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Fernandez-Santamaria R, Ariza A, Bogas G, Salas M, Calvo-Serrano S, Frecha C, Mayorga C, Torres MJ, Fernandez TD. Involvement of autologous myeloid dendritic cells in the evaluation of immediate hypersensitivity reactions to betalactams. Clin Immunol 2024; 262:110166. [PMID: 38432423 DOI: 10.1016/j.clim.2024.110166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 02/01/2024] [Accepted: 02/26/2024] [Indexed: 03/05/2024]
Abstract
BACKGROUND Amoxicillin (AX) and clavulanic acid (CLV) are the betalactam antibiotics (BLs) most used to treat bacterial infections, although they can trigger immediate hypersensitivity reactions (IDHRs). The maturation analysis of monocyte-derived dendritic cells (moDCs) and their capacity to induce proliferative response of lymphocytes are useful to test the sensitisation to a drug, although without optimal sensitivity. Nevertheless, this can be improved using directly isolated DCs such as myeloid DCs (mDCs). METHODS mDCs and moDCs were obtained from 28 allergic patients (AP), 14 to AX, 14 to CLV and from 10 healthy controls (HC). The expression of CCR7, CD40, CD80, CD83, and CD86 was analysed after stimulation with both BLs. We measured the capacity of these pre-primed DCs to induce drug-specific activation of different lymphocyte subpopulations, CD3+, CD4+, CD8+, CD4+Th1, and CD4+Th2, by flow cytometry. RESULTS Higher expression of CCR7, CD40, CD80, CD83, and CD86 was observed on mDCs compared to moDCs from AP after stimulating with the culprit BL. Similarly, mDCs induced higher proliferative response, mainly of CD4+Th2 cells, compared to moDCs, reaching up to 67% of positive results with AX, whereas of only 25% with CLV. CONCLUSIONS mDCs from selective AP efficiently recognise the culprit drug which trigger the IDHR. mDCs also trigger proliferation of lymphocytes, mainly those with a Th2 cytokine pattern, although these responses depend on the nature of the drug, mimicking the patient's reaction.
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Affiliation(s)
- Ruben Fernandez-Santamaria
- Allergy Research Group, IBIMA Plataforma BIONAND, Málaga, Spain; Departamento de Medicina, Universidad de Málaga-UMA, Málaga, Spain
| | - Adriana Ariza
- Allergy Research Group, IBIMA Plataforma BIONAND, Málaga, Spain; Allergy Unit, Hospital Regional Universitario de Málaga-ARADyAL, Málaga, Spain.
| | - Gador Bogas
- Allergy Research Group, IBIMA Plataforma BIONAND, Málaga, Spain; Allergy Unit, Hospital Regional Universitario de Málaga-ARADyAL, Málaga, Spain
| | - Maria Salas
- Allergy Research Group, IBIMA Plataforma BIONAND, Málaga, Spain; Allergy Unit, Hospital Regional Universitario de Málaga-ARADyAL, Málaga, Spain
| | - Silvia Calvo-Serrano
- Allergy Research Group, IBIMA Plataforma BIONAND, Málaga, Spain; Departamento de Medicina, Universidad de Málaga-UMA, Málaga, Spain
| | - Cecilia Frecha
- Allergy Research Group, IBIMA Plataforma BIONAND, Málaga, Spain
| | - Cristobalina Mayorga
- Allergy Research Group, IBIMA Plataforma BIONAND, Málaga, Spain; Allergy Unit, Hospital Regional Universitario de Málaga-ARADyAL, Málaga, Spain
| | - Maria Jose Torres
- Allergy Research Group, IBIMA Plataforma BIONAND, Málaga, Spain; Departamento de Medicina, Universidad de Málaga-UMA, Málaga, Spain; Allergy Unit, Hospital Regional Universitario de Málaga-ARADyAL, Málaga, Spain
| | - Tahia Diana Fernandez
- Allergy Research Group, IBIMA Plataforma BIONAND, Málaga, Spain; Departamento de Biología Celular, Genética y Fisiología, Universidad de Málaga-UMA, Málaga, Spain
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Herrera GB, Veguillas AA, Labella M, Doña I, Salas M, Fernandez-Santamaria R, Céspedes JA, Frecha C, silvia calvo-serrano, Garcia-Otón MDLR, Montañez MI, Mayorga C, Fernandez TD, Torres MJ. Basophil activation test may help achieve a better diagnosis in patients with hypersensitivity reactions to chemotherapeutics. J Allergy Clin Immunol 2023. [DOI: 10.1016/j.jaci.2022.12.363] [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: 02/05/2023]
