Comprehensive mapping of immune tolerance yields a regulatory TNF
receptor 2 signature in a murine model of successful Fel d 1-specific
immunotherapy using high-dose CpG adjuvant
Abstract
Background The prevalence of allergy to cat is expanding worldwide.
Allergen-specific immunotherapy (AIT) has advantages over symptomatic
pharmacotherapy and promises long lasting disease control in allergic
patients. However, there is still a need to improve cat AIT regarding
efficacy, safety and adherence to the treatment. Here we aim to boost
immune tolerance to the major cat allergen Fel d 1 by increasing the
anti-inflammatory activity of AIT with the established immunomodulatory
adjuvant CpG, but at a higher dose than previously used in AIT. Methods
Together with CpG, we used endotoxin-free Fel d 1 as therapeutic
allergen throughout the study in a BALB/c model of allergy to Fel d 1,
thus mimicking the conditions of human AIT trials. Multidimensional
immune phenotyping including mass cytometry was applied to analyze
AIT-specific immune signatures. Results We show that AIT with high-dose
CpG in combination with endotoxin-free Fel d 1 reverts all major
hallmarks of allergy. High dimensional CyTOF analysis of the immune cell
signatures initiating and sustaining the AIT effect indicates the
simultaneous engagement of both, the pDC-Treg and -B cell axis, with the
emergence of a systemic GATA3+ FoxP3hi biTreg population. The regulatory
immune signature also suggests the involvement of the anti-inflammatory
TNF/TNFR2 signaling cascade in NK and B cells at an early stage and in
Tregs later during AIT. Conclusion Our results highlight the potential
of CpG adjuvant in a novel formulation to be further exploited for
inducing allergen-specific tolerance in patients with cat allergy or
other allergic diseases in the future.