The Journal of Clinical Investigation (Mar 2023)

Th2-skewed T cells correlate with B cell response to α-Gal and tick antigens in α-Gal syndrome

  • Danijela Apostolovic,
  • Jeanette Grundström,
  • Mensiena B. Gea Kiewiet,
  • Marija Perusko,
  • Carl Hamsten,
  • Maria Starkhammar,
  • Staffan Paulie,
  • Marianne van Hage

Journal volume & issue
Vol. 133, no. 6

Abstract

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Tick bites have been shown to transmit a novel form of severe food allergy, the galactose-α-1,3-galactose (α-Gal) syndrome (AGS). Cellular responses to α-Gal in patients with AGS have, to date, not been thoroughly scrutinized. Therefore, we investigated T and B cell proliferation, activation, and cytokine profiles in response to tick protein extract (TE) and α-Gal-free TE in patients with AGS and in healthy controls. T and B cells from both patients and controls proliferated in response to TE, but significantly more in patients with AGS. B cell proliferation, but not T cell proliferation, in patients with AGS was reduced by removing α-Gal from the TE. In addition, TE induced a clear Th2 cytokine profile in patients with AGS. Expression of CD23 by B cells correlated only to T cell proliferation. However, both B cell proliferation and CD23 expression were reduced when CD40L and IL-4 were blocked. A large portion of the IgG1 and IgE antibodies binding TE in patients with AGS were directed against the α-Gal epitope. We have, for what we believe to be the first time, investigated T and B cell responses to α-Gal carrying tick proteins in patients with AGS, which will be essential for the understanding of the immune response against an allergenic carbohydrate transmitted by ticks.

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