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Published in: Clinical and Translational Allergy 1/2017

Open Access 01-12-2017 | Research

The efficacy of oral and subcutaneous antigen-specific immunotherapy in murine cow’s milk- and peanut allergy models

Authors: Marlotte M. Vonk, Laura Wagenaar, Raymond H. H. Pieters, Leon M. J. Knippels, Linette E. M. Willemsen, Joost J. Smit, Betty C. A. M. van Esch, Johan Garssen

Published in: Clinical and Translational Allergy | Issue 1/2017

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Abstract

Background

Antigen-specific immunotherapy (AIT) is a promising therapeutic approach for both cow’s milk allergy (CMA) and peanut allergy (PNA), but needs optimization in terms of efficacy and safety.

Aim

Compare oral immunotherapy (OIT) and subcutaneous immunotherapy (SCIT) in murine models for CMA and PNA and determine the dose of allergen needed to effectively modify parameters of allergy.

Methods

Female C3H/HeOuJ mice were sensitized intragastrically (i.g.) to whey or peanut extract with cholera toxin. Mice were treated orally (5 times/week) or subcutaneously (3 times/week) for three consecutive weeks. Hereafter, the acute allergic skin response, anaphylactic shock symptoms and body temperature were measured upon intradermal (i.d.) and intraperitoneal (i.p.) challenge, and mast cell degranulation was measured upon i.g. challenge. Allergen-specific IgE, IgG1 and IgG2a were measured in serum at different time points. Single cell suspensions derived from lymph organs were stimulated with allergen to induce cytokine production and T cell phenotypes were assessed using flow cytometry.

Results

Both OIT and SCIT decreased clinically related signs upon challenge in the CMA and PNA model. Interestingly, a rise in allergen-specific IgE was observed during immunotherapy, hereafter, treated mice were protected against the increase in IgE caused by allergen challenge. Allergen-specific IgG1 and IgG2a increased due to both types of AIT. In the CMA model, SCIT and OIT reduced the percentage of activated Th2 cells and increased the percentage of activated Th1 cells in the spleen. OIT increased the percentage of regulatory T cells (Tregs) and activated Th2 cells in the MLN. Th2 cytokines IL-5, IL-13 and IL-10 were reduced after OIT, but not after SCIT. In the PNA model, no differences were observed in percentages of T cell subsets. SCIT induced Th2 cytokines IL-5 and IL-10, whereas OIT had no effect.

