Allergenic tropomyosins and their cross-reactivities

The ingestion or inhalation of some proteins may lead to adverse immune reactions. Allergens may trigger allergic reactions in genetically predisposed individuals when they are absorbed through the skin or make contact with mucous membranes. An allergic disease often deteriorates the quality of life and may sometimes be life-threatening due to anaphylactic shock. A number of allergens have been characterized from various multicellular organisms to date. It is thought to be reasonable to pay a special attention to the substance which is highly cross-reactive and which causes adverse responses in the molecules that are not sensitized but similar to the sensitized allergen. Tropomyosin has been described as an important food allergen in shrimp, lobster, crab, oysters, squid, and other invertebrates. Allergic reactions to shellfish and mollusks are often cross-reactive, which may be explained by the highly conserved amino acid sequences of tropomyosins among invertebrates, but vertebrate tropomyosins are not known to be allergenic. Several tropomyosins from domestic arthropods have been reported to be allergenic. Recently, it was suggested that an infection of helminthic parasites might lead to sensitization to tropomyosin and elicit allergic reactions to other invertebrates. Much effort has been made to characterize these allergenic tropomyosins from various sources. We will discuss the physicochemical characteristics and the potential application of tropomyosin for the diagnosis and therapeutics of allergic disorders.     

Serotonin; its possible relation to allergic disease

Increased amounts of serotonin as well as histamine have been found in the blood of animals during anaphylactic shock. Certain animals, particularly those in which antihistamines do not prevent anaphylaxis, have been found to have increased quantities of serotonin in the lung tissue during anaphylactic shock. Serotonin is a chemical derived from the amino acid tryptophan, which is widely distributed. It is excreted in the urine as the metabolite 5-hydroxyindoleacetic acid. Serotonin has been found in increased amounts in the blood of patients with carcinoids. The increase of serotonin in the blood and the finding of the excretory product in the urine has become a corroborative sign of the disease. The involvement of serotonin in the production of mental disease is evidenced by the effect of serotonin antagonists, which appear to influence mental behavior.That serotonin antagonists may be of ultimate value in the treatment of allergic disease is a possibility to be considered.     

SEROTONIN—Its Possible Relation to Allergic Disease

Increased amounts of serotonin as well as histamine have been found in the blood of animals during anaphylactic shock. Certain animals, particularly those in which antihistamines do not prevent anaphylaxis, have been found to have increased quantities of serotonin in the lung tissue during anaphylactic shock.Serotonin is a chemical derived from the amino acid tryptophan, which is widely distributed. It is excreted in the urine as the metabolite 5-hydroxyindoleacetic acid. Serotonin has been found in increased amounts in the blood of patients with carcinoids. The increase of serotonin in the blood and the finding of the excretory product in the urine has become a corroborative sign of the disease. The involvement of serotonin in the production of mental disease is evidenced by the effect of serotonin antagonists, which appear to influence mental behavior.That serotonin antagonists may be of ultimate value in the treatment of allergic disease is a possibility to be considered.     

Physico-chemical properties of microbial antigens and the immuno-allergic tests]

Experiments were conducted on guinea pigs sensitized by the delayed and immediate types of allergy. Different antigens obtained from the strain of Brucella abortus BA-19 were used for sensitization and the resolving action. Comparison of the resolving properties of the corpuscular, soluble (ultrasound treated) antigens and purified protein fractions, polysaccharide and RNA was carried out in the skin reactions of the immediate and delayed type, passive skin anaphylaxis, acute anaphylactic shock, and the Schults-Dale test. Immediate reactions to the purified protein fraction were weaker than those to the whole soluble antigen, by which the animals were sensitized. Polysaccharide and the RNA-fractions proved to be inactive in the allergic reactions.     

