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Milk Allergen Micro-Array (MAMA) for Refined Detection of Cow's-Milk-Specific IgE Sensitization
Victoria Garib1,2, Daria Trifonova1,3, Raphaela Freidl1
1Center for Pathophysiology, Infectiology and Immunology, Institute of Pathophysiology and Allergy Research, Medical University of Vienna, 1090 Vienna, Austria.
Nutrients
|May 27, 2023
Summary
A new milk allergen micro-array (MAMA) effectively diagnoses IgE sensitization to cow's milk allergens in children. This diagnostic tool aids in identifying specific allergen components, crucial for understanding cow's milk allergy and anaphylaxis.
Area of Science:
- Allergy and Immunology
- Molecular Diagnostics
- Pediatric Medicine
Background:
- Immunoglobulin E (IgE)-mediated hypersensitivity to cow's milk is a common cause of severe anaphylaxis.
- Accurate diagnosis of cow's milk-specific IgE sensitization is critical.
- Cow's milk allergen molecules aid in refining diagnostic detection.
Purpose of the Study:
- To develop and evaluate a milk allergen micro-array (MAMA) for diagnosing IgE sensitization to cow's milk allergens.
- To assess the utility of MAMA in component-resolved diagnosis of cow's milk allergy in children.
- To analyze IgE sensitization patterns in children with varying degrees of cow's milk-related anaphylaxis and those developing tolerance.
Main Methods:
- Development of a micro-array (MAMA) using ImmunoCAP ISAC technology, including purified natural and recombinant cow's milk allergens and synthetic peptides.
- Analysis of sera from 80 children with confirmed cow's milk intake symptoms, categorized by anaphylaxis severity (Sampson grades 1-5) and non-anaphylactic reactions.
- Subgroup analysis of eleven patients (five tolerant, six sensitive) to study alterations in specific IgE levels.
Main Results:
- MAMA enabled component-resolved diagnosis of IgE sensitization in all children with cow's milk-related anaphylaxis (Sampson grades 1-5) using minimal serum.
- IgE sensitization to caseins and casein peptides was universal in severe anaphylaxis (Sampson grades 4-5).
- Specific IgE reactivity patterns varied, with some children showing sensitization to specific proteins like alpha-lactalbumin or beta-lactoglobulin, and others to cryptic peptide epitopes.
Conclusions:
- The MAMA facilitates the detection of IgE sensitization to multiple cow's milk allergens and peptides in allergic children.
- This diagnostic approach requires only a small volume of serum, making it efficient for clinical use.
- MAMA aids in understanding the complex IgE sensitization profiles associated with cow's milk allergy and anaphylaxis.
