BOLETÍN BIBLIOGRÁFICO
DE INMUNOTERAPIA
Artículo destacado – Octubre 2021
1
Las células T también son importantes en la alergia alimentaria
Allergen-specific T cells and clinical features of food allergy: Lessons from CoFAR immunotherapy cohorts.
Berin MC, Agashe C, Burks AW, Chiang D, Davidson WF, Dawson P, et al.
J Allergy Clin Immunol. 2021 Oct 12:S0091-6749(21)01518-9. doi: 10.1016/j.jaci.2021.09.029. Epub ahead of print.
BACKGROUND
Allergen-specific IL-4+ and IL-13+ CD4+ cells (Type 2 cells) are essential for helping B cells class-switch to IgE and establishing an allergic milieu in the gastrointestinal tract. The role of T cells in established food allergy is less clear.
OBJECTIVE
We examined the food allergen-specific T cell response in participants of two food allergen immunotherapy (IT) trials to assess the relationship of the T cell response to clinical phenotypes including response to IT.
METHODS
Blood was obtained from 84 peanut-allergic and 142 egg-allergic participants who underwent double-blind placebo-controlled food challenges. Peanut and egg-responsive T cells were identified by CD154 upregulation after stimulation with the respective extract. Intracellular cytokines and chemokine receptors were also detected. The response to peanut epicutaneous immunotherapy (CoFAR6, 49 participants receiving EPIT) and egg oral immunotherapy or baked egg diet (CoFAR7, 92 participants) was monitored over time.
RESULTS
Peanut-specific Type 2 and CCR6+ T cells were negatively correlated with each other, and differently associated with immune parameters including specific IgE and basophil activation test. At baseline, Type 2 cells, but not CCR6+ cells, were predictive of clinical parameters including successfully consumed dose of peanut and baked egg tolerance. Exposure to peanut or egg immunotherapy was associated with a decrease in Type 2 cell frequency. At baseline, high egg-specific Type 2 cell frequency was the most predictive immune feature of oral immunotherapy failure.
CONCLUSIONS
Food-specific Type 2 T cells at baseline are informative of threshold of reactivity and response to immunotherapy.