Allergic disease: the diagnosis of peanut allergy and the role of heat shock proteins in chronic allergic inflammation Joost Aalberse Colofon Cover: Landgoed Oostbroek, Utrecht Design: Rozemarijn Klein Heerenbrink, Photography: Joost Aalberse Print: Gildeprint, Enschede ISBN: 978-94-6233-136-5 © 2013 by Cell Stress and Chaperones, for chapter 4 © 2013 by Allergy, for chapter 6 © 2014 by The Journal of Allergy and Clinical Immunology: in Practice, for textbox chapter 7 2011 by Plos One, for chapter 3 2012 by Frontiers in Immunology, for chapter 2 2014 by Clinical and Translational Allergy, for chapter 5 2015 by J.A. Aalberse, for chapter 1 and chapter 8 Address of correspondence J.A. Aalberse, Wilhelmina Children’s Hospital, University Medical Center Utrecht e-mail [email protected] Allergic disease: the diagnosis of peanut allergy and the role of heat shock proteins in chronic allergic inflammation (met een samenvatting in het Nederlands) Proefschrift Ter verkrijging van de graad van doctor aan de Universiteit Utrecht op gezag van de rector magnificus, Prof. Dr. G.J. van der Zwaan ingevolge het besluit van het college voor promoties in het openbaar te verdedigen op donderdag 26 november 2015 des middags te 4.15 uur door Joost Adriaan Aalberse geboren op 22 januari 1977 te Amsterdam Promotor: Prof. Dr. B.J. Prakken Copromotoren: Dr. F. van Wijk Dr. E.F. Knol “Know Thyself” Alexander Pope Uit: Pope, Alexander; An Essay on Man, in Four Epistles. Hartford: Silas Andrus, 1824. Know then thyself, presume not God to scan; The proper study of mankind is Man. Placed on this isthmus of a middle state, A being darkly wise and rudely great: With too much knowledge for the Sceptic side, With too much weakness for the Stoic’s pride, He hangs between; in doubt to act or rest, In doubt to deem himself a God or Beast, In doubt his mind or body to prefer; Born but to die, and reasoning but to err; Alike in ignorance, his reason such Whether he thinks too little or too much: Chaos of thought and passion, all confused; Still by himself abused, or disabused; Created half to rise and half to fall; Great lord of all things, yet a prey to all; Sole judge of truth, in endless error hurled: The glory, jest, and riddle of the world! Contents Chapter 1 General Introduction 11 Chapter 2 HSP; Bystander Antigen in Atopic Diseases? 31 Chapter 3 Cord Blood CD4+ T cells respond to self-heat shock 51 protein 60 Chapter 4 Recognition of self-heat shock protein 60 by T cells 69 from patients with atopic dermatitis Chapter 5 Plasma IL-25 is elevated in a subgroup of patients 85 with clinical reactivity to peanut Chapter 6 Moving from peanut extract to peanut components: 95 Towards validation of component-resolved IgE tests Chapter 7 Discussion 115 Chapter 8 Lekensamenvatting (Nederlands) 131 Chapter 9 Dankwoord 138 CV 142 List of Publications 143