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Elevated IL-5 and IL-13 responses to egg proteins predate the introduction of egg in solid foods in infants with eczema
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2016 (English)In: Clinical and Experimental Allergy, ISSN 0954-7894, E-ISSN 1365-2222, Vol. 46, no 2, 308-316 p.Article in journal (Refereed) Published
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Abstract [en]

Background

Egg allergy is a leading cause of food allergy in young infants; however, little is known about early allergen-specific T-cell responses which predate the presentation of egg allergy, and if these are altered by early egg exposure.

Objective

To investigate the early T-cell responses to multiple egg proteins in relation to patterns of egg exposure and subsequent IgE-mediated egg allergy.

Methods

Egg-specific T-cell cytokine responses (IL-5, IL-13, IL-10, IFNγ and TNFα) to ovomucoid (OM), ovalbumin (OVA), conalbumin (CON) and lysozyme (LYS) were measured in infants with eczema at 4 months of age (n = 40), before randomization to receive ‘early egg’ or a placebo as part of a randomized controlled trial (Australian New Zealand Clinical Trials Registry number 12609000415202) and at 12 months of age (n = 58), when IgE-mediated egg allergy was assessed by skin prick test and food challenge.

Results

In 4–month-old infants, who had not directly ingested egg, those who subsequently developed egg allergy already had significantly higher Th2 cytokine responses to multiple egg allergens, particularly elevated IL-13 responses to OVA (P = 0.004), OM (P = 0.012) and LYS (P = 0.003) and elevated IL-5 to the same antigens (P = 0.031, 0.04 and 0.003, respectively). IL-13 responses (to OVA and LYS) and IL-5 responses (to LYS) at 4 months significantly predicted egg allergy at 12 months. All responses significantly declined with age in the egg-allergic infants, and this did not appear to be modified by ‘early’ introduction of egg.

Conclusions & Clinical Relevance

Elevated egg-specific Th2 cytokine responses were established prior to egg ingestion at 4 months and were not significantly altered by introduction of egg. Th2 responses at 4 months of age predicted egg allergy at 12 months, suggesting that this could be used as a biomarker to select infants for early prevention and management strategies.

Place, publisher, year, edition, pages
2016. Vol. 46, no 2, 308-316 p.
Keyword [en]
allergy prevention, cytokines, eczema, egg allergy, egg protein, infancy
National Category
Respiratory Medicine and Allergy Pediatrics
Identifiers
URN: urn:nbn:se:umu:diva-117827DOI: 10.1111/cea.12608ISI: 000370057800009PubMedID: 26250967OAI: oai:DiVA.org:umu-117827DiVA: diva2:917059
Available from: 2016-04-05 Created: 2016-03-04 Last updated: 2016-04-05Bibliographically approved

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