ImmYOUnology

More than just vaccines


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Allergies are no fun…but the biology behind them is!

Spring is nearly upon us and along with trees and flowers, seasonal allergies will bloom once again.  Even though allergies can be annoying, debilitating and even life-threatening, the science behind them is fascinating.  Science published a timely paper at the end of February describing some of the ways different kinds of allergens work.  Allergens are small parts—individual proteins or molecules—of things that cause allergic responses.

The group who published the study worked with cells called mast cells, one of the common types of the immune cells that respond to allergens and make you itchy, sneezy and swollen.  Before they can activate mast cells, allergens have to be recognized by a particular type of antibody, or immunoglobulin, called immunoglobulin E, or IgE.  On one end, IgE binds an allergen, and on the other it interacts with a protein receptor on mast cell surface.

By connecting the mast cell to the allergen, IgE gives the mast cell permission to do its thing, and its thing is called degranulation.  Mast cells are brimming with packets, or granules, of histamine and heparin and other proteins that damage microbes as well as tissue.  When the cells degranulate, they open up and release their contents into whatever tissue they happen to be in—the skin, the lungs or the gut for example.  Many of the contents released make blood vessels leaky and attract lots of immune cells, causing inflammation.  Antihistamines prevent the released histamine from binding its receptors on blood vessel cells.  Another treatment option currently under investigation is a drug that blocks the interaction between IgE and the receptor on mast cells to prevent this process from even getting started.  

The recent Science paper took a close look at the mast cell response to IgE-bound allergen and showed just how fine-tuned it can be. The researchers activated mast cells with allergens that bound tightly or weakly to IgE and found that the strength of the interaction, also called affinity, changed the way that mast cells responded.

http://commons.wikimedia.org/wiki/File%3ASMCpolyhydroxysmall.jpg

Skin mast cells stained with Toluidine blue

The researchers could study mouse mast cells in culture dishes, because mast cells grow up from stem cells inside bone marrow.  So they grew up mast cells from mouse bone marrow and then gave them the strongly binding allergen (high affinity) or the weakly binding one (low affinity). They could get the mast cells to respond and degranulate with both, but it took 100 times more of the weak binding allergen to get the same response caused by the strong one.

To understand how allergic reactions work in living creatures, researchers often sensitize mouse ears by exposing them to an allergen and later re-introduce the allergen through the bloodstream. Then they can measure how inflamed the ears get and how many and what kinds of immune cells travel to the ear after injecting the allergen.  In this study, the strong binding allergen caused more intense and more sudden ear inflammation and immune cell infiltration than the weaker binding allergen.

So how does this fascinating mechanism actually relate to human allergies, which for some people is a life-threatening condition.  Although some allergies go away with age, there is currently no permanent cure for those that don’t.  Treatment of serious allergies is centered around desensitization immunotherapy, which is just repeated exposure to small doses of allergen over time.  The treatment may last anywhere from months to a lifetime and there are no biomarkers, or biological tests, that tell doctors when the treatment is working.  Instead, they simply test allergens on patients, which could mean pricking the skin or making them eat peanuts one at a time until they do or don’t get sick.  

A clinical study that came out in January helped me understand how knowledge of allergen binding strength could be helpful in treatment.  In this study, children with milk allergies were undergoing oral immunotherapy, which in this case simply meant they had to drink small amounts of milk that were increased over time.  The researchers collected serum samples from the kids in the study and measured levels of IgE as well as the affinity of IgE for proteins found in cow’s milk to see if either would change as kids became more tolerant to milk.

In some cases, the immunotherapy had to be discontinued because the reactions to milk were too severe.  The researchers found that the IgE from the kids whose treatment was discontinued bound more tightly to milk proteins compared to kids who responded well to the treatment.  So the strength of the interaction between IgE and allergens does matter, at least in the case of cow’s milk allergies. This study didn’t look at mast cells, but it does indicate that the molecular details of how IgE connects allergens to mast cells are worth studying.  Those details can provide clues about what is going on inside a person with allergies and how well they may respond to immunotherapy.

