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Mitlehner A, Mitlehner C, Reißmann M, Stoll P, Swoboda I, Mitlehner W. Horse allergy: Curly Horses can mediate immune tolerance. Pneumologie 2024; 78:47-57. [PMID: 37827498 DOI: 10.1055/a-2101-9533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2023]
Abstract
American Bashkir Curly Horses are claimed to be hypoallergenic, but this has not been clinically proven. In the present study, the effect of exposure to Curly Horses was investigated in 141 patients allergic to horses by measuring their lung function and nasal patency during Curly Horse contact. Continuous contact with Curly Horses, including riding and brushing, decreased the allergic riders' reactivity as measured by FEV1, PEF, and PNIF. Subsequent visits (up to 40 or more hours of riding) further reduced reactivity to the Curly Horses. Allergic events to horses occurred only in 72 out of 1312 riding hours, mainly in the first ten riding hours.In 41 out of the 141 patients, it was further investigated whether repeated exposure to Curly Horses could induce tolerance to other horses. Patients in the tolerance induction study were tested annually for horse allergy using a nasal provocation test. The tolerance induction study showed that exposure to Curly Horses induced immune tolerance to other horses in 88% of patients who completed the study.To understand the mechanism causing hypoallergenicity, we performed IgE immunoblots to determine whether Curly Horse hairs contain IgE binding proteins. However, no differences in IgE reactivity were found between Curly and non-Curly Horses. Moreover, the immune tolerance induction study patients did not show decreased IgE reactivity to hairs from Curly or non-Curly Horses even though patients had developed tolerance. However, we did find increasing levels of anti-horse IgG antibodies in the study patients.Overall, our data strongly suggests that continuous exposure to Curly Horses can induce immune tolerance, rendering these patients non-reactive to horses. The reason for the reduced clinical allergenicity of Curly Horses remains unclear, but the data suggest that blocking IgG antibodies may be of importance for immune tolerance development.
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Affiliation(s)
| | | | - Monika Reißmann
- Albrecht Daniel Thaer-Institut for Agricultural and Horticultural Sciences, Humboldt-Universitat zu Berlin, Berlin, Germany
| | - Peter Stoll
- Molecular Biotechnology Section, FH Campus Wien University of Applied Sciences, Wien, Austria
| | - Ines Swoboda
- Molecular Biotechnology Section, FH Campus Wien University of Applied Sciences, Wien, Austria
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Atanasio A, Orengo JM, Sleeman MA, Stahl N. Biologics as novel therapeutics for the treatment of allergy: Challenges and opportunities. FRONTIERS IN ALLERGY 2022; 3:1019255. [DOI: 10.3389/falgy.2022.1019255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Accepted: 09/29/2022] [Indexed: 11/06/2022] Open
Abstract
Over the last 4 decades there has been a significant global increase in the incidence and prevalence of IgE-mediated allergy. Although much progress has been made in the management of allergy via patient education, pharmacotherapy and immunomodulatory treatment regimens, significant unmet need remains. Advancements in our knowledge base surrounding the type 2 immune response, production of IgE and maintenance of immunological memory has led the field to explore targeted intervention of allergic pathways using monoclonal antibodies (mAbs). Intervention at various stages of the allergic cascade offers the opportunity to prevent initiation and/or maintenance of the type 2 immune response and effectively provide therapeutic benefit to patients. Furthermore, a better understanding of the protective mechanisms involved in allergen specific immunotherapy (AIT) has led us to appreciate the interplay of immunoglobulins in the allergic response, specifically the benefit in shifting the IgG:IgE ratio in favor of functionally relevant blocking IgG. Thus, treatments that lower IgE or boost IgG with the ability to outcompete IgE binding to allergen also present a favorable approach in the treatment of allergy. In this short review we discuss and highlight recent advances in the use of biologics to treat severe allergy, highlighting the key challenges but also the significant opportunities and advances to date.
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Zinkhan S, Thoms F, Augusto G, Vogel M, Bachmann MF. On the role of allergen-specific IgG subclasses for blocking human basophil activation. Front Immunol 2022; 13:892631. [PMID: 36275723 PMCID: PMC9582512 DOI: 10.3389/fimmu.2022.892631] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 09/16/2022] [Indexed: 11/30/2022] Open
Abstract
Successful treatment of IgE mediated allergies by allergen-specific immunotherapy (AIT) usually correlates with the induction of allergen-specific IgG4. However, it is not clear whether IgG4 prevents the allergic reaction more efficiently than other IgG subclasses. Here we aimed to compare allergen-specific monoclonal IgG1 and IgG4 antibodies in their capacity to inhibit type I allergic reactions by engaging FcγRIIb. We found that IgG1, which is the dominant subclass induced by viruses, binds with a similar affinity to the FcγRIIb as IgG4 and is comparable at blocking human basophil activation from allergic patients; both by neutralizing the allergen as well as engaging the inhibitory receptor FcγRIIb. Hence, the IgG subclass plays a limited role for the protective efficacy of AIT even if IgG4 is considered the best correlate of protection, most likely simply because it is the dominant subclass induced by classical AITs.
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Affiliation(s)
- Simon Zinkhan
- Department of Immunology, University Clinic of Rheumatology and Immunology, Inselspital, University of Bern, Bern, Switzerland
- Department of BioMedical Research, University of Bern, Bern, Switzerland
| | | | - Gilles Augusto
- Department of Immunology, University Clinic of Rheumatology and Immunology, Inselspital, University of Bern, Bern, Switzerland
- Department of BioMedical Research, University of Bern, Bern, Switzerland
- Nuffield Department of Medicine, The Henry Wellcome Building for Molecular Physiology, The Jenner Institute, University of Oxford, Oxford, United Kingdom
| | - Monique Vogel
- Department of Immunology, University Clinic of Rheumatology and Immunology, Inselspital, University of Bern, Bern, Switzerland
- Department of BioMedical Research, University of Bern, Bern, Switzerland
| | - Martin F. Bachmann
- Department of Immunology, University Clinic of Rheumatology and Immunology, Inselspital, University of Bern, Bern, Switzerland
- Department of BioMedical Research, University of Bern, Bern, Switzerland
- Nuffield Department of Medicine, The Henry Wellcome Building for Molecular Physiology, The Jenner Institute, University of Oxford, Oxford, United Kingdom
- *Correspondence: Martin F. Bachmann,
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López-Sanz C, Jiménez-Saiz R, Esteban V, Delgado-Dolset MI, Perales-Chorda C, Villaseñor A, Barber D, Escribese MM. Mast Cell Desensitization in Allergen Immunotherapy. FRONTIERS IN ALLERGY 2022; 3:898494. [PMID: 35847161 PMCID: PMC9278139 DOI: 10.3389/falgy.2022.898494] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 05/16/2022] [Indexed: 01/21/2023] Open
Abstract
Allergen immunotherapy (AIT) is the only treatment with disease-transforming potential for allergic disorders. The immunological mechanisms associated with AIT can be divided along time in two phases: short-term, involving mast cell (MC) desensitization; and long-term, with a regulatory T cell (Treg) response with significant reduction of eosinophilia. This regulatory response is induced in about 70% of patients and lasts up to 3 years after AIT cessation. MC desensitization is characteristic of the initial phase of AIT and it is often related to its success. Yet, the molecular mechanisms involved in allergen-specific MC desensitization, or the connection between MC desensitization and the development of a Treg arm, are poorly understood. The major AIT challenges are its long duration, the development of allergic reactions during AIT, and the lack of efficacy in a considerable proportion of patients. Therefore, reaching a better understanding of the immunology of AIT will help to tackle these short-comings and, particularly, to predict responder-patients. In this regard, omics strategies are empowering the identification of predictive and follow-up biomarkers in AIT. Here, we review the immunological mechanisms underlying AIT with a focus on MC desensitization and AIT-induced adverse reactions. Also, we discuss the identification of novel biomarkers with predictive potential that could improve the rational use of AIT.
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Affiliation(s)
- Celia López-Sanz
- Department of Immunology, Instituto de Investigación Sanitaria Hospital Universitario de La Princesa (IIS-Princesa), Madrid, Spain
| | - Rodrigo Jiménez-Saiz
- Department of Immunology, Instituto de Investigación Sanitaria Hospital Universitario de La Princesa (IIS-Princesa), Madrid, Spain
- Department of Immunology and Oncology, Centro Nacional de Biotecnología (CNB)-CSIC, Madrid, Spain
- Faculty of Experimental Sciences, Universidad Francisco de Vitoria (UFV), Madrid, Spain
- McMaster Immunology Research Centre (MIRC), Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Vanesa Esteban
- Department of Allergy and Immunology, Instituto de Investigación Sanitaria Fundación Jiménez Díaz (IIS-FJD), Universidad Autónoma de Madrid (UAM), Madrid, Spain
- Faculty of Medicine and Biomedicine, Alfonso X El Sabio University, Madrid, Spain
| | - María Isabel Delgado-Dolset
- Department of Basic Medical Sciences, Facultad de Medicina, Institute of Applied Molecular Medicine Nemesio Díez, Universidad San Pablo-CEU, CEU Universities, Urbanización Montepríncipe, Madrid, Spain
| | - Carolina Perales-Chorda
- Department of Basic Medical Sciences, Facultad de Medicina, Institute of Applied Molecular Medicine Nemesio Díez, Universidad San Pablo-CEU, CEU Universities, Urbanización Montepríncipe, Madrid, Spain
- Centre for Metabolomics and Bioanalysis (CEMBIO), Department of Chemistry and Biochemistry, Facultad de Farmacia, Universidad San Pablo CEU, CEU Universities, Urbanización Montepríncipe, Madrid, Spain
| | - Alma Villaseñor
- Department of Basic Medical Sciences, Facultad de Medicina, Institute of Applied Molecular Medicine Nemesio Díez, Universidad San Pablo-CEU, CEU Universities, Urbanización Montepríncipe, Madrid, Spain
- Centre for Metabolomics and Bioanalysis (CEMBIO), Department of Chemistry and Biochemistry, Facultad de Farmacia, Universidad San Pablo CEU, CEU Universities, Urbanización Montepríncipe, Madrid, Spain
| | - Domingo Barber
- Department of Basic Medical Sciences, Facultad de Medicina, Institute of Applied Molecular Medicine Nemesio Díez, Universidad San Pablo-CEU, CEU Universities, Urbanización Montepríncipe, Madrid, Spain
| | - María M. Escribese
- Department of Basic Medical Sciences, Facultad de Medicina, Institute of Applied Molecular Medicine Nemesio Díez, Universidad San Pablo-CEU, CEU Universities, Urbanización Montepríncipe, Madrid, Spain
- *Correspondence: María M. Escribese
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Yang L, Yang Y, Xu Q, Zhang W, Jiang Q, Li W, Wang Y, Ma D, Lin X, Sun B, Zhu R. Specific IgE and IgG4 Profiles of House Dust Mite Components in Allergen-Specific Immunotherapy. Front Immunol 2022; 12:786738. [PMID: 35197963 PMCID: PMC8858833 DOI: 10.3389/fimmu.2021.786738] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 12/23/2021] [Indexed: 11/29/2022] Open
Abstract
Background Allergen immunotherapy (AIT) can induce immune tolerance to allergens by activating multiple mechanisms, including promoting IgG4 synthesis and blunting IgE production. However, the longitudinal data of sIgE and sIgG4 to allergen components during AIT are limited. Objective We sought to investigate the persistence and evolution of sIgE and sIgG4 against house dust mite (HDM) components during AIT and explore their correlation with clinical responses. Methods Sixty allergic rhinitis (AR) with/without asthma patients receiving AIT for HDM were enrolled in AIT group. Thirty AR patients without receiving AIT served as control group. Blood samples were collected for sIgE, sIgG4 to HDM components (Derp 1, Derf 1, Derp 2, Derf 2, Derp 7, Derp 10, Derp 21 and Derp 23) assay at baseline, Month 6 and Month 18 of AIT. Combined symptom and medication scores (CSMS) were obtained accordingly. Results In the AIT group, sIgG4 to the HDM components of Derp 1, Derf 1, Derp 2 and Derf 2, Derp 21 significantly increased at Month 18 compared to the baseline (36.2 UA/mL vs 158.8 UA/mL, 46.4 UA/mL vs 94.6 UA/mL, 80.5 UA/mL vs 152.3 UA/mL, 78.3 UA/mL vs 205.1 UA/mL, 42.3 UA/mL vs 59.3 UA/mL, all p<0.05), sIgE to HDM components didn’t see differences at baseline and at Month 18 (all p>0.05).The numbers of positive HDM component sIgE and sIgG4 increased from 4.5 to 5 and 0 to 1.5 respectively (both p<0.05). However, the changes of sIgE, sIgG4, sIgE/sIgG4 ratio and the numbers of positive HDM components had no correlations with the improvement of CSMS after AIT (all ρ<0.3). For the control group, the sIgE and sIgG4 did not change significantly during the observational period (all p>0.05). Conclusion AIT can induce the production of sIgG4 to HDM components. However, the increased sIgG4 levels of HDM component do not correlate with the corresponding sIgE levels at baseline or with AIT response. sIgG4 to HDM components do not qualify as a biomarker to evaluate the efficacy of AIT.
