Doing More with Less.

Peanut allergy affects 1 to 3% of children in Western countries and is increasing in prevalence in Africa and Asia. In most patients, peanut allergy develops early in life and continues into adulthood. Peanut allergy is the most common cause of food-related anaphylaxis and death and creates significant medical, financial, and psychosocial burdens on patients and their families.1-3 Until recently, the mainstay of treatment for peanut and other food allergies was strict avoidance of peanut and carrying injectable epinephrine in case of accidental exposure.

Tackling Food Allergy in Infancy.

Atopic dermatitis and food allergy are the most common allergic conditions affecting the infant population. Both immunoglobulin E (IgE)-mediated and non-IgE-mediated food allergy are seen in infancy. Early life feeding guidelines have changed dramatically over the past 30 years, more recently because of an improved understanding of IgE-mediated food allergy. This article focuses on identification, diagnosis, management, and prevention of food allergy in the infant population.

Gamma interferon signaling in macrophage lineage cells regulates central nervous system inflammation and chemokine production.

Intracranial (i.c.) infection of mice with lymphocytic choriomeningitis virus (LCMV) results in anorexic weight loss, mediated by T cells and gamma interferon (IFN-gamma). Here, we assessed the role of CD4(+) T cells and IFN-gamma on immune cell recruitment and proinflammatory cytokine/chemokine production in the central nervous system (CNS) after i.c. LCMV infection. We found that T-cell-depleted mice had decreased recruitment of hematopoietic cells to the CNS and diminished levels of IFN-gamma, CCL2 (MCP-1), CCL3 (MIP-1alpha), and CCL5 (RANTES) in the cerebrospinal fluid (CSF). Mice deficient in IFN-gamma had decreased CSF levels of CCL3, CCL5, and CXCL10 (IP-10), and decreased activation of both resident CNS and infiltrating antigen-presenting cells (APCs). The effects of IFN-gamma signaling on macrophage lineage cells was assessed using transgenic mice, called "macrophages insensitive to interferon gamma" (MIIG) mice, that express a dominant-negative IFN-gamma receptor under the control of the CD68 promoter. MIIG mice had decreased levels of CCL2, CCL3, CCL5, and CXCL10 compared to controls despite having normal numbers of LCMV-specific CD4(+) T cells in the CNS. MIIG mice also had decreased recruitment of infiltrating macrophages and decreased activation of both resident CNS and infiltrating APCs. Finally, MIIG mice were significantly protected from LCMV-induced anorexia and weight loss. Thus, these data suggest that CD4(+) T-cell production of IFN-gamma promotes signaling in macrophage lineage cells, which control (i) the production of proinflammatory cytokines and chemokines, (ii) the recruitment of macrophages to the CNS, (iii) the activation of resident CNS and infiltrating APC populations, and (iv) anorexic weight loss.

IL-10 Indirectly Downregulates IL-4-Induced IgE Production by Human B Cells.

Controlled allergic disease is associated with decreased allergen-specific IgE and increased allergen-specific IgG4. Although IL-10 has been shown to contribute to these changes, the underlying mechanisms are largely unknown. This study explored how IL-10 differentially regulates human IgE and IgG4 production. Highly purified B cells and B cell subsets from healthy individuals were cultured with combinations of anti-CD40, IL-4, and IL-10. In other experiments, PBMCs isolated from healthy donors or from autosomal dominant hyper-IgE syndrome (STAT3 loss-of-function) subjects were cultured with combinations of IL-4 and IL-10. In B cell cultures, IL-10 had no significant effect on IL-4-induced IgE production but increased IL-4-induced IgG4 production over 20-fold. IL-4-induced transcription of Cε and Cγ4 germline transcripts (GLTs) by isolated B cells was not affected by IL-10. In PBMC cultures, IL-4 induced production of both IgE and IgG4 and increased expression of Cε and Cγ4 GLTs above baseline. Unlike in purified B cells, IL-10 diminished IL-4-induced IgE production and expression of Cε GLTs without affecting IgG4 production or expression of Cγ4 GLTs. PBMCs from autosomal dominant hyper-IgE syndrome individuals failed to consistently modulate IgE production in response to IL-4 and IL-10. As measured by flow cytometry, the frequency of IL-10R+ cells was similar between IgE+ and IgG4+ B cells. These data suggest that IL-10 acts indirectly through accessory cells to modulate the production of IgE. For IgG4, IL-10 appears to act directly on B cells to drive IgG4 production, with its effects being downstream of germline transcription.

Androgens suppress antigen-specific T cell responses and IFN-γ production during intracranial LCMV infection.

Intracranial (i.c.) lymphocytic choriomeningitis virus (LCMV) infection of mice results in T cell-driven anorexia and weight loss, which is diminished in males compared to females. We investigated sex-specific effects on antigen-presenting cells (APCs) and T cells after i.c. LCMV infection. Numbers of LCMV-specific T cells, APC activation, and levels of inflammatory cytokines and chemokines in CSF were decreased in males compared to females. Orchidectomy enhanced these immune parameters in males, while dihydrotestosterone treatment of orchidectomized males and intact females decreased some of these parameters. These data suggest that qualitative and quantitative effects of androgens on APCs and T cells may contribute to the well-known, but poorly understood sex differences in immunity and autoimmunity.