Peanut-induced intestinal allergy is mediated through a mast cell–IgE–FcεRI–IL-13 pathway Meiqin Wang, MD, PhD, Katsuyuki Takeda, MD, PhD, Yoshiki Shiraishi,

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Presentation transcript:

Peanut-induced intestinal allergy is mediated through a mast cell–IgE–FcεRI–IL-13 pathway Meiqin Wang, MD, PhD, Katsuyuki Takeda, MD, PhD, Yoshiki Shiraishi, PhD, Masakazu Okamoto, MD, PhD, Azzeddine Dakhama, PhD, Anthony Joetham, BS, Erwin W. Gelfand, MD Journal of Allergy and Clinical Immunology Volume 126, Issue 2, Pages 306-316.e12 (August 2010) DOI: 10.1016/j.jaci.2010.05.017 Copyright © 2010 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 1 Decreased intestinal allergic responses in FcεRI−/− mice. A, Protocol for induction of peanut-induced intestinal allergy. Mice were sensitized and challenged as described in the Methods section. B, Kinetics of development of diarrhea were assessed 30 minutes after the last challenge in WT and FcεRI−/− mice. C, Symptom scores were assessed 30 minutes after oral challenge. ∗P < .001 between mice in the sensitized and challenged with peanut (PE/PE) WT and PE/PE FcεRI−/− groups. D, Body weight changes. Weights were obtained before challenge and after 7 days of challenge. Results were expressed as percentage weight change. Results were obtained from 3 individual experiments with 4 to 5 mice per group. ∗P < .001 compared with all other groups. PBS/PE, Nonsensitized but challenged with PE group. Journal of Allergy and Clinical Immunology 2010 126, 306-316.e12DOI: (10.1016/j.jaci.2010.05.017) Copyright © 2010 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 2 Levels of plasma histamine. Plasma levels of histamine were assessed within 30 minutes after the last challenge. Results were obtained from 3 individual experiments with 4 mice per group. ∗P < .01 compared with all other groups. PBS/PE, Nonsensitized but challenged with peanut group; PE/PE, sensitized and challenged with PE group. Journal of Allergy and Clinical Immunology 2010 126, 306-316.e12DOI: (10.1016/j.jaci.2010.05.017) Copyright © 2010 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 3 Decreased inflammatory cell accumulation in the intestinal walls of FcεRI−/− mice. A, Quantitation of mucosal mast cell numbers in the jejunum. B, Quantitation of mucosal eosinophil numbers in the jejunum. C, Quantitation of mucosal goblet cells in the jejunal epithelium. For mast cells and eosinophils, results are expressed as the number of chloroacetate esterase– or anti–major basic protein–stained cells per square millimeter of lamina propria, respectively. For goblet cells, the number of periodic acid–Schiff–positive cells were divided by the total number of epithelial cells in the villi. Results were obtained from 3 independent experiments, and each experiment included 3 to 4 mice per group. ∗P < .001 compared with all other groups. #P < .01 compared with PBS-sensitized control FcεRI−/− mice. PBS/PE, Nonsensitized but challenged with peanut group; PE/PE, sensitized and challenged with PE group. Journal of Allergy and Clinical Immunology 2010 126, 306-316.e12DOI: (10.1016/j.jaci.2010.05.017) Copyright © 2010 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 4 IL-13 protein levels in intestinal homogenates. Levels of IL-13 were assessed in jejunal homogenates 24 hours after the last challenge. Results were obtained from 3 independent experiments with 4 mice per group. ∗P < .01 compared with all other groups. PBS/PE, Nonsensitized but challenged with peanut group; PE/PE, sensitized and challenged with PE group. Journal of Allergy and Clinical Immunology 2010 126, 306-316.e12DOI: (10.1016/j.jaci.2010.05.017) Copyright © 2010 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 5 Cytokine mRNA expression in jejunum of sensitized and challenged mice. Relative