Einfluss prebiotischer Oligosaccharide und probiotischer Bakterien auf den Phänotyp und die Funktion dendritischer Zellen

Neben der Therapie allergischer Erkrankungen, wie dem allergischen Asthma oder der atopischen Dermatitis, nehmen präventive Maßnahmen zur Vermeidung einer Sensibilisierung einen immer höheren Stellenwert ein. Hierbei scheint der Einsatz von Pre- und Probiotika vielversprechend zu sein. rnrnIm Rahmen dieser Dissertation wurde der Einfluss von Pre- und Probiotika auf den Phänotyp und die Funktion von DCs untersucht. Hierzu wurden unreife DCs aus Vorläuferzellen im Knochenmark von Mäusen differenziert (BM-DCs). Nach Behandlung der Kulturen während der Differenzierung der BM-DCs mit neutrale Humanmilch-analoge Oligosaccharide-enthaltenden Präparationen (NOS-Präparationen) konnte ein Einfluss auf die Zellen nachgewiesen werden; die NOS-Präparationen sind in der Lage, die durch LPS induzierte Ausreifung der BM-DCs zu supprimieren. Weiterhin konnte gezeigt werden, dass die primärstimulatorische Kapazität LPS-stimulierter BM-DCs, die in Anwesenheit von NOS-Präparationen differenziert wurden, sowohl für allogene als auch für syngene T-Zellen signifikant vermindert war. Die Charakterisierung dieser T-Zellen ergab zwar eine verstärkte Expression des für regulatorische T-Zellen charakteristischen Transkriptionsfaktors FoxP3, auf funktioneller Ebene konnte jedoch keine Induktion von regulatorischen T-Zellen beobachtet werden; allerdings wurde in diesen T-Zellen eine Anergie induziert. Der Befund, dass verschiedene NOS-Präparationen unterschiedliche Wirkungen auf die Differenzierung von BM-DCs aufweisen, muss weitergehend untersucht werden. rnrnWeiterhin wurden im Rahmen dieser Arbeit die Auswirkungen einer Kultivierung der BM-DCs mit den beiden probiotischen Bakterien Lactobacillus rhamnosus GG (LGG) und Lactobacillus fermentum analysiert. Hier induzierte ein Kontakt unreifer BM-DCs mit den Bakterien eine Maturierung der Zellen. Das Potential zur Produktion von IL-10 konnte dabei nicht erhöht werden. Im Gegensatz dazu induzierte eine Supplementierung der Kulturen während der Differenzierungsphase der DCs konträre Effekte; die LGG-Gabe resultierte hier in einer unvollständigen Ausreifung der DCs nach LPS-Stimulus. Dies konnte auch auf funktioneller Ebene als stark vermindertes Potential zur T-Zellstimulation bestätigt werden. Inwieweit die Supplementierung mit LGG in tolerogenen DCs resultiert, welche Tregs induzieren können, muss weiter analysiert werden.

Forme atipiche di malattia mani-piedi-bocca: La nostra esperienza

Introduzione: La malattia mani-piedi-bocca è una patologia infettiva tipica della prima infanzia causata dagli enterovirus, in particolare i sierotipi Coxsackievirus A16 ed Enterovirus 71. A partire dal 2008, ne è stata descritta un’epidemia da Coxsackievirus A6, in genere accompagnata da febbre elevata e che si distingue per lo sviluppo di piccole vescicole che progrediscono a lesioni vescicolo-bollose e a bolle vere e proprie. Inoltre, nei pazienti affetti da dermatite atopica, le lesioni tendono a localizzarsi sulle aree eczematose. Abbiamo quindi svolto uno studio osservazionale prospettico per descrivere le caratteristiche cliniche delle forme atipiche di malattia mani-piedi-bocca. Metodi: Sono stati arruolati i pazienti affetti da una forma atipica di malattia mani-piedi-bocca giunti consecutivamente presso l’Ambulatorio di Dermatologia Pediatrica del Policlinico S.Orsola-Malpighi di Bologna tra gennaio 2012 e febbraio 2014. Abbiamo valutato distribuzione, tipologia ed estensione delle lesioni. In un gruppo di pazienti è stata inoltre eseguita l’identificazione virale sul fluido vescicolare. Risultati: Abbiamo arruolato 47 pazienti (68% maschi) con un’età mediana di 22 mesi. Sono stati individuati 3 aspetti clinici principali: 1) forma acrale (distribuzione delle lesioni prevalentemente acrale), nel 62% dei soggetti; 2) eczema coxsackium (lesioni localizzate su aree eczematose), nel 23% dei soggetti; 3) forma diffusa (estensione delle lesioni al tronco), nel 15% dei soggetti. Inoltre, nell’80% circa dei pazienti si riscontravano macule purpuriche acrali, circa la metà dei pazienti aveva lesioni con aspetto purpurico e il 72% un interessamento dei glutei. In 9 su 11 soggetti genotipizzati è stato isolato il Coxsackievirus A6. Conclusioni: Questo studio ha permesso di descrivere tre fenotipi di malattia mani-piedi-bocca atipica, che deve essere correttamente identificata al fine di non porre diagnosi errate quali varicella, eczema herpeticum, vasculiti, impetigine, e di potere così procedere ad una gestione appropriata della patologia.