Conclusion

We have shown clinical protection against allergic manifestations after OIT and SCIT in a CMA and PNA model. Although similar allergen-specific antibody patterns were observed, differences in T cell and cytokine responses were shown. Whether these findings are related to a different mechanism of AIT in CMA and PNA needs to be elucidated.
Literature
2.
5.
go back to reference Erekosima N, et al. Effectiveness of subcutaneous immunotherapy for allergic rhinoconjunctivitis and asthma: a systematic review. Laryngoscope. 2014;124(3):616–27.CrossRefPubMed Erekosima N, et al. Effectiveness of subcutaneous immunotherapy for allergic rhinoconjunctivitis and asthma: a systematic review. Laryngoscope. 2014;124(3):616–27.CrossRefPubMed
6.
go back to reference Roberts G, et al. Grass pollen immunotherapy as an effective therapy for childhood seasonal allergic asthma. J Allergy Clin Immunol. 2006;117(2):263–8.CrossRefPubMed Roberts G, et al. Grass pollen immunotherapy as an effective therapy for childhood seasonal allergic asthma. J Allergy Clin Immunol. 2006;117(2):263–8.CrossRefPubMed
7.
go back to reference Antolin-Amerigo D, et al. Venom immunotherapy: an updated review. Curr Allergy Asthma Rep. 2014;14(7):449.CrossRefPubMed Antolin-Amerigo D, et al. Venom immunotherapy: an updated review. Curr Allergy Asthma Rep. 2014;14(7):449.CrossRefPubMed
8.
go back to reference Mondoulet L, et al. Epicutaneous immunotherapy on intact skin using a new delivery system in a murine model of allergy. Clin Exp Allergy. 2010;40(4):659–67.CrossRefPubMed Mondoulet L, et al. Epicutaneous immunotherapy on intact skin using a new delivery system in a murine model of allergy. Clin Exp Allergy. 2010;40(4):659–67.CrossRefPubMed
9.
go back to reference Oppenheimer JJ, et al. Treatment of peanut allergy with rush immunotherapy. J Allergy Clin Immunol. 1992;90(2):256–62.CrossRefPubMed Oppenheimer JJ, et al. Treatment of peanut allergy with rush immunotherapy. J Allergy Clin Immunol. 1992;90(2):256–62.CrossRefPubMed
10.
go back to reference Nelson HS, et al. Treatment of anaphylactic sensitivity to peanuts by immunotherapy with injections of aqueous peanut extract. J Allergy Clin Immunol. 1997;99(6 Pt 1):744–51.CrossRefPubMed Nelson HS, et al. Treatment of anaphylactic sensitivity to peanuts by immunotherapy with injections of aqueous peanut extract. J Allergy Clin Immunol. 1997;99(6 Pt 1):744–51.CrossRefPubMed
11.
go back to reference Chiang D, Berin MC. An examination of clinical and immunologic outcomes in food allergen immunotherapy by route of administration. Curr Allergy Asthma Rep. 2015;15(6):536.CrossRef Chiang D, Berin MC. An examination of clinical and immunologic outcomes in food allergen immunotherapy by route of administration. Curr Allergy Asthma Rep. 2015;15(6):536.CrossRef
12.
go back to reference Vazquez-Ortiz M, et al. Safety and predictors of adverse events during oral immunotherapy for milk allergy: severity of reaction at oral challenge, specific IgE and prick test. Clin Exp Allergy. 2013;43(1):92–102.CrossRefPubMed Vazquez-Ortiz M, et al. Safety and predictors of adverse events during oral immunotherapy for milk allergy: severity of reaction at oral challenge, specific IgE and prick test. Clin Exp Allergy. 2013;43(1):92–102.CrossRefPubMed
14.
go back to reference Berin MC, Mayer L. Can we produce true tolerance in patients with food allergy? J Allergy Clin Immunol. 2013;131(1):14–22.CrossRefPubMed Berin MC, Mayer L. Can we produce true tolerance in patients with food allergy? J Allergy Clin Immunol. 2013;131(1):14–22.CrossRefPubMed
16.
go back to reference Cavkaytar O, Akdis CA, Akdis M. Modulation of immune responses by immunotherapy in allergic diseases. Curr Opin Pharmacol. 2014;17:30–7.CrossRefPubMed Cavkaytar O, Akdis CA, Akdis M. Modulation of immune responses by immunotherapy in allergic diseases. Curr Opin Pharmacol. 2014;17:30–7.CrossRefPubMed
17.
