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Movérare, Robert
Alternative names
Publications (10 of 22) Show all publications
Vultaggio, A., Nencini, F., Carraresi, A., Pratesi, S., Movérare, R., Eriksson, C., . . . Matucci, A. (2018). IgG4 anti-infliximab in treated patients: Clinical impact and temporal evolution. Allergy. European Journal of Allergy and Clinical Immunology, 73(11), 2172-2181
Open this publication in new window or tab >>IgG4 anti-infliximab in treated patients: Clinical impact and temporal evolution
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2018 (English)In: Allergy. European Journal of Allergy and Clinical Immunology, ISSN 0105-4538, E-ISSN 1398-9995, Vol. 73, no 11, p. 2172-2181Article in journal (Refereed) Published
Abstract [en]

Background: Infliximab (IFX) carries potential risk of immunogenicity with the production of anti-drug antibodies (ADA). ADA may belong to different isotypes and are usually measured by ELISA bridging assay. This test is not designed to detect IgG4 antibodies. The aim was to measure IgG4 anti-IFX antibodies in a cohort of IFX-treated patients and to evaluate their relationship with ADA and their clinical impact.

Methods: Anti-drug antibodies were detected using a bridging ELISA in the serum of 222 treated patients with different clinical outcomes to IFX. The same samples were analyzed for IgG4 anti-IFX antibodies using an experimental ImmunoCAP assay with reduced serum IgG4 background levels. A longitudinal evaluation was performed in a subgroup of 38 patients to define the temporal evolution of IgG4 anti-IFX.

Results: IgG4 anti-IFX was found in 26.6% of patients. Eighty of 222 patients were ADA+ (36%) and the majority (57/80, 71.3%) had IgG4 anti-IFX. Two IgG4-positive but ADA-negative patients were identified. IgG4 anti-IFX levels correlated with the serum levels of ADA. IgG4 anti-IFX was more common in both reactive and nonresponder patients than in tolerant/responder patients. Patients who had experienced IgE-mediated reactions displayed significantly higher IgG4 anti-IFX than IgE-negative reactive patients. The majority of patients tested positive for IgG4 anti-IFX after the first seven infusions.

Conclusions: IgG4 anti-IFX is common in treated patients and a large part of ADA producing patients produce IgG4 antibodies. The IgG4 anti-IFX response does not prevent hypersensitivity reactions to IFX and correlates with the IgE anti-IFX response.

Keywords
anti-drug antibodies, hypersensitivity reactions, IgG4, infliximab
National Category
Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:uu:diva-371402 (URN)10.1111/all.13471 (DOI)000450344300007 ()29719053 (PubMedID)
Available from: 2018-12-20 Created: 2018-12-20 Last updated: 2019-01-07Bibliographically approved
Movérare, R., Blume, K., Lind, P., Crevel, R., DeWitt, Å. M. & Cochrane, S. (2017). Human Allergen-Specific IgG Subclass Antibodies Measured Using ImmunoCAP Technology. International Archives of Allergy and Immunology, 172(1), 1-10
Open this publication in new window or tab >>Human Allergen-Specific IgG Subclass Antibodies Measured Using ImmunoCAP Technology
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2017 (English)In: International Archives of Allergy and Immunology, ISSN 1018-2438, E-ISSN 1423-0097, Vol. 172, no 1, p. 1-10Article in journal (Refereed) Published
Abstract [en]

Background: Knowledge of human IgG subclass antibody responses to various allergens has been hampered by a lack of reliable standardized assays. The aim here was to develop quantitative immunoassays for human IgG1, IgG2, and IgG3 antibodies using ImmunoCAP (R) technology and to evaluate their application. Methods: Enzyme conjugates with isotype-specific monoclonal antibodies and calibrators composed of purified myeloma paraproteins were developed for each assay and used together with other standardized assay reagents for the Phadia (R) 100 instrument. The calibrators were adjusted to the international reference preparation IRP 67/86. The assays were characterized and used together with other standard ImmunoCAP assays to measure antibodies to various allergens in preliminary studies. Results: The new assays had limits of quantitation of 1.0 (IgG1), 4.6 (IgG2), and 0.04 mg(A)/L (IgG3), and coefficients of variation of <20%. Only some minor cross -reactivity with IgG2 was observed for the specific IgG1 assay. The specific IgG2 assay showed a bias for the allotype G2m(23) and compensation factors were used to adjust the measured concentrations accordingly. Preliminary studies indicated a strong and stable IgG4 antibody response to P-lactoglobulin in healthy individuals, a high IgG1 and even higher IgG2 antibody response to house dust mite in sensitized and nonsensitized subjects, and a mixed IgG subclass response to venom allergens in allergic patients with increasing IgG4 antibody levels during venom immunotherapy. Conclusions: The new research assays are valuable tools for immunological studies, enabling the characterization of antibody profiles using a standardized approach, and facilitating data interpretation and the comparison of results across studies.