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Affiliation(s)
- Lin Yang
- Department of Allergy, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Yaqi Yang
- Department of Allergy, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Qingxiu Xu
- Department of Allergy, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Wei Zhang
- Department of Allergy, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Qing Jiang
- Department of Allergy, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Wenjing Li
- Department of Allergy, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Yin Wang
- Department of Allergy, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Dongxia Ma
- Department of Allergy, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Xiaomin Lin
- National Respiratory Medical Center, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China
| | - Baoqing Sun
- National Respiratory Medical Center, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China
- *Correspondence: Rongfei Zhu, ; Baoqing Sun,
| | - Rongfei Zhu
- Department of Allergy, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
- *Correspondence: Rongfei Zhu, ; Baoqing Sun,
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Fungal allergic sensitisation in young rural Zimbabwean children: Gut mycobiome and seroreactivity characteristics. CURRENT RESEARCH IN MICROBIAL SCIENCES 2022; 2:100082. [PMID: 35028627 PMCID: PMC8714770 DOI: 10.1016/j.crmicr.2021.100082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 11/09/2021] [Accepted: 11/12/2021] [Indexed: 11/20/2022] Open
Abstract
Background The prevalence of allergic diseases has increased over the last few decades, with sensitisation to fungal allergens and gut microbiome dysbiosis implicated in this trend. The fungal community in the gut (mycobiome) has yet to be characterised and related to fungal allergic sensitisation. Thus, we characterised the gut mycobiome and related it to fungal sensitisation and seroreactivity among Zimbabwean children. We further determined the effect of host age, sex, Schistosoma haematobium infection and mycobiome composition on fungal sensitisation and seroreactivity. Methods Using shotgun metagenomic sequencing, we characterised the gut microbiome of stool samples of 116 preschool aged children (PSAC) (≤5 years old, 57(49.1%) male and 59 (50.9%) female). Sensitisation to common fungi in Zimbabwe was assessed using skin prick tests (SPTs). Allergen-specific IgM, IgA, IgG, IgE and IgG4 antibodies were quantified by ELISA. We analysed the relationship between fungal genera and SPT reactivity by ANOVA; fungal genera and IgE antibody reactivity by linear regression; variation in mycobiome abundance with host and environmental factors by PERMANOVA; SPT reactivity and host and environmental factors by logistic regression; seroreactivity and host and environmental factors by ANOVA. Results The mycobiome formed <1% of the sequenced gut microbiome and 228 fungal genera were identified. The most abundant genera detected were Protomyces, Taphrina, and Aspergillus. S.haematobium infection had a significant effect on fungal genera. Prevalence of SPT sensitisation to ≥1 fungal species was 96%, and individuals were frequently sensitised to Saccharomyces cerevisiae. Antibodies were detected in 100% of the population. There was no relationship between mycobiome abundance and IgE titres or IgE/IgG4 ratios for each fungal species; no significant differences between SPT reactivity and abundance of fungal species except for S. cerevisiae; and fungal seroreactivity did not significantly differ with age. There were some sex (m>f for, Epicoccum nigrum and Penicillium chrysogenum) and SPT reactivity -related differences in seroreactivity. Conclusion This is the first comprehensive characterisation of gut mycobiome and fungal allergic sensitisation of rural children in Zimbabwe. Although reported allergic disease is low there is a high percentage of sensitisation. Further studies with larger populations are required to understand the role of the mycobiome in allergic diseases.
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Abstract
PRACTICAL RELEVANCE Human allergy to cats affects a substantial and growing proportion of the global population, and cat allergy is regarded as the third most common cause of human respiratory allergies, and the second most common indoor cause. Veterinarians will frequently encounter owners who are cat-allergic, and having an understanding of this disease and the methods available to help control the allergy will assist them in giving appropriate advice, alongside human healthcare professionals. AIM The aim of this review is to summarise currently available data on the prevalence, causes, symptoms and control of human allergy to cats. In terms of managing cat allergy, the emphasis is on reviewing current and emerging modalities to reduce environmental exposure to cat allergens rather than on pharmacotherapy or immunotherapy, as it is in these areas in particular that the veterinarian may be able to offer help and advice to complement that of human healthcare professionals. EVIDENCE BASE The information in this review is drawn from the current and historical literature on human allergy to cats, and approaches to reduce exposure to cat allergens and manage symptoms of cat allergy.
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Atanasio A, Franklin MC, Kamat V, Hernandez AR, Badithe A, Ben LH, Jones J, Bautista J, Yancopoulos GD, Olson W, Murphy AJ, Sleeman MA, Orengo JM. Targeting immunodominant Bet v 1 epitopes with monoclonal antibodies prevents the birch allergic response. J Allergy Clin Immunol 2022; 149:200-211. [PMID: 34126155 DOI: 10.1016/j.jaci.2021.05.038] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 04/16/2021] [Accepted: 05/14/2021] [Indexed: 01/22/2023]
Abstract
BACKGROUND Blocking the major cat allergen, Fel d 1, with mAbs was effective in preventing an acute cat allergic response. OBJECTIVES This study sought to extend the allergen-specific antibody approach and demonstrate that a combination of mAbs targeting Bet v 1, the immunodominant and most abundant allergenic protein in birch pollen, can prevent the birch allergic response. METHODS Bet v 1-specific mAbs, REGN5713, REGN5714, and REGN5715, were isolated using the VelocImmune platform. Surface plasmon resonance, x-ray crystallography, and cryo-electron microscopy determined binding kinetics and structural data. Inhibition of IgE-binding, basophil activation, and mast cell degranulation were assessed via blocking ELISA, flow cytometry, and the passive cutaneous anaphylaxis mouse model. RESULTS REGN5713, REGN5714, and REGN5715 bind with high affinity and noncompetitively to Bet v 1. A cocktail of all 3 antibodies, REGN5713/14/15, blocks IgE binding to Bet v 1 and inhibits Bet v 1- and birch pollen extract-induced basophil activation ex vivo and mast cell degranulation in vivo. Crystal structures of the complex of Bet v 1 with immunoglobulin antigen-binding fragments of REGN5713 or REGN5715 show distinct interaction sites on Bet v 1. Cryo-electron microscopy reveals a planar and roughly symmetrical complex formed by REGN5713/14/15 bound to Bet v 1. CONCLUSIONS These data confirm the immunodominance of Bet v 1 in birch allergy and demonstrate blockade of the birch allergic response with REGN5713/14/15. Structural analyses show simultaneous binding of REGN5713, REGN5714, and REGN5715 with substantial areas of Bet v 1 exposed, suggesting that targeting specific epitopes is sufficient to block the allergic response.
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Affiliation(s)
| | | | | | | | | | - Li-Hong Ben
- Regeneron Pharmaceuticals, Inc, Tarrytown, NY
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IFNG, FCER1A, PCDHB10 expression as a new potential marker of efficacy in grass pollen allergen-specific immunotherapy. Postepy Dermatol Alergol 2021; 38:665-672. [PMID: 34658711 PMCID: PMC8501422 DOI: 10.5114/ada.2021.108925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 04/01/2020] [Indexed: 11/17/2022] Open
Abstract
Introduction Allergen-specific immunotherapy (AIT) is the core treatment in allergic rhinitis and asthma. Although widely used, some patients do not benefit from treatment and there is no efficacy objective marker. Aim To define the profile of gene transcripts during the build-up phase of AIT and their comparison to the control group and then search for a viable efficacy marker in relation to patient symptoms. Material and methods AIT was administered in 22 patients allergic to grass pollen. Analysis of 15 selected transcript expression was performed in whole blood samples taken before AIT (sample A) and after reaching the maintenance dose (sample B). The control group included 25 healthy volunteers (sample C). The primary endpoint was Relative Quantification. The gene expression analysis was followed by clinical evaluation with the use of Allergy Control Score (ACS). Results Comparison between samples A and B of gene expression showed a significant increase in IFNG expression (p = 0.03). In relation to the control group, pretreatment samples from patients showed higher levels of AFAP1L1 (p = 0.006), COMMD8 (p = 0.001), PIK3CD (p = 0.027) and TWIST2 (p = 0.0003) in univariate analysis. A generalized linear regression model was built according to the Bayesian Information Criterion based on the IFNG, FCER1A and PCDHB10 expression pattern for prediction of the AIT outcome. The model showed a correlation in predicted and observed changes in ACS. Conclusions There is a significant change in the expression of IFNG during the build-up phase of AIT. The authors propose an in vitro model of AIT efficacy prediction for further validation.
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Kamal MA, Dingman R, Wang CQ, Lai CH, Rajadhyaksha M, DeVeaux M, Orengo JM, Radin A, Davis JD. REGN1908-1909 monoclonal antibodies block Fel d 1 in cat allergic subjects: Translational pharmacokinetics and pharmacodynamics. Clin Transl Sci 2021; 14:2440-2449. [PMID: 34437752 PMCID: PMC8604232 DOI: 10.1111/cts.13112] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
REGN1908‐1909, a 1:1 cocktail of two fully human IgG4 monoclonal antibodies (mAbs), REGN1908 and REGN1909, is being evaluated for treatment of cat allergy. Both REGN1908 and REGN1909 bind to the dominant cat allergen, Fel d 1. Adults with cat allergy confirmed by skin prick test (SPT) were randomized to single subcutaneous administration of placebo (n = 6) or REGN1908‐1909 at doses of 150 (n = 6), 300 (n = 6), or 600 mg (n = 6). Blood samples were taken at prespecified time points for pharmacokinetic (PK) analysis and exploratory evaluation of biomarkers (IgE and SPT). Safety was assessed. Drug concentration‐time profiles in serum for ascending doses of REGN1908‐1909 were consistent with linear PKs. Noncompartmental analysis showed that maximum concentration (Cmax) and exposure increased proportionately with dose, with similar time to maximum concentration (Tmax) for REGN1908 and REGN1909 (6.2 to 8.2 days across doses), and a longer terminal half‐life for REGN1908 (~ 30 days) relative to REGN1909 (~ 21 days). Adverse events were not dose dependent; there were no dose‐limiting toxicities. REGN1908‐1909 is characterized by linear and dose‐proportional kinetics of the two individual mAb components. A single 600 mg dose maintains total mAb mean concentrations in serum above the target (mean of ~ 10 mg/L) for 8–12 weeks. Maintaining this mean target concentration resulted in translational pharmacodynamic effects: maximal mast cell degranulation in a passive cutaneous anaphylaxis mouse model, and maintenance of clinical efficacy measured by Total Nasal Symptom Score in a previous proof‐of‐mechanism study.
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Affiliation(s)
| | | | | | | | | | | | | | - Allen Radin
- Regeneron Pharmaceuticals, Tarrytown, NY, USA
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11
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Xi GP, Zhang Q, Yin J. Establishment and characterization of murine models of asthma and subcutaneous immunotherapy for Humulus pollen allergy. IMMUNITY INFLAMMATION AND DISEASE 2021; 9:443-455. [PMID: 33434413 PMCID: PMC8127558 DOI: 10.1002/iid3.405] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Revised: 12/24/2020] [Accepted: 12/28/2020] [Indexed: 11/20/2022]
Abstract
Introduction Humulus pollen is an important cause of allergic asthma in East Asia. There have been some murine models for Humulus pollen allergy established by intraperitoneal (IP) sensitization and nasal drip stimulation, but they were not comprehensive enough. Here, we used atomized inhalation for challenge and compared the subcutaneous (SC) and IP sensitization routes to determine the optimal method to establish a model of asthma induced by Humulus pollen. Subsequently, we tried to develop a rapid subcutaneous immunotherapy (SCIT) model for Humulus allergy. Methods BALB/c Mice were sensitized through the SC or IP route, with respective reference to previously established sensitization methods and allergen dosing, and challenged with nebulized Humulus pollen extract to induce asthma. To compare the two sensitization methods, airway hyperresponsiveness (AHR), inflammatory cell infiltration, allergen‐specific serum immunoglobulin (Ig)E (sIgE) levels, cytokine levels, and lung histopathology were assessed. The effects of SCIT (once every other day for 16 days) on airway inflammation, AHR, sIgE, and allergen‐specific serum IgG2a (sIgG2a) levels were evaluated by using the model established in this study. Results Although mice sensitized by the SC or IP routes both showed AHR and airway inflammation, the SC route elicited significantly higher levels of sIgE, eosinophil inflammation, and T helper type 2 cytokines, compared with the IP route. SCIT in the treatment group significantly reduced the titers of sIgE, enhanced the titers of sIgG2a, and effectively alleviated pulmonary inflammation and AHR, compared with the vehicle group. Conclusions The SC route can be used to establish a murine model of Humulus pollen allergy that recapitulates the characteristics of clinical allergic asthma. Short‐term SCIT can significantly improve symptoms and pathophysiology in asthmatic mice.