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Fernandez-Santamaria R, Riggioni C, Peters RL. Editorial comment on "The basophil activation test has high reproducibility and is feasible in the clinical setting". Pediatr Allergy Immunol 2022; 33:e13879. [PMID: 36433846 DOI: 10.1111/pai.13879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 10/23/2022] [Indexed: 11/17/2022]
Affiliation(s)
- Ruben Fernandez-Santamaria
- Allergy Research Group, Instituto de Investigación Biomédica de Málaga- IBIMA, Málaga, Spain.,Departmento de Medicina, Universidad de Málaga-UMA, Málaga, Spain
| | - Carmen Riggioni
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore City, Singapore
| | - Rachel L Peters
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
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Testera-Montes A, Palomares F, Jurado-Escobar R, Fernandez-Santamaria R, Ariza A, Verge J, Salas M, Campo P, Mayorga C, Torres MJ, Rondon C, Eguiluz-Gracia I. Sequential class switch recombination to IgE and allergen-induced accumulation of IgE + plasmablasts occur in the nasal mucosa of local allergic rhinitis patients. Allergy 2022; 77:2712-2724. [PMID: 35340036 DOI: 10.1111/all.15292] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 03/03/2022] [Accepted: 03/09/2022] [Indexed: 01/27/2023]
Abstract
BACKGROUND The involvement of allergen-specific (s)IgE in local allergic rhinitis (LAR) has been debated. Here, we investigate the effect of nasal allergen challenge with Dermatophagoides pteronyssinus (NAC-DP) in mucosal and peripheral B-cell subpopulations in LAR patients. METHODS Nine LAR, 5 allergic rhinitis (AR), and 5 non-atopic healthy control (HC) individuals were subjected to a 3-day NAC-DP protocol, and nasal biopsies and blood samples were collected before and after provocation. Nasal biopsies were used for immunohistochemistry and gene expression studies, whereas the frequency of lymphocyte subsets and basophil activation test (BAT) were analyzed in blood samples by flow cytometry. sIgG was measured in sera. RESULTS NAC-DP induced an increase in IgE+ CD38+ plasmablasts in the nasal mucosa of LAR patients, but not in AR or HC individuals. Markers of sequential recombination to IgE (εCSR) (from IgG) were observed in 33% of LAR, 20% of AR, and 0% of HC subjects. NAC-DP increased the proportion of peripheral CD19+ CD20+ CD38+ plasmablasts in AR and LAR patients, but not in HC. Expression of the mucosal homing receptor CXCR3 in peripheral CD19+ CD20+ CD38+ plasmablasts from LAR, AR, and HC individuals was 7%, 5%, and 0.5%, respectively. In vitro DP stimulation increased proliferating CD19+ CD20+ CD38+ plasmablasts in LAR and AR patients, but not in HC. Serum DP-sIgG was higher in LAR and AR patients as compared to HC. BAT was positive in 33%, 100%, and 0% of LAR, AR, and HC subjects, respectively. CONCLUSION These results suggest that allergen exposure induces the sequential εCSR of IgG+ CD19+ CD20+ CD38+ plasmablasts in the nasal mucosa of LAR patients.
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Affiliation(s)
- Almudena Testera-Montes
- Allergy Unit, Hospital Regional Universitario de Malaga, Malaga, Spain
- Allergy Research Group, Instituto de Investigación Biomédica de Málaga (IBIMA), RICORS "Enfermedades inflamatorias", Málaga, Spain
| | - Francisca Palomares
- Allergy Research Group, Instituto de Investigación Biomédica de Málaga (IBIMA), RICORS "Enfermedades inflamatorias", Málaga, Spain
| | - Raquel Jurado-Escobar
- Allergy Research Group, Instituto de Investigación Biomédica de Málaga (IBIMA), RICORS "Enfermedades inflamatorias", Málaga, Spain
| | - Ruben Fernandez-Santamaria
- Allergy Research Group, Instituto de Investigación Biomédica de Málaga (IBIMA), RICORS "Enfermedades inflamatorias", Málaga, Spain
| | - Adriana Ariza
- Allergy Research Group, Instituto de Investigación Biomédica de Málaga (IBIMA), RICORS "Enfermedades inflamatorias", Málaga, Spain
| | - Jesus Verge
- ENT Unit, Hospital Clinico Virgen de la Victoria, Malaga, Spain
| | - Maria Salas
