38203526 PMCID: PMC10778636 DOI: 10.3390/ijms25010356] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 12/20/2023] [Accepted: 12/21/2023] [Indexed: 01/12/2024] Open
Abstract
The extended cleavage specificity of catfish granzyme-like II has been characterized using substrate phage display. The preference for particular amino acids at and surrounding the cleavage site was further validated by using a panel of recombinant substrates. This serine protease, which has previously been isolated as cDNA from a catfish natural killer-like cell line showed a preference for Ala in the P1 position of the substrate, and for multiple basic amino acids N-terminally of the cleavage site. A closely related zebrafish serine protease (zebrafish esterase-like) showed a very similar cleavage specificity, indicating an evolutionary conservation of this protease specificity among various fish species. Two catfish serine proteases, originating from NK-like cells, have now been isolated and characterized. One of them is highly specific met-ase with similar characteristics as the mammalian granzyme M. This enzyme may be involved in the induction of apoptosis in virus-infected cells, with a potential target in (catfish) caspase 6. In contrast to catfish granzyme-like I, the second enzyme analyzed here does not seem to have a direct counterpart in mammalian NK cells, and its role in the immune function of catfish NK cells is, therefore, still not known. However, this enzyme seems to be able to cleave a number of cytoskeletal proteins, indicating a separate strategy to induce apoptosis in target cells. Both of these enzymes are very interesting targets for further studies of their roles in catfish immunity, as enzymes with similar specificities have also been identified in zebrafish.
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Affiliation(s)
| | | | | | - Lars Hellman
- Department of Cell and Molecular Biology, Uppsala University, Box 596, SE-751 24 Uppsala, Sweden; (M.T.); (S.A.); (Z.F.)
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21
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Li Y, Di C, Song S, Zhang Y, Lu Y, Liao J, Lei B, Zhong J, Guo K, Zhang N, Su S. Choroid plexus mast cells drive tumor-associated hydrocephalus. Cell 2023; 186:5719-5738.e28. [PMID: 38056463 DOI: 10.1016/j.cell.2023.11.001] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Revised: 09/04/2023] [Accepted: 11/01/2023] [Indexed: 12/08/2023]
Abstract
Tumor-associated hydrocephalus (TAH) is a common and lethal complication of brain metastases. Although other factors beyond mechanical obstructions have been suggested, the exact mechanisms are unknown. Using single-nucleus RNA sequencing and spatial transcriptomics, we find that a distinct population of mast cells locate in the choroid plexus and dramatically increase during TAH. Genetic fate tracing and intracranial mast-cell-specific tryptase knockout showed that choroid plexus mast cells (CPMCs) disrupt cilia of choroid plexus epithelia via the tryptase-PAR2-FoxJ1 pathway and consequently increase cerebrospinal fluid production. Mast cells are also found in the human choroid plexus. Levels of tryptase in cerebrospinal fluid are closely associated with clinical severity of TAH. BMS-262084, an inhibitor of tryptase, can cross the blood-brain barrier, inhibit TAH in vivo, and alleviate mast-cell-induced damage of epithelial cilia in a human pluripotent stem-cell-derived choroid plexus organoid model. Collectively, we uncover the function of CPMCs and provide an attractive therapy for TAH.
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Affiliation(s)
- Yiye Li
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Medical Research Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou 510120, China; Breast Tumor Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou 510120, China
| | - Can Di
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Medical Research Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou 510120, China; Breast Tumor Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou 510120, China
| | - Shijian Song
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Medical Research Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou 510120, China; Breast Tumor Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou 510120, China
| | - Yubo Zhang
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Medical Research Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou 510120, China; Breast Tumor Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou 510120, China
| | - Yiwen Lu
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Medical Research Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou 510120, China; Breast Tumor Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou 510120, China
| | - Jianyou Liao
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Medical Research Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou 510120, China
| | - Bingxi Lei
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Medical Research Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou 510120, China; Department of Neurosurgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou 510120, China
| | - Jian Zhong
- Department of Neurosurgery, The First Affiliated Hospital of Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Brain Function and Disease, Guangdong Translational Medicine Innovation Platform, Guangzhou 510080, China
| | - Kaihua Guo
- Department of Anatomy and Physiology, Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou 510080, China
| | - Nu Zhang
- Department of Neurosurgery, The First Affiliated Hospital of Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Brain Function and Disease, Guangdong Translational Medicine Innovation Platform, Guangzhou 510080, China; Department of Anatomy and Physiology, Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou 510080, China
| | - Shicheng Su
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Medical Research Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou 510120, China; Breast Tumor Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou 510120, China; Department of Immunology and Microbiology, Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou 510080, China; Biotherapy Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou 510120, China.
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22
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Beyens M, Toscano A, Ebo D, Gülen T, Sabato V. Diagnostic Significance of Tryptase for Suspected Mast Cell Disorders. Diagnostics (Basel) 2023; 13:3662. [PMID: 38132246 PMCID: PMC10742504 DOI: 10.3390/diagnostics13243662] [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: 11/13/2023] [Revised: 12/11/2023] [Accepted: 12/12/2023] [Indexed: 12/23/2023] Open
Abstract
Tryptase has proven to be a very useful and specific marker to demonstrate mast cell activation and degranulation when an acute (i.e., within 4 h after the event) and baseline value (i.e., at least 24 h after the event) are compared and meet the consensus formula (i.e., an increase of 20% + 2). The upper limit of normal determined by the manufacturer is 11.4 ng/mL; however, this boundary has been the subject of debate. According to ECNM and AIM experts, the normal range of baseline tryptase should be 1 to 15 ng/mL. A genetic trait, hereditary alpha tryptasemia, characterized by an increased alpha coding TPSAB1 copy number is associated with a baseline value above 8 ng/mL. Elevated tryptase can also be found in chronic kidney disease, obesity, and hematological neoplasms. A tryptase > 20 ng/mL serves as a minor criterion to diagnose systemic mastocytosis and an increase in tryptase > 20% + 2 during an acute event is a required criterion in the diagnosis of mast cell activation syndrome. The goal of this review is to demonstrate the (in)significance of tryptase using some clinical vignettes and to provide a practical guide on how to manage and interpret an elevated tryptase level.
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Affiliation(s)
- Michiel Beyens
- Faculty of Medicine and Health Sciences, Department of Immunology, Allergology and Rheumatology, Infla-Med Centre of Excellence, University of Antwerp, 2610 Antwerp, Belgium (A.T.); (V.S.)
- Department of Immunology, Allergology and Rheumatology, University Hospital Antwerp, 2610 Antwerp, Belgium
| | - Alessandro Toscano
- Faculty of Medicine and Health Sciences, Department of Immunology, Allergology and Rheumatology, Infla-Med Centre of Excellence, University of Antwerp, 2610 Antwerp, Belgium (A.T.); (V.S.)
- Department of Immunology, Allergology and Rheumatology, University Hospital Antwerp, 2610 Antwerp, Belgium
| | - Didier Ebo
- Faculty of Medicine and Health Sciences, Department of Immunology, Allergology and Rheumatology, Infla-Med Centre of Excellence, University of Antwerp, 2610 Antwerp, Belgium (A.T.); (V.S.)
- Department of Immunology, Allergology and Rheumatology, University Hospital Antwerp, 2610 Antwerp, Belgium
- Department of Immunology and Allergology, AZ Jan Palfijn Gent, 9000 Ghent, Belgium
| | - Theo Gülen
- Department of Respiratory Medicine and Allergy, K85, Karolinska University Hospital Huddinge, SE-14186 Stockholm, Sweden;
- Department of Medicine Solna, Division of Immunology and Allergy, Karolinska Institutet, SE-17177 Stockholm, Sweden
| | - Vito Sabato
- Faculty of Medicine and Health Sciences, Department of Immunology, Allergology and Rheumatology, Infla-Med Centre of Excellence, University of Antwerp, 2610 Antwerp, Belgium (A.T.); (V.S.)
- Department of Immunology, Allergology and Rheumatology, University Hospital Antwerp, 2610 Antwerp, Belgium
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23
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Cernova J, Patel M, Ligaj M, Goldsmith P, Dhoat S, O'Toole E, Atkar R. Large Congenital Cutaneous Mastocytoma Presenting With Recurrent Persistent Blistering: A Case Report. Cureus 2023; 15:e50306. [PMID: 38205464 PMCID: PMC10777259 DOI: 10.7759/cureus.50306] [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] [Accepted: 12/07/2023] [Indexed: 01/12/2024] Open
Abstract
Congenital cutaneous mastocytoma is an uncommon disorder characterized by abnormal proliferation of mast cells. It typically presents as a single, small, yellowish-brown plaque, and its diagnosis is generally facilitated by distinctive clinical features, including a positive Darrier's sign. This report presents a case of an unusually large, solitary congenital mastocytoma encompassing nearly the entire circumference of the calf, observed in a newborn boy of Bangladeshi origin. Measuring 13x6 cm, the lesion formed large bullae and subsequent erosions. The perplexing clinical appearance prompted a skin biopsy, revealing monomorphic CD117 (c-KIT) positive infiltration without significant cell pleomorphism, confirming the diagnosis of cutaneous mastocytoma. The patient underwent management with potent and very potent topical steroids, oral antihistamines, and non-adhesive dressings, remaining under long-term follow-up with secondary care dermatology. In reporting this case, our objective is to augment the existing scientific literature by providing additional evidence that cutaneous mastocytomas can display a spectrum of clinical presentations, as illustrated in this case.
