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Marquart E, Jalili A, Mothes-Luksch N, Wagner SN, Kinaciyan T. Anaphylactic reaction to carboplatin diagnosed by skin testing-a reliable tool in platinum-based immediate-type hypersensitivity reactions. Wien Med Wochenschr 2023; 173:256-259. [PMID: 35595936 PMCID: PMC10477098 DOI: 10.1007/s10354-022-00938-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 04/29/2022] [Indexed: 11/29/2022]
Abstract
Immediate-type hypersensitivity reactions (IHRs) to carboplatin (CA) are most commonly reported in ovarian cancer patients. A 54-year-old woman with stage IV melanoma suffering from metastasis in the entire right lower extremity was presented to our allergy outpatient clinic for diagnostic work-up due to an anaphylactic reaction with palmoplantar erythema, conjunctivitis along with facial erythema, and an incipient decrease in blood pressure during a chemotherapy regimen with dacarbazine and carboplatin upon re-administration. A subsequently carried out allergological work-up with skin testing (ST) revealed CA to be the culprit drug, whereas cisplatin (CI) was confirmed to be a safe alternative for the patient for following treatments. Here, we report a case of an IHR to carboplatin in a melanoma patient, with CI serving as a safe alternative diagnosed by skin testing.
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Affiliation(s)
- Elias Marquart
- Department of Dermatology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Ahmad Jalili
- Department of Dermatology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
- Dermatology & Skin Care, Bürgenstock Medical Center, Obbürgen, Switzerland
| | - Nadine Mothes-Luksch
- Department of Dermatology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Stephan N Wagner
- Department of Dermatology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
| | - Tamar Kinaciyan
- Department of Dermatology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
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Dezfouli SG, Mothes-Luksch N, Jensen AN, Untersmayr E, Kundi M, Jensen-Jarolim E. Linking cross-reactivity clusters of food and respiratory allergens in PAMD@ to asthma and duration of allergy. World Allergy Organ J 2020; 13:100483. [PMID: 33294115 PMCID: PMC7691607 DOI: 10.1016/j.waojou.2020.100483] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 10/27/2020] [Accepted: 10/29/2020] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Component resolved diagnosis, recently redefined as precision allergy medicine diagnosis - PAMD@, may help understanding allergic cross-reactivity patterns among polysensitized patients and their clinical implication. OBJECTIVE We aimed to investigate similarities among allergens by empirically determining the occurrence of co-sensitization patterns and to relate them to clinical features, in particular to asthma. METHODS A retrospective cohort study in 1057 participants suspected to have allergic sensitization was performed in Vienna. To define cross-reactivity patterns, cluster analysis for 671 patients who showed reaction to at least one of the allergens in ISAC112 was performed and followed by multivariate logistic regression analysis to relate clusters and clinical symptoms, in particular current asthma. RESULTS We determined 18 cross-reactivity clusters, comprising of 6 food, 10 respiratory, and 2 other clusters of allergens. Overall, 14% of the cohort patients were positive for 1 cross-reactivity cluster and 23% to 2 or more clusters. Multisensitized patients who were sensitized to PR-10 allergen proteins in addition to Bermuda timothy grass pollen clusters showed the highest association with asthma (odds ratio, 4.22 and 95% CI: 2.32-7.68) and an increase of 10 years of the duration of allergy increased the odds for a combined sensitization to PR-10 cluster and Bermuda-timothy cluster by 1.27 (95% CI: 1.06-1.53). CONCLUSION Similarities among IgE positivity patterns determined by ISAC112 revealed 18 cross-reactivity clusters. This PAMD@ approach allowed prediction of clinical features and revealed that certain cross-reactivity patterns are related to duration of allergic symptoms.
