Basophil reactivity, wheal size, and immunoglobulin levels distinguish degrees of cow's milk tolerance
In our previous study about 75% of children with cow's milk allergy tolerated baked milk products, which improved their prognosis and quality of life. We sought to identify biomarkers of varying degrees of clinical tolerance among a cohort of children with cow's milk allergy. One hundred t...
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| Published in | Journal of allergy and clinical immunology Vol. 131; no. 1; pp. 180 - 186.e3 |
|---|---|
| Main Authors | , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
New York, NY
Mosby, Inc
01.01.2013
Elsevier Elsevier Limited |
| Subjects | |
| Online Access | Get full text |
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| Abstract | In our previous study about 75% of children with cow's milk allergy tolerated baked milk products, which improved their prognosis and quality of life.
We sought to identify biomarkers of varying degrees of clinical tolerance among a cohort of children with cow's milk allergy.
One hundred thirty-two subjects were initially classified as baked milk–reactive, baked milk–tolerant, or having “outgrown milk allergy” based on the results of oral food challenges. The baked milk–tolerant group was then divided into 3 groups based on the amount and degree of heat-denatured milk protein that they could tolerate. Serum was analyzed for allergen-specific IgE and IgG4 levels, basophil reactivity was assessed in whole blood stimulated with serial 10-fold dilutions of milk protein, and skin prick tests (SPTs) were performed to commercial milk extract. Activated basophils were defined by using flow cytometry as CD63brightCD203c+CD123+HLA-DRdim/−CD41a−lineage−. Data were analyzed by using the Jonckheere-Terpstra test.
Significant differences across the 5 clinical groups were seen for median casein- and milk-specific IgE levels, casein-specific IgG4 levels, and casein IgE/IgG4 ratios; milk-specific to nonspecific basophil activation ratio, median basophil reactivity, and spontaneous basophil activation (CD203c expression after stimulation with RPMI); and milk SPT wheal diameters. Casein- and milk-specific IgE level, milk-specific basophil reactivity, and milk SPT wheal diameter are all significantly greater among patients with milk allergy who react to baked milk than among those who tolerate it.
The majority of patients with milk allergy are able to tolerate some forms of baked milk in their diets. Different phenotypes of children with cow's milk allergy can be distinguished by casein- and milk-specific IgE levels, milk-specific basophil reactivity, and milk SPT mean wheal diameters. Spontaneous basophil activation is greater among patients with more severe clinical milk reactivity. |
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| AbstractList | Background In our previous study about 75% of children with cow's milk allergy tolerated baked milk products, which improved their prognosis and quality of life. Objective We sought to identify biomarkers of varying degrees of clinical tolerance among a cohort of children with cow's milk allergy. Methods One hundred thirty-two subjects were initially classified as baked milk–reactive, baked milk–tolerant, or having “outgrown milk allergy” based on the results of oral food challenges. The baked milk–tolerant group was then divided into 3 groups based on the amount and degree of heat-denatured milk protein that they could tolerate. Serum was analyzed for allergen-specific IgE and IgG4 levels, basophil reactivity was assessed in whole blood stimulated with serial 10-fold dilutions of milk protein, and skin prick tests (SPTs) were performed to commercial milk extract. Activated basophils were defined by using flow cytometry as CD63bright CD203c+ CD123+ HLA-DRdim/− CD41a− lineage− . Data were analyzed by using the Jonckheere-Terpstra test. Results Significant differences across the 5 clinical groups were seen for median casein- and milk-specific IgE levels, casein-specific IgG4 levels, and casein IgE/IgG4 ratios; milk-specific to nonspecific basophil activation ratio, median basophil reactivity, and spontaneous basophil activation (CD203c expression after stimulation with RPMI); and milk SPT wheal diameters. Casein- and milk-specific IgE level, milk-specific basophil reactivity, and milk SPT wheal diameter are all significantly greater among patients with milk allergy who react to baked milk than among those who tolerate it. Conclusions The majority of patients with milk allergy are able to tolerate some forms of baked milk in