Focus on the agents most frequently responsible for perioperative anaphylaxis

Adverse reactions (ARs) to drugs administered during general anesthesia may be very severe and life-threatening, with a mortality rate ranging from 3 to 9%. The adverse reactions to drugs may be IgE and non-IgE-mediated. Neuromuscular blocking agents (NMBA) represent the first cause of perioperative reactions during general anesthesia followed by latex, antibiotics, hypnotic agents, opioids, colloids, dyes and antiseptics (chlorhexidine). All these substances (i.e. NMBA, anesthetics, antibiotics, latex devices) may cause severe systemic non-IgE-mediated reactions or fatal anaphylactic events even in the absence of any evident risk factor in the patient’s anamnesis. For this reason, in order to minimize perioperative anaphylactic reactions, it is important to have rapid, specific, sensitive in vitro diagnostic tests able to confirm the clinical diagnosis of acute anaphylaxis.     

Identification of a new IgE-binding epitope of peanut oleosin that cross-reacts with buckwheat

Peanut and buckwheat induce a severe allergic reaction, anaphylaxis, which is considered to be mediated by immunoglobulin E (IgE). We identified in this study a new IgE-binding epitope of the peanut allergen that cross-reacted with buckwheat. The phosphate-buffered saline-soluble fraction of buckwheat inhibited the binding between IgE and the peanut allergen. A cross-reactive peptide was isolated from the α-chymotrypsin hydrolysate of peanut. Based on the amino acid sequence and mass spectrometric analysis data, the peptide was identified as Ser-Asp-Gln-Thr-Arg-Thr-Gly-Tyr (SDQTRTGY); this sequence is identical to amino acids 2-9 in the N-terminal hydrophilic domain of oleosin 3 which is located on the surface of the lipid storage body. Synthetic SDQTRTGY was found to bind with IgE in the sera of all eight peanut-allergic patients tested. Since many foods of plant origin contain oleosin, the possibility of an anaphylactic cross-reaction in allergic patients should always be considered.     

Identification of a New IgE-Binding Epitope of Peanut Oleosin That Cross-Reacts with Buckwheat

Peanut and buckwheat induce a severe allergic reaction, anaphylaxis, which is considered to be mediated by immunoglobulin E (IgE). We identified in this study a new IgE-binding epitope of the peanut allergen that cross-reacted with buckwheat. The phosphate-buffered saline-soluble fraction of buckwheat inhibited the binding between IgE and the peanut allergen. A cross-reactive peptide was isolated from the α-chymotrypsin hydrolysate of peanut. Based on the amino acid sequence and mass spectrometric analysis data, the peptide was identified as Ser-Asp-Gln-Thr-Arg-Thr-Gly-Tyr (SDQTRTGY); this sequence is identical to amino acids 2–9 in the N-terminal hydrophilic domain of oleosin 3 which is located on the surface of the lipid storage body. Synthetic SDQTRTGY was found to bind with IgE in the sera of all eight peanut-allergic patients tested. Since many foods of plant origin contain oleosin, the possibility of an anaphylactic cross-reaction in allergic patients should always be considered.     

New Type of Allergic Asthma due to IgG “Reaginic” Antibody

This study was undertaken to examine the possibility that IgE is not the only immunoglobulin responsible for immediate allergic reactions. A group of asthmatics were investigated in whom immediate allergic reactivity of the bronchi to common inhalant allergens had been confirmed by provocation tests. Their sera were fractionated and the reaginic activity of the immunoglobulin classes was studied by passive cutaneous anaphylaxis testing in monkeys. The results showed that the immediate allergic reactions were due to IgE antibodies in most patients, but there was a group with reactions due to short-term anaphylactic IgG antibodies. It was not possible to inhibit the IgG-mediated responses with disodium cromoglycate. As these two groups had clearly different serum IgE levels the estimation of IgE provided an important guide to the management of these patients.     

