Transcript strawberry allergy

Peculiarities of Th1 and Th2-cells cytokine synthesis among
allergic patients with food allergy and food intolerance
Sidorovich Olga, Luss Ludmila, Nikonova Margarita, Donetskova Almira,
Burmenskaya Olga
NRC Institute of Immunology FMBA, Out-patient Department, Moscow, Russia
Background: The problem of food allergy and food intolerance has become a global medical and social problem in the last 10 years. In clinical practice we often face serious
food allergy diagnostic and therapy problems because there are no specific clinical markers of allergic reactions to food. The problem is that adverse reactions to food
could be caused by different mechanisms, for example sensibilisation to food allergens and food additives by food allergy. Besides, adverse reactions to food develop by
different gastrointestinal tract pathologies. The algorithm of diagnostics, treatment and prevention of food allergy and food intolerance require different methodical
approaches. Methods:In this work we analysed the levels of Th1- and Th2-lymphocytes, the expression of IL-2, 2Ra, 4, 5, 10, 12a, 12b, TGFβ, IFNγ, transcription factors
FOXP3, T-bet and GATA-3 was measured by 23 patients with food allergy and by 35 patients with food intolerance by PCR method. 20 patients with food intolerance without
any atopy, 20 patients with pollinosis without any signs of food allergy and food intolerance and 20 apparently healthy persons were examined as the control groups.
Result: the levels of Th1- and Th2-lymphocytes measured by the patients with food allergy and food intolerance did not differ appreciably from the measured levels of
apparently healthy persons. There is no difference of IL-2, IL-4, IL-10, IL-12a, IL-12b, TGFβ, INFγ, FOXP3 expression in all groups. However, there was a rising tendency of
IL-5 expression by patients with food allergy in comparison with the rest of the groups. Significant increased expression of GATA-3 was recorded by the patients with food
allergy in comparison with the patients with food intolerance (p<0,05). Conclusion: mRNA expression of cytokine genes showed by patients with food allergy and food
intolerance in remission is comparable with mRNA expression by apparently healthy persons. An important role of GATA-3 has been proven in Th2-response activation by
patients with IgE-dependent food allergy. Thus, the results of this work show the necessity of further research activities to improve immunological methods of examination
of patients with food allergy and food intolerance and development of effective diagnostics, prevention and treatment of these diseases.
Methods of examination:
Clinical and allergological characteristics of the studying groups
- retrospective analysis of the 403 out-patient cards
-
clinical-laboratory methods
-
analysis of the food diaries
- allergological (allergological, food, pharmacological
anamnesis; skin prick tests with food, dust mite, pollen,
epidermal allergens; specific IgE in blood serum)
The range of allergens showed by
patients with food allergy
The range of intolerant products showed by
atopic patients with food intolerance
60%
30%
50%
- analysis of the levels of IFNγ+ T-lymphocytes и IL-4+ T-
Seafood
40%
Cabbage
Tomato
Strawberry
Smoked foods
Aubergine
Chicken
Drupes
Citrus
Chocolate
Cereals
Alcohol
Egg
Fish
25%
Citrus
20%
Cereals
lymphocytes, the expression of IL-2, 2Ra, 4, 5, 10, 12a, 12b,
30%
TGFβ, INFγ, transcription factors FOXP3, T-bet and GATA-3
15%
Milk
Egg
20%
10%
Fish
10%
The criteria of food allergy diagnosis:
5%
0%
0%
• positive allergological and food anamnesis
• elimination effect
• the connection of reactions’ development and taking food
even in small amount or in “hidden allergen”
