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J Allergy Clin Immunol. 2019 Feb;143(2):681-690.e1. doi: 10.1016/j.jaci.2018.03.013. Epub 2018 Apr 27.

Profilin-mediated food-induced allergic reactions are associated with oral epithelial remodeling.

Author information

1
Instituto de Medicina Molecular Aplicada, Grupo Hospital de Madrid, Universidad San Pablo-CEU, Madrid, Spain.
2
Departamento de Ciencias Médicas Básicas, Facultad de Medicina, Universidad San Pablo-CEU, Madrid, Spain.
3
Hospital Virgen del Puerto, Plasencia, Cáceres, Spain.
4
Hospital Universitario de la Princesa, Instituto de Investigación Sanitaria Princesa (IP), Madrid, Spain.
5
Hospital Universitario Clínico San Carlos, Madrid, Spain.
6
Hospital HM Sanchinarro, Madrid, Spain.
7
Hospital Central de la Defensa "Gómez Ulla", Madrid, Spain.
8
Facultad de Ciencias Químicas, Universidad Complutense de Madrid, Madrid, Spain.
9
Instituto de Medicina Molecular Aplicada, Grupo Hospital de Madrid, Universidad San Pablo-CEU, Madrid, Spain; Departamento de Ciencias Médicas Básicas, Facultad de Medicina, Universidad San Pablo-CEU, Madrid, Spain. Electronic address: mariamarta.escribesealonso@ceu.es.

Abstract

BACKGROUND:

In areas of high exposure to grass pollen, allergic patients are frequently sensitized to profilin, and some experience severe profilin-mediated food-induced reactions. This specific population of patients is ideal to study the relationship between respiratory and food allergies.

OBJECTIVE:

We sought to determine the role of oral mucosal epithelial barrier integrity in profilin-mediated allergic reactions.

METHODS:

Thirty-eight patients with profilin allergy stratified into mild or severe according to their clinical history and response to a profilin challenge test and 6 nonallergic subjects were recruited. Oral mucosal biopsies were used for measurement of CD11c, CD3, CD4, tryptase, claudin-1, occludin, E-cadherin, and vascular endothelial growth factor A levels; Masson trichrome staining; and POSTN, IL33, TPSAB, TPSB, and CMA gene expression analysis by using quantitative RT-PCR. Blood samples were used for basophil activation tests.

RESULTS:

Distinct features of the group with severe allergy included the following: (1) impaired epithelial integrity with reduced expression of claudin-1, occludin, and E-cadherin and decreased numbers of epithelial cells, which is indicative of acanthosis, higher collagen deposition, and angiogenesis; (2) inflammatory immune response in the mucosa, with an increased number of CD11c+ and CD4+ infiltrates and increased expression of the cytokine genes POSTN and IL33; and (3) a 10-fold increased sensitivity of basophils to profilin.

CONCLUSIONS:

Patients with profilin allergy present with significant damage to the oral mucosal epithelial barrier, which might allow profilin penetration into the oral mucosa and induction of local inflammation. Additionally, severely allergic patients presented with increased sensitivity of effector cells.

KEYWORDS:

Allergy; epithelial remodeling; grass pollen; inflammation; oral mucosa; profilin

PMID:
29705246
DOI:
10.1016/j.jaci.2018.03.013

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