As described elsewhere in this mini-monograph, the first systematic attempt
to develop a structured approach to assessment of the allergenic potential of
novel food proteins was sponsored jointly by the International Food Biotechnology
Council (IFBC) and the International Life Sciences Institute (ILSI) Allergy
and Immunology Institute (Metcalfe et al. 1996). The proposed scheme took the
form of a decision tree, the starting point for which was determined by the
origin of the novel gene and whether or not it derived from a source considered
to be allergenic. Among the approaches identified were consideration of the
serologic identity of the novel protein with known human allergens; structural
similarity to, or amino acid sequence homology with, allergenic proteins; and
resistance to proteolytic digestion in a simulated gastric fluid. Although such
investigations provide important information and are clearly valuable for the
identification of proteins that display serologic or structural homology with
known allergens, they do not provide a direct assessment of the inherent sensitizing
potential of proteins. For this reason there has been a growing interest in
the design, development, and application of appropriate animal models. The consensus
at the time of the IFBC/ILSI deliberations was that no appropriate animal models
were available. Since then, however, progress has been made, and in 2001 the
Food and Agriculture Organization (FAO) and World Health Organization (WHO)
convened a special consultation panel to consider food allergenicity testing
and possible revisions to the original IFBC/ILSI decision tree (FAO/WHO 2001).
One of the conclusions (conclusion 10) reached by the consultation was that
. . . animal models have not been evaluated for all food allergens but there
is sufficient scientific evidence that using these models will contribute valuable
information regarding the allergenicity of foods derived from biotechnology.
This view has given further impetus to the development of suitable animal
models, and it is timely now to review what has been achieved and what has still
to be accomplished. In this report, progress made in the design and evaluation
of models in the rat, the mouse, the dog, and in swine is reviewed and discussed.
Oral and Intraperitoneal Exposure of Brown Norway Rats
Animal models to study the sensitizing potential of new proteins should ideally
satisfy several important criteria (Penninks and Knippels 2001; Taylor and Lehrer
1996) that are difficult to attain with a single model. Selection of species
and strain, route of exposure for sensitization and challenge as well as the
use of adjuvants are important issues to consider. One approach is to use the
Brown Norway (BN) strain of rats, as this is a high-immunoglobulin (particularly
IgE) responder rat strain. Thus, to a certain degree, this BN rat strain resembles
atopic humans in their genetic predisposition to react more readily to antigens
with production of IgE. It has been suggested that for the evaluation of intrinsic
allergenic potential of new proteins, oral application is preferred, and that
the presence of an adjuvant is to be avoided. BN rats have been used for the
study of oral sensitization to food proteins after administration through the
diet or by gavage dosing either in the presence (Atkinson et al. 1996) or absence
of an adjuvant (Knippels et al. 1998a, 1998b; 1999a, 1999b; 2000).
Studies by Knippels and colleagues used ovalbumin (OVA), a well-defined chicken
egg allergen, as a model protein (Knippels et al. 1998b). In these studies not
only the dose (0.002-20 mg OVA per dose) but also the mode of application
(gavage vs. in the drinking water) and the frequency of application (daily,
twice a week, once a week, once every 2 weeks) were investigated (Knippels et
al. 1998b). Daily intragastric administration of 1 mg OVA for 42 consecutive
days, without the use of adjuvants, resulted in the production of OVA-specific
IgG as well as OVA-specific IgE responses in the majority of rats. In general
the percentage of IgE responders to OVA exceeded 80%, as measured by both enzyme-linked
immunosorbent assay (ELISA) and homologous passive cutaneous anaphylaxis (PCA)
assay. Optimal OVA-specific IgE antibody responses were observed around days
28-35. Sometimes, however, no detectable OVA-specific IgE responses were
induced upon daily gavage dosing with the same dose (1 mg) of OVA. Generally,
using less-frequent administration regimes of 1 mg OVA by gavage did not induce
specific IgG or specific IgE antibody responses. Upon exposure in the drinking
water, OVA-specific IgG but not OVA-specific IgE antibody was produced (Knippels
et al. 1998b).
