Abstract
In order to provide better therapy we strive to increase our knowledge of how the immune system behaves and communicates in common pediatric immunological diseases, such as type 1 diabetes, allergic and celiac diseases. However, when dealing with pediatric diseases, where study subjects are almost exclusively children, blood volumes available for immunological studies are limited and as such must be carefully handled and used to their full extent. Single immune markers can easily be detected by a traditional Enzyme Linked Immunosorbent Assay (ELISA), whereas multiple markers can be detected by a fluorochrome (Luminex) or electrochemiluminescence (MSD) technique. These techniques however are sometimes not sensitive enough to detect low levels of secreted immune markers in limited sample sizes. To detect immune markers at the single-cell level, an Enzyme Linked Immuno-spot (ELISPOT) can be used to pin-point elusive immune markers in common pediatric immunological diseases.
Highlights
Immune homeostasis should be controlled through the innate and adaptive systems used to maintain a balance between tolerance and suppression
Three autoantibodies are usually seen in patients with celiac disease, antibodies against gliadin (AGA), endomysium (EMA) and tissue transglutaminse [32]
The enzyme tissue transglutaminse has been reported to modify the gliadin peptides via deamidation, thereby binding gliadin with higher affinity to HLA-DQ2 and HLA-DQ8, causing an epitope that is recognized by T-cells derived from the gut and increasing gliadin-specific reactivity of T-cells [33,34]
Summary
Immune homeostasis should be controlled through the innate and adaptive systems used to maintain a balance between tolerance and suppression. Inducible antigen-specific sub-populations of CD4+ T-regulatory (Treg) cells are IL-10-producing T-regulatory cell type 1 (Tr1) cells and transforming growth factor (TGF)--secreting Th3 cells. Th1-associated IFN- selectively inhibits proliferation of Th2-cells [5], whereas IL-4 and IL-10 inhibits cytokines synthesized by Th1-cells [6] This cross-regulation may partly explain the strong biases towards Th1 or Th2 responses during several infections in mice and humans [7]. One hypothesis is that Th1- and Th17-cells might cooperate to induce the development of organ-specific autoimmunity, as to in infectious diseases, in which IFN- and IL-17 might work together to increase resistance to infectious diseases [12]. An Enzyme Linked Immuno-spot (ELISPOT) permits the evaluation of a single antigen-specific memory T-cell with regard to frequency (clonal size) and cytokine signature. An ELISPOT is considered advantageous for studies aimed at pin-pointing elusive immune markers in common pediatric immunological diseases
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