Allergy · 2018 · 68 citations · 49 references
Life SciencesDermatologyImmunologyAllergyClinical ImmunologyHypersensitivityAllergic DiseaseB Cell BiologyB-cell ResponsesFood AllergensFood AllergyHumoral ImmunityAllergic Disease MechanismsAnaphylaxis In Food AllergyEpicutaneous SensitizationFood Allergen ResponsesFood Allergen SensitizationIge-mediated Food AllergyIge-mediated ResponsesImmune Cell Depletion
Abstract Background The generation of IgE‐mediated food allergy in humans is silent and only diagnosed upon manifestation of clinical symptoms. While experimental models have been used to investigate some mechanisms of allergic sensitization, the generation of humoral immunity and memory remains to be elucidated. Here, we defined the evolution of allergen‐specific B‐cell responses during epicutaneous sensitization to foods. Methods Wild‐type and genetic knockout animals, and drug or antibody strategies for cell depletion and immunoglobulin signaling blockade were used to investigate epicutaneous sensitization and disease progression; we analyzed allergen‐specific germinal centers and IgG1 + memory B cells by flow cytometry, evaluated humoral responses, and determined clinical reactivity (anaphylaxis). Results Epicutaneous sensitization caused microscopic skin damage, inflammation, and recruitment of activated dendritic cells to the draining lymph nodes. This process generated allergen‐specific IgG1 + germinal center B cells, serum IgG1, and anaphylaxis that was mediated by the alternative pathway. Whether we used peanut and/or ovalbumin from the egg white for sensitization, the allergen‐specific IgG1 + memory compartment predominantly exhibited an immature, pro‐germinal center phenotype (PDL‐2 − CD80 − CD35 + CD73 + ). Subsequent subclinical exposures to the allergen induced IgE + germinal center B cells, serum IgE, and likely activated the classical pathway of anaphylaxis. Conclusions Our data demonstrate that IgG1 + B‐cell immunity against food allergens in epicutaneous sensitization precedes the generation of IgE responses. Therefore, the assessment of allergen‐specific cellular and humoral IgG1 + immunity may help to identify individuals at risk of developing IgE‐mediated food allergy and hence provide a window for therapeutic interventions.
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Factors Associated with the Development of Peanut Allergy in Childhood
Gideon Lack, Deborah Fox, Kate Northstone et al. · New England Journal of Medicine · 2003 · 906 citations