Comparative sensitization studies using different strains of rats have been
performed to confirm that the BN strain rat is the most suitable choice for
these experiments (Knippels et al. 1999b). On the basis of the results of these
studies, it was apparent that upon oral exposure of Wistar, PVG, hooded Lister,
and BN rats to OVA, only the BN rats developed OVA-specific IgE antibodies,
confirming that the BN rat was the most suitable strain for oral sensitization
studies.
In subsequent investigations with BN rats, the sensitizing potential of hen
egg white (HEW) and cow's milk (CM) proteins was examined. Although antigen-specific
IgG responses were found upon daily gavage dosing of the animals with different
concentrations of HEW or CM, only a limited number of IgE responders were observed
as measured by PCA. However, immunoblotting experiments with these rat sera
demonstrated the presence of specific IgE antibodies against both HEW proteins
and CM proteins (Knippels et al. 2000). Moreover, both IgG and IgE antibodies
present in sera of rats sensitized orally to HEW or CM and in sera of HEW- or
CM-allergic patients recognized a comparable profile of allergens in these food
products. These results indicate that the specific protein recognition of induced
antibodies in the BN rat is comparable with that observed in sera from allergic
patients (Knippels et al. 2000).
In addition, BN rats have been sensitized with different doses of either crude
raw peanut extract or roasted peanut extract. Dose levels ranged from 0.01 to
10 mg peanut protein extract per day. No clear differences were observed in
the sensitizing potency of crude raw peanuts extracts or roasted peanut extracts
as measured by Th (T-helper) 2-mediated IgG2a production. Although the number
of positive responders increased as the number of daily exposures increased,
the magnitude of the IgG2a response was similar in the different dose groups.
Only a limited number of animals were IgE-positive as measured by PCA. The IgG2a
responses of animals sensitized orally or intraperitoneally with peanut proteins
were measured using the three purified major peanut allergens Ara h1, Ara h2
and Ara h3 as substrates. After oral sensitization, IgG2a antibodies were directed
against all three major peanut allergens; however, after intraperitoneal sensitization,
IgG2a antibodies were directed mainly toward Ara h2.
More recently, the relative allergenicity of selected allergenic and nonallergenic
proteins, based on human experience, has been investigated in the BN rat oral
exposure model. In these studies Ara h1 purified from peanut, tropomyosin purified
from shrimp or beef, and patatin purified from potatoes were evaluated. Preliminary
results indicated marked differences in the two identical sensitization studies
performed with these purified proteins in BN rats. Investigators found that
the rats in the first study had been unexpectedly preexposed in the diet to
one allergen used for sensitization and to a cross-reacting allergen, and it
is assumed that this affected the results. In the second study the oral sensitizing
potential decreased in the following order: Ara h1 > shrimp tropomyosin >
patatin, with no sensitization to beef tropomyosin in both studies.
In previous oral sensitization studies with soy proteins, it has been shown
that unscheduled dietary preexposure of test animals, or their parental generation,
to the antigen under investigation has important influences on the results of
oral sensitization studies (Knippels et al. 1998a). Exposure of the parental
generation to soy was found to influence the outcome of sensitization studies
with the offspring. These studies showed that BN rats bred and raised on a soy
protein-containing diet for several generations have soy-specific IgG antibodies.
When these rats were fed before breeding with a soy protein-free diet for
6 months, soy protein-specific IgG antibodies were still detectable in
the parental animals and also in serum samples collected from the F1
generation of offspring rats fed on soy protein-free diets for periods
up to 6-12 months. In the second, third, and fourth generations of offspring
bred on a soy protein-free diet, no soy-specific IgG was detected. Oral
sensitization to soy could be achieved in these rats. Therefore, when oral sensitization
studies with proteins are performed, at least two generations of animals have
to be bred on a diet free of the antigen under investigation to get immunologically
naïve and therefore responsive animals.
The BN rat food allergy model was characterized further by Knippels et al.