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Affiliation(s)
- Guang P Xi
- Department of Allergy, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.,Beijing Key Laboratory of Precision Medicine for Diagnosis and Treatment on Allergic Diseases, Beijing, China.,National Clinical Research Center for Dermatologic and immunologic Diseases, Beijing, China
| | - Qian Zhang
- Department of Allergy, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.,Beijing Key Laboratory of Precision Medicine for Diagnosis and Treatment on Allergic Diseases, Beijing, China.,National Clinical Research Center for Dermatologic and immunologic Diseases, Beijing, China
| | - Jia Yin
- Department of Allergy, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.,Beijing Key Laboratory of Precision Medicine for Diagnosis and Treatment on Allergic Diseases, Beijing, China.,National Clinical Research Center for Dermatologic and immunologic Diseases, Beijing, China
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Mares-Mejía I, García-Ramírez B, Torres-Larios A, Rodríguez-Hernández A, Osornio-Hernández AI, Terán-Olvera G, Ortega E, Rodríguez-Romero A. Novel murine mAbs define specific and cross-reactive epitopes on the latex profilin panallergen Hev b 8. Mol Immunol 2020; 128:10-21. [PMID: 33045539 DOI: 10.1016/j.molimm.2020.09.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 09/10/2020] [Accepted: 09/25/2020] [Indexed: 01/06/2023]
Abstract
The production of specific antibodies able to recognize allergens from different sources or block interactions between allergens and antibodies mediating allergic reactions is crucial for developing successful tools for diagnostics and therapeutics. Panallergens are highly conserved proteins present in widely different species, implicated in relevant cross-reactions. The panallergen latex profilin (Hev b 8) has been associated with the latex-food-pollen syndrome. We generated five monoclonal IgGs and one IgE from murine hybridomas against recombinant Hev b 8 and evaluated their interaction with this allergen using ELISA and biolayer interferometry (BLI). Affinity purified mAbs exhibited high binding affinities towards rHev b 8, with KD1 values ranging from 10-10 M to 10-11 M. Some of these antibodies also recognized the recombinant profilins from maize and tomato (Zea m 12 and Sola l 1), and the ash tree pollen (Fra e 2). Competition ELISA demonstrated that some mAb pairs could bind simultaneously to rHev b 8. Using BLI, we detected competitive, non-competitive, and partial-competition interactions between pairs of mAbs with rHev b 8, suggesting the existence of at least two non-overlapping epitopes on the surface of this allergen. Three-dimensional models of the Fv of 1B4 and 2D10 IgGs and docking simulations of these Fvs with rHev b 8 revealed these epitopes. Furthermore, these two mAbs inhibited the interaction of polyclonal IgE and IgG4 antibodies from profilin-allergic patients with rHev b 8, indicating that the mAbs and the antibodies present in sera from allergic patients bind to overlapping epitopes on the allergen. These mAbs can be useful tools for immune-localization studies, immunoassay development, or standardization of allergenic products.
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Affiliation(s)
- Israel Mares-Mejía
- Instituto de Química, Universidad Nacional Autónoma de México, Circuito Exterior, Cd. Universitaria, Coyoacán, Ciudad de México, 04510, Mexico
| | - Benjamín García-Ramírez
- Instituto de Química, Universidad Nacional Autónoma de México, Circuito Exterior, Cd. Universitaria, Coyoacán, Ciudad de México, 04510, Mexico
| | - Alfredo Torres-Larios
- Instituto de Fisiología Celular, Universidad Nacional Autónoma de México, Circuito Exterior, Cd. Universitaria, Coyoacán, Ciudad de México, 04510, Mexico
| | - Annia Rodríguez-Hernández
- Instituto de Química, Universidad Nacional Autónoma de México, Circuito Exterior, Cd. Universitaria, Coyoacán, Ciudad de México, 04510, Mexico
| | - Ana Isabel Osornio-Hernández
- Instituto de Química, Universidad Nacional Autónoma de México, Circuito Exterior, Cd. Universitaria, Coyoacán, Ciudad de México, 04510, Mexico
| | - Gabriela Terán-Olvera
- Instituto de Química, Universidad Nacional Autónoma de México, Circuito Exterior, Cd. Universitaria, Coyoacán, Ciudad de México, 04510, Mexico
| | - Enrique Ortega
- Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Circuito Exterior, Cd. Universitaria, Coyoacán, Ciudad de México, 04510, Mexico.
| | - Adela Rodríguez-Romero
- Instituto de Química, Universidad Nacional Autónoma de México, Circuito Exterior, Cd. Universitaria, Coyoacán, Ciudad de México, 04510, Mexico.
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Flicker S, Zettl I, Tillib SV. Nanobodies-Useful Tools for Allergy Treatment? Front Immunol 2020; 11:576255. [PMID: 33117377 PMCID: PMC7561424 DOI: 10.3389/fimmu.2020.576255] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 09/15/2020] [Indexed: 11/13/2022] Open
Abstract
In the last decade single domain antibodies (nanobodies, VHH) qualified through their unique characteristics have emerged as accepted and even advantageous alternative to conventional antibodies and have shown great potential as diagnostic and therapeutic tools. Currently nanobodies find their main medical application area in the fields of oncology and neurodegenerative diseases. According to late-breaking information, nanobodies specific for coronavirus spikes have been generated these days to test their suitability as useful therapeutics for future outbreaks. Their superior properties such as chemical stability, high affinity to a broad spectrum of epitopes, low immunogenicity, ease of their generation, selection and production proved nanobodies also to be remarkable to investigate their efficacy for passive treatment of type I allergy, an exaggerated immune reaction to foreign antigens with increasing global prevalence.
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Affiliation(s)
- Sabine Flicker
- Division of Immunopathology, Institute of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Ines Zettl
- Division of Immunopathology, Institute of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Sergei V. Tillib
- Institute of Gene Biology, Russian Academy of Sciences, Moscow, Russia
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Gökkaya M, Damialis A, Nussbaumer T, Beck I, Bounas-Pyrros N, Bezold S, Amisi MM, Kolek F, Todorova A, Chaker A, Aglas L, Ferreira F, Redegeld FA, Brunner JO, Neumann AU, Traidl-Hoffmann C, Gilles S. Defining biomarkers to predict symptoms in subjects with and without allergy under natural pollen exposure. J Allergy Clin Immunol 2020; 146:583-594.e6. [DOI: 10.1016/j.jaci.2020.02.037] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 01/31/2020] [Accepted: 02/24/2020] [Indexed: 01/11/2023]
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15
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Teng F, Han F, Zhu X, Yu L, Gai D, Xu C, Cui Y. Identification of continuous immunoglobulin G epitopes of Dermatophagoides farinae allergens by peptide microarray immunoassay. IUBMB Life 2020; 72:1976-1985. [PMID: 32710808 DOI: 10.1002/iub.2333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 05/19/2020] [Accepted: 05/27/2020] [Indexed: 11/09/2022]
Abstract
Dermatophagoides farinae, as a common house dust mite species, is one of the main sources of allergens in the world. At present, Dermatophagoides farinae is found to contain more than 30 groups of allergens. These allergens are used for allergen-specific immunotherapy (AIT) of allergic diseases. During the AIT process, immunoglobulin G (IgG) antibodies can block immunoglobulin E (IgE) antibody-induced allergic reactions in the human body. One of the mechanisms may be that IgG and IgE competitively bind to the same allergic protein, so it is necessary to explore the binding sites (epitopes) of IgG antibodies to allergens. In this study, peptide arrays were constructed to react with the serums from patients with allergic asthma to find the IgG epitopes of several allergens including major allergens (Der f 1, 2) and mid-tier allergens (Der f 4, 5, and 7), and then verified by enzyme-linked immunosorbent assay (ELISA) test. Relevant epitopic sequences were located on the tertiary structure of individual allergens, as reconstructed by homology modeling. One IgG epitope of Der f 1 (90-106aa, NVPSELDLRSLRTVTPI), five IgG epitopes of Der f 4 (61-77aa, ERYQPVSYDIHTRSGDE; 193-209aa, FRSDASTHQWPDDLRSI; 226-242aa, HPFIYHETIYYGGNGIN; 271-287aa, LRWLRNFGTEWGLVPSG; 352-368aa, NDWVGPPTDQHGNILSV), and one IgG epitope of Der f 5 (84-101aa, RYNVEIALKSNEILERDL) were identified. IgG epitopes of Der f 2, 7 were not found. There are overlaps between the IgG and IgE epitopes of Der f 1, 4, and 5. These findings not only reflect the practicality of peptide array and ELISA test in the allergen IgG epitope identification, but also provide more information for further understanding of the human immunological changes during AIT and the molecular mechanisms of IgG blocking IgE activity.
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Affiliation(s)
- Feixiang Teng
- Department of Basic Medicine, Jiangsu Vocational College of Medicine, Yancheng, China
| | - Feifei Han
- Department of Clinical Laboratory, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi, China
| | - Xuming Zhu
- Department of Clinical Laboratory, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi, China
| | - Lili Yu
- Department of Basic Medicine, Jiangsu Vocational College of Medicine, Yancheng, China
| | - Dongzheng Gai
- Department of Internal Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Cong Xu
- Department of Internal Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Yubao Cui
- Department of Clinical Laboratory, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi, China
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16
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Heeringa JJ, McKenzie CI, Varese N, Hew M, Bakx ATCM, Aui PM, Rolland JM, O’Hehir RE, Zelm MC. Induction of IgG 2 and IgG 4 B-cell memory following sublingual immunotherapy for ryegrass pollen allergy. Allergy 2020; 75:1121-1132. [PMID: 31587307 PMCID: PMC7317934 DOI: 10.1111/all.14073] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 08/06/2019] [Accepted: 08/29/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND While treatment for atopic rhinitis is aimed mostly to relieve symptoms, only allergen-specific immunotherapy (AIT) is targeted to modify the natural history of allergic diseases. This results in sustained clinical tolerance, even when treatment has stopped. The immunomodulatory effects of AIT are attributed mainly to increased regulatory T-cell function and increased allergen-specific IgG4 , yet little is known about the effect on the memory B-cell compartment. OBJECTIVE We aimed to examine the effects of AIT on the IgE- and IgG subclass-expressing memory B cells. METHODS We recruited 29 patients with atopic seasonal rhinoconjunctivitis and performed a longitudinal analysis of the peripheral immune compartment before, during, and after sublingual immunotherapy (SLIT) for allergy to temperate grass pollen, predominantly to ryegrass pollen (RGP; Lolium perenne). Using flow cytometry on peripheral blood mononuclear cells and serum immunoassays, we analyzed the effects of a 4 months preseasonal treatment regimen comprising two or three courses in consecutive years on circulating IgE+ and IgG+ memory B cells and allergen-specific Ig levels. RESULTS SLIT increased RGP-specific serum IgG2 and IgG4 , as well as the frequencies of IgG2 + and IgG4 + memory B cells, whereas no effect was observed on the IgE+ memory B-cell compartment. Furthermore, SLIT enhanced proportions of regulatory T cells specific to RGP. These changes were associated with clinical improvement. CONCLUSION Our data provide evidence for immunological effects of SLIT on B-cell memory. Skewing responses toward IgG2 and IgG4 subclasses might be a mechanism to suppress IgE-mediated allergic responses.
