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Piersiala K, Hjalmarsson E, da Silva PFN, Lagebro V, Kolev A, Starkhammar M, Elliot A, Marklund L, Munck-Wikland E, Margolin G, Georén SK, Cardell LO. Regulatory B cells producing IL-10 are increased in human tumor draining lymph nodes. Int J Cancer 2023. [PMID: 37144812 DOI: 10.1002/ijc.34555] [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: 11/08/2022] [Revised: 02/23/2023] [Accepted: 04/06/2023] [Indexed: 05/06/2023]
Abstract
The contribution of different immune cell subsets, especially T cells, in anti-tumor immune response is well established. In contrast to T cells, the anti-tumor contribution of B cells has been scarcely investigated. B-cells are often overlooked, even though they are important players in a fully integrated immune response and constitute a substantial fraction of tumor draining lymph nodes (TDLNs) known also as Sentinel Nodes. In this project, samples including TDLNs, non-TDLNs (nTDLNs) and metastatic lymph nodes from 21 patients with oral squamous cell carcinoma were analyzed by flow cytometry. TDLNs were characterized by a significantly higher proportion of B cells compared with nTDLNs (P = .0127). TDLNs-associated B cells contained high percentages of naïve B cells, in contrary to nTDLNs which contained significantly higher percentages of memory B cells. Patients having metastases in TDLNs showed a significantly higher presence of immunosuppressive B regulatory cells compared with metastasis-free patients (P = .0008). Elevated levels of regulatory B cells in TDLNs were associated with the advancement of the disease. B cells in TDLNs were characterized by significantly higher expression of an immunosuppressive cytokine-IL-10 compared with nTDLNs (P = .0077). Our data indicate that B cells in human TDLNs differ from B cells in nTDLNs and exhibit more naïve and immunosuppressive phenotypes. We identified a high accumulation of regulatory B cells within TDLNs which may be a potential obstacle in achieving response to novel cancer immunotherapies (ICIs) in head and neck cancer.
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Affiliation(s)
- Krzysztof Piersiala
- Division of ENT Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
- Department of Otorhinolaryngology, Karolinska University Hospital, Stockholm, Sweden
| | - Eric Hjalmarsson
- Division of ENT Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | | | - Vilma Lagebro
- Division of ENT Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Aeneas Kolev
- Division of ENT Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
- Department of Otorhinolaryngology, Karolinska University Hospital, Stockholm, Sweden
- Medical unit Head Neck, Lung and skin Cancer, Karolinska University Hospital, Stockholm, Sweden
| | - Magnus Starkhammar
- Division of ENT Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
- Department of Otorhinolaryngology, Karolinska University Hospital, Stockholm, Sweden
| | - Alexandra Elliot
- Division of ENT Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
- Department of Otorhinolaryngology, Karolinska University Hospital, Stockholm, Sweden
- Medical unit Head Neck, Lung and skin Cancer, Karolinska University Hospital, Stockholm, Sweden
| | - Linda Marklund
- Division of ENT Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
- Department of Otorhinolaryngology, Karolinska University Hospital, Stockholm, Sweden
- Medical unit Head Neck, Lung and skin Cancer, Karolinska University Hospital, Stockholm, Sweden
- Department of Surgical Sciences, Section of Otolaryngology and Head and Neck Surgery, Uppsala University, Uppsala, Sweden
| | - Eva Munck-Wikland
- Division of ENT Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
- Department of Otorhinolaryngology, Karolinska University Hospital, Stockholm, Sweden
- Medical unit Head Neck, Lung and skin Cancer, Karolinska University Hospital, Stockholm, Sweden
| | - Gregori Margolin
- Division of ENT Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
- Department of Otorhinolaryngology, Karolinska University Hospital, Stockholm, Sweden
- Medical unit Head Neck, Lung and skin Cancer, Karolinska University Hospital, Stockholm, Sweden
| | - Susanna Kumlien Georén
- Division of ENT Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
- Department of Otorhinolaryngology, Karolinska University Hospital, Stockholm, Sweden
| | - Lars-Olaf Cardell
- Division of ENT Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
- Department of Otorhinolaryngology, Karolinska University Hospital, Stockholm, Sweden
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Piersiala K, da Silva PFN, Lagebro V, Kolev A, Starkhammar M, Elliot A, Marklund L, Munck-Wikland E, Margolin G, Georén SK, Cardell LO. Tumour-draining lymph nodes in head and neck cancer are characterized by accumulation of CTLA-4 and PD-1 expressing Treg cells. Transl Oncol 2022; 23:101469. [PMID: 35714487 PMCID: PMC9207719 DOI: 10.1016/j.tranon.2022.101469] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 05/30/2022] [Accepted: 06/07/2022] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION High Tregs infiltration within the tumour microenvironment (TME) of various cancers shows a positive correlation with poor prognosis. Despite the fact that tumour draining lymph nodes (TDLNs) are recognized as key organs playing a crucial role in response to immunotherapy and modulating anti-cancer immunity, the distribution of Tregs and their role in TDLNs remain uncertain thus far. The purpose of this project is to investigate the density of Tregs in TDLNs and non-TDLNs and their expression of immune checkpoint molecules - PD-1 and CTLA-4. METHODS Samples including TDLNs, non-TDLNs and metastatic lymph nodes (LNs) from 23 patients with oral squamous cell carcinoma (OSCC) were analyzed by multicolour flow cytometry with a focus on Tregs population and expression of CTLA-4 and PD-1. RESULTS TDLNs and metastatic LNs were characterized by a significantly higher infiltration of Tregs defined as CD4+FoxP3+CD25highCD127low cells and significantly higher expression of CTLA-4 and PD-1 on Tregs compared with non-TDLNs. Tregs in TDLNs and metastatic LNs co-expressed CTLA-4 and PD-1 abundantly. High expression of these immune check-point molecules correlated with positive N-stage but not with T-stage. CONCLUSION TDLNs and metastatic LNs are characterized by a high accumulation of Tregs expressing high levels of CTLA-4 and PD-1. High infiltration of Tregs can be a potential driver of an immunosuppressive milieu in TDLNs that can, in turn, favour cancer progression. High accumulation of Tregs expressing CTLA-4 and PD-1 in TDLNs is associated with lymph node involvement, but not with the size of the primary tumour.