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Affiliation(s)
- Shadan Ghandizadeh Dezfouli
- Institute of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Austria
- Center for Public Health, Medical University Vienna, Austria
| | - Nadine Mothes-Luksch
- Institute of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Austria
- AllergyCare® - Allergy Diagnosis, Vienna, Austria
| | | | - Eva Untersmayr
- Institute of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Austria
| | - Michael Kundi
- Center for Public Health, Medical University Vienna, Austria
| | - Erika Jensen-Jarolim
- Institute of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Austria
- AllergyCare® - Allergy Diagnosis, Vienna, Austria
- Comparative Medicine, The Interuniversity Messerli Research Institute, Vienna, Austria
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Glenk LM, Kothgassner OD, Felnhofer A, Gotovina J, Pranger CL, Jensen AN, Mothes-Luksch N, Goreis A, Palme R, Jensen-Jarolim E. Salivary cortisol responses to acute stress vary between allergic and healthy individuals: the role of plasma oxytocin, emotion regulation strategies, reported stress and anxiety. Stress 2020; 23:275-283. [PMID: 31578916 PMCID: PMC7261398 DOI: 10.1080/10253890.2019.1675629] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Numerous studies have demonstrated that acute psychological stress, induced by the Trier Social Stress Test (TSST) paradigm, affects salivary cortisol secretion and self-reported stress measures including anxiety. Allergy has been related to altered cortisol responsiveness and increased stress vulnerability. Here, we investigated acute stress responses and emotion regulation strategies in cohorts of allergic and healthy individuals. Groups of allergics and healthy individuals were subjected to the TSST and experienced levels of stress and anxiety, as well as emotion regulation strategies, were assessed. Cortisol and oxytocin concentrations were measured in saliva or plasma. The present findings confirm earlier results of altered stress responsiveness in allergic individuals. Acute stress by the TSST evoked higher physiological arousal in allergics by means of salivary cortisol secretion. Allergics also scored higher on emotion suppression. However, individuals who were more likely to use reappraisal recovered more efficiently from the cortisol increase. No such effect for reappraisal was found in the healthy population. No differences in self-reported anxiety and stress emerged between the groups. Plasma oxytocin levels prior to the TSST were significantly higher in allergics. Our data corroborate earlier findings on altered stress susceptibility in allergics. Moreover, we identified differences in emotion regulation and oxytocin secretion which should be further explored. Accounting for the emerging global prevalence of allergy, more in-depth research into the experience of stress, coping strategies and stress-related molecules in allergic people is warranted.Short summaryThis study addressed stress experiences and emotion regulation in allergic and non-allergic adults. Allergics scored higher on emotion suppression, had higher pre-stress concentrations of plasma oxytocin and exhibited a stronger salivary cortisol response to stress than healthy people. The research outcomes indicate that allergic individuals cope less efficiently with acute stress but may benefit from adaptive emotion regulation strategies such as reappraisal.
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Affiliation(s)
- L. M. Glenk
- Comparative Medicine, The Interuniversity Messerli Research Institute of the University of Veterinary Medicine Vienna, Medical University Vienna and University Vienna, Vienna, Austria
- CONTACT L. M. Glenk The Interuniversity Messerli Research Institute, Comparative Medicine, Veterinärplatz 1, 1210 Vienna, Austria
| | - O. D. Kothgassner
- Department of Child and Adolescent Psychiatry, Medical University of Vienna; Division of Clinical Psychology at the Medical Directorate of the Vienna General Hospital, Vienna Medical Campus, Vienna, Austria
| | - A. Felnhofer
- Department of Child and Adolescent Medicine, Medical University Vienna, Austria
| | - J. Gotovina
- Comparative Medicine, The Interuniversity Messerli Research Institute of the University of Veterinary Medicine Vienna, Medical University Vienna and University Vienna, Vienna, Austria
- Institute of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - C. L. Pranger
- Comparative Medicine, The Interuniversity Messerli Research Institute of the University of Veterinary Medicine Vienna, Medical University Vienna and University Vienna, Vienna, Austria
- Institute of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - A. N. Jensen
- AllergyCare, Allergy Diagnosis and Study Center, Vienna, Austria
| | - N. Mothes-Luksch
- AllergyCare, Allergy Diagnosis and Study Center, Vienna, Austria
| | - A. Goreis
- Department of Applied Psychology: Health, Development, Enhancement and Intervention, Faculty of Psychology, University of Vienna, Austria
- Outpatient Unit for Research, Teaching and Practice, Faculty of Psychology, University of Vienna, Vienna, Austria
| | - R. Palme
- Unit of Physiology, Pathophysiology und experimental Endocrinology, University of Veterinary Medicine Vienna, Vienna, Austria
| | - E. Jensen-Jarolim
- Comparative Medicine, The Interuniversity Messerli Research Institute of the University of Veterinary Medicine Vienna, Medical University Vienna and University Vienna, Vienna, Austria
- Institute of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
- AllergyCare, Allergy Diagnosis and Study Center, Vienna, Austria
- E. Jensen-Jarolim Institute of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
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Larenas Linnemann DE, Meinlschmidt P, Purschke B, Hofstetter G, Rodríguez Monroy FA, Einhorn L, Mothes-Luksch N, Jaeger H, Jensen-Jarolim E, Pali-Schoell I. Novel foods: Enzymatic and thermal food processing make edible insects non-allergenic. J Allergy Clin Immunol 2019. [DOI: 10.1016/j.jaci.2018.12.108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Pali-Schöll I, Meinlschmidt P, Larenas-Linnemann D, Purschke B, Hofstetter G, Rodríguez-Monroy FA, Einhorn L, Mothes-Luksch N, Jensen-Jarolim E, Jäger H. Edible insects: Cross-recognition of IgE from crustacean- and house dust mite allergic patients, and reduction of allergenicity by food processing. World Allergy Organ J 2019; 12:100006. [PMID: 30937131 PMCID: PMC6439408 DOI: 10.1016/j.waojou.2018.10.001] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 12/21/2018] [Accepted: 01/03/2019] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Insects have become increasingly interesting as alternative nutrient sources for feeding humans and animals, most reasonably in processed form. Initially, some safety aspects - among them allergenicity - need to be addressed. OBJECTIVE To reveal the cross-reactivity of shrimp-, mite- and flies-allergic patients to different edible insects, and further to assess the efficacy of food processing in reducing the recognition of insect proteins by patients' IgE and in skin prick testing of shrimp-allergic patients. METHODS IgE from patients allergic to crustaceans, house dust mite or flies was evaluated for cross-recognition of proteins in house cricket Acheta domesticus (AD), desert locust Schistocerca gregaria (SG) and Yellow mealworm Tenebrio molitor (TM). Changes in IgE-binding and SPT-reactivity to processed insect extracts were determined for migratory locust (Locusta migratoria, LM), after different extraction methods, enzymatic hydrolysis, and thermal processing were applied. RESULTS IgE from patients with crustacean-allergy shows cross-recognition of AD, SG and stable flies; house dust mite allergics' IgE binds to AD and SG; and the flies-allergic patient recognized cricket, desert locust and migratory locust. Cross-reactivity and allergenicity in SPT to LM can be deleted by conventional processing steps, such as hydrolysis with different enzymes or heat treatment, during the preparation of protein concentrates. CONCLUSION The results show that crustacean-, HDM- and stable flies-allergic patients cross-recognize desert locust and house cricket proteins, and crustacean-allergic patients also flies proteins. Furthermore, this study shows that appropriate food processing methods can reduce the risk of cross-reactivity and allergenicity of edible insects.