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Affiliation(s)
- Jorn J. Heeringa
- Department of Immunology and Pathology Central Clinical School Monash University Melbourne Vic. Australia
- Department of Immunology Erasmus MC University Medical Center Rotterdam the Netherlands
- Department of Pediatrics Erasmus MC University Medical Center Rotterdam the Netherlands
| | - Craig I. McKenzie
- Department of Immunology and Pathology Central Clinical School Monash University Melbourne Vic. Australia
| | - Nirupama Varese
- Department of Immunology and Pathology Central Clinical School Monash University Melbourne Vic. Australia
- Department of Respiratory Medicine Allergy and Clinical Immunology (Research) Central Clinical School Monash University, and Alfred Hospital Melbourne Vic. Australia
| | - Mark Hew
- Department of Respiratory Medicine Allergy and Clinical Immunology (Research) Central Clinical School Monash University, and Alfred Hospital Melbourne Vic. Australia
- School of Public Health and Preventive Medicine Monash University Melbourne Vic. Australia
| | - Amy T. C. M. Bakx
- Department of Immunology and Pathology Central Clinical School Monash University Melbourne Vic. Australia
| | - Pei M. Aui
- Department of Immunology and Pathology Central Clinical School Monash University Melbourne Vic. Australia
| | - Jennifer M. Rolland
- Department of Immunology and Pathology Central Clinical School Monash University Melbourne Vic. Australia
- Department of Respiratory Medicine Allergy and Clinical Immunology (Research) Central Clinical School Monash University, and Alfred Hospital Melbourne Vic. Australia
| | - Robyn E. O’Hehir
- Department of Immunology and Pathology Central Clinical School Monash University Melbourne Vic. Australia
- Department of Respiratory Medicine Allergy and Clinical Immunology (Research) Central Clinical School Monash University, and Alfred Hospital Melbourne Vic. Australia
| | - Menno C. Zelm
- Department of Immunology and Pathology Central Clinical School Monash University Melbourne Vic. Australia
- Department of Respiratory Medicine Allergy and Clinical Immunology (Research) Central Clinical School Monash University, and Alfred Hospital Melbourne Vic. Australia
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Storni F, Zeltins A, Balke I, Heath MD, Kramer MF, Skinner MA, Zha L, Roesti E, Engeroff P, Muri L, von Werdt D, Gruber T, Cragg M, Mlynarczyk M, Kündig TM, Vogel M, Bachmann MF. Vaccine against peanut allergy based on engineered virus-like particles displaying single major peanut allergens. J Allergy Clin Immunol 2020; 145:1240-1253.e3. [PMID: 31866435 DOI: 10.1016/j.jaci.2019.12.007] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 12/09/2019] [Accepted: 12/10/2019] [Indexed: 11/23/2022]
Abstract
BACKGROUND Peanut allergy is a severe and increasingly frequent disease with high medical, psychosocial, and economic burden for affected patients and wider society. A causal, safe, and effective therapy is not yet available. OBJECTIVE We sought to develop an immunogenic, protective, and nonreactogenic vaccine candidate against peanut allergy based on virus-like particles (VLPs) coupled to single peanut allergens. METHODS To generate vaccine candidates, extracts of roasted peanut (Ara R) or the single allergens Ara h 1 or Ara h 2 were coupled to immunologically optimized Cucumber Mosaic Virus-derived VLPs (CuMVtt). BALB/c mice were sensitized intraperitoneally with peanut extract absorbed to alum. Immunotherapy consisted of a single subcutaneous injection of CuMVtt coupled to Ara R, Ara h 1, or Ara h 2. RESULTS The vaccines CuMVtt-Ara R, CuMVtt-Ara h 1, and CuMVtt-Ara h 2 protected peanut-sensitized mice against anaphylaxis after intravenous challenge with the whole peanut extract. Vaccines did not cause allergic reactions in sensitized mice. CuMVtt-Ara h 1 was able to induce specific IgG antibodies, diminished local reactions after skin prick tests, and reduced the infiltration of the gastrointestinal tract by eosinophils and mast cells after oral challenge with peanut. The ability of CuMVtt-Ara h 1 to protect against challenge with the whole extract was mediated by IgG, as shown via passive IgG transfer. FcγRIIb was required for protection, indicating that immune complexes with single allergens were able to block the allergic response against the whole extract, consisting of a complex allergen mixture. CONCLUSIONS Our data suggest that vaccination using single peanut allergens displayed on CuMVtt may represent a novel therapy against peanut allergy with a favorable safety profile.
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Affiliation(s)
- Federico Storni
- Department of Rheumatology, Immunology and Allergology, University Hospital Bern, Bern, Switzerland; Department of BioMedical Research, University of Bern, Bern, Switzerland; Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
| | - Andris Zeltins
- Latvian Biomedical Research and Study Centre, Riga, Latvia
| | - Ina Balke
- Latvian Biomedical Research and Study Centre, Riga, Latvia
| | | | | | | | - Lisha Zha
- International Immunology Center of Anhui Agricultural Center, Anhui, China
| | - Elisa Roesti
- Department of Rheumatology, Immunology and Allergology, University Hospital Bern, Bern, Switzerland
| | - Paul Engeroff
- Department of Rheumatology, Immunology and Allergology, University Hospital Bern, Bern, Switzerland
| | - Lukas Muri
- Neuroinfection Laboratory, Institute for Infectious Diseases, University of Bern, Bern, Switzerland
| | - Diego von Werdt
- Institute of Pathology, University of Bern, Bern, Switzerland
| | - Thomas Gruber
- Institute of Pathology, University of Bern, Bern, Switzerland
| | - Mark Cragg
- Antibody and Vaccine Group, Centre for Cancer Immunology, Cancer Sciences Unit, Faculty of Medicine, General Hospital, University of Southampton, Southampton, United Kingdom
| | | | - Thomas M Kündig
- Dermatology, University Hospital Zurich, Zurich, Switzerland
| | - Monique Vogel
- Department of Rheumatology, Immunology and Allergology, University Hospital Bern, Bern, Switzerland
| | - Martin F Bachmann
- Department of Rheumatology, Immunology and Allergology, University Hospital Bern, Bern, Switzerland; Nuffield Department of Medicine, Centre for Cellular and Molecular Physiology, The Jenner Institute, University of Oxford, Oxford, United Kingdom.
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18
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Sookrung N, Tungtrongchitr A, Chaicumpa W. Cockroaches: Allergens, Component-Resolved Diagnosis (CRD) and Component-Resolved Immunotherapy. Curr Protein Pept Sci 2020; 21:124-141. [DOI: 10.2174/1389203720666190731144043] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 06/18/2019] [Accepted: 06/21/2019] [Indexed: 12/27/2022]
Abstract
Allergic diseases are assuming increasing trend of prevalence worldwide. The diseases confer increasing demand on medical and healthcare facilities. Patients with allergies have poor quality of life and impaired cognition. Adult patients have subpar working efficiency while afflicted children are less effective at school, often have school absenteeism and need more attention of their caregivers. All of them lead to negative socio-economic impact. This narrative review focuses on cockroach allergy including currently recognized cockroach allergens, pathogenic mechanisms of allergy, componentresolved diagnosis and allergen-specific immunotherapy, particularly the component-resolved immunotherapy and the molecular mechanisms that bring about resolution of the chronic airway inflammation.
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Affiliation(s)
- Nitat Sookrung
- Center of Research Excellence on Therapeutic Proteins and Antibody Engineering, Department of Parasitology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Anchalee Tungtrongchitr
- Center of Research Excellence on Therapeutic Proteins and Antibody Engineering, Department of Parasitology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Wanpen Chaicumpa
- Center of Research Excellence on Therapeutic Proteins and Antibody Engineering, Department of Parasitology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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19
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Bachmann MF, Mohsen MO, Kramer MF, Heath MD. Vaccination against Allergy: A Paradigm Shift? Trends Mol Med 2020; 26:357-368. [PMID: 32277930 DOI: 10.1016/j.molmed.2020.01.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 11/06/2019] [Accepted: 01/21/2020] [Indexed: 12/23/2022]
Abstract
Since the discovery that IgE antibodies mediate allergy, decades of research have unraveled complex mechanisms associated with conventional immunotherapy and the vital protagonists that shape 'immune tolerance' to allergens. Debate exists on what should constitute the dominant effector mechanism in driving rational drug designs for next-generation immunotherapies. As vaccine technology continues to advance, the development of novel vaccines in this area of continued medical need might stand on a threshold of breakthrough inspired by experiments by Dunbar on the passive vaccination of allergic animals more than 100 years ago. In this opinion article, we discuss both novel insights into IgG antibodies as the principle effector modality induced by specific immunotherapy and advances in antigen-carrier design that may catapult allergy treatment into our modern world.
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Affiliation(s)
- Martin F Bachmann
- Jenner Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK; Department of BioMedical Research, Immunology RIA, Inselspital, University of Bern, Bern, Switzerland
| | - Mona O Mohsen
- Department of BioMedical Research, Immunology RIA, Inselspital, University of Bern, Bern, Switzerland; National Centre for Cancer Care & Research (NCCCR), Doha, State of Qatar
| | - Matthias F Kramer
- Allergy Therapeutics (UK) Ltd, Dominion Way, Worthing, UK; Bencard Allergie GmbH, Leopoldstrasse, Munich, Germany; Bencard Adjuvant Systems (a division of Allergy Therapeutics), Dominion Way, Worthing, UK
| | - Matthew D Heath
- Allergy Therapeutics (UK) Ltd, Dominion Way, Worthing, UK; Bencard Adjuvant Systems (a division of Allergy Therapeutics), Dominion Way, Worthing, UK.
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20
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黄 秋, 魏 欣, 林 霞, 郑 静, 黄 海. [Effect of sublingual immunotherapy with Dermatophagoides Farinae on the expression of specific IgG4 in patients with allergic rhinitis in Hainan area]. LIN CHUANG ER BI YAN HOU TOU JING WAI KE ZA ZHI = JOURNAL OF CLINICAL OTORHINOLARYNGOLOGY, HEAD, AND NECK SURGERY 2020; 34:135-139. [PMID: 32086918 PMCID: PMC10128420 DOI: 10.13201/j.issn.1001-1781.2020.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Indexed: 06/10/2023]
Abstract
Objective:The aim of this study is to investigate the effect of sublingual immunotherapy with Dermatophagoides Farinae on the expression of specific IgG4(sIgG4) in patients with allergic rhinitis (AR) in Hainan area. Method:Seventy-two patients with dust-mite allergic rhinitis, all three generations of whom were local islanders in Hainan, were randomly divided into control group(36 cases) and SLIT group(36 cases). sIgG4 and sIgE expression levels were detected before treatment, 6 months after treatment, 12 months after treatment, and 18 months after treatment. The patient's symptom score, medication score, VAS score and adverse reactions was also assessed. Finally, through statistical analysis of the relevant data collected at 4 time points in the two groups of patients, the efficacy, safety and changes of sIgG4 antibody expression level in patients with allergic rhinitis receiving sublingual specific immunotherapy in Hainan were observed. Result:Symptoms scores, medication scores and VAS scores were significantly improved in the SLIT group after treatment compared with before treatment(P<0.05), and serum sIgG4 increased significantly(P<0.01), serum sIgE showed no significant change(P>0.05). In the control group, symptom scores, medication scores and VAS scores were also significantly improved compared with before treatment(P<0.05), while serum sIgG4 and sIgE showed no significant change(P>0.05). When comparing the two groups, Symptoms scores, medication scores and VAS scores of the SLIT group were significantly lower than those of the control group at 12 months and 18 months after treatment(P<0.05). sIgG4 expression levels in the SLIT group were significantly higher than those in the control group after 6, 12 and 18 months of treatment(P<0.01). There was no significant difference in sIgE expression level between the two groups(P>0.05). No severe systemic adverse reactions occurred in the two groups, and 3 patients showed mild adverse reactions in the SLIT group. Conclusion:Sublingual immunotherapy of Dermatophagoides Farinae was effective and could increase the expression of sIgG4 in patients with Dermatophagoides farinae AR, sIgG4 is expected to be an immunological marker for the objective evaluation of the clinical efficacy of Hapten.
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Affiliation(s)
- 秋菊 黄
- 海南省人民医院耳鼻咽喉头颈外科(海口,570311)Department of Otolaryngology Head and Neck Surgery, Hainan People's Hospital, Haikou, 570311, China
| | - 欣 魏
- 海南省人民医院耳鼻咽喉头颈外科(海口,570311)Department of Otolaryngology Head and Neck Surgery, Hainan People's Hospital, Haikou, 570311, China
| | - 霞 林
- 海南省人民医院耳鼻咽喉头颈外科(海口,570311)Department of Otolaryngology Head and Neck Surgery, Hainan People's Hospital, Haikou, 570311, China
| | - 静 郑
- 海南省人民医院耳鼻咽喉头颈外科(海口,570311)Department of Otolaryngology Head and Neck Surgery, Hainan People's Hospital, Haikou, 570311, China
| | - 海燕 黄
- 海南省人民医院耳鼻咽喉头颈外科(海口,570311)Department of Otolaryngology Head and Neck Surgery, Hainan People's Hospital, Haikou, 570311, China
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21
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Yamada Y, Kidoguchi M, Yata A, Nakamura T, Yoshida H, Kato Y, Masuko H, Hizawa N, Fujieda S, Noguchi E, Miura K. High-Yield Production of the Major Birch Pollen Allergen Bet v 1 With Allergen Immunogenicity in Nicotiana benthamiana. FRONTIERS IN PLANT SCIENCE 2020; 11:344. [PMID: 32300351 PMCID: PMC7142267 DOI: 10.3389/fpls.2020.00344] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 03/09/2020] [Indexed: 05/13/2023]
Abstract
Type I allergy is an immunological disorder triggered by allergens and causes significant health problems. The major allergen of birch pollen is Bet v 1, which belongs to the pathogen-related protein 10 (PR-10) family. Here, we established a rapid and robust method for the production of Bet v 1 in Nicotiana benthamiana leaves, with binding activity to allergic patients' IgE. The Bet v 1 allergen was expressed in N. benthamiana using a strong agroinfiltration-based transient protein expression system, which consists of a deconstructed geminiviral vector system with a double terminator. Five days post-infiltration, the allergen concentration in N. benthamiana leaves was 1.2 mg/g of fresh mass, being this the maximum yield of Bet v 1 in plants reported up to now. A part of plant-derived Bet v 1 was glycosylated. Bet v 1 purified from N. benthamiana or Brevibacillus brevis was used to carry out enzyme-linked immunoassays; both recombinant allergens were found to have comparable binding properties to the IgE of allergic patients. These results suggest that our plant expression system allows rapid and robust production of the allergen, which keeps the immunogenicity.
