Egg-white-specific IgA and IgA2 antibodies in egg-allergic children: Is there a role in tolerance induction?
Article first published online: 7 OCT 2013
© 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd
Pediatric Allergy and Immunology
Volume 25, Issue 1, pages 64–70, February 2014
How to Cite
Egg-white-specific IgA and IgA2 antibodies in egg-allergic children: Is there a role in tolerance induction?. Pediatr Allergy Immunol 2014: 25: 64–70., , , , , .
- Issue published online: 19 FEB 2014
- Article first published online: 7 OCT 2013
- Manuscript Accepted: 3 SEP 2013
- National Institutes of Health (NIH)
- National Institute of Allergy and Infectious Diseases (NIAID). Grant Number: AI 059318
- National Center for Research Resources (NCRR). Grant Number: CTSA ULI RR 029887
- The Louis and Rachel Rudin Foundation, Inc
- Food Allergy Initiative (now Food Allergy Research & Education)
- food allergy;
- egg white;
- immunoglobulin A;
- neutralizing antibodies;
- tolerance induction
Decreased serum food-specific IgA antibodies have been associated with allergic disease in cross-sectional, case–control studies. The purpose of this study was to prospectively compare egg-white-(EW)-specific IgA and IgA2 levels between egg-allergic children and children tolerating egg.
Seventeen egg-allergic children were followed prospectively. Total IgA, EW-specific IgA, and EW-specific IgA2 levels were measured in their sera with a sensitive ELISA. As negative controls were used children with no previous history of egg allergy. Egg-allergic children with or without concomitant milk allergy were evaluated as additional controls with measurement of casein-specific IgA.
After 2.5 ± 0.9 yrs, nine out of the 17 allergic children became tolerant and eight remained allergic to baked egg. Baseline EW-specific IgA2 levels were significantly lower in the egg-allergic subjects (median 23.9 ng/ml) compared with the negative control subjects (99.4 ng/ml) and increased significantly by 28% over the study time period in eight out of the nine allergic children that became tolerant to baked egg. There was no significant change over time in EW-specific IgA in any of the study groups. Non-milk-allergic subjects with concomitant egg allergy had almost threefold higher casein-specific IgA levels than the milk- and egg-allergic subjects (p = 0.025).
These results suggest a potential role for allergen-specific IgA2 antibodies in the induction of food tolerance. Furthermore, they support the hypothesis that immature or impaired production of allergen-specific IgA2 may be associated with the pathophysiology of food allergy, a defect that seems to be selective for the culprit allergen.