their diets. Different phenotypes of children with cow's milk allergy can be distinguished by casein- and milk-specific IgE levels, milk-specific basophil reactivity, and milk SPT mean wheal diameters. Spontaneous basophil activation is greater among patients with more severe clinical milk reactivity. In our previous study about 75% of children with cow's milk allergy tolerated baked milk products, which improved their prognosis and quality of life. We sought to identify biomarkers of varying degrees of clinical tolerance among a cohort of children with cow's milk allergy. One hundred thirty-two subjects were initially classified as baked milk-reactive, baked milk-tolerant, or having "outgrown milk allergy" based on the results of oral food challenges. The baked milk-tolerant group was then divided into 3 groups based on the amount and degree of heat-denatured milk protein that they could tolerate. Serum was analyzed for allergen-specific IgE and IgG(4) levels, basophil reactivity was assessed in whole blood stimulated with serial 10-fold dilutions of milk protein, and skin prick tests (SPTs) were performed to commercial milk extract. Activated basophils were defined by using flow cytometry as CD63(bright)CD203c(+)CD123(+)HLA-DR(dim/-)CD41a(-)lineage(-). Data were analyzed by using the Jonckheere-Terpstra test. Significant differences across the 5 clinical groups were seen for median casein- and milk-specific IgE levels, casein-specific IgG(4) levels, and casein IgE/IgG(4) ratios; milk-specific to nonspecific basophil activation ratio, median basophil reactivity, and spontaneous basophil activation (CD203c expression after stimulation with RPMI); and milk SPT wheal diameters. Casein- and milk-specific IgE level, milk-specific basophil reactivity, and milk SPT wheal diameter are all significantly greater among patients with milk allergy who react to baked milk than among those who tolerate it. The majority of patients with milk allergy are able to tolerate some forms of baked milk in their diets. Different phenotypes of children with cow's milk allergy can be distinguished by casein- and milk-specific IgE levels, milk-specific basophil reactivity, and milk SPT mean wheal diameters. Spontaneous basophil activation is greater among patients with more severe clinical milk reactivity. Background In our previous study about 75% of children with cow's milk allergy tolerated baked milk products, which improved their prognosis and quality of life. Objective We sought to identify biomarkers of varying degrees of clinical tolerance among a cohort of children with cow's milk allergy. Methods One hundred thirty-two subjects were initially classified as baked milk-reactive, baked milk-tolerant, or having "outgrown milk allergy" based on the results of oral food challenges. The baked milk-tolerant group was then divided into 3 groups based on the amount and degree of heat-denatured milk protein that they could tolerate. Serum was analyzed for allergen-specific IgE and IgG4levels, basophil reactivity was assessed in whole blood stimulated with serial 10-fold dilutions of milk protein, and skin prick tests (SPTs) were performed to commercial milk extract. Activated basophils were defined by using flow cytometry as CD63brightCD203c+CD123+HLA-DRdim/-CD41a-lineage-. Data were analyzed by using the Jonckheere-Terpstra test. Results Significant differences across the 5 clinical groups were seen for median casein- and milk-specific IgE levels, casein-specific IgG4levels, and casein IgE/IgG4ratios; milk-specific to nonspecific basophil activation ratio, median basophil reactivity, and spontaneous basophil activation (CD203c expression after stimulation with RPMI); and milk SPT wheal diameters. Casein- and milk-specific IgE level, milk-specific basophil reactivity, and milk SPT wheal diameter are all significantly greater among patients with milk allergy who react to baked milk than among those who tolerate it. Conclusions The majority of patients with milk allergy are able to tolerate some forms of baked milk in their diets. Different phenotypes of children with cow's milk allergy can be distinguished by casein- and milk-specific IgE levels, milk-specific basophil reactivity, and milk SPT mean wheal diameters. Spontaneous basophil activation is greater among patients with more severe clinical milk reactivity. Background: In our previous study about 75% of children with cow's milk allergy tolerated baked milk products, which improved their prognosis and quality of life. Objective: We sought to identify biomarkers of varying degrees of clinical tolerance among a cohort of