Transport of Pru p 3 across gastrointestinal epithelium - an essential step towards the induction of food allergy?

Background Since intestinal absorption of food protein can trigger an allergic reaction, the effect of plant food allergen on intestinal epithelial cell permeability and its ability to cross the epithelial monolayer was evaluated. Objective To study the interaction of Pru p 3 with intestinal epithelium, its natural entrance, analyzing transport kinetics and cellular responses that trigger. Methods This was achieved using Pru p 3, the peach LTP, as a model. Enterocytic monolayers were established by culturing Caco 2 cells, as a model of enterocytes, on permeable supports that separate the apical and basal compartments. Pru p 3 was added to the apical compartment, the transepithelial resistance (TEER) was measured, and the transport was quantified. Results The peach allergen that crossed the cell monolayer was detected in the cell fraction and in the basal medium by immunodetection with specific antibodies and the quantity was measured by ELISA assay. Pru p 3 was able to cross the monolayer without disturbing the integrity of the tight junctions. This transport was significantly higher than that of a non-allergenic peach LTP, LTP1, and occurred via lipid raft pathway. The incubation of Caco 2 cells with Pru p 3 and LTP1 produced the expression of epithelial-specific cytokines TSLP, IL33 and IL25. Conclusion These results suggest that Pru p 3 was able to cross the cell monolayer by the transcellular route and then induce the production of Th2 cytokines. The results of the present study represent a step towards clarifying the importance of Pru p 3 as a sensitizer. Clinical relevance The capacity of food allergens to cross the intestinal monolayer could explain their high allergenic capacity and its fast diffusion through the body associating to severe symptoms.

Allergy to Uncommon Pets: New Allergies but the Same Allergens.

The prevalence of exotic pet allergies has been increasing over the last decade. Years ago, the main allergy-causing domestic animals were dogs and cats, although nowadays there is an increasing number of allergic diseases related to insects, rodents, amphibians, fish, and birds, among others. The current socio-economic situation, in which more and more people have to live in small apartments, might be related to this tendency. The main allergic symptoms related to exotic pets are the same as those described for dog and cat allergy: respiratory symptoms. Animal allergens are therefore, important sensitizing agents and an important risk factor for asthma. There are three main protein families implicated in these allergies, which are the lipocalin superfamily, serum albumin family, and secretoglobin superfamily. Detailed knowledge of the characteristics of allergens is crucial to improvement treatment of uncommon-pet allergies.

Alt a 1 from Alternaria interacts with PR5 thaumatin-like proteins

Alt a 1 is a protein found in Alternaria alternata spores related to virulence and pathogenicity and considered to be responsible for chronic asthma in children. We found that spores of Alternaria inoculated on the outer surface of kiwifruits did not develop hyphae. Nevertheless, the expression of Alt a 1 gene was upregulated, and the protein was detected in the pulp where it co-localized with kiwi PR5. Pull-down assays demonstrated experimentally that the two proteins interact in such a way that Alt a 1 inhibits the enzymatic activity of PR5. These results are relevant not only for plant defense, but also for human health as patients with chronic asthma could suffer from an allergic reaction when they eat fruit contaminated with Alternaria.

Is Microarray Analysis Really Useful and Sufficient to Diagnose Nut Allergy in the Mediterranean Area?