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Affiliation(s)
- Isabella Pali-Schöll
- Comparative Medicine, The Interuniversity Messerli Research Institute of the University of Veterinary Medicine Vienna, Medical University Vienna and University Vienna, Austria
- Institute of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University Vienna, Vienna, Austria
| | - Pia Meinlschmidt
- Department of Food Science and Technology, Institute of Food Technology, University of Natural Resources and Life Sciences (BOKU) Vienna, Vienna, Austria
| | | | - Benedict Purschke
- Department of Food Science and Technology, Institute of Food Technology, University of Natural Resources and Life Sciences (BOKU) Vienna, Vienna, Austria
| | - Gerlinde Hofstetter
- Comparative Medicine, The Interuniversity Messerli Research Institute of the University of Veterinary Medicine Vienna, Medical University Vienna and University Vienna, Austria
| | | | - Lukas Einhorn
- Comparative Medicine, The Interuniversity Messerli Research Institute of the University of Veterinary Medicine Vienna, Medical University Vienna and University Vienna, Austria
- Institute of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University Vienna, Vienna, Austria
| | | | - Erika Jensen-Jarolim
- Comparative Medicine, The Interuniversity Messerli Research Institute of the University of Veterinary Medicine Vienna, Medical University Vienna and University Vienna, Austria
- Institute of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University Vienna, Vienna, Austria
- AllergyCare, Allergy Diagnosis and Study Center Vienna, Vienna, Austriaf
| | - Henry Jäger
- Department of Food Science and Technology, Institute of Food Technology, University of Natural Resources and Life Sciences (BOKU) Vienna, Vienna, Austria
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Roth-Walter F, Schmutz R, Mothes-Luksch N, Lemell P, Zieglmayer P, Zieglmayer R, Jensen-Jarolim E. Clinical efficacy of sublingual immunotherapy is associated with restoration of steady-state serum lipocalin 2 after SLIT: a pilot study. World Allergy Organ J 2018; 11:21. [PMID: 30323863 PMCID: PMC6166283 DOI: 10.1186/s40413-018-0201-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Accepted: 07/30/2018] [Indexed: 12/20/2022] Open
Abstract
Background So far, only a few biomarkers in allergen immunotherapy exist that are associated with a clinical benefit. We thus investigated in a pilot study whether innate molecules such as the molecule lipocalin-2 (LCN2), with implications in immune tolerance demonstrated in other fields, may discriminate A) between allergic and non-allergic individuals, and B) between patients clinically responding or non-responding to sublingual allergen immunotherapy (SLIT) with house dust mite (HDM) extract. Moreover, we assessed haematological changes potentially correlating with allergic symptoms. Methods LCN2-concentrations were assessed in sera of healthy and allergic subjects (n = 126) as well as of house dust mite (HDM) allergics before and during HDM- sublingual immunotherapy (SLIT) in a randomized, double-blind, placebo-controlled trial for 24 weeks. Sera pre-SLIT (week 0), post-SLIT (week 24) and 9 months after SLIT were assessed for LCN2 levels and correlated with total nasal symptom scores (TNSS) obtained during chamber challenge at week 24 in patients receiving HDM- (n = 31) or placebo-SLIT (n = 10). Results Allergic individuals had significantly (p < 0.0001) lower LCN2-levels than healthy controls. HDM-allergic patients who received HDM-SLIT showed a significant increase in LCN2 9 months after termination of HDM-SLIT (p < 0.001), whereas in subjects receiving placebo no increase in LCN2 was observed. Among blood parameters a lower absolute rise in the lymphocyte population (p < 0.05) negatively correlated with symptom improvement (Pearson r 0.3395), and a lower relative increase in the neutrophils were associated with improvement in TNSS (p < 0.05). LCN2 levels 9 months after immunotherapy showed a low positive correlation with the relative improvement of symptoms (Pearson r 0.3293). LCN2-levels 9 months off-SLIT were significantly higher in patients whose symptoms improved during chamber challenge than in those whose symptoms aggravated (p < 0.01). Conclusion Serum LCN2 concentrations 9 months off-SLIT correlated with clinical reactivity in allergic patients. An increase in the LCN2 levels 9 months after HDM-SLIT was associated with a clinical benefit. Serum LCN2 may thus contribute to assess clinical reactivity in allergic patients. Trial registration Part of the data were generated from clinicaltrials.gov Identifier NCT01644617.
