<p>Amb a 1 is the major allergen found in ragweed. Our observations have suggested that Amb a 1 may bind lipopolysaccharide (LPS), which would likely contribute to the allergenicity of Amb a 1. In order to assess whether Amb a 1 can bind LPS, peptide sequences from Amb a 1 were assayed for their ability to bind to LPS using an ELISA based LPS binding assay. A 15 amino acid sequence in the β- chain of Amb a 1 demonstrated affinity for biotin labeled <em>E. coli </em>LPS. The sequence also bound to <em>P.</em> <em>aeruginosa</em> LPS, which is structurally disparate in the lipid A region, indicating that the sequence has flexibility in recognizing different lipid A moieties, or that the binding site may not include the lipid A portion of the LPS molecule. An IL-10 ELISA was also used to determine whether the LPS bound to the peptides induced an immunological response in leukocytes. Peptides containing the LPS-binding sequence were able to bind to LPS and induce IL-10 production, suggesting the interaction between Amb a 1 and LPS may have immunological consequences. We have identified a sequence within the major ragweed allergen Amb a 1 that has the potential to bind to LPS. This indicates that the allergen may provide its own adjuvant when encountered by the immune system, leading to an enhanced immunological response to an otherwise innocuous environmental protein.</p> / Master of Science (MSc)

<p>It has been suggested that environmental factors substantially contribute to the increased prevalence of peanut allergy in industrialized countries. Specifically, the role of disrupted barrier integrity in the gastrointestinal tract has been implicated in the development of food allergy. The use of non-steroidal anti-inflammatory drugs (NSAIDs), which increase intestinal permeability, for the treatment of pain and fever is prevalent in industrialized countries. Therefore, the first aim of this study was to determine whether treatment with indomethacin, a prototypical NSAID, would act in an adjuvant like manner to facilitate sensitization to co-administered peanut protein. Furthermore, we investigated whether indomethacin increases susceptibility to anaphylaxis following oral challenge with peanut in sensitized mice.</p> <p>First, a short model of cholera toxin-mediated sensitization to peanut was developed. Mice were given 1 mg of peanut protein and 5 μg of cholera toxin by oral gavage for 10 consecutive days. This resulted in a robust anaphylactic response and increased peanut-specific IgG1, but not IgE, two weeks following treatment. Mice exposed to peanut during a 10-day treatment with indomethacin (5 mg/kg on alternating days or 3.5 mg/kg daily) did not develop peanut-specific immunoglobulins or anaphylaxis following systemic challenge with peanut protein. Furthermore, treatment with two 5 mg/kg doses of indomethacin 24 and 1 hour before oral challenge did not facilitate anaphylaxis in peanut-sensitized mice. Therefore, we concluded that NSAID treatment is unlikely to play a role in the increased prevalence of peanut allergy, and that NSAID treatment does not increase susceptibility to peanut-induced anaphylaxis in sensitized mice.</p> <p>The second part of this study aimed to develop a short model of epicutaneous sensitization, and address the impact of epicutaneous exposure to peanut during infancy. We investigated the role of site of exposure, duration of exposure, epidermal integrity, strain and age in epicutaneous sensitization. 10 consecutive days of epicutaneous exposure to 20 μg of peanut protein through tape stripped skin induced robust anaphylaxis following i.p. challenge. Neither 7 days of exposure through tape stripped skin, nor 10 days of exposure through intact skin facilitated sensitization. The strength of sensitization was strain-dependent; peanut-specific IgG1 was increased equally in both C57BL/6, and BALB/c mice, and to a greater extent in C3H/HeJ mice. Peanut-specific IgE was increased in both BALB/c and C3H/HeJ mice three weeks following peanut exposure. Epicutaneous exposure beginning one day after birth did not facilitate the development of either peanut-specific IgE or IgG1 in BALB/c mice, or anaphylaxis following systemic challenge. Beginning exposure at 2 weeks of age resulted in peanut-specific IgE and IgG1 production, as well as a robust anaphylaxis following i.p. challenge. Therefore, the development of peanut allergy through epicutaneous exposure is age dependent, and exposure during the neonatal period results in a hyporesponsive response.</p> / Master of Science (MSc)

