title: Immunologic features of infants with milk or egg allergy enrolled in an observational study (Consortium of Food Allergy Research) of food allergy.
abstract: BACKGROUND
  Immune features of infants with food allergy have not been delineated.
  
  
  OBJECTIVE
  We sought to explore the basic mechanisms responsible for food allergy and identify biomarkers, such as skin prick test (SPT) responses, food-specific IgE levels, and mononuclear cell responses, in a cohort of infants with likely milk/egg allergy at increased risk of peanut allergy.
  
  
  METHODS
  Infants aged 3 to 15 months were enrolled with a positive SPT response to milk or egg and either a corresponding convincing clinical history of allergy to milk or egg or moderate-to-severe atopic dermatitis. Infants with known peanut allergy were excluded.
  
  
  RESULTS
  Overall, 512 infants (67% male) were studied, with 308 (60%) having a history of a clinical reaction. Skin test responses, detectable food-specific IgE, or both revealed sensitization as follows: milk, 78%; egg, 89%; and peanut, 69%. SPT responses and food-specific IgE levels were discrepant for peanut (15% for IgE > or = 0.35 kU(A)/L and negative SPT response vs 8% for positive SPT response and IgE <0.35 kU(A)/L, P = .001). Mononuclear cell allergen stimulation screening for CD25, cytokine-inducible SH2-containing protein (CISH), forkhead box protein 3 (FOXP3), GATA3, IL10, IL4, IFNG, and T-box transcription factor (TBET) expression by using casein, egg white, and peanut revealed that only allergen-induced IL4 expression was significantly increased in those with clinical allergy to milk (compared with nonallergic subjects) and in those sensitized to peanut, despite the absence of an increase in GATA3 mRNA expression.
  
