Component-Resolved Diagnostic Study of Egg Allergy in Northern Chinese Children

Background. Egg component-specific IgE can be useful to evaluate and diagnose egg allergy, but their prevalence and clinical significance remain unclear in the local population. Previous studies have led to contradictory results regarding the value of specific IgG and specific IgG4 in sensitization. Objective. We aimed to determine the level of specific IgE, IgG, and IgG4 antibodies to the major egg allergens in egg-allergic children. Methods. Children from 6 months to 10 years of age were recruited. Egg allergy was confirmed by either a strong clinical history or an increased egg white-sIgE level. Other allergies were diagnosed by reactivity to other allergens but without egg-related symptoms and history. The serum sIgE, sIgG, and sIgG4 levels to major egg allergenic components (Gal d 1, Gal d 2, Gal d 3, Gal d 4, and Gal d 5), sIgE level to egg white, and tIgE level were determined by light-initiated chemiluminescent assay (LICA), ELISA, or ImmunoCAP. Results. Egg-allergic children had significantly higher levels of sIgE, sIgG, and sIgG4 to egg components than nonallergic children. Gal d 2 was the predominant allergen, and Gal d 2 sIgE level correlated with the egg white-sIgE level. Ratios of sIgE/sIgG4 to egg components were highest before 1 year of age and dropped gradually in the first decade of life. Conclusion. Patterns of sIgE to egg components could distinguish different forms of egg allergy. Ratios of sIgE/sIgG4 could be useful in predicting tolerance in egg-sensitive subjects, but this needs further evaluation and investigation using more accurate models.

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Component resolved diagnostics in peanut sensitized children with and without a history of clinical reaction

Allergy and Asthma Proceedings ◽

10.2500/aap.2020.41.200061 ◽

2020 ◽

Vol 41 (5) ◽

pp. 336-340

Author(s):

Yasmin Hamzavi Abedi ◽

Cristina P. Sison ◽

Punita Ponda

Keyword(s):

Retrospective Chart Review ◽

Clinical History ◽

Specific Ige ◽

Exact Test ◽

Ara H 1 ◽

Sige Level ◽

History Of ◽

Laboratory Procedures ◽

Ige Mediated ◽

The Relationship

Background: Serum Peanut-specific-IgE (PN-sIgE) and peanut-component-resolved-diagnostics (CRD) are often ordered simultaneously in the evaluation for peanut allergy. Results often guide the plans for peanut oral challenge. However, the clinical utility of CRD at different total PN-sIgE levels is unclear. A commonly used predefined CRD Ara h2 cutoff value in the literature predicting probability of peanut challenge outcomes is 0.35kUA/L. Objective: To examine the utility of CRD in patients with and without a history of clinical reactivity to peanut (PN). Methods: This was a retrospective chart review of 196 children with PN-sIgE and CRD testing, of which, 98 patients had a clinical history of an IgE-mediated reaction when exposed to PN and 98 did not. The Fisher's exact test was used to assess the relationship between CRD and PN-sIgE at different cutoff levels, McNemar test and Gwet’s approach (AC1 statistic) were used to examine agreement between CRD and PN-sIgE, and logistic regression was used to assess differences in the findings between patients with and without reaction history. Results: Ara h 1, 2, 3, or 9 (ARAH) levels ≤0.35 kUA/L were significantly associated with PN-sIgE levels <2 kUA/L rather than ≥2 kUA/L (p < 0.0001). When the ARAH threshold was increased to 1 kUA/L and 2 kUA/L, these thresholds were still significantly associated with PN-sIgE levels of <2, <5, and <14 kUA/L. These findings were not significantly different in patients with and without a history of clinical reactivity. Conclusion: ARAH values correlated with PN-sIgE. Regardless of clinical history, ARAH levels are unlikely to be below 0.35, 1, or 2 kUA/L if the PN-sIgE level is >2 kUA/L. Thus, if possible, practitioners should consider PN-sIgE rather than automatically ordering CRD with PN-sIgE every time. Laboratory procedures that allow automatically and reflexively adding CRD when the PN-sIgE level is ≤5 kUA/L can be helpful. However, further studies are needed in subjects with challenge-proven PN allergy.

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Evaluation of oral food challenge doses adjusted by egg white specific IgE for diagnosing egg allergy in infants: case series study

Nihon Shoni Arerugi Gakkaishi The Japanese Journal of Pediatric Allergy and Clinical Immunology ◽

10.3388/jspaci.35.426 ◽

2021 ◽

Vol 35 (5) ◽

pp. 426-435

Author(s):

Koji Yamasaki ◽

Yutaka Takemura ◽

Tomoyuki Arima ◽

Hiroki Masumi ◽

Megumi Nagai ◽

...