Physiologische Konsequenzen eines gestörten Ceramid Stoffwechsels unter Beteiligung von Ceramidsynthase 3 und saurer Ceramidase = Physiological consequences of a disturbed ceramide metabolism due to altered activities of ceramide synthase 3 and acidic ceramidase

Tiefes Wissen über den Ceramid Stoffwechsel ist rudimentär für das Verständnis der Haut-Pathophysiologie (z.B. für atopische Dermatitis oder Psoriasis ) und unabdingbar für gezielte Therapieansätze. Wenn die zwei wichtigen Barriere Funktionen, gegen transepidermalen Wasserverlust und Pathogene Invasionen undicht werden, sind bestimmte Barriere Komponenten wie z.B. Ceramide stark verändert. In Haut und Hoden führt die Deletion der Ceramid-Synthase 3 zu einem Arrest der epidermalen Reifung und der Spermatogenese, welches ihre Bedeutung für eine intakte Barriere heraushebt. Sphingosin (So), ein Abbauprodukt von Cer, wurde als antimikrobielles Mittel identifiziert. So konnte das Wachstum von Candida albicans hemmen und die Invasion von Pathogenen in tiefere Hautschichten verringern, wodurch ihre mögliche Rolle in der Therapie von Hauterkrankungen gezeigt wurde. Auch eine neue Klasse von Ceramiden, die 1-O-acylceramide, wurde entdeckt. 1-O-acylceramide könnten zu einer funktionellen Wasserdurchlässigkeit Barriere beitragen, da sie zu den hydrophobesten der epidermalen Cers gehören. Die neutrale Glucosylceramidase scheint topologisch mit der 1-Oacylceramid Produktion verbunden zu sein, sowie die Enzyme der Diacylglycerol O-Acyltransferase-2 (DGAT2) Familie eine Rolle dabei spielen könnten. Die Identifizierung der für die 1-O-acylceramid Synthese verantwortlichen Enzyme wir Gegenstand weiterer Forschung sein, jedoch zeigten Untersuchungen an Mäusen, defizient für die saure Ceramidase (Farber-Krankheit), dass Makrophagen ein weiterer potenzieller Produktionsort sein könnten.

T-cell recognition of chemicals, protein allergens and drugs: towards the development of in vitro assays

Chemicals can elicit T-cell-mediated diseases such as allergic contact dermatitis and adverse drug reactions. Therefore, testing of chemicals, drugs and protein allergens for hazard identification and risk assessment is essential in regulatory toxicology. The seventh amendment of the EU Cosmetics Directive now prohibits the testing of cosmetic ingredients in mice, guinea pigs and other animal species to assess their sensitizing potential. In addition, the EU Chemicals Directive REACh requires the retesting of more than 30,000 chemicals for different toxicological endpoints, including sensitization, requiring vast numbers of animals. Therefore, alternative methods are urgently needed to eventually replace animal testing. Here, we summarize the outcome of an expert meeting in Rome on 7 November 2009 on the development of T-cell-based in vitro assays as tools in immunotoxicology to identify hazardous chemicals and drugs. In addition, we provide an overview of the development of the field over the last two decades.

Quantitative repeated open application testing with a rinse-off product in methyldibromo glutaronitrile-sensitive patients: results of the IVDK

While the use of methyldibromo glutaronitrile (MDBGN) in leave-on products is clearly associated with high sensitization or elicitation risk, such a clear-cut relation could be questioned with regard to rinse-off products.

