Calderon T E, Ferrero M, Marino G M, Cordoba A, Beltramo D, Muino J C, Rabinovich G A, Romero M D
Division de Alergia, Hospital Transito Caceres de Allende, Cordoba, Spain.
J Biol Regul Homeost Agents. 2010 Jul-Sep;24(3):261-71.
IgE-mediated responses play a pivotal role in allergic patients with food intolerance. However, the association of food-specific IgG and IgA antibodies with the clinical outcome of allergic patients is still a matter of controversy. In this study we investigate whether beef-specific IgG and IgA antibodies may coexist with beef-specific IgE antibodies in food-allergic patients and examined their clinical relevance in different allergic settings. Beef-specific IgE, IgG and IgA antibodies were determined by solid-phase enzymoimmunoassay (ELISA) in a population of allergic patients (N=125) classified into patients with asthma, skin disease or gastrointestinal disorders, as well as in control subjects (N=80). IgE antibodies specific for citric fruits, tomato, cows milk, chickens egg and wheat were also determined. Beef was the predominant allergenic food in the whole population, not only for IgE (57.6 percent; P less than 0.001), but also for IgG and IgA isotypes (53.6 percent and 34.0 percent, respectively, P less than 0.001). Beef-specific IgE, IgG and IgA antibodies increased significantly in sera from patients with asthma, gastrointestinal disorders and skin allergy compared to sera from control subjects (P less than 0.001). Remarkably, IgG and IgA isotypes were significantly detected, even in the absence of IgE, in the three allergic conditions. All allergic patients, including those showing only IgG and IgA antibodies, significantly ameliorated their symptoms, and their levels of beef-specific antibodies were considerably reduced in response to a cow meat exclusion diet. While patients with gastrointestinal or skin allergic diseases were capable of tolerating beef following an established period of diet exclusion, asthmatic patients experienced a relapse of symptoms and showed a considerable increase in IgE, IgG and IgA-specific antibodies when re-challenged with a beef-enriched diet. Thus, beef-specific IgG and IgA antibodies coexist with IgE antibodies in sera from allergic patients and are significantly associated with the clinical course of allergic disorders, particularly asthma.
IgE介导的反应在食物不耐受的过敏患者中起关键作用。然而，食物特异性IgG和IgA抗体与过敏患者临床结局之间的关联仍存在争议。在本研究中，我们调查了食物过敏患者中牛肉特异性IgG和IgA抗体是否可能与牛肉特异性IgE抗体共存，并研究了它们在不同过敏情况下的临床相关性。通过固相酶免疫测定法（ELISA）在一组分为哮喘、皮肤病或胃肠道疾病患者的过敏患者群体（N = 125）以及对照受试者（N = 80）中测定牛肉特异性IgE、IgG和IgA抗体。还测定了对柑橘类水果、番茄、牛奶、鸡蛋和小麦的特异性IgE抗体。牛肉是整个人群中主要的致敏食物，不仅对于IgE（57.6%；P < 0.001），对于IgG和IgA同种型也是如此（分别为53.6%和34.0%，P < 0.001）。与对照受试者的血清相比，哮喘患者、胃肠道疾病患者和皮肤过敏患者血清中的牛肉特异性IgE、IgG和IgA抗体显著增加（P < 0.001）。值得注意的是，在三种过敏情况下，即使不存在IgE，也能显著检测到IgG和IgA同种型。所有过敏患者，包括仅表现出IgG和IgA抗体的患者，症状均显著改善，并且在排除牛肉饮食后，他们的牛肉特异性抗体水平大幅降低。虽然胃肠道或皮肤过敏性疾病患者在经过一段饮食排除期后能够耐受牛肉，但哮喘患者在症状复发时，并且在重新摄入富含牛肉的饮食后，IgE、IgG和IgA特异性抗体显著增加。因此，牛肉特异性IgG和IgA抗体与过敏患者血清中的IgE抗体共存，并且与过敏性疾病，尤其是哮喘的临床病程显著相关。
