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Biomedical subjects

S O Stapel

Publications and source records attributed to S O Stapel.

At least 19 recordsLinked to original sources

The role of IL-13 in IgE synthesis by allergic asthma patients.

IgE antibodies play a crucial role in allergic type I reactions. Only IL-4 and IL-13 are able to induce an immunoglobulin isotype switch to IgE in B cells. A major question is to what extent these cytokines contribute to the production of IgE in allergic patients. To address this question we used an in vitro culture system in which the production of IgE is dependent on endogenously produced IL-4 and IL-13. In cultures of purified T and B cells from allergic asthma patients and non-atopic controls, T cells were polyclonally stimulated to obtain IL-4, IL-13 and subsequently IgE secretion. The absolute amount of IgE produced was not significantly different between patients and controls. When neutralizing IL-4 antibodies were included during culture, the production of IgE was dramatically inhibited in both patients and controls (production of IgE was reduced to 12%). However, neutralization of IL-13 led to a significantly stronger inhibition of IgE production in the patient group: production of IgE was reduced to 23 +/- 3% versus 50 +/- 10% in the control group. Corresponding with these results, we also observed a higher production of IL-13 by the patients, while the production of IL-4 was not significantly different. A more detailed analysis of the production of IL-13 revealed that patients' T cells were less sensitive to a negative signal controlling IL-13 production. Our results indicate that, at least in vitro, IgE production in allergic asthma patients is more dependent on IL-13 than in non-atopics, due to enhanced IL-13 production and to enhanced IgE production in response to IL-13.

Adult

Reduced production of IL-12 and IL-12-dependent IFN-gamma release in patients with allergic asthma.

In atopic patients, allergen-specific T cells have acquired the Th2 phenotype, which is considered to be responsible for the class switch to IgE Ab formation. Because IL-12 is a key cytokine for the induction of Th1 responses, a reduced capacity to produce this cytokine could lead to aberrant Th2 development. Therefore, we examined the production of IL-12 in whole blood cultures from patients with allergic asthma (n = 15) in comparison with nonatopic control subjects (n = 15) to different stimuli. After stimulation with Staphylococcus aureus Cowan I strain (SAC) we observed a 2.6-fold reduction of IL-12 p70 production in the patient group (p < 0.005). This was not due to a general failure of monocytes from these patients to produce cytokines, because the production of IL-6 was normal. SAC also induced the production of IFN-gamma, which was blocked by neutralization of IL-12. In line with the reduced levels of IL-12 secretion, the patient group showed a 3-fold reduction of IL-12-dependent IFN-gamma production (p < 0.005). The amounts of IL-12 and IFN-gamma were positively correlated in both the patient (R = 0.51 at 0.05% SAC and R = 0.64 at 0.01% SAC) and the control groups (R = 0.64 at 0.05% SAC and R = 0.70 at 0.01% SAC). The IFN-gamma:IL-12 ratio was not different between patients and control subjects, indicating a normal response to IL-12. Diminished production of IL-12 and IFN-gamma could not be explained by an increased production of IL-10, because in SAC-stimulated cultures IL-10 was hardly induced in both groups. Furthermore, after stimulation with Escherichia coli, the production of IL-10 was similar in patients and control subjects.

Adult

Measurement of IgE antibodies against purified grass pollen allergens (Lol p 1, 2, 3 and 5) during immunotherapy.

BACKGROUND: IgE titres tend to rise early after the start of immunotherapy, followed by a decline to pre-immunotherapy levels or lower. OBJECTIVES: We were interested to know whether the early increase in IgE antibodies includes new specificities of IgE, and whether these responses persist. METHODS: Sera of 64 patients undergoing grass pollen immunotherapy were tested for IgE against four purified grass pollen allergens: Lol p 1, 2, 3, and 5. At least two serum samples were taken, one before the start of therapy and one between 5 and 18 months after the first immunization (mean: 10 months). RESULTS: The mean IgE responses to Lol p 1, 2 and 3 showed a moderate but not significant increase. In contrast, the mean IgE response to Lol p 5 showed a significant decrease of > 30%. IgE against total Lohum perenne pollen extract moderately increased (> 20%), showing that a RAST for total pollen is not always indicative for the development of IgE against its major allergens. For > 40% of the patients it was found that IgE against one or more of the four allergens increased, while IgE against the remaining allergen(s) decreased. For 10 sera the ratio of IgE titres against at least two allergens changed by at least a factor of 5. The changes in specific IgE also included conversions from negative (< 0.1 RU) to positive (0.6 to 5.0 RU) for five patients. For two patients, the induction of these 'new' IgE antibodies against major allergens was shown to result in a response that was persistent over several years. CONCLUSION: Although active induction of new IgE specificities by immunotherapy was not really proven, the observations in this study indicate that monitoring of IgE against purified (major) allergens is necessary to evaluate changes in specific IgE in a reliable way.

