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Campana R, Moritz K, Marth K, Neubauer A, Huber H, Henning R, Blatt K, Hoermann G, Brodie TM, Kaider A, Valent P, Sallusto F, Wöhrl S, Valenta R. Frequent occurrence of T cell-mediated late reactions revealed by atopy patch testing with hypoallergenic rBet v 1 fragments. J Allergy Clin Immunol 2015; 137:601-609.e8. [PMID: 26518092 PMCID: PMC4748398 DOI: 10.1016/j.jaci.2015.08.042] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [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: 04/17/2015] [Revised: 08/05/2015] [Accepted: 08/18/2015] [Indexed: 11/18/2022]
Abstract
Background Late allergic reactions are common in the course of allergen-specific immunotherapy and even occur with allergy vaccines with reduced IgE reactivity. Objective We sought to study atopy patch test (APT) reactions and T-cell responses to the recombinant birch pollen allergen Bet v 1 and recombinant hypoallergenic T-cell epitope–containing Bet v 1 fragments in patients with birch pollen allergy with and without atopic dermatitis (AD). Methods A clinical study was conducted in 15 patients with birch pollen allergy with AD (group 1), 5 patients with birch pollen allergy without AD (group 2), 5 allergic patients without birch pollen allergy (group 3), and 5 nonallergic subjects (group 4) by performing skin prick tests and APTs with rBet v 1 and hypoallergenic rBet v 1 fragments. T-cell, cutaneous lymphocyte antigen (CLA)+ and CCR4+ T-cell and cytokine responses were studied by thymidine uptake, carboxyfluorescein diacetate succinimidyl ester staining, and Luminex technology, respectively. Results rBet v 1 and hypoallergenic rBet v 1 fragments induced APT reactions in not only most of the patients with birch pollen allergy with AD (11/15) but also in most of those without AD (4/5). Patients with birch pollen allergy with AD had higher Bet v 1–specific proliferation of CLA+ and CCR4+ T cells compared with patients with birch pollen allergy without AD. There were no differences in Bet v 1–specific CLA+ and CCR4+ proliferation and cytokine secretion in patients with and without APT reactions. Conclusion Hypoallergenic rBet v 1 fragments induce T cell–dependent late reactions not only in patients with birch pollen allergy with AD but also in those without AD, which can be determined based on APT results but not based on in vitro parameters.
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MESH Headings
- Adult
- Allergens/immunology
- Antigens, Plant/immunology
- Betula/adverse effects
- Cytokines/biosynthesis
- Dermatitis, Atopic/diagnosis
- Dermatitis, Atopic/immunology
- Dermatitis, Atopic/metabolism
- Female
- Histamine Release
- Humans
- Hypersensitivity, Delayed/diagnosis
- Hypersensitivity, Delayed/immunology
- Hypersensitivity, Delayed/metabolism
- Hypersensitivity, Immediate/diagnosis
- Hypersensitivity, Immediate/immunology
- Hypersensitivity, Immediate/metabolism
- Lymphocyte Activation/immunology
- Male
- Patch Tests
- Pollen/immunology
- Rhinitis, Allergic, Seasonal/diagnosis
- Rhinitis, Allergic, Seasonal/immunology
- T-Cell Antigen Receptor Specificity/immunology
- T-Lymphocytes/immunology
- T-Lymphocytes/metabolism
- Young Adult
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Affiliation(s)
- Raffaela Campana
- Division of Immunopathology, Department of Pathophysiology, Center of Physiology and Pathophysiology, Vienna General Hospital (AKH), Medical University of Vienna, Vienna, Austria
| | - Katharina Moritz
- Division of Immunology, Allergy and Infectious Diseases (DIAID), Department of Dermatology, Vienna General Hospital (AKH), Medical University of Vienna, Vienna, Austria
| | - Katharina Marth
- Division of Immunopathology, Department of Pathophysiology, Center of Physiology and Pathophysiology, Vienna General Hospital (AKH), Medical University of Vienna, Vienna, Austria
| | | | - Hans Huber
- Biomay AG, Vienna Competence Center, Vienna, Austria
| | | | - Katharina Blatt
- Division of Hematology and Hemostaseology, Department of Internal Medicine I, Vienna General Hospital (AKH), Medical University of Vienna, Vienna, Austria
| | - Gregor Hoermann
- Department of Laboratory Medicine, Vienna General Hospital (AKH), Medical University of Vienna, Vienna, Austria
| | - Tess M Brodie
- Cellular Immunology Laboratory, Institute for Research in Biomedicine, University of Italian Switzerland, Bellinzona, Switzerland
| | - Alexandra Kaider
- Center for Medical Statistics, Informatics and Intelligent Systems, Section for Clinical Biometrics, Medical University of Vienna, Vienna, Austria
| | - Peter Valent
- Division of Hematology and Hemostaseology, Department of Internal Medicine I, Vienna General Hospital (AKH), Medical University of Vienna, Vienna, Austria
| | - Federica Sallusto
- Cellular Immunology Laboratory, Institute for Research in Biomedicine, University of Italian Switzerland, Bellinzona, Switzerland
| | - Stefan Wöhrl
- Division of Immunology, Allergy and Infectious Diseases (DIAID), Department of Dermatology, Vienna General Hospital (AKH), Medical University of Vienna, Vienna, Austria
| | - Rudolf Valenta
- Division of Immunopathology, Department of Pathophysiology, Center of Physiology and Pathophysiology, Vienna General Hospital (AKH), Medical University of Vienna, Vienna, Austria.
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