Transfer and loss of allergen-specific responses via stem cell transplantation: A prospective observational study.


Journal

Allergy
ISSN: 1398-9995
Titre abrégé: Allergy
Pays: Denmark
ID NLM: 7804028

Informations de publication

Date de publication:
09 2020
Historique:
received: 25 10 2019
revised: 31 01 2020
accepted: 10 02 2020
pubmed: 18 3 2020
medline: 15 5 2021
entrez: 18 3 2020
Statut: ppublish

Résumé

Currently, no estimates can be made on the impact of hematopoietic stem cell transplantation on allergy transfer or cure of the disease. By using component-resolved diagnosis, we prospectively investigated 50 donor-recipient pairs undergoing allogeneic stem cell transplantation. This allowed calculating the rate of transfer or maintenance of allergen-specific responses in the context of stem cell transplantation. Allergen-specific IgE and IgG to 156 allergens was measured pretransplantation in 50 donors and recipients and at 6, 12 and 24 months in recipients post-transplantation by allergen microarray. Based on a mixed effects model, we determined risks of transfer of allergen-specific IgE or IgG responses 24 months post-transplantation. After undergoing stem cell transplantation, 94% of allergen-specific IgE responses were lost. Two years post-transplantation, recipients' allergen-specific IgE was significantly linked to the pretransplantation donor or recipient status. The estimated risk to transfer and maintain individual IgE responses to allergens by stem cell transplantation was 1.7% and 2.3%, respectively. Allergen-specific IgG, which served as a surrogate marker of maintaining protective IgG responses, was highly associated with the donor's (31.6%) or the recipient's (28%) pretransplantation response. Hematopoietic stem cell transplantation profoundly reduces allergen-specific IgE responses but also comes with a considerable risk to transfer allergen-specific immune responses. These findings facilitate clinical decision-making regarding allergic diseases in the context of hematopoietic stem cell transplantation. In addition, it provides prospective data to estimate the risk of transmitting allergen-specific responses via hematopoietic stem cell transplantation.

Sections du résumé

BACKGROUND
Currently, no estimates can be made on the impact of hematopoietic stem cell transplantation on allergy transfer or cure of the disease. By using component-resolved diagnosis, we prospectively investigated 50 donor-recipient pairs undergoing allogeneic stem cell transplantation. This allowed calculating the rate of transfer or maintenance of allergen-specific responses in the context of stem cell transplantation.
METHODS
Allergen-specific IgE and IgG to 156 allergens was measured pretransplantation in 50 donors and recipients and at 6, 12 and 24 months in recipients post-transplantation by allergen microarray. Based on a mixed effects model, we determined risks of transfer of allergen-specific IgE or IgG responses 24 months post-transplantation.
RESULTS
After undergoing stem cell transplantation, 94% of allergen-specific IgE responses were lost. Two years post-transplantation, recipients' allergen-specific IgE was significantly linked to the pretransplantation donor or recipient status. The estimated risk to transfer and maintain individual IgE responses to allergens by stem cell transplantation was 1.7% and 2.3%, respectively. Allergen-specific IgG, which served as a surrogate marker of maintaining protective IgG responses, was highly associated with the donor's (31.6%) or the recipient's (28%) pretransplantation response.
CONCLUSION
Hematopoietic stem cell transplantation profoundly reduces allergen-specific IgE responses but also comes with a considerable risk to transfer allergen-specific immune responses. These findings facilitate clinical decision-making regarding allergic diseases in the context of hematopoietic stem cell transplantation. In addition, it provides prospective data to estimate the risk of transmitting allergen-specific responses via hematopoietic stem cell transplantation.

Identifiants

pubmed: 32181893
doi: 10.1111/all.14278
doi:

Substances chimiques

Allergens 0
Immunoglobulin E 37341-29-0

Types de publication

Journal Article Observational Study Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

2243-2253

Informations de copyright

© 2020 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd.

Références

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Auteurs

Markus Debiasi (M)

Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria.

Herbert Pichler (H)

Department of Pediatrics and Adolescent Medicine, St. Anna Children's Hospital, Medical University of Vienna, Vienna, Austria.

Florian Klinglmüller (F)

Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria.

Heidrun Boztug (H)

Department of Pediatrics and Adolescent Medicine, St. Anna Children's Hospital, Medical University of Vienna, Vienna, Austria.

Klara Schmidthaler (K)

Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria.

Jonas Rech (J)

Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria.

David Scherer (D)

Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria.

Christian Lupinek (C)

Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria.

Rudolf Valenta (R)

Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria.
NRC Institute of Immunology FMBA of Russia, Moscow, Russia.

Ewa Kacinska-Pfaller (E)

Department of Pediatrics and Adolescent Medicine, St. Anna Children's Hospital, Medical University of Vienna, Vienna, Austria.

Rene Geyeregger (R)

Children's Cancer Research Institute (CCRI), Vienna, Austria.

Gerhard Fritsch (G)

Children's Cancer Research Institute (CCRI), Vienna, Austria.

Oskar A Haas (OA)

Department of Pediatrics and Adolescent Medicine, St. Anna Children's Hospital, Medical University of Vienna, Vienna, Austria.
Children's Cancer Research Institute (CCRI), Vienna, Austria.

Christina Peters (C)

Department of Pediatrics and Adolescent Medicine, St. Anna Children's Hospital, Medical University of Vienna, Vienna, Austria.

Thomas Lion (T)

Department of Pediatrics and Adolescent Medicine, St. Anna Children's Hospital, Medical University of Vienna, Vienna, Austria.
Children's Cancer Research Institute (CCRI), Vienna, Austria.

Mübeccel Akdis (M)

Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland.
Christine Kühne-Center for Allergy Research and Education, Davos, Switzerland.

Susanne Matthes (S)

Department of Pediatrics and Adolescent Medicine, St. Anna Children's Hospital, Medical University of Vienna, Vienna, Austria.

Cezmi A Akdis (CA)

Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland.
Christine Kühne-Center for Allergy Research and Education, Davos, Switzerland.

Zsolt Szépfalusi (Z)

Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria.

Thomas Eiwegger (T)

Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria.
Division of Immunology and Allergy, Food allergy and Anaphylaxis Program, Department of Pediatrics, The Hospital for Sick Children, Toronto, Canada.
Research Institute, The Hospital for Sick Children, Translational Medicine program, Toronto, Canada.
Department of Immunology, University of Toronto, Toronto, Ontario, Canada.

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