Campana Raffaela, Moritz Katharina, Marth Katharina, Neubauer Angela, Huber Hans, Henning Rainer, Blatt Katharina, Hoermann Gregor, Brodie Tess M, Kaider Alexandra, Valent Peter, Sallusto Federica, Wöhrl Stefan, Valenta Rudolf
Division of Immunopathology, Department of Pathophysiology, Center of Physiology and Pathophysiology, Vienna General Hospital (AKH), Medical University of Vienna, Vienna, Austria.
Division of Immunology, Allergy and Infectious Diseases (DIAID), Department of Dermatology, Vienna General Hospital (AKH), Medical University of Vienna, Vienna, Austria.
J Allergy Clin Immunol. 2016 Feb;137(2):601-609.e8. doi: 10.1016/j.jaci.2015.08.042. Epub 2015 Oct 28.
Late allergic reactions are common in the course of allergen-specific immunotherapy and even occur with allergy vaccines with reduced IgE reactivity.
We sought to study atopy patch test (APT) reactions and T-cell responses to the recombinant birch pollen allergen Bet v 1 and recombinant hypoallergenic T-cell epitope-containing Bet v 1 fragments in patients with birch pollen allergy with and without atopic dermatitis (AD).
A clinical study was conducted in 15 patients with birch pollen allergy with AD (group 1), 5 patients with birch pollen allergy without AD (group 2), 5 allergic patients without birch pollen allergy (group 3), and 5 nonallergic subjects (group 4) by performing skin prick tests and APTs with rBet v 1 and hypoallergenic rBet v 1 fragments. T-cell, cutaneous lymphocyte antigen (CLA)(+) and CCR4(+) T-cell and cytokine responses were studied by thymidine uptake, carboxyfluorescein diacetate succinimidyl ester staining, and Luminex technology, respectively.
rBet v 1 and hypoallergenic rBet v 1 fragments induced APT reactions in not only most of the patients with birch pollen allergy with AD (11/15) but also in most of those without AD (4/5). Patients with birch pollen allergy with AD had higher Bet v 1-specific proliferation of CLA(+) and CCR4(+) T cells compared with patients with birch pollen allergy without AD. There were no differences in Bet v 1-specific CLA(+) and CCR4(+) proliferation and cytokine secretion in patients with and without APT reactions.
Hypoallergenic rBet v 1 fragments induce T cell-dependent late reactions not only in patients with birch pollen allergy with AD but also in those without AD, which can be determined based on APT results but not based on in vitro parameters.
迟发性过敏反应在变应原特异性免疫治疗过程中很常见，甚至在具有降低的IgE反应性的过敏疫苗中也会出现。
我们试图研究桦树花粉过敏患者（有或无特应性皮炎（AD））对重组桦树花粉变应原Bet v 1和含重组低变应原性T细胞表位的Bet v 1片段的特应性斑贴试验（APT）反应和T细胞反应。
对15例患有AD的桦树花粉过敏患者（第1组）、5例无AD的桦树花粉过敏患者（第2组）、5例无桦树花粉过敏的过敏患者（第3组）和5例非过敏受试者（第4组）进行了一项临床研究，用重组Bet v 1和低变应原性重组Bet v 1片段进行皮肤点刺试验和APT。分别通过胸苷摄取、羧基荧光素二乙酸琥珀酰亚胺酯染色和Luminex技术研究T细胞、皮肤淋巴细胞抗原（CLA）（+）和CCR4（+）T细胞及细胞因子反应。
重组Bet v 1和低变应原性重组Bet v 1片段不仅在大多数患有AD的桦树花粉过敏患者（11/15）中诱导了APT反应，而且在大多数无AD的患者（4/5）中也诱导了反应。与无AD的桦树花粉过敏患者相比，患有AD的桦树花粉过敏患者的CLA（+）和CCR4（+）T细胞的Bet v 1特异性增殖更高。有或无APT反应的患者在Bet v 1特异性CLA（+）和CCR4（+）增殖及细胞因子分泌方面没有差异。
低变应原性重组Bet v 1片段不仅在患有AD的桦树花粉过敏患者中，而且在无AD的患者中均诱导T细胞依赖性迟发反应，这可以根据APT结果而非体外参数来确定。
