Basophils, high-affinity IgE receptors, and CCL2 in human anaphylaxis.
BACKGROUND
The role of basophils in anaphylaxis is unclear.


OBJECTIVE
We sought to investigate whether basophils have an important role in human anaphylaxis.


METHODS
In an emergency department study we recruited 31 patients with acute anaphylaxis, predominantly to Hymenoptera venom. We measured expression of basophil activation markers (CD63 and CD203c); the absolute number of circulating basophils; whole-blood FCER1A, carboxypeptidase A3 (CPA3), and L-histidine decarboxylase (HDC) gene expression; and serum markers (CCL2, CCL5, CCL11, IL-3, and thymic stromal lymphopoietin) at 3 time points (ie, during the anaphylactic episode and in convalescent samples 7 and 30 days later). We recruited 134 patients with Hymenoptera allergy and 76 healthy control subjects for comparison. We then investigated whether the changes observed during venom-related anaphylaxis also occur during allergic reactions to food in 22 patients with peanut allergy undergoing double-blind, placebo-controlled food challenge to peanut.


RESULTS
The 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 < .0001) and compared with those in patients with venom allergy and healthy control subjects (21 and 23.4 cells/μL, P < .0001). FCER1A expression during anaphylaxis was also significantly lower than in convalescent samples (P ≤ .002) and control subjects with venom allergy (P < .0001). CCL2 levels (but not those of other serum markers) were significantly higher during anaphylaxis (median, 658 pg/mL) than in convalescent samples (314 and 311 pg/mL at 7 and 30 days, P < .001). Peanut-induced allergic reactions resulted in a significant decrease in circulating basophil counts compared with those in prechallenge samples (P = .016), a decrease in FCER1A expression (P = .007), and an increase in CCL2 levels (P = .003).


CONCLUSIONS
Our findings imply an important and specific role for basophils in the pathophysiology of human anaphylaxis.
University Hospital of Respiratory and Allergic Diseases, Golnik, Slovenia. Electronic address: peter.korosec@klinika-golnik.si.
Peter
P
Korosec
Section of Paediatrics and MRC and Asthma UK Centre in Allergic Mechanisms of Asthma, Imperial College London, London, United Kingdom.
Paul J
PJ
Turner
University Hospital of Respiratory and Allergic Diseases, Golnik, Slovenia.
Mira
M
Silar
University Hospital of Respiratory and Allergic Diseases, Golnik, Slovenia.
Peter
P
Kopac
University Hospital of Respiratory and Allergic Diseases, Golnik, Slovenia.
Mitja
M
Kosnik
Medway School of Pharmacy, University of Kent, Chatham, United Kingdom.
Bernhard F
BF
Gibbs
Section of Allergy and Clinical Immunology, National Heart and Lung Institute and MRC and Asthma UK Centre in Allergic Mechanisms of Asthma, Imperial College London, London, United Kingdom.
Mohamed H
MH
Shamji
Section of Paediatrics and MRC and Asthma UK Centre in Allergic Mechanisms of Asthma, Imperial College London, London, United Kingdom.
Adnan
A
Custovic
University Hospital of Respiratory and Allergic Diseases, Golnik, Slovenia.
Matija
M
Rijavec
D000293:Adolescent; D000328:Adult; D000368:Aged; D000707:Anaphylaxis / Q000097:blood / Q000276:immunology*; D000818:Animals; D001491:Basophils / Q000276:immunology*; D016207:Cytokines / Q000097:blood / Q000276:immunology*; D004311:Double-Blind Method; D005260:Female; D015870:Gene Expression; D006801:Humans; D006927:Hymenoptera / Q000276:immunology; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D021183:Peanut Hypersensitivity / Q000276:immunology*; D017455:Receptors, IgE / Q000276:immunology*; D014688:Venoms / Q000276:immunology; D055815:Young Adult
D016207:Cytokines; D017455:Receptors, IgE; D014688:Venoms
Anaphylaxis; CCL2; CD63 activation; FcεRI expression; basophils; serum tryptase