expression levels of IL4, IL6, IL13, IFNγ, and IL17A normalized to glyceraldehyde-3-phosphate dehydrogenase (GAPDH) in jejunum were determined by means of quantitative RT-PCR, as described in the Methods section. The values obtained in the WT nonsensitized but challenged with peanut group (PBS/PE) were assigned a value of 1 in all assays. Results were representative of 3 independent experiments with 4 mice per group. ∗P < .001 compared with all other groups. n.s., Not significant; PE/PE, sensitized and challenged with PE group. Journal of Allergy and Clinical Immunology 2010 126, 306-316.e12DOI: (10.1016/j.jaci.2010.05.017) Copyright © 2010 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 6 Transfer of BMMCs from WT and IL-4−/−, but not from FcεRI−/−, IL-13−/−, and IL-4/IL-13−/−, mice into FcεRI−/− mice restores their ability to develop diarrhea. Sensitized and challenged WT and FcεRI−/− mice received BMMCs from WT, FcεRI−/−, IL-4−/−, IL-13−/−, or IL-4/IL-13−/− mice on 2 occasions before challenge. Results are representative of 2 independent experiments with 4 mice per group and expressed as percentage with diarrhea during challenge. ∗P < .01 comparing recipients of WT mast cells with recipients of IL-13−/−, IL-4/IL-13−/−, or FcεRI−/− mast cells. ∗∗P < .05 comparing recipients of IL-4−/− mast cells with recipients of IL-13−/−, IL-4/IL-13−/−, or FcεRI−/− mast cells. PE/PE, Sensitized and challenged with PE group. Journal of Allergy and Clinical Immunology 2010 126, 306-316.e12DOI: (10.1016/j.jaci.2010.05.017) Copyright © 2010 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 7 Transferred BMMCs can be detected in intestinal tissue. Sections of jejunum and colon from sensitized and challenged with PE KitW-sh/W-sh mice with or without BMMC transfer were stained with chloroacetate esterase. Mast cells were detected (arrows) in the mucosa of the jejunum and colon after BMMC transfer (B and D). Without BMMC transfer (A and C) mast cells were not detected in the mucosa of the jejunum and colon. Sections of jejunal tissue from PBS- or PE-sensitized and challenged C57B6 mice after transfer of BMMCs from UBI-GFP/BL6 mice were assessed by immunofluorescence. Mast cells from UBI-GFP/BL6 mice were found in the lamina propria of jejunal mucosa of PE-sensitized C57BL/6 mice. Green fluorescent signals identify BMMCs from UBI-GFP/BL6 mice, and blue fluorescent signals identify nuclei stained with 4′-6-diamidino-2-phenylindole (E and F). Journal of Allergy and Clinical Immunology 2010 126, 306-316.e12DOI: (10.1016/j.jaci.2010.05.017) Copyright © 2010 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 8 Decreased intestinal allergic responses in KitW-sh/W-sh mice. A, The development of diarrhea was assessed 30 minutes after the last challenge in WT (white bar) and KitW-sh/W-sh mice (black bar). B, symptom scores were assessed 30 minutes after oral challenge. ∗P < .001 between sensitized and challenged with peanut (PE/PE) WT and PE/PE KitW-sh/W-sh mice after passive sensitization. ∗∗P < .01 between PE/PE KitW-sh/W-sh mice after passive sensitization with and without BMMC transfer from WT mice. Results were obtained from 2 individual experiments with 4 to 5 mice per group. Journal of Allergy and Clinical Immunology 2010 126, 306-316.e12DOI: (10.1016/j.jaci.2010.05.017) Copyright © 2010 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 9 Effect of treatment with IL-13Rα2 protein on PE-induced intestinal allergy. Sensitized and challenged WT mice received IL-13Rα2 every other day during PE challenge. Control mice received human IgG (hIgG) at the same dose and time points. A, Protocol for treatment with IL-13Rα2 protein. ip, Intraperitoneal. B, Treatment with IL-13Rα2 prevented the development of peanut-induced diarrhea. C, Effect of treatment with IL-13Rα2 on mast cell numbers in the jejunal mucosa. D, Effect