Place, publisher, year, edition, pages
KARGER, 2017
Keywords
Allergen, Antibody, IgG subclass, Immunoassay, InnmunoCAP
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:uu:diva-319687 (URN)10.1159/000455098 (DOI)000397364500001 ()28219072 (PubMedID)
Available from: 2017-04-07 Created: 2017-04-07 Last updated: 2017-11-29Bibliographically approved
Sato, S., Yamamoto, M., Yanagida, N., Ito, K., Ohya, Y., Imai, T., . . . Ebisawa, M. (2017). Jug r 1 sensitization is important in walnut-allergic children and youth. [Letter to the editor]. Journal of Allergy and Clinical Immunology: In Practice, 5(6), 1784-1786.e1
Open this publication in new window or tab >>Jug r 1 sensitization is important in walnut-allergic children and youth.
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2017 (English)In: Journal of Allergy and Clinical Immunology: In Practice, ISSN 2213-2198, E-ISSN 2213-2201, Vol. 5, no 6, p. 1784-1786.e1Article in journal, Letter (Other academic) Published
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:uu:diva-342333 (URN)10.1016/j.jaip.2017.04.025 (DOI)000414614200054 ()28552380 (PubMedID)
Available from: 2018-02-20 Created: 2018-02-20 Last updated: 2018-03-21Bibliographically approved
Movérare, R., Blume, K., Lind, P., Crevel, R., DeWitt, A. M. & Cochrane, S. (2017). Measurement of human IgG subclass antibodies to allergens with new research ImmunoCAP assays. Paper presented at 44th Annual Meeting of the Scandinavian-Society-for-Immunology (SSI), OCT 17-20, 2017, Stockholm, SWEDEN. Scandinavian Journal of Immunology, 86(4), 306-306
Open this publication in new window or tab >>Measurement of human IgG subclass antibodies to allergens with new research ImmunoCAP assays
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2017 (English)In: Scandinavian Journal of Immunology, ISSN 0300-9475, E-ISSN 1365-3083, Vol. 86, no 4, p. 306-306Article in journal, Meeting abstract (Other academic) Published
National Category
Immunology in the medical area
Identifiers
urn:nbn:se:uu:diva-346963 (URN)000411865200140 ()
Conference
44th Annual Meeting of the Scandinavian-Society-for-Immunology (SSI), OCT 17-20, 2017, Stockholm, SWEDEN
Available from: 2018-03-23 Created: 2018-03-23 Last updated: 2018-03-23Bibliographically approved
Maruyama, N., Sato, S., Yanagida, N., Cabanos, C., Ito, K., Borres, M. P., . . . Ebisawa, M. (2016). Clinical utility of recombinant allergen components in diagnosing buckwheat allergy [Letter to the editor]. JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE, 4(2), 322-+
Open this publication in new window or tab >>Clinical utility of recombinant allergen components in diagnosing buckwheat allergy
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2016 (English)In: JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE, ISSN 2213-2198, Vol. 4, no 2, p. 322-+Article in journal, Letter (Refereed) Published
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:uu:diva-298956 (URN)10.1016/j.jaip.2015.11.028 (DOI)000372089000020 ()26776372 (PubMedID)
Available from: 2016-07-13 Created: 2016-07-12 Last updated: 2016-07-13Bibliographically approved
Maruyama, N., Nakagawa, T., Ito, K., Cabanos, C., Borres, M. P., Moverare, R., . . . Ebisawa, M. (2016). Measurement of specific IgE antibodies to Ses i 1 improves the diagnosis of sesame allergy. Clinical and Experimental Allergy, 46(1), 163-171
Open this publication in new window or tab >>Measurement of specific IgE antibodies to Ses i 1 improves the diagnosis of sesame allergy
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2016 (English)In: Clinical and Experimental Allergy, ISSN 0954-7894, E-ISSN 1365-2222, Vol. 46, no 1, p. 163-171Article in journal (Refereed) Published
Abstract [en]