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Affiliation(s)
- Krzysztof Piersiala
- Division of ENT Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Stockholm; Department of Otorhinolaryngology, Karolinska University Hospital, Stockholm, Sweden
| | | | - Vilma Lagebro
- Division of ENT Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Stockholm
| | - Aeneas Kolev
- Division of ENT Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Stockholm; Department of Otorhinolaryngology, Karolinska University Hospital, Stockholm, Sweden; Medical unit Head Neck, Lung and skin Cancer, Karolinska University Hospital, Stockholm, Sweden
| | - Magnus Starkhammar
- Division of ENT Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Stockholm; Department of Otorhinolaryngology, Karolinska University Hospital, Stockholm, Sweden
| | - Alexandra Elliot
- Division of ENT Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Stockholm; Department of Otorhinolaryngology, Karolinska University Hospital, Stockholm, Sweden; Medical unit Head Neck, Lung and skin Cancer, Karolinska University Hospital, Stockholm, Sweden
| | - Linda Marklund
- Division of ENT Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Stockholm; Department of Otorhinolaryngology, Karolinska University Hospital, Stockholm, Sweden; Medical unit Head Neck, Lung and skin Cancer, Karolinska University Hospital, Stockholm, Sweden
| | - Eva Munck-Wikland
- Division of ENT Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Stockholm; Department of Otorhinolaryngology, Karolinska University Hospital, Stockholm, Sweden; Medical unit Head Neck, Lung and skin Cancer, Karolinska University Hospital, Stockholm, Sweden
| | - Gregori Margolin
- Division of ENT Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Stockholm; Department of Otorhinolaryngology, Karolinska University Hospital, Stockholm, Sweden; Medical unit Head Neck, Lung and skin Cancer, Karolinska University Hospital, Stockholm, Sweden
| | - Susanna Kumlien Georén
- Division of ENT Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Stockholm; Department of Otorhinolaryngology, Karolinska University Hospital, Stockholm, Sweden
| | - Lars-Olaf Cardell
- Division of ENT Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Stockholm; Department of Otorhinolaryngology, Karolinska University Hospital, Stockholm, Sweden.
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Abstract
OBJECTIVE The objective of this study is to present a novel clinical manifestation of infection with the Omicron variant of the SARS-CoV-2 virus affecting mainly young, vaccinated, and healthy adults. We describe a new group of COVID-19 patients seeking emergency care with symptoms similar to the life-threatening condition epiglottitis. Here, we present a case series and discuss management. METHODS We performed a retrospective single-center case study of patients diagnosed with COVID-19 who were referred to the Ear, Nose, and Throat Emergency Department (ENT ED) between January 1 and January 23, 2022 with clinical symptoms such as acute odynophagia, severe sore throat, and fever. Ethical approval was obtained from the Swedish Ethical Review Authority (2020-02579). Informed consent was obtained from all patients included in the study. RESULTS Twenty patients meeting inclusion criteria were identified. Fifteen patients were fully vaccinated against COVID-19. Four patients needed a short hospitalization for their symptoms. The most common diagnoses were COVID-19-associated acute viral laryngotracheitis and/or viral pharyngitis. Six patients presented with signs of secondary bacterial infection and were put on antibiotics. CONCLUSION Previous variants of SARS-CoV-2 infection affected predominantly the lower respiratory tract and were associated with loss of smell and taste in many patients. The Omicron variant seems to affect predominantly the upper airways and cause acute laryngitis without olfactory dysfunction. In some patients, the clinical manifestation is similar to the symptoms of epiglottitis. In such a case, a prompt examination of the larynx is the gold standard to exclude inflammatory edema in the upper airways. None of the patients described in this study developed epiglottitis. In this study, we discuss the management of acute odynophagia in COVID-19 patients.