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Affiliation(s)
- Franziska Roth-Walter
- 1Comparative Medicine, The Interuniversity Messerli Research Institute of the University of Veterinary Medicine Vienna, Medical University Vienna and University Vienna, Vienna, Austria.,Biomedical International R+D GmbH, Vienna, Austria
| | | | | | | | | | | | - Erika Jensen-Jarolim
- 1Comparative Medicine, The Interuniversity Messerli Research Institute of the University of Veterinary Medicine Vienna, Medical University Vienna and University Vienna, Vienna, Austria.,Biomedical International R+D GmbH, Vienna, Austria.,AllergyCare, Allergy Diagnosis and Study Center, Vienna, Austria.,5Institute of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
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Mothes-Luksch N, Jordakieva G, Hinterhölzl L, Jensen AN, Hallmann PK, Kundi M, Jensen-Jarolim E. Allergy diagnosis from symptoms to molecules, or from molecules to symptoms: a comparative clinical study. World Allergy Organ J 2018; 11:22. [PMID: 30214659 PMCID: PMC6131881 DOI: 10.1186/s40413-018-0199-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 07/24/2018] [Indexed: 01/04/2023] Open
Abstract
Background Classical allergy diagnostic workup “from symptoms to molecules” comprises 1) clinical investigation, 2) skin prick- and IgE- testing, and recently, 3) molecular allergy testing. We aimed to examine the diagnostic fidelity of the alternative approach “from molecules to symptoms”, which was recently suggested in the EAACI Molecular Allergology User’s Guide, in a retrospective clinical study. Methods Records from 202 patients with clinically suspected allergic sensitizations were extracted from files at two sites applying either the “ISAC-first” workup with IgE-testing by immuno-solid phase allergen chip ISAC112 followed by selected skin prick tests (SPT) or the “SPT-first” starting with SPT followed by the microarray test. Results In the ISAC-first procedure significantly less SPTs were performed during allergy diagnosis (median 4 vs. 14). By SPT in 19% of patients in the ISAC-first group and in 34% in the SPT-first group additional respiratory allergens (p = 0.014) were detected not positive in ISAC microarray. By ISAC microarray test 18% additional sensitizations were found in the ISAC-first, and 32% in SPT-first cohort (p = 0.016). For food allergens 13 and 12% additional sensitizations were detected by the microarray not detected by SPT in the two groups (p = 0.800). No additional food allergen was found by SPT in the ISAC-first group, while in 6% of the cases in the SPT-first group detected sensitizations were negative in the microarray. Discussion The ISAC-first approach followed by (fewer) SPTs meets the demands for a patient’s tailored diagnostic work-up and therefore can be considered equivalent to the conventional way using the skin prick test as first screening tool, followed by IgE diagnosis. Conclusions For the diagnostic verification of clinically suspected allergy, the novel concept “from molecules to clinic” offers a reliable diagnostic workup in shorter time. Due to lower skin test numbers it is especially applicable for young children and seniors, in atopic patients, and whenever skin tests get difficult or unreliable. Electronic supplementary material The online version of this article (10.1186/s40413-018-0199-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- N Mothes-Luksch
- 1Institute of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University Vienna, Währinger G. 18-20, 1090 Vienna, Austria.,AllergyCare, Allergy Diagnosis and Study Center, Vienna, Austria.,3Department of Dermatology, Division of Immunology, Allergy and Infectious Diseases, Medical University Vienna, Vienna, Austria
| | - G Jordakieva
- 4Institute of Occupational Medicine, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
| | - L Hinterhölzl
- 1Institute of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University Vienna, Währinger G. 18-20, 1090 Vienna, Austria
| | - A N Jensen
- AllergyCare, Allergy Diagnosis and Study Center, Vienna, Austria
| | - P K Hallmann
- AllergyCare, Allergy Diagnosis and Study Center, Vienna, Austria
| | - M Kundi
- 5Center for Public Health, Medical University Vienna, Vienna, Austria
| | - E Jensen-Jarolim
- 1Institute of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University Vienna, Währinger G. 18-20, 1090 Vienna, Austria.,AllergyCare, Allergy Diagnosis and Study Center, Vienna, Austria.,The Interuniversity Messerli Research Institute, University of Veterinary Medicine Vienna, Medical University Vienna, Vienna, Austria