Allergens

High frequency of celiac disease in Down syndrome.

We screened 115 children with Down syndrome for celiac disease, using antigliadin, antiendomysium, and antireticulin serum antibodies and an intestinal permeability test. Celiac disease was diagnosed in eight children, giving a frequency of 7.0%. We recommend screening for celiac disease in all persons with Down syndrome, with the use of at least the antiendomysium antibody determination.

Autoantibodies

The relationship between RAST and skin test results in patients with asthma or rhinitis: a quantitative study with purified major allergens.

BACKGROUND: Study of the relationship between skin test results and IgE antibody levels is seriously hampered by the use of conventional allergen extracts because the precise amount of relevant allergen for each patient is unknown. OBJECTIVE: This study was designed to investigate skin reactivity with purified major allergens and to assess the relation with serum levels of IgE antibodies and to determine which additional factors contribute to the skin test result. METHODS: We used five purified major allergens (Der p 1, Der p 2, Fel d 1, Lol p 1, and Lol p 5) in skin tests, RASTs, and histamine release tests in 43 multisensitized patients with asthma or rhinitis. RESULTS: The differences in biologic activity of the five major allergens at a given level of specific IgE are within one order of magnitude. A significant residual variation remains in the correlation between skin test results and levels of IgE antibodies, which cannot be explained by imprecision of both tests (Pearson log skin test vs log specific IgE: r = 0.46-0.92). With similar levels of specific IgE, the amount of allergen that is required for a positive skin test result may differ by as much as a factor of 100 between patients. The amount of total IgE in serum contributes significantly to the skin test result. High values of total IgE are accompanied by a lower skin reactivity for allergen. Within individuals, allergens that cause skin test results that deviate from the prediction based on IgE antibody level often show a similar deviation in the histamine release test. This indicates that the type of IgE response (i.e., affinity or epitope recognition pattern) contributes significantly to the skin test result. Skin reactivity for histamine does not significantly influence the skin reactions expressed as allergen threshold. However, increased skin reactions with higher allergen dosages depend on histamine reactivity. CONCLUSION: The major allergens tested show similar biologic activities. In addition to IgE antibody level, total serum IgE and type of IgE antibody response contribute significantly to the skin test threshold for allergens. Even in a system with purified allergens, IgE antibody levels and skin test results are not interchangeable as an indicator of the degree of allergic sensitization.

Adolescent

Screening for coeliac disease in Dutch children with associated diseases.

Our objective was to assess the frequency of coeliac disease in children with associated disorders in the province of "Zuid-Holland". The Netherlands. We therefore screened 115 children with Down's syndrome, 62 children with juvenile rheumatoid arthritis (JRA) and 46 children with diabetes mellitus for CD using the IgA-class of antigliadin, antiendomysium and antireticulin antibodies in serum, and a functional sugar absorption test. The antiendomysium antibody test was the screening test that performed the best. Every patient who has at least one positive test underwent a jejunal biopsy for the diagnosis of CD. No association could be demonstrated between CD and diabetes mellitus. The frequency of CD in Down's syndrome was 7.0%, which is much higher than that found from screening the general population. CD was found in one child with JRA (1.5%), who also had Down's syndrome. We recommend screening for CD in all persons with Down's syndrome using at least the antiendomysium antibody test.

Arthritis, Juvenile

Fel d 1-specific IgG antibodies induced by natural exposure have blocking activity in skin tests.

