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KMID : 1225720140060020121
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Allergy, Asthma & Immunology Research : AAIR
2014 Volume.6 No. 2 p.121 ~ p.125
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Usefulness of nBos d 4, 5 and nBos d 8 Specific IgE Antibodies in Cow’s Milk Allergic Children
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Cingolani Anna
Pillo Sabrina Di
Cerasa Marzia
Rapino Daniele
Consilvio Nicola Pietro
Attanasi Marina
Scaparrotta Alessandra
Marcovecchio M. Loredana
Mohn Angelika
Chiarelli Francesco
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Abstract
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Purpose: The aim of study was to assess the value of recombinants in predicting the degree of symptoms in children with and without anaphylaxis to cow’s milk.
Methods: The study included 79 children (70±40 months) referred to the Allergological Unit of the Pediatric Department between the years 2008-2012. Group A was composed of 17 children (78±49.6 months) with anaphylaxis after ingestion of milk. Group B was composed of 62 children (73.1±38.6 months) without a history of anaphylaxis, but with less severe symptoms (gastrointestinal and/or skin symptoms). All patients from Group B had a positive open challenge with cow’s milk. All patients underwent an allergic evaluation and blood samples were collected to test for IgE to recombinans of milk (nBos d 4, 5, 8).
Results: A significant difference in nBos d 8 emerged with higher levels in Group A (median [IQR]=2.80 [0.91-16.1]) than B (0.65 [0.24-1.67]; P=0.006), whereas there were no statistically significant differences for nBos d 4 and 5. The recombinants’ sum was higher in Group A than B: 8.39 [2.72-41.39] vs 3.04 [1.85-7.31] kUA/L; P=0.044. The recombinant nBos d 8 was superior to the other recombinants in identifying children at risk for anaphylaxis, with an area under the curve of 0.718 (95% CI, 0.57-0.86, P=0.006). Considering a cutoff of 1.8 kUA/L, nBos d 8 had the most favorable sensitivity and specificity ratio (sensitivity=0.65, specificity=0.77) with an odd ratio of 6.02 (95% C.I: 1.89-19.23).
Conclusions: This study suggested 2 phenotypes of allergic children, “high-anaphylaxis-risk” and “milder-risk”. These types can be differentiated through measuring the level of IgE to nBos d 8.
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KEYWORD
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Child, symptoms, milk, allergy, recombinant proteins
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