Dynamics of cytokine mRNA expression and fecal biomarkers in school-children undergoing a double-blind placebo-controlled food challenge series. (December 2016)

• Record Type: Journal Article
• Authors: Winberg, Anna; Nagaeva, Olga; Nagaev, Ivan; Lundell, Catarina; Arencibia, Ignacio; Mincheva-Nilsson, Lucia; Rönmark, Eva; West, Christina E.
• Is Part Of: Cytokine. Volume 88(2016)
• Page Start: 259
• Page End: 266
• Publication Date: 2016-12
• Subjects: Calprotectin -- Food allergy -- Food challenge -- IL-10 -- IL-13 -- Tolerance; DBPCFC double-blind placebo-controlled food challenge -- EDN eosinophil-derived neurotoxin -- OLIN Obstructive Lung Disease In Northern Sweden Studies -- PBMC peripheral blood mononuclear cells -- TGF-β transforming growth factor beta; Cytokines -- Periodicals; 571.844
• DOI: 10.1016/j.cyto.2016.09.014
• Languages: English
• ISSNs: 1043-4666

Abstract

Highlights: Pre and post food challenge cytokine mRNA expression was analyzed. The cytokine mRNA expression pattern differed between food allergic children and controls. Baseline mRNA levels of IL-13 and TNF-α were higher in food allergic children. Baseline mRNA levels of IFN-γ and IL-15 were lower in food allergic children. Increased baseline mRNA levels of IL-13 and IL-10 predicted a positive food challenge outcome. Abstract: Background: There is need for prognostic markers for symptomatic food allergy since current diagnostic methods are insufficient and/or time and labor consuming. Objective: To estimate the cytokine mRNA profiles in peripheral blood mononuclear cells (PBMC) before and after a double-blind placebo-controlled food challenge series in schoolchildren with suspected allergy to milk, egg or cod and in healthy controls. Analyses of fecal inflammatory biomarkers before and after the challenge were included. Methods: Twelve-year-old children from a population-based cohort reporting complete avoidance of milk, egg, cod or wheat due to perceived hypersensitivity were clinically examined and those with suspected food allergy were evaluated with a 3-session double-blind placebo-controlled food challenge (n = 18). Seven healthy controls participated in a double-blind challenge with egg. Before and after the challenge series, the cytokine mRNA expression was quantified for 13 cytokines discriminating between humoral Th2-, cytotoxic Th1-, regulatory Th3/Tr1- and inflammatory responses. Fecal calprotectin and eosinophil-derived neurotoxin (EDN) were also analyzed in children with suspected food allergy before and after the challenge series. Results: Pre challenge, children with suspected food allergy had higher IL-13 and TNF-α expression and lower IFN-γ and IL-15 expression compared to healthy controls (all p < 0.05). Children with challenge-proven food allergy had increased IL13 and IL-10 expression compared to the levels seen in negative challenges (p < 0.05). Post challenge, IL-1β and IL-6 mRNA levels were elevated in the food allergic children compared to controls (p < 0.05). Fecal calprotectin and EDN levels were higher in challenge-proven food allergy compared to a negative challenge although not statistically significantly. Conclusion & clinical relevance: Increased baseline mRNA levels of the Th2-related cytokine IL-13 and the regulatory cytokine IL-10 predicted a positive food challenge outcome. These cytokines in combination with fecal calprotectin and EDN might serve as future prognostic markers for symptomatic, IgE-mediated food allergy but need further validation in a larger patient cohort.