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Clinical reactivity to beef in children allergic to cow's milk.
J Allergy Clin Immunol 1997; 99(3):293-300JA

Abstract

BACKGROUND

Cow's milk is one of the most common food allergens in children. Limited information is available on the prevalence of reactivity to a related food source, beef. The purposes of this study were to examine the prevalence of symptomatic sensitivity to beef in a selected pediatric population and to determine the frequency of concomitant reactivity to cow's milk and beef.

METHODS

Children referred for assessment of atopic dermatitis and possible food hypersensitivity were evaluated for symptomatic reactivity to beef by double-blind placebo-controlled food challenges (DBPCFCs) and subsequent open feedings of beef. Sodium dodecyl-sulfate-polyacrylamide gel electrophoresis (SDS-PAGE), immunoblot, and immunodot blot analyses were performed with patients' sera on preparations of beef extracts subjected to different cooking conditions: raw (no heating), medium, and well-cooked.

RESULTS

Eleven of 335 children referred for evaluation of atopic dermatitis and possible food hypersensitivity were found to have symptomatic sensitivity to beef; eight were also sensitive to milk, as demonstrated in previous DBPCFCs. Eight patients reacted to beef during DBPCFC, and three tolerated beef in a DBPCFC and well-cooked beef in an open challenge but reacted to ingestion of less well-cooked beef. SDS-PAGE of raw beef revealed at least 24 protein fractions. Several protein bands in raw beef appeared to denature with heating. Bovine serum albumin and bovine gamma globulin were heat-labile in the beef extract, but six protein fractions persisted even after heating the beef extract for 2 hours at 85 degrees C. IgE from patients reacting to rare and well-cooked beef bound up to six of these heat-resistant fractions, but IgE from patients reacting only to rare beef failed to bind any of these fractions with one exception. In addition, patients reacting to rare and well-cooked beef had specific IgE to a 17.8 kd fraction, which was only weakly recognized by one patient reacting only to rare beef.

CONCLUSIONS

Specific IgE antibodies to heat-labile beef proteins might explain why some patients can tolerate well-cooked beef but not medium-rare and rare beef. Patients reacting only to rare beef may not need to maintain a complete beef elimination diet.

Authors+Show Affiliations

Department of Pediatrics, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.No affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Controlled Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

9058683

Citation

Werfel, S J., et al. "Clinical Reactivity to Beef in Children Allergic to Cow's Milk." The Journal of Allergy and Clinical Immunology, vol. 99, no. 3, 1997, pp. 293-300.
Werfel SJ, Cooke SK, Sampson HA. Clinical reactivity to beef in children allergic to cow's milk. J Allergy Clin Immunol. 1997;99(3):293-300.
Werfel, S. J., Cooke, S. K., & Sampson, H. A. (1997). Clinical reactivity to beef in children allergic to cow's milk. The Journal of Allergy and Clinical Immunology, 99(3), pp. 293-300.
Werfel SJ, Cooke SK, Sampson HA. Clinical Reactivity to Beef in Children Allergic to Cow's Milk. J Allergy Clin Immunol. 1997;99(3):293-300. PubMed PMID: 9058683.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical reactivity to beef in children allergic to cow's milk. AU - Werfel,S J, AU - Cooke,S K, AU - Sampson,H A, PY - 1997/3/1/pubmed PY - 1997/3/1/medline PY - 1997/3/1/entrez SP - 293 EP - 300 JF - The Journal of allergy and clinical immunology JO - J. Allergy Clin. Immunol. VL - 99 IS - 3 N2 - BACKGROUND: Cow's milk is one of the most common food allergens in children. Limited information is available on the prevalence of reactivity to a related food source, beef. The purposes of this study were to examine the prevalence of symptomatic sensitivity to beef in a selected pediatric population and to determine the frequency of concomitant reactivity to cow's milk and beef. METHODS: Children referred for assessment of atopic dermatitis and possible food hypersensitivity were evaluated for symptomatic reactivity to beef by double-blind placebo-controlled food challenges (DBPCFCs) and subsequent open feedings of beef. Sodium dodecyl-sulfate-polyacrylamide gel electrophoresis (SDS-PAGE), immunoblot, and immunodot blot analyses were performed with patients' sera on preparations of beef extracts subjected to different cooking conditions: raw (no heating), medium, and well-cooked. RESULTS: Eleven of 335 children referred for evaluation of atopic dermatitis and possible food hypersensitivity were found to have symptomatic sensitivity to beef; eight were also sensitive to milk, as demonstrated in previous DBPCFCs. Eight patients reacted to beef during DBPCFC, and three tolerated beef in a DBPCFC and well-cooked beef in an open challenge but reacted to ingestion of less well-cooked beef. SDS-PAGE of raw beef revealed at least 24 protein fractions. Several protein bands in raw beef appeared to denature with heating. Bovine serum albumin and bovine gamma globulin were heat-labile in the beef extract, but six protein fractions persisted even after heating the beef extract for 2 hours at 85 degrees C. IgE from patients reacting to rare and well-cooked beef bound up to six of these heat-resistant fractions, but IgE from patients reacting only to rare beef failed to bind any of these fractions with one exception. In addition, patients reacting to rare and well-cooked beef had specific IgE to a 17.8 kd fraction, which was only weakly recognized by one patient reacting only to rare beef. CONCLUSIONS: Specific IgE antibodies to heat-labile beef proteins might explain why some patients can tolerate well-cooked beef but not medium-rare and rare beef. Patients reacting only to rare beef may not need to maintain a complete beef elimination diet. SN - 0091-6749 UR - https://www.unboundmedicine.com/medline/citation/9058683/Clinical_reactivity_to_beef_in_children_allergic_to_cow's_milk_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0091-6749(97)70045-9 DB - PRIME DP - Unbound Medicine ER -