Background: Component-based diagnosis on multiplex platforms is widely used in food allergy but its clinical performance has not been evaluated in nut allergy. Objective: To assess the diagnostic performance of a commercial protein microarray in the determination of specific IgE (sIgE) in peanut, hazelnut, and walnut allergy. Methods: sIgE was measured in 36 peanut-allergic, 36 hazelnut-allergic, and 44 walnut-allergic patients by ISAC 112, and subsequently, sIgE against available components was determined by ImmunoCAP in patients with negative ISAC results. ImmunoCAP was also used to measure sIgE to Ara h 9, Cor a 8, and Jug r 3 in a subgroup of lipid transfer protein (LTP)-sensitized nut-allergic patients (positive skin prick test to LTP-enriched extract). sIgE levels by ImmunoCAP were compared with ISAC ranges. Results: Most peanut-, hazelnut-, and walnut-allergic patients were sensitized to the corresponding nut LTP (Ara h 9, 66.7%; Cor a 8, 80.5%; Jug r 3, 84% respectively). However, ISAC did not detect sIgE in 33.3% of peanut-allergic patients, 13.9% of hazelnut-allergic patients, or 13.6% of walnut-allergic patients. sIgE determination by ImmunoCAP detected sensitization to Ara h 9, Cor a 8, and Jug r 3 in, respectively, 61.5% of peanut-allergic patients, 60% of hazelnut-allergic patients, and 88.3% of walnut-allergic patients with negative ISAC results. In the subgroup of peach LTP?sensitized patients, Ara h 9 sIgE was detected in more cases by ImmunoCAP than by ISAC (94.4% vs 72.2%, P<.05). Similar rates of Cor a 8 and Jug r 3 sensitization were detected by both techniques. Conclusions: The diagnostic performance of ISAC was adequate for hazelnut and walnut allergy but not for peanut allergy. sIgE sensitivity against Ara h 9 in ISAC needs to be improved.

Wheat allergy in celiac children

Gluten is the main structural protein complex of wheat with equivalent toxic proteins found in other cereals (rye, barley, and oats) which are responsible for different immunologic responses with different clinical expressions of disease. The spectrum of gluten-related disorders has been classified according to pathogenic, clinical, and epidemiological differences in three main forms: (i) wheat allergy (WA), an IgE-mediated disease; (ii) autoimmune disease, including celiac disease (CD), dermatitis herpetiformis, and gluten ataxia; and (iii) possibly immune-mediated, gluten sensitivity [1]. WA is an immunologic Th2 response with typical manifestations which can vary from dermatological, respiratory, and/or intestinal to anaphylactic reactions. In contrast, CD is an autoimmune disorder, a gliadin-specific T-cell response which is enhanced by the action of intestinal tissue transglutaminase (tTG), with a wide clinical spectrum including symptomatic cases with either intestinal (e.g., chronic diarrhea, weight loss) or extraintestinal features (e.g., anemia, osteoporosis, neurologic disturbances) and silent forms that are occasionally discovered as a result of serological screening [1]. We studied wheat allergy in two children with early diagnosis of CD, who developed immediate allergic symptoms after eating small amounts of wheat flour.

Challenges for Allergy Diagnosis in Regions with Complex Pollen Exposures

Over the past few decades, significant scientific progress has influenced clinical allergy practice. The biological standardization of extracts was followed by the massive identification and characterization of new allergens and their progressive use as diagnostic tools including allergen micro arrays that facilitate the simultaneous testing of more than 100 allergen components. Specific diagnosis is the basis of allergy practice and is always aiming to select the best therapeutic or avoidance intervention. As a consequence, redundant or irrelevant information might be adding unnecessary cost and complexity to daily clinical practice. A rational use of the different diagnostic alternatives would allow a significant improvement in the diagnosis and treatment of allergic patients, especially for those residing in complex pollen exposure areas.

