egg-white and Milk-Hypersensitivity

Specific IgG4 antibodies in sera were measured by ELISA in allergic patients who were diagnosed as susceptible to one or more allergens among mite, milk, soybean or egg white, and also in a non-allergic control group, and their diagnostic significance was investigated. The results obtained were as follows. 1. The level of specific IgG4 antibody was significantly higher in each allergic group than in the non-allergic group. 2. The positive rates in the specific IgG4 antibody determination were higher than those in RAST in the milk-, soybean- and egg white-allergic groups. 3. In each allergic group, the causative allergens were detected more accurately by measuring both specific IgG4 antibody and IgE antibody (RAST) than IgE alone. 4. The positive rates in the specific IgG4 antibody determination were higher than those in the skin test in each allergic group. 5. It was demonstrated that the combination of the skin test with specific IgG4 antibody measurement ensured a more accurate detection of causative allergens than the skin test alone. These results indicated that the measurement of the specific IgG4 antibody is a helpful method to detect the causative allergens in allergic patients.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Animals; Child; Child, Preschool; Egg White; Female; Glycine max; Humans; Hypersensitivity; Immunoglobulin G; Infant; Male; Middle Aged; Milk Hypersensitivity; Mites

Confocal laser endomicroscopy (CLE) is a technique that permits real-time detection and quantification of changes in intestinal tissues and cells, including increases in intraepithelial lymphocytes and fluid extravasation through epithelial leaks. Using CLE analysis of patients with irritable bowel syndrome (IBS), we found that more than half have responses to specific food components. Exclusion of the defined food led to long-term symptom relief. We used the results of CLE to detect reactions to food in a larger patient population and analyzed duodenal biopsy samples and fluid from patients to investigate mechanisms of these reactions.. In a prospective study, 155 patients with IBS received 4 challenges with each of 4 common food components via the endoscope, followed by CLE, at a tertiary medical center. Classical food allergies were excluded by negative results from immunoglobulin E serology analysis and skin tests for common food antigens. Duodenal biopsy samples and fluid were collected 2 weeks before and immediately after CLE and were analyzed by histology, immunohistochemistry, reverse transcription polymerase chain reaction, and immunoblots. Results from patients who had a response to food during CLE (CLE. Of the 108 patients who completed the study, 76 were CLE. In a CLE analysis of patients with IBS, we found that more than 50% of patients could have nonclassical food allergy, with immediate disruption of the intestinal barrier upon exposure to food antigens. Duodenal tissues from patients with responses to food components during CLE had immediate increases in expression of claudin-2 and decreases in occludin. CLE

Topics: Adolescent; Adult; Aged; Allergens; Animals; Biopsy; Cell Degranulation; Claudin-2; Cytokines; Duodenum; Egg Hypersensitivity; Egg White; Endoscopy, Digestive System; Eosinophil Cationic Protein; Eosinophils; Female; Food Hypersensitivity; Glycine max; Humans; Immunoglobulin E; Intestinal Mucosa; Intraepithelial Lymphocytes; Irritable Bowel Syndrome; Male; Microscopy, Confocal; Middle Aged; Milk; Milk Hypersensitivity; Occludin; Permeability; Prospective Studies; RNA, Messenger; Tight Junctions; Triticum; Wheat Hypersensitivity; Yeasts; Young Adult

We aimed to assess the possible relationship between food allergy and two key adipokines - leptin and adiponectin - in children with food allergy. A total of forty patients with definite diagnosis of food allergy according to clinical history and specific IgE (sIgE) for food allergens (group I) were enrolled in this pilot study. The control group (group II) included thirty children with no evidence of allergic symptoms. Serum levels of leptin and adiponectin were measured by ELISA. Meanwhile, sIgE was measured for the eight most common food allergens by the immunoblot method in all participants. The median ages in groups I and II were 18·5 and 23·5 months, respectively. The respective Caesarean section rate was 64·9 and 16·7 % in groups I and II (P<0·001). Serum levels of adiponectin were significantly higher in the patient group compared with controls (24·11 (sd 12·14) v. 10·67 (sd 12·23) μg/ml, P<0·001), whereas no statistically meaningful difference was detected in serum leptin concentrations (P=0·92). There was a significant inverse relationship between age and adiponectin levels in group I (P=0·002, r -0·479) and group II (P=0·04, r -0·365), and it was more significant in group I. The most common allergens in the patient group were wheat (52·5 %), hazelnut (52·5 %), cow's milk (50 %) and egg white (30 %). The results of this study suggest an essential link between adiponectin and food allergy that is probably unlikely to be affected by obesity as a confounding factor.