  
  CONCLUSIONS
  Infants with likely milk/egg allergy are at considerably high risk of having increased peanut-specific IgE levels (potential allergy). Peanut-specific serum IgE levels were a more sensitive indicator of sensitization than SPT responses. Allergen-specific IL4 expression might be a marker of allergic risk. Absence of an increase in GATA3 mRNA expression suggests that allergen-specific IL-4 might not be of T-cell origin.
authors.affiliation: Elliot and Roslyn Jaffe Food Allergy Institute, Division of Allergy and Immunology, Department of Pediatrics, Mount Sinai School of Medicine, New York, NY 10029-6574, USA. scott.sicherer@mssm.edu
authors.forename: Scott H
authors.initials: SH
authors.lastname: Sicherer
authors.forename: Robert A
authors.initials: RA
authors.lastname: Wood
authors.forename: Donald
authors.initials: D
authors.lastname: Stablein
authors.forename: A Wesley
authors.initials: AW
authors.lastname: Burks
authors.forename: Andrew H
authors.initials: AH
authors.lastname: Liu
authors.forename: Stacie M
authors.initials: SM
authors.lastname: Jones
authors.forename: David M
authors.initials: DM
authors.lastname: Fleischer
authors.forename: Donald Y M
authors.initials: DY
authors.lastname: Leung
authors.forename: Alexander
authors.initials: A
authors.lastname: Grishin
authors.forename: Lloyd
authors.initials: L
authors.lastname: Mayer
authors.forename: Wayne
authors.initials: W
authors.lastname: Shreffler
authors.forename: Robert
authors.initials: R
authors.lastname: Lindblad
authors.forename: Hugh A
authors.initials: HA
authors.lastname: Sampson
mesh_terms: D000485:Allergens / Q000276:immunology*; D010367:Arachis / Q000276:immunology*; D003876:Dermatitis, Atopic / Q000276:immunology; D021181:Egg Hypersensitivity / Q000150:complications / Q000276:immunology*; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D007223:Infant; D015847:Interleukin-4 / Q000276:immunology / Q000378:metabolism; D007963:Leukocytes, Mononuclear / Q000276:immunology; D008297:Male; D016269:Milk Hypersensitivity / Q000150:complications / Q000276:immunology*; D021183:Peanut Hypersensitivity / Q000175:diagnosis* / Q000276:immunology; D012307:Risk Factors; D012882:Skin Tests
chemical_list: D000485:Allergens; D015847:Interleukin-4; D007073:Immunoglobulin E
references.citation: J Allergy Clin Immunol. 2003 Dec;112(6):1223-8
references.pmid: 14657887
references.citation: J Allergy Clin Immunol. 2004 Nov;114(5):1159-63
references.pmid: 15536425
references.citation: Pediatrics. 1998 Mar;101(3):E8
references.pmid: 9481027
references.citation: J Pediatr. 1998 Jan;132(1):132-6
references.pmid: 9470014
references.citation: Ann Allergy Asthma Immunol. 2004 Sep;93(3 Suppl 2):S1-21
references.pmid: 15478395
references.citation: J Allergy Clin Immunol. 2007 Apr;119(4):1016-8
references.pmid: 17306354
references.citation: Clin Exp Allergy. 2006 Dec;36(12):1538-45
references.pmid: 17177677
references.citation: J Allergy Clin Immunol. 2007 Nov;120(5):1172-7
references.pmid: 17935766
references.citation: J Exp Med. 1988 Sep 1;168(3):853-62
references.pmid: 3049907
references.citation: Ann Allergy Asthma Immunol. 2008 Mar;100(3 Suppl 3):S1-148
references.pmid: 18431959
references.citation: J Allergy Clin Immunol. 2000 Jul;106(1 Pt 1):53-6
references.pmid: 10887305
references.citation: J Allergy Clin Immunol. 2006 Feb;117(2 Suppl Mini-Primer):S470-5
references.pmid: 16455349
references.citation: J Allergy Clin Immunol. 2007 May;119(5):1197-202
references.pmid: 17353036
references.citation: Pediatrics. 2009 Dec;124(6):1549-55
references.pmid: 19917585
references.citation: J Exp Med. 2004 Aug 16;200(4):507-17
references.pmid: 15314076
references.citation: Ann Allergy Asthma Immunol. 2006 Mar;96(3 Suppl 2):S1-68
references.pmid: 16597066
references.citation: J Allergy Clin Immunol. 2003 Dec;112(6):1203-7
references.pmid: 14657884
references.citation: Immunity. 2005 Aug;23(2):191-202
references.pmid: 16111637
references.citation: J Allergy Clin Immunol. 2003 Jul;112(1):183-9
references.pmid: 12847497
references.citation: Eur J Clin Nutr. 1995 Sep;49 Suppl 1:S1-12
references.pmid: 8647057
references.citation: Curr Opin Immunol. 2002 Jun;14(3):366-72
references.pmid: 11973136
references.citation: J Allergy Clin Immunol. 1985 Jun;75(6):646-51
references.pmid: 2409121
references.citation: J Allergy Clin Immunol. 2004 May;113(5):932-9
references.pmid: 15131577
references.citation: Allergy. 2001 May;56(5):403-11
references.pmid: 11350303
references.citation: Clin Exp Allergy. 2008 Jan;38(1):161-8
references.pmid: 18028467
references.citation: J Allergy Clin Immunol. 2007 Dec;120(6):1413-7
references.pmid: 18073126
references.citation: Nat Immunol. 2008 Jul;9(7):733-42
references.pmid: 18516038
references.citation: Pediatrics. 2000 Aug;106(2 Pt 1):346-9
references.pmid: 10920165
references.citation: Pediatrics. 2007 Dec;120(6):1304-10
references.pmid: 18055680
references.citation: J Allergy Clin Immunol. 1999 Oct;104(4 Pt 1):811-9
references.pmid: 10518826
references.citation: J Allergy Clin Immunol. 2007 Sep;120(3):638-46
references.pmid: 17628647
references.citation: Allergy. 2001 May;56(5):393-402
references.pmid: 11350302
references.citation: J Pediatr. 1989 Jul;115(1):23-7
references.pmid: 2738792
references.citation: J Allergy Clin Immunol. 2007 Sep;120(3):491-503; quiz 504-5
references.pmid: 17689596
references.citation: Nat Immunol. 2008 Mar;9(3):310-8
references.pmid: 18300366
references.citation: J Allergy Clin Immunol. 2010 Jan;125(1):191-7.e1-13
references.pmid: 20109746
references.citation: J Allergy Clin Immunol. 1984 Jul;74(1):26-33
references.pmid: 6547461