Sources:

Mastcellaware.com (A whole website about Mast Cells)

Suzuki R., Leach S., Liu W., Ralston E., Scheffel J., Zhang W., Lowell C.A. & Rivera J. (2014). Molecular Editing of Cellular Responses by the High-Affinity Receptor for IgE, Science, 343 (6174) 1021-1025. DOI:

Savilahti E.M., Kuitunen M., Valori M., Rantanen V., Bardina L., Gimenez G., Mäkelä M.J., Hautaniemi S., Savilahti E. & Sampson H.A. & (2014). Changes in IgE and IgG4 epitope binding profiles associated with the outcome of oral immunotherapy in cow’s milk allergy, Pediatric Allergy and Immunology, n/a-n/a. DOI:

Moran T.P., Vickery B.P. & Burks A.W. (2013). Oral and sublingual immunotherapy for food allergy: current progress and future directions, Current Opinion in Immunology, 25 (6) 781-787. DOI:

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Most of us have had a few run-ins with the bane of the kitchen, the fruit fly.  Known better by some as Drosophila melanogaster, scientists have been studying the species since the early 1900s. But until college labs, I never understood what you would want to know about them other than how best to keep them out of your bananas. 

Believe it or not, research using fruit flies has given us much of our modern understanding of genetics. Research using fruit flies led to the idea that chromosomes contain genes, the concept of mapping where genes are within a chromosome, the fact that ionizing radiation causes genetic mutations and the fact that XX chromosomes makes females female and XY makes males male.

By André Karwath aka Aka (Own work) [CC-BY-SA-2.5 (http://creativecommons.org/licenses/by-sa/2.5)], via Wikimedia Commons

Drosophila melanogaster

Fruit flies have more recently been used to understand human immunology.  A study published last month in PlosOne describes immune responses of flies that were born in outer space aboard the shuttle, Discovery.  It may sound far-fetched, but fruit flies are a cheap and compact model organism that has a lot in common with humans, especially when it comes to immunity.

I’ve written a lot about the adaptive immune system—mainly B cells and T cells with very specific receptors that recognize very specific parts of infecting pathogens and become memory B and T cells.  There is another branch of immune cells that make up the innate immune system.  They have receptors that detect general patterns found on pathogens, called (appropriately) pattern recognition receptors.  For example, some recognize sugars arranged in repeated patterns on the surface of bacteria.  Pattern recognition receptors are less specific than receptors on B and T cells, and don’t generate memory.  Instead, they act as a first line of defense that allows immune cells to react quickly and make signaling proteins to direct the immune response toward inflammation.

Toll-like receptors make up the class of innate receptors that kicked off studies into the innate branch of immunity. They were given their name due to their shared genetic sequence with a fruit fly receptor called Toll.  Studies in fruit flies gave researchers major clues throughout the early 1990’s about how Toll-like receptors work. (For a complete history of how it all happened, check out this Nature review, or this free article.)  Toll-like receptors are found on both adaptive and innate immune cells, as well as neurons and epithelial cells. We are constantly sensing our environment via Toll-like receptors. They are vital for responding to viral and bacterial infections and help keep bacteria in our gut microbiomes under control.  Many researchers are looking for the best ways to activate them during vaccination in place of current adjuvants.  It may seem odd, and maybe a little bit gross, but without those pesky flies, we would not know nearly as much about how our own immune systems function.

In case you were curious, the flies born on the space shuttle Discovery—called “space flies” by the authors of the paper—were infected with fungal spores and bacteria and the researchers examined changes in genes involved in immune responses. Unfortunately, the “space flies” were overall immunosuppressed and at a disadvantage compared to “earth flies,” leading the authors  to conclude that gravity plays a key role in immune function.