of treatment with IL-13Rα2 on eosinophil numbers in the jejunal mucosa. E, Relative mMCP-1 mRNA expression in jejunum from WT mice that received IL-13Rα2 or human IgG. ∗P < .01 compared with hIgG treatment. PBS/PE, Nonsensitized but challenged with PE group; PE/PE, sensitized and challenged with PE group. Journal of Allergy and Clinical Immunology 2010 126, 306-316.e12DOI: (10.1016/j.jaci.2010.05.017) Copyright © 2010 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Levels of serum PE antibodies Levels of serum PE antibodies. Serum levels of peanut-specific IgE, IgG1, and IgG2a were assessed by mans of ELISA 24 hours after the last challenge and expressed as OD of diluted serum, as described in the Methods section. Results were obtained from 3 individual experiments with 4 to 5 mice per group. #P < .05 between the sensitized and challenged with peanut (PE/PE) WT and PE/PE FcεRI−/− groups. ∗P < .001 compared with PBS-sensitized control mice. n.s., Not significant; PBS/PE, nonsensitized but challenged with PE group. Journal of Allergy and Clinical Immunology 2010 126, 306-316.e12DOI: (10.1016/j.jaci.2010.05.017) Copyright © 2010 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Decreased mast cell infiltration in the intestinal walls of FcεRI−/− mice. Intestinal mucosal mast cells were quantified in jejunum using chloroacetate esterase staining. Representative sections of nonsensitized but challenged with peanut (PBS/PE) WT mice (A), sensitized and challenged with peanut (PE/PE) WT mice (B), PBS/PE FcεRI−/− mice (C), and PE/PE FcεRI−/− mice (D) are shown (magnification ×200). Bar = 100 μm. Journal of Allergy and Clinical Immunology 2010 126, 306-316.e12DOI: (10.1016/j.jaci.2010.05.017) Copyright © 2010 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Decreased eosinophil accumulation in the intestines of FcεRI−/− mice Decreased eosinophil accumulation in the intestines of FcεRI−/− mice. Eosinophils were identified and numbers were quantitated in jejunum by immunohistochemistry with anti–major basic protein antibody. Representative sections of nonsensitized but challenged with peanut (PBS/PE) WT mice (A), sensitized and challenged with peanut (PE/PE) WT mice (B), PBS/PE FcεRI−/− mice (C), and PE/PE FcεRI−/− mice (D) are shown (magnification ×200). Bar = 100 μm. Journal of Allergy and Clinical Immunology 2010 126, 306-316.e12DOI: (10.1016/j.jaci.2010.05.017) Copyright © 2010 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Decreased numbers of goblet cells in intestinal epithelium of sensitized and challenged FcεRI−/− mice. Representative sections of nonsensitized but challenged with PE (PBS/PE) WT mice (A), sensitized and challenged with PE (PE/PE) WT mice (B), PBS/PE FcεRI−/− mice (C), and PE/PE FcεRI−/− mice (D) are shown. Goblet cells were identified by periodic acid–Schiff staining 24 hours after the last challenge. (Magnification ×200). Bar = 100 μm. Journal of Allergy and Clinical Immunology 2010 126, 306-316.e12DOI: (10.1016/j.jaci.2010.05.017) Copyright © 2010 American Academy of Allergy, Asthma & Immunology Terms and Conditions

mMCP1 mRNA expression levels in jejunum of sensitized and challenged mice. Relative expression levels of mMCP1 normalized to glyceraldehyde-3-phosphate dehydrogenase (GAPDH) in jejunum were determined by means of quantitative RT-PCR. Results were representative of 3 independent experiments with 4 mice per group. ∗P < .001 compared with all other groups. PBS/PE, Nonsensitized but challenged with PE group; PE/PE, sensitized and challenged with PE group. Journal of Allergy and Clinical Immunology 2010 126, 306-316.e12DOI: (10.1016/j.jaci.2010.05.017) Copyright © 2010 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Transfer of BMMCs from WT mice into FcεRI−/− mice increases mast cell accumulation in the jejunal mucosa. Representative jejunal