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Affiliation(s)
- Yuki Yamada
- Graduate School of Life and Environmental Sciences, University of Tsukuba, Tsukuba, Japan
| | - Masanori Kidoguchi
- Department of Medical Genetics, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
- Division of Otorhinolaryngology and Head and Neck Surgery, Department of Sensory and Locomotor Medicine, Faculty of Medical Science, University of Fukui, Fukui, Japan
| | - Akira Yata
- Graduate School of Life and Environmental Sciences, University of Tsukuba, Tsukuba, Japan
| | - Takako Nakamura
- Department of Medical Genetics, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Hideki Yoshida
- Graduate School of Life and Environmental Sciences, University of Tsukuba, Tsukuba, Japan
- Tsukuba-Plant Innovation Research Center, University of Tsukuba, Tsukuba, Japan
| | - Yukinori Kato
- Division of Otorhinolaryngology and Head and Neck Surgery, Department of Sensory and Locomotor Medicine, Faculty of Medical Science, University of Fukui, Fukui, Japan
| | - Hironori Masuko
- Department of Respiratory Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Nobuyuki Hizawa
- Department of Respiratory Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Shigeharu Fujieda
- Division of Otorhinolaryngology and Head and Neck Surgery, Department of Sensory and Locomotor Medicine, Faculty of Medical Science, University of Fukui, Fukui, Japan
| | - Emiko Noguchi
- Department of Medical Genetics, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Kenji Miura
- Graduate School of Life and Environmental Sciences, University of Tsukuba, Tsukuba, Japan
- Tsukuba-Plant Innovation Research Center, University of Tsukuba, Tsukuba, Japan
- *Correspondence: Kenji Miura,
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Kim BG, Kim JN, Jang AS, Shin M. Combined Effects of Lactobacillus rhamnosus and Egg Oral Immunotherapy in a Mouse Model of Egg Allergy. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2020; 12:701-711. [PMID: 32400134 PMCID: PMC7225004 DOI: 10.4168/aair.2020.12.4.701] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 01/17/2020] [Accepted: 02/04/2020] [Indexed: 01/22/2023]
Abstract
Purpose Recent clinical trials have successfully used oral immunotherapy (OIT) to treat food allergies. Probiotics have immunomodulatory effects by balancing Th1/Th2 immunity and enhancing regulatory T-cell activity. In this study, we analyzed the effects of OIT, probiotics alone, and probiotics administered simultaneously with OIT in a mouse model of egg allergy. Methods C3H/HeJ mice were sensitized by intragastric administration of ovomucoid (OM) with cholera toxin. For the OIT regime, increasing doses of OM were administered orally to sensitized mice. Lactobacillus casei variety ramnosus (Lcr35) was also administered. The mice were divided into 4 groups: control (no OIT), OIT, Lcr35, and OIT plus Lcr35 (OIT + Lcr35). The effects of OIT and Lcr35 treatment were estimated based on the symptom score, rectal temperature, serum levels of OM-specific immunoglobulin (Ig)E, IgA, IgG1, and IgG2a immediately after and 2 weeks after ceasing treatment and histological staining of the small intestine. Results The severity of anaphylaxis decreased in all treatment groups. Simultaneous administration of Lcr35 and OIT decreased the severity of anaphylaxis compared to controls and the OIT group. The protective effects were sustained 2 weeks after ceasing treatment in all treatment groups. A significant decrease in OM-specific IgA, IgG1, and IgG2a levels was observed in both the OIT and OIT plus Lcr35 groups. However, a significant decrease in the OM-specific IgE level was observed only in OIT plus Lcr35 treated mice and was sustained 2 weeks after ceasing treatment. Mucin amounts in the small intestine decreased after OIT, OIT plus Lcr35, and Lcr35 treatment with the lowest in the OIT plus Lcr35 group. Conclusions Lcr35 treatment during OIT had some synergic effect for protection against anaphylaxis in a mice model of egg allergy. These findings should be confirmed in future animal studies including more detailed immunological profiles and human studies.
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Affiliation(s)
- Byeong Gon Kim
- Division of Allergy and Respiratory Medicine, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Soonchunhyang University School of Medicine, Bucheon, Korea
| | - Ji Na Kim
- Division of Allergy and Respiratory Medicine, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Soonchunhyang University School of Medicine, Bucheon, Korea
| | - An Soo Jang
- Division of Allergy and Respiratory Medicine, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Soonchunhyang University School of Medicine, Bucheon, Korea
| | - Meeyong Shin
- Department of Pediatrics, Soonchunhyang University Bucheon Hospital, Soonchunhyang University School of Medicine, Bucheon, Korea.
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23
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Mahler V, Zielen S, Rosewich M. Year-round treatment initiation for a 6-grasses pollen allergoid in specific immunotherapy of allergic rhinoconjunctivitis and asthma. Immunotherapy 2019; 11:1569-1582. [PMID: 31852355 DOI: 10.2217/imt-2019-0086] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: Allergen immunotherapy (AIT) is an effective treatment for allergic diseases. We investigate whether treatment-initiation during the pollen season is safe. Methods: RCT-IIIb-trial of 6-grass-pollen-allergoid (Allergovit®) in grass pollen-allergic patients (18-65 years) with moderate-severe rhinitis/rhinoconjunctivitis (± controlled asthma), randomized 2:1 to treatment-initiation during (Group-A) versus outside the pollen season (Group-B). Results: Of 240 patients (32.8 ± 9.9 years, 19.5% asthma) treated, 84.9% (Group-A) and 86.6% (Group-B) reached maintenance dose without delay. Treatment-emergent adverse events occurred in 108 (68.4%/Group-A) and 41 patients (56.2%/Group-B) leading to premature trial-termination in 11 patients (7%/A) versus 3 (4.1%/B). Across groups, physicians (for 190 patients; 85.2%) and patients (192; 86.1%) rated the tolerability as 'very good'-'good'. Phleum pratense-specific IgG4 increased in both groups (p < 0.0001). Conclusion: Year-round allergen immunotherapy-initiation with this preparation is safe.
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Affiliation(s)
- Vera Mahler
- Department of Dermatology, University Hospital Erlangen, Erlangen, Germany.,Paul-Ehrlich-Institut, Langen, Germany
| | - Stefan Zielen
- Department for Children & Adolescents, Division for Allergology, Pneumology & Cystic Fibrosis, University Hospital Goethe University, Frankfurt am Main, Germany
| | - Martin Rosewich
- Department for Children & Adolescents, Division for Allergology, Pneumology & Cystic Fibrosis, University Hospital Goethe University, Frankfurt am Main, Germany
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24
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Fuc E, Złotkowska D, Wróblewska B. Milk and Meat Allergens from Bos taurus β-Lactoglobulin, α-Casein, and Bovine Serum Albumin: An In-Vivo Study of the Immune Response in Mice. Nutrients 2019; 11:E2095. [PMID: 31487844 PMCID: PMC6769769 DOI: 10.3390/nu11092095] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 08/30/2019] [Accepted: 09/01/2019] [Indexed: 01/14/2023] Open
Abstract
The mechanism of food allergy may vary. This study aimed to compare the effects of milk, yogurt, or beef meat supplementation on humoral and cellular immune responses in a mice model. Mice were divided into four groups: The "Milk group" was sensitized with a β-lactoglobulin (β-lg)/α-casein (α-CN) mixture and supplemented cow milk; the "Yogurt group" was sensitized with β-lg/α-CN and supplemented yogurt; the "Beef group" was immunized with bovine serum albumin (BSA) and supplemented beef meat; and the "PBS group" received PBS in all procedures. ELISA was used to measure humoral response, including: Total IgE, specific IgG, and IgA. Cellular response was determined by phenotyping lymphocyte from lymphoid tissue and measuring the Th1/Th2 cytokine concentration with flow cytometry. The qPCR method was used for quantification of the fecal microbiota. The results obtained revealed a lower IgE level for the Yogurt group than for the Milk one. In the Yogurt group, the contribution of regulatory T cells to MLN and PP was higher compared to the other groups. We confirmed that diet supplementation with yogurt modulates the immune response to the prime allergen, and changes the activity of serum antibodies to milk proteins and BSA. Based on a specific antibodies level, we cannot exclude the possibility of CMA mice reaction against BSA.
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Affiliation(s)
- Ewa Fuc
- Department of Immunology and Food Microbiology, Institute of Animal Reproduction and Food Research, Polish Academy of Sciences in Olsztyn, Tuwima 10 Str., 10-748 Olsztyn, Poland.
| | - Dagmara Złotkowska
- Department of Immunology and Food Microbiology, Institute of Animal Reproduction and Food Research, Polish Academy of Sciences in Olsztyn, Tuwima 10 Str., 10-748 Olsztyn, Poland.
| | - Barbara Wróblewska
- Department of Immunology and Food Microbiology, Institute of Animal Reproduction and Food Research, Polish Academy of Sciences in Olsztyn, Tuwima 10 Str., 10-748 Olsztyn, Poland.
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25
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Ihara F, Sakurai D, Okamoto Y. [The analysis of Th2 cell subsets in house dust mite allergic rhinitis patients after sublingual immunotherapy]. Nihon Yakurigaku Zasshi 2019; 154:12-16. [PMID: 31308344 DOI: 10.1254/fpj.154.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Th2 cells are well known to play important roles in allergic diseases including allergic rhinitis (AR). Meanwhile, the factors that induce and sustain the pathogenesis of AR remain unclear. The recent development of sublingual immunotherapy (SLIT) is expected to allow changes to the underlying pathogenesis of AR. However, the phenotype of the pathogenic Th2 cells (Tpath2) cells in house dust mite-induced AR (HDM-AR) and the relation between Tpath2 and SLIT efficacy have not been clarified. Therefore we analyzed the cytokine production and frequency of HDM-reactive T-cell subsets in peripheral blood mononuclear cells (PBMCs) using flow cytometry in 89 HDM-AR patients (placebo; n = 43 and HDM 300 IR; n = 46) who participated in a placebo-controlled study of SLIT with HDM tablets. All patients provided samples both before treatment as a baseline and at the end of the 52-week study. HDM-reactive IL-5+IL-13+CD27-CD161+CD4+ cells and ST2+CD45RO+CD4+ cells were observed in the PBMCs from each patient with HDM-AR; these cells significantly decreased after SLIT in the group treated with active tablets. HDM-reactive ST2+CD45RO+CD4+ cells were significantly lower in active-responders. In conclusion, HDM-reactive ST2+CD45RO+CD4+ cells or those combined with IL-5+IL-13+CD27-CD161+CD4+ cells may be useful as markers indicating the successful treatment of SLIT. These cells may play a crucial role in the pathogenesis of HDM-AR as Tpath2.
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Affiliation(s)
- Fumie Ihara
- Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Medicine, Chiba University.,Department of Medical Immunology, Graduate School of Medicine, Chiba University
| | - Daiju Sakurai
- Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Medicine, Chiba University
| | - Yoshitaka Okamoto
- Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Medicine, Chiba University
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26
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Klimek L, Brehler R, Hamelmann E, Kopp M, Ring J, Treudler R, Jakob T, Worm M, Pfaar O. Entwicklung der subkutanen Allergen-Immuntherapie (Teil 1): von den Anfängen zu immunologisch orientierten Therapiekonzepten. ALLERGO JOURNAL 2019. [DOI: 10.1007/s15007-019-1819-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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27
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Evolution of subcutaneous allergen immunotherapy (part 1): from first developments to mechanism-driven therapy concepts. ACTA ACUST UNITED AC 2019. [DOI: 10.1007/s40629-019-0092-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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28
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Mueller GA, Min J, Foo ACY, Pomés A, Pedersen LC. Structural Analysis of Recent Allergen-Antibody Complexes and Future Directions. Curr Allergy Asthma Rep 2019; 19:17. [PMID: 30815753 DOI: 10.1007/s11882-019-0848-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
PURPOSE OF REVIEW Allergen-antibody complexes are extremely valuable in describing the detailed molecular features of epitopes. This review summarizes insights gained from recently published co-structures and what obstacles impede the acquisition of further data. RECENT FINDINGS Structural epitope data helped define the epitopes of two anti-Fel d 1 antibodies undergoing phase I clinical trials, providing a greater level of detail than was possible through hydrogen-deuterium exchange protection studies. Separately, a human camelid-like antibody structure with lysozyme described several unique features in a long variable loop that interacted with the active site cleft of Gal d 4. Finally, a co-structure conclusively demonstrated that Phl p 7 could function as a superantigen and that an antibody could simultaneously recognize two epitopes. These remarkable assertions would not have been possible without visualization of the complex. Only three new complexes have appeared in the last few years, suggesting that there are major impediments to traditional production and crystallization. The structural data was extremely valuable in describing epitopes. New techniques like cryo-EM may provide an alternative to crystallography.