Sources:

Medzhitov R. & Janeway C.A. (1998). Self-defense: The fruit fly style, Proceedings of the National Academy of Sciences, 95 (2) 429-430. DOI:

O’Neill L.A.J., Golenbock D. & Bowie A.G. (2013). The history of Toll-like receptors — redefining innate immunity, Nature Reviews Immunology, 13 (6) 453-460. DOI:

Taylor K., Kleinhesselink K., George M.D., Morgan R., Smallwood T., Hammonds A.S., Fuller P.M., Saelao P., Alley J. & Gibbs A.G. & (2014). Toll Mediated Infection Response Is Altered by Gravity and Spaceflight in Drosophila, PLoS ONE, 9 (1) e86485. DOI:

http://web.mit.edu/HST.160/www/DrosophilaGenomeResearch.pdf

http://www.benchfly.com/blog/model-organism-week-drosophila-melanogaster-the-fruit-fly/


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Tuning down the immune system could improve the flu vaccine

This post is based on an article I recently wrote for an internship application, so it’s more formal than a typical post, but I think it’s a cool story that helps explain how the flu vaccine works. Enjoy! And stay healthy!

After more than 2,000 confirmed cases and over twenty deaths, the 2013-14 flu season is still approaching its peak.  Vaccination remains the best prevention despite the flu vaccine’s hit-or-miss reputation.   Each year the U.S. Food and Drug Administration recommends three strains of influenza that the World Health Organization believes are worth targeting, and six months later the season’s new vaccine is distributed.

influenza-virus-labels

This nasty viral particle is trying to get inside a cell. It’s covered in NA (red) and HA (blue) proteins.

One of the flu vaccine’s biggest problems is its inability to induce immunity against multiple viral subtypes.  Subtypes of the influenza A virus, like H1N1 or H5N1 are distinguished by the surface proteins hemagglutinin (HA) and neuraminidase (NA).  The vaccine can protect against a few subtypes at a time, but if a subtype not included in the shot makes a strong appearance one season, not much can be done to prevent it from spreading.  This year, the vaccine is pretty spot on. It includes H1N1 which has been making a comeback this year.

This problem has driven researchers to pursue a universal vaccine that could protect against multiple subtypes.  This type of protection is called heterotypic immunity.  One group of scientists from St. Jude Children’s Research Hospital hit on an unexpected way to expand the reach of one flu vaccine to multiple subtypes.  Dr. Maureen McGargill and her group published their study in Nature Immunology in December.  They studied how a common immunosuppressive drug called rapamycin influenced the ability of vaccinated mice to generate heterotypic immunity.  They vaccinated mice with one viral subtype and infected them with three other lethal subtypes.  Surprisingly, the mice who got rapamycin were better able to resist infection by all the subtypes, including an altered H5N1 strain, commonly known as the avian flu.

Rapamycin is commonly used to dampen the immune system to prevent organ transplant rejection.  It blocks an immune system regulating protein called mTOR.  Three other animal vaccine studies previously found that rapamycin enhanced generation of memory T cells, cells that can remember a virus and kill infected cells when they detect viral proteins.  None of these studies linked higher numbers of memory T cells to protection from infection.  McGargill’s group observed both higher memory T cell numbers and better protection, but could not link the two. Rather, they found that protection was related to changes in the kinds of antibodies that the vaccine induced.

The flu vaccine contains pieces of viral proteins called antigens and mice and humans make antibodies that specifically bind these antigens on the viruses and neutralize them.  The more specific the antibodies are though, the more they drive those proteins to mutate so the virus can escape detection.  This shape-shifting tactic is called antigenic drift, and it is part of the reason it is so difficult to predict which vaccine formulation will be most effective each year.    

