title: IgE Antibody Detection and Component Analysis in Patients with Eosinophilic Esophagitis.
abstract: BACKGROUND
  Although IgE antibodies to cow's milk and wheat are common in patients with eosinophilic esophagitis (EoE), titers are low and responses to diet are not dependent on having IgE antibodies.
  
  
  OBJECTIVE
  To better define specific IgE antibody responses to foods, focusing on those foods that appear to play a role in EoE.
  
  
  METHODS
  Adult (n = 46) and pediatric (n = 51) patients with EoE were recruited for skin prick testing and serum measurement (whole and diluted) of IgE antibodies specific for aeroallergens, food extracts, and component allergens by ImmunoCAP. Immuno Solid-phase Allergen Chip analysis was also used to measure the specificity of IgE antibodies to 112 allergen molecules.
  
  
  RESULTS
  In adults and children, there was a higher prevalence of sensitization to food extracts by ImmunoCAP than by skin prick testing. Using Immuno Solid-phase Allergen Chip to assess the specificity of IgE antibodies to 112 allergen molecules, we found that results for food allergens were mostly negative. In contrast, ImmunoCAP assays for specific milk allergens gave positive IgE antibody results in 31 of 34 sera. The correlations between specific IgE antibody to Bos d 4 or Bos d 5 and milk extract were strong (R = 0.89 and 0.76, respectively; P < .001). The evidence that IgE antibodies to foods were directed at minor components of the extracts was further supported by measurements on diluted sera.
  
  
  CONCLUSIONS
  The IgE responses in cow's milk-sensitized patients with EoE are frequently to whey proteins Bos d 4 and Bos d 5, minor components of the extract. These IgE assays may be able to identify the proteins that are relevant to EoE even though IgE is not the primary mechanism.
authors.affiliation: Center for Innovation in Pediatric Practice, Nationwide Children's Hospital, Columbus, Ohio. Electronic address: eae9m@virginia.edu.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Erwin
authors.affiliation: Division of Allergy and Immunology, University of Virginia, Charlottesville, Va.
authors.forename: Anubha
authors.initials: A
authors.lastname: Tripathi
authors.affiliation: Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio.
authors.forename: Princess U
authors.initials: PU
authors.lastname: Ogbogu
authors.affiliation: Division of Allergy and Immunology, University of Virginia, Charlottesville, Va.
authors.forename: Scott P
authors.initials: SP
authors.lastname: Commins
authors.affiliation: Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio.
authors.forename: Maria A
authors.initials: MA
authors.lastname: Slack
authors.affiliation: Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio.
authors.forename: Christine B
authors.initials: CB
authors.lastname: Cho
authors.affiliation: Dermatology, Allergy and Clinical Immunology Laboratory, Johns Hopkins University School of Medicine, Baltimore, Md.
authors.forename: Robert G
authors.initials: RG
authors.lastname: Hamilton
authors.affiliation: Division of Allergy and Immunology, University of Virginia, Charlottesville, Va.
authors.forename: Lisa J
authors.initials: LJ
authors.lastname: Workman
authors.affiliation: Division of Allergy and Immunology, University of Virginia, Charlottesville, Va.
authors.forename: Thomas A E
authors.initials: TA
authors.lastname: Platts-Mills
mesh_terms: D000293:Adolescent; D000328:Adult; D057765:Eosinophilic Esophagitis / Q000150:complications* / Q000276:immunology; D005260:Female; D005512:Food Hypersensitivity / Q000097:blood / Q000150:complications* / Q000175:diagnosis*; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood* / Q000276:immunology; D008297:Male; D008875:Middle Aged; D012882:Skin Tests; D055815:Young Adult
chemical_list: D007073:Immunoglobulin E
keywords: Component-resolved diagnostics; Eosinophilic esophagitis; Food allergy; Serum IgE measurements