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Affiliation(s)
- Geoffrey A Mueller
- National Institute of Environmental Health Sciences, 111 T.W. Alexander Drive MD-MR-01, Research Triangle Park, NC, 27709, USA.
| | - Jungki Min
- National Institute of Environmental Health Sciences, 111 T.W. Alexander Drive MD-MR-01, Research Triangle Park, NC, 27709, USA
| | - Alexander C Y Foo
- National Institute of Environmental Health Sciences, 111 T.W. Alexander Drive MD-MR-01, Research Triangle Park, NC, 27709, USA
| | - Anna Pomés
- Indoor Biotechnologies, Inc., Charlottesville, VA, USA
| | - Lars C Pedersen
- National Institute of Environmental Health Sciences, 111 T.W. Alexander Drive MD-MR-01, Research Triangle Park, NC, 27709, USA
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29
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Allergenspezifische Immuntherapie bei IgE-vermittelten Erkrankungen im Kindes- und Jugendalter. Monatsschr Kinderheilkd 2019. [DOI: 10.1007/s00112-018-0448-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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30
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The Use of Biomarkers to Predict Aero-Allergen and Food Immunotherapy Responses. Clin Rev Allergy Immunol 2018; 55:190-204. [PMID: 29455358 DOI: 10.1007/s12016-018-8678-z] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The incidence of allergic conditions has continued to rise over the past several decades, with a growing body of research dedicated toward the treatment of such conditions. By driving a complex range of changes in the underlying immune response, immunotherapy is the only therapy that modulates the immune system with long-term effects and is presently utilized for the treatment of several atopic conditions. Recent efforts have focused on identifying biomarkers associated with these changes that may be of use in predicting patients with the highest likelihood of positive clinical outcomes during allergen immunotherapy (AIT), providing guidance regarding AIT discontinuation, and predicting symptomatic relapse and the need for booster AIT after therapy. The identification of such biomarkers in food allergy has the additional benefit of replacing oral food challenges, which are presently the gold standard for diagnosing food allergies. While several markers have shown early promise, research has yet to identify a marker that can invariably predict clinical response to AIT. Skin prick testing (SPT) and specific IgE have commonly been used as inclusion criteria for the initiation of AIT and prediction of reactions during subsequent allergen challenge; however, existing data suggests that changes in these markers are not always associated with clinical improvement and can be widely variable, reducing their utility in predicting clinical response. Similar findings have been described for the use of allergen-specific functional IgG4 antibodies, basophil activation and histamine release, and type 2 innate lymphoid cells. There appears to be a promising association between changes in the expression of dendritic cell-associated markers, as well as the use of DNA promoter region methylation patterns in the prediction of allergy status following therapy. The cellular and molecular changes brought about by immunotherapy are still under investigation, but major strides in our understanding are being made.
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31
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Does clinical outcome of birch pollen immunotherapy relate to induction of blocking antibodies preventing IgE from allergen binding? A pilot study monitoring responses during first year of AIT. Clin Transl Allergy 2018; 8:39. [PMID: 30338052 PMCID: PMC6174570 DOI: 10.1186/s13601-018-0226-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Accepted: 09/06/2018] [Indexed: 01/04/2023] Open
Abstract
Background The clinical benefit of allergen-specific immunotherapy (AIT) involves induction of blocking antibodies. It is not clear if these antibodies function via steric hindrance alone or a combination of levels, avidities, and epitope specificities, and clinical outcome cannot be predicted. We aim to in-depth characterize serum antibody profiles during birch pollen AIT, investigate therapy-induced antibodies for their capacity to block IgE binding to Bet v 1 and correlate data with clinical outcomes. Methods Immune responses of five birch pollen allergic patients were monitored during the first year of AIT by nasal provocation tests (NPTs), ImmunoCAP, immunoblots, direct and avidity enzyme-linked immunosorbent assays, mediator release assays, facilitated antigen binding (FAB) assays, and inhibition mediator release assays. Results There was no correlation between NPT results and therapy-induced changes in levels (IgE, IgG, IgA, IgM), avidities, or mediator release potency of Bet v 1-specific antibodies. In FAB assays, blocking antibodies initiated upon AIT were shown to prevent formation of Bet v 1-IgE complexes of an indicator serum pool and significantly correlated with clinical readout. Inhibition mediator release assays using patient-specific IgE for passive sensitization revealed therapy-induced blocking capacities with very good correlation to NPT results. Notably, this assay was the only one to detect a non-responder during treatment in this pilot study. Conclusions Clinical outcome of AIT depends on induction of blocking antibodies able to prevent the patient’s own IgE from allergen binding. Monitoring of clinical efficacy seems to be best achieved using the inhibition mediator release assay, as development of relevant blocking antibodies can be verified in a patient-tailored manner. Electronic supplementary material The online version of this article (10.1186/s13601-018-0226-7) contains supplementary material, which is available to authorized users.
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32
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van Rijt LS, Logiantara A, Canbaz D, van Ree R. Birch pollen-specific subcutaneous immunotherapy reduces ILC2 frequency but does not suppress IL-33 in mice. Clin Exp Allergy 2018; 48:1402-1411. [PMID: 30126007 DOI: 10.1111/cea.13254] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 08/14/2018] [Accepted: 08/15/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND The underlying mechanism of allergen-specific subcutaneous immunotherapy (SCIT) is not yet fully understood, but suppression of allergen-specific Th2 cells and production of allergen-specific IgG4 antibodies are two hallmarks. The impact on the innate arm of the immune system is far less clear. OBJECTIVE The aim of this study was to investigate the effect of birch pollen (BP) SCIT on the innate immune response in a BP SCIT mouse model. METHODS Mice with birch pollen-induced allergic airway inflammation received weekly subcutaneous immunotherapy injections with birch pollen extract (BPE) adsorbed to alum. The effect of the BP SCIT on innate cytokine levels in lung, the number and the functionality of ILC2s and the airway inflammation was determined. RESULTS Mice with BP allergy had an increased level of the innate cytokines IL-33, IL-25, GM-CSF and IL-5+ ILC2s in the lungs. BP SCIT suppressed the number of IL-5+ ILC2s, mast cell tryptase release, Th2 cytokine production, eosinophil recruitment and peribronchial inflammatory infiltrates. In contrast, innate cytokine production and collagen deposition in the airways were not affected. CONCLUSION AND CLINICAL RELEVANCE BP SCIT is able to suppress the adaptive and part of the innate immune response, but this is not sufficient to inhibit collagen deposition and the IL-33 expression in the airways in mice.
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Affiliation(s)
- Leonie S van Rijt
- Department of Experimental Immunology, Amsterdam UMC, location Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Adrian Logiantara
- Department of Experimental Immunology, Amsterdam UMC, location Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Derya Canbaz
- Department of Experimental Immunology, Amsterdam UMC, location Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Ronald van Ree
- Department of Experimental Immunology, Amsterdam UMC, location Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.,Department of Otorhinolaryngology, Amsterdam UMC, location Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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33
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Zhang Q, Yang J, Bautista J, Badithe A, Olson W, Liu Y. Epitope Mapping by HDX-MS Elucidates the Surface Coverage of Antigens Associated with High Blocking Efficiency of Antibodies to Birch Pollen Allergen. Anal Chem 2018; 90:11315-11323. [DOI: 10.1021/acs.analchem.8b01864] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Affiliation(s)
- Qian Zhang
- Regeneron Pharmaceuticals, 777 Old Saw Mill River Rd, Tarrytown, New York 10591, United States
| | - Janice Yang
- Regeneron Pharmaceuticals, 777 Old Saw Mill River Rd, Tarrytown, New York 10591, United States
| | - Joannie Bautista
- Regeneron Pharmaceuticals, 777 Old Saw Mill River Rd, Tarrytown, New York 10591, United States
| | - Ashok Badithe
- Regeneron Pharmaceuticals, 777 Old Saw Mill River Rd, Tarrytown, New York 10591, United States
| | - William Olson
- Regeneron Pharmaceuticals, 777 Old Saw Mill River Rd, Tarrytown, New York 10591, United States
| | - Yashu Liu
- Regeneron Pharmaceuticals, 777 Old Saw Mill River Rd, Tarrytown, New York 10591, United States
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34
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Liu Y, Xing Z, Wang J, Geng C. Salivary Immunoglobulin A, E, and G4 Levels Specific to Dermatophagoides pteronyssinus in Allergic Rhinitis Patients Treated With Subcutaneous Immunotherapy. Am J Rhinol Allergy 2018; 32:458-464. [PMID: 30124065 DOI: 10.1177/1945892418793470] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND Allergen-specific immunotherapy (AIT) is an effective treatment for allergic rhinitis (AR). During the course of AIT, many biomarkers in body fluids change. It is necessary to find effective indicators of AIT. OBJECTIVE To examine levels of salivary immunoglobulin A, E, and G4 (IgA, IgE, and IgG4, respectively) specific to Dermatophagoides pteronyssinus (Dp-IgA, Dp-IgE, and Dp-IgG4, respectively) and their changes in AR patients undergoing subcutaneous immunotherapy (SCIT). METHODS This study included 82 patients with AR sensitized only to Dp and 14 healthy controls. Among patients with AR, 30 patients were not treated with specific immunotherapy (group A), while the remainder (n = 52) received house dust mite SCIT in the up-dosing phase (n = 27; group B) or the maintenance treatment phase (n = 25; group C). Dp-IgA, Dp-IgE, and Dp-IgG4 levels in the saliva were measured using the enzyme-linked immunosorbent assay. Clinical symptoms, concomitant medication, and the Rhinoconjunctivitis Quality of Life Questionnaire score were recorded and correlated with immunoglobulin levels. RESULTS Salivary Dp-IgG4 and Dp-IgA levels were significantly lower in AR patients than in healthy controls ( P < .001 for both), while Dp-IgE levels were significantly higher ( P < .001). SCIT resulted in sustained increases in Dp-IgG4 and Dp-IgA in the maintenance phase compared to the up-dosing phase ( P < .001 for both), whereas Dp-IgE only increased in the up-dosing phase ( P = .004, P < .0125). There was no correlation between the different salivary immunoglobulins and clinical scores during SCIT. CONCLUSIONS This study shows that allergen-specific IgE levels are increased in the saliva of sensitized patients, suggesting that measuring salivary IgE testing should be further considered for the diagnosis of AR. Moreover, allergen-specific IgA and IgG4 in the saliva, which may play protective roles against allergy, may serve as objective indicators for evaluating treatment response to SCIT. However, none of the immunoglobulin reflects subjective symptoms.
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Affiliation(s)
- Yan Liu
- 1 Department of Otorhinolaryngology, Head and Neck Surgery, Peking University People's Hospital, Beijing, China
| | - Zhimin Xing
- 1 Department of Otorhinolaryngology, Head and Neck Surgery, Peking University People's Hospital, Beijing, China
| | - Junge Wang
- 2 Department of Otolaryngology, Beijing Hospital of Traditional Chinese Medicine, Beijing, China
| | - Congli Geng
- 1 Department of Otorhinolaryngology, Head and Neck Surgery, Peking University People's Hospital, Beijing, China
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35
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Orengo JM, Radin AR, Kamat V, Badithe A, Ben LH, Bennett BL, Zhong S, Birchard D, Limnander A, Rafique A, Bautista J, Kostic A, Newell D, Duan X, Franklin MC, Olson W, Huang T, Gandhi NA, Lipsich L, Stahl N, Papadopoulos NJ, Murphy AJ, Yancopoulos GD. Treating cat allergy with monoclonal IgG antibodies that bind allergen and prevent IgE engagement. Nat Commun 2018. [PMID: 29650949 DOI: 10.1038/s41467-018-03636-8.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Acute allergic symptoms are caused by allergen-induced crosslinking of allergen-specific immunoglobulin E (IgE) bound to Fc-epsilon receptors on effector cells. Desensitization with allergen-specific immunotherapy (SIT) has been used for over a century, but the dominant protective mechanism remains unclear. One consistent observation is increased allergen-specific IgG, thought to competitively block allergen binding to IgE. Here we show that the blocking potency of the IgG response to Cat-SIT is heterogeneous. Next, using two potent, pre-selected allergen-blocking monoclonal IgG antibodies against the immunodominant cat allergen Fel d 1, we demonstrate that increasing the IgG/IgE ratio reduces the allergic response in mice and in cat-allergic patients: a single dose of blocking IgG reduces clinical symptoms in response to nasal provocation (ANCOVA, p = 0.0003), with a magnitude observed at day 8 similar to that reported with years of conventional SIT. This study suggests that simply augmenting the blocking IgG/IgE ratio may reverse allergy.