• the positive results of skin prick tests with food allergens
• the positive results of specific IgE to food allergens
Atopic patients
Patients with no allergopathology
n=131 (32,5%)
Patients with allergopathology
n=272 (67,5%)
Honey
30%
Carrot
25%
Spicy food
Chicken
20%
Drupes
15%
Citrus
Chocolate
10%
Potato
Alcohol
5%
Nuts
0%
Fish
Comparison results of skin prick tests
and specific IgE by atopic patients with
food allergy, food intolerance
and non-atopic patients
Clinical presentations of food allergy
and food intolerance
Patients groups
retrospective analysis of the 403 out-patient
cards
The range of intolerant products showed
by patients with no atopy
No atopy
Allergens
Positive results (number of patients)
FA (n=23)
Cough
FI by atopic
persons (n=35)
FI by non-atopic
persons (n=20)
prick
test
prick
test
Asthmatic fit
Vertig
o
Tremor of extremities
Food intolerance
n=20 (15,3%)
Food intolerance
complaints
n=58 (21,3%)
Unstable stool
Skin itch
Skin itch
Control groups
Rhinoconjunctivitis
Hyperemia of face
OAS
Angioedema
Tickling feeling in the throat
Urticaria
Tickling feeling
in the throat
Sneezing
Dermatitis
Dermatitis
Food allergy
n=23 (39,6%)
Food intolerance
n=35 (60,4%)
Healthy
persons
n=20
+
anamnesis
Pollinosis
(with no food
intolerance
complaints)
n=20
0
0
5
10
15
20
1
2
3
4
25
5
6
7
8
number of patients
number of patients
Food allergy
Food intolerance
Food:
Milk
Fish
Egg
Citrus
Pork
Beef
Seafood (crabmeat,
shrimp)
Kiwi fruit
Strawberry
Rye
Wheat
23
3
13
10
1
0
0
2
0
0
1
2
prick
test
23
3
12
10
1
0
0
2
wasn’t
performed
«»
1
2
IFA
23
3
13
10
1
0
0
2
1
2
3
3
0
0
0
0
0
0
0
0
wasn’t
performed
«»
0
0
IFA
0
3(±)
0
1(yolk)
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
1
0
0
0
0
0
0
0
0
0
0
Immunological characteristics of patients with food allergy and food intolerance
Cytokine expression was similar in all groups (food allergy,
food intolerance, pollinosis in remission, healthy persons)
Atopic patients
Parameter
IL-2/HPRT1
IL-4/HPRT1
IL-5/HPRT1
IL-10/HPRT1
IL12a/HPRT1
IL12b/HPRT1
TGFb/HPRT1
IFNG/HPRT1
The high level of IL-5 gene expression trend
was shown in group with the food allergy
GATA-3 gene expression was higher in food allergy
group
Control groups
Food allergy,
n=23
Food intolerance,
n=35
Pollinosis, n=20
Healthy persons,
n=20
0,0007
0,01013
(0,008370,01105)
0,01368
(0,009290,02134)
0,00019
(0,000070,00044)
0,00249
(0,001820,00286)
0,02288
(0,018580,02538)
0,00083
(0,000370,00129)
11,31371
(10,1964913,92881)
0,00489
(0,00465-0,00613)
0,00581
(0,00419-0,00809)
0,00781
(0,00498-0,01226)
0,0006
0,00936
(0,00693-0,02782)
0,01805
(0,01563-0,02062)
0,01389
(0,01105-0,01992)
0,0008
(0,00007-0,00009)
0,00008
(0,00006-0,00014)
0,00011
(0,00007-0,00014)
0,00263
(0,00211-0,00483)
0,00450
(0,00240-0,00572)
0,00255
(0,00176-0,00364)
0,03292
(0,03026-0,03666)
0,03653
(0,02916-0,04123)
0,02251
(0,01858-0,03467)
0,00049
(0,00037-0,00105)
0,00046
(0,00028-0,00094)
0,00105
(0,00074-0,00116)
14,42867
(12,8207517,31342)
13,27287
(11,3137114,92853)
13,69158
(12,5533515,45498)
0,06360
0,05529
0,04782
0,06144
(0,03349(0,03331-0,08204) (0,03467-0,06250) (0,05077-0,10511)
0,08839)
Foxp3/HPRT1
0,09473
0,11204
0,10536
0,09151
(0,07966(0,06479-0,14901) (0,06935-0,12074) (0,08247-0,09807)
0,10511)
IL2Ra/HPRT1
0,02583
0,02693
0,03127
0,02370
(0,01992(0,01737-0,03644) (0,02368-0,03847) (0,01858-0,03235)
0,02816)
The levels of cytocine expression and transcription factor FOXP3 were measured by real-time PCR
125
P<0.05*
100
0,0005
P<0.05*
86%
75
0,0004
75%
50
0,0003
0,0002
25
15%
14%
0,0001
0
Median
25%-75%
Min-Max
0,0000
-0,0001
Control
Food
allergy
Food
Pollinosis
intolerance
GATA-3 low
Food allergy
GATA-3 high
Food intolerance
IFA