粪便 IgE 分析揭示了花生过敏症患者分层的作用。

R Czolk, F Codreanu-Morel, L de Nies, S B Busi, R Halder, O Hunewald, T M Boehm, F Q Hefeng, C De Beaufort, P Wilmes, M Ollert, A Kuehn
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引用次数: 0

摘要

背景和目的:花生过敏(PA)是一种 IgE 介导的食物过敏,其临床结果各不相同。轻度至重度症状会影响多个器官,通常还会影响胃肠道。肠源性 IgE 抗体在天体肠道 PA 症状中的作用尚不清楚。本研究旨在检测 PA 患者粪便中的 IgE 反应,作为患者内分型的一种新方法:方法:收集花生过敏儿童和健康儿童(26 人)的粪便和血清样本,使用多重检测法鉴定 IgE 和细胞因子。通过散弹枪元基因组 DNA 测序和过敏原数据库比对,确定了与已知过敏原具有同源性的微生物肽:结果:与对照组相比,粪便 IgE 特征显示出广泛的多样性,并且 13 种过敏原的含量增加,其中包括食物、毒液、接触和呼吸道过敏原(PC结论:粪便中的 IgE 是过敏原的重要组成部分:肠粘膜释放的粪便 IgE 可能是 PA 中肠道上皮渗漏与抗过敏 TH2 反应之间的关联,从而成为严重腹痛的潜在机制。
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Fecal IgE Analyses Reveal a Role for Stratifying Peanut-Allergic Patients.

Background and objective: Peanut allergy (PA) is an IgE-mediated food allergy with variable clinical outcomes. Mild-to-severe symptoms affect various organs and, often, the gastrointestinal tract. The role of intestine-derived IgE antibodies in astrointestinal PA symptoms is poorly understood. This study aimed to examine fecal IgE responses in PA as a novel approach to patient endotyping.

Methods: Feces and serum samples were collected from peanut-allergic and healthy children (n=26) to identify IgE and cytokines using multiplex assays. Shotgun metagenomics DNA sequencing and allergen database comparisons made it possible to identify microbial peptides with homology to known allergens.

Results: Compared to controls, fecal IgE signatures showed broad diversity and increased levels for 13 allergens, including food, venom, contact, and respiratory allergens (P<.01-.0001). Overall, fecal IgE patterns were negatively correlated compared to sera IgE patterns in PA patients, with the greatest differences recorded for peanut allergens (P<.0001). For 83% of the allergens recognized by fecal IgE, we found bacterial homologs from PA patients' gut microbiome (eg, thaumatin-like protein Acinetobacter baumannii vs Act d 2, 109/124 aa identical). Compared to controls, PA patients had higher levels of fecal IgA, IL-22, and auto-IgE binding to their own fecal proteins (P<.001). Finally, levels of fecal IgE correlated with abdominal pain scores (P<.0001), suggesting a link between local IgE production and clinical outcomes.

Conclusion: Fecal IgE release from the intestinal mucosa could be an underlying mechanism of severe abdominal pain through the association between leaky gut epithelia and anticommensal TH2 responses in PA.

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CiteScore
7.10
自引率
9.70%
发文量
135
审稿时长
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期刊介绍: The Journal of Investigational Allergology and Clinical Immunology (J Investig Allergol Clin Immunol) provides an attractive and very active forum for basic and clinical research in allergology and clinical immunology.Journal of Investigational Allergology and Clinical Immunology publishes original works, reviews, short communications and opinions.
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