Early recovery from cow's milk allergy is associated with decreasing IgE and increasing IgG4 binding to cow's milk epitopes

JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY

卷:125

Article

Savilahti, Emma M.³  Rantanen, Ville^4,6  Lin, Jing S.^1,2  Karinen, Sirkku^4,6  Saarinen, Kristiina M.³  Goldis, Marina^1,2  Makela, Mika J.⁵  Hautaniemi, Sampsa^4,6  Savilahti, Erkki³  Sampson, Hugh A.^1,2 

[1] Mt Sinai Sch Med, Div Pediat Allergy, New York, NY 10029 USA

[2] Mt Sinai Sch Med, Jaffe Inst Food Allergy, New York, NY 10029 USA

[3] Univ Helsinki, Hosp Children & Adolescents, FIN-00014 Helsinki, Finland

[4] Univ Helsinki, Computat Syst Biol Lab, Inst Biomed, Fac Med, FIN-00014 Helsinki, Finland

[5] Univ Helsinki, Hosp Allerg & Skin Dis, FIN-00014 Helsinki, Finland

[6] Univ Helsinki, Genome Scale Biol Res Program, Fac Med, FIN-00014 Helsinki, Finland

关键词: Cow's milk allergy;    tolerance;    epitope;    IgE;    IgG4;    IgA;   

DOI  :  10.1016/j.jaci.2010.03.025

来源: Elsevier

【 摘 要 】

Background: The dynamics and balance of allergen-specific IgG4, and IgA binding might contribute to the development of tolerance in patients with cow's milk allergy (CMA). Profiling of antibody binding to cow's milk (CM) protein epitopes might help in predicting the natural history of allergy. Objective: We sought to investigate differences in IgE, IgG4, and IgA binding to CM epitopes over time between patients with early recovery or with persisting CMA. Methods: We studied serum samples at the time of diagnosis (mean age, 7 months), 1 year later, and at follow-up (mean age, 8.6 years) from 11 patients with persisting IgE-mediated CMA at age 8 to 9 years and 12 patients who recovered by age 3 years. We measured the binding of IgE, IgG4, and IgA antibodies to sequential epitopes derived from 5 major CM proteins with a peptide microarray based immunoassay. We analyzed the data with a novel image-processing method together with machine learning prediction. Results: IgE epitope binding patterns were stable over time in patients with persisting CMA, whereas binding decreased in patients who recovered early. Binding patterns of IgE and IgG4 overlapped. Among patients who recovered early, the signal of IgG4 binding increased and that of IgE decreased over time. IgE and IgG4 binding to a panel of alpha(s1)-, alpha(s2)-, beta-, and kappa-casein regions predicted outcome with significant accuracy. Conclusions: Attaining tolerance to CM is associated with decreased epitope binding by IgE and a concurrent increase in corresponding epitope binding by IgG4. (J Allergy Clin Immunol 2010;125:1315-21.)

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