The Combination of Binding Avidity of Ovomucoid-Specific IgE Antibody and Specific IgG4 Antibody Can Predict Positive Outcomes of Oral Food Challenges during Stepwise Slow Oral Immunotherapy in Children with Hen's Egg Allergy

• Published in: Nutrients 2023-06, Vol.15 (12), p.2770
• Main Authors: Taniuchi, Shoichiro, Sakai, Rika, Nishida, Takahiro, Goma, Meguru, Mitomori, Masatoshi, Imaide, Aya, Enomoto, Masahiro, Nishino, Masamitsu, Okizuka, Yo, Kido, Hiroshi
• Format: Article
• Language: English
• Subjects: Allergens; Allergies; Animals; Asthma; Avidity; Binding; Biomarkers; Chickens; Children; Drug dosages; Egg Hypersensitivity - therapy; Eggs; Female; Food allergies; Food allergy; hen’s egg allergy; IgE binding avidity; Immunoglobulin E; Immunoglobulin G; Immunoglobulins; Immunotherapy; Informed consent; oral food challenge; oral immunotherapy; Ovomucin; ovomucoid-specific IgE; ovomucoid-specific IgG4; Patients; Prognosis; Protein arrays; Supervision
• ISSN: 2072-6643; 2072-6643
• DOI: 10.3390/nu15122770

To increase the prediction accuracy of positive oral food challenge (OFC) outcomes during stepwise slow oral immunotherapy (SS-OIT) in children with a hen's egg (HE) allergy, we evaluated the predictive value of the combination of antigen-specific IgE (sIgE) with antigen binding avidity and sIgG4 values. Sixty-three children with HE allergy undergoing SS-OIT were subjected to repeated OFCs with HE. We measured the ovomucoid (OVM)-sIgE by ImmunoCAP or densely carboxylated protein (DCP) microarray, sIgG4 by DCP microarray, and the binding avidity of OVM-sIgE defined as the level of 1/IC (nM) measured by competitive binding inhibition assays. The OFC was positive in 37 (59%) patients undergoing SS-OIT. Significant differences in DCP-OVM-sIgE, CAP-OVM-sIgE, I/IC , DCP-OVM-sIgG4, the multiplication products of DCP-OVM-sIgE, and the binding avidity of DCP-OVM-sIgE (DCP-OVM-sIgE/IC ) and DCP-OVM-sIgE/sIgG4 were compared between the negative and positive groups ( < 0.01). Among them, the variable with the greatest area under the receiver operating characteristic curve was DCP-OVM-sIgE/IC (0.84), followed by DCP-OVM-sIgE/sIgG4 (0.81). DCP-OVM-sIgE/IC and DCP-OVM-sIgE/sIgG4 are potentially useful markers for the prediction of positive OFCs during HE-SS-OIT and may allow proper evaluation of the current allergic status in the healing process during HE-SS-OIT.