INTERVENÇÕES FISIOTERAPÊUTICAS NUM CONTEXTO LÚDICO JUNTO A CRIANÇAS COM DOENÇAS RESPIRATÓRIAS CRÔNICAS

Verifica-se hoje em dia o aumento da incidência de problemas pulmonares que ocasiona internações hospitalares infantis com maior freqüência. Este projeto baseia-se na visão biopsicossocial da Psicologia da Saúde e leva em conta a valorização de atividades do cotidiano da criança, como o brincar, para sua recuperação. Tem por objetivo principal investigar se a utilização de técnicas interventivas lúdicas em fisioterapia contribui para a melhora dos níveis de oxigenação de crianças asmáticas e por objetivos específicos traçar um breve perfil clínico da criança que procura o Ambulatório de Alergia e Imunologia da Faculdade de Medicina do ABC e verificar a adesão da criança com problemas respiratórios a uma intervenção fisioterapêutica lúdica da criança. A análise qualitativa da intervenção lúdica registra grande envolvimento e participação prazerosa das crianças e ampla aceitação dos pais. Estes resultados sugerem que novas pesquisas sejam realizadas a respeito de intervenções lúdicas em fisioterapia. Utiliza-se de método avaliativo-interventivo quase-experimental. Seus participantes são 58 crianças de ambos os sexos com idade de quatro a 11 anos com as patologias de asma brônquica, bronquite e rinite alérgica, sem a presença da crise. Desenvolve-se por meio de sessão única com cada paciente, com avaliação antes e após da intervenção fisioterápica lúdica por meio das aferições dos sinais vitais, (PA, FC, FR,T°C, incluindo oximetria de pulso e PFE) técnicas de aquecimento, alongamento torácico, fortalecimento abdominal e expansão torácica. Realiza análise qualitativa da responsividade das crianças às técnicas interventivas empregadas no contexto lúdico. Os resultados a respeito do perfil clinico indicam maior incidência de Asma, com 44 casos (75,8620 %), para 11 casos de Rinite (18,9655 %) e apenas três de Bronquite (5,1724 %). Os dados relativos a PA, FC, FR,T°C e ao PFE mostram-se dentro da normalidade. Este estudo não constata diferença significativa em relação ao nível de saturação de O2 após a intervenção lúdica. Quanto à adesão, 55,2 % dos participantes aderiram, sendo que a não adesão deu-se por motivos particulares alegados pelos responsáveis ou indisposição da criança, de dor de cabeça, sonolência e/ou vômito. A análise qualitativa da intervenção lúdica registra grande envolvimento e participação prazerosa das crianças e ampla aceitação dos pais. Estes resultados sugerem que novas pesquisas sejam realizadas a respeito de intervenções lúdicas em fisioterapia.(AU)

INTERVENÇÕES FISIOTERAPÊUTICAS NUM CONTEXTO LÚDICO JUNTO A CRIANÇAS COM DOENÇAS RESPIRATÓRIAS CRÔNICAS

Verifica-se hoje em dia o aumento da incidência de problemas pulmonares que ocasiona internações hospitalares infantis com maior freqüência. Este projeto baseia-se na visão biopsicossocial da Psicologia da Saúde e leva em conta a valorização de atividades do cotidiano da criança, como o brincar, para sua recuperação. Tem por objetivo principal investigar se a utilização de técnicas interventivas lúdicas em fisioterapia contribui para a melhora dos níveis de oxigenação de crianças asmáticas e por objetivos específicos traçar um breve perfil clínico da criança que procura o Ambulatório de Alergia e Imunologia da Faculdade de Medicina do ABC e verificar a adesão da criança com problemas respiratórios a uma intervenção fisioterapêutica lúdica da criança. A análise qualitativa da intervenção lúdica registra grande envolvimento e participação prazerosa das crianças e ampla aceitação dos pais. Estes resultados sugerem que novas pesquisas sejam realizadas a respeito de intervenções lúdicas em fisioterapia. Utiliza-se de método avaliativo-interventivo quase-experimental. Seus participantes são 58 crianças de ambos os sexos com idade de quatro a 11 anos com as patologias de asma brônquica, bronquite e rinite alérgica, sem a presença da crise. Desenvolve-se por meio de sessão única com cada paciente, com avaliação antes e após da intervenção fisioterápica lúdica por meio das aferições dos sinais vitais, (PA, FC, FR,T°C, incluindo oximetria de pulso e PFE) técnicas de aquecimento, alongamento torácico, fortalecimento abdominal e expansão torácica. Realiza análise qualitativa da responsividade das crianças às técnicas interventivas empregadas no contexto lúdico. Os resultados a respeito do perfil clinico indicam maior incidência de Asma, com 44 casos (75,8620 %), para 11 casos de Rinite (18,9655 %) e apenas três de Bronquite (5,1724 %). Os dados relativos a PA, FC, FR,T°C e ao PFE mostram-se dentro da normalidade. Este estudo não constata diferença significativa em relação ao nível de saturação de O2 após a intervenção lúdica. Quanto à adesão, 55,2 % dos participantes aderiram, sendo que a não adesão deu-se por motivos particulares alegados pelos responsáveis ou indisposição da criança, de dor de cabeça, sonolência e/ou vômito. A análise qualitativa da intervenção lúdica registra grande envolvimento e participação prazerosa das crianças e ampla aceitação dos pais. Estes resultados sugerem que novas pesquisas sejam realizadas a respeito de intervenções lúdicas em fisioterapia.(AU)