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Gotovina J, Pranger CL, Jensen AN, Wagner S, Kothgassner OD, Mothes-Luksch N, Palme R, Larenas-Linnemann D, Singh J, Mösges R, Felnhofer A, Glenk LM, Jensen-Jarolim E. Elevated oxytocin and noradrenaline indicate higher stress levels in allergic rhinitis patients: Implications for the skin prick diagnosis in a pilot study. PLoS One 2018; 13:e0196879. [PMID: 29813071 PMCID: PMC5973608 DOI: 10.1371/journal.pone.0196879] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 04/21/2018] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND & AIMS The effects of acute stress on allergic symptoms are little understood. The intention of this clinical study was to study the effects of acute stress and related mediators in allergic rhinitis (AR), taking the wheal and flare reaction in skin prick testing (SPT) as a readout. METHODS 19 healthy and 21 AR patients were first subjected to SPTs with grass pollen-, birch pollen- and house dust mite allergen extracts, histamine and negative control. Subsequently, participants were exposed to a standardized Trier Social Stress Test (TSST), followed by SPT on the contralateral forearm. Stress responders were identified based on the salivary cortisol levels and State-subscale of State-Trait-Anxiety Inventory (STAI-S). Blood samples were collected before and after TSST and adrenaline, noradrenaline, serotonin, oxytocin, platelet activating factor and prostaglandin D2 were analyzed by enzyme immunoassay (EIA). RESULTS SPT results of 14/21 allergics and 11/19 healthy who responded with stress after TSST were evaluated. No significant differences regarding SPT to allergens or histamine before and after the stress test could be calculated at the group level. But, the wheal and flare sizes after TSST increased or decreased substantially in several individuals, and unmasked sensitization in one "healthy" person, which could not be correlated with any mediator tested. The most significant finding, however, was that, independent of TSST, the baseline levels of oxytocin and noradrenaline were significantly higher in allergics. CONCLUSION High baseline levels of noradrenaline points toward higher stress levels in allergic patients, which might be counterregulated by elevated oxytocin. Moreover, our data indicate that acute stress may have a significant influence on SPT fidelity in susceptible individuals.
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Affiliation(s)
- Jelena Gotovina
- Comparative Medicine, The Interuniversity Messerli Research Institute of the University of Veterinary Medicine Vienna, Medical University Vienna and University Vienna, Vienna, Austria
- Institute of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Christina L. Pranger
- Comparative Medicine, The Interuniversity Messerli Research Institute of the University of Veterinary Medicine Vienna, Medical University Vienna and University Vienna, Vienna, Austria
- Institute of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Annika N. Jensen
- AllergyCare, Allergy Diagnosis and Study Center, Vienna, Austria
| | - Stefanie Wagner
- Comparative Medicine, The Interuniversity Messerli Research Institute of the University of Veterinary Medicine Vienna, Medical University Vienna and University Vienna, Vienna, Austria
| | - Oswald D. Kothgassner
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | | | - Rupert Palme
- Unit of Physiology, Pathophysiology and Experimental Endocrinology, University of Veterinary Medicine Vienna, Vienna, Austria
| | | | - Jaswinder Singh
- Institute for Medical Statistics, Informatics and Epidemiology, Faculty of Medicine, University of Cologne, Cologne, Germany
| | - Ralph Mösges
- Institute for Medical Statistics, Informatics and Epidemiology, Faculty of Medicine, University of Cologne, Cologne, Germany
| | - Anna Felnhofer
- Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
| | - Lisa-Maria Glenk
- Comparative Medicine, The Interuniversity Messerli Research Institute of the University of Veterinary Medicine Vienna, Medical University Vienna and University Vienna, Vienna, Austria
| | - Erika Jensen-Jarolim
- Comparative Medicine, The Interuniversity Messerli Research Institute of the University of Veterinary Medicine Vienna, Medical University Vienna and University Vienna, Vienna, Austria
- Institute of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
- AllergyCare, Allergy Diagnosis and Study Center, Vienna, Austria
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Mothes-Luksch N, Raith M, Stingl G, Focke-Tejkl M, Razzazi-Fazeli E, Zieglmayer R, Wöhrl S, Swoboda I. Pru p 3, a marker allergen for lipid transfer protein sensitization also in Central Europe. Allergy 2017; 72:1415-1418. [PMID: 28252802 PMCID: PMC5573991 DOI: 10.1111/all.13151] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/24/2017] [Indexed: 01/01/2023]
Abstract
In the Mediterranean area, lipid transfer proteins (LTPs) are important causes of plant‐food allergies often associated with severe allergic reactions. There, peach LTP (Pru p 3) seems to be the primary sensitizer, whereas in Central Europe, little is known about the importance of LTP sensitization. In this region, allergen extract‐based diagnosis is often complicated by co‐sensitization to Bet v 1, the major birch pollen allergen, its cross‐reactive food allergens, and profilins. We investigated the role of LTP sensitization in Central European patients displaying strong allergic reactions to plant‐derived food. Analysis of IgE reactivity revealed that ten of thirteen patients were sensitized to Pru p 3, nine to Bet v 1, and two to profilin. Our results showed that LTP sensitization represents a risk factor for severe allergic symptoms in Central Europe. Furthermore, the strong IgE reactivity detected in immunoblots of plant‐food extracts indicated that Pru p 3 can be used as a marker allergen for LTP sensitization also in Central European patients.
