Journal of Investigational Allergology and Clinical Immunology最新文献

Background and objectives: Eosinophilic inflammation and IL-5 are key therapeutic targets in type 2 chronic rhinosinusitis with nasal polyposis (CRSwNP). Based on surface expression of CD62L, 2 eosinophil subpopulations, homeostatic and inflammatory, were recently described. Objectives: First, we aimed to investigate the association between these subpopulations and the severity of CRSwNP, and second, to analyze the impact of mepolizumab on tissue eosinophil subpopulations.

Methods: Flow cytometry of nasal polyp (NP) tissue eosinophil subpopulations (CD62Llow, iEos; CD62Lbright, rEos) was performed in 15 CRSwNP patients (with and without severe asthma) treated with mepolizumab for a median of 7.5 months. NP tissue was analyzed at baseline and after the start of therapy. The correlation between the proportion of tissue iEos and the severity of CRSwNP and treatment response was assessed.

Results: The proportion of tissue iEos correlated with higher CRSwNP severity scores and quality of life questionnaire scores (SNOT-22, L-K score) at baseline. A higher and significant improvement in NPS was observed in patients who had been taking mepolizumab for longer than 6 months. Mepolizumab significantly reduced the proportion of iEos in nasal polyp tissue, although a significantly higher number of rEos remained. A greater reduction in tissue iEos was associated with a more significant improvement in quality of life (SNOT-22) and severity (L-K) scores. Finally, in addition to the reduction in tissue eosinophils, mepolizumab induced histological changes characterized by the decrease in edema and goblet cell hyperplasia.

Conclusions: Tissue iEos values correlate with poor sinonasal control in CRSwNP and are reduced by treatment with mepolizumab. A greater decrease in iEos is associated with a significantly greater therapeutic effect of mepolizumab.

Background and objective: The prevalence of food allergy (FA) has increased significantly, and the risk of developing anaphylaxis is unpredictable. Thus, discriminating between sensitized patients and those at risk of a severe reaction is of utmost interest. To explore the mast cell (MC) activation pattern and the presence of T follicular helper (TFH) 13 cells in sensitized patients and patients who experience food anaphylaxis.

Methods: Patients sensitized to lipid transfer protein (LTP) were classified as being at risk of anaphylaxis or sensitized depending on the symptoms elicited by the LTP-containing food. CD34+- derived MCs were obtained from patients and controls, sensitized with pooled sera, and challenged with Pru p 3 (peach LTP). Degranulation, prostaglandin (PG) D2, and cytokine/chemokine release were measured. The TFH13 population was examined using flow cytometry of the peripheral blood of all groups. In parallel, LAD2 cells were activated in the same way as patients' MCs.

Results: A distinguishable pattern of MC activation was found in anaphylaxis patients but not in sensitized patients. Robust degranulation, PGD2, and release of IL-8 and granulocyte-macrophage colony-stimulating factor were more frequent in anaphylaxis patients, whereas secretion of TFG-ß and CCL2 was more frequent in sensitized patients. Anaphylaxis patients also had a larger TFH13 population. The MC activation profile was dependent on the sera rather than the MC source. Consistent with this observation, LAD2 cells reproduce the same pattern as MCs from anaphylactic and sensitized patients.

Conclusion: The distinct profile of MC activation makes it possible to discriminate between patients at risk of an anaphylactic reaction and sensitized patients. Pooled sera may determine MC activation independently of MC origin. Besides, the presence of TFH13 cells in anaphylaxis patients points to an essential role for the affinity of IgE.

Background and objective: With the global population on the rise, edible insects are considered a potential solution to food security, although concerns about risks such as anaphylaxis have been expressed.

Methods: We tested 2014 participants using the ALEX (Allergen Explorer) test, version 2 (ALEX2, Macroarray Diagnostics) and extracts of 3 novel foods: Acheta domesticus, Locusta migratoria, and Tenebrio molitor. IgE-mediated sensitization status was investigated in participants who had never knowingly consumed these insects. Data were recorded using an electronic database.

Results: A total of 195 individuals (9.7% of all participants) were sensitized to insects. Tropomyosin was corecognized by 34%, and 18.5% of results were positive for arginine kinase. Reactivity to sarcoplasmic calcium-binding protein, troponin C, paramyosin, or myosin light chain proteins was recorded in less than 5% of the population, whereas 108 individuals (55.4%) did not react to invertebrate panallergens. A further 33 individuals (16.9%) exhibited monosensitization exclusively to insects. Multivariate analysis revealed an inverse association between reactivity to arachnids and sensitization to insect allergens, while a direct association was identified between Mollusca and Blattoidea and reactivity to tropomyosin. Furthermore, reactivity to myosin light chain protein correlated with sensitization to A domesticus and L migratoria, and reactivity to troponin C with sensitization to A domesticus and T molitor.

Conclusion: IgE-mediated sensitization to edible insect extract was observed in individuals with no prior exposure to these foods. Mites were unlikely to be primary sensitizers owing to their inverse association with insect reactivity. Conversely, the direct association between sensitization to insect extract and reactivity to mollusk and cockroach extract suggests their potential as primary sensitizers in these participants. A positive association was consistently observed for tropomyosin, with reactivity to all studied insects, thus supporting its role as a primary sensitizer.