T cell vaccination induces T cell receptor Vβ-specific Qa-1-restricted regulatory CD8+ T cells

Vaccination of mice with activated autoantigen-reactive CD4+ T cells (T cell vaccination, TCV) has been shown to induce protection from the subsequent induction of a variety of experimental autoimmune diseases, including experimental allergic encephalomyelitis (EAE). Although the mechanisms involved in TCV-mediated protection are not completely known, there is some evidence that TCV induces CD8+ regulatory T cells that are specific for pathogenic CD4+ T cells. Previously, we demonstrated that, after superantigen administration in vivo, CD8+ T cells emerge that preferentially lyse and regulate activated autologous CD4+ T cells in a T cell receptor (TCR) Vβ-specific manner. This TCR Vβ-specific regulation is not observed in β2-microglobulin-deficient mice and is inhibited, in vitro, by antibody to Qa-1. We now show that similar Vβ8-specific Qa-1-restricted CD8+ T cells are also induced by TCV with activated CD4+ Vβ8+ T cells. These CD8+ T cells specifically lyse murine or human transfectants coexpressing Qa-1 and murine TCR Vβ8. Further, CD8+ T cell hybridoma clones generated from B10.PL mice vaccinated with a myelin basic protein-specific CD4+Vβ8+ T cell clone specifically recognize other CD4+ T cells and T cell tumors that express Vβ8 and the syngeneic Qa-1a but not the allogeneic Qa-1b molecule. Thus, Vβ-specific Qa-1-restricted CD8+ T cells are induced by activated CD4+ T cells. We suggest that these CD8+ T cells may function to specifically regulate activated CD4+ T cells during immune responses.

T1/ST2 is preferentially expressed on murine Th2 cells, independent of interleukin 4, interleukin 5, and interleukin 10, and important for Th2 effector function

T helper (Th) cells can be categorized according to their cytokine expression. The differential induction of Th cells expressing Th1 and/or Th2 cytokines is key to the regulation of both protective and pathological immune responses. Cytokines are expressed transiently and there is a lack of stably expressed surface molecules, significant for functionally different types of Th cells. Such molecules are of utmost importance for the analysis and selective functional modulation of Th subsets and will provide new therapeutic strategies for the treatment of allergic or autoimmune diseases. To this end, we have identified potential target genes preferentially expressed in Th2 cells, expressing interleukin (IL)-4, IL-5, and/or IL-10, but not interferon-γ. One such gene, T1/ST2, is expressed stably on both Th2 clones and Th2-polarized cells activated in vivo or in vitro. T1/ST2 expression is independent of induction by IL-4, IL-5, or IL-10. T1/ST2 plays a critical role in Th2 effector function. Administration of either a mAb against T1/ST2 or recombinant T1/ST2 fusion protein attenuates eosinophilic inflammation of the airways and suppresses IL-4 and IL-5 production in vivo following adoptive transfer of Th2 cells.

Synthetic amino acid copolymers that bind to HLA-DR proteins and inhibit type II collagen-reactive T cell clones

Copolymer 1 [poly(Y,E,A,K)] is a random synthetic amino acid copolymer of l-tyrosine, l-glutamic acid, l-alanine, and l-lysine that is effective both in suppression of experimental allergic encephalomyelitis and in the treatment of relapsing forms of multiple sclerosis. Copolymer 1 binds promiscuously and very efficiently to purified HLA-DR molecules within the peptide-binding groove. In the present study, YEAK and YEAK-related copolymers and type II collagen (CII) peptide 261–273, a candidate autoantigen in rheumatoid arthritis (RA), competed for binding to RA-associated HLA-DR molecules encoded by DRB1*0101 and DRB1*0401. Moreover, these copolymers (particularly YEAK, YAK, and YEK) inhibited the response of DR1- and DR4-restricted T cell clones to the CII epitope 261–273 by >50%. This direct evidence both for competitive interactions of these copolymers and CII peptide with RA-associated HLA-DR molecules and for inhibition of CII-specific T cell responses suggests that these compounds should be evaluated in animal models for rheumatoid arthritis.

