Extracellular vesicle–derived protein from Bifidobacterium longum alleviates food allergy through mast cell suppression  Jung-Hwan Kim, PhD, Eun-Ji Jeun,

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Extracellular vesicle–derived protein from Bifidobacterium longum alleviates food allergy through mast cell suppression  Jung-Hwan Kim, PhD, Eun-Ji Jeun, MSc, Chun-Pyo Hong, PhD, Seong-Hoon Kim, MSc, Min Seong Jang, DVM, PhD, Eun-Jung Lee, MSc, Sook Jin Moon, BSc, Chang Ho Yun, PhD, Sin-Hyeog Im, PhD, Seok-Geun Jeong, PhD, Beom-Young Park, PhD, Kyong-Tai Kim, PhD, Ju-Young Seoh, MD, PhD, Yoon-Keun Kim, MD, PhD, Sung-Jong Oh, PhD, Jun-Sang Ham, PhD, Bo-Gie Yang, PhD, Myoung Ho Jang, PhD  Journal of Allergy and Clinical Immunology  Volume 137, Issue 2, Pages 507-516.e8 (February 2016) DOI: 10.1016/j.jaci.2015.08.016 Copyright © 2015 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 1 Effects of B longum KACC 91563 and E faecalis KACC 91532 on food allergy–induced diarrhea. Induction of food allergy was evaluated based on diarrhea occurrence in mice. A, Experimental schedule for food allergy induction in mice. i.g., Intragastric; i.p., intraperitoneal. B, For food allergy induction, 50 mg of OVA was orally administered 5 times. Combined data from 3 independent experiments (OVA vs OVA + B longum: **P < .01, n = approximately 15-17 mice per group). Journal of Allergy and Clinical Immunology 2016 137, 507-516.e8DOI: (10.1016/j.jaci.2015.08.016) Copyright © 2015 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 2 B longum KACC 91563 reduced the number of mast cells in the LP of the small intestine in food allergy–induced mice. A, Paraffin sections of the jejunum of the small intestine were stained for mast cells. A magnification of the LP clearly shows mast cells. The number of mast cells was counted in 4 different fields (n = 5 mice per group; original magnification ×400). HPF, High-power field. B, MCPT-1 levels in serum (n = approximately 6-7 per group). C, Levels of OVA-specific IgE in serum. Values represent means ± SEMs. One-way ANOVA with the Newman-Keuls posttest is applied. Statistical significance: *P < .05 and ***P < .001. Data are representative of 2 to 3 independent experiments. B. l, B longum KACC 91563; E. f, E faecalis KACC 91532. Journal of Allergy and Clinical Immunology 2016 137, 507-516.e8DOI: (10.1016/j.jaci.2015.08.016) Copyright © 2015 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 3 Apoptosis of BMMCs induced by B longum KACC 91563 and its EVs. A, TEM image of EVs derived from B longum KACC 91563 and E faecalis KACC 91532. B, Size of EVs. Error bars indicate means ± SDs from 5 measurements. C, Apoptosis assay. Annexin V+ apoptotic cells were measured by means of fluorescence-activated cell sorting (n = 3). Values represent means ± SEMs. Statistical analysis was performed by using 1-way ANOVA with the Newman-Keuls posttest. **P < .01 and ***P < .001. Data are representative of 2 to 3 independent experiments. D, BMMCs were incubated with whole bacteria or EVs of B longum KACC 91563 or E faecalis KACC 91532 for 2 hours. Apoptotic cells were stained with the DeadEnd Fluorometric TUNEL system. Representative data are shown (magnification ×400). Nuclei of cells are blue, and TUNEL is green. The number of apoptotic cells was counted in 7 different fields (magnification ×100, n = 3 per group). Values represent means ± SEMs. Statistical analysis was performed by using 1-way ANOVA with Newman-Keuls posttest. *P < .05 and **P < .01. B. l, B longum KACC 91563; E. f, E faecalis KACC 91532. Journal of Allergy and Clinical Immunology 2016 137, 507-516.e8DOI: (10.1016/j.jaci.2015.08.016) Copyright © 2015 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 4 EVs of B longum KACC 91563 and E faecalis KACC 91532 were internalized by BMMCs. A, Individual cell populations were incubated with specific bacteria-derived EVs at the indicated temperature. The percentages of cells