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G C Mudde

Publications and source records attributed to G C Mudde.

At least 37 records · Page 2Linked to original sources

Consequences of IgE/CD23-mediated antigen presentation in allergy.

Allergen-specific IgE antibodies are responsible for the generation of immediate-type hypersensitivity reactions. However, as described here by Geert Mudde, Roy Bheekha and Carla Bruijnzeel-Koomen, IgE may also be involved in the uptake and processing of allergens. Such IgE-mediated antigen presentation may lead to a continuous (over) activation of the immune system due to high titers of IgE and the presence of large numbers of allergen-specific Th2 cells. In addition, it may be a cause for the advance of disease from a 'single allergy' to 'multi-allergy' syndrome.

Allergens↗

Evaluation of variables influencing the outcome of the atopy patch test.

BACKGROUND: The number of positive atopy patch test (APT) results in patients with atopic eczema (AE) varies in different studies, probably because of different test techniques. Variables that may influence the outcome of the APT were evaluated. METHODS: APTs were performed in 84 patients with AE, 30 control patients with atopic disease, and 85 healthy volunteers, with house dust mite and grass pollen allergens in concentrations of 100, 1000, 10,000, and 100,000 allergenic units/ml. The influence of 0, 10, or 20 tape strippings was investigated. The tests were performed on the back and/or the antecubital fossa and evaluated after 20 minutes and 24, 48, and 72 hours. In all patients the total and specific serum IgE levels were measured. RESULTS: The maximal number of positive APT results were obtained under the following conditions: an allergen concentration equal to 10,000 allergenic units/ml, 10 tape strippings and readings at 24 and 48 hours. Positive APT results were observed in five of 30 control patients with atopic disease and in none of 85 healthy volunteers. Statistically significantly higher total and allergen-specific serum IgE levels were found in the group of patients with AE with positive APT results. CONCLUSIONS: We recommend the previously described conditions to get an optimal method for APT. The correlation between the APT and the total and specific serum IgE suggests an important role for IgE in the reaction mechanism behind the APT.

Adult↗

Regulation and targeting of T-cell immune responses by IgE and IgG antibodies.

A set of chimeric antibodies with identical F(ab')2 fragments specific for the hapten 5-iodo-4-hydroxyl-3-nitrophenacetyl (NIP), but with different human Fc parts (gamma 1, gamma 2, gamma 3, gamma 4, epsilon), was used to compare the role of IgG and IgE antibodies in antigen presentation by human Epstein-Barr virus (EBV) B cells. Two or three molecules of NIP were coupled to one molecule of Der pI (Der pI-(3)NIP), a major allergen of Dermatophagoides pteronyssinus. Both monomeric IgG and performed complexes of various Der pI/IgG ratios failed to bind significantly to the Fc receptor for IgG on B cells (Fc gamma RII; CD32). Binding of IgG3 (> IgG1)-containing complexes (optimal ratio of antigen to antibody = 1:1) could be enhanced by increasing the number of haptens per Der pI molecule to nine or more. However, antigen presentation mediated by IgG and CD32 was not seen with either pulsed B cells or B cells that were allowed to capture the IgG complexes during the whole stimulation period. IgE binding to CD23 and subsequent IgE-mediated antigen presentation was seen under all conditions tested. Even monomeric immune complexes (IC) (Der pI-(3)NIP/IgE), in the absence of CD23 cross-linking, induced an immune response. As the number of natural epitopes for human antibodies on Der pI was less than five, we conclude that, in vivo, complexes consisting of Der pI/IgG will be directed to antigen-presenting cells expressing the high-affinity receptor for IgG (CD64), whereas IgE will allow antigen presentation by CD23-expressing cells, including B cells.

Allergens↗

Skin disease-related T cells bind to endothelial selectins: expression of cutaneous lymphocyte antigen (CLA) predicts E-selectin but not P-selectin binding.