children with cow's milk allergy. Methods: One hundred thirty-two subjects were initially classified as baked milkareactive, baked milkatolerant, or having aoutgrown milk allergya based on the results of oral food challenges. The baked milkatolerant group was then divided into 3 groups based on the amount and degree of heat-denatured milk protein that they could tolerate. Serum was analyzed for allergen-specific IgE and IgG4 levels, basophil reactivity was assessed in whole blood stimulated with serial 10-fold dilutions of milk protein, and skin prick tests (SPTs) were performed to commercial milk extract. Activated basophils were defined by using flow cytometry as CD63brightCD203c+CD123+HLA-DRdim/-CD41a-lineage-. Data were analyzed by using the Jonckheere-Terpstra test. Results: Significant differences across the 5 clinical groups were seen for median casein- and milk-specific IgE levels, casein-specific IgG4 levels, and casein IgE/IgG4 ratios; milk-specific to nonspecific basophil activation ratio, median basophil reactivity, and spontaneous basophil activation (CD203c expression after stimulation with RPMI); and milk SPT wheal diameters. Casein- and milk-specific IgE level, milk-specific basophil reactivity, and milk SPT wheal diameter are all significantly greater among patients with milk allergy who react to baked milk than among those who tolerate it. Conclusions: The majority of patients with milk allergy are able to tolerate some forms of baked milk in their diets. Different phenotypes of children with cow's milk allergy can be distinguished by casein- and milk-specific IgE levels, milk-specific basophil reactivity, and milk SPT mean wheal diameters. Spontaneous basophil activation is greater among patients with more severe clinical milk reactivity. In our previous study about 75% of children with cow's milk allergy tolerated baked milk products, which improved their prognosis and quality of life. We sought to identify biomarkers of varying degrees of clinical tolerance among a cohort of children with cow's milk allergy. One hundred thirty-two subjects were initially classified as baked milk–reactive, baked milk–tolerant, or having “outgrown milk allergy” based on the results of oral food challenges. The baked milk–tolerant group was then divided into 3 groups based on the amount and degree of heat-denatured milk protein that they could tolerate. Serum was analyzed for allergen-specific IgE and IgG4 levels, basophil reactivity was assessed in whole blood stimulated with serial 10-fold dilutions of milk protein, and skin prick tests (SPTs) were performed to commercial milk extract. Activated basophils were defined by using flow cytometry as CD63brightCD203c+CD123+HLA-DRdim/−CD41a−lineage−. Data were analyzed by using the Jonckheere-Terpstra test. Significant differences across the 5 clinical groups were seen for median casein- and milk-specific IgE levels, casein-specific IgG4 levels, and casein IgE/IgG4 ratios; milk-specific to nonspecific basophil activation ratio, median basophil reactivity, and spontaneous basophil activation (CD203c expression after stimulation with RPMI); and milk SPT wheal diameters. Casein- and milk-specific IgE level, milk-specific basophil reactivity, and milk SPT wheal diameter are all significantly greater among patients with milk allergy who react to baked milk than among those who tolerate it. The majority of patients with milk allergy are able to tolerate some forms of baked milk in their diets. Different phenotypes of children with cow's milk allergy can be distinguished by casein- and milk-specific IgE levels, milk-specific basophil reactivity, and milk SPT mean wheal diameters. Spontaneous basophil activation is greater among patients with more severe clinical milk reactivity. BACKGROUND: In our previous study about 75% of children with cow's milk allergy tolerated baked milk products, which improved their prognosis and quality of life. OBJECTIVE: We sought to identify biomarkers of varying degrees of clinical tolerance among a cohort of children with cow's milk allergy. METHODS: One hundred thirty-two subjects were initially classified as baked milk–reactive, baked milk–tolerant, or having “outgrown milk allergy” based on the results of oral food challenges. The baked milk–tolerant group was then divided into 3 groups based on the amount and degree of heat-denatured milk protein that they could tolerate. Serum was analyzed for allergen-specific IgE and IgG₄ levels, basophil reactivity was assessed in whole blood stimulated with serial 10-fold dilutions of milk protein, and skin prick tests (SPTs) were