<p>BACKGROUND: The ontogeny of peanut allergy (PA) is poorly understood, and the treatment of its most severe manifestation, peanut-induced anaphylaxis (PIA), remains limited to rescue epinephrine. We argued that an untargeted metabolomic analysis would be a useful hypothesis-generating tool to identify novel biomarkers, mediators and possibly therapeutic targets in PA and PIA.</p> <p>METHODS: Models of PA and PIA used in this thesis involved either the oral administration of peanut along with cholera toxin or the topical application of peanut on tape-stripped skin. Liquid-chromatography mass-spectrometry (LC-MS) was performed to identify chemical changes in the serum of mice undergoing sensitization and anaphylaxis. Flow cytometry as well as <em>in vivo</em> gain-of-function and loss-of-function immunological studies were used to determine the biological significance of particular molecules in sensitization.</p> <p>RESULTS: LC-MS followed by multivariant analysis showed that the purine metabolism pathway was altered with elevated levels of uric acid (UA) in sensitized mice. UA depletion using allopurinol and uricase fully prevented the development of the allergic and anaphylactic phenotype. Conversely, administration of UA crystals, instead of cholera toxin or tape stripping along with peanut induced a typical allergic and anaphylactic phenotype. The effects of UA and UA crystals are likely a consequence of effects on the activation of resident dendritic cells. Post-challenge metabolic analysis also revealed a distinct metabolic signature in sensitized mice, highlighted by an increase in several metabolites such as histamine. Likewise, peanut allergic patients display a distinct metabolic profile after oral peanut challenge.</p> <p>CONCLUSION: We identified UA, released after damage to the mucosa and/or skin, as a critical alarmin that facilitates the development of Th2 immunity, specifically PA and PIA. Metabolomics analyses of either mice undergoing anaphylaxis or peanut allergic children subjected to a peanut oral challenge provided an extensive overview of metabolomic changes underlying these conditions. Further studies may lead to the identification of novel biomarkers and mediators.</p> / Master of Science in Medical Sciences (MSMS)

Global prevalence of allergic diseases has been on the rise for the last 30 years. In Canada, this upward trend in allergic diseases has resulted in over 3 million Canadians being affected by allergic asthma. Allergic asthma is triggered by inhalation of environmental allergens resulting in bronchial constriction and inflammation, which leads to clinical symptoms such as wheezing, coughing and difficulty breathing. Asthmatic airway inflammation is initiated by the release of inflammatory mediators (-eg- histamine) released by granulocytic cells (-eg- mast cells and basophils). However, immunoglobulin E (IgE) antibody is also necessary for the initiation of the allergic cascade, and IgE is produced and released exclusively by memory B cells and plasma cells. Allergen crosslinking of IgE:FcεRI complexes on the surface of mast cells and basophils causes degranulation of pro-inflammatory mediators. Acute allergen exposure has also been shown to increase IgE levels in the airways of patients diagnosed with allergic asthma; however, more studies are needed to better understand local airway inflammation. Our group's work, in accordance with the literature, has shown an increase of IgE in the airways of subjects with mild allergic asthma following allergen inhalation challenge. Although regulatory B cells (Bregs) have been shown to modulate IgE-mediated inflammatory processes in allergic asthma pathogenesis, particularly in mouse models of allergic airway disease, the levels and function of these IgE+ B cells and Bregs remain to be elucidated in human models of asthma. The overall objective for this dissertation was to investigate the biology of B cells in allergic asthma pathogenesis, specifically investigating the frequency of IgE+ B cells and Bregs in allergic asthma, and the kinetics of these cells after allergen exposure. First, we characterized IgE+ B cells in the blood and sputum of allergic asthmatics and healthy controls with and without allergies (Chapter 2). We showed that IgE+ B cell levels were higher in sputum, but not blood, of allergic asthmatics compared to controls. We further demonstrated that these findings were consistent across airway IgE+ B cell subsets, which include IgE+ memory B cells and IgE+ plasma cells. Additionally, IgE+ B cells in sputum positively correlated with sputum eosinophils, total IgE and B cell activating factor (BAFF) measured in sputum fluid phase. These findings highlight the association of airway IgE+ B cells with allergic asthma, and suggest that local IgE+ B cell functions contribute to the pathogenesis of asthma. Second, we measured the trafficking of IgE+ B cells in periphery (blood, bone marrow and tonsil) and locally (sputum) in allergic asthmatics following whole lung allergen challenge (Chapter 3). IgE+ B cells only increased in the airways of allergic asthmatics following allergen inhalation challenge; there were no allergen-induced changes in IgE+ B cell levels in blood, bone marrow and tonsil. In addition, we showed allergen-induced increases in BAFF and total IgE, but not allergen-specific IgE in sputum fluid phase. Taken together, chapters 2 and 3 show that allergic asthmatics have elevated