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Affiliation(s)
- J M Orengo
- Regeneron Pharmaceuticals Inc., 777 Old Saw Mill River Road, Tarrytown, NY, 10591, USA.
| | - A R Radin
- Regeneron Pharmaceuticals Inc., 777 Old Saw Mill River Road, Tarrytown, NY, 10591, USA
| | - V Kamat
- Regeneron Pharmaceuticals Inc., 777 Old Saw Mill River Road, Tarrytown, NY, 10591, USA
| | - A Badithe
- Regeneron Pharmaceuticals Inc., 777 Old Saw Mill River Road, Tarrytown, NY, 10591, USA
| | - L H Ben
- Regeneron Pharmaceuticals Inc., 777 Old Saw Mill River Road, Tarrytown, NY, 10591, USA
| | - B L Bennett
- Regeneron Pharmaceuticals Inc., 777 Old Saw Mill River Road, Tarrytown, NY, 10591, USA
| | - S Zhong
- Regeneron Pharmaceuticals Inc., 777 Old Saw Mill River Road, Tarrytown, NY, 10591, USA
| | - D Birchard
- Regeneron Pharmaceuticals Inc., 777 Old Saw Mill River Road, Tarrytown, NY, 10591, USA
| | - A Limnander
- Regeneron Pharmaceuticals Inc., 777 Old Saw Mill River Road, Tarrytown, NY, 10591, USA
| | - A Rafique
- Regeneron Pharmaceuticals Inc., 777 Old Saw Mill River Road, Tarrytown, NY, 10591, USA
| | - J Bautista
- Regeneron Pharmaceuticals Inc., 777 Old Saw Mill River Road, Tarrytown, NY, 10591, USA
| | - A Kostic
- Regeneron Pharmaceuticals Inc., 777 Old Saw Mill River Road, Tarrytown, NY, 10591, USA
| | - D Newell
- Regeneron Pharmaceuticals Inc., 777 Old Saw Mill River Road, Tarrytown, NY, 10591, USA
| | - X Duan
- Regeneron Pharmaceuticals Inc., 777 Old Saw Mill River Road, Tarrytown, NY, 10591, USA
| | - M C Franklin
- Regeneron Pharmaceuticals Inc., 777 Old Saw Mill River Road, Tarrytown, NY, 10591, USA
| | - W Olson
- Regeneron Pharmaceuticals Inc., 777 Old Saw Mill River Road, Tarrytown, NY, 10591, USA
| | - T Huang
- Regeneron Pharmaceuticals Inc., 777 Old Saw Mill River Road, Tarrytown, NY, 10591, USA
| | - N A Gandhi
- Regeneron Pharmaceuticals Inc., 777 Old Saw Mill River Road, Tarrytown, NY, 10591, USA
| | - L Lipsich
- Regeneron Pharmaceuticals Inc., 777 Old Saw Mill River Road, Tarrytown, NY, 10591, USA
| | - N Stahl
- Regeneron Pharmaceuticals Inc., 777 Old Saw Mill River Road, Tarrytown, NY, 10591, USA
| | - N J Papadopoulos
- Regeneron Pharmaceuticals Inc., 777 Old Saw Mill River Road, Tarrytown, NY, 10591, USA
| | - A J Murphy
- Regeneron Pharmaceuticals Inc., 777 Old Saw Mill River Road, Tarrytown, NY, 10591, USA
| | - G D Yancopoulos
- Regeneron Pharmaceuticals Inc., 777 Old Saw Mill River Road, Tarrytown, NY, 10591, USA
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36
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Treating cat allergy with monoclonal IgG antibodies that bind allergen and prevent IgE engagement. Nat Commun 2018; 9:1421. [PMID: 29650949 PMCID: PMC5897525 DOI: 10.1038/s41467-018-03636-8] [Citation(s) in RCA: 146] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 02/23/2018] [Indexed: 12/12/2022] Open
Abstract
Acute allergic symptoms are caused by allergen-induced crosslinking of allergen-specific immunoglobulin E (IgE) bound to Fc-epsilon receptors on effector cells. Desensitization with allergen-specific immunotherapy (SIT) has been used for over a century, but the dominant protective mechanism remains unclear. One consistent observation is increased allergen-specific IgG, thought to competitively block allergen binding to IgE. Here we show that the blocking potency of the IgG response to Cat-SIT is heterogeneous. Next, using two potent, pre-selected allergen-blocking monoclonal IgG antibodies against the immunodominant cat allergen Fel d 1, we demonstrate that increasing the IgG/IgE ratio reduces the allergic response in mice and in cat-allergic patients: a single dose of blocking IgG reduces clinical symptoms in response to nasal provocation (ANCOVA, p = 0.0003), with a magnitude observed at day 8 similar to that reported with years of conventional SIT. This study suggests that simply augmenting the blocking IgG/IgE ratio may reverse allergy. Allergen-specific immunotherapy is used to treat patients affected by acute immunoglobulin E (IgE) responses, but the function mechanism is unclear. Here the authors show that the administration of two cat allergen-specific IgGs reduces allergic responses in mouse models and helps ameliorate clinical symptoms in a phase 1b clinical trial.
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Zhang W, Lin C, Sampath V, Nadeau K. Impact of allergen immunotherapy in allergic asthma. Immunotherapy 2018; 10:579-593. [PMID: 29569506 DOI: 10.2217/imt-2017-0138] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Although traditional pharmacological approaches improve outcomes in disease management for allergic asthma, these fail to modify the underlying immune responses. Allergen immunotherapy remains the only etiological therapy for the treatment of respiratory allergies for which clinical efficacy has been demonstrated through several well-controlled studies. In this review, we examine evidence from the past 5 years regarding the impact of allergen immunotherapy on allergic asthma to inform practitioners and stimulate further discussion and research.
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Affiliation(s)
- Wenming Zhang
- Sean N. Parker Center for Allergy & Asthma Research, Stanford University, Stanford, CA 94305, USA
| | - Chunrong Lin
- Sean N. Parker Center for Allergy & Asthma Research, Stanford University, Stanford, CA 94305, USA
| | - Vanitha Sampath
- Sean N. Parker Center for Allergy & Asthma Research, Stanford University, Stanford, CA 94305, USA
| | - Kari Nadeau
- Sean N. Parker Center for Allergy & Asthma Research, Stanford University, Stanford, CA 94305, USA
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Pavlova KS, Kurbacheva OM, Galitskaya MA, Smirnov DS. ACTUAL CONCEPTION OF ALLERGEN-SPECIFIC IMMUNOTHERAPY MECHANISMS, POTENTIAL BIOMARKERS OF EFFICACY AND WAYS OF ENHANCEMENT. ACTA ACUST UNITED AC 2017. [DOI: 10.36691/rja290] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
The article analyzes international position papers on the allergen-specific immunotherapy mechanisms, discusses potential biomarkers for evaluation of ASIT efficacy, as well as the perspectives for ASIT enhancement.
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Ohsaki A, Venturelli N, Buccigrosso TM, Osganian SK, Lee J, Blumberg RS, Oyoshi MK. Maternal IgG immune complexes induce food allergen-specific tolerance in offspring. J Exp Med 2017; 215:91-113. [PMID: 29158374 PMCID: PMC5748859 DOI: 10.1084/jem.20171163] [Citation(s) in RCA: 91] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Revised: 08/24/2017] [Accepted: 09/28/2017] [Indexed: 12/17/2022] Open
Abstract
The role of maternal immune responses in tolerance induction is poorly understood. To study whether maternal allergen sensitization affects offspring susceptibility to food allergy, we epicutaneously sensitized female mice with ovalbumin (OVA) followed by epicutaneous sensitization and oral challenge of their offspring with OVA. Maternal OVA sensitization prevented food anaphylaxis, OVA-specific IgE production, and intestinal mast cell expansion in offspring. This protection was mediated by neonatal crystallizable fragment receptor (FcRn)-dependent transfer of maternal IgG and OVA immune complexes (IgG-IC) via breast milk and induction of allergen-specific regulatory T (T reg) cells in offspring. Breastfeeding by OVA-sensitized mothers or maternal supplementation with IgG-IC was sufficient to induce neonatal tolerance. FcRn-dependent antigen presentation by CD11c+ dendritic cells (DCs) in offspring was required for oral tolerance. Human breast milk containing OVA-IgG-IC induced tolerance in humanized FcRn mice. Collectively, we demonstrate that interactions of maternal IgG-IC and offspring FcRn are critical for induction of T reg cell responses and control of food-specific tolerance in neonates.
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Affiliation(s)
- Asa Ohsaki
- Division of Immunology, Boston Children's Hospital, Boston, MA
| | | | | | | | - John Lee
- Division of Immunology, Boston Children's Hospital, Boston, MA.,Department of Pediatrics, Harvard Medical School, Boston, MA
| | - Richard S Blumberg
- Gastroenterology Division, Brigham and Women's Hospital, Boston, MA.,Department of Medicine, Harvard Medical School, Boston, MA.,Harvard Digestive Diseases Center, Boston, MA
| | - Michiko K Oyoshi
- Division of Immunology, Boston Children's Hospital, Boston, MA .,Department of Pediatrics, Harvard Medical School, Boston, MA
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Caubet JC, Lin J, Ahrens B, Gimenez G, Bardina L, Niggemann B, Sampson HA, Beyer K. Natural tolerance development in cow's milk allergic children: IgE and IgG4 epitope binding. Allergy 2017; 72:1677-1685. [PMID: 28345783 DOI: 10.1111/all.13167] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/22/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND Although most of cow's milk (CM) allergic children will outgrow their allergy, the pathomechanism of the natural development of tolerance remains poorly understood. It has been suggested that the balance between milk-specific IgE and IgG4 plays a major role. OBJECTIVE We aimed to investigate differences in IgE and IgG4 antibody binding to CM epitopes between patients with persistent CM allergy (CMA) and those that naturally became tolerant. METHODS Sera from 35 children with proven CMA (median age at inclusion of 10 months) were analyzed retrospectively; 22 patients have become tolerant (median age at tolerance acquisition of 51 months) during the study period as confirmed by a negative oral food challenge. IgE and IgG4 binding to sequential epitopes derived from five major CM proteins were measured with a peptide microarray-based immunoassay. RESULTS At baselines, greater intensity and broader diversity of IgE and IgG4 binding have been found in children with persistent CMA beyond 5 years of age compared to patients with transient CMA. Moreover, children with transient CMA had IgE and IgG4 antibodies that more often recognized the same epitopes, compared to those with persistent CMA. From baseline to the time of tolerance development, both IgE and IgG4 binding intensity decreased significantly, particularly in areas of α-s- and β-casein (P<.01, false discovery rate [FDR]<.1). Interestingly, differences between IgE and IgG4 binding intensity to CM peptides decreased when the patients became tolerant. CONCLUSIONS Our results suggest that the overlap between IgE and IgG4 might be important in natural tolerance acquisition. Further studies are needed to confirm our data and can eventually lead to development of more targeted treatment of food allergy.
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Affiliation(s)
- J. C. Caubet
- Geneva University Hospital Geneva Switzerland
- Department of Pediatrics Division of Allergy and Immunology Jaffe Food Allergy Institute Icahn School of Medicine at Mount Sinai New York NY USA
| | - J. Lin
- Department of Pediatrics Division of Allergy and Immunology Jaffe Food Allergy Institute Icahn School of Medicine at Mount Sinai New York NY USA
- Bioinformatics Institute Institute of High Performance Computing A*STAR Singapore Singapore
| | - B. Ahrens
- Department of Pediatric Pneumology and Immunology Charité Universitätsmedizin Berlin Berlin Germany
| | - G. Gimenez
- Department of Pediatrics Division of Allergy and Immunology Jaffe Food Allergy Institute Icahn School of Medicine at Mount Sinai New York NY USA
| | - L. Bardina
- Department of Pediatrics Division of Allergy and Immunology Jaffe Food Allergy Institute Icahn School of Medicine at Mount Sinai New York NY USA
| | - B. Niggemann
- Department of Pediatric Pneumology and Immunology Charité Universitätsmedizin Berlin Berlin Germany
| | - H. A. Sampson
- Department of Pediatrics Division of Allergy and Immunology Jaffe Food Allergy Institute Icahn School of Medicine at Mount Sinai New York NY USA
| | - K. Beyer
- Department of Pediatrics Division of Allergy and Immunology Jaffe Food Allergy Institute Icahn School of Medicine at Mount Sinai New York NY USA
- Department of Pediatric Pneumology and Immunology Charité Universitätsmedizin Berlin Berlin Germany
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van de Veen W, Wirz OF, Globinska A, Akdis M. Novel mechanisms in immune tolerance to allergens during natural allergen exposure and allergen-specific immunotherapy. Curr Opin Immunol 2017; 48:74-81. [DOI: 10.1016/j.coi.2017.08.012] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Revised: 08/14/2017] [Accepted: 08/18/2017] [Indexed: 01/22/2023]
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Martignago I, Incorvaia C, Ridolo E. Preventive actions of allergen immunotherapy: the facts and the effects in search of evidence. Clin Mol Allergy 2017. [PMID: 28638279 PMCID: PMC5471950 DOI: 10.1186/s12948-017-0070-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Allergen immunotherapy (AIT) is the only treatment that works on the causes of allergy. Available AIT nowadays are subcutaneous immunotherapy (SCIT) and sublingual immunotherapy (SLIT) for allergic rhinitis and asthma, while for allergy to Hymenoptera venom only subcutaneous route is recommended. A bulk of trials and meta-analyses demonstrated that efficacy and safety of AIT in decreasing allergic clinical symptoms and use of rescue medications, while its preventive capacity is yet under investigation. The most important of these effects is the prevention of potentially fatal anaphylactic reactions to Hymenoptera stings by venom immunotherapy (VIT). A certain number of studies thus far available showed that AIT, in both forms, is able to prevent the progress of allergic rhinitis into asthma and the development of new sensitizations. These effects should be related to the mechanisms of action of AIT. In fact, it has been demonstrated that both SCIT and SLIT are able to modify the allergen presentation by dendritic cells, with result in modification of the phenotype of allergen-specific T cells, switching from the typical of allergic inflammation Th2-type response to a Th1-type one. Also allergen-specific T regulatory (Treg) cells play a pivotal role by producing suppressive cytokines, such as IL-10 and TGF-beta. However, the only plain evidence of a preventive effect concerns VIT, while the other outcomes need to be furtherly investigated.