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Affiliation(s)
- Krzysztof Piersiala
- Department of ENT Diseases, Karolinska University Hospital, Stockholm, Sweden.,Division of ENT Diseases, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Lara Kakabas
- Department of ENT Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Anna Bruckova
- Department of ENT Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Magnus Starkhammar
- Department of ENT Diseases, Karolinska University Hospital, Stockholm, Sweden.,Division of ENT Diseases, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Lars Olaf Cardell
- Department of ENT Diseases, Karolinska University Hospital, Stockholm, Sweden.,Division of ENT Diseases, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
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Piersiala K, Farrajota Neves da Silva P, Hjalmarsson E, Kolev A, Kågedal Å, Starkhammar M, Elliot A, Marklund L, Margolin G, Munck‐Wikland E, Kumlien Georén S, Cardell L. CD4 + and CD8 + T cells in sentinel nodes exhibit distinct pattern of PD-1, CD69, and HLA-DR expression compared to tumor tissue in oral squamous cell carcinoma. Cancer Sci 2021; 112:1048-1059. [PMID: 33462898 PMCID: PMC7935788 DOI: 10.1111/cas.14816] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 01/15/2021] [Accepted: 01/15/2021] [Indexed: 12/27/2022] Open
Abstract
Anticancer immunotherapies have revolutionized cancer management, yet the effect of systemic anti-programmed cell death protein 1 (PD-1) treatment is predominantly studied in tumor-infiltrating lymphocytes (TILs). Its impact on PD-1 expressing cells in tumor-draining lymph nodes (TDLNs) is not well understood and yet to be explored. Thus, further research aiming for better understanding of the PD-1 pathway not only in tumor tissue but also in TDLNs is warranted. In this study, we investigated the expression of PD-1, CD69, and HLA-DR on CD4+ and CD8+ T cells by flow cytometry analysis of peripheral blood mononuclear cells (PBMCs), TDLNs, and tumor samples from patients with oral squamous cell carcinoma (OSCC). Our data showed that both helper and cytotoxic T lymphocytes in OSCC tissue were highly activated and expressed high level of PD-1 (over 70% positivity). Lymphocytes in TDLNs and peripheral blood expressed significantly lower levels of PD-1 and other activation markers compared to TILs. Moreover, we demonstrated that a significant fraction of PD-1 negative TILs expressed high levels of human leukocyte antigen - DR isotype and CD69. In contrast, PD-1 negative cells in TDLNs and PBMCs scarcely expressed the aforementioned activation markers. Furthermore, we proved that patients with a high percentage of CD3+ PD-1+ cells in tumor-draining lymph nodes had significantly lower disease-free and overall survival rates (log-rank test P = .0272 and P = .0276, respectively). Taken together, we proved that flow cytometry of lymph nodes in OSCC is feasible and may be used to investigate whether PD-1 levels in TDLNs correspond with survival and potentially with response to anti-PD-1 therapy. Such knowledge may ultimately help guide anti-PD-1 treatment.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Antigens, CD/analysis
- Antigens, CD/metabolism
- Antigens, Differentiation, T-Lymphocyte/analysis
- Antigens, Differentiation, T-Lymphocyte/metabolism
- CD4-Positive T-Lymphocytes/immunology
- CD4-Positive T-Lymphocytes/metabolism
- CD8-Positive T-Lymphocytes/immunology
- CD8-Positive T-Lymphocytes/metabolism
- Female
- Flow Cytometry
- HLA-DR Antigens/analysis
- HLA-DR Antigens/metabolism
- Humans
- Lectins, C-Type/analysis
- Lectins, C-Type/metabolism
- Lymphocytes, Tumor-Infiltrating/immunology
- Lymphocytes, Tumor-Infiltrating/metabolism
- Male
- Middle Aged
- Mouth Neoplasms/immunology
- Mouth Neoplasms/pathology
- Programmed Cell Death 1 Receptor/analysis
- Programmed Cell Death 1 Receptor/metabolism
- Sentinel Lymph Node/cytology
- Sentinel Lymph Node/immunology
- Sentinel Lymph Node/pathology
- Squamous Cell Carcinoma of Head and Neck/immunology
- Squamous Cell Carcinoma of Head and Neck/pathology
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Affiliation(s)
- Krzysztof Piersiala
- Division of ENT DiseasesDepartment of Clinical Sciences, Intervention and TechnologyKarolinska InstitutetStockholmSweden
- Department of OtorhinolaryngologyKarolinska University HospitalStockholmSweden
| | | | - Eric Hjalmarsson
- Division of ENT DiseasesDepartment of Clinical Sciences, Intervention and TechnologyKarolinska InstitutetStockholmSweden
| | - Aeneas Kolev
- Division of ENT DiseasesDepartment of Clinical Sciences, Intervention and TechnologyKarolinska InstitutetStockholmSweden
- Department of OtorhinolaryngologyKarolinska University HospitalStockholmSweden
| | - Åsa Kågedal
- Division of ENT DiseasesDepartment of Clinical Sciences, Intervention and TechnologyKarolinska InstitutetStockholmSweden
- Department of OtorhinolaryngologyKarolinska University HospitalStockholmSweden
| | - Magnus Starkhammar
- Division of ENT DiseasesDepartment of Clinical Sciences, Intervention and TechnologyKarolinska InstitutetStockholmSweden
- Department of OtorhinolaryngologyKarolinska University HospitalStockholmSweden
| | - Alexandra Elliot
- Division of ENT DiseasesDepartment of Clinical Sciences, Intervention and TechnologyKarolinska InstitutetStockholmSweden
- Medical Unit Head Neck, Lung and Skin CancerKarolinska University HospitalStokcholmSweden
| | - Linda Marklund
- Division of ENT DiseasesDepartment of Clinical Sciences, Intervention and TechnologyKarolinska InstitutetStockholmSweden
- Department of OtorhinolaryngologyKarolinska University HospitalStockholmSweden
| | - Gregori Margolin
- Department of OtorhinolaryngologyKarolinska University HospitalStockholmSweden
- Medical Unit Head Neck, Lung and Skin CancerKarolinska University HospitalStokcholmSweden
| | - Eva Munck‐Wikland
- Division of ENT DiseasesDepartment of Clinical Sciences, Intervention and TechnologyKarolinska InstitutetStockholmSweden