levels of IgE+ B cells in the airways, that can be further increased after allergen exposure. Therefore, local B cell production of IgE in the lungs may be an important source of IgE for initiation of acute inflammatory responses in allergic airways. Third, we evaluated the levels of Bregs in allergic asthmatics compared to controls, and examined the kinetics, function and distribution (bone marrow, blood and sputum) of Bregs following allergen inhalation challenge (Chapter 4). We showed that Bregs were 2-fold lower in the blood of allergic asthmatics compared to controls, highlighting a possible dysregulation of this regulatory cell type in allergic asthmatics, which may contribute to disease pathology. Furthermore, after whole lung allergen challenge Bregs decreased in the bone marrow with a co-incident increase in the blood and sputum of allergic asthmatics. This pattern reflects potential trafficking of these cells from bone marrow to the airways after exposure to allergic stimuli. Lastly, we stimulated CD19+ B cells purified from blood of allergic asthmatic with IL-4 in vitro. IL-4 is a type 2 cytokine known to isotype-switch B cells to IgE+ B cells, as well as differentiates naïve T cells into Th2 cells, thus propagating the allergic cascade. We found that IL-4 promoted higher proportions of IL-10+ and FoxP3+ Bregs, which demonstrates that Bregs may have a role in dampening IgE-mediated inflammation in a type 2 environment. However, further functional studies are warranted. Taken together, the findings of this dissertation highlight the local compartmental changes in IgE+ B cells and Bregs following allergen challenge of allergic airways. Better understanding the temporal and compartmental shifts in B cell subpopulations, particularly IgE+ B cells and Bregs, may aid in future development of therapeutics. / Thesis / Doctor of Philosophy (PhD)

Atopic dermatitis (AD) is a common skin disease that is characterized by chronic, relapsing skin inflammation and eczematous, itchy lesions. In AD, systemic and local eosinophilia and basophilia is thought to contribute to disease progression in both acute and chronic lesions. It has been previously shown that in chronic allergic inflammatory diseases, tissue eosinophilia and basophilia may in part result from eosinophil/basophil (Eo/B) progenitors trafficking from the bone marrow and maturing in tissue in response to type 2 cytokines including IL-5 and IL-3. We therefore proposed that a similar mechanism could be contributing to the pathogenesis of AD. First, we compared lesional and non-lesional AD tissue, and found approximately 10-fold higher levels of Eo/B progenitors in the lesional tissue (p<0.05). As previous research has shown an increase in Eo/B progenitors in the airways of allergic asthmatics post inhaled allergen challenge, we next examined whether Eo/B progenitors increased locally in the acute phase of AD using the intradermal allergen challenge model. Compared to intradermal diluent challenge there was an increase in Eo/B progenitors (5.5-fold), eosinophils (18-fold) and basophils (2.5-fold) 24 hours post intradermal allergen challenge (all p<0.05). These increases were consistent with findings in allergic airways. Lastly, we examined the relationship between disease severity and Eo/B progenitors in inflamed lesional (chronic) and allergen-challenged (acute) tissue. We found that Eo/B progenitors in lesional tissue positively correlated with disease severity (EASI R=0.71, p<0.05 and SCORAD R=0.65, p<0.05), while in allergen-challenged tissue a trend was seen for a positive correlation between Eo/B progenitors and disease severity (EASI R=0.48, p=0.07 and SCORAD R=0.46, p=0.09). These results highlight the potential involvement of Eo/B progenitors in the disease pathogenesis of AD. / Thesis / Master of Science (MSc) / Atopic dermatitis is a common skin disease that is characterized by chronic, relapsing skin inflammation and eczematous, itchy lesions. In other allergic diseases, a cell called the “eosinophil/basophil progenitor” contributes to the accumulation of inflammatory cells in the diseased organ. We proposed that eosinophil/basophil progenitors found in the skin may be contributing to the development of local allergic inflammation. In patients with moderate-to-severe atopic dermatitis we compared acute responses to intradermal allergen and chronic skin lesions to diluent-challenged and un-affected skin, respectively. Allergen-challenged skin had more eosinophil/basophil progenitors, mature eosinophils and basophils 24 hours’ post-challenge compared to unchallenged skin (p<0.05). Chronic skin lesions had more eosinophil/basophil progenitors than un-affected skin (p<0.05). The number of eosinophil/basophil progenitors positively correlated to disease severity as determined by EASI and SCORAD. Our results suggest that accumulation of eosinophil/basophil progenitors in skin of atopic dermatitis patients could support allergic inflammation and contribute to disease severity.

