Document Detail


Basophil reactivity, wheal size, and immunoglobulin levels distinguish degrees of cow's milk tolerance.
MedLine Citation:
PMID:  22819512     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: In our previous study about 75% of children with cow's milk allergy tolerated baked milk products, which improved their prognosis and quality of life.
OBJECTIVE: We sought to identify biomarkers of varying degrees of clinical tolerance among a cohort of children with cow's milk allergy.
METHODS: One hundred thirty-two subjects were initially classified as baked milk-reactive, baked milk-tolerant, or having "outgrown milk allergy" based on the results of oral food challenges. The baked milk-tolerant group was then divided into 3 groups based on the amount and degree of heat-denatured milk protein that they could tolerate. Serum was analyzed for allergen-specific IgE and IgG(4) levels, basophil reactivity was assessed in whole blood stimulated with serial 10-fold dilutions of milk protein, and skin prick tests (SPTs) were performed to commercial milk extract. Activated basophils were defined by using flow cytometry as CD63(bright)CD203c(+)CD123(+)HLA-DR(dim/-)CD41a(-)lineage(-). Data were analyzed by using the Jonckheere-Terpstra test.
RESULTS: Significant differences across the 5 clinical groups were seen for median casein- and milk-specific IgE levels, casein-specific IgG(4) levels, and casein IgE/IgG(4) ratios; milk-specific to nonspecific basophil activation ratio, median basophil reactivity, and spontaneous basophil activation (CD203c expression after stimulation with RPMI); and milk SPT wheal diameters. Casein- and milk-specific IgE level, milk-specific basophil reactivity, and milk SPT wheal diameter are all significantly greater among patients with milk allergy who react to baked milk than among those who tolerate it.
CONCLUSIONS: The majority of patients with milk allergy are able to tolerate some forms of baked milk in their diets. Different phenotypes of children with cow's milk allergy can be distinguished by casein- and milk-specific IgE levels, milk-specific basophil reactivity, and milk SPT mean wheal diameters. Spontaneous basophil activation is greater among patients with more severe clinical milk reactivity.
Authors:
Lara S Ford; Katherine A Bloom; Anna H Nowak-Węgrzyn; Wayne G Shreffler; Madhan Masilamani; Hugh A Sampson
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2012-07-20
Journal Detail:
Title:  The Journal of allergy and clinical immunology     Volume:  131     ISSN:  1097-6825     ISO Abbreviation:  J. Allergy Clin. Immunol.     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2012-12-25     Completed Date:  2013-03-06     Revised Date:  2014-01-09    
Medline Journal Info:
Nlm Unique ID:  1275002     Medline TA:  J Allergy Clin Immunol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  180-6.e1-3     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2012 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adolescent
Animals
Basophils / immunology*
Cattle
Child
Child, Preschool
Female
Humans
Immune Tolerance*
Immunoglobulin E / blood,  immunology*
Immunoglobulin G / blood,  immunology*
Male
Mast Cells / immunology
Milk / adverse effects
Milk Hypersensitivity / diagnosis*,  immunology*
ROC Curve
Skin Tests
Grant Support
ID/Acronym/Agency:
AI066738/AI/NIAID NIH HHS; AI44236/AI/NIAID NIH HHS; P01 AI044236/AI/NIAID NIH HHS; RR026134/RR/NCRR NIH HHS; UL1 RR029887/RR/NCRR NIH HHS
Chemical
Reg. No./Substance:
0/Immunoglobulin G; 37341-29-0/Immunoglobulin E
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Epidemiology of Streptococcus pneumoniae.
Next Document:  The extracellular matrix and ciliary signaling.