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Affiliation(s)
- Irene Martignago
- Medicine and Surgery Department, University of Parma, via Gramsci n.14, 43126 Parma, Italy
| | | | - Erminia Ridolo
- Medicine and Surgery Department, University of Parma, via Gramsci n.14, 43126 Parma, Italy
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43
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Update on Biomarkers to Predict Responders to Allergen Immunotherapy. CURRENT TREATMENT OPTIONS IN ALLERGY 2017. [DOI: 10.1007/s40521-017-0113-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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44
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Bachmann MF, Kündig TM. Allergen-specific immunotherapy: is it vaccination against toxins after all? Allergy 2017; 72:13-23. [PMID: 27558586 DOI: 10.1111/all.12890] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2016] [Indexed: 01/16/2023]
Abstract
IgE-mediated allergies, in particular allergic rhinoconjunctivitis and asthma, have reached epidemic proportions, affecting about one-third of the population in developed countries. The most effective treatment for allergies is specific immunotherapy (SIT), which involves the injection of increasing doses of an allergen extract to allergic individuals. The current form of SIT was first introduced in 1911 and recently celebrated its 100th birthday for the treatment of hay fever. The concept of this therapy at the time was straightforward, as it was believed that pollen contained toxins against which the patient could be vaccinated. However, the understanding became blurred with the discovery that IgE antibodies were the effector molecules of the allergic response. Subsequent research focused on the idea that SIT should induce tolerance keeping the IgE antibodies at bay. In this review, we will discuss the various hypotheses for the mechanism of SIT and we will put forward the concept that allergens may be viewed as 'protoxins' which need to be activated by IgE antibodies. Within this framework, protoxin-neutralizing antibodies are the key effector molecules while a shift to Th1 or Treg cells mainly contributes to the efficacy of SIT by helping B cells to produce neutralizing IgG antibodies.
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Affiliation(s)
- M. F. Bachmann
- Immunology; RIA; University Hospital Bern; Bern Switzerland
- The Jenner Institute; University of Oxford; Oxford UK
| | - T. M. Kündig
- Department of Dermatology; University Hospital Zürich; Zürich Switzerland
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Cardona V, Luengo O, Labrador-Horrillo M. Immunotherapy in allergic rhinitis and lower airway outcomes. Allergy 2017; 72:35-42. [PMID: 27439141 DOI: 10.1111/all.12989] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/17/2016] [Indexed: 11/29/2022]
Abstract
Allergic rhinitis and asthma constitute two clinical expressions of a single-condition, respiratory allergy. Allergen immunotherapy (AIT) is a form of treatment specifically aimed at modifying the response to sensitizing allergens. The inherent potential benefit of AIT is the simultaneous treatment of all clinical expressions of respiratory allergy. Current data support the effectiveness of subcutaneous and sublingual immunotherapy in rhinitis. Studies also provide proof for a beneficial effect in allergic asthma. Even more, substantial evidence points to the preventive effect on the progression from rhinitis to asthma. Despite the current knowledge on the basic mechanisms underlying the immunological effect of AIT is vast, the specific mechanisms for the preventive effect of primary sensitization or new sensitizations are poorly understood. This review aimed to provide a critical overview of the current knowledge on the effectiveness of AIT and its potential role in secondary prevention of respiratory allergy progression.
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Affiliation(s)
- V. Cardona
- Allergy Section; Department of Internal Medicine; Hospital Vall d'Hebron; Barcelona Spain
- Allergy Research Group; Institut de Recerca Vall d'Hebron; Universitat Autònoma de Barcelona; Barcelona Spain
| | - O. Luengo
- Allergy Section; Department of Internal Medicine; Hospital Vall d'Hebron; Barcelona Spain
- Allergy Research Group; Institut de Recerca Vall d'Hebron; Universitat Autònoma de Barcelona; Barcelona Spain
| | - M. Labrador-Horrillo
- Allergy Section; Department of Internal Medicine; Hospital Vall d'Hebron; Barcelona Spain
- Allergy Research Group; Institut de Recerca Vall d'Hebron; Universitat Autònoma de Barcelona; Barcelona Spain
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Molecular engineering of a therapeutic antibody for Blo t 5-induced allergic asthma. J Allergy Clin Immunol 2016; 139:1705-1708.e6. [PMID: 27923562 DOI: 10.1016/j.jaci.2016.10.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Revised: 09/05/2016] [Accepted: 10/10/2016] [Indexed: 11/22/2022]
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Groh N, von Loetzen CS, Subbarayal B, Möbs C, Vogel L, Hoffmann A, Fötisch K, Koutsouridou A, Randow S, Völker E, Seutter von Loetzen A, Rösch P, Vieths S, Pfützner W, Bohle B, Schiller D. IgE and allergen-specific immunotherapy-induced IgG 4 recognize similar epitopes of Bet v 1, the major allergen of birch pollen. Clin Exp Allergy 2016; 47:693-703. [PMID: 27770477 DOI: 10.1111/cea.12835] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Revised: 09/14/2016] [Accepted: 09/26/2016] [Indexed: 12/20/2022]
Abstract
BACKGROUND Allergen-specific immunotherapy (AIT) with birch pollen generates Bet v 1-specific immunoglobulin (Ig)G4 which blocks IgE-mediated hypersensitivity mechanisms. Whether IgG4 specific for Bet v 1a competes with IgE for identical epitopes or whether novel epitope specificities of IgG4 antibodies are developed is under debate. OBJECTIVE We sought to analyze the epitope specificities of IgE and IgG4 antibodies from sera of patients who received AIT. METHODS 15 sera of patients (13/15 received AIT) with Bet v 1a-specific IgE and IgG4 were analyzed. The structural arrangements of recombinant (r)Bet v 1a and rBet v 1a_11x , modified in five potential epitopes, were analyzed by circular dichroism and nuclear magnetic resonance spectroscopy. IgE binding to Bet v 1 was assessed by ELISA and mediator release assays. Competitive binding of monoclonal antibodies specific for Bet v 1a and serum IgE/IgG4 to rBet v 1a and serum antibody binding to a non-allergenic Bet v 1-type model protein presenting an individual epitope for IgE was analyzed in ELISA and western blot. RESULTS rBet v 1a_11x had a Bet v 1a - similar secondary and tertiary structure. Monomeric dispersion of rBet v 1a_11x was concentration and buffer-dependent. Up to 1500-fold increase in the EC50 for IgE-mediated mediator release induced by rBet v 1a_11x was determined. The reduction of IgE and IgG4 binding to rBet v 1a_11x was comparable in 67% (10/15) of sera. Bet v 1a-specific monoclonal antibodies inhibited binding of serum IgE and IgG4 to 66.1% and 64.9%, respectively. Serum IgE and IgG4 bound specifically to an individual epitope presented by our model protein in 33% (5/15) of sera. CONCLUSION AND CLINICAL RELEVANCE Patients receiving AIT develop Bet v 1a-specific IgG4 which competes with IgE for partly identical or largely overlapping epitopes. The similarities of epitopes for IgE and IgG4 might stimulate the development of epitope-specific diagnostics and therapeutics.
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Affiliation(s)
- N Groh
- Division of Allergology, Paul-Ehrlich-Institut, Langen, Germany
| | - C S von Loetzen
- Department of Biopolymers, University of Bayreuth, Bayreuth, Germany
| | - B Subbarayal
- Department of Pathophysiology and Allergy Research and Christian Doppler Laboratory for Immunomodulation, Medical University of Vienna, Vienna, Austria
| | - C Möbs
- Department of Dermatology and Allergology, Philipps University Marburg, Marburg, Germany
| | - L Vogel
- Division of Allergology, Paul-Ehrlich-Institut, Langen, Germany
| | - A Hoffmann
- Division of Allergology, Paul-Ehrlich-Institut, Langen, Germany
| | - K Fötisch
- Division of Allergology, Paul-Ehrlich-Institut, Langen, Germany
| | - A Koutsouridou
- Division of Allergology, Paul-Ehrlich-Institut, Langen, Germany
| | - S Randow
- Division of Allergology, Paul-Ehrlich-Institut, Langen, Germany
| | - E Völker
- Division of Allergology, Paul-Ehrlich-Institut, Langen, Germany
| | | | - P Rösch
- Department of Biopolymers, University of Bayreuth, Bayreuth, Germany
| | - S Vieths
- Division of Allergology, Paul-Ehrlich-Institut, Langen, Germany
| | - W Pfützner
- Department of Dermatology and Allergology, Philipps University Marburg, Marburg, Germany
| | - B Bohle
- Department of Pathophysiology and Allergy Research and Christian Doppler Laboratory for Immunomodulation, Medical University of Vienna, Vienna, Austria
| | - D Schiller
- Division of Allergology, Paul-Ehrlich-Institut, Langen, Germany
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48
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Ponce M, Diesner SC, Szépfalusi Z, Eiwegger T. Markers of tolerance development to food allergens. Allergy 2016; 71:1393-404. [PMID: 27286276 DOI: 10.1111/all.12953] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/08/2016] [Indexed: 12/30/2022]
Abstract
IgE-mediated reactions to food allergens are the most common cause of anaphylaxis in childhood. Although allergies to cow's milk, egg, or soy proteins, in contrast to peanut and tree nut allergens, resolve within the first 6 years of life in up to 60% due to natural tolerance development, this process is not well understood. At present, there is no cure or treatment for food allergy that would result in an induction of tolerance to the symptom-eliciting food. Avoidance, providing an emergency plan and education, is the standard of treatment. Oral immunotherapeutic approaches have been proven reasonable efficacy; however, they are associated with high rates of side-effects and low numbers of patients achieving tolerance. Nevertheless, mechanisms that take place during oral immunotherapy may help to understand tolerance development. On the basis of these therapeutic interventions, events like loss of basophil activation and induction of regulatory lymphocyte subsets and of blocking antibodies have been described. Their functional importance at a clinical level, however, remains to be investigated in detail. Consequently, there is eminent need to understand the process of tolerance development to food allergens and define biomarkers to develop and monitor new treatment strategies for food allergy.
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Affiliation(s)
- M. Ponce
- Department of Pediatrics and Adolescent Medicine; Medical University of Vienna; Vienna Austria
| | - S. C. Diesner
- Department of Pediatrics and Adolescent Medicine; Medical University of Vienna; Vienna Austria
| | - Z. Szépfalusi
- Department of Pediatrics and Adolescent Medicine; Medical University of Vienna; Vienna Austria
| | - T. Eiwegger
- Department of Pediatrics and Adolescent Medicine; Medical University of Vienna; Vienna Austria
- Division of Immunology and Allergy, Food allergy and Anaphylaxis Program; The Department of Paediatrics; Hospital for Sick Children; Research Institute, Physiology and Experimental Medicine Program; The University of Toronto; Toronto ON Canada
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Abstract
One key approach to increase the efficacy and the safety of immunotherapy is the use of adjuvants. However, many of the adjuvants currently in use can cause adverse events, raising concerns regarding their clinical use, and are geared toward productive immune responses but not necessarily tolerogenic responses. Thus, novel adjuvants for immunotherapy are needed and are being developed. Essential is their potential to boost appropriate tolerogenic adaptive immune responses to allergens while limiting side effects. This review provides an overview of adjuvants currently in clinical use or under development and discusses their therapeutic effect in enhancing allergen-induced tolerance.
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50
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Abstract
Biomarkers (BMKs) are biological parameters that can be measured to predict or monitor disease severity or treatment efficacy. The induction of regulatory dendritic cells (DCs) concomitantly with a downregulation of proallergic DC2s (ie, DCs supporting the differentiation of T-helper lymphocyte type 2 cells) in the blood of patients allergic to grass pollen has been correlated with the early onset of allergen immunotherapy efficacy. The combined use of omics technologies to compare biological samples from clinical responders and nonresponders is being implemented in the context of nonhypothesis-driven approaches. Such comprehensive "panoromic" strategies help identify completely novel candidate BMKs, to be subsequently validated as companion diagnostics in large-scale clinical trials.
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Affiliation(s)
- Philippe Moingeon
- Research and Development, Stallergenes SA, 6 Rue Alexis de Tocqueville, Antony Cedex 92183, France.
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