Document Detail


Presence of functional, autoreactive human milk-specific IgE in infants with cow's milk allergy.
MedLine Citation:
PMID:  22092935     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Occasionally, exclusively breastfed infants with cow's milk allergy (CMA) remain symptomatic despite strict maternal milk avoidance.
OBJECTIVE: To determine whether or not persistence of symptoms could be due to sensitization against endogenous human milk proteins with a high degree of similarity to bovine allergens.
METHODS: Ten peptides representing known bovine milk IgE-binding epitopes [α-lactalbumin (ALA), β- and κ-casein] and the corresponding, highly homologous human milk peptides were labelled with sera from 15 breastfed infants with CMA, aged 3 weeks to 12 months, and peptide (epitope)-specific IgE antibodies were assessed. Nine of the 15 breastfed infants became asymptomatic during strict maternal avoidance of milk and other major food allergens; six infants remained symptomatic until weaned. Ten older children, aged 5-15 years, with CMA were also assessed. The functional capacity of specific IgE antibodies was assessed by measuring β-hexosaminidase release from rat basophilic leukaemia cells passively sensitized and stimulated with human and bovine ALA.
RESULTS: A minimum of one human milk peptide was recognized by IgE antibodies from 9 of 15 (60%) milk-allergic infants, and the majority of older children with CMA. Genuine sensitization to human milk peptides in the absence of IgE to bovine milk was occasionally seen. There was a trend towards specific IgE being detected to more human milk peptides in those infants who did not respond to the maternal milk elimination diet than in those who did (P = 0.099). Functional IgE antibody to human ALA was only detected in infants not responding to the maternal diet.
CONCLUSIONS AND CLINICAL RELEVANCE: Endogenous human milk epitopes are recognized by specific IgE from the majority of infants and children with CMA. Such autoreactive, human milk-specific IgE antibodies appear to have functional properties in vitro. Their role in provoking allergic symptoms in infants exclusively breastfed by mothers strictly avoiding dietary milk remains unclear.
Authors:
K M Järvinen; L Geller; R Bencharitiwong; H A Sampson
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, N.I.H., Extramural     Date:  2011-09-21
Journal Detail:
Title:  Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology     Volume:  42     ISSN:  1365-2222     ISO Abbreviation:  Clin. Exp. Allergy     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-01-31     Completed Date:  2012-05-22     Revised Date:  2013-10-16    
Medline Journal Info:
Nlm Unique ID:  8906443     Medline TA:  Clin Exp Allergy     Country:  England    
Other Details:
Languages:  eng     Pagination:  238-47     Citation Subset:  IM    
Copyright Information:
© 2011 Blackwell Publishing Ltd.
Affiliation:
Division of Pediatric Allergy & Immunology, The Mount Sinai School of Medicine, New York, NY 10029-6574, USA. kirsi.jarvinen-seppo@mssm.edu
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MeSH Terms
Descriptor/Qualifier:
Animals
Antibody Specificity / genetics,  immunology*
Breast Feeding
Cattle
Cell Line, Tumor
Child
Child, Preschool
Female
Humans
Immunoglobulin E / blood,  genetics,  immunology*
Infant
Infant, Newborn
Male
Milk Hypersensitivity / blood,  genetics,  immunology*
Milk Proteins / genetics,  immunology*
Peptides / genetics,  immunology*
Rats
Sequence Homology, Amino Acid
Grant Support
ID/Acronym/Agency:
AI066738/AI/NIAID NIH HHS; AI44236/AI/NIAID NIH HHS; K08 AI091655/AI/NIAID NIH HHS; K12 HD052890-03/HD/NICHD NIH HHS; RR026134/RR/NCRR NIH HHS; UL1 RR029887/RR/NCRR NIH HHS
Chemical
Reg. No./Substance:
0/Milk Proteins; 0/Peptides; 37341-29-0/Immunoglobulin E
Comments/Corrections

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