Atopische Erkrankungen wie Asthma, atopische Dermatitis und allergische Rhinitis sind komplexe, multifaktorielle Erkrankungen. Diese Arbeit untersuchte Gen-Gen- und Gen-Umweltinteraktionen von insgesamt acht Polymorphismen in fünf Kandidatengenen. In einer großen deutschen Geburtskohorte (Multizentrische Allergie Studie, MAS 90) mit longitudinalen klinischen und serologischen Daten wurde der Effekt von Polymorphismen in Genen, die für Interleukin-13 (IL-13), Interleukin-4 (IL-4) und dessen gemeinsamer Rezeptoruntereinheit IL4R-a kodieren, auf Atopie-assoziierte Merkmale untersucht. Zwei Polymorphismen im IL13-Gen (Arg130Gln, C-1055T) zeigten über den gesamten Beobachtungszeitraum von sieben Jahren eine signifikante Assoziation mit erhöhten Gesamt-IgE-Werten. Weiterhin konnte diese Untersuchung zeigen, dass mütterliches Rauchen diesen Effekt auf die IgE-Werte noch verstärkt. Ein Polymorphismus des Komplementfaktor-C5-Rezeptors, der im Mausmodell als Suszeptibilitätslokus für Asthma identifiziert wurde, wurde in der MAS-Kohorte wie auch in einer afro-karibischen Population auf Assoziation mit Atopie-relevanten Merkmalen untersucht. Eine Assoziation konnte zwar nicht gefunden werden, jedoch waren hochsignifikante Unterschiede in der Allelfrequenz in den zwei ethnischen Gruppen auffällig; ein Phänomen, welches auch bei anderen genetischen Varianten in proinflammatorischen Genen beobachtet wurde. Ein funktioneller Polymorphismus des histaminabbauenden Enzyms Histamin-N-Methyl-Transferase wurde auf eine Assoziation mit bronchialer Hyperreagibilität und Asthma in der MAS-Kohorte sowie in einer weiteren kaukasischen Population von asthmatischen Kindern überprüft. Weder eine Assoziation mit Asthma noch eine modulierende Wirkung auf den Schweregrad der bronchialen Hyperreagibilität konnte in den Studienpopulationen gefunden werden. Im Gegensatz zu Untersuchungen bei erwachsenen Asthmatikern scheint diese Variante bei kindlichem Asthma keine entscheidende Rolle zu spielen. / Atopic diseases like asthma, atopic dermatitis and allergic rhinitis are complex traits of multifactorial origin. This study aimed to reveal gene-gene- and gene-environmental interactions of eight polymorphisms in five candidate genes. We examined whether 6 genetic variants of the genes coding for Interleukin-4 (IL-4), Interleukin-13 (IL-13) and their common receptor unit IL4R-alpha had genotypic effects on atopy-related traits such as total serum IgE levels in a large German birth cohort study (Multicenter Atopy Study, MAS 90) with longitudinally well defined phenotypes. Two single nucelotide polymorphisms (SNP) in the IL-13 gene (Arg130Gln, C-1055T) showed a significant association with increased serum IgE levels over the whole period of seven years. In addition, exposure to maternal smoking appears to modify the above effects on total serum IgE levels. We tested the association of atopy-related traits and a SNP of the complement factor 5 receptor (-245T) in the MAS cohort and in an afro-caribbean population. Although we could not observe any association, there was a highly significant difference in the frequency of the -245T allele between the two ethnic populations, a phenomenon previously described for other genetic variants. Histamine N-Methyltransferase (HNMT) catalyses the major pathway of histamine metabolism in the human lung. We tested the functional polymorphism C314T of HNMT for association with asthma and bronchial hyperresponsiveness in two German pediatric populations (MAS, Astmatic children from Freiburg). No association of the T314 Allele with asthma, BHR and other asthma related phenotypes could be observed. We concluded that this SNP might not play a major role in the pathogenesis of asthma or BHR in German children.