Cutaneous lymphocyte antigen (CLA), defined by the HECA-452 antibody, is a cell surface glycoprotein found on a subset of T cells in peripheral blood that binds specifically to E-selectin. This marker is present on the majority of T cells at sites of cutaneous inflammation and immune responses. Based upon such evidence, an association between T cell CLA expression and skin homing has been proposed. To understand better this relationship, we asked whether putative disease-related, antigen-specific T cells expressed CLA. In this study, we employed T helper type 2 (TH2) T cell clones specific for house dust mite (Dermatophagoides pteronyssinus) antigens. These cells were derived from challenged skin of an individual known to react positively to epicutaneous challenge with this agent. In this study, we show that these cloned T cells showed very high homogeneous expression of CLA (nearly 500-fold higher than T cell clones derived from peripheral blood) and bound specifically to recombinant E-selectin. The CLA molecule on these cells was identified not only by HECA-452, but also by CSLEX-1, indicating that it contained sialyl-Le(x) (S-Le(x)) determinants. T cells cloned under similar conditions from peripheral blood were CLA negative or low and bound poorly to E-selectin. Surprisingly, both skin and blood clones bound comparably to P-selectin. This binding was independent of S-Le(x) or CLA expression. We conclude that in sensitized individuals, antigen-specific T cells expressing high levels of CLA localize in skin promptly after epicutaneous challenge. This localization is likely to involve the interaction of S-Le(x) determinants on the CLA molecule with E-selectin on the dermal microvasculature. We further conclude that T cells can interest with P-selectin on endothelium and that S-Le(x) does not appear to be necessary for this interaction.

Animals↗

Different growth factor requirements for human Th2 cells may reflect in vivo induced anergy.

We previously reported the isolation of allergen-specific Th2 lines and clones from atopy patch test (APT) sites of atopic dermatitis (AD) patients. Upon stimulation with allergen or anti-CD3+ phorbol myristate acetate (PMA) IL-4 was released with or without IL-5, while no (or extremely low concentrations of) IL-2 and interferon-gamma (IFN-gamma) were detectable. A high IL-4/IFN-gamma ratio facilitates production of allergen-specific IgE, of which high levels are observed in AD patients. Here we show that the above mentioned Th2 cells are notably different from murine Th2 cells. Not IL-4, which is the autocrine acting growth factor for murine Th2 cells, but IL-2 was needed for proliferation of these human APT-derived Th2 lines and clones. Of significance, unless exogenous IL-2 was added, no proliferative response to allergen, presented by Epstein-Barr virus-transformed B (EBV-B) cells, non-T cells or IgE-bearing Langerhans cells (LC), occurred. Lack of proliferation and IL-2 production after full T cell receptor (TCR) triggering is a characteristic first described for in vitro anergized T cells. However, like the clones we describe in this study, anergic T cells may retain production of cytokines other than IL-2. A further resemblance between anergic T cells and the human Th2 clones reported here is that IL-4 can enhance IL-2-driven proliferation, but is not capable of inducing T cell growth by itself. The absence of IL-4-driven proliferation differentiates human Th2 cells from murine Th2 cells. Both produce IL-4 when stimulated in a cognate fashion, but only murine Th2 cells will proliferate. We conclude that the presently reported human Th2 cells are different from murine Th2 cells, in that they need other T cells to produce IL-2 required for their expansion. Moreover, the Th2 cells phenotypically resemble anergic T cells. As yet, however, we have no clue as to whether these features account for the current Th2 cells only or for human Th2 cells in general. We hypothesize that the Th2 phenotype of AD skin-derived, allergen-specific T cells may be induced in vivo by LC, which lack CD80, and therefore do not provide secondary signals through CD28-CD80 interaction.

Adult↗

Antigen focusing by specific monomeric immunoglobulin E bound to CD23 on Epstein-Barr virus-transformed B cells.

Monomeric IgE bound to the low-affinity receptor for IgE (FcERII-CD23) on EBV-transformed human B cells selectively enhances binding of antigen and therefore presentation to specific T-cell clones. To demonstrate the role of monomeric IgE in antigen focusing, we have made use of a system consisting of human T-cell clones specific for Der-P1 (major allergen of the Dermathophagoides pteronyssinus), Der-P1 coupled to NIP (Der-P1-NIP), and the commercially available chimeric (human-murine) monoclonal IgE antibodies with specificity for the hapten NIP. We have found that monomeric IgE binds to CD23 and remains detectable on the surface of the B cells for a period of at least 16 hours at 37 degrees C. Pulsing of these IgE-anti-NIP (1 microgram/ml) treated B cells for 1 hour at 37 degrees C with low amounts (10 ng/ml) of Der-P1-NIP antigen allows the B cells to stimulate Der-P1-specific T cells. Even with IgE concentrations as low as 20 ng/ml, which were not detectable by immunofluorescence, we were able to induce a significant T-cell response. Furthermore, ongoing specific T-cell-B-cell interactions were not inhibited by the presence of high concentrations of nonspecific IgE molecules (incubated with up to 25 micrograms/ml) on the surface of the B cells. Our data confirm the hypothesis that IgE, bound by either CD23 or the high-affinity receptor for IgE, potentiates the immune response. Therefore, IgE may be seen as the fourth general mechanism for antigen capture by (nonspecific) antigen-presenting cells.

