Distinct transcriptome profiles differentiate nonsteroidal anti-inflammatory drug-dependent from nonsteroidal anti-inflammatory drug-independent food-induced anaphylaxis

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• 作者：Rosa Mu&ntilde ; oz-Cano ; MD ; PhD^a ; ^b ; ^c ; ^{rmunoz@clinic.ub.es" class="auth_mail" title="E-mail the corresponding author} ; Mariona Pascal ; PhD^c ; ^d ; ^e ; Joan Bartra ; MD ; PhD^b ; ^c ; ^e ; Cesar Picado ; MD ; PhD^b ; ^c ; Antonio Valero ; MD ; PhD^b ; ^c ; Do-Kyun Kim ; PhD^a ; Stephen Brooks ; PhD^g ; Michael Ombrello ; MD^g ; Dean D. Metcalfe ; MD^a ; Juan Rivera ; PhD^f ; Ana Olivera ; PhD^a
• 关键词：Anaphylaxis ; food allergy ; lipid transfer protein syndrome ; nonsteroidal anti-inflammatory drugs ; transcriptome analysis
• 刊名：Journal of Allergy and Clinical Immunology
• 出版年：2016
• 出版时间：January 2016
• 年：2016
• 卷：137
• 期：1
• 页码：137-146
• 全文大小：1870 K

文摘

Lipid transfer protein (LTP), an abundant protein in fruits, vegetables, and nuts, is a common food allergen in Mediterranean areas causing diverse allergic reactions. Approximately 40% of food-related anaphylaxis induced by LTPs requires nonsteroidal anti-inflammatory drugs (NSAIDs) as a triggering cofactor.

Objective

We sought to better understand the determinants of NSAID-dependent and NSAID-independent LTP-induced anaphylaxis (LTP-A).

Methods

Selection of patients was based on a proved clinical history of NSAID-dependent or NSAID-independent anaphylaxis to LTPs, positive skin prick test response to LTPs, and serum LTP IgE. Whole-transcriptome (RNA sequencing) analysis of blood cells from 14 patients with NSAID-related LTP-A (NSAID-LTP-A), 7 patients with LTP-A, and 13 healthy control subjects was performed to identify distinct gene expression signatures.

Results

Expression of genes regulating gastrointestinal epithelial renewal was altered in both patient sets, particularly in those with LTP-A, who also presented with gene expression profiles characteristic of an inflammatory syndrome. These included altered B-cell pathways, increased neutrophil activation markers, and increased reactive oxygen species levels. Increased expression of the IgG receptor (CD64) in patients with LTP-A was mirrored by the presence of LTP-specific IgG₁ and IgG₃. Conversely, patients with NSAID-LTP-A were characterized by reduced expression of IFN-γ–regulated genes and IFN-γ levels, as well as upregulated expression of adenosine receptor 3 (ADORA3) and genes related to adenosine metabolism.

Conclusions

Gene ontology analysis suggests disturbances in gut epithelial homeostasis in both groups with LTP-A, with potential integrity breaches in patients with LTP-A that might explain their distinct inflammatory signatures. Differential regulation in patients with LTP-A and those with NSAID-LTP-A of the IFN-γ pathway, IgG receptors, and ADORA3 might provide the pathogenic basis of their distinct responses.