Aktuelle Studien legen nahe, dass ein niedriger Vitamin D-Status assoziiert mit steigenden Breitengraden, mit dem Auftreten von Autoantikörpern und damit einhergehenden Autoimmunerkrankungen positiv korreliert. Trifft UV-B-Strahlung auf die Haut, entsteht aus 7-Dehydrocholesterol nach enzymatischen Prozessen in Leber und Niere, die bioaktive Form von Vitamin D, 1α,25-Dihydroxyvitamin D3 (Calcitriol). Den finalen Stoffwechselschritt katalysiert die 1α-Hydroxylase CYP27B1. Die biologische Wirkung von Calcitriol wird über dessen Bindung an den nukleären Vitamin D-Rezeptor vermittelt, was letztlich zur Transkription der Zielgene führt. Die T-Zell-abhängige Sensibilisierung von Vitamin D-defizienten Cyp27b1-KO- und Wildtyp-Tieren mit Ovalbumin zeigte verstärkte humorale Immunantworten mit erhöhten Konzentrationen von Gesamt- sowie spezifischem IgG1, IgE und IgA bei den Cyp27b1-KO-Mäusen. Die Untersuchung der Leukopoese der Cyp27b1-KO-Tiere zeigte, dass die untersuchten lymphatischen Organe verminderte Gesamtzellzahlen gegenüber Wildtyp-Tieren aufwiesen. Die Präsenz und Verteilung in den jeweiligen Zellkompartimenten offenbarte keine wesentlichen Abweichungen zwischen Cyp27b1-KO- und Wildtyp-Mäusen. In einem Krankheitsmodell mit dem Helminthen Heligmosomoides polygyrus bakeri fielen die Cyp27b1-KO-Tiere durch dem Wildtyp gegenüber erhöhten Gesamt- sowie spezifischen IgE-Werten auf. Zwischen beiden Genotypen zeigten sich keine Unterschiede bei parasitologischen Parametern wie der Wurmlast, der Eianzahl pro Gramm Faeces sowie der Fekundität. Die Ergebnisse dieser Arbeit bestätigen, dass endogen-produziertes Vitamin D einen Einfluss auf die Funktionsweise von Lymphozyten hat. Dies äußert sich in verstärkten IgE-abhängigen Immunantworten bei Cyp27b1-KO-Tieren. In einem Parasiteninfektionsmodell wurden erneut verstärkte IgE-Antworten beobachtet, jedoch waren keine pathophysiologischen Konsequenzen in Bezug auf die Wurmabwehr nachweisbar. / Current studies demonstrate that low vitamin D levels associated with higher latitudes correlate with the occurrence of autoantibodies and linked diseases. Following UV-B radiation of the skin, numerous enzymatic reactions in liver and kidneys causes 7-dehydrocholesterol to turn into the bioactive 1α,25-dihydroxyvitamin D3 (calcitriol). The final and crucial step is thereby performed by the enzyme CYP27B1, an 1α-hydroxylase. The effect of calcitriol is mediated through binding to the vitamin D receptor, resulting in the transcription of target genes. T cell-dependent sensitization of Cyp27b1-wildtype and Cyp27b1-KO mice with ovalbumin revealed an increased humoral immune response in Cyp27b1-KO mice reflected by elevated concentrations of total and specific IgG1, IgE and IgA. Analysis of the leukopoiesis showed a diminished total cell count in bone marrow, thymus, spleen and peritoneal cavity in Cyp27b1-KO compared to Cyp27b1-wildtype mice. However, appearance and distribution of the analyzed cell compartments were comparable. A disease model using the intestinal nematode Heligmosomoides polygyrus bakeri demonstrated enhanced secretion of total and specific IgE in Cyp27b1-KO mice, which confirmed our previous findings. However, this showed no effect on parasite rejection, as seen in comparable results for worm burden, eggs per gram faeces and fecundity of female worms in Cyp27b1-wildtype and Cyp27b1-KO mice. Our work verified the role of endogenous vitamin D for lymphocyte development revealed by increased IgE-dependent immune responses in Cyp27b1-KO mice. Infection with H.p. bakeri confirmed enhanced IgE-responses, however, these results revealed no benefit in parasite clearance.

