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| |  Peptide Microarray Immunoassay Could Help Predict Phenotype, Severity of Milk Allergy in Children: Presented at AAAAI By Carole VanSickle Ellis NEW ORLEANS -- February 28, 2010 -- In infancy, nearly 2.5% of infants show an allergy to cow’s milk; however, only 15% to 20% keep that allergy through childhood to adulthood. New research presented here at the 2010 American Academy of Allergy, Asthma & Immunology (AAAAI) Annual Meeting indicates that certain epitopes may indicate how these changes will occur. “We hope that these data regarding young children and these predictions will help determine what children will and will not outgrow a milk allergy,” said Julie Wang, MD, Mount Sinai Medical Center, New York, New York, on February 27. In the study, 41 patients aged younger than 18 years were selected from a larger clinical study based around analysis of the effects of ingesting heat-denatured milk proteins on milk-allergic individuals. Patients were divided into groups based on the severity of their food allergy, so that 17 were allergic to milk in all forms, 16 were allergic to milk unless it was heated, 8 had outgrown their milk allergy completely, and 11 made up the control group which had no milk allergy at any point in any form. Epitope diversity was analysed using microarray immunoassay. Isolated, single-peptide reactions were not counted in the results since these were expected and considered normal. The microarray immunoassay was used to establish patterns of diversity and binding for immunoglobulin E (IgE) and immunoglobulin G4 (IgG4) milk epitopes so that the patterns for the different allergy classifications could be compared and contrasted. These patterns may help identify clinical phenotypes of milk allergy and predict the severity and duration of a milk allergy condition. Patients who had a persistent milk allergy had increased epitope diversity, with high IgE binding and high IgG4 binding, indicating the presence of an allergic reaction in the system. However, individuals who were “less allergic” and could consume heated milk without adverse effects had similar IgG4 binding patterns to the allergic group, but IgE binding patterns more similar to those who had outgrown their milk allergy. The more severe the reaction during the food challenges, the greater the binding of IgE peptides. IgG4 peptides had no discernible correlation with the severity of the reaction during a challenge. The researchers were able to conclude that IgE epitope diversity on peptide microarray correlated with clinical phenotypes of milk allergy and the severity of a patient’s milk allergy. Funding for this study was provided by the National Institute of Allergy and Infectious Diseases. [Presentation title: Correlation of IgE and IgG4 Milk Epitopes With Different Clinical Phenotypes of Milk Allergy Using Microarray Immunoassay. Abstract 229]
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