Topics: Adiponectin; Allergens; Animals; Birth Weight; Case-Control Studies; Cesarean Section; Child, Preschool; Corylus; Cytokines; Egg Hypersensitivity; Egg White; Enzyme-Linked Immunosorbent Assay; Female; Food Hypersensitivity; Humans; Immunoglobulin E; Infant; Inflammation; Leptin; Male; Milk; Milk Hypersensitivity; Pilot Projects; Skin Tests; Triticum

Topics: Child; Diagnosis, Differential; Egg White; Female; Food Hypersensitivity; Humans; Milk Hypersensitivity; Milk Proteins; Otitis Media; Rhinitis

The skin prick test (SPT) for detecting atopic sensitization is not preferred in young infants with atopic dermatitis (AD) because of concerns about poor skin reactivity. This study aimed to evaluate whether the results of SPT agreed well with those of specific serum immunoglobulin E (sIgE) antibody test in young infants with AD.. This study included 2,077 eligible infants (age, <12 months) with AD who were tested by either SPT or sIgE between 2007 and 2011. Among them, 199 infants tested for egg white (EW) and 192 infants tested for cow's milk (CM), by both SPT and sIgE on the same day were identified and reviewed retrospectively. Kappa statistics and tests for equal kappa statistics were used to evaluate the agreement between the SPT and sIgE.. The mean wheal diameter and the allergen-to-histamine ratio of SPT showed substantial agreement with those of sIgE for EW (κ = 0.62, 0.69) and CM (κ = 0.34, 0.47). The agreement for EW was significantly higher <6-month-old than in ≥6-month-old infants (κ = 0.79 vs. 0.54, P = 0.02), and that for CM was similar (P = 0.60). The mean wheal diameters for EW and CM were evenly distributed, and did not show increasing trends regardless of age in months (Ptrend = 0.13 and 0.06, respectively).. The results of SPT agreed well with those of sIgE. This finding provides a rationale for using SPT, and suggests that SPT can be used along with sIgE to detect food sensitization in young infants with AD.

Topics: Allergens; Animals; Antibody Specificity; Cattle; Dermatitis, Atopic; Egg Hypersensitivity; Egg White; Female; Humans; Immunoglobulin E; Infant; Infant, Newborn; Male; Milk; Milk Hypersensitivity; Reproducibility of Results; Retrospective Studies; Sensitivity and Specificity; Skin Tests

Migraine is a very common headache disorder. Due to the co-occurrence of migraine and allergic disorders, allergic mechanisms have been thought to play a role in migraine pathophysiology. This study aimed to investigate the association between cow's milk allergy and egg-white allergy and migraine-type headache of childhood.. We included 39 children with migraine-type headache and 167 children with no headache who had been evaluated previously in a school screening study program. Egg-white and cow's milk-specific IgE levels were measured for all involved subjects.. Specific IgE levels were positive for cow's milk in 4 children and for egg-white in 2 children, respectively. No meaningful relationship was detected between food allergies and migraine. However, specific IgE levels for egg-white were significantly higher in migraineurs (p=0.008).. Childhood migraine does not appear to be associated with cow's milk or egg-white allergy. However, the elevation of egg-white-specific IgE levels in migraine-type headache may signify the possible presence of shared pathogenetic pathways in the development of migraine and food allergies.

Topics: Animals; Child; Egg Hypersensitivity; Egg White; Female; Humans; Immunoglobulin E; Male; Migraine Disorders; Milk; Milk Hypersensitivity

The diagnosis of food allergy (FA) is usually based on oral food challenge tests (OFC). However, OFCs occasionally induce severe adverse reactions. CD203c expression on basophils is emerging as a potential diagnostic index. We evaluated whether CD203c expression on basophils would be a useful marker of OFC-associated symptoms in hen's egg and cow's milk allergies in children.. Seventy-one patients who had been diagnosed with FA based on OFCs or a convincing history of FA symptoms in the Department of Pediatrics, Sagamihara National Hospital, were recruited. CD203c expression was assessed after stimulation with antigens (egg white, ovomucoid, milk or casein) using allergenicity kits. The CD203c stimulation index (SI = the allergen-induced CD203c expression level divided by the baseline expression level) and the threshold of CD203c expression (the minimum concentration of antigen to induce CD203c SI >or=2) were analyzed in association with tolerance acquisition.. For the CD203c SI, the areas under the receiver-operating characteristic curve were 0.72 for egg white, 0.82 for ovomucoid, 0.84 for milk and 0.67 for casein. The positive predictive value for the threshold of CD203c expression was 94.7% for egg white, 100% for ovomucoid, 85.7% for milk and 75.0% for casein.. Assessment of food antigen-induced CD203c expression on basophils is useful to determine if children will outgrow FA as well as in decision making regarding whether or not to perform OFCs.