(1999a), who studied immune-mediated effects upon oral challenge of sensitized
animals. Local effects induced by oral challenge were studied by measuring gut
permeability. Upon an oral challenge with OVA in OVA-sensitized BN rats, gut
permeability was increased, as evidenced by an increased uptake of a bystander
protein (ß-lactoglobulin). In addition to studies on local effects, systemic
effects were investigated by monitoring respiratory functions and blood pressure
changes (Knippels et al. 1999a). Under the test conditions used, oral challenge
with OVA induced only minor effects on the respiratory system or blood pressure
in a minority of animals. However, this low incidence is considered to be in
accordance with clinical observations in food-allergic patients.
In conclusion the results obtained to date indicate that the BN rat might
be a useful animal model in which to study the potential oral allergenicity
of novel food proteins (Knippels and Penninks 2003). However, further testing
with either whole food or with additional purified non-, weak-, and strong-allergenic
proteins is needed for a more in-depth evaluation of this BN rat model. Moreover,
the BN rat model may also be a promising tool to study in more detail various
mechanistic aspects of food allergy, which might result in new opportunities
with respect to prophylaxis and therapy.
Oral and Systemic Exposure of BALB/c Mice
The Balb/c mouse has also been utilized to evaluate the sensitizing potential
of novel proteins. An advantage of this model is that the Balb/c mouse strain
is known to favor the development of Th2 type immune responses and the production
of IgE antibody.
Although it has been argued that, in the context of assessing the safety of
dietary proteins, oral administration is the preferred route of exposure, it
has been demonstrated that such a regimen may lack the sensitivity required
for effective identification of inherent sensitizing potential. This is probably
attributable, at least in part, to the fact that oral exposure may be associated
with the development of tolerance (Strobel and Mowat 1998). Consequently, the
studies described below focus primarily on systemic (usually intraperitoneal)
exposure of mice to the protein of interest.
Using the Balb/c mouse, it is possible to measure the quality and vigor of
immune responses after systemic exposure to proteins and to define these proteins
as having inherent sensitizing potential if they provoke clear IgE antibody
responses. In effect the strategy is to distinguish between immunogenic proteins
(that are able to induce specific IgG antibody responses, but not IgE responses)
and potentially allergenic proteins (that are able under these conditions to
provoke both IgG and IgE antibody production). It has been possible using this
approach to demonstrate clear differences between proteins with respect to IgE
antibody production. Thus, under conditions of exposure where different proteins
elicit largely comparable IgG antibody responses, there can be very substantial
variations in their ability to induce specific IgE antibody (Dearman et al.
2000, 2001; Dearman and Kimber 2001; Hilton et al. 1994, 1997). It is assumed
that such differences are predicated on the characteristics of the protein that
in turn influence the nature of induced immune responses. Among the features
that may be important in this respect are the following: size, proteolytic stability,
biological function (including enzymatic activity), glycosylation status, overall
immunogenicity and the ways in which protein is processed for subsequent presentation
to the immune system (Huby et al. 2000; Kimber and Dearman 2001a).
It is important to emphasize that this approach is designed specifically to
serve as a tool for hazard identification and characterization (Dearman and
Kimber 2001; Kimber et al. 2000; Kimber and Dearman 2001b). It must be acknowledged
that proteins defined as having an inherent sensitizing potential as a function
of their ability to stimulate IgE responses may not necessarily represent a
risk for human health. For instance, a protein with inherent allergenic activity
as defined above may fail in humans to cause sensitization when experienced
in the diet or if levels of exposure are insufficient to elicit an immune response.
Clearly, development of risk assessments for human allergic disease is going
to be problematic (not least because of the congenital and acquired factors
that influence interindividual differences in susceptibility), but any effective
safety assessment process must incorporate a sensitive and selective method
for identifying potential hazards. It is our view that this approach employing
BALB/c strain mice is currently the best way forward.