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Affiliation(s)
- Jeva Cernova
- Dermatology, Barts Health NHS Trust, London, GBR
| | | | - Marcin Ligaj
- Histopathology, Barts Health NHS Trust, London, GBR
| | | | - Sasha Dhoat
- Dermatology, Barts Health NHS Trust, London, GBR
| | - Edel O'Toole
- Dermatology, Barts Health NHS Trust, London, GBR
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24
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Kuropatkina T, Atiakshin D, Sychev F, Artemieva M, Samoilenko T, Gerasimova O, Shishkina V, Gufranov K, Medvedeva N, LeBaron TW, Medvedev O. Hydrogen Inhalation Reduces Lung Inflammation and Blood Pressure in the Experimental Model of Pulmonary Hypertension in Rats. Biomedicines 2023; 11:3141. [PMID: 38137362 PMCID: PMC10740706 DOI: 10.3390/biomedicines11123141] [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: 10/11/2023] [Revised: 11/16/2023] [Accepted: 11/22/2023] [Indexed: 12/24/2023] Open
Abstract
Hydrogen has been shown to exhibit selective antioxidant properties against hydroxyl radicals, and exerts antioxidant and anti-inflammatory effects. The monocrotaline-induced model of pulmonary hypertension is suitable for studying substances with antioxidant activity because oxidative stress is induced by monocrotaline. On day 1, male Wistar rats were subcutaneously injected with a water-alcohol solution of monocrotaline or a control with an only water-alcohol solution. One group of monocrotaline-injected animals was placed in a plastic box that was constantly ventilated with atmospheric air containing 4% of molecular hydrogen, and the two groups of rats, injected with monocrotaline or vehicle, were placed in boxes ventilated with atmospheric air. After 21 days, hemodynamic parameters were measured under urethane narcosis. The results showed that, although hydrogen inhalation had no effect on the main markers of pulmonary hypertension induced by monocrotaline injection, there was a reduction in systemic blood pressure due to its systolic component, and a decrease in TGF-β expression, as well as a reduction in tryptase-containing mast cells.
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Affiliation(s)
- Tatyana Kuropatkina
- Department of Pharmacology, Faculty of Medicine, Lomonosov Moscow State University, Lomonosovsky Prospect 27-1, 119991 Moscow, Russia; (T.K.); (M.A.); (K.G.)
| | - Dmitrii Atiakshin
- Research Institute of Experimental Biology and Medicine, N.N. Burdenko Voronezh State Medical University, Moskovsky Prispect, 185, 394066 Voronezh, Russia; (D.A.); (T.S.); (O.G.)
- Research and Educational Center for Immunophenotyping, Digital Spatial Profiling and Ultrastructural Analysis Innovative Technologies, People’s Frendship University of Russia, Miklukho-Maklaya St. 6, 117198 Moscow, Russia
| | - Fedor Sychev
- Faculty of Biology, Lomonosov Moscow State University, Leninskie Gory 1-12, 119234 Moscow, Russia; (F.S.); (N.M.)
| | - Marina Artemieva
- Department of Pharmacology, Faculty of Medicine, Lomonosov Moscow State University, Lomonosovsky Prospect 27-1, 119991 Moscow, Russia; (T.K.); (M.A.); (K.G.)
- Faculty of Biology, Lomonosov Moscow State University, Leninskie Gory 1-12, 119234 Moscow, Russia; (F.S.); (N.M.)
| | - Tatyana Samoilenko
- Research Institute of Experimental Biology and Medicine, N.N. Burdenko Voronezh State Medical University, Moskovsky Prispect, 185, 394066 Voronezh, Russia; (D.A.); (T.S.); (O.G.)
| | - Olga Gerasimova
- Research Institute of Experimental Biology and Medicine, N.N. Burdenko Voronezh State Medical University, Moskovsky Prispect, 185, 394066 Voronezh, Russia; (D.A.); (T.S.); (O.G.)
| | - Viktoriya Shishkina
- Research Institute of Experimental Biology and Medicine, N.N. Burdenko Voronezh State Medical University, Moskovsky Prispect, 185, 394066 Voronezh, Russia; (D.A.); (T.S.); (O.G.)
| | - Khaydar Gufranov
- Department of Pharmacology, Faculty of Medicine, Lomonosov Moscow State University, Lomonosovsky Prospect 27-1, 119991 Moscow, Russia; (T.K.); (M.A.); (K.G.)
| | - Natalia Medvedeva
- Faculty of Biology, Lomonosov Moscow State University, Leninskie Gory 1-12, 119234 Moscow, Russia; (F.S.); (N.M.)
| | - Tyler W. LeBaron
- Department of Kinesiology and Outdoor Recreation, Southern Utah University, Cedar City, UT 84720, USA;
- Molecular Hydrogen Institute, Cedar City, UT 84720, USA
| | - Oleg Medvedev
- Department of Pharmacology, Faculty of Medicine, Lomonosov Moscow State University, Lomonosovsky Prospect 27-1, 119991 Moscow, Russia; (T.K.); (M.A.); (K.G.)
- Laboratory of Experimental Pharmacology, National Medical Research Center of Cardiology Named after Accademician Chazov E.I., Akademika Chazova St. 15a, 121552 Moscow, Russia
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25
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Lee S, Park J, Kim NH, Hong H, Sohn KH, Kang HY, Kim MK, You AH. Remimazolam Anaphylaxis during Induction of General Anesthesia Confirmed by Provocation Test-A Case Report and Literature Review. Medicina (Kaunas) 2023; 59:1915. [PMID: 38003965 PMCID: PMC10673581 DOI: 10.3390/medicina59111915] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 10/26/2023] [Accepted: 10/28/2023] [Indexed: 11/26/2023]
Abstract
Background: Remimazolam besylate, a newly developed drug, is linked to various anaphylaxis cases. We present a case of remimazolam anaphylaxis confirmed using a provocation test. Case: A 51-year-old female patient was scheduled for humeral pinning. General anesthesia was induced using remimazolam, rocuronium, and remifentanil. After tracheal intubation, the patient experienced decreased blood pressure, increased heart rate, and a systemic rash. Epinephrine was administered repeatedly, and the patient's vital signs stabilized. Acute phase tryptase levels were within normal limits. After four weeks, intradermal test results were negative. When remimazolam was administered intravenously for the provocation test, facial swelling, flushing, and coughing occurred, which improved with epinephrine. The culprit drug was identified as remimazolam using a provocation test. Conclusions: When anaphylaxis occurs during anesthesia induction, remimazolam should not be ruled out as the causative drug. If the skin test result for remimazolam is negative, a provocation test should be considered. The provocation test should be initiated cautiously at a low dose under careful patient monitoring.
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Affiliation(s)
- Sangho Lee
- Department of Anesthesiology and Pain Medicine, Kyung Hee University College of Medicine, Kyung Hee University Hospital, Seoul 02447, Republic of Korea; (S.L.); (J.P.); (N.H.K.); (H.H.); (H.Y.K.); (M.K.K.)
| | - Joyoung Park
- Department of Anesthesiology and Pain Medicine, Kyung Hee University College of Medicine, Kyung Hee University Hospital, Seoul 02447, Republic of Korea; (S.L.); (J.P.); (N.H.K.); (H.H.); (H.Y.K.); (M.K.K.)
| | - Na Hei Kim
- Department of Anesthesiology and Pain Medicine, Kyung Hee University College of Medicine, Kyung Hee University Hospital, Seoul 02447, Republic of Korea; (S.L.); (J.P.); (N.H.K.); (H.H.); (H.Y.K.); (M.K.K.)
| | - Halin Hong
- Department of Anesthesiology and Pain Medicine, Kyung Hee University College of Medicine, Kyung Hee University Hospital, Seoul 02447, Republic of Korea; (S.L.); (J.P.); (N.H.K.); (H.H.); (H.Y.K.); (M.K.K.)
| | - Kyoung Hee Sohn
- Division of Pulmonary and Allergy, Department of Internal Medicine, Kyung Hee University Hospital, Seoul 02447, Republic of Korea
| | - Hee Yong Kang
- Department of Anesthesiology and Pain Medicine, Kyung Hee University College of Medicine, Kyung Hee University Hospital, Seoul 02447, Republic of Korea; (S.L.); (J.P.); (N.H.K.); (H.H.); (H.Y.K.); (M.K.K.)
| | - Mi Kyeong Kim
- Department of Anesthesiology and Pain Medicine, Kyung Hee University College of Medicine, Kyung Hee University Hospital, Seoul 02447, Republic of Korea; (S.L.); (J.P.); (N.H.K.); (H.H.); (H.Y.K.); (M.K.K.)
| | - Ann Hee You
- Department of Anesthesiology and Pain Medicine, Kyung Hee University College of Medicine, Kyung Hee University Hospital, Seoul 02447, Republic of Korea; (S.L.); (J.P.); (N.H.K.); (H.H.); (H.Y.K.); (M.K.K.)
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26
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Gülen T. A Puzzling Mast Cell Trilogy: Anaphylaxis, MCAS, and Mastocytosis. Diagnostics (Basel) 2023; 13:3307. [PMID: 37958203 PMCID: PMC10647312 DOI: 10.3390/diagnostics13213307] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 09/18/2023] [Revised: 10/10/2023] [Accepted: 10/12/2023] [Indexed: 11/15/2023] Open
Abstract
Our knowledge of biology and mast cell (MC) function, as well as disorders associated with the pathologic activation of MCs, has evolved over the last few decades. Anaphylaxis, mast cell activation syndrome (MCAS), and mastocytosis are interrelated yet distinct conditions within the spectrum of mast cell activation disorders. Nevertheless, all three conditions can co-exist in one and the same patient, as pathologic MC activation is the key finding in all three. When mediator release is excessive and involves multiple systems, anaphylaxis and MCAS may occur. Furthermore, mastocytosis is a clonal disorder of MCs and often presents with anaphylaxis and MCAS. Nevertheless, in some cases, even the proliferative and accumulative features of MCs in mastocytosis can account for symptoms and disease progression. In each case, diagnosis can be only made when the diagnostic consensus criteria are fulfilled. The current article aims to provide a concise clinical update and pinpoint the main difficulties in diagnosing these puzzling disorders of MCs in medical practice.
