Literature DB >> 24393339

Use of IgE and IgG4 epitope binding to predict the outcome of oral immunotherapy in cow's milk allergy.

Emma M Savilahti1, Mikael Kuitunen, Miko Valori, Ville Rantanen, Ludmilla Bardina, Gustavo Gimenez, Mika J Mäkelä, Sampsa Hautaniemi, Erkki Savilahti, Hugh A Sampson.   

Abstract

BACKGROUND: Oral immunotherapy (OIT) with cow's milk (CM) has been reported to induce a number of specific antibody responses, but these remain to be fully characterized. Our objective was to explore whether IgE and IgG4 epitope binding profiles could predict the risk of side effects during CM OIT.
METHODS: The study population consisted of 32 children (6-17 yr of age) with CM allergy: 26 children who successfully completed OIT and six children who discontinued therapy due to adverse reactions. We investigated sera drawn before and after OIT. We analyzed specific IgE and IgG4 binding to CM protein-derived peptides with a microarray-based immunoassay. Antibody binding affinity was analyzed with a competition assay where CM proteins in solution competed with peptides printed on the microarray.
RESULTS: IgE binding to CM peptides decreased and IgG4 binding increased following the OIT in children who attained desensitization. Compared with children who successfully completed OIT, those who discontinued OIT due to adverse reactions developed increased quantities and affinity of epitope-specific IgE antibodies and a broader diversity of IgE and IgG4 binding, but less overlap in IgE and IgG4 binding to CM peptides.
CONCLUSIONS: Detailed analysis of IgE and IgG4 binding to CM peptides may help in predicting whether CM OIT will be tolerated successfully. It may thus improve the safety of the therapy.
© 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Entities:  

Keywords:  IgE; IgG4; antibody affinity; cow's milk allergy; epitope; oral immunotherapy; peptide

Mesh:

Substances:

Year:  2014        PMID: 24393339      PMCID: PMC3997594          DOI: 10.1111/pai.12186

Source DB:  PubMed          Journal:  Pediatr Allergy Immunol        ISSN: 0905-6157            Impact factor:   6.377


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