The coveted universal vaccine would induce antibodies that recognize parts of the virus that are shared, or conserved, by many subtypes and unlikely to mutate.  But B cells, the cells that make antibodies, tend to make more and more specific antibodies over time.  Over several weeks, B cells go from making weak, broadly binding antibodies that can cross-react with many subtypes, to strong and specific ones.   McGargill and her colleagues found that rapamycin interrupted this process and caused the mice to make more of the broadly binding antibodies.  The antibodies also targeted different parts of the hemagglutinin protein.

The group could not determine exactly how the altered antibodies contributed to protection from infection.  They concluded that the antibodies produced after rapamycin treatment were less specific and therefore able to cross-react with several viral subtypes.   As a result, the treated mice were less susceptible to the three different influenza subtypes.

These findings could be useful for quickly designing broadly protective vaccines in the face of a new subtype outbreak or epidemic.  It currently takes about six months to manufacture the annually recommended formulation.  A heterotypic vaccine would not be as dependent on the World Health Organization’s laborious surveillance and data analysis, and could be stored and used for many flu seasons.

Sources:

Bridges CB et al. Effectiveness and cost-benefit of influenza vaccinations on healthy working adults: A randomized controlled trial. JAMA (2000) 284:1655-63.

Keating R. et al. The kinase mTOR modulates the antibody response to provide cross-protective immunity to lethal infection from influenza virus.  Nature Immunology (2013) 14:1266-76.

McMichael A and Haynes B. Influenza vaccines: mTOR inhibition surprisingly leads to protection. Nature Immunology (2013) 14:1205-07.

Pica N and Palese P. Toward a universal influenza virus vaccine: Prospects and challenges. Ann. Rev. Med. (2013) 64:189-202.

http://www.cdc.gov/flu


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Norovirus! (AKA the 24 hour stomach bug) Can it be avoided?

The other day I found myself in the break room near my lab eyeing a container of chocolate-covered nuts left over from the Christmas holiday.  Someone left them out as a treat for foraging graduate students and post-docs.  I stood for a moment holding a single piece in my fingers and as I was about to put it into my mouth, I remembered—Norovirus!

I had no reason to think the nuts could be a reservoir of norovirus, but I did have good reason to avoid shared uncooked food with an unknown history.   A good chunk of my family had just had their holiday ruined by the virus, sometimes known as the 24-hour bug or stomach flu.  It causes gastroenteritis, or inflammation of the gut, complete with diarrhea, vomiting and overall exhaustion.  It can only be transmitted via stool or vomit, and though there was certainly none of that visible in the bin of delicious looking nuts, I began to think of all the hands that may have been inside. If it came from a family holiday party, some of those hands may have belonged to kids who haven’t yet learned to wash them for a full 30 seconds after using the bathroom. I threw the candy away, closed the container and left the break room.

I may have avoided norovirus that day by a judicious food choice, but not everyone has that moment of doubt before sharing a drink, holding a child’s hand or ordering a deli sandwich.  It is sometimes just unavoidable, especially because it’s contagious for up to two weeks after the first horrible 24 hours. The center for disease control estimates that 19-21 million people are infected with norovirus each year and it’s actually responsible for somewhere between 600 and 800 deaths per year. Those most vulnerable are either over 65 or under 5 years old.

These figures are driving researchers to search for a vaccine, even if just for those most vulnerable or during outbreaks.  But norovirus, or I should say noroviruses are particularly complicated. They are split into 5 groups (I-V) based on how similar their DNA sequences are. Those groups, called genogroups, are split into anywhere between 8 and 30 genotypes and those can be further divided into variants.  The classification is complicated enough to require the use of a software program that compares genome sequences.

Only three of the genotypes can infect humans and the strain GII.4 has been the most common cause of outbreaks since the early 2000s.  For decades before that, a different strain dominated, and the power structure may shift again.  The abundance of genotypes and variants and their changing frequencies in communities make vaccine design a daunting task.  On top of that, researchers are still discovering new genotypes and variants.  In 2012 a strain called GII.4-Sydney was identified in Australia and made its way to the UK and the US within a year.