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Affiliation(s)
- Theo Gülen
- Department of Respiratory Medicine and Allergy, Karolinska University Hospital Huddinge, 141 86 Stockholm, Sweden;
- Department of Medicine Solna, Division of Immunology and Allergy, Karolinska Institutet, 171 77 Stockholm, Sweden
- Department of Medicine Huddinge, Karolinska Institutet, 141 52 Stockholm, Sweden
- Mastocytosis Centre Karolinska, Karolinska University Hospital Huddinge, 141 86 Stockholm, Sweden
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27
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Alimohammadi S, Masuda-Kuroki K, Szöllősi AG, Di Nardo A. Factors Influencing Marker Expressions of Cultured Human Cord Blood-Derived Mast Cells. Int J Mol Sci 2023; 24:14891. [PMID: 37834338 PMCID: PMC10573221 DOI: 10.3390/ijms241914891] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 09/02/2023] [Revised: 09/25/2023] [Accepted: 09/29/2023] [Indexed: 10/15/2023] Open
Abstract
Mast cells (MCs) are tissue-resident immune cells of a hematopoietic origin that play vital roles in innate and adaptive immunity. Human MCs can be isolated and differentiated from various tissue sources, including cord blood, when supplemented with cytokines such as stem cell factor, interleukin 3, and interleukin 6. Our current research study has shown significant differences in the marker expressions of human cord blood-derived mast cells (hCBMCs) based on donor dependency and the type of medium used for culturing and differentiation. These findings are particularly relevant given the challenges of obtaining specialty media influencing MC phenotypic marker expressions. We found that hCBMCs cultured in StemSpanTM-XF medium had a moderate expression of mast/stem cell growth factor receptor Kit (c-KIT) (mRNA and protein), low expressions of FcεRI (mRNA) and TLR2 (mRNA and protein) but had high levels of MRGPRX2 (mRNA and protein) expressions. In contrast, hCBMCs cultured in Stem Line II medium expressed FcεRI and TLR2 (mRNA and protein) with higher c-KIT but had lower MRGPRX2 expressions compared to the hCBMCs cultured in the StemSpanTM-XF medium. These results suggest that it is crucial to consider both donor dependency and the medium when investigating MC functions and that further research is needed to fully understand the impact of these factors on the hCBMC marker expressions.
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Affiliation(s)
- Shahrzad Alimohammadi
- Department of Dermatology, School of Medicine, University of California San Diego, La Jolla, CA 92037, USA; (S.A.); (K.M.-K.)
- Doctoral School of Molecular Medicine, University of Debrecen, 4032 Debrecen, Hungary;
| | - Kana Masuda-Kuroki
- Department of Dermatology, School of Medicine, University of California San Diego, La Jolla, CA 92037, USA; (S.A.); (K.M.-K.)
| | - Attila Gábor Szöllősi
- Doctoral School of Molecular Medicine, University of Debrecen, 4032 Debrecen, Hungary;
- Department of Immunology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary
| | - Anna Di Nardo
- Department of Dermatology, School of Medicine, University of California San Diego, La Jolla, CA 92037, USA; (S.A.); (K.M.-K.)
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28
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Konantz M, Williams M, Merkel T, Reiss A, Dirnhofer S, Meyer SC, Valent P, George TI, Tzankov A, Hartmann K. Increased TIM-3 and galectin-9 serum levels in patients with advanced systemic mastocytosis. J Allergy Clin Immunol 2023; 152:1019-1024. [PMID: 37423405 DOI: 10.1016/j.jaci.2023.07.001] [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] [Received: 05/15/2023] [Revised: 06/15/2023] [Accepted: 07/05/2023] [Indexed: 07/11/2023]
Abstract
BACKGROUND Systemic mastocytosis is characterized by expansion of clonal mast cells in various tissues. Several biomarkers with diagnostic and therapeutic potential have recently been characterized in mastocytosis, such as the serum marker tryptase and the immune checkpoint molecule PD-L1. OBJECTIVE We aimed to investigate whether serum levels of other checkpoint molecules are altered in systemic mastocytosis and whether these proteins are expressed in mastocytosis infiltrates in the bone marrow. METHODS Levels of different checkpoint molecules were analyzed in serum of patients with different categories of systemic mastocytosis and healthy controls and correlated to disease severity. Bone marrow biopsies from patients with systemic mastocytosis were stained to confirm expression. RESULTS Serum levels of TIM-3 and galectin-9 were increased in systemic mastocytosis, particularly in advanced subtypes, compared with healthy controls. TIM-3 and galectin-9 levels were also found to correlate with other biomarkers of systemic mastocytosis, such as serum tryptase and KIT D816V variant allele frequency in the peripheral blood. Moreover, we observed expression of TIM-3 and galectin-9 in mastocytosis infiltrates in bone marrow. CONCLUSIONS Together, our results demonstrate for the first time that serum levels of TIM-3 and galectin-9 are increased in advanced systemic mastocytosis. Moreover, TIM-3 and galectin-9 are expressed in bone marrow infiltrates in mastocytosis. These findings provide a rationale for exploring TIM-3 and galectin-9 as diagnostic markers and eventually therapeutic targets in systemic mastocytosis, particularly in advanced forms.
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Affiliation(s)
- Martina Konantz
- Department of Biomedicine, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Margaret Williams
- ARUP Laboratories, Salt Lake City, Utah; University of Utah, Salt Lake City, Utah
| | - Tamara Merkel
- Division of Allergy, Department of Dermatology, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Antonia Reiss
- Department of Biomedicine, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Stefan Dirnhofer
- Department of Pathology, Institute of Medical Genetics and Pathology, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Sara C Meyer
- Department of Biomedicine, University Hospital Basel and University of Basel, Basel, Switzerland; Department of Hematology and Central Hematology Laboratory, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Peter Valent
- Division of Hematology and Hemostaseology, Department of Internal Medicine I, Medical University of Vienna, Vienna, Austria; Ludwig Boltzmann Institute for Hematology and Oncology, Medical University of Vienna, Vienna, Austria
| | - Tracy I George
- ARUP Laboratories, Salt Lake City, Utah; University of Utah, Salt Lake City, Utah
| | - Alexandar Tzankov
- Department of Pathology, Institute of Medical Genetics and Pathology, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Karin Hartmann
- Department of Biomedicine, University Hospital Basel and University of Basel, Basel, Switzerland; Division of Allergy, Department of Dermatology, University Hospital Basel and University of Basel, Basel, Switzerland.
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29
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Pattabiraman G, Engel G, Osborn CV, Murphy SF, Schaeffer AJ, Thumbikat P. Efficacy of Targeted Mast Cell Inhibition Therapy in Chronic Prostatitis/Chronic Pelvic Pain Syndrome. Urology 2023; 180:200-208. [PMID: 37442295 PMCID: PMC10592376 DOI: 10.1016/j.urology.2023.05.047] [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: 02/15/2023] [Revised: 05/02/2023] [Accepted: 05/03/2023] [Indexed: 07/15/2023]
Abstract
OBJECTIVE To identify a subgroup of patients with mast cell dysfunction in chronic prostatitis/chronic pelvic pain syndrome and evaluate efficacy of mast cell-directed therapy. MATERIALS AND METHODS Men with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) were recruited and evaluated in an open-label, interventional uncontrolled trial after therapy with cromolyn sodium and cetirizine hydrochloride. The primary endpoint was a change in mast cell tryptase concentrations after treatment while secondary endpoints were changes in the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) and AUA-SI. Isolated cells from postprostatic massage urine were evaluated for immune changes using mRNA expression analysis. RESULTS 31 patients with a diagnoses of Category III CP/CPPS were consented, 25 patients qualified and 20 completed the study after meeting a prespecified threshold for active tryptase in expressed prostatic secretions. After treatment with cromolyn sodium and cetirizine dihydrochloride for 3-week, active tryptase concentrations were significantly reduced from 49.03±14.05 ug/mL to 25.49±5.48 ug/mL (P<.05). The NIH-CPSI total score was reduced with a mean difference of 5.2±1 along with reduction in the pain, urinary and quality of life subscores (P<.001). A reduction in the AUA-SI was observed following treatment (P<.05). NanoString mRNA analysis of isolated cells revealed downregulation of immune-related pathways including Th1 and Th17 T cell differentiation and TLR signaling. Marked reduction in CD45+ cells and specifically macrophages and neutrophil abundance was observed. CONCLUSION Identification of CP/CPPS patients with mast cell dysfunction may be achieved using tryptase as a discriminating biomarker. Mast cell-directed therapy in this targeted subgroup may be effective in reducing symptoms and modulating the immune inflammatory environment.
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Affiliation(s)
- Goutham Pattabiraman
- Department of Urology, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Geoffrey Engel
- Department of Urology, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Catherine V Osborn
- Department of Urology, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Stephen F Murphy
- Department of Urology, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Anthony J Schaeffer
- Department of Urology, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Praveen Thumbikat
- Department of Urology, Feinberg School of Medicine, Northwestern University, Chicago, IL.
