Real-Life Use of Component-Specific IgE in IgE-Mediated Cow's Milk Protein Allergy in a Spanish Paediatric Allergy Centre.

IF 3 Q3 IMMUNOLOGY

Antibodies Pub Date : 2023-11-17 DOI:10.3390/antib12040076

Caoimhe Cronin, Cristina Muñoz Archidona, Beatriz Fernández Prudencio, Aoife Gallagher, Roberto Velasco Zuniga, Juan Trujillo Wurttele

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Abstract

Background: In Spain, IgE-mediated cow’s milk protein allergy (CMPA) affects approximately 0.69% of infants. Molecular diagnosis may be useful for monitoring natural spontaneous tolerance development in CMPA. The aim of this study was to retrospectively analyse a cohort of paediatric patients with IgE-mediated CMPA who were avoiding milk products awaiting natural tolerance and determine the relationship between disease persistence and major cow’s milk allergens. Methods: A retrospective chart review of 200 patients diagnosed with IgE-mediated CMPA between 2011 and 2020 was conducted. Patients strictly avoided milk products until an oral food challenge was performed. The main outcome was the introduction of liquid milk following a negative oral food challenge and its correlation with IgE and SPT measurements of milk components at diagnosis. Secondary outcomes included the rate of allergic reactions and anaphylaxis during the treatment period and its correlation with IgE and SPT measurements. Results: Of the 200 charts analysed, 122 patients had a negative oral food challenge to milk (61.0%) (95% confidence interval (CI): 54.1–67.5) following a period of strict avoidance of milk. Higher levels of component-specific IgE, especially casein, were associated with failure in the oral food challenge (p = 0.02). Allergic reactions were experienced by 106 children (53%), of which 34 (17%; 95% CI: 12.4–22.8) had anaphylactic reactions. The risk of anaphylaxis was not predicted by raised IgE levels. Conclusions: While a large proportion of children acquired natural tolerance to cow’s milk following a period of strict avoidance, IgE-mediated CMPA persisted in many children. Casein IgE levels at diagnosis were raised in those who failed to achieve natural tolerance. Allergic reactions to milk, including anaphylaxis, occurred commonly, but this was not predicted by raised IgE levels or SPT measurements.

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在西班牙儿科过敏中心，在IgE介导的牛奶蛋白过敏中实际使用成分特异性IgE。

背景:在西班牙，ige介导的牛奶蛋白过敏(CMPA)影响约0.69%的婴儿。分子诊断可能有助于监测CMPA自然自发耐受性的发展。本研究的目的是回顾性分析一组患有ige介导的CMPA的儿科患者，这些患者在等待天然耐受性时避免食用奶制品，并确定疾病持久性与主要牛奶过敏原之间的关系。方法:回顾性分析2011年至2020年诊断为ige介导的CMPA的200例患者。在进行口腔食物挑战之前，患者严格避免乳制品。主要结果是在口腔食物刺激阴性后引入液态奶，以及其与诊断时牛奶成分的IgE和SPT测量的相关性。次要结果包括治疗期间过敏反应和过敏反应的发生率及其与IgE和SPT测量的相关性。结果:在分析的200张图表中，122例患者在严格避免牛奶一段时间后，对牛奶的口腔食物挑战呈阴性(61.0%)(95%置信区间(CI): 54.1-67.5)。较高水平的成分特异性IgE，特别是酪蛋白，与口服食物攻击失败有关(p = 0.02)。过敏反应106例(53%)，其中34例(17%);95% CI: 12.4-22.8)有过敏反应。IgE水平升高不能预测过敏反应的风险。结论:虽然大部分儿童经过一段时间的严格避免后获得了对牛奶的天然耐受性，但ige介导的CMPA在许多儿童中持续存在。未达到自然耐受性的患者诊断时酪蛋白IgE水平升高。对牛奶的过敏反应，包括过敏反应，经常发生，但这不能通过升高的IgE水平或SPT测量来预测。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Antibodies IMMUNOLOGY-

CiteScore

7.10

自引率

6.40%

发文量

审稿时长

11 weeks

期刊介绍： Antibodies (ISSN 2073-4468), an international, peer-reviewed open access journal which provides an advanced forum for studies related to antibodies and antigens. It publishes reviews, research articles, communications and short notes. Our aim is to encourage scientists to publish their experimental and theoretical results in as much detail as possible. There is no restriction on the length of the papers. Full experimental and/or methodical details must be provided. Electronic files or software regarding the full details of the calculation and experimental procedure - if unable to be published in a normal way - can be deposited as supplementary material. This journal covers all topics related to antibodies and antigens, topics of interest include (but are not limited to): antibody-producing cells (including B cells), antibody structure and function, antibody-antigen interactions, Fc receptors, antibody manufacturing antibody engineering, antibody therapy, immunoassays, antibody diagnosis, tissue antigens, exogenous antigens, endogenous antigens, autoantigens, monoclonal antibodies, natural antibodies, humoral immune responses, immunoregulatory molecules.

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