Subcutaneous immunotherapy for bee venom allergy induces epitope spreading and immunophenotypic changes in allergen-specific memory B cells

J Allergy Clin Immunol. 2024 Dec;154(6):1511-1522. doi: 10.1016/j.jaci.2024.08.019. Epub 2024 Aug 30.

Abstract

Background: Allergen immunotherapy (AIT) is the only disease-modifying treatment for allergic disorders. We have recently discovered that allergen-specific memory B cells (Bmem) are phenotypically altered after 4 months of sublingual AIT for ryegrass pollen allergy. Whether these effects are shared with subcutaneous allergen immunotherapy (SCIT) and affect the epitope specificity of Bmem remain unknown.

Objective: The study aimed to evaluate the phenotype and antigen receptor sequences of Bmem specific to the major bee venom (BV) allergen Api m 1 before and after ultra-rush SCIT for BV allergy.

Methods: Recombinant Api m 1 protein tetramers were generated to evaluate basophil activation in a cohort of individuals with BV allergy before and after BV SCIT. Comprehensive flow cytometry was performed to evaluate and purify Api m 1-specific Bmem. Immunoglobulin genes from single Api m 1-specific Bmem were sequenced and structurally modeled onto Api m 1.

Results: SCIT promoted class switching of Api m 1-specific Bmem to IgG2 and IgG4 with increased expression of CD23 and CD29. Furthermore, modeling of Api m 1-specific immunoglobulin from Bmem identified a suite of possible new and diverse allergen epitopes on Api m 1 and highlighted epitopes that may preferentially be bound by immunoglobulin after SCIT.

Conclusions: AIT induces shifting of epitope specificity and phenotypic changes in allergen-specific Bmem.

Keywords: Immunotherapy; allergen epitopes; allergen-specific; memory B cells.

MeSH terms

  • Adult
  • Allergens* / immunology
  • Animals
  • Bee Venoms* / immunology
  • Desensitization, Immunologic* / methods
  • Epitopes / immunology
  • Epitopes, B-Lymphocyte / immunology
  • Female
  • Humans
  • Hypersensitivity / immunology
  • Hypersensitivity / therapy
  • Immunophenotyping
  • Injections, Subcutaneous
  • Insect Proteins / immunology
  • Male
  • Memory B Cells* / immunology
  • Middle Aged
  • Phospholipases A
  • Venom Hypersensitivity

Substances

  • Bee Venoms
  • Allergens
  • Api m 1 allergen, Apis mellifera
  • Insect Proteins
  • Epitopes, B-Lymphocyte
  • Epitopes
  • Phospholipases A