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30
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Nuri T, Jin D, Takai S, Ueda K. Tryptase-Positive Mast Cells Promote Adipose Fibrosis in Secondary Lymphedema through PDGF. Curr Issues Mol Biol 2023; 45:8027-8039. [PMID: 37886950 PMCID: PMC10605118 DOI: 10.3390/cimb45100507] [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: 09/05/2023] [Revised: 09/26/2023] [Accepted: 09/27/2023] [Indexed: 10/28/2023] Open
Abstract
Lymphedema is a chronic and progressive condition that causes physical disfigurement and psychological trauma due to the accumulation of lymphatic fluid in the interstitial space. Once it develops, lymphedema is difficult to treat because it leads to the fibrosis of adipose tissue. However, the mechanism behind this remains unclear. The purpose of this study was to investigate the involvement of mast cells (MCs) in the adipose tissues of patients with lymphedema. We found that fibrosis spread through blood vessels in the adipose tissues of lymphedema patients, and the expression of the collagen I and III genes was significantly increased compared to that of those in normal adipose tissue. Immunostaining of vimentin and α-smooth muscle actin showed that fibroblasts were the main cellular components in severely fibrotic regions. Toluidine blue staining confirmed a significant increase in the number of MCs in the adipose tissues of lymphedema patients, and immunostaining of serial sections of adipose tissue showed a significant increase in the number of tryptase-positive cells in lymphedema tissues compared with those in normal adipose tissues. Linear regression analyses revealed significant positive correlations between tryptase and the expressions of the TNF-α, platelet-derived growth factor (PDGF)-A, and PDGFR-α genes. PDGF-A-positive staining was observed in both fibroblasts and granules of tryptase-positive MCs. These results suggest that MC-derived tryptase plays a role in the fibrosis of adipose tissue due to lymphedema directly or in cooperation with other mediators.
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Affiliation(s)
- Takashi Nuri
- Department of Plastic and Reconstructive Surgery, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan;
| | - Denan Jin
- Department of Innovative Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan; (D.J.); (S.T.)
| | - Shinji Takai
- Department of Innovative Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan; (D.J.); (S.T.)
| | - Koichi Ueda
- Department of Plastic and Reconstructive Surgery, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan;
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31
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Marchi F, Carabelli A. Hypersensitivity to lipoic acid. Eur Ann Allergy Clin Immunol 2023. [PMID: 37671889 DOI: 10.23822/eurannaci.1764-1489.310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/07/2023]
Affiliation(s)
- F Marchi
- S.D. Allergology Clinic, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - A Carabelli
- S.D. Allergology Clinic, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
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32
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Atiakshin D, Kostin A, Shishkina V, Burtseva A, Buravleva A, Volodkin A, Elieh-Ali-Komi D, Buchwalow I, Tiemann M. Space-Flight- and Microgravity-Dependent Alteration of Mast Cell Population and Protease Expression in Digestive Organs of Mongolian Gerbils. Int J Mol Sci 2023; 24:13604. [PMID: 37686410 PMCID: PMC10488096 DOI: 10.3390/ijms241713604] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 08/28/2023] [Accepted: 08/31/2023] [Indexed: 09/10/2023] Open
Abstract
Mast cell (MC)-specific proteases are of particular interest for space biology and medicine due to their biological activity in regulating targets of a specific tissue microenvironment. MC tryptase and chymase obtain the ability to remodel connective tissue through direct and indirect mechanisms. Yet, MC-specific protease expression under space flight conditions has not been adequately investigated. Using immunohistochemical stainings, we analyzed in this study the protease profile of the jejunal, gastric, and hepatic MC populations in three groups of Mongolian gerbils-vivarium control, synchronous experiment, and 12-day orbital flight on the Foton-M3 spacecraft-and in two groups-vivarium control and anti-orthostatic suspension-included in the experiment simulating effects of weightlessness in the ground-based conditions. After a space flight, there was a decreased number of MCs in the studied organs combined with an increased proportion of chymase-positive MCs and MCs with a simultaneous content of tryptase and chymase; the secretion of specific proteases into the extracellular matrix increased. These changes in the expression of proteases were observed both in the mucosal and connective tissue MC subpopulations of the stomach and jejunum. Notably, the relative content of tryptase-positive MCs in the studied organs of the digestive system decreased. Space flight conditions simulated in the synchronous experiment caused no similar significant changes in the protease profile of MC populations. The space flight conditions resulted in an increased chymase expression combined with a decreased total number of protease-positive MCs, apparently due to participating in the processes of extracellular matrix remodeling and regulating the state of the cardiovascular system.
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Affiliation(s)
- Dmitrii Atiakshin
- Research and Educational Resource Center for Immunophenotyping, Digital Spatial Profiling and Ultra-structural Analysis Innovative Technologies, Peoples’ Friendship University of Russia, 6 Miklukho-Maklaya St, 117198 Moscow, Russia; (D.A.); (A.K.); (A.V.)
- Research Institute of Experimental Biology and Medicine, Burdenko Voronezh State Medical University, 394036 Voronezh, Russia; (V.S.); (A.B.); (A.B.)
| | - Andrey Kostin
- Research and Educational Resource Center for Immunophenotyping, Digital Spatial Profiling and Ultra-structural Analysis Innovative Technologies, Peoples’ Friendship University of Russia, 6 Miklukho-Maklaya St, 117198 Moscow, Russia; (D.A.); (A.K.); (A.V.)
| | - Viktoriya Shishkina
- Research Institute of Experimental Biology and Medicine, Burdenko Voronezh State Medical University, 394036 Voronezh, Russia; (V.S.); (A.B.); (A.B.)
| | - Alexandra Burtseva
- Research Institute of Experimental Biology and Medicine, Burdenko Voronezh State Medical University, 394036 Voronezh, Russia; (V.S.); (A.B.); (A.B.)
| | - Anastasia Buravleva
- Research Institute of Experimental Biology and Medicine, Burdenko Voronezh State Medical University, 394036 Voronezh, Russia; (V.S.); (A.B.); (A.B.)
| | - Artem Volodkin
- Research and Educational Resource Center for Immunophenotyping, Digital Spatial Profiling and Ultra-structural Analysis Innovative Technologies, Peoples’ Friendship University of Russia, 6 Miklukho-Maklaya St, 117198 Moscow, Russia; (D.A.); (A.K.); (A.V.)
| | - Daniel Elieh-Ali-Komi
- Institute of Allergology, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 12203 Berlin, Germany;
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, 12203 Berlin, Germany
| | - Igor Buchwalow
- Research and Educational Resource Center for Immunophenotyping, Digital Spatial Profiling and Ultra-structural Analysis Innovative Technologies, Peoples’ Friendship University of Russia, 6 Miklukho-Maklaya St, 117198 Moscow, Russia; (D.A.); (A.K.); (A.V.)
- Institute for Hematopathology, 22547 Hamburg, Germany;
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Fisher CR, Patel R. Activated mast cells in periprosthetic joint infection-associated tissue. Front Immunol 2023; 14:1183977. [PMID: 37654491 PMCID: PMC10467263 DOI: 10.3389/fimmu.2023.1183977] [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: 03/10/2023] [Accepted: 07/31/2023] [Indexed: 09/02/2023] Open
Abstract
Background Periprosthetic joint infection (PJI) is a devastating complication of total joint arthroplasty surgery. Increased densities of activated mast cells have been predicted to be present in PJI compared to non-infectious arthroplasty failure based on analysis of transcriptomic data, but their presence in PJI-associated periprosthetic tissues has not been visually confirmed. Objective This preliminary study investigated the presence and activation status of mast cells in periprosthetic tissues associated with PJI. Methods Periprosthetic tissues from five PJI cases and three arthroplasty failures due to instability and one due to stiffness were immunohistochemically stained using tryptase and microscopically evaluated to enumerate mast cells and evaluate overall activation status within tissue samples. Mast cell activation was evidenced by the release of tryptase into the extracellular space surrounding mast cells. Results Mast cells were found in all samples, with average cellular densities of 22 and 26 cells/mm2 tissue in PJI and uninfected samples, respectively (p, 0.6610). Apparent mast cell activation and degranulation was readily observed throughout each of the five PJI samples studied, but not in any of the uninfected samples studied. Conclusion While preliminary, these findings provide evidence for a role of mast cells in the immune response in PJI. Additional investigation of the role of mast cells during arthroplasty failure is warranted, providing a better understanding of underlying biology and informing potential diagnostic and treatment targets.
