IMMUNO-DEPRESSIVE AND PATHOGENETIC MECHANISMS IN INFECTIOUS ALLERGY

• Published in: Russian Journal of Infection and Immunity
• Main Authors: L. Dobrodeeva K., A. Samodova V., Лилия Добродеева Константиновна, Анна Самодова Васильевна
• Other Authors: ФГБУН ФИЦКИА УРО РАН
• Format: Article in Journal/Newspaper
• Language: Russian
• Published: Publishing house of Saint Petersburg Pasteur Institute 2022
• Subjects: sCD23; IgE; IL-10; T-helpers; cytotoxic T-lymphocytes; activated T-lymphocytes; phagocytic defense deficiency; circulating immune complexes; infectious allergy; Т-хелперы; цитотоксические Т-лимфоциты; активированные Т-лимфоциты; дефицит фагоцитарной защиты; циркулирующие иммунные комплексы; инфекционная аллергия; Arkhangelsk; Архангельск*
• Online Access: https://www.iimmun.ru/iimm/article/view/1680; https://doi.org/10.15789/2220-7619-IAP-1680

Abstract: The incidence of infectious allergy has been growing mainly due to infection with Staphylococcus aureus, Streptococcus pneumoniae, Klebsiella pneumoniae, with enhancing allergic background by yeast-like fungi of the genus Candida. The frequency of infection has currently become a threat without tending to decline. Undoubtedly, Staphylococcus aureus is a pathogenic species producing highly powerful exotoxins exerting properties of cytolysin capable of disrupting the integrity of any cell wall, destroying epithelial cells, damaging mucous membranes in any organ, including the intestines, wherein it becomes accumulated at any location of staphylococcal inflammation. At the same time, almost 90% of cases of allergic reactions are diagnosed with atopic dermatitis because IgE level in some cases of infectious allergy it is increased. The mechanism of the pathogenetic action of reagins is realized by re-binding of antigens to IgE fixed on mast cell and basophil surface resulting in FceR1 cross-linking and release of vasoactive mediators responsible for developing early phase of allergy. IgE concentrations, accounting for only 0.002% of the total blood immunoglobulins in a apparently healthy person, may remain low in atopic bronchial asthma, atopic dermatitis, allergic rhinoconjunctivitis, etc. IgE level is increased not only in atopy, but also in oncopathology, autoimmune diseases, whole body cooling and IgA deficiency. In allergic reactions, an increased level in the extracellular pool of various receptor structures is recorded. Of interest is a comparative analysis of the ratio between frequency of IgE reactions and CD23 shedding in infectious allergies of various etiology. The aim of the study is to establish a role of the CD23 extracellular pool in pathogenetic mechanisms of infectious allergy. There were examined 678 subjects who were at apparently healthy state at the time of the examination, including 545 females and 133 males as well as 1481 patients with verified infectious allergy who live in the Arkhangelsk region. It has been established that patients with staphylococcal infection had markedly aggravated symptom complex of pathological reactions linked to anemia, neutropenia and deficiency of phagocytic protection. Pathological reactions in infectious allergies are accompanied by sharply increased level of sCD23 with its abnormally high concentrations (> 200 ng / ml) found in 51.7% of cases paralleled by increased level of serum IL-10 and reagins in 21.43% and 35.7% cases, respectively, along with phagocytic defense deficit observed in 85.7% as well as accumulation of CEC in 92.86%. A parallel increase in level of sCD23 and IgE is associated with increased percentage of T-helpers, cytotoxic T-lymphocytes, activated T-cells expressing IL-2 receptor, along with upregulated the Major Histocompatibility Complex Class II molecules. Заболеваемость инфекционной аллергией растёт преимущественно за счет инфицирования Staphylococcus aureus, Streptococcus pneumoniae, Klebsiella pneumoniae, с усилением аллергического фона дрожжеподобными грибами рода Candida. Частота инфицирования сегодня принимает угрожающий характер и не имеет тенденции к снижению. Золотистый стафилококк является, безусловно, патогенным, вырабатывает сильнейшие экзотоксины, обладающие свойствами цитолизина, способного нарушить целостность любой клеточной стенки, разрушает эпителиоциты, повреждая слизистые оболочки любых органов, в том числе и кишечника, в котором накапливается при любой локализации стафилококкового воспаления. При этом почти в 90% случаев аллергических реакций ставится диагноз атопический дерматит, поскольку при инфекционной аллергии в ряде случаев увеличивается содержание IgE. Механизм патогенетического действия реагинов реализуется путем повторного связывания антигенов с фиксированными на мембранах тучных клеток и базофилов IgE, вследствие чего происходит перекрестное сшивание FcR1 и выделение вазоактивных медиаторов, ответственных за развитие ранней фазы аллергии. Концентрации IgE, составляя всего 0,002% от общего содержания в крови иммуноглобулинов у практически здорового человека, могут оставаться невысокими при диагнозах атопическая бронхиальная астма, атопический дерматит, аллергический риноконъюктивит и т.