- Allergy Unit, Hospital Regional Universitario de Malaga, Malaga, Spain
- Allergy Research Group, Instituto de Investigación Biomédica de Málaga (IBIMA), RICORS "Enfermedades inflamatorias", Málaga, Spain
| | - Paloma Campo
- Allergy Unit, Hospital Regional Universitario de Malaga, Malaga, Spain
| | - Cristobalina Mayorga
- Allergy Unit, Hospital Regional Universitario de Malaga, Malaga, Spain
- Allergy Research Group, Instituto de Investigación Biomédica de Málaga (IBIMA), RICORS "Enfermedades inflamatorias", Málaga, Spain
- Andalusian Center for Nanomedicine and Biotechnology (BIONAND), Malaga, Spain
| | - Maria Jose Torres
- Allergy Unit, Hospital Regional Universitario de Malaga, Malaga, Spain
- Allergy Research Group, Instituto de Investigación Biomédica de Málaga (IBIMA), RICORS "Enfermedades inflamatorias", Málaga, Spain
- Andalusian Center for Nanomedicine and Biotechnology (BIONAND), Malaga, Spain
- Universidad de Málaga (UMA), Málaga, Spain
| | - Carmen Rondon
- Allergy Unit, Hospital Regional Universitario de Malaga, Malaga, Spain
- Allergy Research Group, Instituto de Investigación Biomédica de Málaga (IBIMA), RICORS "Enfermedades inflamatorias", Málaga, Spain
| | - Ibon Eguiluz-Gracia
- Allergy Unit, Hospital Regional Universitario de Malaga, Malaga, Spain
- Allergy Research Group, Instituto de Investigación Biomédica de Málaga (IBIMA), RICORS "Enfermedades inflamatorias", Málaga, Spain
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Cespedes J, Fernandez-Santamaria R, Herrera GB, Salas M, Dona I, Montes AT, Mayorga C, Saenz de Santa Maria R, Veguillas AA, Jaén MT. CD203c showed greater diagnostic value than CD63 for evaluating immediate reactions to amoxicillin-clavulanic by basophil activation test. J Allergy Clin Immunol 2022. [DOI: 10.1016/j.jaci.2021.12.285] [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: 11/24/2022]
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Eguiluz-Gracia I, Fernandez-Santamaria R, Testera-Montes A, Ariza A, Campo P, Prieto A, Perez-Sanchez N, Salas M, Mayorga C, Torres MJ, Rondon C. Coexistence of nasal reactivity to allergens with and without IgE sensitization in patients with allergic rhinitis. Allergy 2020; 75:1689-1698. [PMID: 31995231 DOI: 10.1111/all.14206] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 12/17/2019] [Accepted: 12/20/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND Allergic rhinitis (AR) and local allergic rhinitis (LAR) are defined by nasal reactivity to aeroallergens with and without positive skin prick test (SPT), respectively. In this study, we aimed to investigate whether both types of allergen-specific reactivity can coexist in the same individual. METHODS Forty-eight patients with perennial rhinitis symptoms and positive SPT with seasonal allergens only (discrepant group) were subjected to consecutive nasal allergen challenges (NAC) with seasonal (NAC-S) and perennial allergens (NAC-P). A nasal lavage was collected before and after the NACs to measure eosinophil cationic protein (ECP). A basophil activation test (BAT) with seasonal and/or perennial allergens was performed in ten patients from the discrepant group and in six seasonal allergic rhinitis (SAR), eight perennial local allergic rhinitis (LAR), six nonallergic rhinitis (NAR), and six healthy control (HC) individuals. RESULTS All patients in the discrepant group tested positive in the NAC-S, and 41 of them (85.4%), also in the NAC-P (group A). Conversely, seven patients tested negative in the NAC-P (group B). ECP in the nasal lavage increased after the NAC-P in the group A (P = .004), but not in the group B. The BAT with seasonal allergens was positive in 100% of SAR and group A cases, whereas the BAT with perennial allergens was positive in 37.5% and 60% of LAR and group A cases, respectively. All NAR and HC subjects tested negative for the BAT. CONCLUSION This study shows that nasal reactivity to aeroallergens with and without positive SPT can coexist in the same patient. We propose the term dual allergic rhinitis for this rhinitis phenotype.