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Affiliation(s)
- Cody R. Fisher
- Mayo Clinic Graduate School of Biomedical Sciences, Department of Immunology, Mayo Clinic, Rochester, MN, United States
- Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, United States
| | - Robin Patel
- Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, United States
- Division of Public Health, Infectious Diseases, and Occupational Medicine, Department of Medicine, Mayo Clinic, Rochester, MN, United States
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de Weger WW, Bruinenberg VM, Gerrits JH, van Lente L, Herpertz CEM, van der Meulen GN, Sprikkelman AB, Koppelman GH, Kamps AWA. Investigation of novel salivary biomarkers in paediatric food allergy. Clin Exp Allergy 2023; 53:883-886. [PMID: 37246596 DOI: 10.1111/cea.14332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 04/03/2023] [Accepted: 04/19/2023] [Indexed: 05/30/2023]
Affiliation(s)
- Wouter W de Weger
- Department of Paediatrics, Martini Hospital, Groningen, The Netherlands
- Department of Paediatric Pulmonology and Paediatric Allergology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- University Medical Center Groningen, GRIAC Research Institute, University of Groningen, Groningen, The Netherlands
| | - Vibeke M Bruinenberg
- Certe, Department of Clinical Chemistry, Martini Hospital, Groningen, The Netherlands
| | - Jeroen H Gerrits
- Certe, Department of Clinical Chemistry, Martini Hospital, Groningen, The Netherlands
| | - Lidy van Lente
- Department of Epidemiology, Martini Hospital, Groningen, The Netherlands
| | | | | | - Aline B Sprikkelman
- Department of Paediatric Pulmonology and Paediatric Allergology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- University Medical Center Groningen, GRIAC Research Institute, University of Groningen, Groningen, The Netherlands
| | - Gerard H Koppelman
- Department of Paediatric Pulmonology and Paediatric Allergology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- University Medical Center Groningen, GRIAC Research Institute, University of Groningen, Groningen, The Netherlands
| | - Arvid W A Kamps
- Department of Paediatrics, Martini Hospital, Groningen, The Netherlands
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Theoharides TC, Kempuraj D. Potential Role of Moesin in Regulating Mast Cell Secretion. Int J Mol Sci 2023; 24:12081. [PMID: 37569454 PMCID: PMC10418457 DOI: 10.3390/ijms241512081] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 07/20/2023] [Accepted: 07/24/2023] [Indexed: 08/13/2023] Open
Abstract
Mast cells have existed for millions of years in species that never suffer from allergic reactions. Hence, in addition to allergies, mast cells can play a critical role in homeostasis and inflammation via secretion of numerous vasoactive, pro-inflammatory and neuro-sensitizing mediators. Secretion may utilize different modes that involve the cytoskeleton, but our understanding of the molecular mechanisms regulating secretion is still not well understood. The Ezrin/Radixin/Moesin (ERM) family of proteins is involved in linking cell surface-initiated signaling to the actin cytoskeleton. However, how ERMs may regulate secretion from mast cells is still poorly understood. ERMs contain two functional domains connected through a long α-helix region, the N-terminal FERM (band 4.1 protein-ERM) domain and the C-terminal ERM association domain (C-ERMAD). The FERM domain and the C-ERMAD can bind to each other in a head-to-tail manner, leading to a closed/inactive conformation. Typically, phosphorylation on the C-terminus Thr has been associated with the activation of ERMs, including secretion from macrophages and platelets. It has previously been shown that the ability of the so-called mast cell "stabilizer" disodium cromoglycate (cromolyn) to inhibit secretion from rat mast cells closely paralleled the phosphorylation of a 78 kDa protein, which was subsequently shown to be moesin, a member of ERMs. Interestingly, the phosphorylation of moesin during the inhibition of mast cell secretion was on the N-terminal Ser56/74 and Thr66 residues. This phosphorylation pattern could lock moesin in its inactive state and render it inaccessible to binding to the Soluble NSF attachment protein receptors (SNAREs) and synaptosomal-associated proteins (SNAPs) critical for exocytosis. Using confocal microscopic imaging, we showed moesin was found to colocalize with actin and cluster around secretory granules during inhibition of secretion. In conclusion, the phosphorylation pattern and localization of moesin may be important in the regulation of mast cell secretion and could be targeted for the development of effective inhibitors of secretion of allergic and inflammatory mediators from mast cells.
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Affiliation(s)
- Theoharis C. Theoharides
- Institute for Neuro-Immune Medicine, Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, FL 33328, USA;
- Laboratory of Molecular Immunopharmacology and Drug Discovery, Department of Immunology, Tufts University School of Medicine, Boston, MA 02111, USA
| | - Duraisamy Kempuraj
- Institute for Neuro-Immune Medicine, Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, FL 33328, USA;
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Tsuchiya M, Fukushima K, Takata K, Ohashi Y, Uchiyama K, Takahira N, Saito H, Tsukada A, Inoue G, Takaso M, Uchida K. Increase in TPSB2 and TPSD1 Expression in Synovium of Hip Osteoarthritis Patients Who Are Overweight. Int J Mol Sci 2023; 24:11532. [PMID: 37511292 PMCID: PMC10380195 DOI: 10.3390/ijms241411532] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 06/20/2023] [Revised: 07/14/2023] [Accepted: 07/14/2023] [Indexed: 07/30/2023] Open
Abstract
While research suggests that increasing body mass index (BMI) is a risk factor for hip osteoarthritis (HOA), the mechanisms of this effect are not fully understood. Tryptases are among the main proteases found in mast cells (MCs) and contribute to OA pathology. TPSB2, which encodes β-tryptase, is increased in the synovium of overweight and obese knee OA patients. However, it remains unclear whether tryptase in the synovium of HOA is increased with increasing BMI. Here, we investigated tryptase genes (TPSB2 and TPSD1) in the synovium of overweight HOA patients. Forty-six patients radiographically diagnosed with HOA were allocated to two groups based on BMI, namely normal (<25 kg/m2) and overweight (25-29.99 kg/m2). TPSB2 and TPSD1 expression in the synovium of the two groups was compared using real-time polymerase chain reaction. To compare TPSB2 and TPSD1 expression in MCs between the groups, we isolated the MC-rich fraction (MC-RF) and MC-poor fraction (MC-PF), extracted using magnetic isolation. TPSB2 and TPSD1 expression was increased in the overweight group compared with the normal group. Expression of both genes in the MC-RF was significantly higher than that in MC-PF in both groups. However, TPSB2 and TPSD1 expression levels in the MC-RF did not differ between the groups. Tryptase genes were highly expressed in the synovium of overweight HOA patients. Further investigation to reveal the role of tryptase in the relationship between increasing BMI and HOA pathology is required.
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Affiliation(s)
- Maho Tsuchiya
- Department of Orthopedic Surgery, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara City 252-0374, Japan; (M.T.); (K.F.); (K.T.); (Y.O.); (H.S.); (A.T.); (G.I.); (M.T.)
| | - Kensuke Fukushima
- Department of Orthopedic Surgery, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara City 252-0374, Japan; (M.T.); (K.F.); (K.T.); (Y.O.); (H.S.); (A.T.); (G.I.); (M.T.)
| | - Ken Takata
- Department of Orthopedic Surgery, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara City 252-0374, Japan; (M.T.); (K.F.); (K.T.); (Y.O.); (H.S.); (A.T.); (G.I.); (M.T.)
| | - Yoshihisa Ohashi
- Department of Orthopedic Surgery, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara City 252-0374, Japan; (M.T.); (K.F.); (K.T.); (Y.O.); (H.S.); (A.T.); (G.I.); (M.T.)
| | - Katsufumi Uchiyama
- Department of Patient Safety and Healthcare Administration, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara City 252-0374, Japan;
| | - Naonobu Takahira
- Department of Rehabilitation, Kitasato University School of Allied Health Sciences, 1-15-1 Kitasato, Minami-ku, Sagamihara City 252-0373, Japan;
| | - Hiroki Saito
- Department of Orthopedic Surgery, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara City 252-0374, Japan; (M.T.); (K.F.); (K.T.); (Y.O.); (H.S.); (A.T.); (G.I.); (M.T.)
| | - Ayumi Tsukada
- Department of Orthopedic Surgery, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara City 252-0374, Japan; (M.T.); (K.F.); (K.T.); (Y.O.); (H.S.); (A.T.); (G.I.); (M.T.)
| | - Gen Inoue
- Department of Orthopedic Surgery, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara City 252-0374, Japan; (M.T.); (K.F.); (K.T.); (Y.O.); (H.S.); (A.T.); (G.I.); (M.T.)
| | - Masashi Takaso
- Department of Orthopedic Surgery, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara City 252-0374, Japan; (M.T.); (K.F.); (K.T.); (Y.O.); (H.S.); (A.T.); (G.I.); (M.T.)
| | - Kentaro Uchida
- Department of Orthopedic Surgery, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara City 252-0374, Japan; (M.T.); (K.F.); (K.T.); (Y.O.); (H.S.); (A.T.); (G.I.); (M.T.)
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Sarwate M, Bakhshwin A. Acute Appendicitis as the First and the Only Presentation of Systemic Mastocytosis. ACG Case Rep J 2023; 10:e01089. [PMID: 37426569 PMCID: PMC10328639 DOI: 10.14309/crj.0000000000001089] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 05/30/2023] [Indexed: 07/11/2023] Open
Abstract
Systemic mastocytosis is a rare myeloproliferative disorder characterized by abnormal accumulation of mast cells in a variety of organs. When affecting the gastrointestinal tracts, it may manifest with steatorrhea, malabsorption, hepatomegaly, splenomegaly, portal hypertension, and ascites, among others. To our knowledge, only one case of systemic mastocytosis has been reported affecting the appendix. We present another case of a 47-year-old woman who was admitted for right-sided acute abdominal pain and found to have systemic mastocytosis in her appendectomy specimen as the first and only manifestation of her disease.