- Medical Unit Head Neck, Lung and Skin CancerKarolinska University HospitalStokcholmSweden
| | - Susanna Kumlien Georén
- Division of ENT DiseasesDepartment of Clinical Sciences, Intervention and TechnologyKarolinska InstitutetStockholmSweden
- Department of OtorhinolaryngologyKarolinska University HospitalStockholmSweden
| | - Lars‐Olaf Cardell
- Division of ENT DiseasesDepartment of Clinical Sciences, Intervention and TechnologyKarolinska InstitutetStockholmSweden
- Department of OtorhinolaryngologyKarolinska University HospitalStockholmSweden
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Vangeti S, Gertow J, Yu M, Liu S, Baharom F, Scholz S, Friberg D, Starkhammar M, Ahlberg A, Smed-Sörensen A. Human Blood and Tonsil Plasmacytoid Dendritic Cells Display Similar Gene Expression Profiles but Exhibit Differential Type I IFN Responses to Influenza A Virus Infection. J Immunol 2019; 202:2069-2081. [PMID: 30760619 DOI: 10.4049/jimmunol.1801191] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Accepted: 01/25/2019] [Indexed: 12/19/2022]
Abstract
Influenza A virus (IAV) infection constitutes an annual health burden across the globe. Plasmacytoid dendritic cells (PDCs) are central in antiviral defense because of their superior capacity to produce type I IFNs in response to viruses. Dendritic cells (DCs) differ depending on their anatomical location. However, only limited host-pathogen data are available from the initial site of infection in humans. In this study, we investigated how human tonsil PDCs, likely exposed to virus because of their location, responded to IAV infection compared with peripheral blood PDCs. In tonsils, unlike in blood, PDCs are the most frequent DC subset. Both tonsil and blood PDCs expressed several genes necessary for pathogen recognition and immune response, generally in a similar pattern. MxA, a protein that renders cells resistant to IAV infection, was detected in both tonsil and blood PDCs. However, despite steady-state MxA expression and contrary to previous reports, at high IAV concentrations (typically cytopathic to other immune cells), both tonsil and blood PDCs supported IAV infection. IAV exposure resulted in PDC maturation by upregulation of CD86 expression and IFN-α secretion. Interestingly, blood PDCs secreted 10-fold more IFN-α in response to IAV compared with tonsil PDCs. Tonsil PDCs also had a dampened cytokine response to purified TLR ligands compared with blood PDCs. Our findings suggest that tonsil PDCs may be less responsive to IAV than blood PDCs, highlighting the importance of studying immune cells at their proposed site of function.
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Affiliation(s)
- Sindhu Vangeti
- Division of Immunology and Allergy, Department of Medicine Solna, Karolinska Institutet, 171 64 Stockholm, Sweden
| | - Jens Gertow
- Division of Immunology and Allergy, Department of Medicine Solna, Karolinska Institutet, 171 64 Stockholm, Sweden
| | - Meng Yu
- Division of Immunology and Allergy, Department of Medicine Solna, Karolinska Institutet, 171 64 Stockholm, Sweden
| | - Sang Liu
- Division of Immunology and Allergy, Department of Medicine Solna, Karolinska Institutet, 171 64 Stockholm, Sweden
| | - Faezzah Baharom
- Division of Immunology and Allergy, Department of Medicine Solna, Karolinska Institutet, 171 64 Stockholm, Sweden
| | - Saskia Scholz
- Division of Immunology and Allergy, Department of Medicine Solna, Karolinska Institutet, 171 64 Stockholm, Sweden
| | - Danielle Friberg
- Department of Surgical Sciences, Uppsala University, 751 85 Uppsala, Sweden
| | - Magnus Starkhammar
- Capio Ear, Nose and Throat Clinic Globen, 121 77 Johanneshov, Sweden; and
| | - Alexander Ahlberg
- Division of Ear, Nose and Throat Diseases, Department of Clinical Science, Intervention and Technology, Karolinska University Hospital Huddinge, Huddinge, 141 86 Stockholm, Sweden
| | - Anna Smed-Sörensen
- Division of Immunology and Allergy, Department of Medicine Solna, Karolinska Institutet, 171 64 Stockholm, Sweden;
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Apostolovic D, Rodrigues R, Thomas P, Starkhammar M, Hamsten C, van Hage M. Immunoprofile of α-Gal- and B-antigen-specific responses differentiates red meat-allergic patients from healthy individuals. Allergy 2018; 73:1525-1531. [PMID: 29319188 DOI: 10.1111/all.13400] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/22/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND The galactose-α-1,3-galactose (α-Gal) epitope is involved in red meat allergy. As α-Gal is structurally similar to the blood group B-antigen, we explored the relationship between the immune responses to α-Gal- and the B-antigen in red meat-allergic patients compared to healthy A/O or B blood donors. METHODS Sera from 51 red meat-allergic patients IgE-positive to α-Gal and 102 healthy blood donors (51 blood group A/O; 51 blood group B) were included. α-Gal- and B-antigen-specific IgE (ImmunoCAP) and IgG/IgG1-4 (ELISA) responses were determined. Basophil activation tests were performed. RESULTS Fifteen healthy donors were IgE positive to α-Gal, of which 3 had blood group B. The allergic patients had significantly higher α-Gal IgE levels compared to the healthy donors. The majority of the allergic patients, but none of the healthy donors, had IgE against the B-antigen. Inhibition studies revealed cross-reactivity between α-Gal and the B-antigen. The biological activity of the B-antigen was confirmed by basophil activation tests. Anti-α-Gal IgG1 and IgG4 levels were significantly higher in the patients compared to the healthy donors. Moreover, the IgG response to the B-antigen was comparable between the allergic patients and healthy A/O donors. CONCLUSION Red meat-allergic patients showed significantly higher α-Gal IgE, IgG1 , and IgG4 levels, reflecting a Th2 response, compared to healthy blood donors. Blood group B donors had significantly reduced antibody responses to α-Gal, due to similarities with the B-antigen, resulting in a lower risk of sensitization to α-Gal and development of red meat allergy.
