TY - JOUR
T1 - IgE Antibody Detection and Component Analysis in Patients with Eosinophilic Esophagitis
AU - Erwin, Elizabeth A.
AU - Tripathi, Anubha
AU - Ogbogu, Princess U.
AU - Commins, Scott P.
AU - Slack, Maria A.
AU - Cho, Christine B.
AU - Hamilton, Robert G.
AU - Workman, Lisa J.
AU - Platts-Mills, Thomas A.E.
N1 - Funding Information:
The National Institutes of Health (grant nos. K23-AI-059317 and R01-AI-20565 ) and the Ohio State University (a Davis Bremer grant) supported this study.
Publisher Copyright:
& Immunology.
PY - 2015/11
Y1 - 2015/11
N2 - Background: Although IgE antibodies to cow's milk and wheat are common in patients with eosinophilic esophagitis (EoE), titers are low and responses to diet are not dependent on having IgE antibodies. Objective: To better define specific IgE antibody responses to foods, focusing on those foods that appear to play a role in EoE. Methods: Adult (n = 46) and pediatric (n = 51) patients with EoE were recruited for skin prick testing and serum measurement (whole and diluted) of IgE antibodies specific for aeroallergens, food extracts, and component allergens by ImmunoCAP. Immuno Solid-phase Allergen Chip analysis was also used to measure the specificity of IgE antibodies to 112 allergen molecules. Results: In adults and children, there was a higher prevalence of sensitization to food extracts by ImmunoCAP than by skin prick testing. Using Immuno Solid-phase Allergen Chip to assess the specificity of IgE antibodies to 112 allergen molecules, we found that results for food allergens were mostly negative. In contrast, ImmunoCAP assays for specific milk allergens gave positive IgE antibody results in 31 of 34 sera. The correlations between specific IgE antibody to Bos d 4 or Bos d 5 and milk extract were strong (R = 0.89 and 0.76, respectively; P < .001). The evidence that IgE antibodies to foods were directed at minor components of the extracts was further supported by measurements on diluted sera. Conclusions: The IgE responses in cow's milk-sensitized patients with EoE are frequently to whey proteins Bos d 4 and Bos d 5, minor components of the extract. These IgE assays may be able to identify the proteins that are relevant to EoE even though IgE is not the primary mechanism.
AB - Background: Although IgE antibodies to cow's milk and wheat are common in patients with eosinophilic esophagitis (EoE), titers are low and responses to diet are not dependent on having IgE antibodies. Objective: To better define specific IgE antibody responses to foods, focusing on those foods that appear to play a role in EoE. Methods: Adult (n = 46) and pediatric (n = 51) patients with EoE were recruited for skin prick testing and serum measurement (whole and diluted) of IgE antibodies specific for aeroallergens, food extracts, and component allergens by ImmunoCAP. Immuno Solid-phase Allergen Chip analysis was also used to measure the specificity of IgE antibodies to 112 allergen molecules. Results: In adults and children, there was a higher prevalence of sensitization to food extracts by ImmunoCAP than by skin prick testing. Using Immuno Solid-phase Allergen Chip to assess the specificity of IgE antibodies to 112 allergen molecules, we found that results for food allergens were mostly negative. In contrast, ImmunoCAP assays for specific milk allergens gave positive IgE antibody results in 31 of 34 sera. The correlations between specific IgE antibody to Bos d 4 or Bos d 5 and milk extract were strong (R = 0.89 and 0.76, respectively; P < .001). The evidence that IgE antibodies to foods were directed at minor components of the extracts was further supported by measurements on diluted sera. Conclusions: The IgE responses in cow's milk-sensitized patients with EoE are frequently to whey proteins Bos d 4 and Bos d 5, minor components of the extract. These IgE assays may be able to identify the proteins that are relevant to EoE even though IgE is not the primary mechanism.
KW - Component-resolved diagnostics
KW - Eosinophilic esophagitis
KW - Food allergy
KW - Serum IgE measurements
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U2 - 10.1016/j.jaip.2015.05.015
DO - 10.1016/j.jaip.2015.05.015
M3 - Article
C2 - 26099818
AN - SCOPUS:84946496803
SN - 2213-2198
VL - 3
SP - 896-904.e3
JO - Journal of Allergy and Clinical Immunology: In Practice
JF - Journal of Allergy and Clinical Immunology: In Practice
IS - 6
ER -