Animals↗

Induction of IgE and IgG1 in human B cell cultures with staphylococcal superantigens: role of helper T cell interaction, resistance to interferon-gamma.

Non-antigen-specific activation of human B lymphocytes for IgE production in vitro requires the presence of interleukin 4 and non-cognate physical interaction with T cells. The latter can be replaced by antibodies directed against the B cells' CD40 structure. Antigen-specific induction of immunoglobulin responses, including IgE, is difficult in human lymphocyte cultures. Thus, we developed a model system which might resemble physiological B lymphocyte stimulation by antigen. Co-cultures of purified tonsillar B cells from normal donors with non-HLA matched T helper clones obtained from the skin of atopic dermatitis patients produced significant levels of IgE and IgG1 after stimulation with appropriate types of staphylococcal exotoxins, provided that IL-4 was also induced in the T cells. Such responses were further enhanced by addition of low doses of anti-CD40 antibodies. Concentrations of anti-CD40, optimal for stimulation of B cells in the absence of T helper lymphocytes, were less effective in this regard and even inhibitory in some experiments. Most powerful immunoglobulin induction was observed when the cultures were spiked with low amounts of IL-4 and anti-CD40 which did not elicit substantial immunoglobulin production in the absence of the staphylococcal exotoxins. Induction of IL-2 in T/B cell cultures by superantigens without production of appreciable quantities of IL-4 provoked considerable IgG1 titer but no IgE. High amounts of interferon-gamma generated by the T cells in vitro in the presence of superantigens did not appear to interfere with immunoglobulin induction. Addition of recombinant interferon at the beginning of the culture period at doses which effectively suppressed IL-4 plus anti-CD40 induced immunoglobulin responses did not inhibit T helper and superantigen dependent B cell activation. Superantigen mediated B cell stimulation for immunoglobulin production was dependent on cell-cell contact. The experimental results presented suggest that this cellular interaction did not necessarily involve T-B cell bridging by superantigens.

Antigens, CD↗

Skin-derived aeroallergen-specific T-cell clones of Th2 phenotype in patients with atopic dermatitis.

T-cell lines have been derived from aeroallergen-induced eczematous patch test sites of patients with atopic dermatitis (AD). Biopsy specimens were obtained 24 hours after allergen application to the skin, and only in vivo-activated T cells were propagated. From one patient, the T-cell lines were subcloned at 0.3 cells per well. With allergen-induced interleukin (IL) production, all clones tested (n = 13) were found to be specific for the allergen, producing IL-4 and granulocyte-macrophage-colony-stimulating factor. No IL-2 or interferon-gamma was found. The allergen-specific proliferative response of these clones, although the response was dependent on exogenous IL-2 or IL-4, also proved that all clones were allergen specific. Under optimal stimulation (aCD3 plus phorbol myristate acetate), 15% of the clones appeared to be of Th0 phenotype and 70% of Th2 phenotype. In 15% of the clones, IL-4 was produced in the absence of IL-2, IL-5, or interferon-gamma. Supernatants of all clones tested induced IgE production by B cells from normal non-atopic donors. The T-cell lines of the other patient demonstrated similar results; allergen-specific proliferation was dependent on exogenous IL-2 or IL-4 and stimulation with aCD3 plus phorbol myristate acetate demonstrated that the T cells in these lines were of the Th2 phenotype. In conclusion, our data reveal that, in AD, percutaneous sensitization to aeroallergens may occur and indicate that allergen-specific Th2 type T cells may be responsible for the high levels of (specific) IgE found in 80% of patients with AD.

Allergens↗

IgE-positive Langerhans cells and Th2 allergen-specific T cells in atopic dermatitis.

In atopic dermatitis (AD) IgE-positive Langerhans cells (LC) may be present in the epidermis. These LC are able to capture allergens by means of their specific IgE, inducing an allergen-specific T-cell response in autologous peripheral blood T cells. Epicutaneous patch testing (EPT) may induce an eczematous reaction when IgE is present on the LC. Thus, both in vivo and in vitro, it appears that IgE may be crucial for induction of allergen-specific T-cell responses. Indeed, the cloning of infiltrating T cells from a positive 12-h EPT produced allergen-specific T cells, wheras no in vivo activated bystander T cells have yet been cloned. Moreover, greater than 85% of the T cells cloned were of Th2 phenotype after anti-CD3 and phorbol myristate acetate stimulation, whereas all clones were Th2 after allergen-specific stimulation, and they were able to induce IgE production in normal B cells. This completes the circle of events, because IgE produced by peripheral B cells may bind to LC and facilitate new allergen-specific reactions in the skin.

