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Maintenance of tolerance to cow's milk in atopic individuals is characterized by high levels of specific immunoglobulin G4.
Clin Exp Allergy. 2007 Jul; 37(7):1103-10.CE

Abstract

BACKGROUND

The central role of specific IgE in cow's milk allergy (CMA) is well documented. However, less is known about the function of other immunoglobulin isotypes in allergy and tolerance to cow's milk proteins (CMPs).

OBJECTIVE

To determine differences in the antibody responses that are associated with allergy and tolerance to cow's milk in allergic, atopic and non-atopic individuals of different age groups.

METHODS

Nineteen infants (<1 year), 18 children (6-14 years) and 41 adults (21-68 years) were included. Each age group was comprised of subjects with CMA, atopic individuals without a history of CMA and non-atopic subjects. Levels of specific IgE, IgG4, IgG1 and IgA to whole cow's milk and the six most abundant individual CMPs were determined in plasma by ELISA. For comparison, specific IgE and IgG4 were measured to ovomucoid and house dust mite (HDM) in individuals allergic for the respective allergens, and in atopic and non-atopic subjects without allergy.

RESULTS

In infants and children with CMA, alphas1-casein and beta-lactoglobulin induced the highest specific IgE response, whereas alphas1-casein was the most allergenic CMP in adult patients. Specific IgG4 and IgG1 responses were the highest to alphas1-casein and beta-lactoglobulin in all age groups, while kappa-casein and alpha-lactalbumin induced the highest levels of IgA. CMP-specific IgG4 was higher in atopic children and adults without CMA, as compared with non-atopic individuals. A similar difference between tolerant atopic and non-atopic subjects was observed for IgG4 specific to ovomucoid, whereas HDM-specific IgG4 was not detectable in these subjects.

CONCLUSION

Maintenance of tolerance to cow's milk in atopic children and adults without CMA is associated with elevated levels of specific IgG4, in combination with low specific IgE. The up-regulation of specific IgG4 in tolerant atopic individuals may be related to the type of allergen and its regular dose of exposure.

Authors+Show Affiliations

Department of Dermatology/Allergology, University Medical Center, Utrecht, The Netherlands.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17581206

Citation

Ruiter, B, et al. "Maintenance of Tolerance to Cow's Milk in Atopic Individuals Is Characterized By High Levels of Specific Immunoglobulin G4." Clinical and Experimental Allergy : Journal of the British Society for Allergy and Clinical Immunology, vol. 37, no. 7, 2007, pp. 1103-10.
Ruiter B, Knol EF, van Neerven RJ, et al. Maintenance of tolerance to cow's milk in atopic individuals is characterized by high levels of specific immunoglobulin G4. Clin Exp Allergy. 2007;37(7):1103-10.
Ruiter, B., Knol, E. F., van Neerven, R. J., Garssen, J., Bruijnzeel-Koomen, C. A., Knulst, A. C., & van Hoffen, E. (2007). Maintenance of tolerance to cow's milk in atopic individuals is characterized by high levels of specific immunoglobulin G4. Clinical and Experimental Allergy : Journal of the British Society for Allergy and Clinical Immunology, 37(7), 1103-10.
Ruiter B, et al. Maintenance of Tolerance to Cow's Milk in Atopic Individuals Is Characterized By High Levels of Specific Immunoglobulin G4. Clin Exp Allergy. 2007;37(7):1103-10. PubMed PMID: 17581206.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Maintenance of tolerance to cow's milk in atopic individuals is characterized by high levels of specific immunoglobulin G4. AU - Ruiter,B, AU - Knol,E F, AU - van Neerven,R J J, AU - Garssen,J, AU - Bruijnzeel-Koomen,C A F M, AU - Knulst,A C, AU - van Hoffen,E, PY - 2007/6/22/pubmed PY - 2007/10/12/medline PY - 2007/6/22/entrez SP - 1103 EP - 10 JF - Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology JO - Clin. Exp. Allergy VL - 37 IS - 7 N2 - BACKGROUND: The central role of specific IgE in cow's milk allergy (CMA) is well documented. However, less is known about the function of other immunoglobulin isotypes in allergy and tolerance to cow's milk proteins (CMPs). OBJECTIVE: To determine differences in the antibody responses that are associated with allergy and tolerance to cow's milk in allergic, atopic and non-atopic individuals of different age groups. METHODS: Nineteen infants (<1 year), 18 children (6-14 years) and 41 adults (21-68 years) were included. Each age group was comprised of subjects with CMA, atopic individuals without a history of CMA and non-atopic subjects. Levels of specific IgE, IgG4, IgG1 and IgA to whole cow's milk and the six most abundant individual CMPs were determined in plasma by ELISA. For comparison, specific IgE and IgG4 were measured to ovomucoid and house dust mite (HDM) in individuals allergic for the respective allergens, and in atopic and non-atopic subjects without allergy. RESULTS: In infants and children with CMA, alphas1-casein and beta-lactoglobulin induced the highest specific IgE response, whereas alphas1-casein was the most allergenic CMP in adult patients. Specific IgG4 and IgG1 responses were the highest to alphas1-casein and beta-lactoglobulin in all age groups, while kappa-casein and alpha-lactalbumin induced the highest levels of IgA. CMP-specific IgG4 was higher in atopic children and adults without CMA, as compared with non-atopic individuals. A similar difference between tolerant atopic and non-atopic subjects was observed for IgG4 specific to ovomucoid, whereas HDM-specific IgG4 was not detectable in these subjects. CONCLUSION: Maintenance of tolerance to cow's milk in atopic children and adults without CMA is associated with elevated levels of specific IgG4, in combination with low specific IgE. The up-regulation of specific IgG4 in tolerant atopic individuals may be related to the type of allergen and its regular dose of exposure. SN - 0954-7894 UR - https://www.unboundmedicine.com/medline/citation/17581206/Maintenance_of_tolerance_to_cow's_milk_in_atopic_individuals_is_characterized_by_high_levels_of_specific_immunoglobulin_G4_ L2 - https://doi.org/10.1111/j.1365-2222.2007.02749.x DB - PRIME DP - Unbound Medicine ER -