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Affiliation(s)
- Mrinal Sarwate
- Robert Tomisch Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH
| | - Ahmed Bakhshwin
- Robert Tomisch Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH
- King Abdulaziz University, Jeddah, Saudi Arabia
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Jarkvist J, Gülen T. Diagnostic Evaluation of Hypersensitivity Reactions to Antibiotics in a Large Cohort of Mastocytosis Patients. Diagnostics (Basel) 2023; 13:2241. [PMID: 37443635 DOI: 10.3390/diagnostics13132241] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 06/27/2023] [Accepted: 06/29/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND Anaphylactic reactions are a well-known feature of mastocytosis, particularly in relation to hymenoptera venom stings. Although data on the frequency of drug hypersensitivity reactions is limited in mastocytosis, it is hypothesized that these patients may be predisposed to hypersensitivity reactions to certain drugs, including antibiotics. Nevertheless, this issue has not been systematically investigated. Thus, we investigate the prevalence and clinical features of hypersensitivity reactions to antibiotics (HRA) in mastocytosis. METHODS A 15-year retrospective study was conducted among 239 (≥18 years old) consecutive mastocytosis patients who were investigated in our center. All patients underwent a thorough allergy work-up, where self-reported reactions were individually evaluated by an allergist. RESULTS Overall, 34 patients (14.2%) were deemed to have HRA. Most patients reacted with cutaneous symptoms (74%), and anaphylaxis was rare, confirmed only in two of 34 patients (0.8%). Beta-lactams were the most common elicitors (63%). There were no differences in age, gender, atopic status and tryptase levels between mastocytosis patients with and without antibiotic hypersensitivity. CONCLUSIONS The present study indicates a similar prevalence of HRA in mastocytosis compared to those of the general population. Moreover, antibiotics appear to be rare elicitors of anaphylaxis in these patients. Hence, our results suggest that mastocytosis patients without a history of HRA may be treated with these drugs without special precautions.
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Affiliation(s)
- Jesper Jarkvist
- Department of Respiratory Medicine and Allergy, Karolinska University Hospital Huddinge, 141 86 Stockholm, Sweden
| | - Theo Gülen
- Department of Respiratory Medicine and Allergy, Karolinska University Hospital Huddinge, 141 86 Stockholm, Sweden
- Department of Medicine Solna, Division of Immunology and Allergy, Karolinska Institutet, 171 77 Stockholm, Sweden
- Department of Medicine Huddinge, Karolinska Institutet, 141 52 Stockholm, Sweden
- Mastocytosis Center Karolinska, Karolinska University Hospital Huddinge, 141 86 Stockholm, Sweden
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Ebo DG, van der Poorten MLM, Hopkins PM. Suspected perioperative anaphylaxis: are we making the correct diagnosis? Br J Anaesth 2023:S0007-0912(23)00235-0. [PMID: 37271719 DOI: 10.1016/j.bja.2023.05.002] [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] [Received: 03/23/2023] [Revised: 05/01/2023] [Accepted: 05/04/2023] [Indexed: 06/06/2023] Open
Abstract
We provide a commentary on aspects of a prospective study of the epidemiology of perioperative anaphylaxis in Japan (Japanese Epidemiologic Study for Perioperative Anaphylaxis [JESPA]). Accurate diagnosis of perioperative anaphylaxis is important for research but essential for clinical safety. We evaluate the diagnostic approach used in the JESPA study and caution against over-reliance on diagnostic tests that lack sensitivity and specificity when clinical data suggest an immediate perioperative hypersensitivity reaction is likely.
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Affiliation(s)
- Didier G Ebo
- Faculty of Medicine and Health Science, Department of Immunology-Allergology-Rheumatology, Antwerp University Hospital and the Infla-Med Center of Excellence, University of Antwerp, Antwerp, Belgium; Department of Immunology and Allergology, AZ Jan Palfijn Ghent, Ghent, Belgium.
| | - Marie-Line M van der Poorten
- Faculty of Medicine and Health Science, Department of Immunology-Allergology-Rheumatology, Antwerp University Hospital and the Infla-Med Center of Excellence, University of Antwerp, Antwerp, Belgium; Faculty of Medicine and Health Science, Department of Paediatrics, University of Antwerp, Antwerp University Hospital, Antwerp, Belgium
| | - Philip M Hopkins
- Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK; Department of Anaesthesia, Leeds Teaching Hospitals NHS Trust, Leeds, UK
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Berlin F, Mogren S, Ly C, Ramu S, Hvidtfeldt M, Uller L, Porsbjerg C, Andersson CK. Mast Cell Tryptase Promotes Airway Remodeling by Inducing Anti-Apoptotic and Cell Growth Properties in Human Alveolar and Bronchial Epithelial Cells. Cells 2023; 12:1439. [PMID: 37408273 DOI: 10.3390/cells12101439] [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: 02/26/2023] [Revised: 05/12/2023] [Accepted: 05/18/2023] [Indexed: 07/07/2023] Open
Abstract
Bronchial and alveolar remodeling and impaired epithelial function are characteristics of chronic respiratory diseases. In these patients, an increased number of mast cells (MCs) positive for serine proteases, tryptase and chymase, infiltrate the epithelium and alveolar parenchyma. However, little is known regarding the implication of intraepithelial MCs on the local environment, such as epithelial cell function and properties. In this study, we investigated whether MC tryptase is involved in bronchial and alveolar remodeling and the mechanisms of regulation during inflammation. Using novel holographic live cell imaging, we found that MC tryptase enhanced human bronchial and alveolar epithelial cell growth and shortened the cell division intervals. The elevated cell growth induced by tryptase remained in a pro-inflammatory state. Tryptase also increased the expression of the anti-apoptotic protein BIRC3, as well as growth factor release in epithelial cells. Thus, our data imply that the intraepithelial and alveolar MC release of tryptase may play a critical role in disturbing bronchial epithelial and alveolar homeostasis by altering cell growth-death regulation.
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Affiliation(s)
- Frida Berlin
- Department of Experimental Medical Science, Lund University, 22184 Lund, Sweden
| | - Sofia Mogren
- Department of Experimental Medical Science, Lund University, 22184 Lund, Sweden
| | - Camilla Ly
- Department of Experimental Medical Science, Lund University, 22184 Lund, Sweden
| | - Sangeetha Ramu
- Department of Experimental Medical Science, Lund University, 22184 Lund, Sweden
| | - Morten Hvidtfeldt
- Department of Respiratory Medicine, Copenhagen University Hospital Bispebjerg, 2400 Copenhagen, Denmark
| | - Lena Uller
- Department of Experimental Medical Science, Lund University, 22184 Lund, Sweden
| | - Celeste Porsbjerg
- Department of Respiratory Medicine, Copenhagen University Hospital Bispebjerg, 2400 Copenhagen, Denmark
| | - Cecilia K Andersson
- Department of Experimental Medical Science, Lund University, 22184 Lund, Sweden
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Wallace DV. Knowledge Gaps in the Diagnosis and Management of Anaphylaxis. Ann Allergy Asthma Immunol 2023:S1081-1206(23)00336-8. [PMID: 37209836 DOI: 10.1016/j.anai.2023.05.010] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 04/19/2023] [Accepted: 05/05/2023] [Indexed: 05/22/2023]
Abstract
Knowledge gaps in the diagnosis and treatment of anaphylaxis impede the clinician's ability to effectively manage patients with anaphylaxis. This review will emphasize the lack of a global consensus on defining and determining the severity of anaphylaxis; the need for validating biomarkers used for diagnosing anaphylaxis; and data collection deficiencies. Perioperative anaphylaxis has a wide differential diagnosis, often requires treatment beyond epinephrine, and poses a challenge for the clinician in identifying the responsible trigger(s), and in preventing future reactions. Consensus-derived definitions and determination of risk factors for biphasic, refractory, and persistent anaphylaxis are needed, recognizing that these often impact the emergency department observation time following recovery from initial anaphylaxis. Knowledge gaps exist in the use of epinephrine, including route of administration, dosage, needle length, and ideal timing for administration. Consensus is needed on when and how many epinephrine auto-injectors to prescribe and how to prevent patient underuse and accidental injury. The role of antihistamines and corticosteroids in the prevention and treatment of anaphylaxis requires consensus and additional research. A consensus-derived algorithm for management of idiopathic anaphylaxis is needed. The role of beta blockers and angiotensin-converting enzyme inhibitors in the incidence, severity, and treatment of anaphylaxis remain unanswered. Rapid recognition and treatment of anaphylaxis in the community needs improvement. The article will conclude with exploring the recommended components of both a patient-specific and generic anaphylaxis emergency plan, including when to activate emergency medical services, all of which are paramount to improving patient outcomes.
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Affiliation(s)
- Dana V Wallace
- Nova Southeastern University College of Allopathic Medicine - Fort Lauderdale, Florida.
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42
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Mondello C, Baldino G, Cianci V, Forzese E, Asmundo A, Ieni A, Ventura Spagnolo E. Postmortem Biochemistry and Immunohistochemistry in Anaphylactic Death Due to Hymenoptera Sting: A Forensic Case Report. Int J Environ Res Public Health 2023; 20:ijerph20095640. [PMID: 37174160 PMCID: PMC10177871 DOI: 10.3390/ijerph20095640] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 04/03/2023] [Accepted: 04/21/2023] [Indexed: 05/15/2023]
Abstract
BACKGROUND Postmortem assessment of anaphylactic death is a challenge for forensic pathologists. One of the most frequent elicitors of anaphylaxis is insect venom. Here, a case of anaphylactic death due to Hymenoptera stings is reported to highlight the contribution of postmortem biochemistry and immunohistochemistry in assessing the cause of death. CASE REPORT A 59-year-old Caucasian man working on his farm was presumably stung by a bee and died. He had a history of previous sensitization to insect venom. The autopsy revealed no signs of insect puncture, mild edema of the larynx, and foamy edema in the bronchial tree and lungs. Routine histology showed endo-alveolar edema and hemorrhage, bronchospasm, and scattered bronchial obstruction due to mucus hyperproduction. Biochemical analysis was performed, and serum tryptase was equal to 189 µg/L, total IgE was 200 kU/L, and specific IgE dosage was positive for bee and yellow jacket species. Immunohistochemistry for tryptase detection was carried out, revealing mast cells and degranulated tryptase expression in the larynx, lungs, spleen, and heart. These findings led to the diagnosis of anaphylactic death due to Hymenoptera stings. CONCLUSIONS The case highlights that the role of biochemistry and immunohistochemistry in the postmortem assessment of anaphylactic reactions should be stressed by forensic practitioners.