The purpose of the study was to examine home conditions, housing satisfactions, and allergen avoidance practices of people with allergic rhinitis, focusing on female patients who lived in an urban area in a hot, humid climate. The Morris and Winter theory of housing adjustment provides a theoretical base for this study. Nine hypotheses were tested to investigate interrelationships among home conditions, housing satisfaction in terms of health issues, allergen avoidance practices, and age. A sample of 41 female allergy patients aged 20 to 77 years completed a screening questionnaire and an in-depth survey questionnaire. The researcher visited their dwellings to conduct home observations and to take photos.Dust mite allergens were reported as the most common allergy triggers. Presence of cockroaches, presence of furry pets outdoors, molds in bathrooms, and molds in kitchens were the most common problematic home conditions. Open shelves, bookcases, drapes, horizontal blinds, and foam rubber pillows were the most common allergy related items found in respondents' bedrooms. Concerning health issues, the majority of the respondents were satisfied with their homes. Allergen avoidance practices were not followed regularly, particularly, using allergen-proof pillowcases and sheets, washing bedding in hot water, wearing a particle mask when vacuuming, using an exhaust fan, an air cleaner, a dehumidifier, and cockroach traps. The respondents who received suggestions from doctors were more likely to follow allergen avoidance practices than those who did not receive suggestions.The result shows a significant negative relationship between problematic home conditions and housing satisfaction in terms of health issues. A significant negative relationship between age and allergen avoidance practices was found. Older sufferers were less likely to use allergen-proof products. They also lived in older homes that were more likely to have allergy related conditions. The most common obstacles that prevented respondents from improving their homes in order to avoid allergens were cost of products, emotional attachment to pets, not having time to improve homes, and procrastination. Based on these findings, design recommendations, home maintenance recommendations, and lifestyle practice recommendations were developed. / Ph. D.

Yes

Chronic exposure to the ubiqutious airborne fungus, Alternaria alternata, has long been implicated in the development and exacerbation of human allergy and asthma. Alt a 1 was identified previously by several groups as the major allergen secreted by A. alternata, due to its IgE-specific reactivity with sera from atopic patients. Despite the well-documented clinical importance of Alternaria and its major allergen, little knowledge exists regarding their role and interaction with the innate immune system. Here for the first time we characterize the innate immune response to A.alternata and verify the significance of Alt a 1 in contributing to this response in human airway cells and murine models. Our studies establish a baseline response for both a chronic and single-challenge murine inhalation model with Alternaria spores. Both models demonstrate live conidia induce a robust response, arguably more pathologically relevant compared to studies employing Alternaria extracts. We also elucidate the overall importance of Alt a 1 by utilizing recombinant Alt a 1 protein, A. alternata (Δalt a 1) deletion mutants, and an A.alternata (Alt a 1+) overexpression mutant. Both Alt a 1 protein and A. alternata conidia stimulated production of pro-inflammatory cytokines/chemokines in mice after a single intranasal challenge. Infiltration of effector cells (macrophages, neutrophils, eosinophils, and lymphocytes) into the lungs along with other hallmarks of airway inflammation was observed. In addition, Alt a 1 protein and conidia evoked secretion of pro-inflammatory cytokines in treated human airway epithelial cells while the Alt a 1+ overxpression mutant induced a significantly higher response. In contrast, spores of Δalt a 1 caused an attenuated response in both human cells and murine lungs suggesting that this single protein may play a major role in inducing the innate immune response in airway epithelium at the organismal level. Finally, we identified key biochemical properties of the Alt a 1 protein including a single histidine required for esterase activity and a unique RXLR-like motif which controls Alt a 1's ability to bind external lipids and enter human airway cells. Overall, these results improve our understanding of how Alternaria induces innate immunity and identifies possible therapeutic targets within allergenic proteins. / Ph. D.