that internalized EVs are represented with a bar graph. ns, Not significant. B, Representative images are shown. Nuclei of cells are blue, and DiI-labeled EVs are red. Values represent means ± SEMs. The Student t test was applied. Statistical significance: **P < .01. The number of cells was counted in 25 different fields was shown (n = approximately 3-4 per group; original magnification ×400). Data are representative of 2 independent experiments. B. l, B longum KACC 91563; E. f, E faecalis KACC 91532. Journal of Allergy and Clinical Immunology 2016 137, 507-516.e8DOI: (10.1016/j.jaci.2015.08.016) Copyright © 2015 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 5 Suppression of food allergy responses through ESBP, a major protein of B longum KACC 91563–derived EVs. A, Proteins of B longum KACC 91563 and its EVs were analyzed by using SDS-PAGE. ESBP and ASBP were identified through proteomic analysis. B, Experimental schedule for food allergy induction and administrations of ESBP or ASBP in mice. C, Abilities of GST-tagged recombinant ESBP or ASBP (50 μg) to suppress allergic diarrhea (OVA + GST vs OVA + ESBP: ***P < .001, n = approximately 6-22 mice per group). Recombinant GST protein–treated mice were used as a positive control. Data are combined from 3 independent experiments. D, Paraffin-embedded sections of jejunum were stained for mast cells (original magnification ×400). E, The number of mast cells was counted in 4 different fields and represented by a bar graph (n = 4 mice per group). Statistical analysis was performed by using 1-way ANOVA with the Newman-Keuls posttest. *P < .05. F, Levels of MCPT-1 in serum (n = approximately 3-6 per group). Data are representative of 2 independent experiments. i.g., Intragastric; i.p., intraperitoneal. Journal of Allergy and Clinical Immunology 2016 137, 507-516.e8DOI: (10.1016/j.jaci.2015.08.016) Copyright © 2015 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 6 Proposed mechanism of attenuation of food allergy by B longum KACC 91563. B longum KACC 91563 in the intestinal lumen secretes small-sized EVs that contain bacterial components. The EVs penetrate through intestinal epithelial cells and specifically induce apoptosis of mast cells in the LP. The reduction of mast cells results in suppression of food allergy. Journal of Allergy and Clinical Immunology 2016 137, 507-516.e8DOI: (10.1016/j.jaci.2015.08.016) Copyright © 2015 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig E1 Characterization of B longum KACC 91563 and E faecalis KACC 91532. A, Morphologic features of B longum KACC91563 and E faecalis KACC 91532 were analyzed by using TEM. B, B longum KACC91563 and E faecalis KACC 91532 were administered for 2 weeks, and FISH analysis was performed on fecal samples. Journal of Allergy and Clinical Immunology 2016 137, 507-516.e8DOI: (10.1016/j.jaci.2015.08.016) Copyright © 2015 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig E2 Effects of B longum KACC 91563 and E faecalis KACC 91532 on the low-dose food allergy model. For food allergy induction, 10 mg of OVA was orally administered 7 times (OVA vs OVA + B longum: *P < .05, n = approximately 6-8 mice per group). Journal of Allergy and Clinical Immunology 2016 137, 507-516.e8DOI: (10.1016/j.jaci.2015.08.016) Copyright © 2015 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig E3 Alleviation of food allergy by B. longum KACC 91563 was not associated with T cell–mediated immune responses. A, After the fifth intragastric challenge of OVA, MLN cells were cultured with OVA for 72 hours, and concentrations of IL-4, IL-5, IL-9, IL-10, IL-13, IL-17, and IFN-γ in the culture supernatants were measured. B, Cells were isolated from spleens and MLNs and stained for CD4 and Foxp3. Proportions of Foxp3+ Treg cells were assessed by using fluorescence-activated cell sorting. Values represent means ± SEMs (n = 4 per group). Data are representative of 2 independent experiments. B. l, B