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A critical step of the protocol is the use of an appropriate filter for the collection of PM10 particles from ambient air (see step 1.1). The filter has to be strong enough to endure brushing with an electrical toothbrush, and not all filter materials fulfill this requirement. The staining protocol was established with a PM10 particle concentration of 8x106 particles per ml. However if the material is limited and pooling of samples is not appropriate, the method will probably function as well, but the antibody concentrations (see steps 3.5 and 3.8) might have to be adjusted.
Bet v 1 staining of PM10 particles did not result in distinct populations of positively and negatively stained particles. This might be caused by the varying amounts of Bet v 1 allergen adsorbed to each of the particles ranging from very little up to a high amount. This could result in the expansion of the APC signal thus shifting the population towards APC positivity. As it is difficult to separate the positive from the negative particles, two quantification methods were used to determine the differences in the Bet v 1 content of the PM10>0.5 specimens: (i) relative quantification by measuring the median APC fluorescence intensity of all particles, and (ii) determining the percentage of APC positive particles. Regarding the Bet v 1 load of particles from low and high pollen season PM10>0.5, both methods revealed similar results. Still, relative quantification by median fluorescence intensity of all particles is recommended as it is independent of placing the gate and therefore probably less error-prone.
To date many studies examine the allergen content in ambient air particulate matter by extracting the respective allergen and subsequent quantification with ELISA5,12-14,17. There is a fundamental difference between the procedure described here and the quantification with ELISA: ELISA quantifies the extracted and dissolved antigen, while flow cytometry analyzes the particle-bound antigen. By means of ELISA the Bet v 1 load of the tested PM10 samples (n=8) was below the detection limit of 1.2 ng/ml (data not shown). Similarly, Buters and others identified no Bet v 1 in the PM <2.5 µm fraction and only about 7% in the 10 µm >PM >2.5 µm fraction, but more than 93% in the PM >10 µm fraction of ambient air13. The contrasting results of the ELISA on the one hand and the FACS analysis on the other hand, may be caused by differences in the detection method in conjunction with divergent sensitivity. Further research however is needed to fully understand this difference.
A method to visualize particle-bound antigen is scanning electron microscopy10,14. By scanning electron microscopy, Ormstad et al. visualized Bet v 1 on the surface of suspended particulate matter soot particles sampled in the high pollen season and to a lesser extent on particles sampled in the low pollen season15. Additionally, allergens from pollen, latex and also β-glucans were found to be adsorbed to combustion particles in ambient air10. This method, however, does not allow quantification of the particle-bound allergen.
By use of flow cytometry, particle-bound Bet v 1 allergen could be quantified. Thus, flow cytometry may offer a new way to characterize the 10 to 0.5 µm biological fraction of PM10 as with other suitable antibodies on hand, this method might be extended to the detection of other antigens on ambient air particles, e.g., mold, dust mite allergens or LPS. As PM10 particles adsorb not only biological material, but also chemicals and metals quite easily, unspecific binding of antibodies could, however, pose a problem. If a new antibody is tested, a critical step is to prove specific binding. This can be done by, for example, blocking the binding capacity of the specific antibody with the corresponding antigen prior to staining11.
As Bet v 1 content of ambient air can differ from birch pollen count12,13,18, allergic symptoms might perhaps correlate better with allergen level than with pollen count14,18. Hence, the presented method in conjunction with clinical data enables to examine in future experiments whether allergic reactions to birch correspond to the Bet v 1 allergen load of PM10>0.5.