Wayne G Shreffler, MD, PhD
- ADJUNCT ASSOCIATE PROFESSOR | Pediatrics
BS, University of Washington
MS, New York University, Graduate School of Arts & Sciences
PhD, New York University, Graduate School of Arts & Sciences
Postdoctoral Fellows: Bert Ruiter PhD, Katherine Bloom MD
Research Personnel: Caitlin Woo, Kehinde Kassim, Shashi Neerukonda, Neisha Rivers, Anita Saha
Summary of Research Studies :
Mechanisms of Allergenicity Allergy to peanut (Arachis hypogaea) tends to be persistent and severe, and it represents an increasingly prevalent public health problem. More than 3 million Americans have peanut and/or tree nut allergy. To help account for the severity and prevalence of peanut allergy we hypothesize that peanut glycans function as Th2 adjuvants, directly activating innate immune cells to promote a strong and persistent allergic response in susceptible individuals. Most of the characterization of allergens has focused on structural properties such as size, solubility, stability, etc, that contribute to their allergenicity. There has been less attention directed at whether these proteins, or associated molecules, possess innate immunostimulatory function. Mammalian innate immune cells have evolved to recognize molecules like LPS as pathogen-associated molecular patterns (PAMPs) and in response promote a Th1 immune response to associated microbial proteins. Similarly, there are molecular patterns that have Th2 adjuvant function. Among the few well-studied Th2 PAMPs are glycans from Schistosoma mansoni egg antigens. Some of the core fucosylated and xylosylated complex mannose glycans implicated from schistosomes are also common on plant, arthropod, and helminth but not mammalian glycoproteins. Therefore these glycans make attractive candidates as non-self signals recognized by the innate immune system to induce Th2-skewed responses in susceptible individuals and contribute to clinical allergy. Mechanisms of Immune Tolerance in Children with Food Allergy The majority of infants and toddlers diagnosed with milk allergy will go on to outgrow the condition on their own by the time they reach school age. We are collaborating with Anna Nowak-Wegrzyn, M.D. and Hugh A. Sampson, M.D. to study mechanisms for the resolution of milk and egg allergy. Two putative mechanisms of food allergy resolution are currently being investigated: 1. As food allergy may be driven by a failure of normal immune tolerance, we hypothesize that its resolution will be associated with an increase of allergen-specific regulatory T cells. Using CFSE to identify allergen-specific cells by proliferation, we are currently measuring the frequency of CD4 T cells expressing a CD25+ CD127- FoxP3+ phenotype in the peripheral blood from food-allergic children over multiple time points as they become tolerant. 2. Basophils are the largest population of allergen-specific cells in peripheral blood. We are studying basophil activation both directly ex vivo and in response to in vitro allergen stimulation in patients as they become tolerant. We hypothesize that basophil hyporesponsiveness will predict clinical tolerance. Clonal Diversity of B cell Response to Food Antigens Individuals with immediate hypersensitivity to food have a pathological immune response to ubiquitous dietary antigens characterized by the failure of immune tolerance and the production of specific IgE. There is a spectrum of immunity to food proteins from non-sensitized, to sensitized, transiently allergic, or persistently allergic individuals. The natural history of this immune response and how it varies between these groups is poorly understood. We hypothesize that increased allergen-specific antibody diversity, avidity, and IgE/ IgG4 ratio are markers of Th2 immune progression and will correlate with reaction severity and allergy persistence. We have developed a microarray-based immunoassay for the analysis of peanut-specific IgE clonal diversity and shown in a retrospective study a correlation between diversity and reaction severity. We have now developed such an assay for milk allergens as well. This study aims to follow a cohort of milk-sensitized children and age-matched controls prospectively using these markers to evaluate longitudinal changes in the humoral immune responses between and within clinical groups in order to better understand the natural history of milk allergy and the potential prognostic usefulness of these disease markers.
Wanich N, Nowak-Wegrzyn A, Sampson HA, Shreffler WG. Allergen-specific basophil suppression associated with clinical tolerance in patients with milk allergy. J Allergy Clin Immunol 2009 Apr; 123(4): 789-794.
Shreffler WG, Wanich N, Moloney M, Nowak-Wegrzyn A, Sampson HA. Association of allergen-specific regulatory T cells with the onset of clinical tolerance to milk protein. J Allergy Clin Immunol 2009 Jan; 123(1): 43-52.
Flinterman AE, Knol EF, Lencer DA, Bardina L, den Hartog Jager CF, Lin J, Pasmans SG, Bruijnzeel-Koomen CA, Sampson HA, van Hoffen E, Shreffler WG. Peanut epitopes for IgE and IgG4 in peanut-sensitized children in relation to severity of peanut allergy. J Allergy Clin Immunol 2008 Mar; 121(3): 737-743.
Shreffler WG, Castro RR, Kucuk ZY, Charlop-Powers Z, Grishina G, Yoo S, Burks AW, Sampson HA. The major glycoprotein allergen from Arachis hypogaea, Ara h 1, is a ligand of dendritic cell-specific ICAM-grabbing nonintegrin and acts as a Th2 adjuvant in vitro. J Immunol 2006 Sep 15; 177(6): 3677-3685.
Shreffler WG, Lencer DA, Bardina L, Sampson HA. IgE and IgG4 epitope mapping by microarray immunoassay reveals the diversity of immune response to the peanut allergen, Ara h 2. J Allergy Clin Immunol 2005 Oct; 116(4): 893-899.
Shreffler WG, Beyer K, Chu TH, Burks AW, Sampson HA. Microarray immunoassay: association of clinical history, in vitro IgE function, and heterogeneity of allergenic peanut epitopes. J Allergy Clin Immunol 2004 Apr; 113(4): 776-782.
Lin J, Bardina L, Shreffler WG. Microarrayed allergen molecules for diagnostics of allergy. Methods Mol Biol 2009; 524: 259-272.
Shreffler WG. The perfectly potent peanut. J Allergy Clin Immunol 2009 Feb; 123(2): 352-353.
Moloney M, Shreffler WG. Basic science for the practicing physician: flow cytometry and cell sorting. Ann Allergy Asthma Immunol 2008 Nov; 101(5): 544-549.
Berin MC, Shreffler WG. T(H)2 adjuvants: implications for food allergy. J Allergy Clin Immunol 2008 Jun; 121(6): 1311-1320.
Shreffler WG. Evaluation of basophil activation in food allergy: present and future applications. Curr Opin Allergy Clin Immunol 2006 Jun; 6(3): 226-233.