The standard protocol used by Kimber and colleagues (Dearman et al. 2001,
2002) can be summarized briefly as follows. Groups of mice (conventionally five
per group) receive one of various concentrations of the test protein by intraperitoneal
injection. Seven days later this treatment is repeated. At various periods following
the initiation of exposure, mice are exsanguinated by cardiac puncture. Individual
and pooled serum samples are prepared and stored frozen until analysis. Protein-specific
IgG antibody responses are measured using ELISA. For the evaluation of IgE antibody
responses, a homologous PCA assay is used. Studies using three proteins of differing
sensitizing potential serve to provide an illustrative example of results obtained
with this protocol.
Mice were exposed to equal volumes of either 0.2% peanut agglutinin (a minor
allergen of the peanut) (Barnett et al. 1983; Burks et al. 1994), 2% ovalbumin
(OVA), or a crude potato protein extract (PPE; 10%) containing acid phosphatase
activity (and which is assumed to lack significant sensitizing activity). All
proteins elicited specific IgG antibody responses that were of maximal vigor
14 days after the initiation of exposure. Under these same conditions of exposure,
strong IgE responses were observed 14, 28, and 42 days after exposure of mice
to either peanut agglutinin or OVA. In contrast, PPE failed to stimulate high-titer
IgE antibody, with only a very weak and transient signal detectable at 28 days.
In separate experiments, responses induced in mice after intraperitoneal administration
have been compared with those observed after gavage exposure. In the latter
case mice received a daily gavage dose of 1 mg test protein for 28 or 42 days.
Results obtained with OVA are instructive. Although oral dosing resulted in
the elicitation of IgG antibody responses in a proportion of exposed mice, only
variable and low-grade IgE antibody production was found. This is in contrast
to the strong IgE responses observed after systemic exposure of mice to OVA
(Dearman et al. 2001). As discussed above, the difficulty in generating robust
IgE responses to OVA suggests that for the purposes of hazard identification
and assessment of inherent sensitizing activity, systemic exposure may be more
appropriate than oral dosing.
Against this background the need now is for a more extensive and more searching
evaluation of the accuracy and utility of this approach, and to this end it
will be necessary to examine the characteristics of antibody responses induced
by a wider range of proteins (including known allergens and proteins known or
believed not to cause allergic sensitization). It will be necessary also to
determine the reliability and robustness of the method within the context of
well-managed interlaboratory collaborative trials. In addition to further examination
of this experimental approach for the purposes of hazard identification and
characterization, other research objectives are currently being addressed.
The first of these relates to the influence of resistance to proteolytic digestion
on sensitizing activity. Previous investigations have indicated that there exists
an association between the resistance of proteins to digestion in a simulated
gastric fluid and sensitizing activity (Astwood et al. 1996). Although this
correlation is not absolute, evaluation of resistance to proteolysis is currently
regarded as one component of the safety assessment process (Bannon et al. 2003).
It is frequently assumed that such an association reflects the fact that for
a protein to induce sensitization after oral ingestion, it will have to display
some level of stability in the gastric environment in order to interact effectively
with the mucosal immune system. However, it is clear (after gavage exposure
at least) that even unstable proteins are able to elicit immune responses in
mice when dosed orally (Dearman et al. 2002). On this basis it seems reasonable
to suggest that the observed correlation with resistance to proteolysis may
not be attributable solely to survivability in the gastrointestinal tract. One
hypothesis is that the susceptibility or otherwise to proteolytic digestion
may impact on the way in which antigen-presenting cells process proteins for
subsequent presentation to the immune system.
A second objective would be to characterize in greater detail the quality
of immune responses provoked in mice by protein immunogens and protein allergens.
Investigations are focused currently on definition of the cytokine secretion
profiles induced by proteins. Preliminary evidence indicates that, as expected,
and consistent with their ability to elicit IgE antibody responses, proteins
with known sensitizing potential are associated with a preferential type 2 cytokine
expression phenotype. It remains to be seen whether evaluation of cytokine secretion
profiles provides an additional or alternative approach to the identification
of inherent sensitizing activity.
