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Egg-white-specific IgA and IgA2 antibodies in egg-allergic children: is there a role in tolerance induction?

AbstractBACKGROUND:
Decreased serum food-specific IgA antibodies have been associated with allergic disease in cross-sectional, case-control studies. The purpose of this study was to prospectively compare egg-white-(EW)-specific IgA and IgA2 levels between egg-allergic children and children tolerating egg.
METHODS:
Seventeen egg-allergic children were followed prospectively. Total IgA, EW-specific IgA, and EW-specific IgA2 levels were measured in their sera with a sensitive ELISA. As negative controls were used children with no previous history of egg allergy. Egg-allergic children with or without concomitant milk allergy were evaluated as additional controls with measurement of casein-specific IgA.
RESULTS:
After 2.5 ± 0.9 yrs, nine out of the 17 allergic children became tolerant and eight remained allergic to baked egg. Baseline EW-specific IgA2 levels were significantly lower in the egg-allergic subjects (median 23.9 ng/ml) compared with the negative control subjects (99.4 ng/ml) and increased significantly by 28% over the study time period in eight out of the nine allergic children that became tolerant to baked egg. There was no significant change over time in EW-specific IgA in any of the study groups. Non-milk-allergic subjects with concomitant egg allergy had almost threefold higher casein-specific IgA levels than the milk- and egg-allergic subjects (p = 0.025).
CONCLUSIONS:
These results suggest a potential role for allergen-specific IgA2 antibodies in the induction of food tolerance. Furthermore, they support the hypothesis that immature or impaired production of allergen-specific IgA2 may be associated with the pathophysiology of food allergy, a defect that seems to be selective for the culprit allergen.
AuthorsGeorge N Konstantinou, Anna Nowak-Węgrzyn, Ramon Bencharitiwong, Luda Bardina, Scott H Sicherer, Hugh A Sampson
JournalPediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology (Pediatr Allergy Immunol) Vol. 25 Issue 1 Pg. 64-70 (Feb 2014) ISSN: 1399-3038 [Electronic] England
PMID24118158 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
Copyright© 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Chemical References
  • Allergens
  • Caseins
  • Egg Proteins, Dietary
  • Immunoglobulin A
Topics
  • Allergens (immunology)
  • Animals
  • Caseins (immunology)
  • Cattle
  • Child, Preschool
  • Egg Hypersensitivity (complications, immunology)
  • Egg Proteins, Dietary (immunology)
  • Female
  • Follow-Up Studies
  • Humans
  • Immune Tolerance
  • Immunity, Humoral
  • Immunoglobulin A (blood, immunology)
  • Infant
  • Male
  • Milk Hypersensitivity (complications, immunology)
  • Prospective Studies

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