Topics: Animals; Area Under Curve; Basophils; Caseins; Cattle; Child; Child, Preschool; Egg Hypersensitivity; Egg White; Female; Humans; Immunoglobulin E; Male; Milk; Milk Hypersensitivity; Ovomucin; Phosphoric Diester Hydrolases; Predictive Value of Tests; Pyrophosphatases; Sensitivity and Specificity

The patch test with food antigens (atopy patch test, APT) has been reported as a more specific method than prick or RAST for the early detection of cow's milk and/or egg sensitizations in children. Standardization of APT extracts is a major issue on the road towards full clinical exploitation of this assay. Here, we used sodium dodecyl sulphate polyacrylamide gel electrophoresis (SDS-PAGE) to characterize sensitivity and specificity of commercial preparations of APT for milk and egg allergies, which are expected to improve the reliability of this test, when compared with fresh food allergen sources. We found that: (i) SDS-PAGE is an appropriate technique for quality control of APT and (ii) commercial milk and egg APT are equivalent to fresh food preparations in terms of allergen content. Clinical trials aimed at characterizing sensitivity and specificity of APT in the diagnosis of food allergy in children will benefit from this technique.

Topics: Allergens; Animals; Egg Hypersensitivity; Egg Proteins, Dietary; Egg White; Egg Yolk; Electrophoresis, Polyacrylamide Gel; Milk; Milk Hypersensitivity; Milk Proteins; Patch Tests; Quality Control; Reproducibility of Results

Clinical adverse reactions to egg may occur in infants or children who have never eaten egg. They may be sensitized or even react at first egg ingestion. Few studies are available concerning the reality of egg white allergy in such sensitized children, the natural evolution of this condition and the appropriate decisions to make.. To analyze the actuality and natural course of egg allergy in children sensitized without previous of hen's egg ingestion.. We set up a clinical decision tree based on clinical history and specific egg white IgE to manage patients who had never ingested egg but were sensitized as demonstrated by a positive SPT and report a cohort of 30 such children. The mean level of egg white specific IgE at first analysis, i.e. before 12 months, was high, 28.3 KU(A) /L, with a large range, from 0.6 to >100 KU(A) /L, below 6 KU(A) /L in only 8 patients. In 6 children ("no challenge" group), IgE values remained >8 KU(A) /L by the end of the survey and the oral challenge with egg was always denied. Their mean + SD IgE level was at 51.7 + 38 KU(A) /L at 1 year and 19.7 + 13 KU(A) /L at a mean age of 34 + 5 months. All had an associated anaphylactic reaction with milk and 5 were still allergic to milk by the end of the survey. In the remaining 24 infants, egg was given for the first time at a mean age of 30 + 9 months, by error in 4 cases, all exhibiting an immediate reaction, and in a hospital setting in 20, among whom 14 reacted. Among those 18, with a specific IgE level at 9.1 + 10 KU(A) /L at 28 + 9 months, 4 became tolerant between 3 and 4 years, with specific IgE levels below 1.3 KU(A) /L and a 5th one with specific IgE >100 KU(A) /L at 6 months tolerated scrambled eggs at age 7 year, with specific IgE at 2.6 KU(A) /L. In the 6 others, labeled "non allergic", egg white specific IgE levels were significantly lower, whatever the age, than in the "no challenge" group. The age at challenge was 35 + 8 months, with a mean specific IgE level at 1.0 + 0.9 KU(A) /L.. In children sensitized to egg without previous ingestion of that food, egg tolerance appears probably in some by the age of 3 but may reveal much more prolonged in a limited number.

Topics: Decision Trees; Egg Hypersensitivity; Egg Proteins, Dietary; Egg White; Female; Humans; Immunoglobulin E; Infant; Male; Milk Hypersensitivity; Time Factors

The skin prick test is the most widely used test for detecting IgE-mediated food hypersensitivity. Our study aimed to define firstly the correlations between results obtained with prick tests using commercial extracts and fresh foods, and secondly the correlations between these results and those obtained with labial and/or oral challenge. We compared the wheal diameters read at 15 min with commercial extracts and fresh foods, for four foods, in 430 children with suspected food allergy. For cow's milk, wheal diameters were larger with commercial extracts, but the difference was not significant. Conversely, wheal diameters were significantly larger with fresh foods for the other food allergens. Skin prick tests were positive in 40% of cases with commercial extracts and in 81.3% with fresh foods. The overall concordance between a positive prick test and positive challenge was 58.8% with commercial extracts and 91.7% with fresh foods. These results indicate that fresh foods may be more effective for detecting the sensitivity to food allergens. Fresh foods should be used for primary testing for egg, peanut, and cow's milk sensitivity.

Topics: Adolescent; Adult; Animals; Arachis; Child; Child, Preschool; Egg White; Egg Yolk; Female; Food; Food Hypersensitivity; Humans; Immunoglobulin E; Infant; Male; Milk; Milk Hypersensitivity; Reagent Kits, Diagnostic; Skin Tests

Topics: Allergens; Animals; Antigens; Chickens; Child; Citrus; Dermatitis, Atopic; Egg White; Female; Fluoroimmunoassay; Food Hypersensitivity; Humans; Immunoglobulin E; Meat; Milk Hypersensitivity; Swine; United States