performed to commercial milk extract. Activated basophils were defined by using flow cytometry as CD63ᵇʳⁱᵍʰᵗCD203c⁺CD123⁺HLA-DRᵈⁱᵐ/⁻CD41a⁻lineage⁻. Data were analyzed by using the Jonckheere-Terpstra test. RESULTS: Significant differences across the 5 clinical groups were seen for median casein- and milk-specific IgE levels, casein-specific IgG₄ levels, and casein IgE/IgG₄ ratios; milk-specific to nonspecific basophil activation ratio, median basophil reactivity, and spontaneous basophil activation (CD203c expression after stimulation with RPMI); and milk SPT wheal diameters. Casein- and milk-specific IgE level, milk-specific basophil reactivity, and milk SPT wheal diameter are all significantly greater among patients with milk allergy who react to baked milk than among those who tolerate it. CONCLUSIONS: The majority of patients with milk allergy are able to tolerate some forms of baked milk in their diets. Different phenotypes of children with cow's milk allergy can be distinguished by casein- and milk-specific IgE levels, milk-specific basophil reactivity, and milk SPT mean wheal diameters. Spontaneous basophil activation is greater among patients with more severe clinical milk reactivity. In our previous study about 75% of children with cow's milk allergy tolerated baked milk products, which improved their prognosis and quality of life.BACKGROUNDIn our previous study about 75% of children with cow's milk allergy tolerated baked milk products, which improved their prognosis and quality of life.We sought to identify biomarkers of varying degrees of clinical tolerance among a cohort of children with cow's milk allergy.OBJECTIVEWe sought to identify biomarkers of varying degrees of clinical tolerance among a cohort of children with cow's milk allergy.One hundred thirty-two subjects were initially classified as baked milk-reactive, baked milk-tolerant, or having "outgrown milk allergy" based on the results of oral food challenges. The baked milk-tolerant group was then divided into 3 groups based on the amount and degree of heat-denatured milk protein that they could tolerate. Serum was analyzed for allergen-specific IgE and IgG(4) levels, basophil reactivity was assessed in whole blood stimulated with serial 10-fold dilutions of milk protein, and skin prick tests (SPTs) were performed to commercial milk extract. Activated basophils were defined by using flow cytometry as CD63(bright)CD203c(+)CD123(+)HLA-DR(dim/-)CD41a(-)lineage(-). Data were analyzed by using the Jonckheere-Terpstra test.METHODSOne hundred thirty-two subjects were initially classified as baked milk-reactive, baked milk-tolerant, or having "outgrown milk allergy" based on the results of oral food challenges. The baked milk-tolerant group was then divided into 3 groups based on the amount and degree of heat-denatured milk protein that they could tolerate. Serum was analyzed for allergen-specific IgE and IgG(4) levels, basophil reactivity was assessed in whole blood stimulated with serial 10-fold dilutions of milk protein, and skin prick tests (SPTs) were performed to commercial milk extract. Activated basophils were defined by using flow cytometry as CD63(bright)CD203c(+)CD123(+)HLA-DR(dim/-)CD41a(-)lineage(-). Data were analyzed by using the Jonckheere-Terpstra test.Significant differences across the 5 clinical groups were seen for median casein- and milk-specific IgE levels, casein-specific IgG(4) levels, and casein IgE/IgG(4) ratios; milk-specific to nonspecific basophil activation ratio, median basophil reactivity, and spontaneous basophil activation (CD203c expression after stimulation with RPMI); and milk SPT wheal diameters. Casein- and milk-specific IgE level, milk-specific basophil reactivity, and milk SPT wheal diameter are all significantly greater among patients with milk allergy who react to baked milk than among those who tolerate it.RESULTSSignificant differences across the 5 clinical groups were seen for median casein- and milk-specific IgE levels, casein-specific IgG(4) levels, and casein IgE/IgG(4) ratios; milk-specific to nonspecific basophil activation ratio, median basophil reactivity, and spontaneous basophil activation (CD203c expression after stimulation with RPMI); and milk SPT wheal diameters. Casein- and milk-specific IgE level, milk-specific basophil reactivity, and milk SPT wheal diameter are all significantly greater among patients with milk allergy who react to baked milk than among those who tolerate it.The majority of patients with milk allergy are able to tolerate some forms of baked milk in their diets. Different phenotypes of children with cow's milk allergy can be distinguished by casein- and milk-specific IgE levels, milk-specific basophil reactivity, and milk SPT mean wheal diameters. Spontaneous basophil activation is greater among patients with more severe clinical milk reactivity.CONCLUSIONSThe majority of patients with milk allergy are able to tolerate some forms of baked milk in their diets. Different phenotypes of children with cow's milk allergy can be distinguished by casein- and milk-specific IgE levels, milk-specific basophil reactivity, and milk SPT mean wheal diameters. Spontaneous basophil activation is greater among patients with more severe clinical milk reactivity. |