Falcarinol is a covalent cannabinoid CB1 receptor antagonist and induces pro-allergic effects in skin

The skin irritant polyyne falcarinol (panaxynol, carotatoxin) is found in carrots, parsley, celery, and in the medicinal plant Panax ginseng. In our ongoing search for new cannabinoid (CB) receptor ligands we have isolated falcarinol from the endemic Sardinian plant Seseli praecox. We show that falcarinol exhibits binding affinity to both human CB receptors but selectively alkylates the anandamide binding site in the CB(1) receptor (K(i)=594nM), acting as covalent inverse agonist in CB(1) receptor-transfected CHO cells. Given the inherent instability of purified falcarinol we repeatedly isolated this compound for biological characterization and one new polyyne was characterized. In human HaCaT keratinocytes falcarinol increased the expression of the pro-allergic chemokines IL-8 and CCL2/MCP-1 in a CB(1) receptor-dependent manner. Moreover, falcarinol inhibited the effects of anandamide on TNF-alpha stimulated keratinocytes. In vivo, falcarinol strongly aggravated histamine-induced oedema reactions in skin prick tests. Both effects were also obtained with the CB(1) receptor inverse agonist rimonabant, thus indicating the potential role of the CB(1) receptor in skin immunopharmacology. Our data suggest anti-allergic effects of anandamide and that falcarinol-associated dermatitis is due to antagonism of the CB(1) receptor in keratinocytes, leading to increased chemokine expression and aggravation of histamine action.

Combined moxidectin and environmental therapy do not eliminate Chorioptes bovis infestation in heavily feathered horses

Chorioptes bovis infestation is a common cause of pastern dermatitis in the horse, with a predilection in draft horses and other horses with thick hair 'feathers' on the distal limbs. The treatment of this superficial mite is challenging; treatment failure and relapse are common. Furthermore, C. bovis infestation may affect the progression of chronic pastern dermatitis (also known as chronic proliferative pastern dermatitis, chronic progressive lymphoedema and dermatitis verrucosa) in draft horses, manifesting with oedema, lichenification and excessive skin folds that can progress to verruciform lesions. An effective cure for C. bovis infestation would therefore be of great clinical value. In a prospective, double-blind, placebo-controlled study, the efficacy of oral moxidectin (0.4 mg/kg body weight) given twice with a 3 week interval in combination with environmental treatment with 4-chloro-3-methylphenol and propoxur was tested in 19 heavily feathered horses with clinical pastern dermatitis and C. bovis infestation. Follow-up examinations over a period of 180 days revealed significantly more skin crusting in the placebo group than in the treatment group. However, no other differences in clinical signs or the numbers of mites detected were found between the two groups. The results of this study suggest that moxidectin in combination with environmental insecticide treatment as used in this study is ineffective in the treatment of C. bovis in feathered horses.

Clinical characteristics and causes of pruritus in cats: a multicentre study on feline hypersensitivity-associated dermatoses

Hypersensitivity dermatitides (HD) are often suspected in cats. Cats with HD are reported to present with one or more of the following patterns: miliary dermatitis, eosinophilic dermatitis, self-induced symmetrical alopecia or head and/or neck excoriations. Previous reports on feline HD included small numbers of animals, took place in geographically restricted areas or did not compare these conditions with other causes of pruritus. The goal of the present study was to analyse 72 parameters covering signalment, clinical, laboratory and treatment characteristics from a large group of pruritic cats from different geographical areas. Of the 502 cats, the following diagnoses were made: flea HD (29% of cases), food HD (12%) nonflea/nonfood HD (20%) and other diseases in which pruritus was a feature (24%). Cats with signs consistent with a HD but which did not complete a food trial were not analysed further (15% of cases). Most cats with nonflea HD exhibited signs compatible with one or more of the four typical lesional patterns, but none of these patterns was found to be pathognomonic for any specific diagnosis. Food HD and nonflea/nonfood HD were found to be clinically undistinguishable. Young adult, purebred and female cats appeared predisposed to nonflea/nonfood HD. As many diagnoses presented with similar lesional patterns, a thorough clinical work-up is required for establishment of a specific diagnosis.

