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Clinical and Molecular Allergy
Published in: Clinical and Molecular Allergy 1/2012

Open Access 01-12-2012 | Research

The usefulness of casein-specific IgE and IgG4 antibodies in cow's milk allergic children

Authors: Komei Ito, Masaki Futamura, Robert Movérare, Akira Tanaka, Tsutomu Kawabe, Tatsuo Sakamoto, Magnus P Borres

Published in: Clinical and Molecular Allergy | Issue 1/2012

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Abstract

Background

Cow's milk allergy is one of the most common food allergies among younger children. We investigated IgE antibodies to milk, and IgE and IgG4 antibodies to casein, α-lactalbumin and β-lactoglobulin in cow's milk allergic (CMA) and non-allergic (non-CMA) children in order to study their clinical usefulness.

Methods

Eighty-three children with suspected milk allergy (median age: 3.5 years, range: 0.8-15.8 years) were diagnosed as CMA (n = 61) or non-CMA (n = 22) based on an open milk challenge or convincing clinical history. Their serum concentrations of allergen-specific (s) IgE and IgG4 antibodies were measured using ImmunoCAP®. For the sIgG4 analysis, 28 atopic and 31 non-atopic control children were additionally included (all non-milk sensitized).

Results

The CMA group had significantly higher levels of milk-, casein- and β-lactoglobulin-sIgE antibodies as compared to the non-CMA group. The casein test showed the best discriminating performance with a clinical decision point of 6.6 kUA/L corresponding to 100% specificity. All but one of the CMA children aged > 5 years had casein-sIgE levels > 6.6 kUA/L. The non-CMA group had significantly higher sIgG4 levels against all three milk allergens compared to the CMA group. This was most pronounced for casein-sIgG4 in non-CMA children without history of previous milk allergy. These children had significantly higher casein-sIgG4 levels compared to any other group, including the non-milk sensitized control children.

Conclusions

High levels of casein-sIgE antibodies are strongly associated with milk allergy in children and might be associated with prolonged allergy. Elevated casein-sIgG4 levels in milk-sensitized individuals on normal diet indicate a modified Th2 response. However, the protective role of IgG4 antibodies in milk allergy is unclear.
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Metadata
Title
The usefulness of casein-specific IgE and IgG4 antibodies in cow's milk allergic children
Authors
Komei Ito
Masaki Futamura
Robert Movérare
Akira Tanaka
Tsutomu Kawabe
Tatsuo Sakamoto
Magnus P Borres
Publication date
01-12-2012
Publisher
BioMed Central
Published in
Clinical and Molecular Allergy / Issue 1/2012
Electronic ISSN: 1476-7961
DOI
https://doi.org/10.1186/1476-7961-10-1

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