Allergic airway diseases such as rhinitis, asthma, and chronic rhinosinusitis are responsible for causing a huge economic burden on patients and society. Patients suffering from asthma often have allergies to pollen, dust mite, and mold. Interestingly, studies have shown that there is a correlation between severe asthma and sensitization to fungi including Aspergillus, Alternaria, Cladosporium, and Penicillium. This project has been focused on studying the innate immunomodulatory activities of the major allergen Alt a 1, from the ubiquitous airborne fungus, Alternaria alternata. In several studies, 90-100% of allergic patients who are sensitized to Alternaria, have Alt a 1 specific IgE antibodies indicating that it is a major and clinically relevant allergen. Although progress has been made over the past few decades regarding elucidating the mechanistic underpinnings of allergic inflammation, more research needs to be done, especially in regards to innate immunity and its role in the sensitization and exacerbation aspects of allergic diseases. Published studies have increasingly made it clear that Toll-like receptors (TLRs) are key players in innate immunity to several allergens. For example, the dust mite allergen, Der p 2, has been shown to mimic the activity of human and mouse MD2 in the presence of LPS to trigger a response through TLR4. Bet v 1, an allergen from Birch tree, has been shown to enter and be transported through lung epithelium in patient cells. It is hypothesized that transcytosis of allergens like Bet v 1 may contribute to sensitization and exacerbation in atopic individuals. This project was focused on two primary aims; (1) Characterize the innate immune response of Alt a 1 in human airway epithelial cells, and (2) Identify if and how Alt a 1 can enter human airway cells. We found that Alt a 1 was able to stimulate innate immune responses in bronchial epithelial cells and this was dependent upon TLR2, TLR4 and the downstream adaptor proteins MyD88 and TIRAP. We also found in our studies that Alt a 1 rapidly enters bronchial epithelial cells. Furthermore, our data suggests that endocytosis of Alt a 1 may be partially dependent upon interaction with phosphatidyl-inositol-3-phosphate (PI-3-P). / Ph. D. / Allergic airway diseases such as rhinitis, asthma, and chronic rhinosinusitis are responsible for causing a huge economic burden on patients and society. Patients suffering from asthma often have allergies to pollen, dust mite, and mold. Interestingly, studies have shown that there is a correlation between severe asthma and allergy to several fungal species including Aspergillus, Alternaria, Cladosporium, and Penicillium. This project has been focused on studying how the allergen, Alt a 1, from the fungus, <i>Alternaria alternata</i>, can cause an allergic response in the human airways. In several studies, 90-100% of allergic patients who have allergy to Alternaria, have proteins in their bloodstream that specifically recognize Alt a 1. This indicates that they are allergic to Alt a 1. Though we know that these patients have allergy to Alt a 1, we do not know how this protein causes the characteristic symptoms of allergy, such as a runny nose, watery eyes, hives, and breathing difficulty. Published studies have increasingly made it clear that molecules on the surface of cells that line the airways are important players in the body’s response to allergens. A dust mite allergen, Der p 2, can interact with one such receptor on human cells. The receptor may not be the only way that allergens can cause a response. Studies have shown that allergens can directly enter human cells. For example, a Birch tree allergen, Bet v 1, has been shown to enter human lung cells. This project was focused on two primary aims; (1) Identify how human airway cells response to Alt a 1, and (2) Identify if and how Alt a 1 can enter human airway cells. We found that Alt a 1 was able to cause human airway cells to produce several molecules that lead to the characteristic symptoms of allergy, and that this response was dependent on a receptor on human airway cells. We also found that Alt a 1 rapidly enters human airway cells.