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Affiliation(s)
- D. Apostolovic
- Department of Medicine Solna; Immunology and Allergy Unit; Karolinska Institutet and University Hospital; Stockholm Sweden
| | - R. Rodrigues
- Department of Clinical Immunology and Transfusion Medicine; Karolinska University Hospital; Stockholm Sweden
| | - P. Thomas
- Department of Medicine Solna; Immunology and Allergy Unit; Karolinska Institutet and University Hospital; Stockholm Sweden
| | - M. Starkhammar
- Department of Internal Medicine; Södersjukhuset; Stockholm Sweden
| | - C. Hamsten
- Department of Medicine Solna; Immunology and Allergy Unit; Karolinska Institutet and University Hospital; Stockholm Sweden
| | - M. van Hage
- Department of Medicine Solna; Immunology and Allergy Unit; Karolinska Institutet and University Hospital; Stockholm Sweden
- Department of Clinical Immunology and Transfusion Medicine; Karolinska University Hospital; Stockholm Sweden
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Larsson OJ, Manson ML, Starkhammar M, Fuchs B, Adner M, Kumlien Georén S, Cardell LO. The bronchodilatory capacity of imiquimod: the existence of two mechanisms. Am J Physiol Lung Cell Mol Physiol 2016; 311:L178-9. [PMID: 27407080 DOI: 10.1152/ajplung.00223.2016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Olivia J Larsson
- Division of ENT Diseases, CLINTEC, Karolinska Institutet, Stockholm, Sweden
| | - Martijn L Manson
- Centre for Allergy Research, Karolinska Institutet, Stockholm, Sweden; and Institute for Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Magnus Starkhammar
- Division of ENT Diseases, CLINTEC, Karolinska Institutet, Stockholm, Sweden; Centre for Allergy Research, Karolinska Institutet, Stockholm, Sweden; and
| | - Barbara Fuchs
- Division of ENT Diseases, CLINTEC, Karolinska Institutet, Stockholm, Sweden
| | - Mikael Adner
- Centre for Allergy Research, Karolinska Institutet, Stockholm, Sweden; and Institute for Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Susanna Kumlien Georén
- Division of ENT Diseases, CLINTEC, Karolinska Institutet, Stockholm, Sweden; Centre for Allergy Research, Karolinska Institutet, Stockholm, Sweden; and
| | - Lars-Olaf Cardell
- Division of ENT Diseases, CLINTEC, Karolinska Institutet, Stockholm, Sweden; Department of ENT Disease, Karolinska University Hospital, Stockholm, Sweden;
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Larsson OJ, Manson ML, Starkhammar M, Fuchs B, Adner M, Kumlien Georén S, Cardell LO. The TLR7 agonist imiquimod induces bronchodilation via a nonneuronal TLR7-independent mechanism: a possible role for quinoline in airway dilation. Am J Physiol Lung Cell Mol Physiol 2016; 310:L1121-9. [PMID: 27084847 DOI: 10.1152/ajplung.00288.2015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Accepted: 04/07/2016] [Indexed: 11/22/2022] Open
Abstract
Toll-like receptor (TLR) 7 agonists are known to reduce allergic airway inflammation. Their recently reported ability to rapidly relax airways has further increased their interest in the treatment of pulmonary disease. However, the mechanisms behind this effect are not fully understood. The present study, therefore, aimed to determine whether airway smooth muscle (ASM)-dependent mechanisms could be identified. TLR7 agonists were added to guinea pig airways following precontraction with carbachol in vitro or histamine in vivo. Pharmacological inhibitors were used to dissect conventional pathways of bronchodilation; tetrodotoxin was used or bilateral vagotomy was performed to assess neuronal involvement. Human ASM cells (HASMCs) were employed to determine the effect of TLR7 agonists on intracellular Ca(2+) ([Ca(2+)]i) mobilization. The well-established TLR7 agonist imiquimod rapidly relaxed precontracted airways in vitro and in vivo. This relaxation was demonstrated to be independent of nitric oxide, carbon monoxide, and cAMP signaling, as well as neuronal activity. A limited role for prostanoids could be detected. Imiquimod induced [Ca(2+)]i release from endoplasmic reticulum stores in HASMCs, inhibiting histamine-induced [Ca(2+)]i The TLR7 antagonist IRS661 failed to inhibit relaxation, and the structurally dissimilar agonist CL264 did not relax airways or inhibit [Ca(2+)]i This study shows that imiquimod acts directly on ASM to induce bronchorelaxation, via a TLR7-independent release of [Ca(2+)]i The effect is paralleled by other bronchorelaxant compounds, like chloroquine, which, like imiquimod, but unlike CL264, contains the chemical structure quinoline. Compounds with quinoline moieties may be of interest in the development of multifunctional drugs to treat pulmonary disease.