CD4(+)CD25(+) T cells expressing FoxP3 in Icelandic horses affected with insect bite hypersensitivity

Insect bite hypersensitivity (IBH) is an IgE-mediated dermatitis caused by bites of midges from the genus Culicoides. We have shown previously that peripheral blood mononuclear cells (PBMC) from IBH-affected horses produce higher levels of IL-4 and lower levels of IL-10 and TGF-beta1 than those from healthy horses, suggesting that IBH is associated with a reduced regulatory immune response. FoxP3 is a crucial marker of regulatory T cells (Tregs). Here we have determined the proportion of CD4(+)CD25(+)FoxP3(+) T cells by flow cytometry in PBMC directly after isolation or after stimulation with Culicoides extract or a control antigen (Tetanus Toxoid). There were no differences between healthy and IBH horses either in the proportion of FoxP3(+)CD4(+)CD25(+) cells in freshly isolated PBMC or in the following stimulation with Tetanus Toxoid. However, upon stimulation of PBMC with the allergen, expression of FoxP3 by CD4(+)CD25(+high) and CD4(+)CD25(+dim) cells was significantly higher in healthy than in IBH horses. Addition of recombinant IL-4 to PBMC from healthy horses stimulated with the allergen significantly decreased the proportion of FoxP3 expressing cells within CD4(+)CD25(+high). These results suggest that IBH is associated with a decreased number of allergen-induced Tregs. This could be a consequence of the increased IL-4 production by PBMC of IBH-affected horses.

Selective cloning, characterization, and production of the Culicoides nubeculosus salivary gland allergen repertoire associated with equine insect bite hypersensitivity

Salivary gland proteins of Culicoides spp. have been suggested to be among the main allergens inducing IgE-mediated insect bite hypersensitivity (IBH), an allergic dermatitis of the horse. The aim of our study was to identify, produce and characterize IgE-binding salivary gland proteins of Culicoides nubeculosus relevant for IBH by phage surface display technology. A cDNA library constructed with mRNA derived from C. nubeculosus salivary glands was displayed on the surface of filamentous phage M13 and enriched for clones binding serum IgE of IBH-affected horses. Ten cDNA inserts encoding putative salivary gland allergens were isolated and termed Cul n 2 to Cul n 11. However, nine cDNA sequences coded for truncated proteins as determined by database searches. The cDNA sequences were amplified by PCR, subcloned into high level expression vectors and expressed as hexahistidine-tagged fusion proteins in Escherichia coli. Preliminary ELISA results obtained with these fusions confirmed the specific binding to serum IgE of affected horses. Therefore, the putative complete open reading frames derived from BLAST analyses were isolated by RACE-PCR and subcloned into expression vectors. The full length proteins expressed in Escherichia coli showed molecular masses in the range of 15.5-68.7 kDa in SDS-PAGE in good agreement with the masses calculated from the predicted protein sequences. Western blot analyses of all recombinant allergens with a serum pool of IBH-affected horses showed their ability to specifically bind serum IgE of sensitized horses, and ELISA determinations yielded individual horse recognition patterns with a frequency of sensitization ranging from 13 to 57%, depending on the allergen tested. The in vivo relevance of eight of the recombinant allergens was demonstrated in intradermal skin testing. For the two characterized allergens Cul n 6 and Cul n 11, sensitized horses were not available for intradermal tests. Control horses without clinical signs of IBH did not develop any relevant immediate hypersensitivity reactions to the recombinant allergens. The major contribution of this study was to provide a repertoire of recombinant salivary gland allergens repertoire from C. nubeculosus potentially involved in the pathogenesis of IBH as a starting basis for the development of a component-resolved serologic diagnosis of IBH and, perhaps, for the development of single horse tailored specific immunotherapy depending on their component-resolved sensitization patterns.

Increased IL-4 and decreased regulatory cytokine production following relocation of Icelandic horses from a high to low endoparasite environment

Insect bite hypersensitivity (IBH) is an IgE-mediated dermatitis of horses caused by bites of Culicoides spp. IBH does not occur in Iceland where Culicoides are absent. However, following importation into continental Europe where Culicoides are present, >or=50% of Icelandic horses (1st generation) develop IBH but

Cloning, production and characterization of antigen 5 like proteins from Simulium vittatum and Culicoides nubeculosus, the first cross-reactive allergen associated with equine insect bite hypersensitivity