Theanine is a candidate amino acid for pharmacological stabilization of mast cells

The increasing occurrences of allergic disorders may be attributed to exposure to environmental factors that contribute to the pathogenesis of allergy. The health benefits of green tea have been widely reported but are largely unsubstantiated. Theanine is the major amino acid present in green tea. In this study, we investigated the role of theanine in both IgE- and non- IgE-induced allergic response. Theanine inhibited compound 48/80-induced systemic anaphylactic shock and ear swelling responses. IgE-mediated passive cutaneous anaphylaxis was inhibited by the oral administration or pharmaceutical acupuncture of theanine. Histamine release from mast cells was decreased with the treatment of theanine. Theanine also repressed phorbol 12-myristate 13-acetate and calcium ionophore A23187-induced TNF-α, IL-1β, IL-6, and IL-8 secretion by suppressing NF-κB activation. Furthermore, theanine suppressed the activation of caspase-1 and the expression of receptor interacting protein-2. The current study demonstrates for the first time that theanine might possess mast cell-stabilizing capabilities.     

Justified concern or exaggerated fear: the risk of anaphylaxis in percutaneous treatment of cystic echinococcosis-a systematic literature review

Percutaneous treatment (PT) emerged in the mid-1980s as an alternative to surgery for selected cases of abdominal cystic echinococcosis (CE). Despite its efficacy and widespread use, the puncture of echinococcal cysts is still far from being universally accepted. One of the main reasons for this reluctance is the perceived risk of anaphylaxis linked to PTs. To quantify the risk of anaphylactic reactions and lethal anaphylaxis with PT, we systematically searched MEDLINE for publications on PT of CE and reviewed the PT-related complications. After including 124 publications published between 1980 and 2010, we collected a total number of 5943 PT procedures on 5517 hepatic and non-hepatic echinococcal cysts. Overall, two cases of lethal anaphylaxis and 99 reversible anaphylactic reactions were reported. Lethal anaphylaxis occurred in 0.03% of PT procedures, corresponding to 0.04% of treated cysts, while reversible allergic reactions complicated 1.7% of PTs, corresponding to 1.8% of treated echinococcal cysts. Analysis of the literature shows that lethal anaphylaxis related to percutaneous treatment of CE is an extremely rare event and is observed no more frequently than drug-related anaphylactic side effects.     

Contribution of classic and alternative effector pathways in peanut-induced anaphylactic responses

Food allergy affects approximately 5% of children and is the leading cause of hospitalization for anaphylactic reactions in westernized countries. However, the pathways of anaphylaxis in food allergy are still relatively unknown. We investigated the effector pathways of allergic and anaphylactic responses of different strains of mice in a clinical relevant model of peanut allergy. C3H/HeOuJ, C57BL/6 and BALB/c mice were sensitized by intragastric peanut extract and challenged by intragastric or intraperitoneal injection of peanut. Peanut-specific T cell responses, IgE, IgG1 and IgG2a and mucosal mast cell degranulation were induced to different extent in C3H/HeOuJ, C57BL/6 and BALB/c mice. Interestingly, anaphylactic symptoms after systemic challenge were highest in C3H/HeOuJ followed by C57BL/6 but were absent in BALB/c mice. Mechanistic studies showed that the food allergic systemic anaphylaxis was dependent on platelets, FcRγ and mast cells, and partially dependent on platelet activating factor and monocytes/macrophages, depending on mouse strain. These data demonstrate that in three mouse strains, components of the classic and alternative anaphylactic cascade are differently expressed, leading to differential outcomes in parameters of allergic disease and food induced systemic anaphylaxis.     

Dissociation of experimental allergic encephalomyelitis protective effect and allergic side reactions in tolerization with neuroantigen

Administration of autoantigens under conditions that induce type 2 immunity frequently leads to protection from T cell-mediated autoimmune diseases. Such treatments, however, are inherently linked to the induction of IgG1 Abs and to the risk of triggering anaphylactic reactions. We studied the therapeutic benefit vs risk of immune deviation in experimental allergic encephalomyelitis of SJL mice induced by MP4, a myelin basic protein-proteolipid protein (PLP) fusion protein. MP4 administration in IFA induced type 2 T cell immunity, IgG1 Abs, and experimental allergic encephalomyelitis protection, and all three were enhanced by repeat injections. Despite high Ab titers, anaphylactic side reactions were not observed when MP4 was repeatedly injected in IFA or as soluble Ag s.c. In contrast, lethal anaphylaxis was seen after s.c. injection of soluble PLP:139-151 peptide, but not when the peptide was reinjected in IFA. Therefore, the Ab response accompanying the immune therapy constituted an anaphylactic risk factor only when the autoantigen was not retained in an adjuvant and when it was small enough to be readily disseminated within the body. Taken together, our data show that treatment regimens can be designed to boost the protective type 2 T cell response while avoiding the risk of Ab-mediated allergic side effects.     

