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- Title
Elevated IL-5 and IL-13 responses to egg proteins predate the introduction of egg in solid foods in infants with eczema.
- Authors
Metcalfe, J. R.; D'Vaz, N.; Makrides, M.; Gold, M. S.; Quinn, P.; West, C. E.; Loh, R.; Prescott, S. L.; Palmer, D. J.
- Abstract
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.
- Subjects
INTERLEUKIN-13; INTERLEUKIN receptors; ECZEMA; TREATMENT of eczema; FOOD allergy in infants; T cells; PREVENTION; PHYSIOLOGY
- Publication
Clinical & Experimental Allergy, 2016, Vol 46, Issue 2, p308
- ISSN
0954-7894
- Publication type
Article
- DOI
10.1111/cea.12608