Insect bite hypersensitivity (IBH) is an IgE-mediated seasonal dermatitis of the horses associated with bites of Simulium (black fly) and Culicoides (midge) species. Although cross-reactivity between Simulium and Culicoides salivary gland extracts has been demonstrated, the molecular nature of the allergens responsible for the observed cross-reactivity remains to be elucidated. In this report we demonstrate for the first time in veterinary medicine that a homologous allergen, present in the salivary glands of both insects, shows extended IgE cross-reactivity in vitro and in vivo. The cDNA sequences coding for both antigen 5 like allergens termed Sim v 1 and Cul n 1 were amplified by PCR, subcloned in high level expression vectors, and produced as [His](6)-tagged proteins in Escherichia coli. The highly pure recombinant proteins were used to investigate the prevalence of sensitization in IBH-affected horses by ELISA and their cross-reactive nature by Western blot analyses, inhibition ELISA and intradermal skin tests (IDT). The prevalence of sensitization to Sim v 1 and Cul n 1 among 48 IBH-affected horses was 37% and 35%, respectively. In contrast, serum IgE levels to both allergens in 24 unaffected horses did not show any value above background. Both proteins strongly bound serum IgE from IBH-affected horses in Western blot analyses, demonstrating the allergenic nature of the recombinant proteins. Extended inhibition ELISA experiments clearly showed that Sim v 1 in fluid phase is able to strongly inhibit binding of serum IgE to solid phase coated Cul n 1 in a concentration dependent manner and vice versa. This crucial experiment shows that the allergens share common IgE-binding epitopes. IDT with Sim v 1 and Cul n 1 showed clear immediate and late phase reactions to the allergen challenges IBH-affected horses, whereas unaffected control horses do not develop relevant immediate hypersensitivity reactions. In some horses, however, mild late phase reactions were observed 4h post-challenge, a phenomenon reported to occur also in challenge experiments with Simulium and Culicoides crude extracts probably related to lipopolysaccaride contaminations which are also present in E. coli-expressed recombinant proteins. In conclusion our data demonstrate that IgE-mediated cross-reactivity to homologous allergens, a well-known clinically relevant phenomenon in human allergy, also occurs in veterinary allergy.

Molecular cloning and characterization of equine thymic stromal lymphopoietin

Thymic stromal lymphopoietin (TSLP) is a novel cytokine that plays a central role in T helper 2 (Th2) cell differentiation and allergic inflammation. It is predominantly expressed by epithelial cells, and its expression is increased in patients with atopic dermatitis and asthma. Mice overexpressing TSLP in the skin develop allergic dermatitis and mice overexpressing TSLP in lungs develop asthma-like disease. However, it is not known whether TSLP plays an important role in equine allergies. Therefore, we cloned and sequenced the complete translated region of equine TSLP gene and measured its expression in various tissues. The equine TSLP gene is organized in 4 exons and encodes a protein of 143 amino acids, which has 62% amino acid identity with human TSLP.

Update in clinical allergy and immunology

In the recent years, a tremendous body of studies has addressed a broad variety of distinct topics in clinical allergy and immunology. In this update, we discuss selected recent data that provide clinically and pathogenetically relevant insights or identify potential novel targets and strategies for therapy. The role of the microbiome in shaping allergic immune responses and molecular, as well as cellular mechanisms of disease, is discussed separately and in the context of atopic dermatitis, as an allergic model disease. Besides summarizing novel evidence, this update highlights current areas of uncertainties and debates that, as we hope, shall stimulate scientific discussions and research activities in the field.

Characterization of canine dendritic cells in healthy, atopic, and non-allergic inflamed skin

Atopic dermatitis in humans and dogs is a chronic relapsing allergic skin disease. Dogs show a spontaneous disease similar to the human counterpart and represent a model to improve our understanding of the immunological mechanisms, the pathogenesis of the disease, and new therapy development. The aim of the study was to determine the frequency and phenotype of dendritic cells (DC) in the epidermis and dermis of healthy, canine atopic dermatitis lesional, and non-allergic inflammatory skin to further validate the model and to obtain insights into the contribution of DC to the pathogenesis of skin diseases in dogs. We first characterized canine skin DC using flow-cytometric analysis of isolated skin DC combined with an immunohistochemical approach. A major population of canine skin dendritic cells was identified as CD1c(+)CD11c(+)CD14(-)CD80(+)MHCII(+)MAC387(-) cells, with dermal DC but not Langerhans cells expressing CD11b. In the epidermis of lesional canine atopic dermatitis and non-allergic inflammatory skin, we found significantly more dendritic cells compared with nonlesional and control skin. Only in canine atopic dermatitis skin did we find a subset of dendritic cells positive for IgE, in the epidermis and the dermis. Under all inflammatory conditions, dermal dendritic cells expressed more CD14 and CD206. MAC387(+) putative macrophages were absent in healthy but present in inflamed skin, in particular during non-allergic diseases. This study permits a phenotypic identification and differentiation of canine skin dendritic cells and has identified markers and changes in dendritic cells and macrophage populations related to allergic and non-allergic inflammatory conditions. Our data suggest the participation of dendritic cells in the pathogenesis of canine atopic dermatitis similar to human atopic dermatitis and further validate the only non-murine spontaneous animal model for this disease.