Cat-allergic patients frequently have IgG antibodies directed against Fel d 1. The aim of this study was to investigate whether these IgG antibodies influence the results of the skin test. Titrated skin tests were performed with Fel d 1 and IgE and IgG antibody levels were measured in 59 patients with cat allergy. Levels of specific IgG against Fel d 1 ranged from less than 0.25 to 3.5 microgram/ml. By means of a multiple regression analysis it was shown that the amount of specific IgG antibodies contributes significantly to the results of the skin test. Presence of specific IgG against Fel d 1 was accompanied by higher skin thresholds for Fel d 1. In conclusion, this study indicates that even low levels of specific IgG, induced by natural exposure to cat allergens, have a blocking effect on the early phase skin reaction.

Adolescent

The decay of house dust mite allergens, Der p I and Der p II, under natural conditions.

BACKGROUND: Fluctuations in the level of mite allergens in domestic house dust are the result of changes in the balance between synthesis, removal and decay. Purely physical forces as well as enzymatic degradation, mediated by house dust inhabiting microbes, may contribute to the decay of allergens in domestic dust. Knowledge about the speed of decay is essential for an understanding of the dynamics of allergen levels. OBJECTIVE: The present study is a quantitative assessment of the speed of decay at nine combinations of temperature (15 degrees C, 20 degrees C and 25 degrees C) and relative humidity (33%, 55% and 75%). METHODS: Samples of mite infested material of an old rug were stored at these temperature/relative humidity-combinations for 6, 12 or 18 months, after the mites were killed by either a freezing treatment or an acaricide (lindane). The microbes living in the rug presumably survive these treatments. Concentrations of Der p I and Der p II + Der f II, in extracts of the rug material, were measured by radio immunoassay. RESULTS: No significant changes in the levels of der p I and Der p II + Der f II, could be detected even after 1 1/2 year at a high temperature and humidity. CONCLUSION: These findings indicate that mite allergens can be extremely stable under normal domestic circumstances.

Allergens

Multiplicity of cross-reactive epitopes on Bet v I as detected with monoclonal antibodies and human IgE.

Six monoclonal antibodies against Bet v I, the major cross-reactive allergen of birch pollen (Betula verrucosa), were obtained. Four did not react with fruits, but two monoclonal antibodies (mAbs) (5H8 and 9C11) were reactive with apple and other fruits. These two cross-reactive antibodies reacted with identical or overlapping sites, but differed in their relative degree of cross-reactivity toward various fruits and hazelnut. Cross-reactive human IgE antibodies reacted with a nonoverlapping epitope, as indicated by results of a two-site radioimmunoassay (RIA) with the fruit-reactive mAb 9C11. By isoelectric focusing (IEF) in conjunction with immunoblotting, a maximum of seven isoforms could be distinguished. Depletion of birch-pollen extract for Bet v I with the most reactive mAb (7F7) removed approximately 95% of the IgE cross-reactivity between birch pollen and apple extract. The remaining 5% cross-reactive material was still capable of inhibiting the binding of IgE to apple allergen completely, and was reactive with mAbs 5H8 and 3C4. By means of IEF/immunoblot, it was shown that these mAbs recognize an isoform of Bet v I that is poorly, if at all, recognized by mAb 7F7. These results illustrate the heterogeneity of Bet v I, both with respect to the cross-reactive sites as well as to the backbone structure. This type of heterogeneity has possible implications for the use of monoclonal antibodies in allergen standardization.

Adult

Grass pollen immunotherapy induces highly cross-reactive IgG antibodies to group V allergen from different grass species.

Sera from two groups of patients receiving grass pollen immunotherapy were tested on IgG reactivity with group V allergen from six different grass species. One group of patients was treated with a mixture of 10 grass species, and the other with a mixture of five. Only Lolium perenne, Dactylis glomerata, and Phleum pratense were present in both mixtures. Although Anthoxanthum odoratum and Secale cereale were absent from the mixture of five, IgG responses to Ant o V and Sec c V were comparable in both patient groups. This reactivity was inhibited for 92-99% with L. perenne extract, illustrating the cross-reactive nature of the IgG antibodies. The presence of A. odoratum and S. cereale in the mixture resulted in only minor amounts of species-specific anti-group V IgG. These results indicate that application of just one grass species in immunotherapy might be sufficient to induce an IgG response that covers other relevant Gramineae species as well.