Allergens↗

A prospective study of in vitro anti-HBs producing B cells (spot-ELISA) following primary and supplementary vaccination with a recombinant hepatitis B vaccine in insulin dependent diabetic patients and matched controls.

A prospective study of the immune response after hepatitis B vaccination was carried out in 32 insulin dependent diabetes mellitus (IDDM) patients and their age and sex matched healthy controls. A sensitive, immunoenzymatic technique was used, able to detect in vitro specific antibody production by mitogen stimulated individual B cells. In-vivo serologic response after vaccination with a standard scheme (0, 1 and 6 months) of 20 micrograms recombinant hepatitis B (HB) vaccine was significantly impaired in the IDDM patients both with respect to the number of nonresponders (25 versus 3%, P less than 0.05) and antibody titers reached (1,377 vs. 9,060 IU/L, P less than 0.05). The total number of in vitro IgM- and IgG-class immunoglobulin producing B cells as detected by the spot-ELISA, was found to be comparable in both groups. Specific IgG anti-HBs (and to a lesser extent IgM anti-HBs) showed impairment in the diabetic population as a whole. The number of IgG anti-HBs producing B cells was markedly depressed one month following vaccination, which is probably a reflection of homing of B cells outside the circulation. Responding subjects were identified early during their vaccination by the detection of in vitro anti-HBs production using the spot-ELISA. Non-responding healthy subjects and IDDM patients as a group showed a low number of IgG anti-HBs spots, suggesting a reduced specific memory B cell frequency. In 13 of 15 hypo- and nonresponders with positive IgG anti-HBs spots supplementary vaccination(s) resulted in improved anti-HBs levels.

Adult↗

IgE: an immunoglobulin specialized in antigen capture?

IgE bound to the low-affinity receptor for immunoglobulin E (Fc epsilon R) on antigen-presenting cells (APCs) may permit binding of antigens to APCs prior to their processing and presentation. Here, G. C. Mudde and colleagues argue that the unique characteristics of IgE serological responses together with the distribution of Fc epsilon RII (CD23) on APCs are consistent with this novel function of IgE. The concept of IgE involvement in antigen capture is discussed in relation to Langerhans cells, B cells and follicular dendritic cells.

Animals↗

The Langerhans cell: an underestimated cell in atopic disease.

Langerhans cells (LC) are very potent antigen-presenting cells. In atopic disorders such as allergic rhinitis and atopic dermatitis LC are known to bear IgE surface molecules. IgE-positive LC can bind allergen and present it to T lymphocytes to induce an allergen-specific T-cell response and IgE synthesis. Therefore, IgE-bearing LC might play an important role in the triggering of the immune system to maintain ongoing IgE synthesis. The importance of the IgE-bearing LC in atopy has not been assessed but deserves further investigation to find out more about the part played by these cells, not only in the atopic disorders described here but also in others such as gastrointestinal allergy and allergic asthma.

Dermatitis, Atopic↗

Early detection of active cytomegalovirus (CMV) infection after heart and kidney transplantation by testing for immediate early antigenemia and influence of cellular immunity on the occurrence of CMV infection.

To determine the incidence of active cytomegalovirus (CMV) infection after organ transplantation and its relationship with the immune system, 55 renal and 14 cardiac transplant recipients were closely monitored for active CMV infection (expression of CMV immediate early antigen in granulocytes--antigenemia--and positive cultures) and immune parameters. All 19 CMV-seronegative recipients with seronegative donors remained seronegative, showing that no CMV transmission occurred by leukocyte-depleted blood products. Primary CMV infection occurred in 4 of 11 (36%) patients with positive donors and was symptomatic in 1 (9%) patient. Active CMV infection was found in 29 of 39 (74%) seropositive patients and was symptomatic in 3 (8%) patients. CMV antigenemia was always the first indication of active CMV infection (antigenemia, on average, at day 45 +/- 15; immunoglobulin G rise at day 71 +/- 36; and positive cultures at day 70 +/- 17). Cellular immunity, as measured by lymphocyte proliferation (LPT), proved to be of importance in the prevention of active CMV infection, as 14 of 15 patients with negative LPT obtained active CMV infections with antigenemia and positive cultures, whereas 1 of 10 patients with positive LPT did so (P less than 0.0001).

Antibodies, Monoclonal↗

Allergen presentation by epidermal Langerhans' cells from patients with atopic dermatitis is mediated by IgE.

