Usefulness of nBos d 4, 5 and nBos d 8 Specific IgE Antibodies in Cow's Milk Allergic Children.
10.4168/aair.2014.6.2.121
- Author:
Anna CINGOLANI
1
;
Sabrina DI PILLO
;
Marzia CERASA
;
Daniele RAPINO
;
Nicola Pietro CONSILVIO
;
Marina ATTANASI
;
Alessandra SCAPARROTTA
;
M Loredana MARCOVECCHIO
;
Angelika MOHN
;
Francesco CHIARELLI
Author Information
1. Department of Pediatrics, University of Chieti, Chieti, Italy. cingolanianna@libero.it
- Publication Type:Original Article
- Keywords:
child;
symptoms;
milk;
allergy;
recombinant proteins
- MeSH:
Anaphylaxis;
Antibodies*;
Child*;
Eating;
Humans;
Hypersensitivity;
Immunoglobulin E*;
Methods;
Milk*;
Phenotype;
Recombinant Proteins;
Skin
- From:Allergy, Asthma & Immunology Research
2014;6(2):121-125
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: The aim of study was to assess the value of recombinants in predicting the degree of symptoms in children with and without anaphylaxis to cow's milk. METHODS: The study included 79 children (70+/-40 months) referred to the Allergological Unit of the Pediatric Department between the years 2008-2012. Group A was composed of 17 children (78+/-49.6 months) with anaphylaxis after ingestion of milk. Group B was composed of 62 children (73.1+/-38.6 months) without a history of anaphylaxis, but with less severe symptoms (gastrointestinal and/or skin symptoms). All patients from Group B had a positive open challenge with cow's milk. All patients underwent an allergic evaluation and blood samples were collected to test for IgE to recombinans of milk (nBos d 4, 5, 8). RESULTS: A significant difference in nBos d 8 emerged with higher levels in Group A (median [IQR]=2.80 [0.91-16.1]) than B (0.65 [0.24-1.67]; P=0.006), whereas there were no statistically significant differences for nBos d 4 and 5. The recombinants' sum was higher in Group A than B: 8.39 [2.72-41.39] vs 3.04 [1.85-7.31] kUA/L; P=0.044. The recombinant nBos d 8 was superior to the other recombinants in identifying children at risk for anaphylaxis, with an area under the curve of 0.718 (95% CI, 0.57-0.86, P=0.006). Considering a cutoff of 1.8 kUA/L, nBos d 8 had the most favorable sensitivity and specificity ratio (sensitivity=0.65, specificity=0.77) with an odd ratio of 6.02 (95% C.I: 1.89-19.23). CONCLUSIONS: This study suggested 2 phenotypes of allergic children, "high-anaphylaxis-risk" and "milder-risk". These types can be differentiated through measuring the level of IgE to nBos d 8.
