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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
Author(s) -
Metcalfe J. R.,
D'Vaz N.,
Makrides M.,
Gold M. S.,
Quinn P.,
West C. E.,
Loh R.,
Prescott S. L.,
Palmer D. J.
Publication year - 2016
Publication title -
clinical and experimental allergy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.462
H-Index - 154
eISSN - 1365-2222
pISSN - 0954-7894
DOI - 10.1111/cea.12608
Subject(s) - egg allergy , ovalbumin , allergy , food allergy , immunology , allergen , lysozyme , immunoglobulin e , placebo , biology , medicine , antigen , antibody , pathology , biochemistry , alternative medicine
Summary 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, IFN γ and TNF α) 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.