To investigate the role of IgE-bearing Langerhans' cells (LC) from atopic dermatitis (AD) patients in antigen presentation, IgE+LC and non-IgE bearing LC (IgE-LC) from AD patients were investigated for their antigen-presenting capacity and compared to antigen-presenting cells (APC) from peripheral blood. The T-cell response to Candida albicans, using IgE+LC from AD patients as APC, was in the same range as with IgE-LC. Also, the T-cell response to Candida with autologous APC from peripheral blood did not significantly differ between these groups. In contrast to this finding, the T-cell response to house dust allergen (HDA) was dependent on the type of APC used. If non-T cells from peripheral blood were used as APC, both AD patients and controls responded to HDA. However, when LC were used as APC, a T-cell response to HDA was only observed in the presence of IgE+LC. IgE-LC from AD patients or LC from normal controls were unable to present HDA. Preincubation of IgE+LC with anti-IgE or anti-kappa/lambda antibodies inhibited HDA-induced T-cell proliferation, whereas the response to Candida was not affected. These in vitro results, which demonstrate the necessity of cell-bound IgE on LC for the presentation of aero-allergens, strongly correlate with the in vivo presence of a positive delayed patch reaction to the same antigens. When the LC of a patient appeared to be IgE-, the in vitro proliferative response as well as, in most cases, the in vivo patch test reaction to the same antigens was negative. In conclusion, these experiments demonstrate that there are at least two different mechanisms by which LC capture antigens for antigen presentation. In one of them cell-bound IgE, as can be demonstrated on LC from AD patients, plays a crucial role. The binding and presentation of HDA by APC from peripheral blood can take place independently of cell-bound IgE. Candida can be presented by both types of APC in the absence of IgE.

Allergens↗

Is booster injection with hepatitis B vaccine necessary in healthy responders? A study of the immune response.

Loss of protective anti-HBs levels (less than 10 IU/l) was noted in 5 (13%) of 38 well documented healthy responders to hepatitis B vaccine 30 months after completing the initial standard vaccination series. Revaccination with a single booster injection of 20 micrograms hepatitis B vaccine intramuscularly resulted in anti-HBs levels well above those initially obtained, thus confirming considerable immunological memory. Both decline prior to and rise after booster injection were proportional to the anti-HBs level obtained initially. The antibody production after a single booster injection was closely monitored in 13 individuals. A swift response was observed from day 4 onwards in all subjects. Based on passive immunization data and in vitro infection of human hepatocytes, this time delay is likely to permit infection of hepatocytes. Therefore, until further data on longterm follow-up of vaccinated in individuals in whom anti-HBs levels have dropped to less than 10 IU/l reveal compelling evidence to the contrary, booster injections remain mandatory for those individuals at risk.

Adult↗

The influence of T cell depletion on recovery of T cell proliferation to herpesviruses and Candida after allogeneic bone marrow transplantation.

To test the influence of T cell depletion of the marrow in allogeneic bone marrow transplantation on functional T cell recovery, in vitro lymphocyte proliferation tests (LPTs) to microbial antigens were regularly performed in 23 recipients of normal BM and in 25 patients receiving BM with a fixed low number of T cells (1 x 10(5) T cells/kg body weight; recipients of T-depleted BM). The long-term recovery of positive LPT to at least 1 of the 4 tested microbial antigens--Candida, herpes simplex virus (HSV), varicella-zoster virus (VZV), and cytomegalovirus--was nearly similar in both groups: 16/23 versus 18/25. Recovery of LPT to Candida and HSV in the first 3 months appeared to be greatly influenced by prophylactic measures; only 2/23 recipients of normal BM, receiving amphotericin B, showed a positive LPT to Candida versus 13/25 recipients of T-depleted BM (P less than 0.01). In contrast, only 1/23 seropositive recipients of T-depleted BM, receiving acyclovir, showed a positive LPT to HSV versus 9/22 recipients of normal BM (P less than 0.05). A positive LPT to CMV in the first 3 months was found in 9/9 seropositive recipients of normal BM, versus in 5/11 seropositive recipients of T-depleted BM (P less than 0.05). Five of the 6 patients with a negative LPT died of CMV-interstitial pneumonia versus 1/14 with positive LPT (P less than 0.01). We conclude that in CMV-seropositive recipients of allogeneic BM, T cell depletion of the graft affects the early recovery of T cell proliferation to CMV, which is associated with a higher risk of fatal CMV-interstitial pneumonia.

Antigens, Fungal↗