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Egg allergen specific IgE diversity predicts resolution of egg allergy in the population cohort HealthNuts.

Allergy 2018 July 24
BACKGROUND: IgE-mediated egg allergy presents as one of the most common food allergies in children. Measurement of egg white-specific IgE levels in serum or skin prick test has been shown to be a poor predictor of clinical allergy to raw egg white, and also to baked or cooked egg. Recent developments in component resolved diagnostic (CRD) technology have enabled us to improve the way in which we diagnose and predict peanut allergy through examining IgE specificity to individual peptides.

OBJECTIVES: We aimed to investigate whether egg CRD could improve current methods to diagnose various egg allergy phenotypes as well as predict the development of tolerance to egg.

METHODS: Using the HealthNuts cohort of food challenge-proven egg allergic and egg sensitised tolerant age matched 12 month infants with longitudinal follow-up at 2 and 4 years (n=451), we measured serum egg white, Gal d 1, 2, 3, and 5 specific IgE using ImmunoCAP.

RESULTS: Gal d 1 sensitisation increased the risk of persistent egg allergy by 2.5-fold. The production of specific IgE to all four egg allergens (Gal d 1, 2, 3 or 5) increased the risk of having persistent raw egg allergy 4-fold (OR 4.19 (95% CI: 1.25-14.07). We did not find any improvements of using Gal d 1, 2, 3 or 5 to diagnose current egg allergy compared to egg white sIgE.

CONCLUSION: Sensitization to multiple egg allergens Gal d 1, 2, 3 or 5 may be a prognostic marker that could be useful for patient management and identifying individuals at risk of developing persistent egg allergy This article is protected by copyright. All rights reserved.

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