Allergic responses, characterized by the activation of mast cells and basophils, are driven by the cross-linking of IgE and release of proinflammatory mediators. A quantitative assessment of allergic responses can be achieved by using Evans Blue dye to monitor changes in vascular permeability after allergen challenge.
Allergic responses are the result of the activation of mast cells and basophils, and the subsequent release of vasoactive and proinflammatory mediators. Exposure to an allergen in a sensitized individual can result in clinical symptoms that vary from minor erythema to life threatening anaphylaxis. In the laboratory, various animal models have been developed to understand the mechanisms driving allergic responses. Herein, we describe a detailed method for measuring changes in vascular permeability to quantify localized allergic responses. The local anaphylaxis assay was first reported in the 1920s, and has been adapted from the technique published by Kojima et al. in 20071. In this assay, mice sensitized to OVA are challenged in the left ear with vehicle and in the right ear with OVA. This is followed by an intravenous injection of Evans Blue dye. Ten min after injecting Evans Blue, the animal is euthanized and the dye that has extravasated into the ears is extracted overnight in formamide. The absorbance of the extracted dye is then quantified with a spectrophotometer. This method reliably results in a visual and quantifiable manifestation of a local allergic response.
Type I hypersensitivity is mediated by antigen-induced cross-linking of IgE on the surface of mast cells and basophils. This results in cellular degranulation and the release of vasoactive and proinflammatory mediators such as histamine, tryptase, and platelet-activating factor2. Following the release of preformed mediators during degranulation, mast cells synthesize and release prostaglandins and leukotrienes, which further increase vascular permeability3. The initial clinical response occurs rapidly and is referred to as an “immediate reaction”. In the skin, a wheal-and-flare response is readily visible within minutes of antigen challenge. Depending on the dose of the challenge, it is possible to observe a “late phase response” a few hr later. Late phase swelling is due to localized edema and leukocyte recruitment into the tissues2. Histamine, generally considered to be the major mediator taking part in immediate allergic responses, acts on histamine receptor 1 (HR1) expressed on vessels and histamine receptor 2 (HR2) expressed on smooth muscle. The combined effect increases blood flow and vascular permeability at the site of inflammation4.
A variety of animal models of allergy have been developed in order to study the mechanisms involved in allergic inflammation, including models of allergic asthma, systemic anaphylaxis, and local anaphylaxis. Intravenous dye administration has been used to measure localized allergic responses in animal models for almost a century, with publications describing this technique dating back to the 1920s5. Rabbits and guinea pigs were the first animal models used to test immediate hypersensitivity reactions, and the most sensitive responses were generally found in the ear5,6. The assay was later validated for use in rats7 and mice8.
Historically, a variety of experimental methods have been used, including injection of antigen prior to injection of dye, injection of dye prior to injection of antigen, and simultaneous injection of dye and antigen. Intravenous dye administration as a means for measuring allergic responses is a versatile assay as it can be used for measuring active, passive, and reverse passive reactions5,9. Numerous dyes have been utilized to assess allergic responses, including Trypan Blue, Pontamine Sky Blue, Evans Blue, Geigy Blue 536, and India Ink5,6,9. A solution of 0.5% Evans Blue is currently the standard dye used for measuring allergic responses in the skin.
The anaphylactic response to challenge is transient; maximum intensity is reached within 10 – 15 min of dye injection, and no reaction is visible if dye is administered more than 30 min after challenge, regardless of the animal species used9. Quantification of dye extravasation was originally obtained by measuring wheal size as indicated by the blue dye7-9. Additionally, counts of degranulated mast cells can be quantified by excising skin tissue from the site of the reaction and staining with toluidine blue7. Mast cell degranulation is often used as a marker for cutaneous, IgE-mediated allergic responses, as mast cells are the main local cell population expressing the high affinity IgE receptor FcεRI. Spectrophotometric techniques for measuring dye extravasation into the tissue were developed for passive cutaneous anaphylaxis (PCA) in the rat10 and mouse11 in the 1990’s.
The following local anaphylaxis assay protocol was adapted from Kojima et al.1, and utilizes chicken egg ovalbumin (OVA) as the antigen for eliciting allergic responses. However, antigens other than OVA may be used if desired. The assay then uses Evans Blue dye to monitor changes in vascular permeability that occur due to mast cell IgE cross-linking and histamine release.