Assessment of Allergenicity in Dogs I
Thioredoxin reduces disulfide (S-S) groups on proteins to the sulfhydryl
state, and researchers have examined whether thioredoxin-induced changes in
disulfide proteins affect the recognition of these proteins by IgE antibody.
To address this question, studies have been performed using high IgE-producing
dogs (Ermel et al. 1997). These animals were descended from a colony of inbred,
high IgE-producing spaniel/retriever/basenji dogs maintained at the Animal
Resources Service, School of Veterinary Medicine at the University of California,
Davis (Davis, California, USA).
On the basis of skin-test challenge of dogs sensitized previously to the native
proteins, the disulfide allergens that have been studied show decreased allergenicity
upon reduction by thioredoxin, apparently as a result of changes in IgE epitope
accessibility. This decrease was demonstrated first with the major allergens
of wheat [this decrease was shown with gliadins and glutenins in dogs as well
as in humans (Buchanan et al. 1997)] and more recently with the major milk allergen
ß-lactoglobulin (del Val et al. 1999). Further research with ß-lactoglobulin
revealed that, in addition to decreasing the skin-test challenge response in
animals previously sensitized to the native protein, thioredoxin treatment alleviated
the clinical symptoms manifested by the dog (vomiting and diarrhea or constipation).
Recently, it has been shown that the thioredoxin-reduced (disarmed) form of
ß-lactoglobulin can be stabilized by either reoxidation or derivatization
with a physiologic disulfide compound (cystamine or oxidized glutathione) (Morigasaki
et al. 2001, 2003).
Dogs that were originally sensitized to CM, beef, wheat, and soy proteins
were shown to produce specific IgE antibodies and to respond to oral challenges
with clinical manifestations similar to those provoked in humans. Additional
animals have been sensitized to peanut, walnut, or Brazil nut extracts to determine
whether sensitization with these preparations is also accompanied by clinical
reactions, and whether cross-reactivity occurs between the different preparations
(Teuber et al. 2002). At 6 months of age, these dogs displayed positive intradermal
skin test reactions to these extracts. IgE immunoblotting of sera to peanut,
walnut, and Brazil nut showed strong recognition of proteins in the aqueous
preparations. At 2 years of age, each of the peanut-sensitized and most of the
Brazil nut- and walnut-sensitized dogs reacted on oral challenge with the corresponding
primary immunogen. Little or no cross-reactivity occurred among the different
preparations measured, either by skin tests or oral food challenges, similar
to that in the human clinical picture. Furthermore, on the basis of skin tests
and oral challenges, the hierarchy of nut and cereal allergen reactivity was
also similar to that seen with humans (peanuts > tree nuts > soy >
wheat > barley).
The similarity of the immune response to that observed in humans raises the
possibility that the dog could be used to study food allergy and that this model
could potentially be used to assess the allergenicity of proteins, including
those to which human populations have not been exposed. In addition to being
used to assess the allergenicity of the native form of proteins, the dog could
in theory predict whether either the introduced protein of interest or an unsuspected
host component had become an allergen as a result of the transformation process.
To address this question, pups from three litters were sensitized at birth
to a transgenic corn leaf preparation containing a protein of interest that
on the basis of digestibility and amino acid sequence analyses was unlikely
an allergen. These same pups were sensitized simultaneously to several known
allergens (peanut, soy, milk, ragweed extracts). The results obtained over a
2-year period demonstrated that although the known allergens elicited skin-test
responses, the protein of interest showed negligible activity. The results support
the conclusions that the protein of interest is not an allergen, that the protein
had not become an allergen in the transformed leaf, and that unidentified components
of the host also had not become allergenic.
Results obtained during the past decade support the use of high IgE-producing
dogs as a potential model to assess and predict the importance of proteins as
human food allergens. The profile of allergenic foods, response to individual
allergens, and clinical reactions of dogs are all similar to those observed
in humans. Furthermore, the ranking of the potency of major food allergens is
comparable. The dog has additional advantages as an animal model. Its large
size permits the performance of gastrointestinal studies such as sampling of
mucosa under endoscopy without sacrificing the animal. In addition, as animals
can be challenged repeatedly, individuals can be alternately fed comparative
diets such as control versus thioredoxin-treated milk preparations.