go back to reference Dioszeghy V et al. Differences in phenotype, homing properties and suppressive activities of regulatory T cells induced by epicutaneous, oral or sublingual immunotherapy in mice sensitized to peanut. Cell Mol Immunol. 2017;14(9):770–782. doi:10.1038/cmi.2016.14.CrossRefPubMed Dioszeghy V et al. Differences in phenotype, homing properties and suppressive activities of regulatory T cells induced by epicutaneous, oral or sublingual immunotherapy in mice sensitized to peanut. Cell Mol Immunol. 2017;14(9):770–782. doi:10.​1038/​cmi.​2016.​14.CrossRefPubMed
18.
go back to reference Vickery BP, et al. Peanut oral immunotherapy modifies IgE and IgG4 responses to major peanut allergens. J Allergy Clin Immunol. 2013;131(1):128–34.CrossRefPubMed Vickery BP, et al. Peanut oral immunotherapy modifies IgE and IgG4 responses to major peanut allergens. J Allergy Clin Immunol. 2013;131(1):128–34.CrossRefPubMed
19.
go back to reference Akdis CA, Akdis M. Mechanisms of allergen-specific immunotherapy and immune tolerance to allergens. World Allergy Organ J. 2015;8(1):17.CrossRefPubMed Akdis CA, Akdis M. Mechanisms of allergen-specific immunotherapy and immune tolerance to allergens. World Allergy Organ J. 2015;8(1):17.CrossRefPubMed
20.
go back to reference Leonard SA, et al. Oral immunotherapy induces local protective mechanisms in the gastrointestinal mucosa. J Allergy Clin Immunol. 2012;129(6):1579–87.CrossRefPubMedPubMedCentral Leonard SA, et al. Oral immunotherapy induces local protective mechanisms in the gastrointestinal mucosa. J Allergy Clin Immunol. 2012;129(6):1579–87.CrossRefPubMedPubMedCentral
21.
go back to reference Berin C, Wang W. Oral immunotherapy in the sensitized mouse: barriers to tolerance induction. J Allergy Clin Immunol. 2010;125(2):Ab25.CrossRef Berin C, Wang W. Oral immunotherapy in the sensitized mouse: barriers to tolerance induction. J Allergy Clin Immunol. 2010;125(2):Ab25.CrossRef
22.
go back to reference Syed A, et al. Peanut oral immunotherapy results in increased antigen-induced regulatory T-cell function and hypomethylation of forkhead box protein 3 (FOXP3). J Allergy Clin Immunol. 2014;133(2):500–10.CrossRefPubMedPubMedCentral Syed A, et al. Peanut oral immunotherapy results in increased antigen-induced regulatory T-cell function and hypomethylation of forkhead box protein 3 (FOXP3). J Allergy Clin Immunol. 2014;133(2):500–10.CrossRefPubMedPubMedCentral
23.
go back to reference van Wijk F, et al. The effect of the food matrix on in vivo immune responses to purified peanut allergens. Toxicol Sci. 2005;86(2):333–41.CrossRefPubMed van Wijk F, et al. The effect of the food matrix on in vivo immune responses to purified peanut allergens. Toxicol Sci. 2005;86(2):333–41.CrossRefPubMed
24.
go back to reference Schouten B, et al. Acute allergic skin reactions and intestinal contractility changes in mice orally sensitized against casein or whey. Int Arch Allergy Immunol. 2008;147(2):125–34.CrossRefPubMed Schouten B, et al. Acute allergic skin reactions and intestinal contractility changes in mice orally sensitized against casein or whey. Int Arch Allergy Immunol. 2008;147(2):125–34.CrossRefPubMed
25.
go back to reference Li XM, et al. A murine model of IgE-mediated cow’s milk hypersensitivity. J Allergy Clin Immunol. 1999;103(2 Pt 1):206–14.CrossRefPubMed Li XM, et al. A murine model of IgE-mediated cow’s milk hypersensitivity. J Allergy Clin Immunol. 1999;103(2 Pt 1):206–14.CrossRefPubMed
26.
go back to reference Thyagarajan A, et al. Evidence of pathway-specific basophil anergy induced by peanut oral immunotherapy in peanut-allergic children. Clin Exp Allergy. 2012;42(8):1197–205.CrossRefPubMedPubMedCentral Thyagarajan A, et al. Evidence of pathway-specific basophil anergy induced by peanut oral immunotherapy in peanut-allergic children. Clin Exp Allergy. 2012;42(8):1197–205.CrossRefPubMedPubMedCentral
27.
go back to reference Jutel M, et al. Influence of bee venom immunotherapy on degranulation and leukotriene generation in human blood basophils. Clin Exp Allergy. 1996;26(10):1112–8.CrossRefPubMed Jutel M, et al. Influence of bee venom immunotherapy on degranulation and leukotriene generation in human blood basophils. Clin Exp Allergy. 1996;26(10):1112–8.CrossRefPubMed
28.
