Allergy Asthma Immunol Res.  2014 Mar;6(2):121-125. 10.4168/aair.2014.6.2.121.

Usefulness of nBos d 4, 5 and nBos d 8 Specific IgE Antibodies in Cow's Milk Allergic Children

• Cingolani
• Di Pillo S
• Cerasa M
• Rapino D
• Consilvio
• Attanasi M
• Scaparrotta A
• Marcovecchio ML
• Mohn A
• Chiarelli

• KMID: 2260255
• DOI: http://doi.org/10.4168/aair.2014.6.2.121

Abstract

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.

Keyword

child; symptoms; milk; allergy; recombinant proteins

MeSH Terms

Anaphylaxis
Antibodies*
Child*
Eating
Humans
Hypersensitivity
Immunoglobulin E*
Methods
Milk*
Phenotype
Recombinant Proteins
Skin
Antibodies
Immunoglobulin E
Recombinant Proteins

Figure

• 

  Fig. 1 ROC curve for the recombinant allergens (nBos d 4, nBos d 5, nBos d 8) and the recombinants' sum.

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