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Affiliation(s)
- Cristina Mondello
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Via Consolare Valeria, 98125 Messina, Italy
| | - Gennaro Baldino
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Via Consolare Valeria, 98125 Messina, Italy
| | - Vincenzo Cianci
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Via Consolare Valeria, 98125 Messina, Italy
| | - Elena Forzese
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Via Consolare Valeria, 98125 Messina, Italy
| | - Alessio Asmundo
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Via Consolare Valeria, 98125 Messina, Italy
| | - Antonio Ieni
- Department of Human Pathology of Adult and Childhood "Gaetano Barresi", University of Messina, Via Consolare Valeria, 98125 Messina, Italy
| | - Elvira Ventura Spagnolo
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Via Consolare Valeria, 98125 Messina, Italy
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Röntynen P, Kukkonen K, Savinko T, Mäkelä MJ. Interaction of mediators and effector cells in cashew nut-induced anaphylaxis. Ann Allergy Asthma Immunol 2023:S1081-1206(23)00269-7. [PMID: 37098406 DOI: 10.1016/j.anai.2023.04.014] [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] [Received: 12/23/2022] [Revised: 04/10/2023] [Accepted: 04/17/2023] [Indexed: 04/27/2023]
Abstract
BACKGROUND The underlying mechanisms of an immediate food-induced allergic reaction involve mast-cell degranulation and recruitment of other effector cells, such as lymphocytes, eosinophils, and basophils. How the interaction of various mediators and cells results in anaphylaxis is not fully understood. OBJECTIVE To evaluate changes in platelet-activating factor (PAF), platelet-activating factor acetylhydrolase (PAF-AH), tryptase, eosinophils, basophils, and eosinophil cationic protein (ECP) in cashew nut-induced anaphylaxis. METHODS Open cashew nut challenges were performed on 106 children (aged 1-16 years), sensitized to cashew nut, with earlier allergic reaction to cashew nut or no known exposure. PAF, PAF-AH, tryptase, ECP, eosinophils, and basophils were measured at four timepoints. RESULTS 34/72 (47%) positive challenges were defined as anaphylactic. Eosinophil count decreased progressively during an anaphylactic reaction at all four timepoints (P< .005*) compared to baseline. Although significant PAF elevation was observed 1 hour from moderate-to-severe reaction (P= .039*), PAF seemed to peak especially in anaphylaxis but did not achieve statistical significance. PAF peak ratio (peak PAF/baseline PAF) was significantly greater in anaphylactic reactions compared to the no-anaphylaxis group (P= .008*). Maximal percentage change in eosinophils revealed negative correlation to severity score and PAF peak ratio (Spearman's rho -0.424 and -0.516, respectively). Basophils decreased significantly in moderate-to-severe reactions and in anaphylaxis (P< .05*) compared to baseline. Delta-tryptase (peak tryptase minus baseline) did not differ significantly between anaphylaxis and the no-anaphylaxis subgroups (P= .05). CONCLUSION PAF is a specific anaphylaxis biomarker. Marked decline of eosinophils during anaphylaxis may be related to robust secretion of PAF reflecting migration of eosinophils to target tissues.
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Affiliation(s)
- Petteri Röntynen
- Skin and Allergy Hospital, University of Helsinki and Helsinki University Hospital, Finland.
| | - Kaarina Kukkonen
- University of Helsinki and Helsinki University Hospital, Children's Hospital, and Pediatric Research Center, Finland
| | - Terhi Savinko
- Skin and Allergy Hospital, University of Helsinki and Helsinki University Hospital, Finland
| | - Mika J Mäkelä
- Skin and Allergy Hospital, University of Helsinki and Helsinki University Hospital, Finland
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Cochran AL, Coop C, Neaves BI, Wood ST. The Curious Case of Elevated Tryptase: Workup and Differential in Family of Four. Cureus 2023; 15:e38065. [PMID: 37228529 PMCID: PMC10208158 DOI: 10.7759/cureus.38065] [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] [Accepted: 04/23/2023] [Indexed: 05/27/2023] Open
Abstract
Elevated basal serum tryptase (BST) levels are markers of both mast cell activation and overall mast cell burden. We present a family of four individuals with elevated tryptase levels greater than or equal to 20 mcg/L, all of whom exhibited signs and symptoms suggestive of mast cell activation. Differential diagnoses included hereditary alpha tryptasemia (HaT), systemic mastocytosis (SM), and mast cell activation syndrome (MCAS). In three individuals, SM was ruled out with normal morphology on bone marrow biopsy combined with negative genetic markers. Further workup would be required for the diagnosis of MCAS since serum tryptase levels were not obtained in our emergency department during acute episodes. Although genetic testing for HaT was not available upon initial workup, HaT remains the most likely explanation for this family's elevated BST.
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Affiliation(s)
| | | | | | - Stuart T Wood
- Infectious Disease, Keesler Medical Center, Biloxi, USA
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45
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Couto ML, Silva M, Barbosa MJ, Ferreira F, Fragoso AS, Azenha Rama T. Defining hereditary alpha- tryptasemia as a risk/modifying factor for anaphylaxis: are we there yet? Eur Ann Allergy Clin Immunol 2023. [PMID: 36927821 DOI: 10.23822/eurannaci.1764-1489.288] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 03/18/2023]
Abstract
Summary Hereditary α-tryptasemia (HαT) is a common autosomal dominant genetic trait with variable penetrance associated with increased serum baseline tryptase (SBT) levels. Clinical manifestations may range from an absence of symptoms to overtly severe and recurrent anaphylaxis. Symptoms have been claimed to result from excessive activation of EGF-like module-containing mucin-like hormone receptor-like 2 (EMR2) and protease-activated receptor 2 (PAR-2) receptors by α/β-tryptase heterotetramers. Herein, we aimed to review the evidence on whether HαT can be considered a hereditary risk factor or a modifying factor for anaphylaxis. Increased SBT levels have been linked to an increased risk of anaphylaxis. Likewise, recent studies have shown that HαT might be associated with a higher risk of developing anaphylaxis and more severe anaphylaxis. The same has also been shown for patients with clonal mast cell disorders, in whom the co-existence of HαT might lead to a greater propensity for severe, potentially life-threatening anaphylaxis. However, studies leading to such conclusions are generally limited in sample size, while other studies have shown opposing results. As such, further studies investigating the potential association of HαT with anaphylaxis caused by different triggers, and different severity grades, in both patients with clonal mast cell (MC) activation syndromes and the general population are still needed.
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Affiliation(s)
- M L Couto
- Basic and Clinical Immunology Service, Department of Pathology, Faculty of Medicine, University of Porto, Porto, Portugal
| | - M Silva
- Basic and Clinical Immunology Service, Department of Pathology, Faculty of Medicine, University of Porto, Porto, Portugal
| | - M J Barbosa
- Basic and Clinical Immunology Service, Department of Pathology, Faculty of Medicine, University of Porto, Porto, Portugal
| | - F Ferreira
- Basic and Clinical Immunology Service, Department of Pathology, Faculty of Medicine, University of Porto, Porto, Portugal
| | - A S Fragoso
- Basic and Clinical Immunology Service, Department of Pathology, Faculty of Medicine, University of Porto, Porto, Portugal
| | - T Azenha Rama
- Basic and Clinical Immunology Service, Department of Pathology, Faculty of Medicine, University of Porto, Porto, Portugal.,Immunoalergology Service, São João University Hospital Center, Porto, Portugal.,EPIUnit-Institute of Public Health, University of Porto, Porto, Portugal.,Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
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46
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Sánchez-García L, Pérez-Torres A, Gudiño-Zayas ME, Zamora-Chimal J, Meneses C, Kamhawi S, Valenzuela JG, Becker I. Leishmania major-Infected Phlebotomus duboscqi Sand Fly Bites Enhance Mast Cell Degranulation. Pathogens 2023; 12:207. [PMID: 36839479 PMCID: PMC9960273 DOI: 10.3390/pathogens12020207] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 12/31/2022] [Accepted: 01/16/2023] [Indexed: 02/01/2023] Open
Abstract
Leishmania parasites infect mammalian hosts through the bites of sand fly vectors. The response by mast cells (MC) to the parasite and vector-derived factors, delivered by sand fly bites, has not been characterized. We analyzed MC numbers and their mediators in BALB/c mice naturally infected in the ear with Leishmania major through the bite of the sand fly vector Phlebotomus duboscqi and compared them to non-infected sand fly bites. MC were found at the bite sites of infective and non-infected sand flies throughout 48 h, showing the release of granules with intense TNF-α, histamine, and tryptase staining. At 30 min and 48 h, the MC numbers were significantly higher (p < 0.001) in infected as compared to non-infected bites or controls. Neutrophil recruitment was intense during the first 6 h in the skin of infected and non-infected sand fly bites and decreased thereafter. An influx of neutrophils also occurred in lymph nodes, where a strong TNF-α stain was observed in mononuclear cells. Our data show that MC orchestrate an early inflammatory response after infected and non-infected sand fly bites, leading to neutrophilic recruitment, which potentially provides a safe passage for the parasite within the mammalian host.