Allergens

Variability of crossreactivity of IgE antibodies to group I and V allergens in eight grass pollen species.

Crossreactivity to Dactylis glomerata, Festuca rubra, Phleum pratense, Anthoxanthum odoratum, Secale cereale, Zea mays, and Phragmites communis of IgE antibodies against Lol p I or Lol p V was investigated by means of RAST-inhibition. Within a group of sera the degree of crossreactivity was demonstrated to be highly variable. Individual sera were not always equally crossreactive to all pollen species. A high degree of crossreactivity for Group I allergens did not necessarily implicate the same for Group V. Group I and Group V representatives were found to be present in all eight species. It was demonstrated that within this group of grass species significant quantitative and qualitative differences exist, with respect to Group I and Group V allergens. Species with a low phylogenetic affinity to Lolium perenne, like Zea mays and Phragmites communis showed a very low degree of reactivity, even when measured with the most crossreactive sera. A higher taxonomic relationship however, did not always implicate a closer antigenic resemblance. Antigenically both allergens from Zea mays are more similar to Lol p I and Lol p V, than the analogues in Secale cereale.

Allergens

'Horoscope effect' not only for seasonal but also for non-seasonal allergens.

We report on the relation between the month of birth and the chance of developing an IgE antibody response as found in a study sample of 150,000 subjects. Our results confirm that for the three seasonal allergens birch pollen, grass pollen and house dust mite, an increased relative risk was found for subjects born up to 3 months before the main season for that allergen in The Netherlands. For cat and dog allergy an increased relative risk was found from November to January, perhaps reflecting increased exposure to these pets during the winter. Surprisingly, however, also for egg white and cow's milk a clearly increased relative risk was found from November to January and a decreased relative risk in May. These data support the hypothesis of a 'sensitive' period in the first months of life during which allergen exposure is more likely to prime for an allergy later in life. The results with the non-seasonal allergens suggest that another seasonal factor exists which early in life assists (or prevents) priming by allergen.

Allergens

Statistical analysis of IgE antibodies to the common inhalant allergens in 44,496 sera.

A statistical analysis of RAST screening of 44,496 sera, submitted in 1986 and 1987 for routine diagnostic allergic examination, was performed. The sera were tested on a fixed panel of allergens, regardless of the patient's history. The association of a positive RAST with age and month of birth was studied. It was concluded that among the inhalant allergens, house-dust mite was the most frequent sensitizer for all age groups, followed by grass pollen and cat dander. Sensitization to cat dander occurred twice as often as sensitization to dog dander. Among children less than 4 years of age, a different profile of sensitization was found, indoor allergens (mites, animal danders) being more important than outdoor allergens (pollen). Furthermore, we found that children born during December-February had a slightly but significantly greater chance of becoming sensitized to grass pollen compared with children born during September and November (P less than .05). Children born during July-September had a greater chance of becoming sensitized to house dust mite compared with children born during January-March (P less than .05). Finally, it was found that children born during October-December had a greater chance of becoming sensitized to dog dander compared with children born during March-May.

Administration, Inhalation

Characterization with monoclonal and polyclonal antibodies of a new major allergen from grass pollen in the group I molecular weight range.

We have purified a 24/25 kd allergen from orchard grass pollen (Dactylis glomerata) that has an allergenic potency similar to that of the major group I allergen. We provisionally named this allergen grass 4B1 after the monoclonal antibody used for its identification and purification. This monoclonal antibody was obtained by immunizing mice with whole Lolium perenne-pollen extract and by screening the antibody producing hybrids for reactivity with Dactylis glomerata-pollen extract. Grass 4B1 is physicochemically separable from the group I allergen. Polyclonal rabbit antibodies to grass 4B1 do not react with group I allergen or vice versa. Ninety-five sera with IgE antibodies to grass pollen were tested for IgE antibodies to grass 4B1, and greater than 90% was positive in this test. The median response to grass 4B1 was 70% of that to Lol p I.

Allergens