The dog is, however, not without limitations. Dogs are expensive to maintain,
and their immune response (with respect to cytokines and chemokines, for example)
is not as well characterized as in models such as the mouse or rat. Furthermore,
sensitization is a lengthy process, often requiring up to 18 months of repeated
immunization in the presence of adjuvant to achieve a stable response.
In view of its promise, the dog warrants further study as a model to assess
and predict potential food allergens. Like other animal models currently being
studied (mouse, rat, pig), the dog may offer specific advantages for investigation
of this increasingly important problem.
Allergenicity in Dogs II: Spontaneous Food Hypersensitivity/Allergy
in a Colony of Dogs
Models used to identify and rank isolated proteins for the potential to induce
IgE antibody are highly sensitive for allergenic proteins; however, they may
have low specificity for these proteins as dietary components, and these models
may not have the power to identify allergens in whole foods. Ideally, to detect
foods that are truly allergenic, a model should provide for sensitization by
the oral route without adjuvants and demonstrate a clinical response characteristic
of atopic disease. Such a model should also manifest IgE responses. It has been
suggested that such a model exists in the spontaneously food-allergic dog.
Spontaneous allergic disease in dogs was first reported by Wittich (1941).
This report described seasonal rhinitis and conjunctivitis analogous to human
hay fever. Later, rhinitis, conjunctivitis, and asthmatic signs were demonstrated
after exposing a seasonally spontaneous allergic dog to aerosolized ragweed
pollens (Patterson 1960). Although these initial reports in the literature focused
on hay fever-like symptoms in dogs, the more common manifestation observed
by veterinarians in practice is that of allergic dermatitis, and this was first
characterized in detail by Halliwell (1971). From these early observations it
was clear that the dog's ability to manifest allergic disease signs similar
to humans provided a useful model. Thus, reports have appeared concerning induced
allergic disease in dogs ( Butler et al. 1983; Gold et al. 1972; Patterson et
al. 1974; Peters et al. 1982), and most recently, the induced allergic dog model
has been applied to oral sensitization to food proteins (Ermel et al. 1997).
Evidence from more than 30 years of clinical observations shows that spontaneous
hypersensitivity to food by dogs is associated with atopic dermatitis (Chamberlain
1978; Criep 1968; Reedy et al. 1997; White 1986). Spontaneous food hypersensitivity
manifested as dermatitis and enteric signs associated with elevated food allergen-specific
IgE has recently been described in the founding stock of a colony of Maltese
beagle dogs.
About half of the offspring in this colony manifest clinical signs of atopic
disease before 6 months of age when fed standard chow. Additional studies of
offspring from this founding stock, reported below, demonstrate the ability
of these dogs to be sensitized to allergens present in food, and to respond
with clinical signs of atopic disease to food allergens in amounts comparable
with those reported to elicit disease in humans. Furthermore, clinical disease
is associated with elevated levels of food allergen-specific IgE (Jackson
and Hammerberg 2002).
Twelve Maltese
beagle dogs 1-3 years of age, born and reared indoors without exposure
to helminth or arthropod parasites, demonstrated clinical signs of nonseasonal
atopic dermatitis when fed standard dog chow containing corn, wheat, and soy
proteins, among other ingredients (Jackson et al. In press). The dogs were given
monthly tablets containing soy and pork for flavoring. The amount of soy and
pork protein contained in each tablet provided about 1-2 mg/kg body weight
for each dog. Two months before the start of the trial, the diet was changed
to a hypoallergenic food consisting of cooked rice and duck, which allowed resolution
of clinical signs of atopic dermatitis. On day 0, prior to receiving the flavored
tablet, and at regular intervals for 45 days, dogs were bled and scored for
pruritus, erythema and excoriation, and evidence of secondary skin/otic infections.
