title: IgE-binding activity to enzyme-digested ovomucoid distinguishes between patients with contact urticaria to egg with and without overt symptoms on ingestion.
abstract: BACKGROUND
  We occasionally see egg-allergic children who develop contact urticaria to hen's egg despite the absence of the overt symptoms on ingestion. The mechanisms remain to be elucidated.
  
  
  METHODS
  Twenty-one subjects with positive reactions to 20-min patch tests for egg-white antigens were divided into subgroups with positive (n = 10) and negative (n = 11) results to oral challenge tests by the same antigens. We measured IgE antibody for egg white and its components, and IgE-binding activities to digestive enzyme-treated ovomucoid by RAST inhibition.
  
  
  RESULTS
  There were no significant differences in IgE antibody titers to egg white (positive vs negative: 30.3% vs 15.3%, P=0.130), ovomucoid (21.5% vs 10.2%, P= 0.078), ovotransferrin (9.9% vs 3.7%, P = 0.105), and lysozyme (3.4% vs 2.9%, P=0.944), except ovalbumin (16.8% vs 5.6%, P=0.024), between the positive and negative subjects in the provocation tests. In contrast, the concentration (1.93 microg/ml) of pepsin-treated ovomucoid needed for 50% RAST inhibition in the challenge-positive subjects was significantly (P=0.0003) lower than that (114.9 microg/ml) of negative subjects. Similar but less significant differences were obtained when ovomucoid fragments treated with chymotrypsin (0.91 microg/ml vs 6.86 microg/ml, P=0.014) and trypsin (0.75 microg/ml vs 4.67 microg/ml, P= 0.041) were used as inhibitors.
  
  
  CONCLUSIONS
  We suggest that IgE antibodies from subjects showing contact urticaria despite the absence of reactions to the ingestion of egg white recognize the epitope(s) unstable to digestive enzymes.
authors.affiliation: Department of Pediatrics, Fujita Health University School of Medicine, Nagoya, Aichi, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Yamada
authors.forename: A
authors.initials: A
authors.lastname: Urisu
authors.forename: M
authors.initials: M
authors.lastname: Kakami
authors.forename: H
authors.initials: H
authors.lastname: Koyama
authors.forename: R
authors.initials: R
authors.lastname: Tokuda
authors.forename: E
authors.initials: E
authors.lastname: Wada
authors.forename: Y
authors.initials: Y
authors.lastname: Kondo
authors.forename: H
authors.initials: H
authors.lastname: Ando
authors.forename: Y
authors.initials: Y
authors.lastname: Morita
authors.forename: S
authors.initials: S
authors.lastname: Torii
mesh_terms: D000284:Administration, Oral; D000485:Allergens / Q000276:immunology; D000818:Animals; D002648:Child; D002675:Child, Preschool; D002918:Chymotrypsin / Q000737:chemistry; D003207:Conalbumin / Q000276:immunology; D004311:Double-Blind Method; D004529:Egg White / Q000009:adverse effects; D004531:Eggs / Q000009:adverse effects*; D005260:Female; D005512:Food Hypersensitivity / Q000175:diagnosis* / Q000276:immunology; D006801:Humans; D007073:Immunoglobulin E / Q000276:immunology; D007223:Infant; D008297:Male; D009113:Muramidase / Q000276:immunology; D010047:Ovalbumin / Q000276:immunology; D010059:Ovomucin / Q000276:immunology* / Q000378:metabolism; D010434:Pepsin A / Q000737:chemistry; D010919:Placebos; D011852:Radioallergosorbent Test; D014357:Trypsin / Q000737:chemistry; D014581:Urticaria / Q000175:diagnosis* / Q000276:immunology
chemical_list: D000485:Allergens; D010919:Placebos; D003207:Conalbumin; D010059:Ovomucin; D007073:Immunoglobulin E; D010047:Ovalbumin; D009113:Muramidase; D002918:Chymotrypsin; D014357:Trypsin; D010434:Pepsin A