Food Specific IgE as A Biomarker of Oral Immunotherapy Efficacy in Comparison to Double Blind Food Challenge Test

• Published in: The Egyptian journal of immunology Vol. 24; no. 2; p. 109
• Main Authors: ELBadawy, Nissreen E, Abdel-Latif, Randa S
• Format: Journal Article
• Language: English
• Published: Egypt 01.06.2017
• ISSN: 1110-4902

Specific immunotherapy (SIT) is one of the important lines for the treatment of food allergy. Efficacy tests for clinical response to SIT are limited and subjective. In this study, we aimed to evaluate the validity of food specific Ig E levels as a biomarker of clinical improvement in children with food allergy treated with oral immunotherapy (OIT). We analysed 184 children with food allergy, 143 had undergone 2 years of food OIT and 41 were on allergen restricted diet and considered as control. All patients were subjected to Double-Blind Placebo-Controlled Food Challenge test (DBPCFC), allergic symptom score calculation, and serum food specific Ig E level before and after oral immunotherapy for treated patients and after 2 year of allergen restricted diet for the control group. Receiver Ooperating Ccharacteristic Ccurves (ROCs) analysis was done to determine the cut off, areas under the curve, sensitivity, and specificity were calculated for the specific Ig E test. According to the result of DBPCFC and result of food specific Ig E test, milk Milk allergy was the most frequently food allergy as it was encountered in 76 children out of 184 children (41.3%) , followed by egg and fish allergy in 64(34.7%), and 44 (23.7%) cases, respectively. Oral desensitization was successful in 91 %, 82%, and 67% of patients with milk, Egg, and fish allergy, respectively. The OIT group showed a statistically significant greater reduction in symptom scores compared to the control group (P < 0.001). Also, there was a significant decrease in food specific Ig E level in responders for all types of food allergy tested (P ˂0.001), and . In responders group, there was significant correlation between the specific IgE level and symptom scores (r = 0.5, P = 0.03). Food specific Ig E levels cut off levels were < 0.8, < 2.05, and < 23 IU/ml allowed detection of effective OIT for milk, egg, and fish allergy, respectively. It is concluded that serum specific Ig E is correlated correlates with the clinical response to OIT and offers an advantage over double blind challenge test which is a risky and time consuming process.