Component resolved diagnostic study of cow's milk allergy in infants and young children in northern China.

Abstract

BACKGROUND:

Increasing dairy consumption in China has been accompanied by rising incidence of milk allergy. Here we analyzed profiles of specific immunoglobulin E (sIgE) against cow's milk proteins, and assessed their value for milk allergy diagnosis among infants and young children from northern China.

METHODS:

Sera collected from 48 patients with milk allergy and 27 negative control subjects was analyzed by enzyme-linked immunosorbent assay to measure sIgE to α-lactalbumin (Bos d 4), β-lactoglobulin (Bos d 5), α-casein (Bos d 9), β-casein (Bos d 11), and κ-casein (Bos d 12).

RESULTS:

Among milk-allergic individuals, most were sensitized to at least one milk protein; about half were sensitized to Bos d 5, Bos d 9, Bos d 11 and Bos d 12, respectively, while few had positive serum sIgE against Bos d 4. Bos d 12 sIgE had the largest area under curve (AUC) (0.878; 95% CI, 0.800-0.957) and thus showed the best diagnostic performance in discriminating between milk-allergic and non-milk allergic patients, with a sensitivity of 92.6% and specificity of 72.9% using a statistically optimal cut-off value (OD450nm, 0.191). The combinations of Bos d 5 + Bos d 12 showed an AUC of 0.926, which was larger than for any individual components.

CONCLUSIONS:

Our results revealed inter-individual variation in the sensitization to different milk allergen component. Bos d 12 sIgE showed best performance in diagnosing milk allergy. Milk allergy diagnostic accuracy was further improved using combinations of milk allergen components by application of ROC curves based on logistic regression.

• Authors: Junpu Li, Jiayi Zhang, Cuiya Qiong, Tiantian She, Ying Bian, Shuxiang Lin, Huiqiang Li
• Journal: International immunopharmacology (Int Immunopharmacol) Vol. 61 Pg. 126-131 (Aug 2018) ISSN: 1878-1705 [Electronic] Netherlands
• PMID: 29859469 (Publication Type: Journal Article)
• Copyright: Copyright © 2018 Elsevier B.V. All rights reserved.

Chemical References

• Allergens
• Bos d 5 allergen, Bos taurus
• Lipocalins
• Immunoglobulin E

Topics

• Allergens (immunology)
• Animals
• Cattle
• Child, Preschool
• China
• Diagnosis, Differential
• Female
• Humans
• Immunoglobulin E (blood)
• Infant
• Infant, Newborn
• Lipocalins (immunology)
• Male
• Milk Hypersensitivity (diagnosis)
• Predictive Value of Tests
• Prognosis
• Reference Standards
• Sensitivity and Specificity