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Egg-white-specific IgA and IgA2 antibodies in egg-allergic children: Is there a role in tolerance induction?

Authors

  • George N. Konstantinou,

    Corresponding author
    1. Division of Allergy & Immunology, The Jaffe Food Allergy Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
    2. Department of Allergy and Clinical Immunology, 424 General Military Training Hospital, Thessaloniki, Greece
    • Correspondence

      George N. Konstantinou, Department of Allergy and Clinical Immunology, 424 General Military Training Hospital, 11 Eleftheriou Venizelou Street, Kalamaria, Thessaloniki 55 133, Greece

      Tel.: +30 231 550 3444

      Fax: +30 231 550 3444

      E-mail: gnkonstantinou@gmail.com

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  • Anna Nowak-Węgrzyn,

    1. Division of Allergy & Immunology, The Jaffe Food Allergy Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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  • Ramon Bencharitiwong,

    1. Division of Allergy & Immunology, The Jaffe Food Allergy Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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  • Luda Bardina,

    1. Division of Allergy & Immunology, The Jaffe Food Allergy Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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  • Scott H. Sicherer,

    1. Division of Allergy & Immunology, The Jaffe Food Allergy Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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  • Hugh A. Sampson

    1. Division of Allergy & Immunology, The Jaffe Food Allergy Research Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Abstract

Background

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.

Methods

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.

Results

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).

Conclusions

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.

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