Background: Allergic sensitization is the most important risk factor for asthma and rhinitis among children, adolescents and young adults. Less is known about the incidence and remission of allergic sensitization, particularly in older adults. Furthermore, it is not clear if the earlier documented increase in prevalence of allergic sensitization continues. This thesis is focused on prevalence, incidence and remission of allergic sensitization to airborne allergens among adolescents and adults as well as on time trends in prevalence among adults. Furthermore, associated risk factors and the relation of allergic sensitization to asthma and rhinitis were assessed. Methods: In the study of children and adolescents, incidence, remission and prevalence of allergic sensitization were assessed in a cohort study of schoolchildren, aged 7-8 years (y) at baseline. In the studies of adults, incidence and remission of allergic sensitization were assessed in a randomly selected adult population sample in 1994 (n=664) aged 20-69 y, which was followed up in 2004 (n=555). Trends in prevalence of allergic sensitization were assessed by comparing two cross-sectional studies; the cohort from 1994 and another randomly selsected population sample examined in 2009 (n=737). The relation of allergic sensitization to asthma and rhinitis was determined in the adult cohort in 2009. Allergic sensitization was assessed by skin prick test (SPT) with ten common airborne allergens at ages 7-8, 11-12 and 19 y in the cohort of children and in the participants ≤ 60 y in the adult cohorts. Specific IgE to nine airborne allergens was analyzed in the adult cohorts in 2004 and 2009. Risk factors for allergic sensitization and variables defining respiratory disease and symptoms were assessed by questionnaires in the cohort of children and by structured interviews in the adult cohorts. Results: The 10-year cumulative incidence of allergic sensitization among the adults from 1994 to 2004 was 5%, while remission was 32%. In both adult cohorts, the prevalence of allergic sensitization was highest among young adults, aged 20-29 y, 55% and 61% and decreased significantly with increasing age. Among children and adolescents, both incidence and persistence of allergic sensitization were high, and the prevalence of allergic sensitization increased by age from 21% at age 7-8 y to 42% at age 19 y. Multisensitization at age 19 y was strongly associated with early onset of sensitization. The prevalence of sensitization to the major specific allergens birch, timothy, cat and dog as well as multisensitization (from 40% in 1994 to 56% in 2009, p=0.002) increased significantly from 1994 to 2009 among the adults. Sensitization to any allergen increased from 35% to 39%, however not significantly (p=0.13). A family history of allergic rhinitis was strongly and consistently associated with allergic sensitization in all ages. Male sex and urban living were significantly positively and birth order and furry animals at home in childhood were negatively associated with onset of sensitization before the age of 7-8 y, but not with onset of sensitization from 11-12y to 19 y. Young adult age and urban living were significant factors associated with allergic sensitization in adult age. Sensitization to any animal was significantly positively associated with current asthma (OR4.80 (95% CI 2.68-8.60)), whereas both sensitization to any pollen (OR 4.25 (2.55-7.06)) and any animal (OR 3.90 (95% CI 2.31-6.58)) were associated with current allergic rhinitis. The association between allergic sensitization and allergic rhinitis was strongest in young adult age and decreased with increasing age, while asthma was similarly associated with sensitization to any animal across all adult ages. Among asthmatics, the prevalence of allergic sensitization decreased with increasing age of asthma onset. Conclusion: Both incidence and persistence of allergic sensitization were high among children and adolescents explaining the increase in prevalence by increasing age. An inverse pattern with low incidence and high remission of allergic sensitization was seen among adults. The decrease in prevalence of allergic sensitization by increasing adult age might at least partly be explained by normal ageing and not only by an effect of year of birth (cohort effect). The significant increase in prevalence of sensitization to the specific allergens explained the significant increase in multisensitization over 15 years. A family history of allergy was the strongest and the only consistent risk factor for allergic sensitization in all ages. The prevalence of allergic sensitization decreased with increasing age of asthma onset among adult asthmatics.

