Otsuka Yukiko, Morita Hideyuki, Kimura Yuka, Mori Rikako, Miyazaki Kumiko, Shimokawa Yuko, Tatabayashi Koji, Funato Michinori, Kaneko Hideo
Division of Pediatrics, National Hospital Organization, Nagara Medical center, Gifu, Japan.
National Institute of Hygiene and Epidemiology, Hanoi, Vietnam.
Asian Pac J Allergy Immunol. 2024 Dec;42(4):341-345. doi: 10.12932/AP-220720-0927.
Recent treatment for food allergies involves the intake of allergy-causing foods at doses lower than the threshold dose determined by the oral food challenge (OFC). For a more successful treatment, it is necessary to identify a biomarker to establish safer doses of allergens in foods consumed at home.
In this study, we aim to investigate whether the pattern of sensitization to cow's milk (CM) is related to the threshold dose of CM.
Fifty patients with sensitization to casein (casein-specific IgE titer ≥ 0.7 UA/ml) and who have undergone the CM OFC test from July 2013 to July 2015 were enrolled. They were examined for the presence or absence of sensitization to β-lactoglobulin (BLG) (BLG-specific IgE ≥ 0.7 UA/ml). They were divided into two groups, namely, the only-casein-specific IgE-positive (C) group, and both casein- and BLG-specific IgE-positive (C + B) group.
The C group had 26 patients and the C + B group had 24. Both the CM- and casein-specific IgE titers were higher in the C + B group than in the C group. The positivity rates determined from OFC test results were 53.8 and 87.5%, and the threshold doses of CM were 88.7 and 31.1 ml in the C and C + B groups, respectively. In patients with low casein-specific IgE titers (≤ 10 UA/ml), the C + B group showed a significantly lower threshold dose of CM than the C group.
Our results suggest that children with CM allergy sensitized to casein alone have a higher threshold dose than those sensitized to both casein and BLG.
食物过敏的近期治疗方法包括摄入低于口服食物激发试验（OFC）确定的阈值剂量的致敏食物。为了使治疗更成功，有必要确定一种生物标志物，以确定在家中食用的食物中过敏原的更安全剂量。
在本研究中，我们旨在调查对牛奶（CM）的致敏模式是否与CM的阈值剂量相关。
纳入了50例对酪蛋白致敏（酪蛋白特异性IgE滴度≥0.7 UA/ml）且在2013年7月至2015年7月期间接受CM OFC试验的患者。检查他们是否存在对β-乳球蛋白（BLG）的致敏（BLG特异性IgE≥0.7 UA/ml）。他们被分为两组，即仅酪蛋白特异性IgE阳性（C）组和酪蛋白及BLG特异性IgE均阳性（C + B）组。
C组有26例患者，C + B组有24例。C + B组的CM和酪蛋白特异性IgE滴度均高于C组。根据OFC试验结果确定的阳性率分别为53.8%和87.5%，C组和C + B组的CM阈值剂量分别为88.7 ml和31.1 ml。在酪蛋白特异性IgE滴度较低（≤10 UA/ml）的患者中，C + B组的CM阈值剂量明显低于C组。
我们的结果表明，仅对酪蛋白致敏的CM过敏儿童的阈值剂量高于对酪蛋白和BLG均致敏的儿童。
