Investigating the T regulatory cells and Sirtuin-I serum level in immunotherapy treated house dust mite allergic asthma patients

Abstract

Objectives

House dust mite aeroallergens are predominant triggers of frequent asthma attacks among adults and children. The intensity of asthma and immune reaction necessitates treatment alternatives based on adjusting chosen immunity biomarkers to control the exacerbation of symptoms and establish long-term immune tolerance. In this study, we selected CD4⁺CD25⁺Foxp3⁺ regulatory T cells (Tregs), FOXP3, and Sirtuin-1 as they are known to have a potential role in the immune reaction in different allergic diseases. We investigated their interplay during HDM allergic asthma and its respective immunotherapy.

Methods

Eighty-four subjects were divided into 3 groups; healthy controls (CT), HDM asthma patients without immunotherapy (WOIT), and HDM asthma patients treated with subcutaneous immunotherapy for 6 months before recruitment (WIT). They were enrolled according to the pulmonary function, skin prick tests, and HDM-specific IgE. CD4⁺ CD25⁺ and CD4⁺ CD25⁺ FOXP3^+hi T cells Cell percentages, FOXP3 gene expression, and Sirtuin-1 (Sirt1) serum level were analyzed.

Results

We found that there is a significant difference between WOIT and WIT groups in the CD4⁺ CD25⁺ and CD4⁺ CD25⁺ FOXP3^+hi T cell percentages. While there is no statistically significant difference between WOIT and WIT groups in FOXP3 level. On the controversy, the SIRT1 level in the CT group (4.53 ± 3.880) significantly decreased in the WOIT and WIT groups.

Conclusion

This study revealed that both CD4 CD25 and CD4 CD25 high FOXP3 cell percentages increased in the WIT group and declined in the WOIT group. While, FOXP3 gene expression increased in both groups. In addition, the Sirt1 serum level showed some improvement in WIT group after a serious drop in the WOIT group comparing with the CT group. The modulation of these biomarkers for the remission and control of allergic asthma can be a prognostic outcome of immunotherapy which needs to be confirmed by larger scale studies.

Keywords:

• HDM
• asthma
• CD4 + CD25 + Foxp3+ regulatory T cells
• FOXP3
• Sirt1

Funding and Acknowledgments

The authors gratefully acknowledge Qassim University, represented by the Deanship of Scientific Research, on the financial support for this research under the number (10236-des-2020-1-3-I) during the academic year 1442 AH/2020 AD.

Institutional review board statement

The study was conducted following the Declaration of Helsinki and approved on the 10^th of October 2021 by the Institutional Review Board (IRB) of Zagazig University, Egypt no: 8098-15-10-2021.

Informed consent statement

Informed consent was obtained from all subjects involved in the study.

Declaration of interest

The authors declare no competing interests.

Data availability statement

All data generated or analyzed during the current study are included in this article.

Additional information

Funding

This research was funded by Qassim University, represented by the Deanship of Scientific Research, on the financial support for this research under the number (10236-des-2020-1-3-I) during the academic year 1442 AH/2020 AD.’’