华亿体育（中国）游戏平台

Release date：2018-11-26

JACI

[IF:13.1]

The diagnostic utility of serum assays for total IgG4 and specific IgG4 antibodies to cow's milk proteins in children with eosinophilic esophagitis: Comparison with an unselected birth cohort
DOI: https://doi.org/10.1016/j.jaci.2016.12.108
Abstract:
Rationale
Eosinophilic esophagitis (EoE) is associated with specific IgG4 antibodies (sIgG4) to common foods, especially cow’s milk (CM). Little is known regarding the epidemiology of sIgG4 to CM or other foods in the general population. Thus, the diagnostic utility of IgG4 assays is unclear.
Methods
We studied 67 children (median age=11 years) diagnosed with EoE by esophageal biopsy at The University of Virginia (Charlottesville, VA) or Nationwide Children’s Hospital (Columbus, OH); 101 controls (median age=12.8 years) from a birth cohort unselected for any disease (Project Viva); and 40 unrelated non-allergic controls (median age=12 years) without specific IgE antibodies (sIgE) to foods. Sera were assayed for sIgE and sIgG4 to CM proteins (alpha-lactalbumin, beta-lactoglobulin, caseins) and total IgG4 (tIgG4) by ImmunoCAP.
Results
The prevalence of CM sensitization (sIgE ≥0.10 IU/mL) among the pediatric EoE patients and unselected controls was 79% (n=53/67) and 22% (n=22/101), respectively. The titers of sIgG4 to the CM proteins were higher in EoE patients than in unselected controls (p<0.001). Elevated tIgG4 based on laboratory values (p<0.01) and sIgG4 to alpha-lactalbumin and caseins (p<0.001) were more common in EoE patients compared to unselected controls. Furthermore, the mean sIgG4 to CM (all three proteins) as a percentage of tIgG4 was higher in EoE patients than in unselected controls (p<0.001). Similar serological differences between EoE patients and non-allergic controls were also observed.
Conclusions
Among children with EoE, sIgG4 to CM can significantly contribute to tIgG4. The results suggest that titer of sIgG4 to CM proteins could be incorporated into a diagnostic algorithm for EoE.
© 2016 Published by Elsevier Inc.
All Authors: Alexander J. Schuyler Elizabeth A. Erwin Emily Oken Sheryl Rifas-Shiman Jonas Lidholm Jeffrey Wilson Anubha Tripathi Lisa J. Workman Diane R. Gold Thomas A.E. Platts-Mills

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