1. Sensitize Mice
2. Local Anaphylaxis Assay
Animals that have undergone the assay successfully will have skin and eyes that appear blue. PBS sensitized animals should not react to either PBS or OVA challenge, therefore both ears should remain white (Figure 1A). In OVA sensitized animals, the ear receiving the PBS challenge (left) should be either completely white or lightly blue in a localized manner at the site of injection. The ear receiving the OVA challenge (right) should become progressively darker blue during the 10 min after dye administration (Figure 1B).
PBS sensitized animals will have negligible absorbance readings for both the PBS and OVA challenge (Figure 2A). For OVA sensitized animals, PBS injection generally results in a mean absorbance reading of 0.13 and a standard deviation of 0.04. Conversely, a 50 μg OVA challenge results in a mean absorbance reading of 0.58 and a standard deviation of 0.18 (Figure 2B). The amount of OVA used for challenge may be adjusted for individual experiments if necessary. For example, a 20 μg OVA challenge results in a mean absorbance of 0.30 and a standard deviation of 0.10 (Figure 2C), however a challenge less than 20 μg may not give reliable results. Changes in OVA concentration must be optimized and validated prior to use.
Results may be graphically paired, with PBS absorbance compared to OVA absorbance. Alternatively, results may be plotted as a single value, with the PBS absorbance subtracted from the OVA absorbance for each individual animal.
Figure 1: Ear pigmentation in PBS and OVA sensitized animals. (A). Ear pigmentation in PBS sensitized animals. The left ear (challenged with PBS) and the right ear (challenged with 50 μg OVA) show little to no dye extravasation. (B). Ear pigmentation in OVA sensitized animals. There is no allergic response in the left ear (challenged with PBS), as indicated by an absence of blue dye extravasation. The right ear (challenged with 50 μg OVA) shows a bright blue coloring indicative of increased vascular permeability, a direct result of cell activation in the ear tissue.
Figure 2: Representative O.D. values for OVA sensitized animals. O.D. values derived from spectrophotometric measurements taken at 620 nm. (A). 50 μg OVA challenge in PBS sensitized animals. O.D. values for both PBS and OVA challenge are negligible. (B). 50 μg OVA challenge in OVA sensitized animals. PBS challenge results in O.D. values <0.2 and OVA challenge results in O.D. values >0.3. (C). 20 μg OVA challenge. PBS challenge results in O.D. values <0.2. The right ears have slightly reduced O.D. values due to a smaller challenge dose of OVA used.
Numerous markers of allergic disease are used to assess the strength of allergic responses following allergen challenge, including changes in levels of circulating histamine, Th2 cytokine production, and cell recruitment into bronchoalveolar fluid in the setting of airway challenge. While monitoring changes in these parameters is important for studying allergic reactions, biological markers do not always correlate with clinical allergic disease. The local anaphylaxis assay described in this protocol provides reproducible measurement of localized vascular permeability as a correlate for localized allergic disease. By using blue dye extravasation, this protocol enables both visualization and relative quantification of a localized allergic reaction. In contrast to allergy assays that rely on clinical scoring, the primary outcome of this assay (blue dye extravasation as measured by spectrophotometric absorbance) is not easily subjected to observer bias. Another advantage is that animals are euthanized shortly after challenge, limiting any discomfort potentially caused by the allergen challenge and dye administration. The alternative use of a hand-held spectrophotometer described by Akiyama et al.10 allows for the continuous measurement of changes in vascular permeability. However, Evans Blue dye is toxic, and injection will ultimately lead to the animal needing to be euthanized.
While this assay has a number of strengths, it does have the limitation of being somewhat technically challenging. Reliable results are dependent on consistent and successful ear and tail vein injections. If the entire challenge dose is not administered into the ear, if ear injection results in obvious puncture of a blood vessel, or if the Evans Blue intravenous injection is not complete, the animal should be excluded from analysis. In our laboratory, investigators have had to practice the intradermal ear injections for several weeks before developing proficiency. Additionally, it is important to run proper controls for the assay. Specifically, PBS injection should routinely be used as an internal control, as animals seem to respond slightly differently to damage caused by needle insertion. The PBS reading gives a baseline measure for changes in vascular permeability induced by the injection itself. In lieu of using intradermal ear injections, the assay may also be applied to the back skin of mice. Investigators may find this route to be less technically challenging, and, in addition, it allows for the testing of multiple antigens simultaneously.
