Immunologic changes in children with egg allergy ingesting extensively heated egg
ABSTRACT Prior studies have suggested that heated egg might be tolerated by some children with egg allergy.
We sought to confirm tolerance of heated egg in a subset of children with egg allergy, to evaluate clinical and immunologic predictors of heated egg tolerance, to characterize immunologic changes associated with continued ingestion of heated egg, and to determine whether a diet incorporating heated egg is well tolerated.
Subjects with documented IgE-mediated egg allergy underwent physician-supervised oral food challenges to extensively heated egg (in the form of a muffin and a waffle), with tolerant subjects also undergoing regular egg challenges (in a form of scrambled egg or French toast). Heated egg-tolerant subjects incorporated heated egg into their diets. Skin prick test wheal diameters and egg white, ovalbumin, and ovomucoid IgE levels, as well as ovalbumin and ovomucoid IgG4 levels, were measured at baseline for all subjects and at 3, 6, and 12 months for those tolerant of heated egg.
Sixty-four of 117 subjects tolerated heated egg, 23 tolerated regular egg, and 27 reacted to heated egg. Heated egg-reactive subjects had larger skin test wheals and greater egg white-specific, ovalbumin-specific, and ovomucoid-specific IgE levels compared with heated egg- and egg-tolerant subjects. Continued ingestion of heated egg was associated with decreased skin test wheal diameters and ovalbumin-specific IgE levels and increased ovalbumin-specific and ovomucoid-specific IgG4 levels.
The majority of subjects with egg allergy were tolerant of heated egg. Continued ingestion of heated egg was well tolerated and associated with immunologic changes that paralleled the changes observed with the development of clinical tolerance to regular egg.
- SourceAvailable from: Kitty Verhoeckx
- "Several human studies have been performed in which egg allergic patients were challenged with heated and/or unheated eggs. In general, 50–85% of children with egg allergy are able to tolerate baked egg (Bartnikas and Phipatanakul, 2013; Cortot et al., 2012; Lemon-Mulé et al., 2008; Turner et al., 2013). This percentage varies depending on the characteristics of the allergic patients (age, severity of the allergy, etc.), heating procedure, matrix used, etc. "
Article: Food processing and allergenicity[Show abstract] [Hide abstract]
ABSTRACT: Food processing can have many beneficial effects. However, processing may also alter the allergenic properties of food proteins. A wide variety of processing methods is available and their use depends largely on the food to be processed. In this review the impact of processing (heat and non-heat treatment) on the allergenic potential of proteins, and on the antigenic (IgG-binding) and allergenic (IgE-binding) properties of proteins has been considered. A variety of allergenic foods (peanuts, tree nuts, cows' milk, hens' eggs, soy, wheat and mustard) have been reviewed. The overall conclusion drawn is that processing does not completely abolish the allergenic potential of allergens. Currently, only fermentation and hydrolysis may have potential to reduce allergenicity to such an extent that symptoms will not be elicited, while other methods might be promising but need more data. Literature on the effect of processing on allergenic potential and the ability to induce sensitisation is scarce. This is an important issue since processing may impact on the ability of proteins to cause the acquisition of allergic sensitisation, and the subject should be a focus of future research. Also, there remains a need to developed robust and integrated methods for the risk assessment of food allergenicity. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.Food and Chemical Toxicology 03/2015; 80. DOI:10.1016/j.fct.2015.03.005 · 2.90 Impact Factor
[Show abstract] [Hide abstract]
- "High concentrations of Gal d1 are associated with persistent allergy to eggs. It has been suggested that the lower the Gal d 1 concentration, the higher the probability of tolerance to cooked egg  . "
ABSTRACT: Component resolved diagnosis is a new concept in the investigation of pediatric allergic disease. The aim of the present paper is to review the available data on component resolved diagnosis with respect to implications for investigation of children with allergic disease. In most conditions head-to-head comparisons of component resolved diagnosis with traditional IgE testing have not been performed. Rather than alternatives the molecular methods should be seen as adjuncts to the cheaper traditional specific IgE tests. It may be appropriate to determine IgE antibodies to components as part of the diagnostic work-up in selected cases of peanut and birch pollen allergy and in hymenoptera allergy. However, cost benefit analyses of component resolved diagnosis compared with traditional work-up of allergy are needed. Prospectively planned protocols for assessment of the extent to which component resolved diagnosis may be able to improve the selection of children to immunotherapy and, thus, the efficacy of immunotherapy, are needed. Finally, studies of component resolved diagnosis with microarray technology in screening panels with hundreds of components should be undertaken before it can be determined to which extent such panel screening, if at all, may be helpful in children.08/2012; 2012:806920. DOI:10.5402/2012/806920
[Show abstract] [Hide abstract]
- "Chez 117 enfants allergiques à l'oeuf, 64 tolèrent l'oeuf sous forme de gâteaux et crêpes bien cuits (muffin et waffle), 23 sous forme d'oeuf brouillé et 27 ne tolèrent pas l'oeuf cuit. Chez les enfants tolérants l'oeuf cuit, la poursuite de l'ingestion régulière de l'oeuf au degré de cuisson auquel ils ne réagissent pas n'entraîne pas d'incident et s'accompagne de modifications immunologiques identiques à celles observées lors de l'acquisition de la tolérance à l'oeuf . Il est possible de prévoir les enfants qui tolèreront le blanc d'oeuf très cuit. "
ABSTRACT: Elimination diets are still the basic means of managing food allergy. In the past, such diets were very severe and strict. Recent work has shown that a large number of elimination diets, previously prescribed, were not very useful, could even be iatrogenic. The diet can and must be adapted to each situation. Most often, it is not very limiting. It can sometimes even be therapeutic. We will first discuss the objectives and the basis of diets for food allergy, and then we will consider some practical aspects of these diets, based on the results of the allergy workup.Revue Française d Allergologie 04/2009; 49(3):112-115. DOI:10.1016/j.reval.2009.01.022 · 0.22 Impact Factor