Norovirus 4

Up close scanning electron microscopic image of norovirus particles

There is evidence that infection with norovirus can generate immunity in some people, meaning that once they get infected, they are protected from re-infection for some weeks or months. However, no one knows how all of the viral subgroups and variants might affect immunity and vaccine design. In a study published in September, researchers from the University of Florida infected mice with one of two closely related norovirus strains and found major differences in the immune responses.

One of the two strains was much better at activating a class of immune cells called antigen presenting cells. These include dendritic cells and macrophages, and they are experts at displaying pieces of virus and training B and T cells to respond to the infection and turn into memory cells. As a result of the enhanced response, infected mice were protected from a reinfection six weeks later.

{Researchers determine “protection” by measuring how much virus shows up in an animal’s organs after infection. In this case, they measured norovirus in the small and large intestines and in the lymph nodes attached to the intestines.}

Oddly enough, the researchers narrowed down the cause of these changes down to a group of structural proteins whose sequences only varied by about 10% between the two strains.

A key finding in this study was that the protective norovirus strain protected mice from re-infection with both strains.  This is important since any vaccine against norovirus would have to protect against several strains and genotypes. It also points out specific characteristics of the immune response that make all the difference between becoming immune or getting re-infected, for example, robust antigen presentation and B and T cell memory.  A vaccine that could foster those characteristics could potentially protect people from several norovirus strains.  It may take a while to get there. In the meantime I will keep my hands clean and out of community candy dishes.

prevent-norovirus

*A reader noted that the poster above says norovirus is contagious for 2-3 days, whereas I wrote above that it can be contagious for 2 weeks.  To clarify, the virus is most contagious for 2-3 days, but it can continue to be shed in stool for 2 weeks. See http://www.cdc.gov/norovirus/preventing-infection.html for more.

Sources:

The CDC

Zhu S., Regev D., Watanabe M., Hickman D., Moussatche N., Jesus D.M., Kahan S.M., Napthine S., Brierley I. & Hunter R.N. & (2013). Identification of Immune and Viral Correlates of Norovirus Protective Immunity through Comparative Study of Intra-Cluster Norovirus Strains, PLoS Pathogens, 9 (9) e1003592. DOI:

Hoa Tran T.N., Trainor E., Nakagomi T., Cunliffe N.A. & Nakagomi O. (2013). Molecular epidemiology of noroviruses associated with acute sporadic gastroenteritis in children: Global distribution of genogroups, genotypes and GII.4 variants, Journal of Clinical Virology, 56 (3) 269-277. DOI:

Cancer immunotherapy named Science breakthrough of the year for 2013

It was exciting to see today that Science Magazine called cancer immunotherapy the breakthrough of 2013. The author Jennifer Couzin-Frankel calls it a “breakthrough strategy” and though she admits the approach is not yet widespread, she highlights promising clinical trials that have stacked up this year. “Immunotherapy marks an entirely different way of treating cancer-by targeting the immune system, not the tumor itself,” she wrote. The article deals mainly with experiments focused on activating T cells by blocking surface proteins that shut T cells down. To learn more about other approaches, see my post about cancer vaccines.  


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Update on antibiotic resistance week: FDA makes recommendations to limit antibiotics in agriculture

I mentioned in my post on antibiotic resistance that most farm animals in the U.S. are constantly on antibiotics to prevent disease and promote growth (these two outcomes are not necessarily linked).  In the E.U. this practice was halted years ago to avoid the risk of antibiotic resistance from developing.  It seems that the U.S. F.D.A. is also going in this direction. They put out a policy that recommends suspending the use of antibiotics for healthy animals. Check out these two links to learn more:

http://www.nytimes.com/2013/12/12/health/fda-to-phase-out-use-of-some-antibiotics-in-animals-raised-for-meat.html?smid=fb-share&_r=1&

 

http://www.wired.com/wiredscience/2013/12/fda-213-vfd/#more-390021