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01.12.2012 | Research | Ausgabe 1/2012 Open Access

Clinical and Molecular Allergy 1/2012

The usefulness of casein-specific IgE and IgG4 antibodies in cow's milk allergic children

Zeitschrift:
Clinical and Molecular Allergy > Ausgabe 1/2012
Autoren:
Komei Ito, Masaki Futamura, Robert Movérare, Akira Tanaka, Tsutomu Kawabe, Tatsuo Sakamoto, Magnus P Borres
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1476-7961-10-1) contains supplementary material, which is available to authorized users.

Competing interests

The authors declare that they have no competing interests.

Authors' contributions

All authors have contributed to the final interpretation of data and the writing of the manuscript that has been approved by all parts. Furthermore, KI initiated and coordinated the Japanese part of the study. MF carried out sample collection. RM reviewed the results and coordinated the writing of the manuscript. AK coordinated the collaboration between Japan and Sweden. TK performed data analysis. TS supervised the study design and process. MB planned the Swedish part of the study including writing of manuscript.

Abstract

Background

Cow's milk allergy is one of the most common food allergies among younger children. We investigated IgE antibodies to milk, and IgE and IgG4 antibodies to casein, α-lactalbumin and β-lactoglobulin in cow's milk allergic (CMA) and non-allergic (non-CMA) children in order to study their clinical usefulness.

Methods

Eighty-three children with suspected milk allergy (median age: 3.5 years, range: 0.8-15.8 years) were diagnosed as CMA (n = 61) or non-CMA (n = 22) based on an open milk challenge or convincing clinical history. Their serum concentrations of allergen-specific (s) IgE and IgG4 antibodies were measured using ImmunoCAP®. For the sIgG4 analysis, 28 atopic and 31 non-atopic control children were additionally included (all non-milk sensitized).

Results

The CMA group had significantly higher levels of milk-, casein- and β-lactoglobulin-sIgE antibodies as compared to the non-CMA group. The casein test showed the best discriminating performance with a clinical decision point of 6.6 kUA/L corresponding to 100% specificity. All but one of the CMA children aged > 5 years had casein-sIgE levels > 6.6 kUA/L. The non-CMA group had significantly higher sIgG4 levels against all three milk allergens compared to the CMA group. This was most pronounced for casein-sIgG4 in non-CMA children without history of previous milk allergy. These children had significantly higher casein-sIgG4 levels compared to any other group, including the non-milk sensitized control children.

Conclusions

High levels of casein-sIgE antibodies are strongly associated with milk allergy in children and might be associated with prolonged allergy. Elevated casein-sIgG4 levels in milk-sensitized individuals on normal diet indicate a modified Th2 response. However, the protective role of IgG4 antibodies in milk allergy is unclear.
Zusatzmaterial
Authors’ original file for figure 1
12948_2011_102_MOESM1_ESM.pdf
Authors’ original file for figure 2
12948_2011_102_MOESM2_ESM.pdf
Authors’ original file for figure 3
12948_2011_102_MOESM3_ESM.pdf
Literatur
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