Predictive value of IgE/IgG4 antibody ratio in children with egg allergy.

Abstract

BACKGROUND:

The aim of this study was to investigate the role of specific IgG4 antibodies to hen's egg white and determine their utility as a marker for the outcome of oral challenge test in children sensitized to hen's egg

METHODS:

The hen's egg oral food challenge test was performed in 105 sensitized children without atopic dermatitis, and the titers of egg white-specific immunoglobulin G4 (IgG4) and immunoglobulin E (IgE) antibodies were measured. To set the cut-off values of IgG4, IgE, and the IgE/IgG4 ratio for predicting positive results in oral challenges, receiver operating characteristic curves were plotted and the area under the curves (AUC) were calculated.

RESULTS:

Sixty-four of 105 oral challenges with whole eggs were assessed as positive. The AUC for IgE, IgG4, and IgE/IgG4 for the prediction of positive results were 0.609, 0.724, and 0.847, respectively. Thus, the IgE/IgG4 ratio generated significantly higher specificity, sensitivity, positive predictive value (%), and negative predictive value (%) than the individual IgE and IgG4. The negative predictive value of the IgE/IgG4 ratio was 90% at a value of 1.

CONCLUSIONS:

We have demonstrated that the egg white-specific serum IgE/IgG4 ratio is important for predicting reactivity to egg during food challenges.

• Authors: Shindou Okamoto, Shoichiro Taniuchi, Kyoko Sudo, Yasuko Hatano, Keiji Nakano, Tomohiko Shimo, Kazunari Kaneko
• Journal: Allergy, asthma, and clinical immunology : official journal of the Canadian Society of Allergy and Clinical Immunology (Allergy Asthma Clin Immunol) Vol. 8 Issue 1 Pg. 9 (06 07 2012) ISSN: 1710-1492 [Electronic] England
• PMID: 22676477 (Publication Type: Journal Article)