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Affiliation(s)
- Laura Sánchez-García
- División Ciencias de la Salud, Universidad Autónoma del Estado de Quintana Roo, Chetumal C.P. 77039, Mexico
| | - Armando Pérez-Torres
- Departamento de Biología Celular y Tisular, Laboratorio de Inmunología Comparada de Piel y Mucosas, Facultad de Medicina, Universidad Nacional Autónoma de México, Avenida Universidad 3000, Ciudad de México C.P. 04510, Mexico
| | - Marco E. Gudiño-Zayas
- Unidad de Investigación en Medicina Experimental, Facultad de Medicina, Universidad Nacional Autónoma de México, Avenida Universidad 3000, Ciudad de México C.P. 04510, Mexico
| | - Jaime Zamora-Chimal
- Unidad de Investigación en Medicina Experimental, Facultad de Medicina, Universidad Nacional Autónoma de México, Avenida Universidad 3000, Ciudad de México C.P. 04510, Mexico
| | - Claudio Meneses
- Vector Molecular Biology Section, Laboratory of Malaria and Vector Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, MD 20852, USA
| | - Shaden Kamhawi
- Vector Molecular Biology Section, Laboratory of Malaria and Vector Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, MD 20852, USA
| | - Jesus G. Valenzuela
- Vector Molecular Biology Section, Laboratory of Malaria and Vector Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, MD 20852, USA
| | - Ingeborg Becker
- Unidad de Investigación en Medicina Experimental, Facultad de Medicina, Universidad Nacional Autónoma de México, Avenida Universidad 3000, Ciudad de México C.P. 04510, Mexico
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Özdemir Ç, Kuzu S, Şenol Y, Yiğit T, Güldün E, Bucak A, Ulu Ş, Tokyol Ç. A Role for Mast Cell-Mediated Antibodies in the Formation of Cholesteatoma and Cholesteatoma-Induced Bone Erosion. Diagnostics (Basel) 2023; 13. [PMID: 36766559 DOI: 10.3390/diagnostics13030455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Revised: 01/18/2023] [Accepted: 01/24/2023] [Indexed: 01/28/2023] Open
Abstract
The study aimed to evaluate the effects and relationships between mast cells in the matrix, mast cell enzymes tryptase and chymase, epithelial proliferation, microvascular density, and bone destruction in cholesteatoma. Thirty-five biopsies diagnosed with cholesteatoma and seven healthy skin tissues taken from the retro-auricular region for control were evaluated. Immunohistochemical studies were performed with CD117, CD34, Ki-67, chymase, and tryptase antibodies, in a single session for all cases and the control group. The relationship between erosion size and antibody load was determined. The mean cholesteatoma epithelium Ki-67 was higher than the control group (p < 0.001). CD117-positive mast cells, chymase-positive mast cells, tryptase-positive mast cells, and microvessel density were significantly higher in the cholesteatoma matrix compared to the control group (p < 0.002, p < 0.001, p < 0.005). In the group with bone erosion scores of two and above, immunohistochemical markers tended to be higher. A positive correlation was found between CD117 and chymase, tryptase, and microvessel density; between tryptase, chymase, and microvessel density; and between chymase and microvessel density. CD117-positive mast cells and chymase-positive mast cells stimulate angiogenesis, increase the epithelium's proliferative capacity in the cholesteatoma matrix, and form cholesteatoma. The increased proliferation of cholesteatoma epithelium and increased vascular density in the matrix exacerbate bone erosion.
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48
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Valent P, Akin C, Sperr WR, Horny HP, Arock M, Metcalfe DD, Galli SJ. New Insights into the Pathogenesis of Mastocytosis: Emerging Concepts in Diagnosis and Therapy. Annu Rev Pathol 2023; 18:361-386. [PMID: 36270293 DOI: 10.1146/annurev-pathmechdis-031521-042618] [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] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Mastocytosis is a heterogeneous group of neoplasms defined by a numerical increase and accumulation of clonal mast cells (MCs) in various organ systems. The disease may present as cutaneous mastocytosis or systemic mastocytosis (SM). On the basis of histopathological and molecular features, clinical variables, and organ involvement, SM is divided into indolent SM, smoldering SM, SM with an associated hematologic neoplasm, aggressive SM, and MC leukemia. Each variant is defined by unique diagnostic criteria and a unique spectrum of clinical presentations. A key driver of MC expansion and disease evolution is the oncogenic machinery triggered by mutant forms of KIT. The genetic background, additional somatic mutations, and comorbidities also contribute to the course and prognosis. Patients with SM may also suffer from mediator-related symptoms or even an MC activation syndrome. This article provides an update of concepts on the genetics, etiology, and pathology of mastocytosis, with emphasis on diagnostic criteria and new treatment concepts.
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Affiliation(s)
- Peter Valent
- Department of Internal Medicine I, Division of Hematology and Hemostaseology, Medical University of Vienna, Vienna, Austria; .,Ludwig Boltzmann Institute for Hematology and Oncology, Medical University of Vienna, Vienna, Austria
| | - Cem Akin
- Division of Allergy and Clinical Immunology, University of Michigan, Ann Arbor, Michigan, USA
| | - Wolfgang R Sperr
- Department of Internal Medicine I, Division of Hematology and Hemostaseology, Medical University of Vienna, Vienna, Austria; .,Ludwig Boltzmann Institute for Hematology and Oncology, Medical University of Vienna, Vienna, Austria
| | - Hans-Peter Horny
- Institute of Pathology, Ludwig-Maximilian University, Munich, Germany
| | - Michel Arock
- Department of Hematological Biology, Pitié-Salpêtrière Charles-Foix Hospital, AP-HP Sorbonne University, Paris, France
| | - Dean D Metcalfe
- Mast Cell Biology Section, Laboratory of Allergic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Stephen J Galli
- Department of Pathology, Department of Microbiology and Immunology, Sean N. Parker Center for Allergy and Asthma Research, Stanford University School of Medicine, Stanford, California, USA
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49
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Copaescu AM, Carter MC. An atypical case of Hymenoptera venom anaphylaxis. J Allergy Clin Immunol Pract 2023; 11:1326-1328.e9. [PMID: 36693538 DOI: 10.1016/j.jaip.2023.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 01/03/2023] [Accepted: 01/04/2023] [Indexed: 01/22/2023]
Affiliation(s)
- Ana Maria Copaescu
- Department of Medicine, Division of Allergy and Clinical Immunology, McGill University Health Centre (MUHC), McGill University, Montreal, Quebec, Canada; The Research Institute of the McGill University Health Centre, McGill University, McGill University Health Centre (MUHC), Montreal, Quebec, Canada; Centre for Antibiotic Allergy and Research, Department of Infectious Diseases, Austin Health, Heidelberg, Victoria, Australia.
| | - Melody C Carter
- Mast Cell Biology Section, Laboratory of Allergic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, United States
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50
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Kačar M, Rijavec M, Šelb J, Korošec P. Clonal mast cell disorders and hereditary α- tryptasemia as risk factors for anaphylaxis. Clin Exp Allergy 2023; 53:392-404. [PMID: 36654513 DOI: 10.1111/cea.14264] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [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: 09/22/2022] [Revised: 11/12/2022] [Accepted: 11/23/2022] [Indexed: 01/20/2023]
Abstract
The association between Hymenoptera venom-triggered anaphylaxis (HVA) and clonal mast cell-related disorders (cMCD) has been known for decades. However, recent breakthroughs in peripheral blood screening for KIT p.D816V missense variant have revealed the true extent of this clinical association whilst adding to our understanding of the underlying aetiology. Thus, recent large studies highlighted the presence of KIT p.D816V among 18.2% and 23% of patients with severe Hymenoptera venom-triggered anaphylaxis. A significant proportion of those patients have normal serum basal tryptase (BST) levels, with no cutaneous findings such as urticaria pigmentosa or other systemic findings such as organomegaly that would have suggested the presence of cMCD. These findings of an increased prevalence suggest that the impact of cMCD on anaphylaxis could be clinically underestimated and that the leading question for clinicians could be changed from 'how many patients with cMCD have anaphylaxis?' to 'how many patients with anaphylaxis have cMCD?'. The discovery of hereditary α-tryptasemia (HαT)-a genetic trait caused by an increased copy number of the Tryptase Alpha/Beta 1 (TPSAB1) gene-, first described in 2016, is now known to underlie the majority of cases of elevated BST outside of cMCD and chronic kidney disease. HαT is the first common heritable genetic modifier of anaphylaxis described, and it is associated with increased risk for severe HVA (relative risk = 2.0), idiopathic anaphylaxis, and an increased prevalence of anaphylaxis in patients with cMCD, possibly due to the unique activity profile of α/β -tryptase heterotetramers that may potentiate immediate hypersensitivity reaction severity. Our narrative review aims to highlight recent research to have increased our understanding of cMCD and HαT, through recent lessons learned from studying their association with HVA. Additionally, we examined the studies of mast cell-related disorders in food and drug allergy in an effort to determine whether one should also consider cMCD and/or HαT in cases of severe anaphylaxis triggered by food or drugs.
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Affiliation(s)
- Mark Kačar
- University Hospital of Respiratory and Allergic Diseases, Golnik, Slovenia.,Medical Faculty, University of Ljubljana, Ljubljana, Slovenia
| | - Matija Rijavec
- University Hospital of Respiratory and Allergic Diseases, Golnik, Slovenia.,Biotechnical Faculty, University of Ljubljana, Ljubljana, Slovenia
| | - Julij Šelb
- University Hospital of Respiratory and Allergic Diseases, Golnik, Slovenia.,Medical Faculty, University of Ljubljana, Ljubljana, Slovenia
| | - Peter Korošec
- University Hospital of Respiratory and Allergic Diseases, Golnik, Slovenia.,Faculty of Pharmacy, University of Ljubljana, Ljubljana, Slovenia
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