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Updated: Jun 14, 2025
Basophil Activation Test for Allergy Diagnosis
Published on: May 31, 2021
Subcutaneous immunotherapy for bee venom allergy induces epitope spreading and immunophenotypic changes in
Craig I McKenzie1, Simone Reinwald2, Brett Averso3
1Department of Immunology, School of Translational Medicine, Monash University, Melbourne, Australia.
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.
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