Department of Dermatology, University of Zurich, Zurich, Switzerland.
Mabylon AG, Schlieren, Switzerland.
Allergy. 2023 Jun;78(6):1605-1614. doi: 10.1111/all.15659. Epub 2023 Feb 7.
Peanut allergy is a type-I hypersensitivity immune reaction mediated by the binding of peanut allergens to IgE-FcεRI complexes on mast cells and basophils and by their subsequent cellular degranulation. Of all major peanut allergens, Ara h 2 is considered the most anaphylactic. With few options but allergen avoidance, effective treatment of allergic patients is needed. Passive immunotherapy (herein called PIT) based on prophylactic administration of peanut-specific monoclonal antibodies (mAbs) may present a promising treatment option for this under-served disease.
Fully human recombinant anti-peanut IgG mAbs were tested in mice sensitized to peanut allergen extract. Allergic mice received intravenous immunotherapy with anti-peanut Ara h 2-specific IgG1 or IgG4 mAbs cocktails, and were then challenged by a systemic injection of high-dose peanut allergen extract. The protection from allergic anaphylaxis was measured by monitoring the core body temperature.
PIT with peanut-specific mAbs was associated with a significant and dose-dependent reduction of anaphylactic reactions in peanut-sensitized mice challenged with peanut allergen extract. Complete protection was observed at doses approximately 0.3-0.6 mg mAbs. Mixtures of mAbs were more effective than single mAbs, and effective treatment could be obtained with mAbs of both IgG1 and IgG4 subclasses. The therapeutic effect of anti-Ara h 2 mAbs was based on allergen neutralization and independent of the Fcγ receptor and mast-cell inhibition.
This is the first report that shows that human-derived anti-peanut mAbs can prevent allergic anaphylaxis in mice. The study demonstrates that neutralizing allergenic epitopes on Ara h 2 by mAbs may represent a promising treatment option in peanut-allergy.
花生过敏是一种由 IgE-FcεRI 复合物与花生过敏原结合,并随后引起肥大细胞和嗜碱性粒细胞脱颗粒的 I 型超敏反应介导的免疫反应。在所有主要的花生过敏原中,Ara h 2 被认为是最具过敏反应性的。由于除了避免过敏原之外几乎没有其他选择,因此需要对过敏患者进行有效的治疗。基于预防性给予花生特异性单克隆抗体(mAbs)的被动免疫疗法(下文称为 PIT)可能为这种服务不足的疾病提供一种有前途的治疗选择。
在对花生过敏原提取物致敏的小鼠中测试了完全人源重组抗花生 IgG mAbs。过敏小鼠接受静脉免疫疗法,给予抗花生 Ara h 2 特异性 IgG1 或 IgG4 mAbs 鸡尾酒,然后通过全身注射高剂量的花生过敏原提取物进行挑战。通过监测核心体温来测量对过敏性过敏反应的保护作用。
用花生特异性 mAbs 进行 PIT 与花生致敏小鼠用花生过敏原提取物进行挑战时过敏反应的显著且剂量依赖性降低有关。在大约 0.3-0.6mg mAbs 剂量下观察到完全保护。mAbs 的混合物比单 mAbs 更有效,并且可以用 IgG1 和 IgG4 亚类的 mAbs 获得有效治疗。抗-Ara h 2 mAbs 的治疗效果基于过敏原中和,并且与 Fcγ 受体和肥大细胞抑制无关。
这是第一项表明人源抗花生 mAbs 可以预防小鼠过敏过敏反应的报告。该研究表明,mAbs 中和 Ara h 2 上的变应原表位可能是花生过敏的一种有前途的治疗选择。