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Affiliation(s)
- Olivia J Larsson
- Division of ENT Diseases, CLINTEC, Karolinska Institutet, Stockholm, Sweden
| | - Martijn L Manson
- Centre for Allergy Research, Karolinska Institutet, Stockholm, Sweden; and Institute for Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Magnus Starkhammar
- Division of ENT Diseases, CLINTEC, Karolinska Institutet, Stockholm, Sweden; Centre for Allergy Research, Karolinska Institutet, Stockholm, Sweden; and
| | - Barbara Fuchs
- Division of ENT Diseases, CLINTEC, Karolinska Institutet, Stockholm, Sweden
| | - Mikael Adner
- Centre for Allergy Research, Karolinska Institutet, Stockholm, Sweden; and Institute for Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Susanna Kumlien Georén
- Division of ENT Diseases, CLINTEC, Karolinska Institutet, Stockholm, Sweden; Centre for Allergy Research, Karolinska Institutet, Stockholm, Sweden; and
| | - Lars-Olaf Cardell
- Division of ENT Diseases, CLINTEC, Karolinska Institutet, Stockholm, Sweden; Department of ENT Disease, Karolinska University Hospital, Stockholm, Sweden;
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Apostolovic D, Tran TAT, Sánchez-Vidaurre S, Cirkovic Velickovic T, Starkhammar M, Hamsten C, van Hage M. Red meat allergic patients have a selective IgE response to the α-Gal glycan. Allergy 2015; 70:1497-500. [PMID: 26190542 DOI: 10.1111/all.12695] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/12/2015] [Indexed: 11/24/2022]
Abstract
Galactose-α-1,3-galactose (α-Gal) is a mammalian carbohydrate with significance in a novel type of food allergy. Patients with IgE against α-Gal report severe allergic symptoms 3-6 h after consumption of red meat. We investigated whether IgE from red meat allergic patients recognizes other mammalian glycans than α-Gal or glycans from the plant kingdom and insects of importance in allergy. We found that none of the 24 red meat allergic patients investigated had an IgE antibody response against the other abundant mammalian glycan N-glycolylneuraminic acid or against cross-reactive carbohydrate determinants from plant or venom sources (nCup a 1, nArt v 1, and MUXF3). Deglycosylation of an α-Gal-containing protein, bovine thyroglobulin, significantly reduced the IgE response. In conclusion, we show that red meat allergic patients have a selective IgE response to the α-Gal glycan found in red meat. Other common glycans reactive in allergic disease are not targets of red meat allergic patients' IgE.
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Affiliation(s)
- D. Apostolovic
- Clinical Immunology and Allergy Unit; Department of Medicine Solna; Karolinska Institutet and University Hospital; Stockholm Sweden
- Center of Excellence for Molecular Food Sciences; Faculty of Chemistry; University of Belgrade; Belgrade Serbia
| | - T. A. T. Tran
- Clinical Immunology and Allergy Unit; Department of Medicine Solna; Karolinska Institutet and University Hospital; Stockholm Sweden
| | - S. Sánchez-Vidaurre
- Clinical Immunology and Allergy Unit; Department of Medicine Solna; Karolinska Institutet and University Hospital; Stockholm Sweden
| | - T. Cirkovic Velickovic
- Center of Excellence for Molecular Food Sciences; Faculty of Chemistry; University of Belgrade; Belgrade Serbia
| | - M. Starkhammar
- Department of Internal Medicine; Södersjukhuset; Stockholm Sweden
| | - C. Hamsten
- Clinical Immunology and Allergy Unit; Department of Medicine Solna; Karolinska Institutet and University Hospital; Stockholm Sweden
- Center for Inflammatory Diseases; Karolinska Institutet; Stockholm Sweden
| | - M. van Hage
- Clinical Immunology and Allergy Unit; Department of Medicine Solna; Karolinska Institutet and University Hospital; Stockholm Sweden
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10
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Starkhammar M, Kumlien Georén S, Dahlén SE, Cardell LO, Adner M. TNFα-blockade stabilizes local airway hyperresponsiveness during TLR-induced exacerbations in murine model of asthma. Respir Res 2015; 16:129. [PMID: 26494305 PMCID: PMC4618779 DOI: 10.1186/s12931-015-0292-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Accepted: 10/09/2015] [Indexed: 01/11/2023] Open
Abstract
Viral infections are a common cause of asthma exacerbation. These maladies are sometimes complicated by bacterial infections. Toll-like receptors (TLRs) are in the forefront of our microbial defence, with TLR3 responding to viral and TLR4 to bacterial stimulation. The present study was designed to evaluate the effect of concomitant TLR3 and TLR4 stimulation in a murine model of allergic asthma. BALB/c mice were stimulated intranasally with a combination of poly(I:C) and LPS activating TLR3 and TLR4, respectively. This resulted in the development of airway hyperresponsiveness (AHR) in the proximal part of the lung, along with signs of neutrophilic inflammation. Analysis of the bronchioalveolar lavage fluid (BALF) revealed a marked increase in TNFα. In contrast, the allergic airway inflammation induced by ovalbumin administration to sensitized mice caused AHR in the whole lung along with an increase in eosinophils and lymphocytes in the BALF and lung. When poly(I:C) + LPS were given to mice with an ongoing allergic airway inflammation induced by ovalbumin, the AHR was further increased in the peripheral lung and neutrophils appeared together with eosinophils and lymphocytes in the BALF and lung. Treatment with the TNFα-blocking antibody infliximab blunted the AHR increase, without affecting the cells influx in BALF. To conclude; a combined TLR3- and TLR4-stimulation, representing a concomitant viral and bacterial infection, causes an AHR that is further exaggerated during an ongoing allergic inflammation. The airway stabilizing effect of infliximab indicates the possible future use of TNFα blockade in treatment of microbial induced exacerbations of allergic asthma.