| Author | Nowak-Węgrzyn, Anna H. Sampson, Hugh A. Bloom, Katherine A. Masilamani, Madhan Ford, Lara S. Shreffler, Wayne G. |
| Author_xml | – sequence: 1 givenname: Lara S. surname: Ford fullname: Ford, Lara S. organization: Jaffe Food Allergy Institute, Mount Sinai School of Medicine, New York, NY – sequence: 2 givenname: Katherine A. surname: Bloom fullname: Bloom, Katherine A. organization: Jaffe Food Allergy Institute, Mount Sinai School of Medicine, New York, NY – sequence: 3 givenname: Anna H. surname: Nowak-Węgrzyn fullname: Nowak-Węgrzyn, Anna H. organization: Jaffe Food Allergy Institute, Mount Sinai School of Medicine, New York, NY – sequence: 4 givenname: Wayne G. surname: Shreffler fullname: Shreffler, Wayne G. organization: Massachusetts General Hospital, Boston, Mass – sequence: 5 givenname: Madhan surname: Masilamani fullname: Masilamani, Madhan organization: Jaffe Food Allergy Institute, Mount Sinai School of Medicine, New York, NY – sequence: 6 givenname: Hugh A. surname: Sampson fullname: Sampson, Hugh A. email: Hugh.Sampson@mssm.edu organization: Jaffe Food Allergy Institute, Mount Sinai School of Medicine, New York, NY |
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| ContentType | Journal Article |
| Copyright | 2012 American Academy of Allergy, Asthma & Immunology American Academy of Allergy, Asthma & Immunology 2014 INIST-CNRS Copyright © 2012 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved. Copyright Elsevier Limited Jan 2013 |
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| Keywords | immunomodulation basophil activation SPT immunotherapy extensively heated baked Cow's milk allergy biomarker tolerance Skin prick test Food allergy Immunopathology Temperature Immunoglobulins Immunomodulation Granulocyte Biological marker Tolerance Environmental factor Activation Basophil Protein Bak Heat Immunology Reactivity Treatment Immunotherapy Digestive diseases Cow milk |
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| Snippet | In our previous study about 75% of children with cow's milk allergy tolerated baked milk products, which improved their prognosis and quality of life.
We... Background In our previous study about 75% of children with cow's milk allergy tolerated baked milk products, which improved their prognosis and quality of... Background: In our previous study about 75% of children with cow's milk allergy tolerated baked milk products, which improved their prognosis and quality of... In our previous study about 75% of children with cow's milk allergy tolerated baked milk products, which improved their prognosis and quality of... BACKGROUND: In our previous study about 75% of children with cow's milk allergy tolerated baked milk products, which improved their prognosis and quality of... |
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| SubjectTerms | Adolescent Age Allergic diseases Allergies Allergy and Immunology Animals baked basophil activation basophils Basophils - immunology Biological and medical sciences biomarker Biomarkers blood serum casein Cattle Child Child, Preschool children Cow's milk allergy Digestive allergic diseases extensively heated Female flow cytometry Food Food allergies Fundamental and applied biological sciences. Psychology Fundamental immunology Humans Immune Tolerance immunoglobulin E Immunoglobulin E - blood Immunoglobulin E - immunology immunoglobulin G Immunoglobulin G - blood Immunoglobulin G - immunology immunomodulation Immunopathology Immunotherapy Male Mast Cells - immunology Medical sciences Milk Milk - adverse effects milk allergy Milk Hypersensitivity - diagnosis Milk Hypersensitivity - immunology Patients phenotype Pizza prognosis Proteins Quality of life ROC Curve Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis Skin Tests tolerance |
| Title | Basophil reactivity, wheal size, and immunoglobulin levels distinguish degrees of cow's milk tolerance |
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