<p>Background: The reasons why some individuals become IgE-sensitised and allergic are largely unknown, though genetic- and early life environmental factors seem to be of importance.</p><p>Objective: The overall aim of this thesis was to investigate the relationship between IgE-sensitisation and allergic disease, viral infections, genetic markers and early life cytokines.</p><p>Results: IgE-sensitised children were found to have reduced numbers of IL-12 producing cord blood mononuclear cells (CBMC), whereas children diagnosed with eczema were found to have reduced numbers of IFN-γ producing CBMC. When dividing the children into early onset of IgE-sensitisation and late onset of IgE-sensitisation we found that the children with an early onset had low numbers of PHA-induced IL-4, IL-12 and IFN-γ secreting CBMC. At the age of two there was a general exacerbation of cytokine responses in the IgE-sensitised children, and the results were similar for the children with early onset IgE-sensitisation. Children with a late onset IgE-sensitisation were more similar to the non-sensitised children, but with a specific increase in the response to cat allergen (IL-4 and IFN-γ). The mothers of IgE-sensitised children, were just as their children, found to have an exaggerated cytokine response as compared to mothers of non-sensitised children. Maternal responses correlated well to the responses seen in the child, though the samples were taken two years after delivery.</p><p>Cytomegalovirus (CMV) infection in early life was associated to reduced numbers of IL-4, and increased numbers of IFN-γ producing cells at the age of two. No association between CMV seropositivity and IgE-sensitisation was seen. Epstein-Barr virus (EBV) infection, on the other hand, was inversely correlated with IgE –sensitisation, whereas no statistically significant association to cytokine production could be seen.</p><p>We also showed that the IL12B 1188 C-allele was associated to having a positive skin prick test at the age of two. The rare alleles of the three SNPs investigated (IL12B 1188C, IL12RB1132C and IRF1 1688A) were all associated to low IL-12 production at birth.</p><p>Conclusions: Our results indicate that allergic diseases are complex traits, and that both the genetic and the cytokine background differ between the different allergic diseases. We can also conclude that the time of onset seem to play a role when investigating IgE-sensitisation, and that perhaps early and late onset IgE-sensitisation have partly different causes. CMV and EBV infection early in life are associated to a protective cytokine profile and to protection from IgE-sensitisation, respectively, again indicating the heterogeneity and the complexity of allergic diseases.</p>

Mast cell progenitors originate from the bone marrow and migrate to the lungs via the blood. During maturation, these cells acquire granules that contain a potent array of bronchoconstrictive mediators. The number of pulmonary mast cells is augmented in asthmatic patients and in mice with allergic airway inflammation, possibly contributing to airway hyperreactivity. An increase in mast cells is likely due to an increased recruitment of committed mast cell progenitors from the blood. However, until now a committed mast cell progenitor population has not been found in adult peripheral blood. We isolated Lin- c-kithi ST2+ integrin β7hi CD16/32hi progenitors from murine blood and showed that these cells were committed to the mast cell lineage. Based on the expression of FcεRI, these cells were less mature in Th1-prone C57BL/6 mice than in Th2-prone BALB/c mice. Asthma is associated with elevated levels of IgE. Upon exposure to allergens, IgE immune complexes are formed. In a mouse model of allergic airway inflammation, we showed that intranasal administration of IgE immune complexes to antigen-sensitized mice resulted in an increased number of mast cell progenitors compared with antigen administration alone. The increase in mast cell progenitors was independent of the low-affinity IgE receptor CD23. Rather, signaling through the common FcRγ-chain was required to enhance the number of lung mast cell progenitors. Signaling through FcεRI was likely responsible for the increase. However a role for FcγRIV could not be excluded. CD11c+ cells, such as dendritic cells, are important for antigen sensitization. In a mouse model of allergic airway inflammation, these cells are also important for the development of airway hyperreactivity, eosinophilia and Th2 cytokine production in response to antigen challenge. We showed that CD11c+ cells are critical for the recruitment of lung mast cell progenitors and the subsequent increase in mast cells. These CD11c+ cells were needed for the upregulation of endothelial vascular cell adhesion molecule-1 (VCAM-1), which is a prerequisite for the antigen-induced recruitment of lung mast cell progenitors.

Mémoire numérisé par la Direction des bibliothèques de l'Université de Montréal.

Mémoire numérisé par la Division de la gestion de documents et des archives de l'Université de Montréal.

Fluvastatin, the HMG-CoA reductase inhibitor known for its role in the treatment of hypercholesterolemia and cardiovascular disease, has more recently been shown to play a role in the immune response. Given the critical role that mast cells play in allergy and inflammatory diseases such as asthma, which effects one third of America’s population, we assessed the effect of fluvastatin on mast cell and basophils function. We demonstrate that fluvastatin downregulated IgE-mediated cytokine production. Additionally, in vivo studies showed that fluvastatin suppressed IgE-mediated anaphylaxis. Interestingly, the effects of fluvastatin showed dependence on genetic background, as C57BL/6 mast cells were sensitive, while 129/Sv mast cells were resistant to fluvastatin. Characterizing the role of fluvastatin on mast cells may prove to be therapeutically important.

