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Intranasal Immunization and Milk Collection in Studies of Maternal Immunization in New Zealand White Rabbits (Oryctolagus cuniculus)
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Individual cow's milk allergens as prognostic markers for tolerance development?

B Ahrens1, L C Lopes de Oliveira, L Grabenhenrich

  • 1Department of Pediatric Pneumology and Immunology, Charité, Universitätsmedizin, Berlin, Germany.

Clinical and Experimental Allergy : Journal of the British Society for Allergy and Clinical Immunology
|October 31, 2012
PubMed
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Low levels of cow

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Area of Science:

  • Allergy and Immunology
  • Pediatric Allergy
  • Clinical Diagnostics

Background:

  • Cow's milk allergy (CMA) is a prevalent food allergy in early childhood.
  • Most children outgrow CMA, but predicting tolerance development is challenging.
  • Lack of reliable prognostic markers hinders personalized management of CMA.

Purpose of the Study:

  • To evaluate if IgE levels to specific cow's milk allergens can predict tolerance development.
  • To identify reliable biomarkers for distinguishing persistent CMA from outgrown CMA.
  • To assess the utility of component-resolved diagnostics in predicting CMA prognosis.

Main Methods:

  • Followed 52 children diagnosed with CMA via DBPCFC.
  • Assessed specific IgE, IgG, and IgG4 to crude cow's milk protein and individual allergens.
  • Performed serial serological analysis prior to repeated oral food challenges.

Main Results:

  • Low levels of IgE to cow's milk (CM)-specific IgE, α-lactalbumin, β-lactoglobulin, κ-casein, and α(s1)-casein correlated with outgrowing CMA.
  • IgE levels to total casein, lactoferrin, β-casein, and β-lactoglobulin (Bos d5.0101) did not show significant correlation.
  • Specific IgG and IgG4 levels were not useful predictors of tolerance development.

Conclusions:

  • CM-specific IgE, particularly to individual allergens, serves as a valuable prognostic marker for CMA persistence.
  • Component-resolved diagnostics offer similar predictive value but may not be cost-effective for routine use.
  • Measurement of specific IgG or IgG4 antibodies is not recommended for predicting tolerance in CMA.