Background The number of reported cases of allergic reactions to sesame seeds (Sesamum indicum) has increased significantly. The specific IgE tests and skin prick tests presently available for diagnosis of sesame allergy are all based on crude sesame extract and are limited by their low clinical specificity. Thus, oral food challenge (OFC) is still the gold standard in the diagnosis. Objective The aim was to identify the allergen components useful to diagnose sesame-allergic children with the goal to reduce the number of OFCs needed. Methods Ninety-two sesame-sensitized children were consecutively enrolled and diagnosed based on OFC or convincing history. Specific IgE to purified native 11S globulin (nSes i 11S), 7S globulin (nSes i 7S), 2S albumin (nSes i 2S), and two recombinant 2S albumins (rSes i 1 and rSes i 2) was measured by ELISA and/or ImmunoCAP (rSes i 1/streptavidin application). Results Based on area under curve (AUC) values from receiver operating characteristic (ROC) analysis, rSes i 1 was shown to have the best diagnostic performance of the allergen components in ELISA. The experimental rSes i 1 ImmunoCAP test had larger AUC (0.891; 95% CI, 0.826-0.955) compared to the commercially available sesame ImmunoCAP (0.697; 95% CI, 0.589-0.805). The clinical sensitivity and specificity for the rSes i 1 ImmunoCAP test at optimal cut-off (3.96 kUA/L) were 86.1% and 85.7%, respectively. Conclusion and Clinical Relevance Sensitization to Ses i 1 is strongly associated with clinical sesame allergy. Measurement of specific IgE to rSes i 1 could reduce the numbers of OFCs needed.

Keywords
2S albumin, molecular-based allergy diagnostics, oral food challenge, Ses i 1, sesame
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:uu:diva-276829 (URN)10.1111/cea.12626 (DOI)000367924500017 ()26310924 (PubMedID)
Available from: 2016-02-16 Created: 2016-02-16 Last updated: 2017-11-30Bibliographically approved
Kuitunen, M., Englund, H., Remes, S., Moverare, R., Pelkonen, A., Borres, M. P. & Makela, M. J. (2015). High IgE levels to -lactalbumin, -lactoglobulin and casein predict less successful cow's milk oral immunotherapy. Allergy. European Journal of Allergy and Clinical Immunology, 70(8), 955-962
Open this publication in new window or tab >>High IgE levels to -lactalbumin, -lactoglobulin and casein predict less successful cow's milk oral immunotherapy
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2015 (English)In: Allergy. European Journal of Allergy and Clinical Immunology, ISSN 0105-4538, E-ISSN 1398-9995, Vol. 70, no 8, p. 955-962Article in journal (Refereed) Published
Abstract [en]

BackgroundA new treatment option for persistent cow's milk allergy (CMA) is oral immunotherapy (OIT). Not all patients develop tolerance during therapy, and markers to identify those who will benefit from it are needed. The objective was to study the IgE and IgG(4) antibody profiles to milk and milk proteins before and after OIT in relation to clinical outcome. MethodsSeventy-six children (5-17years) with challenge-verified CMA were subjected to a 6-month OIT protocol. The treatment aimed at reaching a maintenance dose of 200ml CM (high dose=HD). Those who did not reach target were analysed as a low-dose (LD) group. Sera were characterized before and after OIT regarding serum levels of IgE and IgG(4) to milk and five milk allergen components evaluated together with clinical CMA symptoms and outcome of OIT. ResultsFifty-five (72%) patients reached the maintenance dose (HD) during therapy. High specific IgE levels towards the milk allergens -lactalbumin (P=0.048), -lactoglobulin (P=0.006) and casein (P=0.015) before OIT start were associated with lower maintenance dose reached. Patients who developed desensitization had a larger increase in IgG(4) levels to -lactalbumin (P=0.034), -lactoglobulin (P=0.010), casein (P=0.047) and lactoferrin (P=0.030) during treatment than those who failed. ConclusionsComponent-resolved diagnostics before OIT can help to identify children with lower probability of a successful OIT outcome, as high IgE levels to -lactalbumin, -lactoglobulin and casein are associated with lower maintenance dose reached. An increase in the IgG(4) concentration to milk components during treatment indicated effective desensitization.