sections of sensitized and challenged with PE (PE/PE) FcεRI−/− mice (A), PE/PE FcεRI−/− recipients of BMMCs from WT mice (B), PE/PE FcεRI−/− recipients of BMMCs from FcεRI−/− mice (C), PE/PE FcεRI−/− recipients of BMMCs from IL-13−/− mice (D), PE/PE FcεRI−/− recipients of BMMCs from IL-4−/− mice (E), PE/PE FcεRI−/− recipients of BMMCs from IL-4/IL-13−/− mice (F), and quantitation of mucosal mast cell (MC) numbers in the jejunum (G). ∗P < .05, PE/PE FcεRI−/− recipients of BMMCs from WT mice and from IL-4−/− mice compared with all other groups (magnification ×200). Bar = 100 μm. Journal of Allergy and Clinical Immunology 2010 126, 306-316.e12DOI: (10.1016/j.jaci.2010.05.017) Copyright © 2010 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Effect of treatment with IL-13Rα2 protein on PE-induced intestinal allergy. Sensitized and challenged WT mice received IL-13Rα2 every other day during PE challenge. Control mice received human IgG at the same dose and time points. A, Chloroacetate esterase staining of representative jejunal sections in IL-13Rα2- or human IgG–treated mice. B, Major basic protein staining of representative jejunal sections of IL-13Rα2- or human IgG–treated mice. (Magnification ×200). Bar = 100 μm Journal of Allergy and Clinical Immunology 2010 126, 306-316.e12DOI: (10.1016/j.jaci.2010.05.017) Copyright © 2010 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Effect of IL-13Rα2 on goblet cell numbers in jejunum Effect of IL-13Rα2 on goblet cell numbers in jejunum. Representative sections of jejunum of IL-13Rα2- and human IgG–treated mice after periodic acid–Schiff staining (magnification ×200). Journal of Allergy and Clinical Immunology 2010 126, 306-316.e12DOI: (10.1016/j.jaci.2010.05.017) Copyright © 2010 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Quantitation of goblet cells in jejunum after treatment with IL-13Rα2 Quantitation of goblet cells in jejunum after treatment with IL-13Rα2. ∗∗P < .01 comparing IL-13Rα2-treated mice with control animals. PBS/PE, Nonsensitized but challenged with PE group; PE/PE, sensitized and challenged with PE group. Journal of Allergy and Clinical Immunology 2010 126, 306-316.e12DOI: (10.1016/j.jaci.2010.05.017) Copyright © 2010 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Effect of IL-13Rα2 treatment on cytokine expression in jejunal tissue Effect of IL-13Rα2 treatment on cytokine expression in jejunal tissue. Relative levels of TH2 cytokine mRNA expression in jejunum from WT mice that received IL-13Rα2 or human IgG are shown. ∗P < .01 compared with human IgG treatment. GAPDH, Glyceraldehyde-3-phosphate dehydrogenase; PBS/PE, nonsensitized but challenged with peanut group; PE/PE, sensitized and challenged with PE group. Journal of Allergy and Clinical Immunology 2010 126, 306-316.e12DOI: (10.1016/j.jaci.2010.05.017) Copyright © 2010 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Effect of IL-13Rα2 treatment on cytokine protein levels in jejunal tissue. TH1/TH2 cytokines protein levels in intestinal homogenates from WT mice that received IL-13Rα2 or human IgG are shown. ∗P < .05 compared with human IgG treatment. PBS/PE, Nonsensitized but challenged with peanut group; PE/PE, sensitized and challenged with PE group. Journal of Allergy and Clinical Immunology 2010 126, 306-316.e12DOI: (10.1016/j.jaci.2010.05.017) Copyright © 2010 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Effect of IL-13Rα2 treatment on plasma histamine levels. ∗P < Effect of IL-13Rα2 treatment on plasma histamine levels. ∗P < .05 compared with human IgG treatment. PBS/PE, Nonsensitized but challenged with peanut group; PE/PE, sensitized and challenged with PE group. Journal of Allergy and Clinical Immunology 2010 126, 306-316.e12DOI: (10.1016/j.jaci.2010.05.017) Copyright © 2010 American Academy of Allergy, Asthma & Immunology Terms and Conditions