Parasitische Würmer wie Filarien können das Immunsystem ihres Wirtes modulieren. Diese Immunmodulation schützt nicht nur den Parasiten, sondern kann auch den Wirt vor allergischen Reaktionen schützen. In der vorliegenden Arbeit konnte belegt werden, dass Filariencystatin, ein sezernierter Proteinaseinhibitor des Fadenwurms Acanthocheilonema viteae Th2-assoziierte Entzündungen und die daraus resultierende Atemwegserkrankung im murinen Asthmamodell supprimiert. Diese Effekte von Cystatin beruhen wahrscheinlich auf der Induktion von IL-10 sezernierenden Makrophagen. Dafür spricht, dass sowohl die Depletion von Makrophagen, als auch die Blockierung von IL-10 den schützenden Effekt von Cystatin aufhoben. In einem murinen Dermatitismodell konnte durch Cystatinapplikation die Entzündung der Haut ebenfalls unterbunden werden. Die Verbesserung der atopischen Dermatitis führte zu einem Anstieg von TGF-Beta in den Ekzemregionen. Zusammenfassend belegen die Daten, dass ein einzelnes rekombinantes Helminthenprotein den anti-allergischen Effekt einer Gesamtwurminfektion nachahmen kann. Des weiteren wurde untersucht, ob die Immunmodulation von Helminthen an die Biologie des Wurmes gebunden ist. Der Einfluss einer gastrointestinalen Wurminfektion mit Heligmosomoides polygyrus wurde in Modellen mucosa-assoziierter allergischer Atemwegsentzündung und nicht-mukosa-assoziierter, kutanen Dermatitis untersucht. Im Asthmamodell konnte eine Reduzierung der Inflammation beobachtet werden, im Dermatitis Modell keinerlei Verbesserung des klinischen Bildes. Die Wurminfektion führte zu erhöhten Werten von Foxp3+ regulatorischen T-Zellen (Treg) in peribronchialen Lymphknoten, im Gegensatz dazu konnten keine Treg Zellen in ekzematöser Haut nachgewiesen werden. Diese Ergebnisse sind ein wichtiger Aspekt beim Einsatz von Helminthen zur Behandlung allergischer Erkrankungen, da die Lokalisation des Wurmes ein entscheidender Faktor in Richtung Verbesserung oder Verschlimmerung allergischer Erkrankungen zu sein scheint. / Parasitic worms, like filariae, have the intriguing capacity to modulate immune responses directed against them. This immunomodulation protects the parasite and was found to mediate a negative correlation between parasite infections and the prevalence of allergic disease. In the present study filarial cystatin (Av17), a secreted protease inhibitor of the filarial nematode Acanthocheilonema viteae, was found to suppress Th2-related inflammation and allergic airway responsiveness in mice. These effects of Av17 on allergic airway inflammation were probably due to induction of IL-10 secreting macrophages. Depletion of macrophages as well as blocking of IL-10 by application of anti-IL-10 receptor antibodies, prevented the curative effects and restored allergic airway inflammation. Treatment with cystatin in a model of allergic skin disease, suppressed inflammation, too. The protective effect on atopic dermatitis was accompanied by an increase of TGF-Beta in the eczema region. Hence, the data demonstrate that treatment with a single recombinant helminth protein can exert the anti-allergic effects of helminth infections. Furthermore this study investigated if immunomodulation by helminths is dependent on the biology of the worm. Infection with the gastrointestinal nematode Heligmosomoides polygyrus, was analyzed in models of mucosa-associated airway disease and non-mucosal, cutaneous atopic dermatitis. Infected mice showed reduced signs of allergic airway inflammation but no differences in phenotypical signs of dermatitis. Worm infection was associated with elevated numbers of Foxp3+ regulatory T cells (Treg) in peribronchial lymph nodes in the asthma model, whereas Treg cells were basically absent in eczematous skin. These findings might be an important aspect for future considerations of helminths for treatment of allergic diseases, as localisation of the parasites might be a crucial factor leading to amelioration or aggravation of allergic disease.