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Affiliation(s)
- Magnus Starkhammar
- Centre for Allergy Research, Karolinska Institutet, Stockholm, Sweden.,Division of ENT diseases, CLINTEC, Karolinska Institutet, Stockholm, Sweden.,Department of ENT Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Susanna Kumlien Georén
- Centre for Allergy Research, Karolinska Institutet, Stockholm, Sweden.,Division of ENT diseases, CLINTEC, Karolinska Institutet, Stockholm, Sweden
| | - Sven-Erik Dahlén
- Division of ENT diseases, CLINTEC, Karolinska Institutet, Stockholm, Sweden.,Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Lars-Olaf Cardell
- Centre for Allergy Research, Karolinska Institutet, Stockholm, Sweden.,Division of ENT diseases, CLINTEC, Karolinska Institutet, Stockholm, Sweden.,Department of ENT Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Mikael Adner
- Division of ENT diseases, CLINTEC, Karolinska Institutet, Stockholm, Sweden. .,Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden. .,Unit of Experimental Asthma and Allergy Research, Institute of Environmental Medicine, Scheeles väg 1, Karolinska Institutet, SE-171 77, Stockholm, Sweden.
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11
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Apostolovic D, Tran TAT, Hamsten C, Starkhammar M, Cirkovic Velickovic T, van Hage M. Immunoproteomics of processed beef proteins reveal novel galactose-α-1,3-galactose-containing allergens. Allergy 2014; 69:1308-15. [PMID: 24942937 DOI: 10.1111/all.12462] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/12/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND Red meat allergy presents a novel form of food allergy with severe delayed allergic reactions where IgE antibodies are directed against the carbohydrate α-Gal epitope. Food preparation and processing can influence the allergenicity of proteins. The aim of this study was to characterize the proteomic profile of different beef preparations and to investigate their α-Gal reactivity and potential allergenicity. METHODS Extracts from raw, boiled, fried, and medium rare prepared beef were assessed by 2D PAGE for the comparison of protein profiles. IgE-binding proteins were identified using immunoblot-coupled proteomic analysis using sera from red meat-allergic patients. Presence of the α-Gal epitope was verified using anti-α-Gal antibody and IgE inhibition immunoblot with α-Gal. RESULTS Multiple IgE-binding proteins were detected in the different beef preparations, many of which were also recognized by the anti-α-Gal antibody. Protein spots reacting with IgE in patient sera were analyzed by MS/MS, resulting in identification of 18 proteins with high identification scores. Seven of the 18 beef allergens identified using meat-allergic patient sera were also recognized by the anti-α-Gal monoclonal antibody, and four of them were stabile to thermal treatment. Furthermore, a dose-dependent inhibition of red meat-allergic patients' IgE to beef by α-Gal was demonstrated. CONCLUSIONS We show that the α-Gal epitope is commonly present in IgE-reactive beef proteins recognized by meat-allergic patients. Seven novel α-Gal-containing IgE-binding proteins were identified, of which four were stable to heat treatment. Thus, the allergenicity of red meat proteins is preserved even upon different thermal cooking.
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Affiliation(s)
- D. Apostolovic
- Department of Medicine Solna Clinical Immunology and Allergy Unit; Karolinska Institutet and University Hospital; Stockholm Sweden
- Center of Excellence in Molecular Food Sciences; Faculty of Chemistry; University of Belgrade; Belgrade Serbia
| | - T. A. T. Tran
- Department of Medicine Solna Clinical Immunology and Allergy Unit; Karolinska Institutet and University Hospital; Stockholm Sweden
| | - C. Hamsten
- Department of Medicine Solna Clinical Immunology and Allergy Unit; Karolinska Institutet and University Hospital; Stockholm Sweden
- Center for Inflammatory Diseases; Karolinska Institutet; Stockholm Sweden
| | - M. Starkhammar
- Department of Internal Medicine; Södersjukhuset; Stockholm Sweden
| | - T. Cirkovic Velickovic
- Center of Excellence in Molecular Food Sciences; Faculty of Chemistry; University of Belgrade; Belgrade Serbia
| | - M. van Hage
- Department of Medicine Solna Clinical Immunology and Allergy Unit; Karolinska Institutet and University Hospital; Stockholm Sweden
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12
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Hamsten C, Starkhammar M, Tran TAT, Johansson M, Bengtsson U, Ahlén G, Sällberg M, Grönlund H, van Hage M. Identification of galactose-α-1,3-galactose in the gastrointestinal tract of the tick Ixodes ricinus; possible relationship with red meat allergy. Allergy 2013; 68:549-52. [PMID: 23414348 DOI: 10.1111/all.12128] [Citation(s) in RCA: 140] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/02/2013] [Indexed: 11/28/2022]
Abstract
Patients with IgE antibodies against the carbohydrate epitope galactose-α-1,3-galactose (α-Gal) have reported severe allergic reactions after consumption of red meat. Investigations have revealed associations between IgE to α-Gal and tick bites. We provide the first direct evidence that α-Gal is present within ticks thus potentially explaining the relationship between tick exposure and sensitization to α-Gal, with development of red meat allergy as a secondary phenomena. Serum from Swedish patients with delayed severe reactions to red meat was included in the study. A dose-dependent inhibition of IgE responses to α-Gal by the tick Ixodes ricinus is demonstrated. Furthermore, using cryostat-cut sections of I. ricinus, we show that both a monoclonal and a polyclonal antibody against α-Gal stains the gastrointestinal tract of the tick. The same pattern is seen when staining with patient sera IgE positive to α-Gal. These results confirm that the α-Gal epitope is present in I. ricinus and imply host exposure to α-Gal during a tick bite. This provides further evidence that tick bites are associated with IgE responses to α-Gal and red meat allergy.
