Kinetics of mast cell, basophil, and oral food challenge responses in omalizumab-treated adults with peanut allergy.
Kinetics of mast cell, basophil, and oral food challenge responses in omalizumab-treated adults with peanut allergy.
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DOI：
10.1016/j.jaci.2012.05.039
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发表时间：
2012-11
影响因子：
14.2
通讯作者：
Wood, Robert A.
中科院分区：
文献类型：
--
作者：
Savage, Jessica H.;Courneya, Jean-Paul;Sterba, Patricia M.;MacGlashan, Donald W.;Saini, Sarbjit S.;Wood, Robert A.
针对IgE的单抗在花生过敏患者中显示出临床疗效，但以前的研究没有涉及临床反应的动力学或肥大细胞和嗜碱性粒细胞在食物诱导的过敏反应中的作用。我们试图确定临床对奥马珠单抗的反应动力学，以及临床改善是否与肥大细胞或嗜碱性粒细胞抑制有关。对花生过敏的受试者用奥马珠单抗治疗6个月，并评估临床和细胞反应。在基线时，受试者接受了双盲、安慰剂对照的口服食物挑战(OFC)、皮肤点刺试验滴定(SPTT)和花生嗜碱性粒细胞组胺释放(BHR)。在第2周重复BHR，然后每周重复一次，直到BHR降至基线的20%以下。在BHR减少后(如果BHR没有下降，则在第8周)重复OFC和SPTT，并在6个月时再次进行。14名受试者参加了这项研究。在第二次食物挑战中，花生引起过敏症状的阈值剂量显著增加(80至6500 mg，P<；0.01)。花生诱发的BHR被完全抑制(n=5)，或者需要增加10倍的变应原才能诱导最大的BHR(n=9)，SPTT反应与基线相比没有显著变化。在奥马珠单抗治疗6个月后，没有观察到OFC阈值剂量或BHR的进一步变化，但在SPTTS中发现了显著的抑制。临床对奥马珠单抗的反应发生在治疗的早期，当嗜碱性粒细胞而不是肥大细胞被抑制时，支持嗜碱性粒细胞在急性食物反应中的作用。
Monoclonal antibodies directed at IgE demonstrate clinical efficacy in subjects with peanut allergy, but previous studies have not addressed the kinetics of the clinical response or the role of mast cells and basophils in the food-induced allergic response. We sought to determine the kinetics of the clinical response to omalizumab and whether clinical improvement is associated with either mast cell or basophil suppression. Subjects with peanut allergy were treated with omalizumab for 6 months and assessed for clinical and cellular responses. At baseline, subjects had a double-blind, placebo-controlled oral food challenge (OFC), skin prick test titration (SPTT), and basophil histamine release (BHR) to peanut. BHR was repeated at week 2 and then weekly until it decreased to less than 20% of baseline values. The OFCs and SPTTs were repeated after the BHR reduction (or at week 8 if BHR did not decrease) and again at 6 months. Fourteen subjects enrolled in the study. At the second food challenge, there was a significant increase in the threshold dose of peanut inducing allergic symptoms (80 to 6500 mg, P < .01). Peanut-induced BHR was either completely suppressed (n = 5) or 10-fold more allergen was required to induce maximal BHR (n = 9), and SPTT responses were not significantly changed from baseline. After 6 months of omalizumab, further changes in the OFC threshold dose or BHR were not observed, but a significant suppression in SPTTs was identified. The clinical response to omalizumab occurs early in treatment when the basophil, but not the mast cell, is suppressed, supporting a role for the basophil in acute food reactions.
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影响因子：
14.2
作者：
Saini, SS;Richardson, JJ;MacGlashan, DW
通讯作者：
MacGlashan, DW
影响因子：
14.2
作者：
Vonakis, Becky M.;Vasagar, Kavitha;Saini, Sarbjit S.
通讯作者：
Saini, Sarbjit S.
使用鼻内猫过敏原激发，奥马珠单抗对嗜碱性粒细胞和肥大细胞反应的影响。
影响因子：
14.2
作者：
Eckman, John A.;Sterba, Patricia M.;Kelly, Denise;Alexander, Val;Liu, Mark C.;Bochner, Bruce S.;MacGlashan, Donald W., Jr.;Saini, Sarbjit S.
通讯作者：
Saini, Sarbjit S.
影响因子：
158.5
作者：
Leung, DYM;Sampson, HA;Shanahan, WR
通讯作者：
Shanahan, WR
影响因子：
14.2
作者：
MacGlashan, Donald W., Jr.;Savage, Jessica H.;Saini, Sarbjit S.
通讯作者：
Saini, Sarbjit S.