go back to reference Xiang Z, Moller C, Nilsson G. Readministration of IgE is required for repeated passive cutaneous anaphylaxis in mice. Int Arch Allergy Immunol. 2006;141(2):168–71.CrossRefPubMed Xiang Z, Moller C, Nilsson G. Readministration of IgE is required for repeated passive cutaneous anaphylaxis in mice. Int Arch Allergy Immunol. 2006;141(2):168–71.CrossRefPubMed
29.
go back to reference Xiang Z, et al. IgE-mediated mast cell degranulation and recovery monitored by time-lapse photography. J Allergy Clin Immunol. 2001;108(1):116–21.CrossRefPubMed Xiang Z, et al. IgE-mediated mast cell degranulation and recovery monitored by time-lapse photography. J Allergy Clin Immunol. 2001;108(1):116–21.CrossRefPubMed
30.
go back to reference Van Ree R, et al. Measurement of IgE antibodies against purified grass pollen allergens (Lol p 1, 2, 3 and 5) during immunotherapy. Clin Exp Allergy. 1997;27(1):68–74.CrossRefPubMed Van Ree R, et al. Measurement of IgE antibodies against purified grass pollen allergens (Lol p 1, 2, 3 and 5) during immunotherapy. Clin Exp Allergy. 1997;27(1):68–74.CrossRefPubMed
31.
go back to reference Varshney P, et al. A randomized controlled study of peanut oral immunotherapy: clinical desensitization and modulation of the allergic response. J Allergy Clin Immunol. 2011;127(3):654–60.CrossRefPubMedPubMedCentral Varshney P, et al. A randomized controlled study of peanut oral immunotherapy: clinical desensitization and modulation of the allergic response. J Allergy Clin Immunol. 2011;127(3):654–60.CrossRefPubMedPubMedCentral
34.
go back to reference Suarez-Fueyo A, et al. Grass tablet sublingual immunotherapy downregulates the TH2 cytokine response followed by regulatory T-cell generation. J Allergy Clin Immunol. 2014;133(1):130–8.CrossRefPubMed Suarez-Fueyo A, et al. Grass tablet sublingual immunotherapy downregulates the TH2 cytokine response followed by regulatory T-cell generation. J Allergy Clin Immunol. 2014;133(1):130–8.CrossRefPubMed
35.
go back to reference Chehade M, Mayer L. Oral tolerance and its relation to food hypersensitivities. J Allergy Clin Immunol. 2005;115(1):3–12 (quiz 13).CrossRefPubMed Chehade M, Mayer L. Oral tolerance and its relation to food hypersensitivities. J Allergy Clin Immunol. 2005;115(1):3–12 (quiz 13).CrossRefPubMed
36.
37.
go back to reference Shamji MH, Durham SR. Mechanisms of immunotherapy to aeroallergens. Clin Exp Allergy. 2011;41(9):1235–46.CrossRefPubMed Shamji MH, Durham SR. Mechanisms of immunotherapy to aeroallergens. Clin Exp Allergy. 2011;41(9):1235–46.CrossRefPubMed
39.
go back to reference Jutel M, et al. IL-10 and TGF-beta cooperate in the regulatory T cell response to mucosal allergens in normal immunity and specific immunotherapy. Eur J Immunol. 2003;33(5):1205–14.CrossRefPubMed Jutel M, et al. IL-10 and TGF-beta cooperate in the regulatory T cell response to mucosal allergens in normal immunity and specific immunotherapy. Eur J Immunol. 2003;33(5):1205–14.CrossRefPubMed
41.
go back to reference Polukort SH, et al. IL-10 enhances IgE-mediated mast cell responses and is essential for the development of experimental food allergy in IL-10-deficient mice. J Immunol. 2016;196(12):4865–76.CrossRefPubMedPubMedCentral Polukort SH, et al. IL-10 enhances IgE-mediated mast cell responses and is essential for the development of experimental food allergy in IL-10-deficient mice. J Immunol. 2016;196(12):4865–76.CrossRefPubMedPubMedCentral
42.
go back to reference Finkelman FD. Anaphylaxis: lessons from mouse models. J Allergy Clin Immunol. 2007;120(3):506–15 (quiz 516-7).CrossRefPubMed Finkelman FD. Anaphylaxis: lessons from mouse models. J Allergy Clin Immunol. 2007;120(3):506–15 (quiz 516-7).CrossRefPubMed
Metadata
Title
The efficacy of oral and subcutaneous antigen-specific immunotherapy in murine cow’s milk- and peanut allergy models
Authors
Marlotte M. Vonk
Laura Wagenaar
Raymond H. H. Pieters
Leon M. J. Knippels
Linette E. M. Willemsen
Joost J. Smit
Betty C. A. M. van Esch
Johan Garssen
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Clinical and Translational Allergy / Issue 1/2017
Electronic ISSN: 2045-7022
DOI
https://doi.org/10.1186/s13601-017-0170-y

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