Differential response in allergen-specific IgE, IgGs, and IgA levels for predicting outcome of oral immunotherapy.

Abstract

BACKGROUND:

Oral immunotherapy (OIT) induces desensitization and/or tolerance in patients with persistent food allergy, but the biomarkers of clinical outcomes remain obscure. Although OIT-induced changes in serum allergen-specific IgE and IgG4 levels have been investigated, the response of other allergen-specific IgG subclasses and IgA during OIT remains obscure.

METHODS:

A pilot study was conducted to investigate egg OIT-induced changes in allergen-specific IgE, IgG subclasses, and IgA levels and search for possible prediction biomarkers of desensitization. We measured serum levels of egg white-, ovomucoid-, and ovalbumin-specific IgE, IgA, and IgG subclasses by high-sensitivity allergen microarray in 26 children with egg allergy who received rush OIT.

RESULTS:

Allergen-specific IgE gradually decreased while IgG4 increased during 12-month OIT. Serum levels of IgG1, IgG3, and IgA increased significantly after the rush phase, then decreased during the maintenance phase. IgG2 levels changed in a manner similar to that of IgG4. In particular, significantly high fold increases in egg white-specific IgG1, relative to baseline, after the rush phase and high IgA levels before OIT were observed in responders, compared with low-responders to OIT. Patients who could not keep desensitization showed relatively small changes in all immunoglobulin levels during OIT.

CONCLUSION:

The response to OIT was associated with significant increases in serum allergen-specific IgG1 levels after rush phase and high baseline IgA levels, compared with small changes in immunoglobulin response in low-responders. The characteristic IgG1 changes and IgA levels in the responders could be potentially useful biomarkers for the prediction of positive clinical response to OIT.

• Authors: Mayumi Sugimoto, Norio Kamemura, Mizuho Nagao, Makoto Irahara, Shoji Kagami, Takao Fujisawa, Hiroshi Kido
• Journal: Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology (Pediatr Allergy Immunol) Vol. 27 Issue 3 Pg. 276-82 (05 2016) ISSN: 1399-3038 [Electronic] England
• PMID: 26764899 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © 2016 The Authors. Pediatric Allergy and Immunology Published by John Wiley & Sons Ltd.

Chemical References

• Allergens
• Biomarkers
• Immunoglobulins

Topics

• Administration, Oral
• Allergens (immunology)
• Biomarkers (blood)
• Child
• Child, Preschool
• Desensitization, Immunologic (methods)
• Egg Hypersensitivity (immunology)
• Female
• Humans
• Immunoglobulins (blood)
• Male
• Pilot Projects
• Treatment Outcome