д. Концентрации IgE повышаются не только при атопии, но и при онкопатологии, аутоиммунных болезнях, общем охлаждении и дефиците содержания IgA. При аллергических реакциях регистрируется увеличение содержания внеклеточного пула различных рецепторных структур. Представляет интерес сравнительный анализ соотношения частоты реакций IgE и щеддинга CD23 при инфекционной аллергии различной этиологии. Цель исследования – установить роль внеклеточного пула CD23 в патогенетических механизмах инфекционной аллергии. Обследовано 678 практически здоровых на момент обследования человек из них 545 женщин и 133 мужчин и 1481 больных с диагнозом инфекционная аллергия, проживающих в Архангельской области. Установлено, что у больных со стафилококковой инфекцией происходит значительное усугубление симптомокомплекса патологических реакций с формированием анемии, нейтропении и дефицита фагоцитарной защиты. Патологические реакции при инфекционной аллергии сопровождаются резким увеличением содержания sCD23 с аномально высокими их концентрациями (>200 нг/мл) в 51,7 % случаев, что сопровождается увеличением содержания в крови IL-10 и реагинов в 21,43 % и 35,7% случаев соответственно на фоне дефицита фагоцитарной защиты в 85,7% и накопления ЦИК в 92,86%. Параллельное увеличение концентрации sCD23 и IgE ассоциировано с повышением содержания Т-хелперов, цитотоксических Т-лимфоцитов, активированных Т-клеток с рецептором к IL-2 и молекул Главного комплекса гистосовместимости класса II.The incidence of infectious allergies is growing mainly due to infection with Staphylococcus aureus, Streptococcus pneumoniae, Klebsiella pneumoniae, with an increase in the allergic background with yeast-like fungi of the genus Candida. The frequency of infection is now threatening and does not tend to decrease. Staphylococcus aureus is, of course, pathogenic, it produces the strongest exotoxins with the properties of cytolysin, capable of disrupting the integrity of any cell wall, destroys epithelial cells, damaging the mucous membranes of any organs, including the intestines, in which it accumulates at any localization of staphylococcal inflammation. At the same time, in almost 90% of cases of allergic reactions, atopic dermatitis is diagnosed, since the IgE content in some cases increases with infectious allergy. The mechanism of the pathogenetic action of reagins is realized by re-binding of antigens to IgE fixed on the membranes of mast cells and basophils, as a result of which cross-linking of FcR1 occurs and the release of vasoactive mediators responsible for the development of the early phase of allergy. IgE concentrations, accounting for only 0.002% of the total blood immunoglobulins in a practically healthy person, may remain low in diagnoses of atopic bronchial asthma, atopic dermatitis, allergic rhinoconjunctivitis, etc. IgE concentrations increase not only in atopy, but also in oncopathology, autoimmune diseases, general cooling and IgA deficiency. In allergic reactions, an increase in the content of the extracellular pool of various receptor structures is recorded. Of interest is a comparative analysis of the ratio of the frequency of IgE reactions and CD23 schedding in infectious allergies of various etiologies. The aim of the study is to establish the role of the extracellular pool of CD23 in the pathogenetic mechanisms of infectious allergy. We examined 678 people who were practically healthy at the time of the examination, including 545 women and 133 men and 1481 patients with a diagnosis of infectious allergy living in the Arkhangelsk region. It has been established that in patients with staphylococcal infection, there is a significant aggravation of the symptom complex of pathological reactions with the formation of anemia, neutropenia and deficiency of phagocytic protection. Pathological reactions in infectious allergies are accompanied by a sharp increase in the content of sCD23 with abnormally high concentrations (> 200 ng / ml) in 51.7% of cases, which is accompanied by an increase in the content of IL-10 and reagins in the blood in 21.43% and 35.7% cases, respectively, against the background of a phagocytic defense deficit in 85.7% and an accumulation of CEC in 92.86%. A parallel increase in the concentration of sCD23 and IgE is associated with an increase in the content of T-helpers, cytotoxic T-lymphocytes, activated T-cells with an IL-2 receptor, and molecules of the Major Histocompatibility Complex Class II.