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Affiliation(s)
- N. Mothes-Luksch
- Comparative Immunology and Oncology; Department of Pathophysiology and Allergy Research; Center of Pathophysiology, Infectiology and Immunology; Medical University of Vienna; Vienna Austria
| | - M. Raith
- Molecular Biotechnology Section; FH Campus Wien; University of Applied Sciences, Campus Vienna Biocenter; Vienna Austria
| | - G. Stingl
- Department of Dermatology; Division of Immunology, Allergy and Infectious Diseases; Medical University of Vienna; Vienna Austria
| | - M. Focke-Tejkl
- Division of Immunopathology; Department of Pathophysiology and Allergy Research; Center for Pathophysiology, Infectiology and Immunology; Medical University of Vienna; Vienna Austria
| | - E. Razzazi-Fazeli
- VetCore Facility for Research; University of Veterinary Medicine Vienna; Vienna Austria
| | | | - S. Wöhrl
- FAZ - Floridsdorf Allergy Center; Vienna Austria
| | - I. Swoboda
- Molecular Biotechnology Section; FH Campus Wien; University of Applied Sciences, Campus Vienna Biocenter; Vienna Austria
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Lukschal A, Wallmann J, Bublin M, Hofstetter G, Mothes-Luksch N, Breiteneder H, Pali-Schöll I, Jensen-Jarolim E. Mimotopes for Api g 5, a Relevant Cross-reactive Allergen, in the Celery-Mugwort-Birch-Spice Syndrome. Allergy Asthma Immunol Res 2015; 8:124-31. [PMID: 26739405 PMCID: PMC4713875 DOI: 10.4168/aair.2016.8.2.124] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2014] [Revised: 05/22/2015] [Accepted: 07/09/2015] [Indexed: 11/20/2022]
Abstract
PURPOSE In the celery-mugwort-birch-spice syndrome, a significant proportion of IgE is directed against high molecular weight (HMW) glycoproteins, including the celery allergen Api g 5. BIP3, a monoclonal antibody originally raised against birch pollen, recognizes HMW allergens in birch and mugwort pollens, celery, and Apiaceae spices. Our aim was to generate mimotopes using BIP3 for immunization against the HMW allergens relevant in the celery-mugwort-birch-spice cross reactivity syndrome. METHODS Mimotopes were selected from a random-peptide display library by BIP3 and applied in IgE inhibition assays. The 3 phage clones with the highest inhibitory capacity were chosen for immunization of BALB/c mice. Mouse immune sera were tested for IgG binding to blotted birch pollen extract and used for inhibiting patients' IgE binding. Furthermore, sera were tested for binding to Api g 5, to horseradish peroxidase (HRP) as a second glycoprotein, or to non-glycosylated control allergen Phl p 5 in ELISA, and the specific Api g 5-specific IgG titers were determined. RESULTS Three rounds of biopanning resulted in phage clones exhibiting 7 different sequences including 1 dominant, 1-6-cyclo-CHKLRCDKAIA. Three phage clones had the capacity to inhibit human IgE binding and induced IgG to the HMW antigen when used for immunizing BALB/c mice. The induced BIP3-mimotope IgG reached titers of 1:500 specifically to Api g 5, but hardly reacted to glycoprotein HRP, revealing a minor role of carbohydrates in their epitope. CONCLUSIONS The mimotopes characterized in this study mimic the epitope of BIP3 relevant for Api g 5, one of the cross-reactive HMW allergens relevant in the celery-mugwort-birch-spice syndrome. BIP3 mimotopes may be used in the future for hyposensitization in this clinical syndrome by virtue of good and specific immunogenicity.
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Affiliation(s)
- Anna Lukschal
- Department of Comparative Medicine, Messerli Research Institute of the University of Veterinary Medicine Vienna, the Medical University of Vienna and the University of Vienna, Vienna, Austria
| | - Julia Wallmann
- Department of Comparative Medicine, Messerli Research Institute of the University of Veterinary Medicine Vienna, the Medical University of Vienna and the University of Vienna, Vienna, Austria
| | - Merima Bublin
- Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Gerlinde Hofstetter
- Department of Comparative Medicine, Messerli Research Institute of the University of Veterinary Medicine Vienna, the Medical University of Vienna and the University of Vienna, Vienna, Austria
| | | | - Heimo Breiteneder
- Department of Comparative Medicine, Messerli Research Institute of the University of Veterinary Medicine Vienna, the Medical University of Vienna and the University of Vienna, Vienna, Austria
| | - Isabella Pali-Schöll
- Department of Comparative Medicine, Messerli Research Institute of the University of Veterinary Medicine Vienna, the Medical University of Vienna and the University of Vienna, Vienna, Austria
| | - Erika Jensen-Jarolim
- Department of Comparative Medicine, Messerli Research Institute of the University of Veterinary Medicine Vienna, the Medical University of Vienna and the University of Vienna, Vienna, Austria.,Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria.