These measurements were combined for a total clinical score.
Clinical scores for pruritus showed marked increases at 8-13 days after
ingestion of the flavored tablet. Specific IgE antibodies for soy showed statistically
significant increases from day 0 levels at day 5 (p = 0.001), day 8 (p
= 0.03), and day 20 (p = 0.03). Antibodies for pork tended to be
elevated on day 5, but only on day 20 was there a statistically significant
increase (p = 0.03). Even though corn was not part of the tablet composition,
significant increases occurred in anti-corn IgE at the three time points
sampled from days 20 to 45. No significant increase was observed in total serum
IgE, indicating there was no major polyclonal stimulation of IgE production
by the ingestion of this amount of allergen. Thus, the elevated levels of allergen-specific
IgE were not due to a nonspecific increase in total serum IgE. Indeed, there
was a statistically significant decrease in total serum IgE at day 5.
These results demonstrate that development of clinically significant pruritic
skin disease and otitis occurring in Maltese
beagle dogs 2-5 days after being fed small amounts of selected food proteins
is associated with elevated levels of serum IgE specific for these food proteins.
A second peak of allergen-specific IgE at about 20 days was also observed. This
dynamic response in specific IgE associated with food allergen challenge during
maintenance on a hypoallergenic diet can be exploited to identify naturally
sensitizing and eliciting allergen epitopes on food allergens.
Peanut Allergy in a Swine Model
Experimentally induced allergic disease in large animals that closely mimics
allergic diseases in humans can be a useful model. Investigations in swine and
calves demonstrate the induction of hypersensitivity responses that are similar
to those of human allergic disease (Barratt et al. 1978). Young piglets have
been used as models for sensitization/tolerance to CM and soy proteins, with
responses that parallel those seen in young children (Bailey et al. 1993; Hankins
et al. 1992; Heppell et al. 1989; Li et al. 1991; Rees et al. 1989; Wilson et
al. 1989). It is frequently assumed that similarities exist between swine and
humans with respect to skin and gastrointestinal tract anatomy and physiology
as well as immunology. The development and characterization of the swine as
a model for the allergen-sensitizing capacity of novel proteins will be a valuable
tool for investigations into the immunopathologic mechanisms of gastrointestinal
allergy.
Although anti-swine IgE is not available commercially, IgE-like responses
in swine include Ascaris suum airways sensitization and challenge that
lead to eosinophil infiltration and a late-phase asthmatic reaction (Alving
et al. 1991; Fornhem et al. 1996). Immediate skin-test responses with heat-inactivated
serum to antigenic soybean products and Ascaris suum extracts have also
been described (Barriga and Ingalls 1984; Dreau et al. 1994). Moreover, gastrointestinal-associated
adverse immunologic reactions include emesis, diarrhea, bleeding, and weight
loss, which are also associated with human gastrointestinal allergy.
Because the newborn piglet mimics many of the features of the human newborn,
particularly with respect to digestive and immunologic function, a neonatal
swine food allergy model has been developed using peanut as the sensitizing
agent. Preliminary experimental designs included intragastric and intraperitoneal
sensitizations in the presence or absence of cholera toxin as an adjuvant at
different times with oral challenges 2 weeks after the last sensitization. Animals
were taken off food and water 18 hr prior to oral challenge. An optimal sensitization
regimen consisted of a dose of 500 µg/mL peanut extract administered by
intraperitoneal injection in the presence of 100 µg cholera toxin on days
7, 8, and 9, followed by two additional boosts on days 17 and 25. Using this
sensitization regime, greater than 75% of peanut-sensitized piglets responded
with clinical symptoms of emesis, extreme lethargy/malaise, tremors, convulsions,
and major areas of edematous rashes. The allergic response was determined by
repeated intragastric challenge with 10 g peanut meal and skin testing with
peanut extracts (whole peanut extract, Ara h1 and 2) performed on alternating
weeks beginning at week 5 and ending at week 12.