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Affiliation(s)
- Ibon Eguiluz-Gracia
- Allergy Unit, Hospital Regional Universitario de Malaga, Instituto de Investigación Biomédica de Málaga-IBIMA and ARADyAL, Málaga, Spain
| | | | - Almudena Testera-Montes
- Allergy Unit, Hospital Regional Universitario de Malaga, Instituto de Investigación Biomédica de Málaga-IBIMA and ARADyAL, Málaga, Spain.,Universidad de Málaga-UMA, Málaga, Spain
| | - Adriana Ariza
- Allergy Research Group, Instituto de Investigación Biomédica de Málaga-IBIMA and ARADyAL, Málaga, Spain
| | - Paloma Campo
- Allergy Unit, Hospital Regional Universitario de Malaga, Instituto de Investigación Biomédica de Málaga-IBIMA and ARADyAL, Málaga, Spain
| | - Ana Prieto
- Pediatrics Unit, Hospital Regional Universitario de Malaga, Málaga, Spain
| | - Natalia Perez-Sanchez
- Allergy Unit, Hospital Regional Universitario de Malaga, Instituto de Investigación Biomédica de Málaga-IBIMA and ARADyAL, Málaga, Spain
| | - Maria Salas
- Allergy Unit, Hospital Regional Universitario de Malaga, Instituto de Investigación Biomédica de Málaga-IBIMA and ARADyAL, Málaga, Spain
| | - Cristobalina Mayorga
- Allergy Research Group, Instituto de Investigación Biomédica de Málaga-IBIMA and ARADyAL, Málaga, Spain
| | - Maria Jose Torres
- Allergy Unit, Hospital Regional Universitario de Malaga, Instituto de Investigación Biomédica de Málaga-IBIMA and ARADyAL, Málaga, Spain.,Universidad de Málaga-UMA, Málaga, Spain
| | - Carmen Rondon
- Allergy Unit, Hospital Regional Universitario de Malaga, Instituto de Investigación Biomédica de Málaga-IBIMA and ARADyAL, Málaga, Spain
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Fernandez-Santamaria R, Rodriguez-Nogales A, Pérez-Sanchez N, Salas M, Ariza A, Malagón P, Martin-Serrano Ortiz A, Fernandez TD, Mayorga C, Torres M, Montañez MI. Recognition of synthetic antigenic determinants of clavulanic acid by dendritic cells in patients with immediate allergic reactions to this drug. J Allergy Clin Immunol 2019. [DOI: 10.1016/j.jaci.2018.12.060] [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: 10/27/2022]
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Montañez MI, Mayorga C, Bogas G, Barrionuevo E, Fernandez-Santamaria R, Martin-Serrano A, Laguna JJ, Torres MJ, Fernandez TD, Doña I. Epidemiology, Mechanisms, and Diagnosis of Drug-Induced Anaphylaxis. Front Immunol 2017; 8:614. [PMID: 28611774 PMCID: PMC5446992 DOI: 10.3389/fimmu.2017.00614] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [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: 03/14/2017] [Accepted: 05/09/2017] [Indexed: 12/14/2022] Open
Abstract
Anaphylaxis is an acute, life-threatening, multisystem syndrome resulting from the sudden release of mediators by mast cells and basophils. Although anaphylaxis is often under-communicated and thus underestimated, its incidence appears to have risen over recent decades. Drugs are among the most common triggers in adults, being analgesics and antibiotics the most common causal agents. Anaphylaxis can be caused by immunologic or non-immunologic mechanisms. Immunologic anaphylaxis can be mediated by IgE-dependent or -independent pathways. The former involves activation of Th2 cells and the cross-linking of two or more specific IgE (sIgE) antibodies on the surface of mast cells or basophils. The IgE-independent mechanism can be mediated by IgG, involving the release of platelet-activating factor, and/or complement activation. Non-immunological anaphylaxis can occur through the direct stimulation of mast cell degranulation by some drugs, inducing histamine release and leading to anaphylactic symptoms. Work-up of a suspected drug-induced anaphylaxis should include clinical history; however, this can be unreliable, and skin tests should also be used if available and validated. Drug provocation testing is not recommended due to the risk of inducing a harmful reaction. In vitro testing can help to confirm anaphylaxis by analyzing the release of mediators such as tryptase or histamine by mast cells. When immunologic mechanisms are suspected, serum-sIgE quantification or the use of the basophil activation test can help confirm the culprit drug. In this review, we will discuss multiple aspects of drug-induced anaphylaxis, including epidemiology, mechanisms, and diagnosis.
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Affiliation(s)
- Maria Isabel Montañez
- Research Laboratory, IBIMA-Regional University Hospital of Malaga-UMA, Málaga, Spain.,Andalusian Center for Nanomedicine and Biotechnology-BIONAND, Málaga, Spain
| | - Cristobalina Mayorga
- Research Laboratory, IBIMA-Regional University Hospital of Malaga-UMA, Málaga, Spain.,Allergy Unit, IBIMA-Regional University Hospital of Malaga-UMA, Málaga, Spain
| | - Gador Bogas
- Allergy Unit, IBIMA-Regional University Hospital of Malaga-UMA, Málaga, Spain
| | - Esther Barrionuevo
- Allergy Unit, IBIMA-Regional University Hospital of Malaga-UMA, Málaga, Spain
| | | | - Angela Martin-Serrano
- Research Laboratory, IBIMA-Regional University Hospital of Malaga-UMA, Málaga, Spain.,Andalusian Center for Nanomedicine and Biotechnology-BIONAND, Málaga, Spain
| | | | - Maria José Torres
- Andalusian Center for Nanomedicine and Biotechnology-BIONAND, Málaga, Spain.,Allergy Unit, IBIMA-Regional University Hospital of Malaga-UMA, Málaga, Spain
| | - Tahia Diana Fernandez
- Research Laboratory, IBIMA-Regional University Hospital of Malaga-UMA, Málaga, Spain
| | - Inmaculada Doña
- Allergy Unit, IBIMA-Regional University Hospital of Malaga-UMA, Málaga, Spain
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