longum KACC 91563; E. f, E faecalis KACC 91532. Journal of Allergy and Clinical Immunology 2016 137, 507-516.e8DOI: (10.1016/j.jaci.2015.08.016) Copyright © 2015 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig E4 Effect of B longum KACC 91563 on mast cells in the intestine under homeostatic conditions. B longum KACC 91563 was administered into mice without induction of food allergy. A, Intestinal mast cell population was assessed by using fluorescence-activated cell sorting (n = 5 mice per group). B, Paraffin-embedded sections of the jejunum were stained for mast cells, and the number of mast cells was counted in 3 different fields (n = approximately 4-5 mice per group; original magnification ×400). ND, Normal diet. Values represent means ± SEMs. Journal of Allergy and Clinical Immunology 2016 137, 507-516.e8DOI: (10.1016/j.jaci.2015.08.016) Copyright © 2015 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig E5 Effect of acetate, a metabolite of B longum, on food allergy. A and C, Experimental schedule for food allergy induction and acetate administration in mice. B, Acetate (150 mmol/L) was administered in drink to mice every day from day 19 of the food allergy model and occurrence of allergic diarrhea was analyzed to examine the effect of acetate on food allergy symptoms (n = 5 mice per group). D, Acetate (150 mmol/L) was administered in drink to mice every day from day 0 of the food allergy model and occurrence of allergic diarrhea was analyzed to examine the effect of acetate on food allergy symptoms (n = approximately 5-10 mice per group). i.g., Intragastric; i.p., intraperitoneal. Journal of Allergy and Clinical Immunology 2016 137, 507-516.e8DOI: (10.1016/j.jaci.2015.08.016) Copyright © 2015 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig E6 ESBP attenuates food allergy in a dose-dependent manner. A, Purification of GST-tagged recombinant ESBP and ASBP. B and C, Injection of ESBP and ASBP into the mouse that was part of the food allergy model at various concentrations (0.5, 5, and 50 μg) and measurement of diarrhea occurrence (OVA + GST 50 μg vs OVA + ESBP 50 μg: **P < .01, n = 6 mice per group). Journal of Allergy and Clinical Immunology 2016 137, 507-516.e8DOI: (10.1016/j.jaci.2015.08.016) Copyright © 2015 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig E7 Effects of ESBP on mast cells, eosinophils, and Foxp3+ Treg cells in the small intestine. Mast cells, eosinophils, and Foxp3+ Treg cells in the LP were analyzed by using flow cytometry. A, Mast cells were gated as IgE+c-kit+ cells. B, Eosinophils were gated as Siglec-F+CCR3+ cells. C, Foxp3+ Treg cells were gated as CD4+Foxp3+ cells. Values represent means ± SEMs. Statistical analysis was performed by using 1-way ANOVA with the Newman-Keuls posttest. **P < .01. Data are representative of 2 independent experiments. Journal of Allergy and Clinical Immunology 2016 137, 507-516.e8DOI: (10.1016/j.jaci.2015.08.016) Copyright © 2015 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig E8 Administration of B longum KACC 91563 during the effector phase of the food allergy model has no suppressive effect. A, Experimental schedule for food allergy induction and B longum KACC 91563 administration in mice. B, Diarrhea occurrence (n = approximately 4-9 mice per group). C, Proportion of mast cells in the small intestine was determined by using fluorescence-activated cell sorting analysis (n = approximately 4-7 mice per group). D, MCPT-1 levels in serum. E, Paraffin-embedded sections of the small intestine were stained for mast cells. Numbers of mast cells were counted in 3 different fields (n = approximately 3-4 mice per group; original magnification ×400). Values represent means ± SEMs. i.g., Intragastric; i.p., intraperitoneal. Journal of Allergy and Clinical Immunology 2016 137, 507-516.e8DOI: (10.1016/j.jaci.2015.08.016) Copyright © 2015 American Academy of Allergy, Asthma & Immunology Terms and Conditions