Experimental Pulmonary and Inflammatory Research (EXPIRE), Department of Pathology & Medical Biology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Groningen Research Institute of Asthma and COPD (GRIAC), University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Allergy. 2018 Apr;73(4):862-874. doi: 10.1111/all.13382. Epub 2018 Jan 31.
Allergen-specific immunotherapy can induce long-term suppression of allergic symptoms, reduce medication use, and prevent exacerbations of allergic rhinitis and asthma. Current treatment is based on crude allergen extracts, which contain immunostimulatory components such as β-glucans, chitins, and endotoxin. Use of purified or recombinant allergens might therefore increase efficacy of treatment.
Here, we test application of purified natural group 1 and 2 allergens from Dermatophagoides pteronyssinus (Der p) for subcutaneous immunotherapy (SCIT) treatment in a house dust mite (HDM)-driven mouse model of allergic asthma.
HDM-sensitized mice received SCIT with crude HDM extract, a mixture of purified Der p1 and 2 (DerP1/2), or placebo. Upon challenges, we measured specific immunoglobulin responses, allergen-induced ear swelling response (ESR), airway hyperresponsiveness (AHR), and inflammation in bronchoalveolar lavage fluid (BAL) and lung tissue.
ESR measurement shows suppression of early allergic response in HDM-SCIT- and DerP1/2-SCIT-treated mice. Both HDM-SCIT and DerP1/2-SCIT are able to suppress AHR and eosinophilic inflammation. In contrast, only DerP1/2-SCIT is able to significantly suppress type 2 cytokines in lung tissue and BAL fluid. Moreover, DerP1/2-SCIT treatment is uniquely able suppress CCL20 and showed a trend toward suppression of IL-33, CCL17 and eotaxin levels in lung tissue.
Taken together, these data show that purified DerP1/2-SCIT is able to not only suppress AHR and inflammation, but also has superior activity toward suppression of Th2 cells and HDM-induced activation of lung structural cells including airway epithelium.
We postulate that treatment with purified natural major allergens derived from HDM will likely increase clinical efficacy of SCIT.
变应原特异性免疫疗法可诱导长期抑制过敏症状,减少药物使用,并预防过敏性鼻炎和哮喘的恶化。目前的治疗方法基于粗过敏原提取物,其中包含免疫刺激成分,如β-葡聚糖、几丁质和内毒素。因此,使用纯化或重组过敏原可能会提高治疗效果。
在这里,我们测试了从屋尘螨(HDM)中提取的纯化天然 1 组和 2 组过敏原(Der p)在 HDM 驱动的过敏性哮喘小鼠模型中的皮下免疫治疗(SCIT)治疗中的应用。
HDM 致敏的小鼠接受了粗 HDM 提取物、纯化的 Der p1 和 2(DerP1/2)混合物或安慰剂的 SCIT。在挑战时,我们测量了特异性免疫球蛋白反应、过敏原诱导的耳部肿胀反应(ESR)、气道高反应性(AHR)以及支气管肺泡灌洗液(BAL)和肺组织中的炎症。
ESR 测量显示,HDM-SCIT 和 DerP1/2-SCIT 治疗的小鼠早期过敏反应受到抑制。HDM-SCIT 和 DerP1/2-SCIT 均能抑制 AHR 和嗜酸性粒细胞炎症。相比之下,只有 DerP1/2-SCIT 能够显著抑制肺组织和 BAL 液中的 2 型细胞因子。此外,DerP1/2-SCIT 治疗能够特异性地抑制 CCL20,并显示出抑制肺组织中 IL-33、CCL17 和 eotaxin 水平的趋势。
综上所述,这些数据表明,纯化的 DerP1/2-SCIT 不仅能够抑制 AHR 和炎症,而且还具有抑制 Th2 细胞和 HDM 诱导的肺结构细胞(包括气道上皮细胞)激活的优越活性。
我们推测,用源自 HDM 的纯化天然主要过敏原治疗可能会提高 SCIT 的临床疗效。