Long-term changes in milk component immunoglobulins reflect milk oral immunotherapy outcomes in Finnish children.
cow's milk allergy
immunoglobulins
long-term follow-up
milk components
oral immunotherapy
Journal
Allergy
ISSN: 1398-9995
Titre abrégé: Allergy
Pays: Denmark
ID NLM: 7804028
Informations de publication
Date de publication:
02 2023
02 2023
Historique:
revised:
17
06
2022
received:
22
02
2022
accepted:
12
07
2022
pubmed:
16
8
2022
medline:
1
2
2023
entrez:
15
8
2022
Statut:
ppublish
Résumé
Milk oral immunotherapy (OIT) may increase the amount of milk protein that can be ingested without triggering an allergic reaction. It is important to understand why some patients benefit from the treatment while others do not. The aim was to define the differences in the milk allergen component-specific (casein, α-lactalbumin, ß-lactoglobulin) immunoglobulin (sIg [sIgE, sIgG4, and sIgA]) levels relative to the long-term outcomes of milk OIT. In this long-term, open-label follow-up study, 286 children started milk OIT between 2005 and 2015. Follow-up data were collected at two points: the post-buildup phase and long term (range 1-11 years, median 6 years). Comparisons of sIg levels were made among three outcome groups of self-reported long-term milk consumption (high-milk dose, low-milk dose, and avoidance). A total of 168 (59%) of the 286 patients on OIT participated. Most patients (57%) were in the high-dose group; here, 80% of these patients had a baseline casein sIgE value less than 28 kUA/L, they had the lowest casein sIgE levels at all time (p < .001), their casein sIgG4/IgE levels increased, and long-term casein sIgA was highest compared with the low-dose and avoidance groups (p = .02). Low-milk dose group had the highest casein sIgG4/IgE levels in long term (p = .002). The baseline Ig profiles and responses to milk OIT differed depending on long-term milk consumption. Lower casein sIgE levels were associated with better outcome. Milk casein sIgA differed in the long term among high-milk consumers.
Sections du résumé
BACKGROUND
Milk oral immunotherapy (OIT) may increase the amount of milk protein that can be ingested without triggering an allergic reaction. It is important to understand why some patients benefit from the treatment while others do not.
OBJECTIVE
The aim was to define the differences in the milk allergen component-specific (casein, α-lactalbumin, ß-lactoglobulin) immunoglobulin (sIg [sIgE, sIgG4, and sIgA]) levels relative to the long-term outcomes of milk OIT.
METHODS
In this long-term, open-label follow-up study, 286 children started milk OIT between 2005 and 2015. Follow-up data were collected at two points: the post-buildup phase and long term (range 1-11 years, median 6 years). Comparisons of sIg levels were made among three outcome groups of self-reported long-term milk consumption (high-milk dose, low-milk dose, and avoidance).
RESULTS
A total of 168 (59%) of the 286 patients on OIT participated. Most patients (57%) were in the high-dose group; here, 80% of these patients had a baseline casein sIgE value less than 28 kUA/L, they had the lowest casein sIgE levels at all time (p < .001), their casein sIgG4/IgE levels increased, and long-term casein sIgA was highest compared with the low-dose and avoidance groups (p = .02). Low-milk dose group had the highest casein sIgG4/IgE levels in long term (p = .002).
CONCLUSION
The baseline Ig profiles and responses to milk OIT differed depending on long-term milk consumption. Lower casein sIgE levels were associated with better outcome. Milk casein sIgA differed in the long term among high-milk consumers.
Identifiants
pubmed: 35969113
doi: 10.1111/all.15479
pmc: PMC10087274
doi:
Substances chimiques
Caseins
0
Immunoglobulin E
37341-29-0
Allergens
0
Immunoglobulin A, Secretory
0
Banques de données
ClinicalTrials.gov
['NCT02640014']
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
454-463Informations de copyright
© 2022 The Authors. Allergy published by European Academy of Allergy and Clinical Immunology and John Wiley & Sons Ltd.
Références
Allergy. 2023 Feb;78(2):454-463
pubmed: 35969113
Pediatr Allergy Immunol. 2021 May;32(4):734-741
pubmed: 33393118
J Allergy Clin Immunol. 2013 Sep;132(3):737-739.e6
pubmed: 23806635
Int Arch Allergy Immunol. 2014;164(1):32-9
pubmed: 24853260
J Allergy Clin Immunol. 2013 Mar;131(3):805-12
pubmed: 23273958
J Allergy Clin Immunol. 2007 Nov;120(5):1172-7
pubmed: 17935766
Pediatr Allergy Immunol. 2013 Mar;24(2):114-21
pubmed: 22957704
Pediatr Allergy Immunol. 2014 Dec;25(8):740-6
pubmed: 25251921
J Allergy Clin Immunol Pract. 2017 Mar - Apr;5(2):250-272
pubmed: 28283151
J Allergy Clin Immunol Pract. 2019 Jul - Aug;7(6):1912-1919
pubmed: 30776522
Nat Rev Dis Primers. 2018 Jan 04;4:17098
pubmed: 29300005
J Allergy Clin Immunol. 2021 Jan;147(1):1-13
pubmed: 33436161
J Allergy Clin Immunol. 2008 Dec;122(6):1154-60
pubmed: 18951617
Pediatr Allergy Immunol. 2016 May;27 Suppl 23:1-250
pubmed: 27288833
J Allergy Clin Immunol. 2010 Jun;125(6):1315-1321.e9
pubmed: 20462631
J Allergy Clin Immunol. 2008 Feb;121(2):343-7
pubmed: 18158176
J Biol Stand. 1981 Oct;9(4):431-7
pubmed: 7320024
Allergy. 2022 Jun;77(6):1852-1862
pubmed: 35001400
Acad Radiol. 2013 Jul;20(7):807-15
pubmed: 23582776
Allergy. 2017 Aug;72(8):1133-1147
pubmed: 28058751
Allergy. 2004 Sep;59(9):980-7
pubmed: 15291907
Acta Paediatr. 2013 Feb;102(2):172-6
pubmed: 22897785
Asia Pac Allergy. 2018 Jul 23;8(3):e28
pubmed: 30079306
Allergy. 1996 Jun;51(6):412-6
pubmed: 8837665
Allergy. 2022 Apr;77(4):1291-1293
pubmed: 34874567
Pediatr Allergy Immunol. 2019 May;30(3):356-362
pubmed: 30685892
Nat Methods. 2016 Sep;13(9):731-40
pubmed: 27348712
Front Immunol. 2020 Nov 03;11:568598
pubmed: 33224138
Allergy. 2015 Aug;70(8):955-62
pubmed: 25951431
J Allergy Clin Immunol. 2012 Dec;130(6):1260-74
pubmed: 23195525