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Jensen-Jarolim E, Gomez-Casado C, Pacios LF, Hofstetter G, Mothes-Luksch N, Roth GA, Singer J, Diaz-Perales A, Roth-Walter F. The Major Allergens of Birch Pollen and Cow Milk, Bet v 1 and Bos d 5, Are Structurally Related to Human Lipocalin 2, Enabling Them to Manipulate T-Helper Cells Depending on Their Load with Siderophore-Bound Iron. J Allergy Clin Immunol 2015. [DOI: 10.1016/j.jaci.2014.12.1544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Roth-Walter F, Gomez-Casado C, Pacios LF, Mothes-Luksch N, Roth GA, Singer J, Diaz-Perales A, Jensen-Jarolim E. Bet v 1 from birch pollen is a lipocalin-like protein acting as allergen only when devoid of iron by promoting Th2 lymphocytes. J Biol Chem 2014. [DOI: 10.1074/jbc.a114.567875] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Roth-Walter F, Gomez-Casado C, Pacios LF, Mothes-Luksch N, Roth GA, Singer J, Diaz-Perales A, Jensen-Jarolim E. Bet v 1 from birch pollen is a lipocalin-like protein acting as allergen only when devoid of iron by promoting Th2 lymphocytes. J Biol Chem 2014; 289:17416-21. [PMID: 24798325 PMCID: PMC4067174 DOI: 10.1074/jbc.m114.567875] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
It is hypothesized that allergens are at the borderline of self and non-self and, through as yet elusive circumstances, mount a Th2 response for allergic sensitization. The major birch pollen allergen Bet v 1 is considered the prototype for the PR-10 protein family causing respiratory allergy. Here, we give structural evidence that Bet v 1 is a lipocalin-like protein with a striking structural resemblance to human lipocalin 2. Lipocalin 2 is highly expressed in the lung where it exerts immunoregulatory functions dependent on being loaded with siderophore-bound iron (holo-form) or not (apo-form). We demonstrate that similar to lipocalin 2, Bet v 1 is capable of binding iron via catechol-based siderophores. Thereby, calculated Kd values of 66 nm surpassed affinities to known ligands nearly by a power of 10. Moreover, we give functional evidence of the immunomodulatory capacity of Bet v 1 being dependent on its iron-loaded state. When incubated to human immune cells, only the apo-form of Bet v 1, but not the holo-form, was able to promote Th2 cells secreting IL13. These results provide for the first time a functional understanding on the allergenicity of Bet v 1 and a basis for future allergen immunotherapies counteracting Th2 immune responses on a molecular basis.
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Affiliation(s)
- Franziska Roth-Walter
- From the Comparative Medicine Unit, Messerli Research Institute, University of Veterinary Medicine Vienna, Medical University of Vienna, and University of Vienna, A-1210 Vienna, Austria
| | - Cristina Gomez-Casado
- the Biotechnology Department, Center for Plant Biotechnology and Genomics, Technical University of Madrid, 28040 Madrid, Spain
| | - Luis F Pacios
- the Biotechnology Department, Center for Plant Biotechnology and Genomics, Technical University of Madrid, 28040 Madrid, Spain
| | | | - Georg A Roth
- the Department of Anesthesiology, General Intensive Care and Pain Medicine, Medical University of Vienna, Austria, and
| | - Josef Singer
- the Unit of Comparative Immunology and Oncology, Department of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, 1090 Vienna, Austria
| | - Araceli Diaz-Perales
- the Biotechnology Department, Center for Plant Biotechnology and Genomics, Technical University of Madrid, 28040 Madrid, Spain
| | - Erika Jensen-Jarolim
- From the Comparative Medicine Unit, Messerli Research Institute, University of Veterinary Medicine Vienna, Medical University of Vienna, and University of Vienna, A-1210 Vienna, Austria, the Unit of Comparative Immunology and Oncology, Department of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, 1090 Vienna, Austria
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Satorina J, Szalai K, Willensdorfer A, Mothes-Luksch N, Lukschal A, Jensen-Jarolim E. Do hypoallergenic cats exist? -- Determination of major cat allergen Fel d 1 production in normal and hypoallergenic cat breeds. Clin Transl Allergy 2014. [PMCID: PMC4072467 DOI: 10.1186/2045-7022-4-s2-p11] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Geusau A, Mothes-Luksch N, Nahavandi H, Pickl WF, Wise CA, Pourpak Z, Ponweiser E, Eckhart L, Sunder-Plassmann R. Identification of a homozygous PSTPIP1 mutation in a patient with a PAPA-like syndrome responding to canakinumab treatment. JAMA Dermatol 2013; 149:209-15. [PMID: 23426477 DOI: 10.1001/2013.jamadermatol.717] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Pyogenic sterile arthritis, pyoderma gangrenosum, and acne (PAPA) syndrome (OMIM 604416) is a rare autosomal dominant inherited autoinflammatory syndrome characterized by pyogenic sterile arthritis and less frequently accompanied by pyoderma gangrenosum and acne. It is associated with dominant missense mutations in the proline-serine-threonine phosphatase-interacting protein 1 gene (PSTPIP1) located on chromosome 15. The patient was diagnosed as having features of a PAPA-like syndrome in which cutaneous manifestations, such as pyoderma gangrenosum and acne fulminans, predominated. OBSERVATIONS Sequencing of the PSTPIP1 gene was performed in the patient and his extended family. The patient's DNA analysis revealed a homozygous nucleotide exchange c.773G>C in the PSTPIP1 gene, leading to the substitution of glycine 258 by alanine (p.Gly258Ala), a previously reported heterozygous polymorphism. Heterozygous changes were identified in both of the patient's parents and in 7 other family members, all of whom were asymptomatic. The patient was treated with canakinumab, a human anti-interleukin 1β monoclonal antibody, which led to rapid remission of the symptoms. CONCLUSIONS To our knowledge, this is the first reported case of the resolution of dermatological symptoms associated with a PAPA-like syndrome using canakinumab treatment. Further study of the p.Gly258Ala variant is warranted to determine whether this mutation has a role in causing an apparently recessive cutaneous syndrome resembling PAPA syndrome.