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Affiliation(s)
| | - M. Starkhammar
- Department of Internal Medicine; Södersjukhuset; Stockholm; Sweden
| | - T. A. T. Tran
- Department of Medicine Solna; Clinical Immunology and Allergy Unit; Karolinska Institutet and University Hospital Solna; Stockholm; Sweden
| | | | - U. Bengtsson
- Department of Internal Medicine; Södersjukhuset; Stockholm; Sweden
| | - G. Ahlén
- Division of Clinical Microbiology; Department of Laboratory Medicine; Karolinska Institutet and University Hospital Huddinge; Stockholm; Sweden
| | - M. Sällberg
- Division of Clinical Microbiology; Department of Laboratory Medicine; Karolinska Institutet and University Hospital Huddinge; Stockholm; Sweden
| | - H. Grönlund
- Department of Medicine Solna; Clinical Immunology and Allergy Unit; Karolinska Institutet and University Hospital Solna; Stockholm; Sweden
| | - M. van Hage
- Department of Medicine Solna; Clinical Immunology and Allergy Unit; Karolinska Institutet and University Hospital Solna; Stockholm; Sweden
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13
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Starkhammar M, Kumlien Georén S, Swedin L, Dahlén SE, Adner M, Cardell LO. Intranasal administration of poly(I:C) and LPS in BALB/c mice induces airway hyperresponsiveness and inflammation via different pathways. PLoS One 2012; 7:e32110. [PMID: 22355412 PMCID: PMC3280225 DOI: 10.1371/journal.pone.0032110] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2011] [Accepted: 01/23/2012] [Indexed: 11/24/2022] Open
Abstract
Background Bacterial and viral infections are known to promote airway hyperresponsiveness (AHR) in asthmatic patients. The mechanism behind this reaction is poorly understood, but pattern recognizing Toll-like receptors (TLRs) have recently been suggested to play a role. Materials and Methods To explore the relation between infection-induced airway inflammation and the development of AHR, poly(I:C) activating TLR3 and LPS triggering TLR4, were chosen to represent viral and bacterial induced interactions, respectively. Female BALB/c or MyD88-deficient C57BL/6 mice were treated intranasally with either poly(I:C), LPS or PBS (vehicle for the control group), once a day, during 4 consecutive days. Results When methacholine challenge was performed on day 5, BALB/c mice responded with an increase in airway resistance. The maximal resistance was higher in the poly(I:C) and LPS treated groups than among the controls, indicating development of AHR in response to repeated TLR activation. The proportion of lymphocytes in broncheoalveolar lavage fluid (BALF) increased after poly(I:C) treatment whereas LPS enhanced the amount of neutrophils. A similar cellular pattern was seen in lung tissue. Analysis of 21 inflammatory mediators in BALF revealed that the TLR response was receptor-specific. MyD88-deficient C57BL/6 mice responded to poly (I:C) with an influx of lymphocytes, whereas LPS caused no inflammation. Conclusion In vivo activation of TLR3 and TLR4 in BALB/c mice both caused AHR in conjunction with a local inflammatory reaction. The AHR appeared to be identical regardless of which TLR that was activated, whereas the inflammation exhibited a receptor specific profile in terms of both recruited cells and inflammatory mediators. The inflammatory response caused by LPS appeared to be dependent on MyD88 pathway. Altogether the presented data indicate that the development of AHR and the induction of local inflammation might be the result of two parallel events, rather than one leading to another.
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Affiliation(s)
- Magnus Starkhammar
- Division of ENT Diseases, CLINTEC, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
- Unit for Experimental Asthma and Allergy Research, The National Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Susanna Kumlien Georén
- Division of ENT Diseases, CLINTEC, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
- Unit for Experimental Asthma and Allergy Research, The National Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Linda Swedin
- Unit for Experimental Asthma and Allergy Research, The National Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- The Centre for Allergy Reseach, Karolinska Institutet, Stockholm, Sweden
| | - Sven-Erik Dahlén
- Unit for Experimental Asthma and Allergy Research, The National Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- The Centre for Allergy Reseach, Karolinska Institutet, Stockholm, Sweden
| | - Mikael Adner
- Unit for Experimental Asthma and Allergy Research, The National Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- The Centre for Allergy Reseach, Karolinska Institutet, Stockholm, Sweden
| | - Lars Olaf Cardell
- Division of ENT Diseases, CLINTEC, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
- The Centre for Allergy Reseach, Karolinska Institutet, Stockholm, Sweden
- * E-mail:
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