Functional iron-deficiency in women with allergic rhinitis is associated with symptoms after nasal provocation and lack of iron-sequestering microbes

Lisa-Marie Petje, Sebastian A Jensen, Sebastian Szikora, Martin Sulzbacher, Tina Bartosik, Petra Pjevac, Bela Hausmann, Karin Hufnagl, Eva Untersmayr, Lisa Fischer, Erich Vyskocil, Julia Eckl-Dorna, Erika Jensen-Jarolim, Gerlinde Hofstetter, Sheriene Moussa Afify, Claus G Krenn, Georg A Roth, Elisa Rivelles, Stephan Hann, Franziska Roth-Walter, Lisa-Marie Petje, Sebastian A Jensen, Sebastian Szikora, Martin Sulzbacher, Tina Bartosik, Petra Pjevac, Bela Hausmann, Karin Hufnagl, Eva Untersmayr, Lisa Fischer, Erich Vyskocil, Julia Eckl-Dorna, Erika Jensen-Jarolim, Gerlinde Hofstetter, Sheriene Moussa Afify, Claus G Krenn, Georg A Roth, Elisa Rivelles, Stephan Hann, Franziska Roth-Walter

No abstract available

Keywords: allergic rhinitis; ceruloplasmin; clinical reactivity; functional iron deficiency; microbes.

Conflict of interest statement

EJJ declares shareholdership in Biomedical Int. R+D GmbH, Vienna, Austria. FRW and EJJ are inventors of EP2894478, owned by Biomedical International R+D GmbH, Vienna, Austria. The other authors declare no relevant conflict of interest in relation to this publication.

Figures

FIGURE 1

Functional iron deficiency and elevated ceruloplasmin as a marker for clinical reactivity in allergic women. A, Serum iron, transferrin saturation, serum ceruloplasmin, and urinary hepcidin levels of sera from allergic (n=27) and nonallergic (n=24) premenopausal women. B, Spearman correlation matrix of total nasal symptom score (TNSS), visual analogue scale (VAS), weight of nasal secretions—as a measure of clinical reactivity—with blood, nasal fluid parameters as well as gut iron, gut copper, and gut cobalt of stool extracts of women that underwent nasal provocation with grass or birch pollen extract (n=38). C, Linear regression analysis of TNSS with ceruloplasmin from serum and nasal secretions, D, Linear regression analysis of TNSS with gut iron and gut cobalt. D, Linear regression of gut iron with hemopexin, ferritin, and the reciprocal value of ceruloplasmin. Positive and significant dependencies in linear regression analysis are depicted in red; significant negative ones in green dots. Prior analysis normality and lognormality tests were employed. Student's t test was used for parametric; Mann‐Whitney U test was used for nonparametric data. *p < 0.05, **p < 0.01

FIGURE 2

Members of the genera Ruminococcus and Bacteroides show a negative correlation with clinical reactivity with Ruminococcus ASV being decreased in allergics A, Side‐by‐side comparison of Spearman correlations of gut microbiome ASVs to total nasal symptom score (TNSS), serum ceruloplasmin, and gut iron (dark green and dark red, significant after FDR adjustments q<0.05; light green and red are not significant trends). B, Linear regressions to TNSS (n=38), C, to serum ceruloplasmin (n=38), and D, to gut iron (n=20) of the relative abundance of ASV of the genera Bacteroides, Ruminococcus, and Alistipes negatively associated with TNSS as well as relative abundance of ASV of Faecalibacterium positively associated with TNSS (green when negatively associated and significant, gray when not significant, red when positively associated and significant). E, Comparison of relative abundance of ASVs from the genera Ruminococcus, Bacteroides, Alistipes, and Faecalibacterium in allergics (n=26) and nonallergics (n=22) as well as the summarized relative abundance of ASVs positively associated with TNSS. Data were nonparametric and Mann‐Whitney U test were used for statistical analysis. **p<0.01