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Use of IgE and IgG4 epitope binding to predict the outcome of oral immunotherapy in cow’s milk allergy. 2015

Pediatr Allergy Immunol. Author manuscript; available in PMC 2015 May 1.
Published in final edited form as:
PMCID: PMC3997594
NIHMSID: NIHMS548748

Changes in IgE and IgG4 epitope binding profiles associated with the outcome of oral immunotherapy in cow’s milk allergy

Emma M. Savilahti, MD, PhD,a Mikael Kuitunen, MD, PhD,a Miko Valori, BSc,b Ville Rantanen, MSc,b Ludmilla Bardina, MSc,c Gustavo Gimenez, BSc,c Mika J. Mäkelä, MD, PhD,d Sampsa Hautaniemi, DTech,b Erkki Savilahti, MD PhD,a and Hugh A. Sampson, MDc
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The publisher’s final edited version of this article is available at Pediatr Allergy Immunol

Abstract

Background

Oral immunotherapy (OIT) with cow’s milk (CM) has been reported to induce a number of specific antibody responses, but these remain to be fully characterized. Our objective was to explore whether IgE and IgG4 epitope binding profiles could predict the risk of side effects during cow’s milk OIT.

Methods

The study population consisted of 32 children (6 – 17 years of age) with cow’s milk allergy: 26 children who successfully completed OIT and 6 children who discontinued therapy due to adverse reactions. We investigated sera drawn before and after OIT. We analyzed specific IgE and IgG4 binding to CM protein derived peptides with a microarray based immunoassay. Antibody binding affinity was analyzed with a competition assay where CM proteins in solution competed with peptides printed on the microarray.

Results

IgE binding to CM peptides decreased and IgG4 binding increased following the OIT in children who attained desensitization. Compared with children who successfully completed OIT, those who discontinued OIT due to adverse reactions developed increased quantities and affinity of epitope-specific IgE antibodies and a broader diversity of IgE and IgG4 binding, but less overlap in IgE and IgG4 binding to CM peptides.

Conclusions

Detailed analysis of IgE and IgG4 binding to CM peptides may help in predicting whether CM OIT will be tolerated successfully. It may thus improve the safety of the therapy.

Keywords: antibody affinity, cow’s milk allergy, epitope, IgE, IgG4, oral immunotherapy, peptide

LINK TO: Use of IgE and IgG4 epitope binding to predict the outcome of oral immunotherapy in cow’s milk allergy. Pediatr Allergy Immunol. 2014 May;25(3):227-35.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3997594/

 

 

in Medical Journals: OIT Publications 2015

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