Allergen immunotherapy improves defective follicular regulatory T cells in patients with allergic rhinitis.
BACKGROUND
The function of follicular regulatory T (TFR) cells, especially in regulating IgE production in patients with allergic diseases, is poorly understood.


OBJECTIVE
We sought to investigate the phenotype, function, and clinical relevance of TFR cells in patients with allergic rhinitis (AR).


METHODS
The phenotype and frequency of tonsillar and circulating TFR cells were characterized by using flow cytometry. TFR cell function was examined in an assay by coculturing with follicular helper T cells and B cells. The associations between TFR cells and the clinical features in patients with AR before and after allergen immunotherapy (AIT) were analyzed.


RESULTS
TFR cells were detected in germinal centers of tonsils, but compared with subjects without AR, the frequencies decreased in patients with AR who were allergic to house dust mites. Circulating TFR cells in blood were phenotypically and numerically correlated with tonsillar TFR cells, and a reduction of circulating TFR cells but not total or CXCR5- regulatory T cells was noted in patients with AR compared with healthy control subjects. Moreover, circulating TFR cells in patients with AR showed a specific defect in suppressing IgE production but were capable of suppressing production of other immunoglobulin types. We identified negative associations of circulating TFR cell frequencies and function with antigen-specific IgE levels or disease severity in patients with AR. After AIT, the frequencies and function of circulating TFR cells were improved, which positively associated with disease remission.


CONCLUSION
Impairment in TFR cells might contribute to aberrant IgE production in patients with AR, and AIT improves defective TFR cell function. TFR cells might serve as a potential biomarker to monitor clinical response to AIT.
['Yao|Yin|Y|', 'Wang|Zhi-Chao|ZC|', 'Wang|Nan|N|', 'Zhou|Peng-Cheng|PC|', 'Chen|Cai-Ling|CL|', 'Song|Jia|J|', 'Pan|Li|L|', 'Liao|Bo|B|', 'Zhang|Xin-Hao|XH|', 'Yang|Yong-Shi|YS|', 'Xu|Xiao-Yan|XY|', 'Zhu|Rong-Fei|RF|', 'Yu|Di|D|', 'Liu|Zheng|Z|']
D000293:Adolescent D000328:Adult D001402:B-Lymphocytes D002478:Cells, Cultured D003888:Desensitization, Immunologic D005260:Female D006801:Humans D007136:Immunoglobulins D008297:Male D008875:Middle Aged D014066:Palatine Tonsil D065631:Rhinitis, Allergic D050378:T-Lymphocytes, Regulatory D055815:Young Adult
allergen immunotherapy follicular regulatory T cells Allergic rhinitis IgE