IL-18, although antiallergic when administered with IL-12, stimulates IL-4 and histamine release by basophils

IL-18 is a proinflammatory cytokine that plays an important role in natural killer cell activation and T helper 1 (Th1) cell responses. Mast cells and basophils are major inducers and effectors of allergic inflammation. Here we show that basophils and mast cells derived by culture of bone marrow cells with IL-3 for 10 days express IL-18Rα chain and that basophils produce large amounts of IL-4 and IL-13 in response to stimulation with IL-3 and IL-18. Injection of IL-12 and IL-18 inhibits IgE production in helminth-infected wild-type mice and abolishes the capacity of their basophils to produce IL-4 and IL-13 in response to stimulation either with IL-3 and IL-18 or with FcɛR cross-linkage. By contrast, this combination of cytokines actually increases IgE levels in helminth-infected IFN-γ−/− mice and enhances IL-4 and IL-13 production by their basophils. Furthermore, injection of IL-18 alone enhances basophil production of IL-4 and histamine both in wild-type and IFN-γ−/− mice. Thus, IL-18 has the potential to stimulate basophils but, when given with IL-12, exhibits an antiallergic action in vivo.

A novel pair of immunoglobulin-like receptors expressed by B cells and myeloid cells

An Fcα receptor probe of human origin was used to identify novel members of the Ig gene superfamily in mice. Paired Ig-like receptors, named PIR-A and PIR-B, are predicted from sequence analysis of the cDNAs isolated from a mouse splenic library. Both type I transmembrane proteins possess similar ectodomains with six Ig-like loops, but have different transmembrane and cytoplasmic regions. The predicted PIR-A protein has a short cytoplasmic tail and a charged Arg residue in the transmembrane region that, by analogy with the FcαR relative, suggests the potential for association with an additional transmembrane protein to form a signal transducing unit. In contrast, the PIR-B protein has an uncharged transmembrane region and a long cytoplasmic tail containing four potential immunoreceptor tyrosine-based inhibitory motifs. These features are shared by the related killer inhibitory receptors. PIR-A proteins appear to be highly variable, in that predicted peptide sequences differ for seven randomly selected PIR-A clones, whereas PIR-B cDNA clones are invariant. Southern blot analysis with PIR-B and PIR-A-specific probes suggests only one PIR-B gene and multiple PIR-A genes. The PIR-A and PIR-B genes are expressed in B lymphocytes and myeloid lineage cells, wherein both are expressed simultaneously. The characteristics of the highly-conserved PIR-A and PIR-B genes and their coordinate cellular expression suggest a potential regulatory role in humoral, inflammatory, and allergic responses.

IL-4 and -5 prime human mast cells for different profiles of IgE-dependent cytokine production

Mast cells (MC) are stem cell factor-dependent tissue-based hematopoietic cells with substantial functional heterogeneity. Cord blood-derived human MC (hMC) express functional receptors for IL-5, and IL-5 mediates stem cell factor-dependent comitogenesis of hMC in vitro. Although IL-5 is not required for normal hMC development, we considered that it might prime hMC for their high-affinity Fc receptor for IgE (FcɛRI)-dependent generation of cytokines, as previously demonstrated for IL-4. Compared with hMC maintained in stem cell factor alone, hMC primed with IL-5 expressed 2- to 4-fold higher steady-state levels of TNF-α, IL-5, IL-13, macrophage inflammatory protein 1α, and granulocyte-macrophage colony-stimulating factor transcripts 2 h after FcɛRI crosslinking and secreted 2- to 5-fold greater quantities of the corresponding cytokines, except IL-13, at 6 h. Unlike IL-4, IL-5 priming did not enhance FcɛRI-dependent histamine release. Thus, IL-5 augments cytokine production by hMC by a mechanism distinct from that of IL-4 and with a different resultant profile of cytokine production. These observations suggest a potentially autocrine effect of IL-5 on hMC for amplification of allergic immune responses, in addition to its recognized paracrine effects on eosinophils, and implicate both IL-4 and IL-5 in the modulation of the hMC phenotype.

Resolution of peanut allergy: case-control study

Objectives: To determine whether there are any differences between children who remain mildly or moderately allergic to peanut and children with similar histories but a negative reaction on challenge with peanut.