Keywords
cow's milk allergy, desensitization, oral immunotherapy, specific IgE, specific IgG(4)
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:uu:diva-260807 (URN)10.1111/all.12647 (DOI)000358608500007 ()25951431 (PubMedID)
Available from: 2015-08-31 Created: 2015-08-25 Last updated: 2017-12-04Bibliographically approved
Glaumann, S., Nilsson, C., Asarnoj, A., Moverare, R., Johansson, S. G., Borres, M. P., . . . Nopp, A. (2015). IgG(4) antibodies and peanut challenge outcome in children IgE-sensitized to peanut [Letter to the editor]. Pediatric Allergy and Immunology, 26(4), 386-389
Open this publication in new window or tab >>IgG(4) antibodies and peanut challenge outcome in children IgE-sensitized to peanut
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2015 (English)In: Pediatric Allergy and Immunology, ISSN 0905-6157, E-ISSN 1399-3038, Vol. 26, no 4, p. 386-389Article in journal, Letter (Refereed) Published
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:uu:diva-257474 (URN)10.1111/pai.12370 (DOI)000355149800016 ()25779767 (PubMedID)
Available from: 2015-07-03 Created: 2015-07-02 Last updated: 2017-12-04Bibliographically approved
Ebisawa, M., Moverare, R., Sato, S., Borres, M. P. & Ito, K. (2015). The predictive relationship between peanut- and Ara h 2-specific serum IgE concentrations and peanut allergy [Letter to the editor]. JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE, 3(1), 131-132.e1
Open this publication in new window or tab >>The predictive relationship between peanut- and Ara h 2-specific serum IgE concentrations and peanut allergy
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2015 (English)In: JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE, ISSN 2213-2198, Vol. 3, no 1, p. 131-132.e1Article in journal, Letter (Refereed) Published
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:uu:diva-257479 (URN)10.1016/j.jaip.2014.10.014 (DOI)000354210100027 ()25577637 (PubMedID)
Available from: 2015-08-17 Created: 2015-07-02 Last updated: 2016-02-09Bibliographically approved
Nozawa, A., Okamoto, Y., Moverare, R., Borres, M. P. & Kurihara, K. (2014). Monitoring Ara h 1, 2 and 3-sIgE and sIgG4 antibodies in peanut allergic children receiving oral rush immunotherapy. Pediatric Allergy and Immunology, 25(4), 323-328
Open this publication in new window or tab >>Monitoring Ara h 1, 2 and 3-sIgE and sIgG4 antibodies in peanut allergic children receiving oral rush immunotherapy
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2014 (English)In: Pediatric Allergy and Immunology, ISSN 0905-6157, E-ISSN 1399-3038, Vol. 25, no 4, p. 323-328Article in journal (Refereed) Published
Abstract [en]

Background: The aim was to study the clinical efficacy and safety of rush oral immunotherapy (OIT) for severe peanut-allergic children and to measure the antibody responses. Methods: Eighteen Japanese children were enrolled after a positive double-blind, placebo-controlled food challenge (DBPCFC). The patients ingested peanuts up to 3-5 times a day every 30 min, increasing the dose by 20% every time. The goal dose was 3.5-7 g. IgE, IgG, and IgG4 antibody levels to peanut, and peanut allergen components were measured during up to 3 yr of maintenance treatment. Results: Two children dropped out due to side effects. Sixteen patients (14 boys and two girls, median: 9 yr range: 5-14 yr) achieved the goal dose after a median of 11 days (range: 4-19 days). Their median threshold dose at DBPCFC was 0.20 g (range: 0.015-1.0 g). All were sensitized to Ara h 2. Fourteen of them had a history of previous anaphylaxis. In total, 173 adverse events were observed during the treatment (27% of the total ingestions) of which 74 needed medications. The median IgE, IgG, and IgG4 antibody levels to peanut increased during rush OIT. The IgG4 levels were high during the whole maintenance phase. IgE and IgG4 antibodies to Ara h 2 dominated the serological response during the treatment. Conclusions: The present rush OIT protocol for children with severe peanut allergy was effective and relatively safe. A sustained Ara h 2-specific IgG4 antibody response characterized the treatment.

Keywords
peanut allergy, children, oral immunotherapy, IgE, IgG4, desensitization
National Category
Respiratory Medicine and Allergy Pediatrics
Identifiers
urn:nbn:se:uu:diva-229310 (URN)10.1111/pai.12243 (DOI)000338037100004 ()
Available from: 2014-08-06 Created: 2014-08-05 Last updated: 2017-12-05Bibliographically approved
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