Increase of natural killer cells in children with liver transplantation-acquired food allergy
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Keywords
Children, Immunosuppressive drugs, Food allergy, Kidney transplantation, Liver transplantation
Abstract
Background: Transplantation-acquired food allergies (TAFA) are frequently reported and considered to be caused by immunosuppressive therapy.
The aim of this study was to investigate the allergic and immunologic responses in children who had liver or kidney transplantations.
Methods: Twelve children receiving liver transplantations and 10 children receiving kidney transplantations were investigated. All children underwent the allergy work-up and in most of them, lymphocyte screening and serum cytokine measurements were also performed.
Results: TAFA were found in 7/12 (58%) children with liver transplantations and in none of the 10 children with kidney transplantations. The mean age at transplantation was significantly lower in children who underwent liver transplantations (p < 0.001). The immunosuppressive therapy administered to children with liver transplantation was tacrolimus in 11 patients and cyclosporine in one patient, while all 10 children with kidney transplantation received tacrolimus plus mycophenolate. The most common antigenic food was egg. The natural killer (NK) cell numbers were significantly higher in liver-transplant children than in kidney-transplant children. No significant differences were found in the serum cytokine levels.
Conclusions: This study confirms that liver-transplant children treated with tacrolimus alone have a higher risk of developing TAFA than kidney-transplant children treated with tacrolimus plus mycophenolate. NK cells might be involved in this difference.
References
2. Asante-Korang A, Boyle GJ, Webber SA, Miller SA, Fricker FJ. Experience of FK506 immune suppression in pediatric heart transplantation: a study of long term adverse effects. J Heart Lung Transplant. 1996;15:415-22.
3. Frischmeyer-Guerriero PA, Wisniewski J, Wood RA, Nowak-Wegrzyn A. Manifestations and long-term outcome of food allergy in children after solid organ transplantation. J Allergy Clin Immunol. 2008;122:1031-3.
4. Boyle RJ, Hardikar W, Tang ML. The development of food allergy after liver transplantation. Liver Transplant. 2005;11: 326-30.
5. Levy Y, Davidovits M, Cleper R, Shapiro R. New-onset post-transplantation food allergy in children: is it attributable only to the immunosuppressive protocol? Pediatr Transplant. 2009;13:63-9.
6. Eiwegger T, Gruber S, Geiger C, Mayer E, Dehlink E, Bannert C, et al. Impact systemic immune-suppression after solid organ transplantation on allergen-specific responses. Allergy. 2011;66:271-8.
7. Hinds R, Dhawan A. Food allergy after liver transplantation is it the result of T-cell imbalance? Pediatr Transplant. 2006;10:647-9.
8. Shroff P, Mehta RS, Chinen J, Karpen SJ, Davis CM. Presentation of atopic disease in a large cohort of pediatric liver transplant recipients. Pediatr Transplant. 2012;16:379-84.
9. Brown C, Haringman N, Davies C, Gore C, Hussain M, MieliVergani G, et al. High prevalence of food sensitization in young children with liver disease: a clue to food allergy pathogenesis? Pediatr Allergy Immunol. 2012;23:771-8.
10. Lee Y, Lee YM, Kim MJ, Lee SK, Choe YH. Long-term follow-up of de novo allergy in pediatric liver transplantation: 10 yr experience of a single center. Pediatr Transplant. 2013;17:251-5.
11. Wisniewski J, Lieberman J, Nowak-Wegrzyn A, Kerkar N, Aron R, Iyer K, et al. De novo food sensitization and eosinophilic gastrointestinal disease in children post-liver transplantation. Clin Transplant. 2012;26:365-71.
12. Noble C, Peake J, Lewindon PJ. Increase in the novo allergies after pediatric liver transplantation: the Brisbane experience. Pediatr Transplant. 2011;15:451-4.
13. Ozbek OY, Ozeay F, Avei Z, Haberal A, Haberal M. Food allergy after liver transplantation in children: a prospective study. Pediatr Allergy Immunol. 2009;20:741-7.
14. Label MJ, Chapdelaine H, Paradis L, Des Roches A, Alvarez F. Increase in de novo food allergies after pediatric transplantation: tacrolimus vs. cyclosporine immunosuppression. Pediatr Transplant. 2014;18:733-9.
15. Chen Y, Inobe J, Marks R, Gonnella P, Kuchroo VK, Weiner HL. Peripheral deletion of antigen-reactive T cell in oral tolerance. Nature. 1995;376:177-80.
16. Prussin C, Lee J, Foster B. Eosinophilic gastrointestinal disease and peanut allergy are alternatively associated with IL-5+ and IL5− Th2 responses. J Allergy Clin Immunol. 2009;124: 1326-32.
17. Dukin D, Berin MC, Mayer L. Allergic sensitization can be induced via multiple physiologic routes in an adjuvant-dependent manner. J Allergy Clin Immunol. 2011;128:1251-8.
18. Berin MC, Shreffler WG. Th2 adjuvants: implications for food allergy. J Allergy Clin Immunol. 2008;121:1311-20.
19. Cardet JC, Boyce JA. Addition of mycophenolate mofetil to tacrolimus is associated with decrease in food-specific IgE levels in a pediatric patient with liver transplantation-associated food allergy. J Allergy Clin Immunol Pract. 2013;1:104-6.
20. Ohata K, Espinoz JL, Lu X, Kondo Y, Nakao S. Mycophenolic acid inhibits natural killer cell proliferation and cytotoxic function: a possible disadvantage of including mycophenolate mofetil in the graft versus host disease prophylaxis regimen. Biol Blood Marrow Transplant. 2011;7:205-13.
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