Keyword(s):

Case Series ◽

Food Challenge ◽

Specific Ige ◽

Egg White ◽

Oral Food Challenge ◽

Egg Allergy ◽

Case Series Study ◽

Series Study

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Component resolved diagnosis of egg yolk is an indispensable part of egg allergy

Allergologia et Immunopathologia ◽

10.15586/aei.v49i2.31 ◽

2021 ◽

Vol 49 (2) ◽

pp. 6-14

Author(s):

Huang Lunhui ◽

Shao Yanhong ◽

Li Shaoshen ◽

Bao Huijing ◽

Liu Yunde ◽

...

Keyword(s):

Operating Characteristic ◽

Egg Yolk ◽

Specific Ige ◽

Diagnostic Value ◽

Egg White ◽

Enzyme Linked Immunosorbent Assay ◽

Egg Allergy ◽

Component Resolved Diagnosis ◽

Allergen Components

Introduction and objectives: It was urgent to explain the role of egg yolk allergen sensitization to the egg allergic population and we would evaluate the diagnostic value of allergen components in whole eggs, including egg white and egg yolk.Materials and methods: Firstly, we collected 99 positive and 21 negative sera against egg allergy. Then we used modified enzyme linked immunosorbent assay (ELISA) to survey specific IgE (sIgE) to all-proven and single component in eggs, Ovomucoid (Gal d 1), Ovalbumin (Gal d 2), Ovotransferrin (Gal d 3), Lysozyme C (Gal d 4), Serum Albumin (Gal d 5), and YGP42(Gal d 6) in allergic and non-allergic populations. Last but not least, we studied the sIgE reactivities to egg allergen components by receiver operating characteristic (ROC) analysis.Results: Among egg-allergic individuals, nearly 10% were sensitized to five of six egg allergen components, and the cross-reaction frequency between two egg yolk allergens with Gal d 1 was about 30% in the groups diagnosed with egg allergy or non-allergy. The best component-combination diagnosis in egg allergy of Gal d 1+ Gal d 6 demonstrated the largest area under curve (AUC) of 0.994.Conclusions: Our results suggested that there were individual differences in allergenicity of different egg allergen components, especially in the samples negative to egg allergy diagnosed but sensitive to egg yolk components. It was indicated that component resolved diagnosis of egg yolk improved the value for egg allergy management indispensably.

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Relationship between specific IgE to egg components and natural history of egg allergy in Danish children

Pediatric Allergy and Immunology ◽

10.1111/pai.12644 ◽

2016 ◽

Vol 27 (8) ◽

pp. 825-830 ◽

Cited By ~ 8

Author(s):

Josefine Gradman ◽

Charlotte G Mortz ◽

Esben Eller ◽

Carsten Bindslev-Jensen

Keyword(s):

Natural History ◽

Specific Ige ◽

Egg Allergy ◽

History Of ◽

Egg Components

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Egg white specific IgE levels in serum as clinical reactivity predictors in the course of egg allergy follow-up

Pediatric Allergy and Immunology ◽

10.1111/j.1399-3038.2009.00940.x ◽

2009 ◽

Vol 21 (4p1) ◽

pp. 634-639 ◽

Cited By ~ 18

Author(s):

Elena Montesinos ◽

Antonio Martorell ◽

Rubén Félix ◽

Juan Carlos Cerdá

Keyword(s):

Specific Ige ◽

Egg White ◽

Egg Allergy

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Utility of Gal d 1-Specific IgE Levels in Predicting Reactivity to Boiled Egg in Chinese Children

International Archives of Allergy and Immunology ◽

10.1159/000519324 ◽

2021 ◽

pp. 1-7

Author(s):

Dan Ming ◽

Rongxiu Zheng

Keyword(s):

Specific Ige ◽

Diagnostic Value ◽

Egg White ◽

Chinese Children ◽

Egg Allergy ◽

Clinical Sensitivity ◽

Receiver Operating Characteristic Curves ◽

Allergen Components ◽

Quantitative Measurements ◽

Food Challenges

Background: Many researchers have reported predicting the outcome of oral food challenges (OFCs) on the basis of specific IgE (sIgE) levels. However, the clinical usefulness of the determination of IgE antibodies to egg allergen components in Chinese children with suspected boiled egg allergy is not well studied. Objective: Our objective was to assess the diagnostic performance of sIgE to egg white and Gal d 1, 2, 3, and 5 based on the open challenge outcome for boiled egg. Methods: A total of 48 child patients with a suspect of boiled egg allergy were included. Serum egg white and Gal d 1, 2, 3, and 5 sIgE were measured by ImmunoCAP. Diagnostic value was assessed by area under the receiver operating characteristic curves (AUC). Results: Using the OFC results as the reference parameter, Gal d 1 sIgE had the highest AUC (0.84) compared with egg white (0.77) and other investigated components (ranging from 0.51 to 0.71). The clinical sensitivity and specificity for the sIgE to Gal d 1 at optimal cutoff (6.15 kUA/L) were 73.7% and 96.7%, respectively. Sensitization to Gal d 1 with a cutoff value of >7.48 kUA/L indicated a 90% probability of positive challenge. Conclusion: Quantitative measurements of Gal d 1 sIgE antibodies using ImmunoCAP are useful in the management of boiled egg allergy in Chinese children.

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