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Immunologic changes in children with egg allergy ingesting extensively heated egg.

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Many children with egg allergy can tolerate heated egg, a finding supported by immunologic changes indicating developing tolerance. Continued consumption of heated egg is safe and well-tolerated.

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Area of Science:

  • Allergy and Immunology
  • Pediatric Allergy
  • Food Science

Background:

  • Previous research suggests some children with egg allergy can tolerate heated egg.
  • This study aimed to confirm and further investigate heated egg tolerance in this population.

Purpose of the Study:

  • Confirm tolerance of heated egg in children with egg allergy.
  • Identify clinical and immunological predictors of heated egg tolerance.
  • Characterize immunological changes with continued heated egg consumption.
  • Assess the tolerability of a diet including heated egg.

Main Methods:

  • Physician-supervised oral food challenges with extensively heated egg (muffins, waffles) were conducted.
  • Tolerant subjects underwent regular egg challenges (scrambled eggs, French toast).
  • Immunological markers (skin prick tests, IgE, IgG4 levels) were measured at baseline and follow-up.

Main Results:

  • 64 out of 117 children tolerated heated egg; 23 tolerated regular egg.
  • Children reacting to heated egg had higher IgE levels and larger skin test wheals.
  • Continued heated egg intake reduced skin test wheals and IgE, while increasing IgG4 levels.

Conclusions:

  • A majority of children with egg allergy demonstrated tolerance to heated egg.
  • Continued ingestion of heated egg was well-tolerated and linked to immunological shifts mirroring those seen in developing regular egg tolerance.