즉시형 우유 알레르기 환자에서 카제인 특이 IgE와 IgG의 유용성
Usefulness of casein specific IgE and IgG antibodies to immediate type cow’s milk allergy
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Purpose: Cow’s milk-specific IgE (CM-IgE) has been proposed as one of the valuable markers for diagnosis of clinical cow’s milk (CM) allergy. In this study, we evaluated the additional usefulness of casein-specific IgE (casein-IgE) and IgG (casein-IgG) for the diagnosis of clinical CM allergy. Methods: Fifty-eight subjects, aged from 3 months to 154 months, were enrolled. Thirty-four patients showed immediate-type of clinical CM allergy, and 24 patients were atopic controls. The serum levels of CM-IgE, casein-IgE, and casein-IgG were measured. Patients were divided into 2 groups: those aged under 12 months and those aged 12 months or over. The diagnostic values of each antibody were analyzed and compared using the Mann-Whitney U-test and receiver operating characteristic curves. Results: CM allergy had significantly higher levels of CM-IgE and casein-IgE, and lower levels of casein-IgG/IgE ratio when compared to atopic controls in both age groups (P<0.05). CM-IgE and casein-IgE were shown to be better predictive markers for immediate-type CM allergy in patients under 12 months, while casein-IgG/IgE ratio was a more useful marker in those aged 12 months or over. Considering 100% positive predictive values, cutoff points were 1.04 kU/L for CM-IgE, 0.11 kU/L for casein-IgE, 19.5 for casein-IgG/IgE ratio in patients aged under 12 months, and 7.1 kU/L for CM-IgE, 1.41 kU/L for casein-IgE, 12.51 for casein-IgG/IgE ratio in those aged 12 months or over. Conclusion: CM-IgE, casein-IgE, and casein-IgG/IgE ratio are useful markers for predicting immediate-type CM allergy. Further studies are needed on diagnostic decision points for CM allergy using combination of cutoff values of these 3 markers.
Abstract
Purpose: Cow’s milk-specific IgE (CM-IgE) has been proposed as one of the valuable markers for diagnosis of clinical cow’s milk (CM) allergy. In this study, we evaluated the additional usefulness of casein-specific IgE (casein-IgE) and IgG (casein-IgG) for the diagnosis of clinical CM allergy. Methods: Fifty-eight subjects, aged from 3 months to 154 months, were enrolled. Thirty-four patients showed immediate-type of clinical CM allergy, and 24 patients were atopic controls. The serum levels of CM-IgE, casein-IgE, and casein-IgG were measured. Patients were divided into 2 groups: those aged under 12 months and those aged 12 months or over. The diagnostic values of each antibody were analyzed and compared using the Mann-Whitney U-test and receiver operating characteristic curves. Results: CM allergy had significantly higher levels of CM-IgE and casein-IgE, and lower levels of casein-IgG/IgE ratio when compared to atopic controls in both age groups (P<0.05). CM-IgE and casein-IgE were shown to be better predictive markers for immediate-type CM allergy in patients under 12 months, while casein-IgG/IgE ratio was a more useful marker in those aged 12 months or over. Considering 100% positive predictive values, cutoff points were 1.04 kU/L for CM-IgE, 0.11 kU/L for casein-IgE, 19.5 for casein-IgG/IgE ratio in patients aged under 12 months, and 7.1 kU/L for CM-IgE, 1.41 kU/L for casein-IgE, 12.51 for casein-IgG/IgE ratio in those aged 12 months or over. Conclusion: CM-IgE, casein-IgE, and casein-IgG/IgE ratio are useful markers for predicting immediate-type CM allergy. Further studies are needed on diagnostic decision points for CM allergy using combination of cutoff values of these 3 markers.