Comprehensive metabolomic analysis of peanut-induced anaphylaxis in a murine model

Acute anaphylaxis caused by food allergy is a potentially life-threatening allergic reaction that results in thousands of hospitalizations in North America every year. There are currently no effective means of treatment for anaphylaxis beyond the administration of epinephrine which is only given after a reaction has already started. Furthermore, knowledge regarding the underlying physico-chemical basis of anaphylaxis is largely incomplete. Arguably, the study of anaphylaxis by comprehensive metabolomics offers a unique opportunity to study this phenomenon due to its ability to provide a snap-shot of the chemical state of a subject experiencing anaphylaxis encompassing both endogenous and exogenous factors including dietary and environmental effects. In this study, we sought to apply a comprehensive metabolomics approach using liquid chromatography–mass spectrometry to a murine model of peanut-induced anaphylaxis. The results of this study revealed that the metabolomic profiles of mice experiencing peanut-induced anaphylaxis followed a distinct pattern that mirrors the time-stage of anaphylaxis being experienced. Direct comparison of anaphylactic mice to time-matched control mice showed that the metabolomic profiles changed considerably as the anaphylactic reaction progressed. This comparison also revealed changes in both known biomarkers of anaphylaxis such as histamine and methylhistamine as well as a suite of metabolites chemically similar to known anaphylaxis mediators but whose biological functions are not well understood. These metabolites include a number of phospholipids such as a variety of phosphatidylcholines and lyso-phosphatidylcholines that may be of interest for further investigation regarding their potential as anaphylaxis mediators or chemical precursors to mediators.     

Prevention of anaphylactic death by macrophage blockade.

Data in the literature concerning the role of macrophages in anaphylaxis are contradictory. In the present study the effect of macrophage blockade induced by gadolinium chloride (GdCl3) on anaphylactic shock was investigated. Our observations show that GdCl3 prevents the lethal anaphylactic shock of mice sensitized to ovalbumin. GdCl3 given i.v. in a dose of 1 mg/100 g body weight 24 or 48 h before the elicitation of anaphylactic shock resulted in 90% survival, compared to the 43% survival in the control group. The same dose of this rare earth metal salt also greatly reduced the mortality in mice sensitized with ovalbumin containing Bordetella pertussis vaccine, and the symptoms of anaphylaxis including the accumulation of 5-hydroxytryptamine in the liver. Our results suggest that macrophages play an important role in anaphylaxis.     

ANTIBIOTIC ANAPHYLAXIS

Anaphylactic reactions following the injection of penicillin or other antibiotics have increased greatly during the past several years. These untoward reactions to penicillin were infrequent during the first nine years of penicillin therapy and there can be no doubt that hypersensitivity to these drugs is developing in many people. Therefore promiscuous use of them is to be condemned. It is safer not to use antibiotics parenterally in patients with allergic conditions such as bronchial asthma. The further use of a particular antibiotic should be avoided if the patient has previously shown any hypersensitivity to that drug.A questionnaire was answered by more than 1,000 California physicians who reported that over 300 patients had severe anaphylactic reactions from parenteral penicillin and streptomycin. There were seven deaths.Since the antibiotics should still be used when needed, prevention of anaphylaxis is of fundamental importance. The frequency of these reactions can be greatly reduced by the use of antihistaminic solutions combined with the antibiotics. Treatment of these shock-like reactions demands the prompt administration of epinephrine intramuscularly, antihistaminic solutions intravenously and oxygen.