Physical, histologic, and immunologic assessments were made after oral challenges,
skin testing, or tissue analysis. Control animals receiving either phosphate-buffered
saline (PBS) or PBS with cholera toxin did not show signs, symptoms, or immunologic
or histologic evidence of gastrointestinal allergy. Additionally, peanut-sensitized
animals challenged with soybean/peanut-free diet did not respond with allergic
symptoms, suggesting a peanut-specific response. The following physical observations
were evident in only peanut-sensitized piglets. Whole-body rashes, including
maculopapular rashes, lethargy, and difficulty in breathing as evidenced by
stridor, were present within 2 hr of oral challenge. Gastrointestinal signs
included contractions and emesis within 2 hr of oral challenge and diarrhea
within 18 hr. Labored breathing was in evidence and required treatment in two
animals.
Immunologic assessment revealed a 2- to 3-fold increase in peripheral blood
mononuclear cell (PBMC) proliferation to whole-peanut extract and peanut allergens
Ara h1 and 2 compared with PBMC proliferation to medium alone or rice as a control
allergen protein. Peanut-specific IgG increased from baseline levels at day
7 (0.1-0.5 µg/mL) to greater than 100 µg/mL by day 40 and persisted
to day 90. Immediate skin-test responses as evidenced by wheal and flare reactions
suggested an IgE-mediated hypersensitivity response. In PCA experiments, serum
from peanut skin-test-positive and oral challenge-positive animals
administered intradermally into naïve animals responded with positive skin
test to an intravenous challenge of peanut extract 24 hr after intradermal skin
sensitization. Heat treatment at 56°C for 1 hr ablated the skin-sensitizing
ability, further suggesting an IgE-mediated mechanism.
Animals responding within 2 hr to an oral challenge by emesis were sacrificed
for physical and histological assessment of gastrointestinal tract tissues.
Dissection of the stomach of these animals revealed minor quantities of peanut
meal compared with abundant amounts of peanut meal in the stomachs of nonsensitized
or soybean-/peanut-free diet-challenged animals. A summary of histologic
data from 6 controls and 17 peanut positive-challenged animals revealed
the following information. The most prominent findings were vascular congestion
and hemorrhage that occurred primarily in the proximal intestine. Similar features
appeared in other parts of the intestinal tract but did not appear as severe
and were probably associated with the early sacrifice of the animals and failure
of food to reach the intestinal extremities. Additional markers of a gastrointestinal
allergic response included mucus extrusion and submucosal edema. Specifically,
the esophagus was routinely normal. The stomach showed normal architecture (10
pigs) focal eosinophilia and submucosal edema (2 pigs), and large amounts of
mucus extrusion into the lumen (5 pigs), with vascular congestion and hemorrhage
in 2 pigs. In the small intestine the following were observed: focal eosinophilia
with large numbers in 2 pigs, submucosal edema (10 pigs), mucus extrusion (2
pigs), epithelial denudation (3 pigs), focal villous shortening (2 pigs), and
vascular congestion (14 pigs) with hemorrhage in 3 pigs. The proximal small
intestine appeared to be more affected than the distal region. Evidence of food
in this region was also limited, suggesting that the early sacrifice may contribute
to the limited finding in the distal regions of the small intestine. The colon
was normal in 11 pigs, with occasional vascular congestion in 4 pigs; 2 pigs
demonstrated crypt abscesses.
In conclusion, the neonatal swine model is an appropriate peanut food-allergy
model that can be used to determine the relative physical signs of human allergy
including emesis, erythematous rashes, and skin testing. Tissue abnormalities
appear to be similar to other endoscopically obtained tissues from allergen-sensitized/challenged
animals.
Conclusion
Considerable progress has been made in developing animal models for the assessment
of the allergenic potential of novel proteins. However, it is important to acknowledge
that none of these has yet been evaluated rigorously or validated formally.
Much still has to be achieved, but with a continued investment in relevant research,
it should prove possible to contribute to the safety assessment process by providing
one or more methods based on responses in animals.
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Last Updated: June 17, 2003