참고문헌 (24)
- Ahn K, "Prevalence of immediate-type food allergy in Korean schoolchildren : a population-based study", Allergy Asthma Proc, 33, pp.481~487 (2012)
- Kim J, "The incidence and risk factors of immediate type food allergy during the first year of life in Korean infants : a birth cohort study", Pediatr Allergy Immunol, 22, pp.715~719 (2011)
- Sicherer SH, "Epidemiology of food allergy", J Allergy Clin Immunol, 127, pp.594~602 (2011)
- 박미란, "Prevalence of Immediate-Type Food Allergy in Early Childhood in Seoul", Allergy, Asthma & Immunology Research, 6(2), pp.131~136 (2014), 대한천식알레르기학회
- Host A, "Clinical course of cow's milk protein allergy", intolerance and atopic diseases in childhood, 2002, pp.13(Suppl 15), 23~28
- Wood RA, "The natural history of milk allergy in an observational cohort", J Allergy Clin Immunol, 131, pp.805~812 (2013)
- Rona RJ, "The prevalence of food allergy : a meta-analysis", J Allergy Clin Immunol, 120, pp.638~646 (2007)
- Hochwallner H, "Cow's milk allergy: from allergens to new forms of diagnosis, therapy and prevention", Methods, 66, pp.22~33 (2014)
- Host A, "Cow's milk allergy: where have we come from and where are we going?", Endocr Metab Immune Disord Drug Targets, 14, pp.2~8 (2014)
- Nicolaou N, "Reintroduction of cow's milk in milk-allergic children", Endocr Metab Immune Disord Drug Targets, 14, pp.54~62 (2014)
- Ito K, "The usefulness of casein-specific IgE and IgG4 antibodies in cow's milk allergic children", Clin Mol Allergy, 10, pp.1~ (2012)
- Garcia-Careaga M Jr, "Gastrointestinal manifestations of food allergies in pediatric patients", Nutr Clin Pract, 20, pp.526~535 (2005)
- Garcia-Ara C, "Specific IgE levels in the diagnosis of immediate hypersensitivity to cows' milk protein in the infant", J Allergy Clin Immunol, 107, pp.185~190 (2001)
- Ahrens B, "Individual cow's milk allergens as prognostic markers for tolerance development?", Clin Exp Allergy, 42, pp.1630~1637 (2012)
- Garcia-Ara MC, "Cow's milk-specific immunoglobulin E levels as predictors of clinical reactivity in the follow-up of the cow's milk allergy infants", Clin Exp Allergy, 34, pp.866~870 (2004)
- Chatchatee P, "Identification of IgE-and IgG-binding epitopes on alpha(s1)-casein : differences in patients with persistent and transient cow's milk allergy", J Allergy Clin Immunol, 107, pp.379~383 (2001)
- Buchanan AD, "Egg oral immunotherapy in nonanaphylactic children with egg allergy", J Allergy Clin Immunol, 119, pp.199~205 (2007)
- Jones SM, "Clinical efficacy and immune regulation with peanut oral immunotherapy", J Allergy Clin Immunol, 124, pp.292~300 (2009)
- van Neerven RJ, "IgE-mediated allergen presentation and blocking antibodies : regulation of T-cell activation in allergy", Int Arch Allergy Immunol, 141, pp.119~129 (2006)
- Savilahti EM, "Specific antibodies to cow's milk proteins in infants : effect of early feeding and diagnosis of cow's milk allergy", Eur J Nutr, 49, pp.501~504 (2010)
- Jarvinen KM, "Role of maternal elimination diets and human milk IgA in the development of cow's milk allergy in the infants", Clin Exp Allergy, 44, pp.69~78 (2014)
- Sampson HA, "Relationship between food-specific IgE concentrations and the risk of positive food challenges in children and adolescents", J Allergy Clin Immunol, 100, pp.444~451 (1997)
- "Establishing a cut-off for the serum levels of specific IgE to milk and its components for cow’s milk allergy: Results from a specific population" (2014)[URL]
- 장광천, "한국 아나필락시스의 진료", Allergy Asthma & Respiratory Diseases, 1(3), pp.181~196 (2013), 대한 소아알레르기 호흡기학회