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Affiliation(s)
- Alexandra Geusau
- Division of Immunology, Allergy, and Infectious Diseases, Department of Dermatology, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria.
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Mothes-Luksch N, Stumvoll S, Linhart B, Focke M, Krauth MT, Hauswirth A, Valent P, Verdino P, Pavkov T, Keller W, Grote M, Valenta R. Disruption of allergenic activity of the major grass pollen allergen Phl p 2 by reassembly as a mosaic protein. J Immunol 2008; 181:4864-73. [PMID: 18802090 DOI: 10.4049/jimmunol.181.7.4864] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
The recognition of conformational epitopes on respiratory allergens by IgE Abs is a key event in allergic inflammation. We report a molecular strategy for the conversion of allergens into vaccines with reduced allergenic activity, which is based on the reassembly of non-IgE-reactive fragments in the form of mosaic proteins. This evolution process is exemplified for timothy grass pollen-derived Phl p 2, a major allergen for more than 200 million allergic patients. In a first step, the allergen was disrupted into peptide fragments lacking IgE reactivity. cDNAs coding for these peptides were reassembled in altered order and expressed as a recombinant mosaic molecule. The mosaic molecule had lost the three-dimensional structure, the IgE reactivity, and allergenic activity of the wild-type allergen, but it induced high levels of allergen-specific IgG Abs upon immunization. These IgG Abs crossreacted with group 2 allergens from other grass species and inhibited allergic patients' IgE binding to the wild-type allergen. The mosaic strategy is a general strategy for the reduction of allergenic activity of protein allergens and can be used to convert harmful allergens into safe vaccines.
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Affiliation(s)
- Nadine Mothes-Luksch
- Division of Immunopathology, Department of Pathophysiology, Center of Physiology, Pathophysiology and Immunology, Vienna General Hospital, Medical University of Vienna, Vienna, Austria
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Linhart B, Mothes-Luksch N, Vrtala S, Kneidinger M, Valent P, Valenta R. A hypoallergenic hybrid molecule with increased immunogenicity consisting of derivatives of the major grass pollen allergens, Phl p 2 and Phl p 6. Biol Chem 2008; 389:925-33. [PMID: 18627317 DOI: 10.1515/bc.2008.105] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Allergen-specific immunotherapy is currently based on the administration of allergen extracts containing natural allergens. However, its broad application is limited by the poor quality of these extracts. Based on recombinant allergens, well-defined allergy vaccines for allergen-specific immunotherapy can be produced. Furthermore, they can be modified to reduce their allergenic activity and to avoid IgE-mediated side effects. Here, we demonstrate that the immunogenicity of two grass pollen-derived hypoallergenic allergen derivatives could be increased by engineering them as a single hybrid molecule. We used a hypoallergenic Phl p 2 mosaic, generated by fragmentation of the Phl p 2 sequence and reassembly of the resulting peptides in an altered order, and a truncated Phl p 6 allergen, to produce a hybrid protein. The hybrid retained the reduction of IgE reactivity and allergenic activity of its components as shown by ELISA and basophil activation assays. Immunization with the hybrid molecule demonstrated the increased immunogenicity of this molecule, leading to higher levels of allergen-specific IgG antibodies compared to the single components. These antibodies could inhibit patients' IgE binding to the wild-type allergens. Thus, the described strategy allows the development of safer and more efficacious vaccines for the treatment of grass pollen allergy.
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Affiliation(s)
- Birgit Linhart
- Division of Immunopathology, Department of Pathophysiology, Center of Physiology, Pathophysiology and Immunology, Medical University of Vienna, Vienna, Austria.
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