Through underexpression and overexpression studies, CD23 has been shown to negatively regulate IgE production. To investigate CD23 destabilization and its effects on CD23 shedding and IgE synthesis in vivo, we utilized an anti-CD23 stalk monoclonal (19G5) which has previously been shown to enhance proteolysis of CD23 in vitro. Compared to isotype control-treated mice, mice injected with 19G5 displayed enhanced serum soluble CD23 and IgE. Because 19G5 injection substantially enhanced CD23 shedding, it was useful in investigating the identity of the CD23 sheddase. 19G5 enhanced CD23 shedding in ADAM8-/-, ADAM9-/-ADAM15-/-, and ADAM9-/-ADAM12-/-ADAM15-/- mice, ruling out these ADAMs as candidate CD23 sheddases. Through the use of an ADAM10 inhibitor, we blocked CD23 shedding from murine B cells while increasing CD23 surface levels, and thus we identified ADAM10 as the CD23 sheddase. During the course of the ADAM investigation, we discovered that the 129/SvJ inbred mouse strain carried five amino acid substitutions within its CD23 gene. The mutations resulted in reduced CD23 surface expression and hyper IgE levels in vivo. The hyper IgE phenotype was consistent with a more rapid clearance of Nippostrongylus brasiliensis from the gut of 129/SvJ mice. B cells from 129/SvJ spleens proliferated more rapidly than those from BALB/c after stimulation with IL-4 and CD40 ligand trimer in vitro. However, in vitro IgE levels in supernatants from 129/SvJ B cells were significantly reduced, suggesting that the B cells were no longer responsive to IL-4 in vitro. Although the affinity of the IgE-129/SvJ CD23 interaction was similar to that of the BALB/c, 129/SvJ B cells exhibited a reduced number of IgE binding sites, demonstrating that high levels of CD23 are essential for controlling IgE synthesis. This finding was further confirmed in another disease model, namely the mouse asthma model. Mice overexpressing CD23 displayed suppressed allergic lung inflammation and reduced levels of IgE and Th2 cytokines and chemokines. Overall, the data provide a direct demonstration for CD23's role in regulating IgE production in vivo and suggest that therapies aimed at stabilizing cell surface CD23 would inhibit proteolysis and increase surface expression, and thus would be beneficial in controlling allergic disease.

ADAM10 is a zinc-dependent metalloprotease. ADAM10 has emerged as a key regulator of cellular processes by cleaving and shedding extracellular domains of multiple transmembrane receptors and ligands. In this study, we examined the role of ADAM10 in the immune system. Here, we show that knocking out ADAM10 on the mature B2 cell causes a defect in the development of secondary lymphoid architecture that becomes more severe post-immunization. We also show that overexpression of ADAM10 leads to a defect in hematopoiesis, which eliminates B2 lymphocyte development. This defect additionally induces accumulation of myeloid derived suppressor cells, MDSCs. ADAM10Tg MDSCs function synonymous to tumor MDSCs. Of the two subpopulations of MDSCs, granulocytic MDSCs increase parasitic clearance in a model of N. brasiliensis. Monocytic MDSCs are more immunosuppressive in regards to tumor. Both subpopulations are dependent on the presence of mast cells for activity. It is thought that this relationship is mediated through histamine and IL-13. During N. brasiliensis infection, ADAM10Tg mice, lacking B2 B cells but having intact B1 B cells, makes increased IgE over WT mice. This production of IgE is thought to be produced by the B1 cells. Of the two types of B1 cells, B1a cells make the majority of the IgE. This IgE production is enhanced by MDSC accumulation and can be induced by MDSC adoptive transfer in a parasite-free mouse. Lastly, ADAM10 is the key sheddase for CD23 on B2 cells. When IgE is bound to its antigen to form an immune complex, IC, it binds CD23 and is internalized. After CD23 bound to IgE ICs is internalized, it is sorted into bexosomes. These bexosomes are transferred to dendritic cells which are responsible for presenting to T cells and inducing an increased antigen-specific immune response. Overall, ADAM10 is important for many aspects of the immune response.