The local anaphylaxis assay is extremely versatile, as the challenge dose can be manipulated depending on the experiment. If it is necessary to look at changes in allergic responses, it may be beneficial to use a lower OVA challenge dose, such as 20 μg. This allows for increased sensitivity in monitoring changes in absorbance, as it will be less likely that the saturation point for cell activation will be reached.
Additionally, this assay can be used to study passive cutaneous anaphylaxis (PCA). In this setting, antigen-specific IgE is injected into one ear and vehicle into the other. 24 hr later, the animal is given an intravenous challenge of antigen and Evans Blue dye. The PCA model can reduce the time it takes to complete the experiment, the number of animals used, and allow investigators to look at the specific effects of IgE cross-linking.
Despite taking longer to perform, there are some advantages to using the active cutaneous anaphylaxis (ACA) model described in this paper. Sensitization through weekly exposure to antigen mimics the process by which individuals develop allergic disease, as sensitization is usually systemic and people generally have both allergen-specific IgE and IgG in circulation. While IgE cross-linking is the primary means of mast cell degranulation, mast cells also respond to IgG cross-linking. Therefore, the ACA model allows for researchers to investigate mechanisms of allergic responses in addition to only IgE-mediated disease. In conclusion, while the method of sensitization used is at the discretion of the investigator, the local anaphylaxis assay is versatile and can be used with a variety of sensitization methodologies.
Ear swelling, a commonly used marker for assessing allergic responses, can also be measured after OVA challenge. We have found that ears challenged with OVA have significantly more swelling than ears challenged with PBS at 1 hr post injection. In contrast to the Evans Blue test, we have observed that ear thickness measurements are less sensitive than dye extravasation and exhibit greater variability between investigators as ear thickness can be altered by compression of the ear when using measuring devices.
Mouse strains other than BALB/c may be used for the local anaphylaxis assay; however absorbance readings will vary slightly depending on the strain used. Because of their propensity to develop strong Th2 responses, BALB/c mice generally produce reliable, reproducible readings with this assay.
This assay allows for the quantification of localized allergic responses in animals sensitized to a variety of antigens. Antigen selection is flexible, as the assay has been successfully performed with common allergens, such as OVA and Keyhole Limpet Hemocyanin (KLH). Furthermore, in lieu of sensitization, a local allergic reaction can be elicited in a naïve animal by injecting antibodies that cross-link IgE or IgE receptors on basophils and mast cells, or by ligating non-IgE activation receptors on these cells such as CD200R31.
The authors have nothing to disclose.
The authors would like to acknowledge Dr. Ellen M. Fox for her work regarding this model of local anaphylaxis. This work was supported by the Uniformed Services University of the Health Sciences grant number R073UE.
Name of Material/ Equipment | Company | Catalog Number | Comments/Description |
BALB/c Mice | The Jackson Laboratory | 651 | |
PBS pH 7.4 | Quality Biologic | 114-058-101 | |
Ovalbumin | Sigma | A5503-10G | |
Imject Alum | Thermo Scientific | 77161 | Mix thoroughly before use |
Evans Blue Dye | Sigma | E2129 | |
Formamide | Sigma | 295876 | 99%+ Spectrophotometric grade |
Isoflurane, USP | Phoenix | NDC 57319-474-06 | |
1cc Insulin syringes | BD | 329654 | |
3/10 cc Insulin syringe with 31G needle | Terumo | NDC 100861 | |
27G Needles | BD | 305109 | |
Forceps | F.S.T. | 11000-12 | |
Surgical scissors | F.S.T. | 14070-12 | |
5ml Polystyrene round-bottom tubes | BD Falcon | 352058 | |
1.5ml Microcentrifuge tubes | Medical Supply Partners | 15-1151 | |
15ml Conical tubes | BD Falcon | 352097 | |
Flat-bottom 96 well plate | Costar | 3590 | |
Scotch tape | |||
RC2 Rodent Anesthesia System | VetEquip | 922100 | |
Vortex Genie 2 | Scientific Industries | SI-0236 | Model G560 with 3 inch platform |