Basophils, high-affinity IgE receptors and CCL2 in human anaphylaxis

Publication date: Available online 22 March 2017
Source:Journal of Allergy and Clinical Immunology
Author(s): Peter Korosec, Paul J. Turner, Mira Silar, Peter Kopac, Mitja Kosnik, Bernhard F. Gibbs, Mohamed H. Shamji, Adnan Custovic, Matija Rijavec
BackgroundThe role of basophils in anaphylaxis is unclear.ObjectiveTo investigate whether basophils have an important role in human anaphylaxis.MethodsIn an emergency department study, we recruited 31 patients with acute anaphylaxis, predominantly to hymenoptera venom. We measured expression of basophil activation markers (CD63, CD203c), the absolute number of circulating basophils, whole-blood FcεRI, CPA3 and HDC gene expression, and serum markers (CCL2, CCL5, CCL11, IL-3, TSLP) at three time points (during the anaphylactic episode, and in convalescent samples 7 and 30 days later). We recruited 134 hymenoptera-allergic and 76 healthy controls for comparison. We then investigated whether the changes observed during venom-related anaphylaxis also occur during allergic reactions to food in 22 peanut-allergic individuals undergoing double-blind placebo-controlled food challenge to peanut (DBPCFC).ResultsThe number of circulating basophils was significantly lower during anaphylaxis (median 3.5 cells/μl) than 7 and 30 days later (17.5 and 24.7 cells/μl, P<0.0001), and compared to venom-allergic and healthy controls (21 and 23.4 cells/μl, P<0.0001). FcεRI expression during anaphylaxis was also significantly lower than in convalescent samples (P≤0.002) and venom-allergic controls (P<0.0001). CCL2 (but not other serum markers) was significantly higher during anaphylaxis (median 658 pg/ml) than in convalescent samples (314 and 311 pg/ml, 7 and 30 days, P<0.001). Peanut-induced allergic reactions resulted in a significant decrease in circulating basophils compared to pre-challenge samples (P=0.016), a decrease in FcεRI expression (P=0.007), and an increase in CCL2 (P=0.003).ConclusionsOur findings imply an important and specific role for basophils in the pathophysiology of human anaphylaxis.

Teaser

We demonstrate a substantial reduction in circulating basophils and whole blood FcεRI gene expression during acute anaphylaxis. There was an increase in the major basophil chemotactic factor CCL2, which correlated with a decrease in basophils.


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